LIC Jeevan Arogya Policy

LIC Jeevan Arogya Plan is a comprehensive health insurance plan which provides financial protection for you and your family. It is an excellent policy for insuring self, spouse, children, parents and parents-in-law.

Select the amount of Initial Daily Benefit, which is the daily Hospital Cash Benefit applicable in the first policy year.

• This is the amount that LIC will be liable to pay to the insured in case of hospitalization in the first policy year on a per day basis. The Major Surgical Benefit covers the insured for 100 times the Initial Daily Benefit that you have opted for. Hence, the initial Major Surgical Benefit Sum Assured will be Rs. 1 lakh, Rs. 2 lakh, Rs. 3 lakh, Rs. 4 lakh respectively. Other benefits like Day Care Procedure Benefit, Other Surgical Benefit and Premium Waiver Benefit (PWB), as specified below, is also payable depending on the daily Hospital Cash Benefit that you have chosen.

NO, LIC Jeevan Arogya offers a lump sum benefit which is not related to the actual cost of medicines.

No, LIC does not have a mediclaim policy. You can complement your existing mediclaim policy with LIC Jeevan Arogya plan.

To file a claim in LIC Jeevan Arogya plan, the Insured or the Insured’s spouse or nominee should put in a written request to LIC informing them of their liability. Important points to be followed are;

- The Claim should be submitted within 30 days of discharge from the hospital or procedure or death of the insured. - The claim should be submitted in the prescribed format shared on the LIC website or available at their Branch offices. - All documents as mentioned in the claim form, should be attached to the claim form. In general, the following documents are required to be submitted in original or in attested form. - Claim Form (duly filled and signed) - Policy Document - Discharge Summary with details of treatment received - Copy of Summary of Surgeon’s Operation Notes (In case of surgery) - Death Summary in case of death of the patient under treatment - Bills and receipts of hospital expenses, medications, medical procedures, medical investigations (tests) - Any other documents material to the claim or asked by LIC

Once the claim is reviewed and approved, the amount shall be transferred to the claimant as a lumpsum payment.

LIC’s Jeevan Arogya Policy is a health Insurance policy offered by Life Insurance Corporation of India. It provides coverage for hospitalisation expenses, including medical, surgical, and diagnostic procedures. It also covers pre and post-hospitalization expenses. The importance of the Policy lies in the fact that it helps policyholders financially during times of medical emergencies and hospitalisation. Medical expenses in India can be very high, especially if you need to be hospitalised for a long period of time. Jeevan Arogya can help you cover these expenses and reduce the burden on your finances. In addition, Jeevan Arogya's policy also provides the following benefits.

• Coverage of the entire family, including spouse, children, parents, and parents-in-law
• Hospitalization Cash benefit
• Pre and Post Hospitalization coverage
• Day Care procedure benefit
• No Claim benefit
• Premium waiver benefit
• Ambulance benefit
• The insurer can add Accident Benefit Rider and Term Assurance Rider as per the requirement.
• Flexible premium payment options

The premium of the LIC Jeevan Arogya Policy is dependent on a number of factors and will have to be carefully calculated using the help of a LIC representative, partner or agent. The factors on which the premium is dependent are as below.

• Age of the Policyholder: The premium of the policy usually increases with the age of the insured as the propensity to fall sick increases
• Pre-existing diseases: If the insured has any pre-existing diseases, the premium of the policy may go up
• Sum Insured: The greater the Sum insured, the higher will be the premium of the policy.
• Location: At times, the location of the insured also defines the premium amount. For example, the premium of a policy purchased in the city may be more than that in a small town in lieu of the cost of medical facilities.
• The number of Family members included in the policy: If the number of people covered under the policy is more, the total premium amount will tend to be higher.
• Policy term: The Term of the policy is dependent on the age of the primary insurer. The premium of the policy may vary as per the Policy term.
• Additional Riders opted: Any additional riders like Accident Benefit or Term Assurance, if opted, may increase the amount of Premium of the policy.
• Amount of Hospitalization Cash benefit opted: The Insurer can choose the amount of daily hospitalisation cash benefit while taking the policy. The higher the amount of cash benefit chosen, the higher will be the premium of the policy.

LIC Jeevan Arogya Policy provides coverage for hospitalisation expenses at any Hospital or Nursing Home that is recognised by the Ministry of Health and Family Welfare. The Quick Cash Facility under the policy is provided through LIC Network hospitals. The list of network hospitals is available on the LIC website and alternatively will be available at their branch centres or through their agents and partners. The list is also shared with the insured along with the policy document.

LIC’s Jeevan Arogya policy covers a wide range of illnesses and medical procedures. Some of the diseases covered under the policy are:

• Cancer
• Heart Attack
• Stroke
• Kidney Failure
• Major Organ Transplant
• Multiple Sclerosis

The complete list of the diseases along with the associated terms and exclusions, is available on the LIC website. You can also refer to the policy document.

No, LIC provides a lumpsum amount under a Quick Cash facility to the insured under the Jeevan Arogya Policy. If the insured undergoes any eligible major surgery at any of the LIC’s listed network hospitals, (s)he can avail of the Quick Cash Facility. Under the facility, LIC provides up to 50% of the Major Surgical Benefit amount as advance to the Insured even during hospitalisation. The facility can be availed for planned or emergency procedures. The disbursal of the advance amount is subject to approval by the TPA or the LIC representative. The amount disbursed ensures that the insured does not face any financial issues during his / her hospitalisation. The amount is later adjusted from the final claim amount.

The LIC Jeevan Arogya Policy covers 140 Major Surgical procedures apart from smaller surgical procedures. A few of the major surgical procedures covered in the policy are:

• Major Surgery of the Aorta
• CABG
• Heart Valve Replacement
• Coronary Angioplasty
• Bone Marrow transplant
• Craniotomy
• Nerve grafting
• Lung transplant
• Liver transplant

The complete list of the Surgical Procedures, along with the associated terms and exclusions, is available on the LIC website. The list also forms part of the Policy document.

The major benefits under the LIC Jeevan Arogya Policy are as below

• Coverage for the entire family
• Hospitalization Cash Benefit
• Day Care procedure benefits
• Pre and Post hospitalisation coverage
• No Claim Benefit
• Ambulance benefit
• Additional Riders: The Insurer can add additional riders to the policy as per his/ her requirement, namely accident benefit Rider and Term Assurance Rider
• Premium Waiver benefit
• Quick Cash Facility
• Flexible premium Payment Options

LIC Jeevan Arogya's plan covers more than 100 daycare procedures. You can find a detailed list in your policy documents. Here are some examples of the daycare procedures covered under the plan.

• Sinus surgery
• Removal of foreign bodies from the eyes
• Glaucoma surgery
• Tonsil operations
• Stone removal surgery
• Angioplasty