LIC Jeevan Arogya Plan

Summary of LIC Jeevan Arogya Plan – Table No. 904

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.

In this plan, you get paid an amount irrespective of the treatment costs. So Jeevan Arogya can be effectively used as a backup to your health insurance plan to provide an additional cover to some of the incidental expenses which you incur during hospitalisation.

We will explain in detail how LIC Jeevan Arogya works with the help of examples to help you understand this plan health plan better.

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Family Cover
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Quick Cash
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Medical Benefit
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Key Features

Family Cover

One health insurance policy that covers self, spouse, children, parents and parents-in-law.

Covers hospitalisation, surgery costs and more
Medical benefit

Provides benefit payout irrespective of actual medical cost incurred

Avail along with mediclaim

Can be availed along with existing mediclaim policy for the same hospitalisation / surgery

New member in family cover

Cover can be extended to new members of the family in case of marriage and childbirth

Quick Cash Facility

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 (for 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)


LIC Jeevan Arogya Plan Benefits are classified as follows:
  • Hospital cash benefit (HCB)
  • Major Surgical Benefit (MSB)
  • Day Care Procedure Benefit
  • Other Surgical Benefit
  • Ambulance Benefit
  • Premium waiver Benefit (PWB)
Hospital Cash Benefit (HCB)

In Jeevan Arogya, selecting the Hospital Cash Benefit (HCB), is the most important and starting point in understanding its benefits. All other benefits are linked to this amount.

Hospital Cash Benefit is the cash you get on a daily basis in case any member covered by this plan is hospitalised. You can choose your HCB to be any of the following:

  • Rs. 1,000 per day
  • Rs. 2,000 per day
  • Rs. 3,000 per day
  • Rs. 4,000 per day

You are eligible to receive the HCB if you have been admitted to the hospital for 24 hours. The daily cash benefit is only extended for the hospitalisation period after the first 24 hours in a non-ICU ward or room of the hospital.

Every year, this Daily Cash Benefit shall be increased by 5% of the HCB selected on purchase till it reached 1.5 times the HCB value chosen on purchase. So if you had chosen an HCB of Rs. 2,000 per day, the value of HCB will be as follows:

1st year HCB = Rs. 2,000
2nd year HCB = Rs. 2,100
3rd year HCB = Rs. 2,200
… it will keep increasing every year till it reaches 1.5 times i.e. Rs. 3,000 per day and the continue to remain the same.


In case there are no claims in the policy in a year, the HCB will be increased by 5% in addition to the increase shown above. Tho No Claim Benefit does not have an upper limit and will continue to accrue as long as no claims are made in the policy.
In case of hospitalisation of greater than 4 hours in the ICU ward of the hospital, you would be eligible to double the HCB benefit for that period.

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

List of Major Surgeries covered under LIC Jeevan Arogya.


  • You can only claim the the Major Surgical Benefit for treatment of a condition which first occurred or manifested itself after the policy was taken.
  • Maximum annual benefit that can be availed for each of the persons covered in the plan - 100% of Major Surgical Benefit Sum Assured.
  • Maximum lifetime benefit that can be availed for each of the persons covered in the plan - 800% of Major Surgical Benefit Sum Assured.
Daycare Procedure Benefit

In case any of the members covered in the plan undergoes a Daycare Procedure, an amount equal to 5 times the HCB will be paid out. It does not matter what the actual cost of the daycare treatment is.

List of Daycare Procedures covered in LIC Jeevan Arogya Plan.


  • Maximum annual benefit that can be availed for each of the persons covered in the plan - 3 Surgical Procedures.
  • Maximum lifetime benefit that can be availed for each of the persons covered in the plan- 24 Surgical Procedures.
Other Surgical Benefit

In case of a of a surgery which is not part of the Major Surgical Benefit List of the Daycare Procedure List, an amount equal to 2 times the HCB shall be paid for each day of hospitalisation. The period of hospitalisation should be greater than 24 hours to eligible for this amount.


  • Maximum annual benefit that can be availed for each of the persons covered in the plan - 15 days in first policy year and 45 days per year thereafter.
  • Maximum lifetime benefit that can be availed for each of the persons covered in the plan - 360 days.
Ambulance Charge Benefit

In case of a major surgery listed under Category 1 & Category 2 and if a cost of ambulance has been incurred, an additional sum of Rs. 1,000 will be paid out.

Premium Waiver Benefit (PWB)

In case of Category 1 & Category 2 surgeries, the one-year premium for the next policy year is waived off.

No Claims Benefit (NCB)

In case of no claims in a policy year, the HCB would increase by 5% of the initial amount selected. So for every year of no claims, you will get an increased HCB and hence the associated increase in other benefits too.

Adding new members

If the policyholders get married after taking the policy, spouse and in-laws can be added to the plan. They have to be added within 6 months of marriage. The cover though will only start from the next policy anniversary. The increase in premium will also be on the next renewal date.

You can add a new born also to the plan once the child is 90 days old. The cover though will only start from the next policy anniversary. The increase in premium will also be on the next renewal date. Adopted children can also be added to the plan.

Addition of parents or existing in-laws will only be allowed at the start of the plan. It will not be allowed at a later point of time

Quick Cash Facility

In case of a Category 1 or Category 2 Major Surgery in a Network Hospital of LIC, the applicant can claim 50% of the amount while in hospital itself. They do not have to wait for the hospitalisation to get over to get the total amount.

Tax Benefit


The premiums paid in Jeevan Arogya are exempted from tax under Sec 80D.


  Minimum Maximum
Entry age of Self/Spouse 18 years 65 years
Entry age of Children 91 days 17 years
Entry age of Parents 18 years 75 years
Age at Maturity - 80 years



The Jeevan Arogya plan has the following exclusions in its coverage:

  • 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​