Introducing LICs New Health Plan Jeevan Arogya

1. Introducing LICs New Health Plan Jeevan Arogya

2. Special Attractions • Maximum Number of days for HCB increased to 720 days • Maximum Number of days for ICU increased to 360 days • No of Surgeries in MSB increased to 140 MSB available for Minors also • Addition of 140 Day Care Procedures (DCPB) • All other Surgeries covered under Other Surgical Benefit (OSB)

3. Special Attractions • Age at entry for PI and Spouse increased to 65 Years • Age at entry for Parents and Parents-in-law is 75 Years • Maximum Health cover for elders - up to 80 Yrs • Premiums are guaranteed for 3 Yrs • Optional Term Rider and Accident Benefit

4. Income Tax Rebate IT Rebate Under Section 80(D) available for Full Premium Paid 4

5. USP of LICs Jeevan Arogya Comprehensive Family Health plan: Covering entire family consisting of • Husband • Wife • Dependent Children • Dependent Parents of Husband and/or Wife

6. Entry age limits-LICs Jeevan Arogya • Entry Age up to 65 yrs for Husband and wife. • Entry Age up to 75 yrs for parents/in-laws • Entry Age from 91 days to 17 years for children • Risk cover Self, Spouse, Parents, in-laws : 80 Yrs Children : 25 Yrs

7. USP of LICs Jeevan Arogya A novel policy offering Multiple benefits: • Hospital cash benefit (HCB). • Major surgical benefit (MSB) • Day Care Procedure Benefit(DCPB) • Other Surgical Benefit(OSB)

8. USP of LICs Jeevan Arogya Other Benefits: • Premium waiver benefit • Ambulance expenses • Quick cash Advance Payment • No claim bonus • Auto increase in HCB& MSB to take care of inflation with no increase in premium

9. Risk cover under LICs Jeevan Arogya • Risk cover up to 4 lacs per insured Subject to overall limit of 10 lacs (All our Health Policies put togethor) • Guaranteed renewal after every three yrs

10. HCB options for each Life • Rs.1000/- per Day • Rs.2000/- per Day • Rs.3000/- per Day • Rs.4000/- per Day

11. 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 • Parents < or = Insured Spouse

12. 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 First day also) will be allowed

13. HCB - Benefits at a glance

14. Hospital Cash Benefit( HCB) • Fixed per day benefit to cover expenses on the event of hospitalization of insured members for sickness/accidental body injury. • Benefit payout is fixed irrespective of actual expenses incurred.

15. Major Surgical Benefit (MSB) • MSB = (HCB X 100) • MSB risk cover limits do not include MSB of Plan 901 & 902

16. Major Surgical Benefit(MSB) • A percentage of sum assured is paid in the event of insured members undergoing specified surgeries. • Benefit is fixed irrespective of actual expenses incurred. Advantageous to the insured members • MSB is available to all the insured including children for all ages

17. MSB- Benefits at a glance • MSB allowed for 140 surgical procedures Annual Limit 100 times of HCB in a policy year (Min 1 Lac) Life time Limit 800 times of HCB during entire policy term (Min 8 Lacs)

18. Premium waiver benefit In the event of any insured undergoing major surgery under category I or 2 premium payable for one year from the next premium due date coinciding or following the date of surgery is waived

19. 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

20. Other surgical benefit(OSB) OSB = 2 x HCB • Any surgery other than MSB, DCPB surgeries • At least 24 hours stay in Hospital is required • Annual limit : 15 days in First policy year 45 days in each subsequent years • Life time limit : 360 days per insured

21. 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/-

22. Accident Benefit Rider This benefit is available only if Term Assurance Benefit rider is 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/-

23. Quick cash facility • Advance amount to PI • Cat I or Cat 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

24. Ambulance charges • Rs. 1000/- reimbursed per insured towards Ambulance charges • Ambulance charges incurred for transportation of the insured to undergo Major Surgeries under category 1 or 2

25. 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

26. USP of LICs Jeevan Arogya • 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

27. USP of LICs Jeevan Arogya 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.

28. Rebates available on Tabular premiums

29. Addition of members

30. USP of LICs Jeevan Arogya • Addition of newly eligible members during the currency of the policy. • Fixed Benefit scheme: Benefit paid as opted irrespective of actual expenses for hospitalization and Surgeries • Benefits are payable independent of payments received through mediclaim or any other health schemes.

31. 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.

32. The waiting Period for availing 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

33. Things to remember: • Since it is purely MEDICAL INSURANCE plan and premium does not have any saving element hence there is no maturity claim • No Death claim under basic plan. • Loan, surrender, assignment- n.a. • Mode of payment- Yly, Hly, Mly(ECS only)

34. Underwriting

35. Sample Benefit Illustration – for HCB 1000

36. Benefit comparision with ICICI prudential Hospital care II

37. Benefit comparision with ICICI prudential Hospital care II

38. THANK YOU