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LIC's Jeevan Arogya ( Plan No 904) - A unique Health Policy for self/ spouse/ children/ Parents/ Parent-in-laws,
with benefits on Hospitalization & Surgeries, alongwith option of Life cover & DAB, available in Hly & Yly mode of payment
Hospital Cash Benefits (HCB) ~ Amount Payable (for HCB Rs4000) in case of Hospitalization ( Double Amount is Paid for ICU Duration )
Note : Above amounts will further be enhanced, by Rs 200, as & when 'No Claim Bonus' becomes due
Various Surgical Claim Benefits ~ Major Surgeries (MSB)/ Day Care Procedures (DCPB)/ Other Surgeries (OSB) :
Other Major Benefits / Features / USPs ( HCB options available of Rs1000, 2000, 3000 & 4000)1- Ambulance Charges, Rs 1000 Lumpsum, paid in lieu of incurred Ambulance Transit expenses, for 57 MSB (Cat I & II).2- Auto escalation of 'per-day' amount of daily HCB, @ 5%, per year, of 1st Year Amount, for first 10 years.3- Auto escalation of 'Lumpsum' amount of MSB / DCPB, @ 5%, per year, of 1st Year Amount, for first 10 years.4- Auto escalation of 'per-day' amount of Other Surgical Benefit, @ 5%, per year, of 1st Year Amount, for first 10 years.5- Additional escalation as "No Claim Bonus", in all Benefits, @ 5% of 1st Year Amount, whenever due in 3-Year Blocks.6- Added No Claim Bonus is Permanent - once added, it is not removed in case of submission of Future Claims.7- No Loading or increase in future premium installment because of any claim taken.8- Instead, Waiver of premium of Full Policy for 1 year in case if any of 57 listed Major surgeries, MSB (Cat I & II) are performed.9- Almost' Fixed Premium in the for entire policy term, if due premiums are timely paid.
No increase in premiums due to increase in age . LIC can revise the premiums at 3-Year intervals , dependingon its experience, but the revised premium will be charged at age at entry, not at the 'then' present age.
10- Provision for granting Advance (50% of the due Claim) as 'Quick Cash Benefit' for 57 MSB (Cat I & II) (in TPA Network Hospitals only)11- Full Premium upto Rs15000(self) +Rs15000/20000(parents), exempted from I-tax, under section 80D, under present I-Tax Provisions.12- All Claim Payments will be made in the specified Bank account of the policy holder directly.13- LIC Claim Payments are not related to actual expenses incurred & are payable even if reimbursement from mediclaim, etc has been taken.14- Jeevan Arogya (T904) provides Health claim cover upto 80 Years of age for all adults covered & 18/25 Years for covered children15- Migration Option available for minor beneficiaries for taking new individual Policy at age 18 / 25 Yrs, allowing time credits gained.Yly Premium installment ~ Single member Policy (HCB-4000), with Mode & HCB rebates, Incl "4 Lac TR+DAB" & Service Tax @ 12.36%
Waiting Periods : Not covered in 1st 90 days, except for accidental cases; 2 Year Specific waiting period for 17 listed treatments. Exclusions : Child Birth/Pre-existing illnesses / cosmetic / non-allopathic / Diagnostic medical checkups, etc ; Treatment should be in India & in a min. 10 Bed Hospital.
Info. handout for internal circulation - refer circular/brochure for details Insurance is a subject matter of solicitation
AmountAge
25
Male Female
30
35
9019 8133
10355 9481
11849 10938
14875
AgeAmount
Male Female
50 20223 17434
Age
60
40 13927 12777
45 16711
Amount (W/o TR+DAB)
Male Female
55 17623 13478
20458 15134
65 23362 16672
1 Day 2 Days 3 Days 4 Days 5 Days 6 Days 7 Days Addl Days
(28 Hrs+) (52 Hrs+) (76 Hrs+) (100 Hrs+) (124 Hrs+) (148 Hrs+) (172 Hrs+) [[+24 Hrs]]
4000 8000 12000 16000 20000 24000 32000 .+4000/day
4800 9600 14400 19200 24000 28800 38400 .+4800/day
34800 46400 .+5800/day5800 11600 17400 23200
.+6000/day6000 12000 18000 24000
Counted as =Total Hours =
1st Year
5th year
10th year
11/+ Yr +NCB1st Year4,00,000 6,00,000+
≥ 11th year 30000 36000 48000
29000
LumpsumLumpsum
80,00020,000 30000+ Lumpsum
2,40,000 3,60,000+1,60,000 2,40,000+
NO
LumpsumNature
Per Day Payable
HCB ?PayablePayablePayablePayable
Surgical Procedures (~Benefits given for choosen HCB of Rs 4000)
15 Listed MSB (Cat 1)- Like Heart valve replacement, Kidney transplant, etc
42 Listed MSB (Cat 2)- Like Heart valve repair, major lung, liver, stomach surgeries etc
60 Listed MSB (Cat 3)- Like Thyroid, Adrenal Gland, Gall Bladder, Joint replacement, etc
23 Listed MSB (Cat 4)- Like ureter surgeries, eye related, amputations, some joints, etc
140 Listed Day Care Surgeries (DCPB), where Hospitalization is not requiredAll Other Surgeries (OSB), where Hospitalization is required
Lumpsum1,20,000+
8000 per day 12000+ p.d.
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