LIC Jeevan Arogya Plan 904 (LIC Health Insurance Plan)

          LIC Jeevan Arogya Policy is a Non-Participating Health Insurance Plan, which covers you and your family at the time of medical emergency. LIC Jeevan Arogya Plan 904 was a modified Jeevan Arogya 903 Plan in force from 16th November 2013. The LIC Health Insurance Plan 904 provides health insurance cover for the entire family including Individual, Spouse, Children, Parents and Parents in Law.

          Every Person worries because of the unfortunate events or the unexpected health issues that may occur in future. This LIC Health Plan 904 is a Non-Linked Plan, which provides financial protection at the time of Hospitalization and Surgeries. The Principal Insured can use the LIC Jeevan Arogya Premium Calculator for the yearly and half yearly premiums.

Features

• Premium Payment options are Flexible.
• Health Cover will increase every year.
• In the case of the Hospitalization and Surgery, financial protection is provided.
• The Benefit limit is flexible to choose.
• Regardless of actual medical costs lump sum benefits are made available to the Life Assured.
• No Claim Benefit: If there is No Claim during the Policy Commencement Date and next Renewal Date, the Principal Insured will get the No Claim Benefit from the LIC.

Eligibility Conditions 

Name of the Insured	Minimum Entry Age	Maximum Entry Age	Maximum Ceasing Cover Age
Principal Insured/Spouse	18 years	65 years	80 years
Parents/Parents in Law	18 years	75 years	80 years
Dependent Children	91 Days	17 years (last birthday)	25 years (last birthday)
Modes of Premium Payment: Half Yearly or Yearly.

Benefits 

Hospital Cash Benefits (HCB): In the event of Hospitalization of the Insured and their family members the Hospital Cash Benefits is provided. The Minimum Initial Daily Benefit of Rs 1000/- and the multiples of 1000/- is paid.

Major Surgical Benefit (MSB): The Principal Insured during Jeevan Arogya cover period, undergoes any of the surgery, the MSB sum assured for the surgery as mentioned in the MSB Annexure will be paid to the PI. LIC will provide Ambulance Charges of Rs 1000/- in addition at the time of Major Surgical Treatment.

Day Care Procedure Benefit (DCPB): If the Insured is undergoing any specified Day Care Procedure mentioned in the Day Care Procedure Benefit Annexure will get an amount of 5 times the applicable daily benefit (ADB).

Other Surgical Benefit (OSB): If any of the Insured of Jeevan Arogya Plan, undergoing any surgery not listed in the Day Care Procedure Benefit or Major Surgical Benefit will get an amount of two times the ADB as a daily benefit for a continuous period of 24 hours during the cover period.

Grace Period: The Insured will be provided 30 days of Grace Period for the payment of due Premium. Finally policy lapses if the premium amount is not made available within the Grace Period.

Cooling-off period: LIC will provide 15 days of time for the Policy Holder to return the Policy if not satisfied with the Terms and Conditions of the Policy.

Riders

1. Accident Benefit Rider.
2. Term Assurance Rider.

Accident Benefit Rider: This Rider applies to the Insured and Spouse. The Accident Benefit Rider will be available by paying an extra premium of Rs 0.50/- for every Rs 1000/- of the Accident Benefit Sum Assured per policy year. If the case of sudden death, along with the Term Insurance Sum Assured a lump sum amount is available for the Nominee. After the Policy Anniversary, the Insured will not be required to pay Additional Premium for Accident Benefits rider.

Eligibility Conditions:

Minimum Age of Entry	18 years
Maximum Age of Entry	50 years
Benefit Closing Age	60 years
Maximum Term	35 years
Sum Assured	Minimum: 25,000/-.
	Maximum: The Amount equal to Term Assurance Sum Assured, subject to a maximum of Rs 50 lakh for the overall limit of existing policies.
Sum Assured in Multiples	Rs 5,000/-.

Term Assurance Rider: LIC Jeevan Arogya Term Assurance Rider is an optional rider for Principal Insured or Insured Spouse only. The Premium amount is made available along with the base plan. During the term, if unfortunate death occurs an amount equal to Term Assurance Sum Assured will be payable.

Eligibility Conditions:

Minimum Age of Entry	18 years
Maximum Age of Entry	50 years
Benefit Closing Age	60 years
Maximum Term	35 years
Sum Assured	Minimum: 100,000/-.
	Maximum: The Amount equal to MSB Sum Assured, subject to a maximum of Rs 25 lakh for the overall limit of existing policies.
Sum Assured in Multiples	Rs 25,000/-.

Additional Information 

Death Benefit: The Insured will not get any Death Benefit unless opted for Accident Benefit Rider or Term Assurance Rider Benefit.

Maturity Benefit: There is no Maturity Benefit at the end of the cover period.

Loan Facility: The Principal Insured will not get any loan for this Jeevan Arogya Plan.

Surrender Value: No Surrender Value is made available for Jeevan Arogya Policy.

Discontinuance of Premiums: If the Life Assured does not pay the premiums within grace period the policy will lapse, and no benefits are made available for the Principal Insured.

Revival: The Policyholder can revive the plan within two years from the due date of first unpaid premium.

Options available 

Option to migrate: The Children included in this plan can migrate to new health insurance plan after the completion of 18 years of age or at the specified exit age. The Policyholder can purchase the policy within 90 days after the termination of the existing policy.

Cover to new members: If the Principal Insured gets married, the spouse and parents in law can be included within six months from the date of marriage. The Newborn child or legally adopted child can join within three months from the date of birth or legal adoption.

Quick Cash Facility: The Principal Insured can avail the 50% of the MSB amount, for the treatment of any surgery listed in the Major Surgical Benefit (MSB).

Claim Process 

           The Nominee/Life Assured can apply for Claim at the time of completion of the Policy Term or during the sudden Hospitalization of the Policyholder. Apply with all the required documents for the Claim amount. The Documents required at the time of Claim Process is available below.

• Original Policy Bond / Document.
• NEFT Form.
• Discharge form.
• Proof of Accident and Disability.
• Proof of title.
• Cancel check or Bank Passbook xerox.

Note:

Treatments not covered during the particular waiting period:

• Treatment for Cataract.
• Treatment for benign enlargement of prostate gland.
• Treatment for adenoid or tonsillar disorders.
• Treatment for benign uterine disorders like fibroids, uterine prolapse, dysfunctional uterine bleeding, etc.
• Treatment for anal fistula or anal fissure.
• Treatment for benign thyroid disorders.
• Treatment for slip disc.
• Treatment for degenerative joint conditions.
• Treatment for Gallstones.
• Treatment of Hernia.
• Treatment for Piles.
• Treatment for sinus disorders.
• Treatment for varicose veins.
• Treatment for hydrocele.
• Treatment for benign breast disorders e.g. fibroadenoma, fibrocystic disease, etc.
• Treatment for Carpal tunnel syndrome.
• Treatment for kidney or urinary tract stones.

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