LIC Health Insurance Policy – Jeevan Arogya – Should you opt?
LIC Health Insurance Policy – Jeevan Arogya Review
Health has been a major issue of concern for everyone. Health insurance plan is an effective tool to reduce the financial burden in case of hospitalization. LIC Jeevan Argoya Plan is a unique health insurance plan that comes with several good features and benefits. It also has a few riders that can be considered on need basis. In this article we would provide LIC Health Insurance Jeevan Argoya Plan details, its features, premium, exclusions and do the review.
Also Read: What is Incurred Claim Ratio in Health Insurance Plans?
Overview about LIC Jeevan Arogya
The Jeevan Arogya Plan allows you to choose the level of health cover in the form of Initial Daily Benefit according to your need. The options available are Rs. 1,000 per day, Rs. 2,000 per day, Rs. 3,000 per day, Rs. 4,000 per day. This is the sum payable to you per day in case of hospitalization during the first year of policy coverage.
In addition to the above, many major surgeries are also included in the coverage up to 100 times the Initial Daily Benefit you have chosen. Thus, the Initial Major Surgical Benefit Sum Assured will be Rs. 1 lakh, 2 lakh, 3 lakh, and 4 lakh respectively.
Features of LIC Health Insurance – Jeevan Arogya Plan
The distinctive features of the Jeevan Arogya plan are as under-
1) Jeevan Arogya Plan is a non-participating and non-linked plan that provides a comprehensive health insurance cover against certain specified health risks.
2) The policy has defined benefits. As benefits are pre-defined, so they are not linked to actual expenses.
3) The plan can be taken for the extended family like parents or parents-in-law.
4) All types of surgeries including daycare Treatments are covered under this policy.
5) You are eligible for a No Claim Bonus.
6) The payment of premiums can be paid on a regular basis over the term of the policy either yearly or half-yearly. A grace period of 30 days is also provided for the same.
7) The total premium to be charged for the policy will be the sum of premiums in respect of each member to be covered in that policy.
8) An additional Critical Rider Illness Benefit is also offered along with Critical Illness being covered.
9) If you are not satisfied with the terms and conditions of the plan, you can return the policy to the company within 15 days from the date of receipt of the policy. The corporation will cancel the policy and return the premium.
10) The plan offers the facility of claiming the policy by filing a cashless claim or a reimbursement claim. The cashless claim can be filed for both planned and emergency hospitalization.
11) No loan facility can be availed against this policy.
12) No assignment can be allowed under this plan.
Benefits offered in LIC Jeevan Arogya Health Insurance Plan
The various benefits offered under this plan have been described below-
1) Hospital Cash Benefit (HCB) – If any of the insured life is hospitalized due to accidental body injury or sickness and the stay exceeds more than 24 continuous hours or part thereof, provided that any such part stay exceeds a continuous period of 4 hours in a non-ICU ward or room of a hospital, the Hospital Cash Benefit is payable.
2) Major Surgical Benefit (MSB) – Under this benefit, the insured person is covered for any major medical surgery defined in the Major Surgical Benefit Annexure within the covered period in a hospital due to accidental body injury or sickness.
3) Day-care procedure benefit – For all Day Care Procedures falling under this policy, to take care of the insured’s medical needs, a lump sum amounting to 5 times the Daily Benefit would be paid regardless of the actual cost incurred.
4) Other Surgical Benefit – If any surgery is performed upon the policyholder that is not covered under the policy, then a daily benefit amounting to double the applicable Daily Benefit would be paid out for each extended period of 24 hours.
5) Ambulance Benefit – A lump sum amount of Rs. 1,000 is paid for emergency transportation costs for the ambulance whenever a major surgery is not successful.
6) Premium Waiver Benefit – Under any of such events where the Major Surgical Benefits are not successful, the company would be waiving off the total annualized premium of one year.
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Who is eligible for LIC Health Insurance – Jeevan Arogya Plan?
It is a comprehensive health plan that can cover self, spouse, children, parents, and parents-in-law, all in one plan. Here is the eligibility criteria.
For self and spouse:
- The minimum age required for enrollment is 18 years.
- The maximum age permitted is 65 years.
- The maximum age of coverage is 80 years.
For parents and parents-in-laws:
- The maximum age permitted for their enrollment in the plan is 65 years.
- The maximum age of coverage is 80 years.
- The minimum age required for enrollment is 91 days.
- The maximum age permitted for enrollment is 17 years.
- The maximum age of coverage is 25 years.
Are there any IT exemptions available in LIC Jeevan Arogya Health Insurance Plan?
The premium paid for the Jeevan Arogya Plan is eligible for deduction under section 80D of the Income Tax Act, 1961 up to Rs. 25,000 for normal people and Rs. 50,000 for senior citizens.
Are there any riders in LIC Health Insurance – Jeevan Arogya Plan?
Here are the riders in this plan:
1) Accident Benefit rider: Jeevan Arogya Health Insurance Plan can be enhanced by attaching the Rider of Accident Benefit Rider. Under this rider, an additional premium of Rs 0.50 for every Rs. 1,000 is to be paid every policy year in respect for each life covered. In case of unfortunate death due to an accident, an amount equal to Accident Benefit Sum Assured shall be payable.
2) New Term assurance rider: One more rider that can be attached to the policy of principal insured and /or his spouse is New Term Assurance Rider equal to the MSB Sum Assured. In case of unfortunate death, an amount equal to Term Assurance Sum Assured will be payable on death during the term for which Term Assurance Rider has opted for.
What are the sample premiums?
It is an insurance plan in which the entire family can be covered. The premium rates are different for all. LIC Health Insurance Premium calculator would help you to know approx. rates under this health plan. It would also help you to know premiums for the LIC Health insurance policy for a family.
|Age at enrolment||Premium for Principal Inssured (male)||Premium for spouse (female)/Parent of PI/Spouse (Female)||Child|
What are the exclusions in LIC Jeevan Arogya Health Insurance Plan?
There are always some exclusions in the Health Insurance Plan. Here are the major exclusions in this plan.
- Pre-existing diseases and any related complications arising thereof.
- AIDS/HIV related diseases
- Organ donor expenditure
- Dental Treatment
- Nervous or mental treatment
- Hospitalization and injuries related to war, civil or criminal proceedings
- Injury or sickness due to consumption of alcohol or drugs
- Suicide or injury or sickness due to an attempt of suicide.
- Genetic or congenital disorders or birth defects unless expressly covered under the plan
- No- allopathic treatments
- Injury and hospitalization owing to prolonged childbirth or pregnancy
- Injuries arising due to adventurous sports like bungee jumping, sky diving, martial arts, Paragliding, mountaineering, hunting, scuba diving, racing, etc.
Where can I check the LIC Health Insurance Plan claim forms?
You can download LIC Jeevan Argya claim form here.
What is LIC Health insurance contact number?
You can contact LIC Call Center at 022 6827 6827 for more info.
Also Read: Best Health Insurance Plans for parents in India
LIC Health Insurance Policy – Jeevan Arogya – Should you opt?
If you review the pros and cons, Jeevan Arogya Plan from LIC is a comprehensive non-linked and non-participating health insurance plan to combat the rising costs of the health care. The plan is a complete package for an individual that can be opted for immediate as well as an extended family too. From financial benefits to increased health cover, lump-sum benefit to NO Claim Benefit, the policy has it all. Premiums are little high compared to other health insurance plans offered by private insurance companies. Other than this, there are no other major negative factors in this health insurance plan.
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LIC Health Insurance Policy – Jeevan Arogya Plan
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Dear Suresh Ji
Recently I met the LIC Person He told Following Information about the Health /Arogya Policy:
1. This Policy can be used for Secondary Policy.
2. Even if we claimed Hospitalization charges through primary health policy (summited the original Bills).
3. using the Xerox One more time we can Claim the LIC Arogya policy and it is not called the original bills.
4. Amount Will be paid to Account Holder not to Hospital.
Do not Know How much it is correct is it possible to make two claims ?
Veera, Many insurance agents would try to attract policy holders with all these gimmicks. 1) You can consider this as secondary health policy – Good 2) When you claim first time through cashless (assume), there is record with both hospital and insurance company that it is paid directly to hospital. There is no way you can claim again with any other method. 3) Assume, policy holder makes payment and want to claim later. In this case, any insurance company would ask for original bills. If policy holder claims with one insurance company with original bills, insurance company would approach hospital, would verify and get their signatures and then process the payment. There is no way one can claim with xerox bills (unless during covid time where insurance companies relaxed rules) with secondary insurance company, unless policy holder in collaboration with hospital can manipulate and get paid. 4) If the bills are paid by policy holder and later claimed with insurance company, amount would anyways paid to the account holder.
If I am in your place, I would complain to IRDA about that agent who is trying to influence policy holders giving false statements and encouraging for fraud.
It appears LiIC will not pay 100% of the expenses incurred for treatment. They have shown the payments percentage wise which is not clear. They also state the it will supplement claims from other schemes. Can we claim from two companies. The reimbursement is not 100% for day care treatments also.
I have got the following doubts
1.Pre existing diseases shall not be covered.For how long?
2.Whether cash less facility is available for Covid 19 illness and LIC personally ensures it?
3.If the husband is 68 yrs old and wife 63 yrs will it cover only wife or both.Can the wife take an individual policy excluding her husband?
4 GST payable
5.Premium for 63 yr old
6.Whether any pre medical tests will be conducted
Hello Ramakrishna, Here are the clarifications 1) Pre existing diseases needs to be disclosed and LIC would accept them. Till such time these are not covered 2) Regular health insurance plans do not cover covid-19. One need to take covid-19 specific insurance 3) One can take individual policy seperately irrespective of the state 4) GST is additional (as always) 5) No info is available in brochure / LIC website about medical tests, hence I am assuming these are not required. But we can’t rule out any specific condition which is not updated on their website.
Hello Ramakrishna, Small correction to my response. Regd point no. 2. Regular health insurance covers all covid-19 related hospitalizations, but may not be 100%. It depends on your health insurance plan which would indicate what all would be covered. e.g. most of the consumables like PPE Kits, tissue paper, crepe bandage, gown, foot covers, slippers, disposable gloves, syringes, gowns, masks etc, are not covered in standard health insurance plans. These would account for 10% to 20% of the total hospital bill. Best way is to check with health insurance company what all are covered before taking the policy
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