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Introducing JEEVAN AROGYA Table 903: New Health Benefit Plan. Health Insurance, Central Office, Hyderabad. Comprehensive insurance for a motorcycle is approximately Rs.1500/-.
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Introducing JEEVAN AROGYATable 903: New Health Benefit Plan Health Insurance, Central Office, Hyderabad
Comprehensive insurance for a motorcycle is approximately Rs.1500/- Comprehensive insurance for an entry level car in India is approximately Rs.12000/- and goes up to Rs.20000/- for mid level cars
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
Special Attractions • 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
USPs Other 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
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 limit 10. 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)
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
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
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
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 Insured
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/-
Accident Benefit Rider This 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/-
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
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
No Claim Benefit • During 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
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
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.
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
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
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