Introducing JEEVAN AROGYA Table 903: New Health Benefit Plan
Health Insurance, Central Office, Hyderabad
Comprehensive
insurance for an
entry level car in
India is
approximately
Rs.12000/- and goes
up to Rs.20000/- for
mid level cars
Comprehensive insurance for a motorcycle is
approximately Rs.1500/-
That is all it takes for you and your family to be free from all hospitalization worries every year with LIC’s
Jeevan Arogya
YES
Total family hospitalization & surgical insurance for the price of your car insurance…
Because we believe you love your family more than your vehicle
A little bit
Special Attractions• Benefit payout is fixed irrespective of actual
expenses incurred. • Can be availed along with Medi-claim for the
same Hospitalization/ Surgery• On the basis of Xerox copies of Bills• Guaranteed Premium for 3 years. • Auto Renewal Date (ARD) after each 3 Yrs
to revisit Premium depending on experience. • New Premium rate applicable on age at entry
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Special Attractions1. Hospitalization Cash Benefit (HCB) : Rs.1000, 2000, 3000, 4000 PER DAY
• Up to Rs. 4000 per day for maximum no. of 720 days• Up to Rs. 8000 per day for max. no. of 360 days in ICU
2. Major Surgical Benefit (MSB) :100 times HCB/ADB• No of Surgeries increased to 140• MSB available for Minors also• MSB Benefit is in addition to MSB under Plan 901/ 902
3. Day Care Procedures (DCPB) : 5 times HCB/ADB• Addition of 140 Surgeries, 3 in a year, 24 in life-time
4. Other Surgical Benefit (OSB) : 2 times HCB/ADB• All other Surgeries covered
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USPsOther Benefits:
5. Premium Waiver Benefit : One annualized premium
w.e.f next instalment Premium following Surgery
• PWB under 57 Surgeries (15 Surgeries 100% + 42 60% S.A.)
6. Ambulance Expense @ Rs.1000 p.a per person
for 57 Surgeries (15 Surgeries 100% + 42 60% S.A.)
7. Auto increase @ 5% in both HCB & MSB up to 50%
even if there is any claim to take care of inflation
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USPs 8. Quick Cash : • 50% Advance Payment under 57 Surgeries
• (15 Surgeries 100% + 42 60% S.A under MSB only)
• Performed in Net Work Hospitals
9. No Claim Benefit• 5% of Initial HCB on ARD is added without any upper limit10. Term Assurance & Accident Benefit Riders : (Optional )• Up to 25/ 50 lacs respectively till age 60 years Maximum term 35 years. S.A.= MSB S.A. Minimum S.A. for Term Rs.1 lac, For A.B. Rs.25,000
Special Attractions• Age at entry for PI and Spouse from 18 to 65 Yrs
• For Parents/ Parents-in-laws 18 to 75 Yrs• For Children 91 days to 17 Yrs
• Maximum Health cover for every one up to 80 Yrs • Except up to max. 25 Yrs for dependent Children
• Risk cover up to 4 lacs per insured Subject to overall limit of 10 lacs
• (All our Health Policies put together)
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HCB limits for each Insured• P.I As per his/her choice
• Spouse < or = P.I
• Children < or = Spouse / < or = P.I if no spouse
Children to have equal HCB
• Parents < or = Insured• Parents in law < = Insured • Parents/ Parents in law to have equal HCB
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HCB : Benefits at a glance HCB increases by 5% every year Up to1.5 times.Eg. Rs 1000/- after 1 Yr becomes Rs.1050 and in the 11th Year becomes Rs.1500/-(Max) • Hospitalization eligibility condition: Fraction of 4 Hours treated as a day First 28 hrs eligible for 1 day benefit First 24 hours : No benefit Exception: When hospital stay exceeds continuous period of 6 days and 4 hours, HCB for 7 days (including 1st day also) is allowed
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HCB : Benefits at a glanceAnnual limit
for each insuredMaximum limit for each
insured during entire policy term
1st policy year 30 days of hospitalization of which 15 days of ICU is allowed.subsequent years Each year- 90 days of hospitalization of which 45 days of ICU is allowed.
720 days .of which360 days of ICU allowed
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MSB- Benefits at a glance
• MSB allowed for 140 surgical procedures
• 100% SA 15, 60% SA 42, 40% SA 60, 20% SA 23 Annual Limit • 100 times of HCB in a policy year (Max. 4 lacs)
Life time Limit • 800 times HCB in full policy term (Max. 32 lacs)
Day Care Procedure Benefit (DCPB)• DCPB = 5 X HCB
• 140 Listed day care procedures
• 3 Day care Procedures per year
• 24 Day care Procedures in Policy Life time
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Other Surgical Benefit (OSB)
OSB = 2 x HCB
• Any surgery other than MSB, DCPB
• At least 24 hours stay in Hospital required
• Annual limit : 15 days in 1st policy year• 45 days in each subsequent years
• Life time limit : 360 days per Insured14
Term Assurance Benefit Rider Minimum Term Assurance SA : Rs. 1,00,000 Maximum Term Assurance SA : Equal to initial MSB-SA (i.e.,100 X HCB ) Term Assurance SA : in multiples of Rs.25000/-
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Minimum Entry Age 18 Yrs completed
Maximum Entry Age 50 Yrs (NBD)
Maximum age for cover 60 Yrs (NBD)
Maximum Term 35 Years
Accident Benefit RiderThis benefit available if Term Assurance Benefit rider opted Minimum Benefit : Rs. 25,000 Maximum Benefit : Equal to initial MSB-SA ( i.e.,100 X HCB) AB Sum Assured shall be in multiples of Rs.5000/-
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Minimum Entry Age 18 Yrs completedMaximum Entry Age 50 Yrs completedMaximum age for cover 60 Yrs completedMaximum Term 35 Years
Quick Cash facility
• Advance 50% of MSB amount to PI
• Category I or II Surgeries
• Hospitalized in a ‘Net work’ Hospital
• PI/ Relative informs LIC/TPA
• TPA processes request/ advices LIC on payment
• LIC credits eligible amount to PI Bank account
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Ambulance charges
• Rs. 1000/- reimbursed per insured per Year towards Ambulance charges
• Ambulance charges incurred for transportation of the insured to undergo Major Surgeries under category 1 or 2
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No Claim BenefitDuring the period between two Automatic
Renewal Dates or from DOC to next Automatic Renewal Date, if there are no claims in respect of any insured, No claim Benefit is payable
No claim benefit would be equal to 5% of initial Daily Benefit
Effective from the immediately following automatic renewal date
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USPs
Premium rate may be reviewed for every 3 years
If revised, the new rate corresponding to the age at entry of each insured will be the new premium
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Illustration-1 Example PI takes a Policy in 2011 Age of PI in 2011 = 36 If premium revised in 2014
The new premium rate of PI will be the revised premium corresponding to age 36 in the new table.
Rebates available on Tabular premiumsMode
Rebate Rebate for HCB Opted
Hly Yly
2000 HCB 3000HCB 4000HCB
PI others PI others PI others
1% 2% Rs.500 Rs.250 Rs.1000 Rs.500 Rs.1500 Rs.750
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Addition of members
Condition When to include
The cover starts from
Marriage/remarriage of the Principal Insured after DOC
Within 1 Year from the date of marriage
The following policy anniversary
A Child born or Legally adopted child after DOC
Health Cover starts from the policy anniversary falling immediately after the child completes 3 months
Legally adopted child is more than 3 months old
From the policy anniversary falling after date of adoption
New members must be included by the Principal Insured only. No new members will be allowed after the death of the principal insured.
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The policy lapses…
• When premium is not paid within days of grace, the policy lapses and no benefits will be payable there after .
• Policy can be revived within 2 years from the date of first unpaid premium subject to payment of outstanding premiums with interest and underwriting.
• Others : Loan Facility is not there• Assignment facility is not there
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The waiting Period foravailing the benefits……………….
0 days for accident claims 90 days from the Date of Commencement for
HCB & MSB
45 days after revival, if revived within 90 days from FUP of the policy. for Hospital Cash Benefit and Major Surgical Benefit
90 days if revived after 90 days from FUP
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Nature of Benefit 1st Pol Year (Rs)
2nd Pol Year (Rs)
Max. eligibleDuring the Policy
term (Rs)Hospital Cash Benefit (HCB) including ICU Benefit 45,000 1,41,750 16,20,000
Major Surgical Benefit (MSB) 1,00,000 1,05,000 12,00,000Other Surgeries Benefit (OSB) 30,000 94,500 10,80,000Day Care Procedure Benefit (DCPB) 15,000 15,750 1,80,000
Maximum Benefit under the policy per insured 40,80,000
Ambulance Charges incurred Rs.1000/- per insured per year Premium Waiver Benefit One Year PremiumNo Claim Benefit Increase in HCB by 5%
Benefit Illustration – for HCB 1000
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Total Premium (Rs.) Total Maximum Benefits(Rs)Insured/ Age/ Term 4000 HCB1. Male-PI-45/35 3,90,622 (4 lacs) 1,68,72,000 (1.7 cr.)2. Spouse-40/35 2,81,160 1,68,72,0003. Son-17/8 22,983 1,21,92,0004. Daughter-10/15 36,516 1,59,20,0005. Parent1-70/10 2,34,146 1,43,48,0006. Parent2-65/15 2,16,900 1,59,20,0007. Parent inlaw M-65/15 3,06,208 1,59,20,0008. Parent inlaw F-60/20 2,62,293 1,59,20,000Total Premium Paid Rs.17,50,829 Less IT Rebate Rs.2,47,163 Net Premium Paid / Total Maximum Benefits Rs.15,03,666
Rs.12,39,64,000
Total Premium/ Benefit Rs.15 lacs Rs .12.5 crore
Cost/ Benefit Illustration : 8 lives
Product Positioning
• Vis-à-vis Medi-claim • As no Maturity/ Saving/ Unit Investment/ Withdrawal
element• Long term up to 80 yrs cover
• Auto Renewal Premium after each 3 years applicable on age at entry throughout term of policy
• Market Segment :Everyone & Anyone
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THANK YOU