LIC Jeevan Arogya

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  • 194,096 Views

LIC Jeevan Arogya Plan


LIC Jeevan Arogya is a non-linked Health Insurance Policy which helps individuals to cope up with the rising medical costs. In this plan you can cover yourself, spouse, children, parents as well as mother-in-law and father-in-law. It is a comprehensive health insurance policy for the entire family.
 

Key Features of LIC Jeevan Arogya

 
  • One health insurance policy that covers self, spouse, children, parents and parents-in-law
  • Covers hospitalisation, surgery and much more
  • Provides benefit payout irrespective of actual medical cost incurred
  • Can be availed along with existing mediclaim policy for the same hospitalisation / surgery
  • Cover can be extended to new members of the family in case of marriage and childbirth
  • Quick Cash Facility is available on hospitalisation instead of waiting to make a claim for the benefit after discharge
  • Under Quick Cash, 50% advance payment is given by LIC (under 57 surgeries performed in network hospitals)
  • Payout made on the basis of photocopy of bills
  • No Claim Benefit is 5% of initial Hospitalisation Cash Benefit (HCB)

 

What is covered in LIC Jeevan Arogya?

 
  • Hospitalisation Cash Benefit (HCB)
  • Major Surgical Benefit (MCB) is 100 times the HCB / Accidental Death Benefit (ADB)
  • Day Care Procedure Benefit paid as lump sum
  • Other Surgical Benefits (where all other surgeries are covered) is 2 times HCB / ADB
  • Ambulance charges up to Rs 1000 per insured per year, for major surgeries under category 1 or 2
  • Premium Waiver Benefit
  • Auto increase @ 5% in both HCB and MCB up to 50% even if there is any claim

 

Hospitalisation Cash Benefit in detail:

  • Choose from Rs 1000 to Rs 4000 per day
  • Up to Rs 4000 per day for maximum 720 days
  • Up to Rs 8000 per day for maximum 360 days in ICU

 

Daycare procedures (which do not require 24 hr hospitalisation) in detail:

  • 5 times Hospitalisation Cash Benefit (HCB) / Accidental Death Benefit (ADB)
  • 140 surgeries
  • 3 daycare procedures covered in a year, and  24 procedures covered in a lifetime

 

Waiting period for availing benefits in LIC Jeevan Arogya

  • Accidental claims - 0 days
  • HCB and MSB - 90 days from policy start date

 

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Additional Benefits of LIC Jeevan Arogya

 
  • Term Rider and Accidental Benefit rider available as an option
  • Increasing health cover every year as a No Claim Benefit

 

Eligibility conditions and other restrictions in LIC Jeevan Arogya

 

 

Minimum

Maximum

Daily Hospitalisation Benefit (in Rs.)

 

1000/day excl ICU

4000/day excl ICU

Major Surgical Benefit (in Rs.)

1,00,000

4,00,000

Entry Age of Self/Spouse (in years)

18

65

Entry Age of Children (in years)

91 days

17

Entry Age of Parents (in years)

18 years

75

Age at Maturity (in years)

-

80

Payment modes

Yearly, Half-yearly, Quarterly or Monthly (ECS mode only)

 

Sample illustration of premium amount in LIC Jeevan Arogya

 
The below illustration is for an individual opting for a Daily Hospitalisation Benefit of Rs 1,000 per day:

 

LIC Jeevan Arogya Sample Illustration

 

Tax Benefits


This plan offers tax benefits for the premiums as a deduction from the taxable income under section 80D of the Income Tax Act.

 

Exclusions - What is not covered in LIC Jeevan Arogya Policy?

 
  •  Pre-existing conditions (unless disclosed and accepted by LIC)
  • Routine check-ups and Non-allopathic treatments
  • Epidemic diseases or conditions (classified by Central or State Government)
  • Cosmetic or beauty treatments, circumcision, dental treatments
  • Plastic surgery (unless necessary for treatment of illness or due to an accident and performed within 6 months of the event occurrence)
  • Any treatment arising from insured person’s failure  to act on proper medical advice
  • Self-inflicted injuries or attempted suicide
  • Abuse of drugs, alcohol or intoxicants
  • Conditions existing at birth (congenital conditions)
  • Rest cure, general weakness, nervous breakdown or related conditions, infertility or sterilisation
  • Sexually transmitted diseases like HIV / AIDS
  • Pregnancy or child-birth related conditions
  • Any act of war, invasion of foreign enemy, naval or military operations etc
  • Radioactive contamination
  • Criminal or illegal acts
  • Natural catastrophe like earthquake, floods etc
  • Participation in dangerous sports like racing, scuba diving, bungee jumping
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