LIC Health Insurance Plan

LIC Jeevan Arogya is a health insurance plan which is offered by Life Insurance Corporation of India. This company is known as one of the trusted life insurance companies of India as it provides 100% financial security to the client when it comes to the life and health insurances. LIC has created the best performance records regarding Life Insurance business and the company is totally focused on providing the best financial cover against sickness and death of a person at a reasonable price and the client can get the best returns after the investment. The Jeevan Arogya plan is also referred to as LIC health insurance plan.

 Health insurance plan is very important for every person because it provides you with the best financial support during severe injuries and support will be provided to the family in case the client suffers from an unfortunate death. Even minor injuries are also covered under this plan and you are known with the fact that medical costs are increasing every day. Due to change in Lifestyle, you can see that health rate is deteriorating and that’s why you need to make sure that you invest in the best insurance plan.

The Eligibility Criteria For LIC Jeevan Arogya Plan

CriteriaMinimumMaximum
Age at entry for a self/spouse18 years65 years
Age at entry for children91 days17 years
Age at entry for parents18 years75 years
Age at maturity80 years
Daily hospitalization benefitRs.1000 a day excluding ICU4000 a day excluding ICU
Major surgical benefitRs.1,00,000Rs.4,00,000

 Here is the List of Covers Offered by LIC Jeevan Arogya Plan

  • Maturity benefit:  Under this policy, you won’t be able to get any kind of maturity benefit.
  • Hospitalization cash benefit:  one can easily avail the hospitalization cash benefit in case of accidental injury or any kind of sickness. It covers hospitalization up to 30 days in the first year and then becomes thrice after the second year.
  • Major surgical benefit:  if the insured person is going through any kind of surgery which lies within the policy period, then that person can definitely avail the major surgical benefit provided by the LIC plan. The cover is offered five times in the case of daycare procedure and it is maximum three times in a year while total 24 times during the policy tenure.
  • Some other surgical benefits: There are certain surgeries which are not covered under the main surgical benefit and those surgeries would come under this category. Maximum days of coverage during the first years are 15 and then 45 afterward.

Benefits of LIC Jeevan Arogya Health Plan

  • Hospital cash benefit: If an insured person is hospitalized because of any sickness or accidental injury and stays in the hospital for more than 24 hours then the amount paid by the person will come under this plan.
  • Daycare procedure BENEFIT:  due to some medical requirements, if the insured person is going through any kind of day care procedure, then the amount equal to five times of daily benefit will be paid to the person irrespective of actual costs.
  • Major surgical benefit:  if the person faces any kind of surgery within the plan period, then the benefit percentage for The Eligible surgery will be paid to the insured.
  • AMBULANCE BENEFIT:  during the surgeries, and accidents, the company will pay emergency transportation cost to the insured person.
  • Premium waiver benefit:  if the surgical benefits fail during an event, then the total annualized premium with respect to the policy from the date of installment premium Due till the next date of surgery will be waived off by the company.
  • No claim benefit: if the insured person doesn’t fall ill and is not able to claim the health benefit, then the health cover will be increased every year.

What are the Features of LIC Jeevan Arogya Plan?

  • LIC Jeevan Arogya Plan is a non-participating plan which doesn’t have any special benefits like FAB or LA like some other insurance plans offered by the company.
  • This plan has no investment benefits but only health issues are covered under this plan.
  • The benefits of this health insurance are predefined and therefore they can’t be linked with the actual expenses.
  • For taking the hospital cash benefits, you will need to submit the medical bills in order to get your claim to accepted and processed by the company. This claim process goes on similarly like the typical health plan.
  • Whenever the insured wants to claim in case of a medical emergency, then he will be paid twice the DHC at the time when he is admitted to ICU.
  • Half of the amount of surgery is covered under this plan during hospitalization.
  • The grace period under this plan is for around 30 days for annual or semi-annual

 Why should a Person buy LIC Jeevan Arogya Health Plan?

 The LIC policy has some unique features because of which people prefer to buy this plan. Here are some of these features which will force you to invest in the LIC Jeevan Arogya plan

  • The LIC Jeevan Arogya plan is not only meant for a person but it also covers the family. In this plan, the parents of insured are covered which is because of the unique proposition of the LIC policies.
  • This plan covers all kind of surgeries which also include Day Care treatments.
  • There is not any kind of claim bonus available now.
  • Under this plan, the insured would also be able to get additional critical illness ride benefit.
  • The critical illnesses are also covered under this plan.
  • The online tracking of this application can also be done under this
  • The insured will be allowed to get income tax benefit as the health insurance premiums paid up to 15000 for the normal residents and Rs.20,000 are paid for the senior citizens.
  • The renewal and online purchase of plans also come under the plan.

The Details of LIC Jeevan Arogya Policy

This plan is a non-linked health policy which is offered by LIC in order to help the people to deal with all kinds of medical expenditure. This plan provides the health insurance to against some particular health risks and it also offers great financial support to the insured during the emergencies.

Key features of the LIC Jeevan Arogya Plan

  • No claim bonus options
  • Options to choose from a number of flexible  benefits
  • Select from a number  of premium  payment  options
  • Health cover getting increased every year
  • Insured can get lump sum benefit irrespective of the actual medical costs
  • Financial protection in case of surgery  or accident

How Can a Person Choose the Best LIC Jeevan Arogya Plan?

First Step: AT first, the person needs to select the health cover from various options available under the plan. The amount of initial daily benefit according to the requirement starts from Rs. 1000, then Rs. 2000, Rs. 3000 and Rs.4000 per day. The amount would be paid to the insured in case of any hospitalization during the first year per day. The major surgical benefits would be a hundred times of the initial daily benefit. Therefore, you can assume that the initial surgical benefits will be around one lakh, two lakh, three lakh, and four lakh rupees. Upon the Hospital cash benefit, day care procedure benefit, premium waiver benefit, and other surgical benefits are included in the plan.

Second Step:

The premium of the plan is needed to be selected according to the gender, age, and health cover option and payment mode.

The LIC Jeevan Arogya premium table for the principal assured is given here

Entry Age Premium
201922.65
302242.90
402799.70
503768.00

The LIC Jeevan Arogya Premium Table for Child is given here

ENTRY AGE PREMIUM
0792.00
5794.75
10812.35
15870.75

All of the premiums are exclusive of the service tax asked during the plan.

Benefits Which are Not covered Under LIC Jeevan Arogya Health Plan?

There are certain things which are not covered under this plan and here are the particular exclusions in the LIC life insurance plan which won’t benefit to any insured person:

  • When a claim is raised due to the result of any pre-existing disease or the complications caused by past disease if it isn’t mentioned in the proposal form. It should be accepted by the company otherwise the person won’t get the health benefit for that disease complications.
  • The complications which are related to HIV/AIDS don’t come under the claim of this plan.
  • When the injury, death, hospitalization, and disablement of the insured person is caused due to war and it should be irrespective of unplanned, planned invasion, rebellion, civil war, revolution, martial law, civil commotion, military power, riots, arrests, detainment, and restraints, then the person won’t be eligible for claiming compensation.
  • During any kind of experimental surgery of treatment, the assured person wo n’t get any claim amount.
  • Organ donor expenditure doesn’t come under the LIC Jeevan Arogya Plan.
  • Dental Treatment doesn’t come under this
  • For any kind of non-allopathic treatments, a person can’t claim the amount of insurance.
  • When the insured doesn’t act on the medical advice and there is a failure in the treatment, the bank won’t take responsibility for another treatment.
  • Congenital conditions, genetic disorders or any kind of birth defects are not covered in this plan.
  • Mental problem treatment expenditure and any other kind of nervous issues.
  • Any kind of body injury which has been occurred due to civil commotion, violent labor disturbances or public disorder.
  • If the insured person is involved in any kind of illegal or criminal activities, then he isn’t supposed to claim for the Jeevan Arogya Plan.
  • Due to prolonged childbirth or pregnancy
  • Compensation won’t be paid in the case of illness disease, disablement, injury, a death which has been caused due to terrorism, chemical or biological weapon, nuclear or any radioactive weapons, contamination by ionizing radiation or radioactivity from any nuclear waste. If a person gets injured while working in high tension supply, underground mines or if he is engaged in any activities like horseback riding or big game hunting.
  • If a person harms his/her own body with a planning, attempts suicide or exposed to danger on his own, then he can’t claim for the insurance.
  • If the injured person gets sick due to alcohol or any drugs without taking advice from a doctor.
  • If a person gets hurt due to driving in a race, skydiving, martial arts, bungee-jumping, parachuting, caving, scuba diving or any other underwater activities, then no compensation would be paid by the bank in any case.

Procedure to Claim LIC Jeevan Arogya Health Policy

There are two main ways with the help of which one can easily claim the LIC medical insurances.  Here are the two ways which you can choose while claiming for this plan:

  • Reimbursement Claim
  • Cashless Claim which can be for emergency admission and planned hospitalization. In both of these cases, the third party person assists the insured person.

What are the Documents Required to Claim the LIC Jeevan Arogya Plan?

You can’t go straight to the bank and ask for your claim but you need to know the procedure to do the claim while you suffer from any injury or disease.  First of all, you will need to get the LIC claim from online or from the bank and then you can attach the following documents with the claim form.

  • Prescriptions
  • Attested photocopies of Bills and discharge summary
  • Doctor’s certificate
  • Advance and final receipts
  • Various kind of test reports
  • Copy of the photo id proof
  • For the package treatment, you will need to submit the details of package bills.
  • Photocopies of all the medical bills supported by the prescriptions
  • Copies of the various investigations done during the procedure

These are the documents which you will need for claiming the Jeevan Arogya Plan and the procedure is quite simple and hassle-free due to which most of the people are selecting it as their health insurance plan.