Health Insurance by LIC (Top Plans, Features and Benefits)

Life Insurance Corporation of India (LIC) is predominantly known as India’s largest Life Insurance company. That being said, it is a little-known fact that LIC also provides 3 Health Insurance Plans. They are:

• LIC Health Protection Plus (Withdrawn)
• LIC JEEVAN AROGYA
• LIC Cancer Cover Policy

Let us understand each of these plans so that you can choose the most relevant plan for your needs.

Health Insurance by LIC

LIC Jeevan Arogya

The LIC Jeevan Arogya plan is LIC’s primary health insurance plan for Indians. The plan is a non unit-linked health insurance policy that covers the policyholder and his family against hospitalization expenses.

Eligibility

• The maximum entry age for self/spouse is 65 years
• The maximum entry age for parents/in-laws is 75 years
• The maximum entry age for children is 17 years

LIC Jeevan Arogya Benefits

The policy will provide the following benefits:

• Hospital cash benefit
• Major surgical benefit
• Day care procedures
• Other surgical benefit
• Ambulance
• Premium waiver

Let us understand each of the benefits of the LIC Jeevan Arogya Plan in detail.

Hospital Cash Benefit: The hospital cash benefit (HCB) is the most important aspect of the Jeevan Arogya policy. Understanding HCB is critical if you want to understand your policy. The HCB is the amount of hospitalization cash that you will get every day in case of hospitalization in your family. There are 4 HCB amounts that you can choose from:

• Rs.1,000/Day
• Rs.2,000/Day
• Rs.3,000/Day
• Rs.4,000/Day

They higher the HCB you choose, the higher the benefit and the higher the premium you have to pay.

Major Surgical Benefit: If there is a requirement for a major surgical intervention during the policy tenure, the policyholder will be entitled to receiving 100 times his HCB amount as a benefit. So if a policyholder has selected the HCB of Rs.1,000 a day, he will be entitled to Rs.1 Lakh as a surgical benefit. Similarly, if the holder has an HCB of Rs.4000 a day, he will be entitled to Rs.4 lacs as a surgical benefit.
It is also important to note that the major surgeries are classified into 4 categories and the benefits are according to each category.

Type of Surgery and HCB to be paid

• Category 1 – 100% of HCB
• Category 2 – 60% of HCB
• Category 3 – 40% of HCB
• Category 4 – 20% of HCB

So for instance, a policyholder having an HCB of 1000/day gets admitted to the hospital for a Category 2 surgery, he will be eligible to get a benefit of 60% of 1 lac, i.e Rs. 60,000.
In another example, let’s say a policyholder having an HCB of 1000/day gets admitted to the hospital for a Category 1 surgery, he will be eligible to get a benefit of 100% of 1 lac, i.e Rs 1 lac.

Day Care Procedures: This policy also provides coverage for Day Care procedures. A Day Care procedure is any treatment that does not require prolonged hospitalization. Examples of Day Care treatment would be dialysis, chemotherapy, tonsillectomy, etc. This is where the treatment does not need hospitalization for over 24 hours.

LIC Jeevan Arogya policy provides coverage of 5 times the HCB amount. So, if your HCB amount is Rs.1,000, your eligible Day Care amount would be Rs.5,000.

Other Surgical Benefits: If the policyholder or his family gets admitted for surgery that is excluded from the Major Surgical Categories, he/she will be eligible for twice the HCB/day.

Ambulance Charge: Ambulance charge up to a maximum amount of Rs.1,000 is eligible to the policyholder.

NCB Benefit: For every claim-free year the HCB will be increased by 5%.

Premium Waver: If the policyholder gets admitted for a Category 1/Category 2 surgery, he/she is eligible for the next year’s premium to be waived off. This could provide much-needed financial relief to the holder.

Quick Cash Benefit: The policyholder can choose to claim 50% of his MCB amount while in the hospital itself, in the event of a Category 1 or 2 surgery.

LIC Jeevan Arogya Premium

Check out the premium chart for LIC Jeevan Aroyga below.

LIC Jeevan Arogya Riders

LIC also provides 2 Riders that the policyholder can avail. A Rider is an additional clause that the holder can incorporated in his policy for an extra fee. Let us understand the 2 available Riders under LIC Jeevan Arogya.

Term assurance rider: If the policyholder decides to avail of the optional Term Assurance Rider, he will be eligible towards a maturity or death benefit equal to his Major Surgical Benefit (MSB). So, if his MSB is Rs.2 lacs, he will be getting Rs.2 lacs on policy maturity or death.

Accident Benefit Rider: This is where the holder can avail of accidental coverage by paying an additional premium. Coverage will be similar to the Term Assurance Rider.

Policy Exclusions

Following disorders are excluded under this policy:

• Pre-existing disorders (unless agreed by LIC)
• Epidemics
• Experimental treatments
• Cosmetic treatments
• Circumcision
• Congenital anomalies
• Dental treatment
• Self-afflicted injuries
• Damage caused due to War, revolutions and invasions, acts of god like earthquakes, volcanic eruptions and avalanches
• Damage caused due to illegal activities and adventure sports
• Nuclear damage

LIC Cancer Cover Policy

This is LIC’s cancer coverage policy. People looking to cover themselves and their families against the growing risk of cancer can avail of this policy. The policy has 2 variants:

• Option 1
• Option 2

Option 1 (Level Sum Insured)

The sum insured will remain the same throughout the duration of the policy. If you choose to buy a policy of 5 lakhs, the cover will remain 5 lakhs throughout the policy term.

Option 2 (Increasing Sum Insured)

Under Option 2, the policyholder will be eligible to receive a No claim bonus of 10% (on sum insured) for every year (up till 5 years).

Apart from difference in sum insured, the rest of the policy terms are the same. Let us discuss about the rest of the policy terms below:

Eligibility

• Maximum entry age – 65 years
• Minimum policy term – 10 years
• Maximum policy term – 30 years
• Minimum sum insured – Rs 10 Lakhs
• Maximum sum insured – Rs 50 Lakhs

LIC Cancer Cover Benefits

Benefits of the policy include the following:

• Coverage of early stage cancers
• Coverage of major stage cancers

Coverage of early and major stage cancers

Following early and major stage cancers are covered under this policy:

• Carcinoma-in-situ (CIS)
• Thyroid Cancer
• Bladder Cancer
• Prostate Cancer
• Chronic Lymphocytic Leukemia
• Cervical Intraepithelial Neoplasia

Waiting Period

The assured will have to wait for 180 days from the date of policy issuance for the policy benefits to get initiated. No benefits will be payable to the policyholder if there is hospitalization within 180 days of policy issuance.

LIC Cancer Cover Premium

Exclusions

Following disorders are excluded under this policy:

• Pre-existing conditions
• Any sickness occurring within 180 days of policy issuance
• Tumors caused due to HIV/AIDS
• Benign or low malignant tumors
• Dysplasia
• Intra-epithelial neoplasia
• CIN-1, CIN -2 and CIN-3
• Non-melanoma skin carcinoma
• Chronic lymphocytic leukemia (less than RAI stage 3)
• Gastro-Intestinal Stromal Tumors (classified as T1N0M0 or below and with having a mitotic count of less than or equal to 5/50 HPFs)
• T1N0M0 categorized Thyroid Cancers
• Conditions caused due to nuclear contamination