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
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:
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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