Jeevan arogya

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Jeevan arogya

  1. 1. What is the situation today What New
  2. 2. The Cost of Health care shooting up exponentiallyPresent Generation spend more on Health Care Next Insure Guru
  3. 3. Health InsuranceHealth Insurance plan must take care1) Daily Expenses in Hospital2) Surgical Expenses3) Out Patient expenses4) All expenses in and out of Hospital5) Waiver of premium during stay at Hospital6) Risk Coverage in case of any exigencies Whether your existing plan offers all the above Insure Guru
  4. 4. LIC’s Jeevan Arogya Insure Guru
  5. 5. LIC’s Jeevan Arogya gives you• Valuable financial protection in case of hospitalisation, surgery etc• Increasing Health cover every year• Lump sum benefit irrespective of actual medical costs• No claim benefit• Flexible benefit limit to choose from• Flexible premium payment options Insure Guru
  6. 6. Benefits Under Jeevan Arogya• Hospital cash benefit (HCB)• Major Surgical Benefit (MSB)• Day Care Procedure Benefit• Other Surgical Benefit• Other Optional benefits(PWB) Insure Guru
  7. 7. Benefits Under Jeevan Arogya• Hospital cash benefit (HCB)• Major Surgical Benefit (MSB)• Day Care Procedure Benefit• Other Surgical Benefit• Ambulance Benefit• Premium waiver Benefit (PWB) Insure Guru
  8. 8. Benefits Under Jeevan Arogya• Hospital cash benefit (HCB)• Major Surgical Benefit (MSB))• Day Care Procedure Benefit• Other Surgical Benefit• Ambulance Benefit• Premium waiver Benefit (PWB) Insure Guru
  9. 9. Benefits Under Jeevan Arogya• Hospital cash benefit (HCB)• Major Surgical Benefit (MSB)• Day Care Procedure Benefit• Other Surgical Benefit• Ambulance Benefit• Premium waiver Benefit (PWB) Insure Guru
  10. 10. Benefits Under Jeevan Arogya• Hospital cash benefit (HCB)• Major Surgical Benefit (MSB)• Day Care Procedure Benefit• Other Surgical Benefit Insure Guru
  11. 11. Benefits Under Jeevan Arogya• Hospital cash benefit (HCB)• Major Surgical Benefit (MSB)• Day Care Procedure Benefit• Other Surgical Benefit• Ambulance Benefit• Premium waiver Benefit (PWB)• Other Optional benefits Insure Guru
  12. 12. Hospital Cash Benefit (HCB)Feature Principal Insured Spouse(If any), Insured Children Insured (PI) Parents/In lawMin Initial Daily Rs. 1000/- Rs. 1000/- Rs. 1000/-BenefitMax Initial Daily Rs. 4000/- Equal or less than PI Equal or less than PIBenefitMax Age for Cover 80 yrs 80 yrs 25 yrs HCB (Within India only) is payable on per day basis. Double the cash benefit for ICU. Max 30 days hospitalization & not more than 15 days in ICU (2 times HCB) for 1st policy year for each one Max 90 days and incl not more than 45 days in ICU in the 2nd year onwards for each insured Limited to a max of 720 days (incl of 360 days for ICU) during entire policy term for each insured HCB to increase 5% till it reaches 1.5 times And arithmetic addition of an amount equal to “No Claim Benefit” Stay in Hospital exceeds a continuous period of 24 yrs or part thereof thereafter. Stay more than 7 days even for 1s 24 hours also payable. Insure Guru Next
  13. 13. Major Surgical Benefit(MSB)Feature Principal Insured Spouse(If any), Insured Children Insured (PI) Parents/In lawSum Assured (MSB 100 times ADB 100 times of ADB of 100 times of ADB ofSA) of PI insured Spouse each childMax Annual benefit 100% of Sum 100% of Sum Assured 100% of Sum Assured AssuredMax Life Time 800% of MSB SA 800% of MSB SA 800% of MSB SA Quick Cash facility: 50% of eligible MSB amount subject to approval from TPA in select Hospitals MSB shall be a percentage of Sum Assured and is payable regardless of actual costs incurred Rs. 1000/- towards Ambulance expenses Premium Waiver benefit for next one year Surgery within India. Insure Guru Next
  14. 14. Day Care Procedure Benefit (DCPB)Feature Principal Insured Spouse(If any), Insured Children Insured (PI) Parents/In lawLump sum benefit 5 times of ADB 5 times of ADB in HCB 5 times of ADB INpayable in HCB HCBMax Annual benefit 3 Surgical ProceduresMax Life Time 24 Surgical Procedures If a DCPB is performed, no HCB shall be paid DCPB is payable as one lump sum and proof of surgery is required All surgical procedures should be done by a Physician or Surgeon, to the satisfaction of the Corporation No transfer of left over benefit to other insured Surgery within India Insure Guru Next
  15. 15. Other Surgical Benefit (OSB)Feature Principal Insured Spouse(If any), Insured Children Insured (PI) Parents/In lawDaily Benefit amount 2 times of ADB 2 times of ADB 2 times of ADBMax Annual benefit 15 Days in Year 1 and 45 days per year thereafterMax Life Time 360 days OSB is payable as daily benefit Proof of surgery done by a Physician or Surgeon, is subject to the satisfaction of the Corporation No transfer of left over benefit to other insured Surgery required but not listed under MSB or DCPB Next Insure Guru
  16. 16. Other Options Accident Benefit RiderTerm Rider BenefitMin Term Assurance SA: Rs. 100000/- Min AB SA: Rs. 25000/-Max Term Assurance SA: Equal to MSBSAMin Entry Age: 18 Years completed Max AB SA: Equal toMax Entry Age: 50 Years NBDMax Maturity Age: 60 Years NBD Term Assurance SAMax Term: 35 Years(SA be in multiples of Rs. 25000/-) AB SA shall be in multiples of Rs. 5000/- Insure Guru
  17. 17. Other Benefits Contd…….Death Benefit:• No death benefit unless TA Rider benefit is opted forOn death of the Principal Insured(PI)• Surviving Insured Spouse will become PI, if already option given at the beginning of contract• If the Insured Spouse had predeceased the PI, Then the other Insured will have the option to take new policy on following conditions – The new policy will be issued without any underwriting if the new policy is bought within 90 days of the termination of the existing policy – The maximum entry age will not apply for the new policy – The outstanding Waiting periods and outstanding period of any Exclusion will however apply under the new policy – Other terms and conditions including premium rates will be as applicable for the new policyMaturity Benefit: No benefits are payable at the end of the cover period Insure Guru
  18. 18. Feature Eligibility Conditions Principal Parents & Parents-in- Insured Children Insured law (PI)/Insured SpouseMinimum Entry Age 18 Yrs LBD 18 Yrs LBD 3 Months(Completed)Maximum Entry Age 65 Yrs LBD 75 Yrs LBD 17 Yrs LBDMax Cover ceasing 80 Yrs 80 yrs 25 yrsageDate of cover expiry Policy anniversary on which the Insured life attains Maximum coverin respect of each ceasing ageInsured coveredunder the planNominations AllowedAssignments1s 24 hoursNot Allowed s even for also payable.Mode of Premium Yearly, Half Yearly and Monthly(ECS Only)Grace Period 30 days for Yearly , Half Yearly mode and 15 days for Monthly ModeRevival Period 2 Years from due date of FUP Insure Guru
  19. 19. Points to be noted• Premium guaranteed for first 3 years and may be revised after every 3 years based on Health conditions• All existing members must be added in first instance. New members can be added through Child birth (Children)-3 Months, Marriage (Spouse, Parents-in-law)- 6 Months from next Policy anniversary Insure Guru
  20. 20. Points to be noted Contd………Waiting Period• 90 days from DOC other than accidental bodily injury• 45 days from DOR, if request for revival recd within 90 days from the due date of FUP• 90 days from DOR, if request for revival recd beyond 90 days from the due date of FUPSpecific Waiting Period (treatments)• 2 years from Date of Cover Commencement• 2 Years from DOCC, if request for revival recd within 90 days from the due date of FUP• 2 Years days from DOR, if request for revival recd beyond 90 days from the due date of FUP Insure Guru Next
  21. 21. Treatments in respect of Specific waiting periodi. Treatment for adenoid or tonsillar disordersii. Treatment for anal fistula or anal fissureiii. Treatment for benign enlargement of prostate glandiv. Treatment for benign uterine disorders like fibroids, uterine prolapse,dysfunctional uterine bleeding etcv. Treatment for Cataractvi. Treatment for Gall stonesvii. Treatment for slip discviii. Treatment for Pilesix. Treatment for benign thyroid disordersx. Treatment for Herniaxi. Treatment for hydrocelexii. Treatment for degenerative joint conditionsxiii. Treatment for sinus disordersxiv. Treatment for kidney or urinary tract stonesxv. Treatment for varicose veinsxvi. Treatment for Carpal tunnel syndrome Enter Pleasexvii. Treatment for benign breast disorders e.g. fibroadenoma, fibrocystic disease etc Insure Guru
  22. 22. Points to be noted Contd………Termination of PolicyIf policy is issued on a single life• Non Payment of premium within revival period• On death• On Date of cover expiry• On exhausting all the life time maximum Benefits Limits as specified aboveIf policy is issued on more than one life• Non Payment of premium within revival period• On death or Date of cover expiry of the PI and if the Policy does not continue with the IS as the PI• On death or Date of cover expiry of IS after Policy continues with the IS as the PI after the PI dies or reaches his/her Date of cover expiry• On PI exhausting all the life time maximum Benefits Limits as specified above Insure Guru
  23. 23. What is different from Mediclaim• Pre defined benefit- No reimbursement, but lump sum paid based on pre-defined benefit• Not based on expenses incurred• This will tend to indirectly reduce the Health care cost, which is rising due to cash less mediclaim benefit• All benefit is dependent on HCB Insure Guru
  24. 24. Why wait GetLIC’s Jeevan ArogyaEnjoy Your Life with your family Insure Guru

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