Lic health protection plus 902

LIC’s HEALTH PROTECTION PLUS
(PLAN NO 902)
A UNIQUE & COMPLETE HEALTH PLAN
FOR YOU
&
YOUR FAMILY MEMBERS
( Launched on 29th April 2009)

THIS PLAN
PROVIDES
SAFETY OF HEALTH
ALONG WITH
ATTRACTIVE INVESTMENT OPTION

UNIT-LINKED HEALTH PLAN
BENEFITS AVAILABLE
1. HOSPITAL CASH BENEFITS (HCB)
2. MAJOR SURGICAL BENEFITS (MSB)
3. DOMICILIARY TREATMENT BENEFITS (DTB)

ELIGIBILITY
- PRINCIPAL INSURED, SPOUSE & CHILDREN ARE
ELIGIBLE AND CAN BE INCLUDED AT INCEPTION
ONLY.
- ADDITION OF MEMBERS IS ALLOWED ONLY IN CASE
OF ADOPTION /NEW BORN / MARRIAGE.

ELIGIBILITY
ENTRY AGE - 18 YRS (LBD) - 55 YRS (NBD)
(FOR PRINCIPAL INSURED/SPOUSE)
- 3 MONTHS (COMPLETED) – 17 YRS ( NBD)
(FOR CHILDREN)
MAXIMUM PREMIUM
CEASING AGE - 65 YRS (NBD) FOR PRINCIPAL INSURED

MINIMUM PREMIUM
(FOR STANDARD LIVES)
If policy is issued on single life-
Higher of - 5,000/- p.a. and 6 times the Hospital Cash Benefit (HCB) of PI
If policy is issued on 2 lives-
Higher of- 7,500/- p.a. and the arithmetic sum of 6 times the HCB of PI and
3 times the HCB of other Insured
If policy is issued on more than 2 lives-
Higher of- 10,000/- p.a. and the arithmetic sum of 6 times the HCB of PI and
3 times the HCB of each of the other Insured.
(MAXIMUM PREMIUM – NO LIMIT)

MODE OF PAYMENTS
- YLY,HLY OR MLY(ECS ONLY) MODE AVAILABLE
- NO MODE REBATE
DAYS OF GRACE
FOR YLY/HLY MODE :
ONE CALENDER MONTH (NOT LESS THAN 30
DAYS)
FOR MLY(ECS) : 15 DAYS

Hospital Cash Benefit (HCB)
FIRST YEAR – TOTAL 18 DAYS (INCL 9 DAYS IN ICU)
LATER YEARS- TOTAL 60 DAYS(INCL 30 DAYS IN ICU)
( 365 DAYS IN TOTAL DURING POLICY LIFE- 90 DAYS FOR CHILDREN
UNTIL AGE 5)
(5% INCREASE EVERY YEAR SUBJECT TO MAX 1.5 TIMES OF HCB)
AMOUNT OPTED AT THE TIME OF PROPOSAL WILL BE CALLED INITIAL
DAILY BENEFIT (IDB)
MINIMUM PER DAY MAXIMUM PER DAY
PI 250/- 2500/-
SPOUSE 250/- 1500/-
CHILDREN 250/- 1500/-
(DOUBLE IN CASE OF ICU)

HCB (Contd.)
WAITING PERIOD
- 180 DAYS ( NOT APPLICABLE IN ACCIDENT)
- 90 DAYS ( AFTER REVIVAL)
- NO BENEFIT IN FIRST 48 HOURS OF HOSPITALISATION

BENEFITS
MAJOR SURGICAL BENEFITS(MSB)
SUM ASSURED OF POLICY – 200 X IDB
MAXIMUM MSB IN ONE YEAR – 100% SUM ASSURED
DURING TOTAL POLICY TERM – MAXIMUM 3 TIMES OF
SA PER MEMBER
WAITING PERIOD :
180 DAYS - ( NOT APPLICABLE IN ACCIDENT)
90 DAYS - ( AFTER REVIVAL)
ELIGIBILTY FOR CHILDERN
- ON COMPLETION OF 18 YEARS

(Contd.)
BENEFITS (MSB)
RATE FOR REIMURSEMENT
100% , 60% & 40% OF S. A. AS PER SURGICAL PROCEDURES
Example :
100 % SA for Open chest surgery for repair of any of the heart valves
60 % SA for Total Replacement of Hip or knee joint following accident
40 % SA for Partial excision of Thyroid gland
BENEFITS AVAILBLE UPTO AGE 75 FOR PI/SPOUSE AND 25 YEARS FOR CHILDREN
(FOR COMPLETE DETAILS ,SEE ORIGINAL CIRCULAR)

BENEFITS
DOMICILIARY TREATMENT BENEFITS (DTB)
- ACTUAL EXPENSE SUBJECT TO MINIMUM- 2500/-
- PAYABLE NOT MORE THAN 50% OF POLICY FUND
- MAXIMUM TWICE IN A YEAR
- ADMISSIBLE ONLY AFTER THREE YEARS PREMIUM IS PAID
- THERE SHOULD BE MINIMUM ONE YEAR BALANCE IN POLICY FUND
- BENEFITS WILL STOP AT EARLIER OF
1. FUND BEING EXHAUSTED
2. DEATH OF ALL INSURED OR
3. CHILDREN ATTAINING 25 YEARS OF AGE

BENEFITS PAYABLE ON DEATH
DEATH OF PI(SINGLE LIFE)/DEATH OF ALL MEMBERS
–FUND VALUE TO NOMINEE OR LEGAL HEIR
DEATH OF PI(OTHER MEMBERS ALIVE) – PREMIUM STOPS, COVER ON
ALL MEMBERS CONTINUES
DEATH OF INSURED MEMBER(S), OTHER THAN PI – THE PAYMENT OF PREMIUMS AND
COVER FOR PI AND OTHER INSURED MEMBERS, IF ANY, SHALL CONTINUE.
DEATH OF PI AND SPOUSE - THE BENEFITS FOR CHILDREN SHALL CONTINUE
AND CAN BE CLAIMED BY THE ELDEST MAJOR CHILD COVERED UNDER
THE POLICY. IF ALL THE CHILDREN COVERED ARE MINOR, THEN
BENEFITS WILL BE CLAIMED BY THE LEGAL GUARDIAN.

OTHER FEATURES
- AS DTB CAN BE AVAILED AFTER PAYMENT OF 3
YEARS PREMIUM,
- NO SURRENDER ALLOWED ,
- NO PARTIAL WITHDRAWAL ALLOWED ,
- NO LOAN ALLOWED
,- REVIVAL WITHIN TWO YEARS OF FUP ,
- NO SWITCHING OF FUND AVAILABLE

Contd.
OTHER FEATURES
- PREMIUM HOLIDAY – POLICY CAN BE REVIVED BY PAYING ONLY
LATEST INSTALMENT PREMIUM PROVIDED THREE YEARS PRM
ALREADY PAID AND BALANCE IN FUND IS ATLEAST EQUAL TO
ONE ANNUALISED PREMIUM.
- NO BACK DATING ALLOWED.
- COOLING OFF- 15 DAYS
- NO ASSIGNMENT ALLOWED .

HEALTH PROTECTION PLUS FUND
CHARGES
Allocation Charges – 30% in first yr and thereafter 6%
Policy Administration Charges – 75/- pm during first policy year &
25/- thereafter
Fund Management Charges – 1.25% pa of unit fund
HCB/MSB Premium - based on age (monthly)
For Children –MSB Charges start from 18 Yrs of age)
(Service Charges Appplicable)

FUND DETAILS
PREMIUMS COLLECTED WILL BE INVESTED AFTER
DEDUCTION OF VARIOUS CHARGES
- INVESTMENT IN GOVT/GOVT GUARANTEED SECURITIES/CORP DEBT
NOT LESS THAN 50%
- SHORT TERM INVESTMENTS(MONEY MKT,GOVT SECS,CORP DEBT)
NOT MORE THAN 90%
- INVESTMENT IN LISTED SHARES
BETWEEN 10% TO 50%
( NAV ON DAILY BASIS )
OBJECTIVE- INCOME & GROWTH WITH LOW RISK

REVIVAL/REINSTATEMENT
DUE PREMIUM NOT PAID – CHARGES FOR HCB/MSB AND
OTHERS WILL BE DEDUCTED FROM POLICY FUND, IF
AVAILABLE .
IN CASE OF INSUFFICIENT FUND IN POLICY FUND, THE
COVER OF HCB/MSB WILL BE WITHDRAWN & POLICY
WILL BE TERMINATED .

PROPOSAL FORM
- OLD FORMS OF PLAN 901 CAN BE USED WITH
MODIFICATION ,
- CHANGE OF NAME /PLAN NO AT EVERY PLACE ,
- ITEM “H” – CHANGE TO “ HEALTH PROTECTION
PLUS FUND”
PREVIOUS INSURANCE DETAILS
AS PER ANNEXURE IV FOR ALL LIVES.

TAXATION
PREMIUM PAID UNDER THE POLICY
WILL BE ELIGIBLE FOR TAX REBATE
UNDER SECTION 80(D) OF I.T.ACT.

UNDERWRITING
FOR
UNDERWRITING
FEATURES
FOR

UNDERWRITING
FOR
SUM UNDER
CONSIDERATION(SUC)
-Sum Assured for MSB granted under policies taken under
plan 901/902 only for the last 2 years will be clubbed as
SUC.
- Other plans will not be clubbed.
SUC WILL BE BASIS FOR
- calling for special reports ,
- determining the limit of medical examiners ,
- determining non-medical eligibility.

UNDERWRITING
FOR
AGE PROOF
Only Standard Age proof & NSAP-I
(NSAP-I – NO TERM RESTRICTION OF 25 YEARS)

UNDERWRITING
FOR
NON-MEDICAL SCHEME
NON-MEDICAL ( SPECIAL & GENERAL(PROFESSIONALS))
NON-MEDICAL ( GENERAL TO OTHERS)
Age Nearer Birthday Sum Under Consideration
Up to 45 Yrs Rs. 5 Lacs
Ages between 46 and 50 years Rs. 4 Lacs
Sum Under Consideration
Age Nearer Birthday SAP NSAP-I
Up to 35 Yrs Rs. 4 Lacs Rs. 3 Lacs
Ages between 36 and 45 years Rs. 2 Lacs Rs. 1 Lacs
Ages between 46 and 50 years Rs. 1 Lacs Rs. 50,000/-

UNDERWRITING
FOR
SPECIAL MEDICAL REPORTS
Sum Under Consideration Up to 35 36 to 45 46 to 50 51 to 55
50000 to 100000 FMR FMR FMR FMR FBS RUA
100001 to 200000 FMR FMR FMR FBS RUA
FMR FBS RUA
ECG HBA1C
200001 to 300000 FMR
FMR FBS
RUA
FMR FBS RUA
ECG HBA1C
FMR FBS RUA
ECG HBA1C
300001 to 500000 FMR
FMR FBS
RUA ECG
HBA1C
FMR FBS RUA
ECG HBA1C
FMR FBS RUA
ECG HBA1C
CTMT
500001 to 1000000 FMR
FMR FBS
RUA ECG
HBA1C
FMR FBS RUA
ECG HBA1C
LIPIDOGRAM
FMR FBS RUA
ECG HBA1C
LIPIDOGRAM

LIC’s HEALTH PROTECTION
PLUS
ILLUSTRATION
FOR CHARGES & BENEFITS ON PREMIUM OF 15,000/-
IDB=2,500/- ON AGE OF 35,45 & 50 SA=200 X
IDB=5 LACS
AGE 35 45 50
HCB PREMIUM CHARGES 839.75 1232.25 1521
MSB PREMIUM CHARGES 790 1770 2675
SERVICE TAX 162.98 300.23 419.6
EDUCATION CESS 4.89 9.01 12.59
TOTAL RISK PREM 1797.61 3311.48 4628.19
POL ALLOCATION CHARGES 4500 4500 4500
POL ADMIN CHARGES 900 900 900
SERVICE TAX+ EDUC CESS 556.2 556.2 556.2
INVESTIBLE FUND 7246.19 5732.32 4415.61
TOTAL NON-RISK PRM 13202.4 11688.5 10371.81
HCB/DAYS AVAILABLE IN 1ST YEAR 18 18 18
HCB AMOUNT IN 1ST YEAR(INCL ICU) 67500 67500 67500
HCB/DAYS AVAILABLE IN 2ND YEAR 60 60 60
HCB AMOUNT IN 2ND YEAR(INCL ICU) 236250 236250 236250
MAX MSB PER YEAR 500000 500000 500000
TOTAL MSB DURING POLICY TERM 1500000 1500000 1500000

ILLUSTRATION
AGE OF PI=40 & HCB OPTED = 2000/-
AGE OF SPOUSE=35 & HCB OPTED = 750/-
AGE OF ONE CHILD=10 & HCB OPTED = 250/-
HCB PREMIUM CHARGES 1034.73
MSB PREMIUM CHARGES 1158.50
SERVICE TAX 219.32
EDUCATION CESS 6.58
TOTAL RISK PREM 2419.13
POL ALLOCATION CHARGES 4500
POL ADMIN CHARGES 900
SERVICE TAX+ EDUC CESS 556.2
INVESTIBLE FUND 6624.67
TOTAL NON-RISK PRM 12580.87
HCB/DAYS AVAILABLE IN 1ST YEAR 18,18,18
HCB AMOUNT IN 1ST YEAR(INCL ICU) 54000,20250,6750
HCB/DAYS AVAILABLE IN 2ND YEAR 60,60,60
HCB AMOUNT IN 2ND YEAR(INCL ICU) 189000,70875,23625
MAX MSB PER YEAR 400000,150000,50000
TOTAL MSB DURING POLICY TERM 1200000,450000,150000

ILLUSTRATION
AGE OF PI=40 & HCB OPTED = 2500/-
AGE OF SPOUSE=35 & HCB OPTED = 1500/-
AGE OF ONE CHILD=10 & HCB OPTED = 1000/-
HCB PREMIUM CHARGES 1587.95
MSB PREMIUM CHARGES 1645.00
SERVICE TAX 323.30
EDUCATION CESS 9.70
TOTAL RISK PREM 3565.94
POL ALLOCATION CHARGES 6750
POL ADMIN CHARGES 900
SERVICE TAX+ EDUC CESS 787.95
INVESTIBLE FUND 10496.11
TOTAL NON-RISK PRM 18934.06
HCB/DAYS AVAILABLE IN 1ST YEAR 18,18,18
HCB AMOUNT IN 1ST YEAR(INCL ICU) 67500,40500,27000
HCB/DAYS AVAILABLE IN 2ND YEAR 60,60,60
HCB AMOUNT IN 2ND YEAR(INCL ICU) 236250,141750,94500
MAX MSB PER YEAR 500000,300000,200000
TOTAL MSB DURING POLICY TERM 1500000,900000,600000

UNDERWRITING
FOR
LIC’s HEALTH PROTECTION PLUS – PLAN
902
USP
- CLAIMS AMOUNT RECEIVED UNDER HCB/MSB ARE
INDEPENDENT OF
CLAIMS/REIMBURSEMENT RECEIVED FROM ANY OTHER
INSURANCE
COMPANIES
- BENEFIT AVAILABLE UNDER HCB/MSB ARE INDEPENDENT OF
ACTUAL EXPENDITURE INCURRED.
- A PERSON CAN TAKE A HEALTH PROTECTION PLUS PLAN FOR
5 LACS
EVEN IF HE HAS TAKEN A HEALTH PLUS POLICY FOR 5
LACS. THUS
THE MAXIMUM HEALTH INSURANCE THAT CAN BE ALLOWED
ON ONE

(PLAN NO 902)
THANK YOU

Lic health protection plus 902

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