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Introducing

LICs New Health Plan

Jeevan Arogya

Special Attractions

Maximum Number of days for HCB increased to 720 days

Maximum Number of days for ICU increased to 360 days

No of Surgeries in MSB increased to 140

MSB available for Minors also

Addition of 140 Day Care Procedures (DCPB)

All other Surgeries covered under

Other Surgical Benefit (OSB)2

Special Attractions

Age at entry for PI and Spouse increased to 65 Years

Age at entry for Parents and Parents-in-law is 75 Years

Maximum Health cover for elders - up to 80 Yrs

Premiums are guaranteed for 3 Yrs

Optional Term Rider and Accident Benefit

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Income Tax Rebate

IT Rebate Under Section 80(D)

available for Full Premium Paid

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USP of LICs Jeevan Arogya

Comprehensive Family Health plan:

Covering entire family consisting of

Husband

Wife

Dependent Children Dependent Parents of Husband

and/or Wife

Entry age limits-LICs Jeevan Arogya

Entry Age up to 65 yrs for Husband and wife.

Entry Age up to 75 yrs for parents/in-lawsEntry Age from 91 days to 17 years for children

Risk cover Self, Spouse, Parents, in-laws : 80 YrsChildren : 25 Yrs

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USP of LICs Jeevan Arogya

A novel policy offering Multiple benefits:

Hospital cash benefit (HCB).

Major surgical benefit (MSB)

Day Care Procedure Benefit(DCPB)

Other Surgical Benefit(OSB)

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USP of LICs Jeevan ArogyaOther Benefits:

Premium waiver benefit

Ambulance expenses

Quick cash Advance Payment

No claim bonus

Auto increase in HCB& MSB to take care of inflation with no increase in premium

Risk cover under LICs Jeevan Arogya

Risk cover up to 4 lacs per insured Subject to overall limit of 10 lacs (All our Health Policies put togethor)

Guaranteed renewal after every three yrs

HCB options for each Life

Rs.1000/- per Day

Rs.2000/- per Day

Rs.3000/- per Day

Rs.4000/- per Day

HCB limits for each Insured

P.I As per his/her choice

Spouse < or = P.I

Children < or = Spouse / < or = P.I if no spouse

Parents < or = Insured Spouse

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HCB - Benefits at a glance HCB increases by 5% every year Up to1.5 times.

Eg. Rs 1000/- after 1 Yr becomes Rs.1050 and in the 11th Year becomes Rs.1500/-(Max) Hospitalization eligibility condition:

Fraction of 4 Hours treated as a day

First 28 hrs eligible for 1 day benefit

First 24 hours No benefit

Exception: When hospital stay exceeds continuous

period of 6 days and 4 hours, HCB for 7 days

(including First day also) will be allowed

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HCB - Benefits at a glance

Annual limit

for each insured

Maximum limit for each insured during entire

policy term

1st policy year

30 days of hospitalization of which 15 days of ICU is allowed.

subsequent years

Each year- 90 days of hospitalization of which 45 days of ICU is allowed.

720 days .

of which

360 days of ICU

allowed

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Hospital Cash Benefit( HCB)

Fixed per day benefit to cover expenses on the event of hospitalization of insured members for sickness/accidental body injury.

Benefit payout is fixed irrespective of actual expenses incurred.

Major Surgical Benefit (MSB)

• MSB = (HCB X 100)

• MSB risk cover limits do not include

MSB of Plan 901 & 902

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Major Surgical Benefit(MSB)

A percentage of sum assured is paid in the event of insured members undergoing specified surgeries.

Benefit is fixed irrespective of actual expenses incurred. Advantageous to the insured members

MSB is available to all the insured including children for all ages

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MSB- Benefits at a glance

MSB allowed for 140 surgical procedures

Annual Limit

100 times of HCB in a policy year (Min 1 Lac)

Life time Limit

800 times of HCB during entire policy term (Min 8 Lacs)

Premium waiver benefit

In the event of any insured undergoing major surgery under category I or 2 premium payable for one year from the next premium due date coinciding or following the date of surgery is waived

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Day care procedure benefit(DCPB)

DCPB = 5 X HCB

• 140 Listed day care procedures

• 3 Day care Procedures per year

• 24 Day care Procedures in

Policy Life time

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Other surgical benefit(OSB)

OSB = 2 x HCB

Any surgery other than MSB, DCPB surgeries

At least 24 hours stay in Hospital is required

Annual limit : 15 days in First policy year

  45 days in each subsequent years

Life time limit : 360 days per insured

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Term Assurance Benefit Rider

Minimum Term Assurance SA : Rs. 1,00,000 Maximum Term Assurance SA : Equal to initial

MSB-SA (i.e.,100 X HCB ) Term Assurance SA - in multiples of Rs.25000/-

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Minimum Entry Age 18 Yrs completed

Maximum Entry Age 50 Yrs (NBD)

Maximum age for cover 60 Yrs (NBD)

Maximum Term 35 Years

Accident Benefit RiderThis benefit is available only if Term Assurance Benefit rider is opted

Minimum Benefit : Rs. 25,000 Maximum Benefit : Equal to initial MSB-SA

( i.e.,100 X HCB) AB Sum Assured shall be in multiples of Rs.5000/-

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Minimum Entry Age 18 Yrs completed

Maximum Entry Age 50 Yrs completed

Maximum age for cover 60 Yrs completed

Maximum Term 35 Years

Quick cash facility

Advance amount to PI

Cat I or Cat II Surgeries

Hospitalized in a ‘Net work’ Hospital

PI/relative informs LIC/TPA

TPA processes request/advices LIC on payment

LIC credits eligible amount to PI Bank account

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Ambulance charges

Rs. 1000/- reimbursed per insured towards

Ambulance charges

Ambulance charges incurred for transportation of the insured to undergo Major Surgeries under category 1 or 2

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No claim Benefit

During the period between two automatic renewal dates or From DOC to next Automatic renewal date, if there are no claims in respect of any insured, No claim Benefit is payable

No claim benefit would be equal to 5% of initial Daily Benefit

Effective from the immediately following automatic renewal date

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USP of LICs Jeevan Arogya

Premium rate may be reviewed

for every 3 years

If revised, the new rate corresponding to

the age at entry of each insured will be

the new premium

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USP of LICs Jeevan Arogya

Example

PI takes a Policy in 2011

Age of PI in 2011 = 36

If premium revised in 2014

The new premium rate of PI will

be the revised premium corresponding

to age 36 in the new table.

Rebates available on Tabular premiums

Mode Rebate

Rebate for HCB Opted

Hly Yly

2000 HCB 3000HCB 4000HCB

PI others PI others PI others

1% 2% Rs.500 Rs.250 Rs.1000 Rs.500 Rs.1500 Rs.750

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Addition of members

ConditionWhen to include

The cover

starts from

Marriage/remarriage of the Principal Insured after DOC

Within 1 Year from the date of marriage

The following policy anniversary

A Child born or Legally adopted child after DOC

Health Cover starts from the policy anniversary falling immediately after the child completes 3 months

Legally adopted child is more than 3 months old

From the policy anniversary falling after date of adoption

New members must be included by the Principal Insured only. No new

members will be allowed after the death of the principal insured.

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USP of LICs Jeevan Arogya

Addition of newly eligible members during the currency of the policy.

Fixed Benefit scheme: Benefit paid as opted irrespective of actual expenses for hospitalization and Surgeries

Benefits are payable independent of payments received through mediclaim or any other health schemes.

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The policy lapses…

When premium is not paid within days of grace, the policy lapses and no benefits will be payable there after .

Policy can be revived within 2 years from the date of first unpaid premium subject to payment of outstanding premiums with interest and underwriting.

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The waiting Period for availing the benefits……………….

0 days for accident claims

90 days from the Date of Commencement for HCB & MSB

45 days after revival, if revived within 90 days from FUP of the policy. for Hospital Cash Benefit and Major Surgical Benefit

90 days if revived after 90 days from FUP

Things to remember:

• Since it is purely MEDICAL INSURANCE plan and premium does not have any saving element hence there is no maturity claim

• No Death claim under basic plan. • Loan, surrender, assignment- n.a.• Mode of payment- Yly, Hly, Mly(ECS only)

Underwriting

NM(S)

Age n.b.d Upto 45yrs 46 to 50

SUC 5 LAC 4 LAC

NM(G)

Age n.b.d UPTO 35 yrs 36 to 50

SUC 5 LAC 2 LAC

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Nature of Benefit1st Pol

Year (Rs)2nd Pol Year (Rs)

Max. eligible

During the Policy term (Rs)

Hospital Cash Benefit (HCB) including ICU Benefit

45,000 1,41,750 16,20,000

Major Surgical Benefit (MSB) 1,00,000 1,05,000 12,00,000

Other Surgeries Benefit (OSB) 30,000 94,500 10,80,000

Day Care Procedure Benefit (DCPB)

15,000 15,750 1,80,000

Maximum Benefit under the policy per insured

40,80,000

Ambulance Charges incurred Rs.1000/- per insured per year

Premium Waiver Benefit One Year Premium

No Claim Benefit Increase in HCB by 5%

Sample Benefit Illustration – for HCB 1000

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Benefits during the policy term for a HCB of Rs.2000/-Benefit LIC ICICI

Daily Hospital Cash Benefit(including. ICU benefit)

90,000 1st yr1,80,000/year

2,83,500 2nd YrMajor Surgical Benefit 80,000 to 2 lacs 20,000 to 3 lacsDay care surgical Benefit 30,000 1st yr ---

Other surgical Benefit60,000 1st yr

---1,89,000 2nd yr

Non surgical benefit -- 2000/day (Max8000)Recuperative benefit -- 6000

Prolonged stay benefit --2000/day after 30days of Hospital stay

Health check up benefit --4000(Total for all insured in the pol term)

Benefit comparision with ICICI prudential Hospital care II

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Benefits during the policy term for a HCB of Rs.2000/-

Benefit LIC ICICI

Max per annum3,61,000 1st yr

8,00,0006,84,000 2nd Yr

Benefits in the policy term

68,00,000 40,00,000

Ambulance charges(extra)

1000/member/yr ---

Additional BenefitsPWB, AB rider,

No such facilitiesDeath Benefit

rider

Benefit comparision with ICICI prudential Hospital care II

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THANK YOU