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Old April 1st, 2016, 05:00 PM
Sumit Bhardwaj
Super Moderator
 
Join Date: Nov 2011
Default Re: Mediclaim Policy in LIC

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
-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)


Things Covered Under this Policy:
-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

Eligibility conditions
Criteria Minimum Maximum

Age at entry for self/spouse 18 years 65 years
Age at entry for children 91 days 17 years
Age at entry for parents 18 years 75 years
Age at maturity - 80 years
Daily hospitalisation benefit Rs.1000 a day excluding ICU 4000 a day excluding ICU
Major surgical benefit Rs.1,00,000 Rs.4,00,000

Exclusions
Listed below are the exclusions of LIC Jeevan Arogya plan.
-Pre existing conditions
-Epidemic conditions
-Plastic surgery
-Cosmetic treatments
-Beauty treatments
-Attempted suicide
-Injuries from self harm
-Abuse of drugs
-Congenital conditions
-Pregnancy conditions
-Child birth conditions
-Radioactive conditions
-Injuries from natural catastrophe
-Injuries incurred from participating from dangerous sports.
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