Jeevan Arogaya Plan
Features
Introductions :
Health has been a major concern on everybody’s mind, including yours. In these days of skyrocketing medical expenses, when a family member is ill, it is a traumatic time for the rest of the family. As a caring person, you do not want to let any unfortunate incident to affect your plans for you and your family. So why let any medical emergencies shatter your peace of mind.
LIC has launched LIC’s Jeevan Arogya, a unique non-linked Health Insurance plan which provides health insurance cover against certain specified health risks and provides you with timely support in case of medical emergencies and helps you and your family remain financially independent in difficult times.
LIC’s Jeevan Arogya gives you:
• Valuable financial protection in case of hospitalisation, surgery etc
• Increasing Health cover every year
• Lump sum benefit irrespective of actual medical costs
• No claim benefit
• Flexible benefit limit to choose from
• Flexible premium payment options
Very easy to choose your plan
Step 1 Choose the level of Health cover you need
Step 2 Work out the premium payable along with our Representative
Step 1: Choose the level of Health cover you need:
You can choose the amount of Initial Daily Benefit (i.e. the daily Hospital Cash Benefit applicable in the first year of the policy) as per your need from out of the following choices:
` 1000 per day ` 2000 per day ` 3000 per day ` 4000 per day
This is the amount that will be payable to you in the event of hospitalisation in the first year on a per day basis. The Major Surgical Benefit that you will be covered for will be 100 times the Initial Daily Benefit you have chosen. Thus the initial Major Surgical Benefit Sum Assured will be ` 1 lakh, 2 lakh, 3 lakh, 4 lakh respectively. Other benefits such as Day Care Procedure Benefit, Other Surgical Benefit and Premium waiver Benefit (PWB) mentioned below shall also be payable depending upon the daily Hospital Cash Benefit chosen.
Step 2: Work out the premium payable along with our representative
Your premium will depend on your age, gender, the Health cover option you have chosen, whether you are Principal Insured or other insured life and the mode of payment.
How long are each insured under this policy?
Each of the insured are covered for Health risks up to age (80). Children are insured up to age 25 years.
1. Payment of Premiums: You may pay premiums regularly at yearly, half-yearly, quarterly or monthly (ECS mode only) intervals over the term of the policy.
The premium in respect of each individual will be payable from the date of entry into the policy till the date of exit from the policy and will depend on the age of the insured member, the level of Hospital Cash Benefit (HCB) chosen, whether the insured member is Principal Insured or any other Insured life (in case of cover for more than one member in a policy). The level of premium for Principal Insured and the other insured members shall be different for the same age and same level of cover.
The premiums are guaranteed for 3 years from the date of commencement of policy. Thereafter i.e. at the end of every 3 years, the Corporation reserves the right to review the premium to take account of the experience of the portfolio subject to prior approval from IRDA. The rates applicable on every Automatic Renewal Date shall be guaranteed for a further period of 3 years i.e. till next Automatic Renewal Date.
The premium rates in respect of each insured member on renewal will be based on age of that member at the time of inclusion into the policy.
The total premium to be charged for a policy will be the sum of premiums in respect of each member to be covered in that policy.
2. Mode and High HCB Rebates:
Mode Rebate:
Yearly mode : 2% of tabular premium
Half-yearly mode : 1% of the tabular premium
HCB Rebates:
In respect of a member covered under a policy, if HCB is more than ` 1000, then the premium arrived at in respect of that member shall be reduced by an amount (`) given below:
HCB (`) For PI For each insured member
other than PI
2000 500 250
3000 1000 500
4000 1500 750
3. Automatic Renewal Date: The installment premium will be guaranteed in respect of each Insured for a period of 3 years from the Date of Commencement of the policy, i.e. for the first 3 years of the policy. Thereafter, at the end of every third policy anniversary, the premiums may be reviewed to take into account the Corporation’s experience, subject to prior approval from IRDA. These premium due dates, at the end of every third policy anniversary, starting from the date of commencement of policy till the date of cover expiry, on which the installment premiums are reviewable, will be referred as Automatic Renewal Dates in respect of all Insured in the Policy.
On any Automatic Renewal Date in the future, the installment premium will be based on the age of the Insured at the time of inclusion into the policy and the Corporation’s premium rates then prevailing for this product.
4. Options:
A) Cover to new additional members: If PI gets married/ remarried during the term of the policy, the spouse and parents-in-law can be included in the policy within six months from the date of marriage / remarriage, but the cover shall start from the policy anniversary coinciding with or next following the date of inclusion. Enhanced premium shall be due from such policy anniversary.
Similarly, Any child born/legally adopted after taking the policy can also be covered from the next immediate policy anniversary date following the date on which the child completes the age of 3 months. If the age of legally adopted child on the date of adoption is more than 3 months, the child can be covered from policy anniversary coinciding with or next following the date of adoption. Enhanced premiums shall be due from such policy anniversary.
Inclusion of each additional member will be on payment of enhanced premiums and subject to various terms and conditions of the plan.
Any addition of new lives shall be allowed by the PI only. After the death of PI, no addition will be allowed.
Addition in any other case will not be allowed. The existing spouse, parents, parents-in-law and children, if not covered at the time of taking policy, shall not be covered under the policy.
If both of the parents (father and mother) are alive and are eligible for cover, then either both of them will have to be covered or none of them will be covered. The PI will not have any option to choose one of them. The same condition will apply for parents-in-law also.
B) Quick Cash facility: If any of the insured lives undergoes any eligible surgery covered under Category I or II of MSB in any of the listed network hospitals, you, as PI will have an option to avail Quick Cash facility. Under this facility, 50% of eligible MSB amount would be made available even during the period of hospitalization of any of the insured lives covered (the surgery may be either planned or emergency due to accident) instead of waiting for making a claim for the benefit after discharge. It will be only an advance payment in the event of hospitalization for any MSB defined in the surgeries listed under categories I & II and permissible under the policy conditions of the plan. This will be, however, subject to approval from the TPA (Third Party Administrator), and the advance amount will be adjusted from the final settlement of MSB claim amount.
This facility of advance payment could be availed by submitting your Bank Account details in the prescribed format. The amount of advance shall be credited to your bank account directly.
C) Term Assurance Rider: You, as PI, and your spouse may opt for Term Assurance as optional rider equal to the MSB SA. In case of unfortunate death, an amount equal to Term Assurance Sum Assured will be payable on death during the term for which Term Assurance Rider is opted for.
D) Accident Benefit Rider: You and your spouse may also opt for Accident Benefit Rider if Term Assurance Rider has been opted for. Maximum Accident Benefit Sum Assured shall be equal to the Term Assurance Rider SA. In case of unfortunate death due to an accident, an amount equal to Accident Benefit Sum Assured shall be payable.
Accident Benefit Rider will be available under the plan by payment of additional premium of ` 0.50 for every `1,000/- of the Accident Benefit Sum Assured per policy year in respect of each life to be covered.
The additional premium for this benefit will not be required to be paid on and after the Policy anniversary on which the Term Assurance Rider ceases.