LIC Jeevan Arogya

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LIC Jeevan Arogya Plan

LIC Jeevan Arogya Plan is non-linked health insurance plan offered by LIC(Life Insurance Corporation of India), the most trusted and dominant life insurance company in India, provides a full financial security when it comes to insurances in terms of health and life. LIC has crossed many milestones and has set exceptional performance records in various aspects of life insurance business. The company focuses on giving an adequate financial cover against death or sicknesses at a much reasonable cost and the funds gets invested to the best of the investors to earn a attractive return. It also Termed as LIC Health Insurance.

Health Insurance plans play an important role in the insurance portfolio of an individual. Firstly, it offers tremendous financial or monetary support to the policy holder if he/she is disabled after an accident resulting in to permanent disability, temporary disability and even an unfortunate death. Secondly, the degree of injuries or enormity doesn’t matter, minor injuries are also usually cover under the plan. With increased medical costs and a change in lifestyle, health is the biggest asset for human being which gets affected and the same needs to be taken care of as the saying goes “Health is Wealth”. LIC health insurance plans have all encompassing plans which acts as an armor to cover the risks associated with an accident.

LIC JEEVAN AROGYA PLAN ELIGIBILITY CRITERIA

Coverage for Minimum Entry Age Maximum Entry Age
You and/or your Spouse 18 Years 65 Years
Your parents and/or your parents-in-laws 18 Years 75 Years
Your Children 91 Days 17 Years


LIC JEEVAN AROGYA PLAN COVERAGE

Coverage Type Coverage Offered Maximum Coverage
Daily Hospital Cash (DHC) Rs. 1,000; Rs. 2,000; Rs. 3,000; Rs. 4,000. (Minimum 24 hours hospitalization required). Covers hospitalization maximum up to 30 days in the first year (15 days in ICU), which becomes thrice second year onwards
Major Surgical Benefits (MSB) Between Rs. 1, 00,000 to Rs. 4, 00,000 (Maximum 100 times the DHC). Covers up to 140 major surgeries.
Daycare Procedure Benefits 5 times the DHC in case of a daycare procedure Maximum 3 times in a year and 24 times during the policy tenure in India
Other Surgical Benefits Twice the DHC is payable in case of hospitalization of more than 24 hours when the insured undergoes a surgery other than the included in MSB. Maximum days of coverage in the first years are 15 and 45 thereafter.


LIC JEEVAN AROGYA PLAN UNIQUE FEATURES

Unique Features of Plan
A non-linked, non-participating health insurance plan
  • The plan has no specific benefit like LA or FAB like other life insurance plans offered by the company.
  • The plan has no investment benefit.
  • Only health issues are covered.
A health insurance plan with defined benefits Benefits are pre-defined and so not linked to actual expenses.
A health insurance plan with hospital cash benefits You need to submit your medical bills for your claim to be accepted and processed. The claim process goes on just like a typical health plan.
Claim in a medical emergency Twice the DHC when admitting to ICU
Surgeries covered under MSB 50% of sum assured during hospitalization
Special categories under MSB The premium of one year is waved off.
Grace period under the plan 30 days for annual and semi-annual premium payment.

 

Why To Buy LIC Jeevan Arogya Plans?

LIC policies have unique features like

  • It’s not only an individual insurance plan but a family coverage plan as well. Parents are also covered under this plan which is the unique proposition of LIC policies.
  • The plan covers all kind of surgeries which includes Day Care treatments as well.
  • A No Claim Bonus is available.
  • Additional Critical Illness Rider Benefit is also available under this plan.
  •  Critical Illnesses are also covered.
  • Online tracking of application.
  • Online purchase and renewal of plans.
  • Income Tax Benefit - Health Insurance Premiums paid upto Rs 15000/- for normal residents and Rs 20000/- for Senior Citizens are allowed for a deduction from the taxable income each year under section 80D.

LIC health insurance plan is named as LIC’s Jeevan Arogya Plan which is a unique non participating non linked plan.

LIC Jeevan Arogya Policy Details:

LIC Jeevan Arogya is a non-linked health insurance policy offered by Life Insurance Corporation of India (LIC) to help individuals deal with medical expenses. The plan provides health insurance against certain specified health risks and offers a great financial support during exigencies.

Key Features of LIC Jeevan Arogya are as follows:

  • Substantial financial protection in case of hospitalization or surgery.
  • Lump sum benefit irrespective of actual medical costs.
  • Increased health cover every year.
  • No Claim Bonus.
  • One can choose various flexible benefits.
  • One can also choose various premium payment options.

How to Choose proper  LIC Jeevan Arogya plan?

Step 1:

One has to choose the level of Health cover which means the amount of Initial Daily Benefit as per the requirement from Rs 1000/ day, Rs 2000/ day, Rs 3000/ day and Rs 4000/ day. This amount will be paid in case of hospitalization in the first year per day. Additionally, the major surgical benefits will be 100 times the Initial Daily Benefit. Therefore, the Initial Major Surgical Benefits Sum Assured will be Rs 1 lakh, Rs 2 lakhs, Rs 3  lakhs, and Rs 4 lakhs respectively. Benefits like Day Care procedure Benefit, Other Surgical benefits and Premium Waiver Benefit ( PWB) is also dependable upon the daily Hospital Cash Benefit.

Step 2:

Premium needs to be chosen which depends primarily on the age, gender, the health cover option that one has chosen and the mode of payment.

The LIC Jeevan Arogya premium table for Principal Insured (Male) is as follows:

Entry Age Premium
20 1922.65
30 2242.90
40 2799.70
50 3768.00

 

The LIC Jeevan Arogya premium table for Spouse (Female) / Parent (Principal Insured / Spouse) Female is as follows:

Entry Age Premium
20 1393.15
30 1730.65
40 2240.60
50 2849.10

 

The LIC Jeevan Arogya premium table for Child is as follows:

Entry Age Premium
0 792.00
5 794.75
10 812.35
15 870.75

All the premiums above are exclusive of the service tax.

Benefits of LIC Jeevan Arogya:

  • Hospital cash Benefit (HCB): If any of the insured is hospitalized due to accidental injury or sicknesses, stays in the hospital for a continuous period of 24 hours, provided any such part stay exceeds 4 hours in a NON-ICU ward/ room of a hospital, an amount equal to the Applicable Daily Benefit under the plan will payable.
  • Day Care Procedure Benefit: Due to medical needs, if the insured is undergoing any day care procedure under this plan, a lump sum amount equal to 5 times the applicable Daily Benefit shall be paid, irrespective of the actual costs incurred.
  • Major Surgical benefit: Due to accidental injury or sicknesses, if the insured individual undergoes a surgery within the plan period, then the respective benefit percentage for the eligible surgeries will be paid.
  • Other Surgical Benefit: If the insured individual undergoes a surgery which is not in the specified list, then a daily benefit equal to two timed the Applicable daily Benefit shall be paid for each extended period of 24 hours.
  • Ambulance Benefit : In case where Major Surgical Benefits fails in any event, then the company will provide the emergency transportation costs by ambulance , an additional lump sum of Rs 1000/- will be payable.
  • Premium Waiver Benefit (PWB): In case where Major Surgical Benefits fails in any event, the total annualized premium which is the total one year premium with respect to the policy from the date of installment premium due coinciding with or next following the date of the surgery will be waived off.

 

LIC Jeevan Arogya Eligibility Criteria

  Minimum Entry Age ( Yrs) Maximum Entry Age ( Yrs)
Self/ Spouse 18 65 ( last birthday)
Parents / Parents in law 18 65 ( last birthday)
Children 91 days 17 years ( last Birthday)


Insured individuals are covered up to 80 years of age and Children are covered upto 25 years of age.

What is not covered in LIC Jeevan Arogya Health Plan?

The following are the exclusions under which the LIC(Life India of Corporation) life insurance  will not pay any benefit to the Insured Person:

  • Any claim arising as a result of any pre existing disease or their resultant complications unless otherwise mentioned in the proposal form which has been accepted by the company.
  • AIDS/ HIV related complications.
  • Payment of compensation in case of injury, death, disablement, hospitalization of the insured person due to or arising out of , directly or indirectly due to war irrespective of planned or unplanned, invasion, act of foreign enemy, rebellion,  hostilities, civil war, martial law, revolution, insurrection, military or usurper power, civil commotion, seizure, riot or capture , arrests, restraints and detainments.
  • Any experimental treatment or surgery.
  • Organ donor expenses.
  • Dental treatment.
  • Knowingly harming body, self created and planned injury, suicide or attempted suicide, deliberately exposure to danger or sickness aggravation by non adherence to medical advise by insured person.
  • If the insured person is injured or fall sick due to consumption of alcohol or drugs or narcotics without professional advise of the Doctor.
  • Participation in winter sports or any hazardous pursuits like driving or riding or race, bungee-jumping, skydiving, martial arts, hunting, parachuting, mountaineering, caving or pot-holing, hand gliding, scuba diving or driving in races, underwater activities involving use of breathing apparatus or not rallies using a bicycle or motorized vehicle, yachting or boating outside coastal water miles of 2 miles, participation in professional sports.
  • Compensation in case of death, Injury, disablement, illness disease,  hospitalization of the insured person due to or arising out of , directly or indirectly due to
    • Contamination by radioactivity or Ionizing radiation from any nuclear fuel or nuclear waste.
    • Nuclear & radioactive weapon materials.
    • Chemical and Biological Weapon
    • Terrorism
    • Working in electrical installation with high tension supply, or underground mines or explosive magazines,  or as jockies or circus personnel, or engaged in activities like racing on horseback, wheels, big game hunting.
  • Payment of compensation due to prolonged child birth or pregnancy.
  • Involvement in any criminal or illegal activities.
  • For bodily injury which occur due to involvement in any violent labour disturbances riot or public disorder or civil commotion.
  • Nervous problem or mental problem treatment.
  • Genetic disorders, congenital conditions or birth defects unless specifically covered.
  • Treatments taken due to insured’s failure to act on proper medical advise.
  • Non Allopathic treatments.

How to Claim LIC Jeeevan Arogya policy?

There are two ways by which one can claim LIC medical insurance which are

  • Cashless Claim
  • Reimbursement Claim

LIC Cashless claims can be either for planned hospitalization or for emergency admission. In both the cases, TPA (Third Party Administrator) assist the insured person and process the LIC claims. However, the cashless facility is available where the TPA is associated with the network hospitals.

Documents Required To Claim LIC Jeevan Arogya Plan

The following documents needs to be submitted along with the filled up LIC claim form and Doctor’s Certificate:

  • Discharge Summary.
  • Prescriptions.
  • Bills
  • Advance receipt and final receipts.
  • Diagnostic Test Reports, Scan, X-ray, ECG and other related reports. 

Checklist of Documents for LIC Jeevan Arogya Claim Submission:

  • Claim form.
  • Copy of photo id proof.
  • Attested photocopies of Discharge Summary.
  • Attested photocopies of the Hospital bills with breakup of charges.
  • For package treatment, details of package bills.
  • Medico Legal Certificate (MLC) in accidental cases.
  • Copies of all investigations.
  • Copies of all medicine bills supported by prescriptions.

LIC life insurance Customer Zone provides services exclusively to its customers like change of address, releasing premium paid certificate, acceptance of certificate for pension policies, resolving any policy related questions. One can get information on premium position, bonus, loan, revival of lapsed policies and the products which are offered by LIC. Assistance is also provided for filling up of forms and registration on LICs Customer Portal.

LIC Jeevan Arogya: Contact Details.

One can call at 1251 from any MTNL/ BSNL number and for others the same number can be contacted by dialing the STD code. For any complains or grievances, one can contact to CRM Grievance Redressal Officer on the telephone numbers as mentioned in the company website.

PolicyBazaar will help you to compare LIC Jeevan Arogya insurance plan benefits, features and premium to buy best LIC life insurance Policy at ease of one click. Get reviews and premium calculator to buy or renew your LIC policy online.

LIC Health Insurance - Latest News

  • LIC wants Axis Bank to sell its Insurance Policies

    LIC has sent proposal to Axis Bank which says to sell LIC's products through their branches. If Axis Bank starts selling the LIC products, it would be an opportunity that could show the way to several tie-ups in the future as a new rule allows banks to tie up with more than one insurance company.

    This could be a disadvantage for some insurance companies who have an alliance to sell their products exclusively for example MAX. Axis Bank says they cannot respond on the matter as the insurance industry is showing a shift in the way it sells insurance policies. State-run LIC, which controls more than half of the insurance market, had built trust and platform who sell its products door-to-door.

    It is difficult to break LIC's network by late private sector entrants. Some got into special tie-ups with banks to sell their insurance policies, but that blocks others from doing so. The regulator forced banks to go for up to three bank alliances. LIC, which receive less than 5% premium income from banks, would make more benefit if Axis agrees as it is key growth drivers.

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