Salient features of LIC’s Jeevan Arogya
1. The minimum age of entry in this case is 18 years, while 65 is the upper limit for principal insured.
2. Minimum Sum Insured 1,00,000 to Maximum Sum Insured 4,00,000.
3. Provides Fixed benefits for Hospitalization and almost all types of Surgical procedures
4. Benefit payable irrespective of Cost Incurred
5. Benefit is additional to any other health insurance cover, so if you have any other health insurance, you can claim under both insurance.
6. Multiple lives can be covered under one policy i.e. Spouse, Children, Parents & Parents-in-law can also be added
7. Premium for Basic Plan will be guaranteed for 3 years only
Benefits in LIC’s Jeevan Arogya
1- Hospital Cash Benefit (HCB) – If Principal Insured or Insured Members is hospitalized due to Accidental Bodily Injury or sickness & stay in hospital exceeds 24 hours then HCB is payable.
2- Major Surgical Benefit (MSB) – Insured undergoing any listed surgeries due to Accidental Bodily Injury or Sickness then Major Surgical Benefit (MSB) is payable.
3- Ambulance Benefit – In the event of Major Surgical Benefit Rs. 1000/- Ambulance Benefit is also payable.
4- Premium Waiver Benefit – In the event of Major Surgical Benefit Total One Year Premium from the date of due coinciding with or next following the date of Surgery will be waived.
5- Day Care Procedure Benefit (DCPB) – In the event of Insured undergoing specified Day Care Procedure mentioned then Day Care Procedure Benefit is Payable. Not payable if Hospital Cash Benefit is paid
6- Other Surgical Benefit (OSB) – If Insured under goes any Surgery not listed under Major Surgical Benefit or Day Care Procedure & stay in hospital exceeds 24 hours Other Surgical Benefit is payable.
Two Riders available –
a. Term Assurance Rider
1. Available for Principal Insured & Spouse only.
2. The sum insured would be an amount equal to Major Surgical Benefit Sum Assured.
3. Minimum – 100 times of Initial Day Care Procedure Benefit (DCPB) .
4. Maximum – 25 lacs including all existing Term Ins. Policies.
b. Accident Rider
1. Eligible only – if Term Assurance Rider is selected.
2. Available for Principal Insured & SPOUSE only.
3. An amount equal to Term Assurance Rider Sum Assured is eligible.
4. Premium of Rs. 0.50/ 1000 Sum Assured is payable.
Advantages on LIC’s Jeevan Arogya
1. Premiums are guaranteed only for a period of 3 years.
2. Existing Members can be removed at any time on request.
3. On Death of Principal Insured’s Spouse can become Principal Insured & continue with new premium.
Disadvantages on LIC’s Jeevan Arogya
1. After end of every third policy year premiums will be reviewed based on LIC’s Claim experience, Premiums will be changed from next following due date.
2. Day Care Procedure Benefit (DCPB) is not payable if Hospital Cash Benefit is paid.
3. For Term Assurance Rider maximum limit is only 25 lacs including all existing Term Insurance Policies.
4. Very low Maximum Sum Insured is only 4 lacs.
The Bottom Line
1- Maximum Sum Insured is ONLY 4 lacs. Any critical disease like Heart Attack, Cancer and related treatment today needs minimum 5-10 lacs in good hospital and this will rise in future with inflation.
2- Term Assurance Rider maximum limit is only 25 lacs including all existing Term Ins. Policies, so if you have already a term insurance policy with 25 lacs Sum Insured, you cannot opt for this rider.
3- Total surgical benefit (SB) in whole policy term i.e. till 80 years is only three times of maximum limit i.e. 4 lacs, if anybody takes 4 lacs Sum Insured (which is the maximum available), then he can only claim worth 32 lacs (i.e. eight claims of 4 lacs each), in whole life span of the policy i.e. upto 80 years.
Please don’t buy this policy by ignoring your existing health insurance/mediclaim policy. Buy only as a add on to existing health insurance policy.