LIC Health Protection Plus

Eligibility of LIC Health Protection Plus Plan

The LIC Health Protection Plus Plan is a comprehensive health shield designed to cover the family comprising policyholder, spouse and children. All Indian nationals are eligible to purchase the plan. The criteria for buying the LIC Health Protection Plus Policy are:

Minimum Entry Age (age last birthday)

• Principal Insured: 18years.
• Spouse Insured: 18 years.
• Children Insured: 3 months (completed). 

Minimum Entry Age - HCB Cover (age last birthday)

• Principal Insured: 18years.
• Spouse Insured: 18 years.
• Children Insured: 3 months (completed). 

Minimum Entry Age - MSB Cover (age last birthday)

• Principal Insured: 18years.
• Spouse Insured: 18 years.
• Children Insured: 18 years. 

Maximum Entry Age (age nearer birthday)

• Principal Insured: 55 years.
• Spouse Insured: 55 years.
• Children Insured: 17 years. 

Maximum Coverage Age for HCB and MSB (age nearer birthday)

• Principal Insured: 75 years.
• Spouse Insured: 75 years.
• Children Insured: 25 years. 

Core Benefits by LIC Health Protection Plus Plan

The LIC Health Plan design is unique because the premium is divided into two distinct components - health risk cover and investment in market instruments to ensure handsome yields. Thus the benefits are also classified into two. 

Payable on Death

• In case of the Principal Insured’s death and other insured, will pay the fund value of units held in Policy Fund to the nominee or the legal heir. 
• In case of demise of the Principal Insured only, premium payment will cease, and the other policyholders will enjoy the health cover. 
• In case of an insured member’s demise other than the Principal Insured, the premium and cover will continue as usual. 
• If the Principal Insured and the spouse expire, the covered children will receive the benefits, starting from the eldest. 

Hospital Cash Benefit

Hospital Cash Benefit is payable in LIC Health Protection Plus Policy to the Principal Insured or any other insured due to an accident or illness if the stay exceeds continuous 52 hours. The quantum is based on the chosen Initial Daily Benefit. It increases by 5% every policy year till it reaches a maximum of 1.5 times the Initial Daily Benefit. The payable HCB per day amounts are described below: 

Principal Insured

• Minimum: Rs.250
• Maximum: Rs.2500

Insured Spouse

• Minimum: Rs.250
• Maximum: Rs.1500

Insured Children

• Minimum: Rs.250
• Maximum: Rs.1500

Major Surgical Benefit

It is payable when the Principal Insured or any of the policy insured members are hospitalized for surgery applicable only for those defined in the policy document. The quantum cover is 200 times the HCB amount. The amount remains fixed in the LIC Health Protection Plus Plan and does not change in the subsequent years. The sum assured for the MSB is described below:

Principal Insured

• Minimum: 200 times of the initial HCB
• Maximum: 100% of the sum assured.

Insured Spouse

• Minimum: 200 times of the initial HCB
• Maximum: 100% of the sum assured.

Insured Children

• Minimum: 200 times of the initial HCB
• Maximum: 100% of the sum assured.

Domiciliary Treatment Benefit

The benefit is payable to the policyholder only upon satisfying certain conditions described below:

• Minimum three years premium has been paid.
• The minimum claim amount should be Rs.2500.
• The maximum amount is limited to 50% of the Policy Fund on the payment date.
• Maximum two payments are allowed in a policy year on a single policy. 

Tax Benefits

This LIC Plan also offers tax benefits u/s 80D.

*Tax benefit is subject to changes in tax laws. Standard T&C Apply.

Premium Structure

As already discussed, the LIC Health Protection Plus Plan premium has two components for health cover and investment. The defined premium rates are:

For Standard Lives

• Single Life: Higher of Rs.2500 pa, and six times of HCB of the PI.
• Double Life: Higher of Rs.7500 pa and the sum six times of HCB of the PI, and three times the HCB of the other insured.
• More than two lives: Higher of Rs.10000 pa and the sum six times of HCB of the PI, and three times the HCB of each of the other insured.

*Standard T&C Apply

For Sub-Standard Lives

• Single Life: Higher of Rs.5000 p.a., and nine times of HCB of the PI.
• Double Life: Higher of Rs.7500 p.a. and the sum six times of HCB of the PI, and five times the HCB of the other insured.
• More than two lives: Higher of Rs.10000 p.a. and the sum nine times of HCB of the PI, and five times the HCB of each of the other insured.

***** The premium will marginally reduce if the other insured have standard lives. 

*Standard T&C Apply

Documents Required for LIC Health Protection Plus Plan

The copies of valid documents required for LIC Health Protection Plus Policy purchase are standard requirements detailed below:

• ID proof
• Date of birth proof
• Address proof

Documents needed for filing claims include:

• Claim Form
• Hospital Discharge summary
• Bills, invoices, and receipts in original
• Investigative and diagnostic reports
• Photo ID

The Process to Buy LIC Health Protection Plus Plan Online 

The simplest method to purchase LIC Health Protection Plus Policy is online at the insurer’s official portal or any of the aggregators who facilitate the process. The standard steps involved are:

Step 1: Invoke the buy online at the chosen web site.

Step 2: Input personal details like name, gender, date of birth, address, and the communication phone number. 

Step 3: Enter pre-existing health conditions, if any, and information related to smoking or drinking. 

Step 4: Choose the financial parameters and upload scanned copies of requisite documents. 

Step 5: Approve the received quote and pay the premium online using the safe gateway to complete the process. 

Exclusions of LIC Health Protection Plus Plan

It is essential to be aware of LIC Health Protection Plus Policy’s applicable exclusions to ensure a seamless claim experience. The standard exclusions in the policy are:

Hospital Cash Benefit

• An initial waiting period of 180 from the risk inception date or 90 days from the revival date
• Hospitalization exclusively for investigations and physiotherapy

Major Surgery Benefit

• Surgeries not listed in the LIC Health Protection Plus Plan
• Surgery triggered within the first 180 days from risk inception or 90 after the policy has been revived

Common Exclusions

• Treatment of any pre-existing disease
• Any epidemic declared by the government
• Treatment resulting from pregnancy
• Treatment-related to congenital disabilities
• Dental and cosmetic surgery
• Treatment of HIV/AIDS, alcoholic or drug abuse, war injuries
• Self-inflicted injuries or attempted suicide
• Any peril, arising from the natural calamity
• Injuries or medical conditions resulting from adventure and extreme sports

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