Major Surgical Benefit (MSB)
In case of a major surgery during the policy period, an amount equal to 100 times the initial HCB selected will be paid to the policyholder as part of this benefit. So the payouts for MSB will be as follows:
| Initial Hospital Cash Benefit( HCB) Selected | Major Surgical Benefit (MSB) |
| Rs. 1,000 per day | Rs. 1,00,000 |
| Rs. 2,000 per day | Rs. 2,00,000 |
| Rs. 3,000 per day | Rs. 3,00,000 |
| Rs. 4,000 per day | Rs. 4,00,000 |
The list of Major Surgeries are divided into Category 1, Category 2, Category 3 and Category 4. You will be paid only a % of the total MSB as shown below:
| Category of Surgery | % of MSB to be Paid |
| Category 1 | 100% |
| Category 2 | 60% |
| Category 3 | 40% |
| Category 4 | 20% |
Example: In case you have opted for HCB of Rs. 2,000 per day, the MSB will work out to Rs. 2,00,000. Now you will get the following payouts in case of a Major Surgery.
| Category of Major Surgery | Payout |
| Category 1 | Rs. 2,00,000 |
| Category 2 | Rs. 1,20,000 |
| Category 3 | Rs. 80,000 |
| Category 4 | Rs. 40,000 |
So here is the list of 140 Major Surgeries which are eligible for the payout and the Category of these Surgeries which will determine the amount of payment you will receive.
| # | List of Major Surgeries | Category | % of MSB Sum Assured |
| I | Cardiovascular System | ||
| 1 | Major Surgery of Aorta | Category 1 | 100% |
| 2 | CABG (two or more coronary arteries must be bypassed) via open chest surgery | Category 1 | 100% |
| 3 | Heart Valve Replacement using mechanical prosthesis | Category 1 | 100% |
| 4 | Heart/Heart-Lung Transplant | Category 1 | 100% |
| 5 | Aortic root transplantation with coronary artery reimplantation for proximal aortic aneurysm | Category 1 | 100% |
| 6 | Pericardiotomy / Pericardectomy | Category 2 | 60% |
| 7 | Initial implantation of permanent pacemaker in the heart | Category 2 | 60% |
| 8 | Mitral valve repair | Category 2 | 60% |
| 9 | Aortic valve repair | Category 2 | 60% |
| 10 | Tricuspid valve repair | Category 2 | 60% |
| 11 | Pulmonary valve repair | Category 2 | 60% |
| 12 | Coronary Angioplasty with stent implantation (two or more coronary arteries must be stented) | Category 3 | 40% |
| 13 | Major vein repair with or without grafting for traumatic & nontraumatic lesions | Category 3 | 40% |
| II | Haemic & Lumphatic System | ||
| 14 | Bone marrow transplant (as recipient) | Category 1 | 100% |
| 15 | Major excision and grafting of Lymphoedema | Category 2 | 60% |
| 16 | Splenectomy | Category 2 | 60% |
| III | Nervous System | ||
| 17 | Repair of Cerebral or Spinal Arterio- Venous Malformations or aneurysms | Category 1 | 100% |
| 18 | Craniotomy for malignant Cerebral tumours | Category 1 | 100% |
| 19 | Excision of pineal gland | Category 1 | 100% |
| 20 | Excision of the pituitary gland | Category 1 | 100% |
| 21 | Craniotomy for non malignant space occupying lesions | Category 2 | 60% |
| 22 | Operations on Surbaracahnoid space of brain | Category 2 | 60% |
| 23 | Intracranial transection of Cranial nerve | Category 2 | 60% |
| 24 | Other operations on the meninges of the Brain | Category 2 | 60% |
| 25 | Microvascular decompression of cranial nerves/nervectomy | Category 2 | 60% |
| 26 | Craniotomy for drainage of extradural, subdural or intracerebral space | Category 3 | 40% |
| 27 | Decompression surgery for Entrapment Syndrome | Category 3 | 40% |
| 28 | Unilateral or Bilateral sympathectomy | Category 3 | 40% |
| 29 | Peripheral nerve Graft | Category 3 | 40% |
| 30 | Free Fascia Graft for Facial Nerve Paralysis | Category 3 | 40% |
| 31 | Excision of deep seated peripheral nerve tumour | Category 3 | 40% |
| 32 | Multiple Miscrosurgical Repair of digital nerve | Category 3 | 40% |
| 33 | Bur-hole Drainage of Extradural, subdural or intracerebral space | Category 4 | 20% |
| IV | Respiratory Sysytem | ||
| 34 | Lung Transplantation | Category 1 | 100% |
| 35 | Unilateral Pneumonectomy | Category 2 | 60% |
| 36 | Diaphragmatic/Hiatus Hernia Repair | Category 2 | 60% |
| 37 | Thoracotoplasty | Category 2 | 60% |
| 38 | Open Lobectomy of Lung | Category 2 | 60% |
| 39 | Excision of benign mediastinal lesions | Category 2 | 60% |
| 40 | Partial Extirpation of Bronchus | Category 2 | 60% |
| 41 | Partial Pharyngectomy | Category 2 | 60% |
| 42 | Total Pharyngectomy | Category 2 | 60% |
| 43 | Total Laryngectomy | Category 2 | 60% |
| 44 | Excision of Diaphragmatic tumours | Category 2 | 60% |
| 45 | Pleurectomy or Pleural decortication | Category 3 | 40% |
| 46 | Tracheal reconstruction for various lesion | Category 3 | 40% |
| V | Digestive System | ||
| 47 | Excision of esophagus and stomach | Category 1 | 100% |
| 48 | Abdominal-Perineal Pull Through Resection of rectum with Colo-Anal Anastomosis | Category 1 | 100% |
| 49 | Total excision of oesophagus | Category 2 | 60% |
| 50 | Total excision of stomach | Category 2 | 60% |
| 51 | Resection and Anastomosis of any part of digestive tract | Category 3 | 40% |
| 52 | Open Surgery for treatment of Peptic Ulcer | Category 3 | 40% |
| 53 | Artificial opening into stomach | Category 4 | 20% |
| VI | Endocrine System | ||
| 54 | Complete excision of Adrenal glands | Category 2 | 60% |
| 55 | Complete excision of Thyroid gland | Category 2 | 60% |
| 56 | Complete excision of Parathyroid gland | Category 2 | 60% |
| 57 | Partial excision of Adrenal glands | Category 3 | 40% |
| 58 | Partial excision of Thyroid gland | Category 3 | 40% |
| 59 | Partial excision of Parathyroid gland | Category 3 | 40% |
| VII | ENT | ||
| 60 | Total ear amputation with reconstruction | Category 2 | 60% |
| 61 | Transmastoid removal cholesteatoma with extended Mastoidectomy | Category 2 | 60% |
| 62 | Total Nasal Reconstruction due to Traumatic lesions | Category 2 | 60% |
| 63 | Labyrinthotmy for various lesions | Category 3 | 40% |
| VIII | Oral | ||
| 64 | Wide excision and Major reconstruction of malignant Oro-pharyngeal tumours | Category 2 | 60% |
| 65 | Total Glossectomy | Category 3 | 40% |
| 66 | Wide local Excision for oral leukoplakia | Category 4 | 20% |
| IX | Eye | ||
| 67 | Orbit Tumour Exenteration /Flap reconstruction | Category 3 | 40% |
| 68 | Corneal or Retinal Repair for Traumatic eye injuries | Category 4 | 20% |
| 69 | Penetrating injuries of the eye or repair of ruptured globe | Category 4 | 20% |
| X | Liver, Gall Bladder & Pancreas | ||
| 70 | Liver Transplantation | Category 1 | 100% |
| 71 | Partial Resection of Liver | Category 2 | 60% |
| 72 | Partial Pancreatectomy | Category 2 | 60% |
| 73 | Cholecystectomy/Choledochotomy for various Gall bladder lesions | Category 3 | 40% |
| XI | Musculoskeletal System (Due to accident only) | ||
| 74 | Replantation of upper limb | Category 2 | 60% |
| 75 | Replantation of lower limb | Category 2 | 60% |
| 76 | Total prosthetic replacement of hip joint using cement | Category 3 | 40% |
| 77 | Total prosthetic replacement of hip joint not using cement | Category 3 | 40% |
| 78 | Other total prosthetic replacement of hip joint | Category 3 | 40% |
| 79 | Total prosthetic replacement of knee joint using cement | Category 3 | 40% |
| 80 | Total prosthetic replacement of knee joint not using cement | Category 3 | 40% |
| 81 | Other total prosthetic replacement of knee joint | Category 3 | 40% |
| 82 | Total prosthetic replacement of other joint using cement | Category 3 | 40% |
| 83 | Total prosthetic replacement of other joint not using cement | Category 3 | 40% |
| 84 | Other total prosthetic replacement of other joint | Category 3 | 40% |
| 85 | Prosthetic replacement of head of femur using cement | Category 3 | 40% |
| 86 | Prosthetic replacement of head of femur not using cement | Category 3 | 40% |
| 87 | Other prosthetic replacement of head of femur | Category 3 | 40% |
| 88 | Prosthetic replacement of head of humerus using cement | Category 3 | 40% |
| 89 | Prosthetic replacement of head of humerus not using cement | Category 3 | 40% |
| 90 | Other prosthetic replacement of head of humerus | Category 3 | 40% |
| 91 | Prosthetic replacement of any other bone using cement | Category 3 | 40% |
| 92 | Prosthetic replacement of any other bone not using cement | Category 3 | 40% |
| 93 | Other prosthetic replacement of any other bone | Category 3 | 40% |
| 94 | Prosthetic interposition reconstruction of joint | Category 3 | 40% |
| 95 | Other interposition reconstruction of joint | Category 3 | 40% |
| 96 | Excision reconstruction of joint | Category 3 | 40% |
| 97 | Other reconstruction of joint | Category 3 | 40% |
| 98 | Implantation of prosthesis for limb | Category 3 | 40% |
| 99 | Amputation of arm | Category 3 | 40% |
| 100 | Amputation of leg | Category 3 | 40% |
| 101 | Fixation of fracture of spine | Category 3 | 40% |
| 102 | Elevation, Exploration and Fixation of fractured Zygoma | Category 3 | 40% |
| 103 | Amputation of hand | Category 4 | 20% |
| 104 | Amputation of foot | Category 4 | 20% |
| 105 | Therapeutic endoscopic operations on cavity of knee joint | Category 4 | 20% |
| 106 | Replantation of finger following traumic amputation | Category 4 | 20% |
| 107 | Surgical Drainage and Curettage for osteomyelitis | Category 4 | 20% |
| XII | Oro-Maxillofacial Surgery | ||
| 108 | Major reconstructive oro-maxillafacial surgery due to trauma or burns and not for cosmetic purpose | Category 2 | 60% |
| 109 | Osteotomy including segmental resection with bone grafting for Mandibular and maxillary lesions | Category 2 | 60% |
| XIII | Kidney / Urinary Tract / Reproductive System | ||
| 110 | Renal transplant (recipient) | Category 1 | 100% |
| 111 | Hysterectomy for malignant conditions | Category 2 | 60% |
| 112 | Radical prostatovesiculectomy | Category 2 | 60% |
| 113 | Microvascular reattachment of penis following traumatic amputation | Category 2 | 60% |
| 114 | Total nephrectomy due to medical advic (not as a transplant donor) | Category 3 | 40% |
| 115 | Partial excision of kidney | Category 3 | 40% |
| 116 | Open extirpation of lesion of kidney | Category 3 | 40% |
| 117 | Excision of ureter | Category 3 | 40% |
| 118 | Total excision of bladder | Category 3 | 40% |
| 119 | Kidney injury repair | Category 3 | 40% |
| 120 | Pyloplasty/Ureterocalcycostomy for pelvic ureteric junction obstruction | Category 3 | 40% |
| 121 | Amputation of penis | Category 3 | 40% |
| 122 | Excision of vagina | Category 3 | 40% |
| 123 | Unilateral or Bilateral excision of adnexa of uterus | Category 3 | 40% |
| 124 | Partial excision of bladder | Category 4 | 20% |
| 125 | Therapeutic ureteroscopic operations on ureter | Category 4 | 20% |
| 126 | Urinary diversion | Category 4 | 20% |
| 127 | Replantation of ureter | Category 4 | 20% |
| 128 | Unilateral or Bilateral excision of testes | Category 4 | 20% |
| 129 | Other operations on Scrotum and tunica vaginalis testis | Category 4 | 20% |
| 130 | Reconstruction of the testis | Category 4 | 20% |
| 131 | Open surgical excision and destruction of prostate tissue | Category 4 | 20% |
| 132 | Extirpation of lesion of vulva | Category 4 | 20% |
| 133 | Excision of vulva | Category 4 | 20% |
| XIV | Operations on the sinuses | ||
| 134 | Operations on frontal sinus | Category 3 | 40% |
| 135 | Operations on maxillary antrum using sublabial approach | Category 4 | 20% |
| XV | Others | ||
| 136 | Radical Mastectomy | Category 2 | 60% |
| 137 | Malignant soft tissue tumour excision and reconstruction | Category 3 | 40% |
| 138 | Excision and Major Flap Repair of skin and Subcutaneous tissue due to Major Burns | Category 3 | 40% |
| 139 | Simple Mastectomy | Category 4 | 20% |
| 140 | TIPS procedure for portal Hypertension | Category 4 | 20% |
Understand the plan in detail - Review of the LIC Jeevan Arogya Plan.
Do drop in a comment, if there is any clarification you would want on this plan.