The LIC Health Insurance Plan, funds of the LIC, financially support the management of unforeseen medical expenses. The rising cost of healthcare can leave a hole in the pocket and therefore require adequate health coverage.

LIC’s health insurance plans provide a way to manage such unexpected expenses and prevent your budget from becoming too vinegar.

Types of LIC Health Insurance Plans


  • 1. LIC Jeevan Arogya Health Insurance Plans
  • 2. LIC Cancer Cover Health Insurance Plans
LIC Health Insurance Plan

1. LIC Jeevan Arogya Health Insurance Plan


LIC Jeevan Arogya Health insurance Plan is a non-committed health insurance company that helps individuals cope with rising medical costs. In this plan, you can assure yourself, your spouse, your children, your parents, your mother-in-law, and your father-in-law.

LIC Health Insurance Plan For Family is a comprehensive policy for the whole family. In this plan you will receive an amount independent of the processing costs. LIC Health Insurance can therefore be used effectively as an alternative to your health insurance to cover some of the additional costs incurred during your stay in hospital.

Also read: Top 10 Best Health Insurance Plans In India 2019

Features, Benefits, Exclusions Of LIC Health Insurance Plan


Features of LIC
Jeevan Arogya.
1. It is a complete health insurance.
2.The insurance offer covers your 
parents, spouse, children and parents-in law.
3.Financial protection of medical 
expenses.
4.Allows payment of benefits regardless of medical expenses.
5.No compensation
6.Premium Payment – Flexible Premium Payment Options
7.Flexible performance limit.
8.The insurance cover can be extended
to new family members.
9.May be linked to an existing drug 
policy for the same medical reason.
10.Increase in health insurance from 
year to year.
11.Waiting time – There is no general 
waiting time for hospitalization or 
surgery for accidental injury.
12. Credit facility – No loans are available under this Directive.
13.Present value – There is no cash value available under this plan.
14.Restart policy – The policy can 
be reactivated within 2 years from
the date of your first unpaid 
premium.
Benefits of LIC policy
Jeevan 
Arogya ( LIC health insurance plan)
1.Sickness allowance (Hospitalization Allowance,{HOSPITAL CASH BENEFIT} HCB)  
2.Great surgical advantage {MAJOR SURGICAL BENEFIT} (MSB) 
3.Provision of a day care procedure 
4.Other surgical advantages 
 5. Premium waiver (PWB) 
ambulance
 Exclusions under LIC
Health Insurance plan
1.Addiction costs Pre-existing conditions
2.Expenses for plastic surgery Injuries due to deliberate self-injury pregnancy conditions delivery terms
3.Event caused by natural disasters
4.Injuries due to participation in dangerous sports activities 
5.Congenital diseases 
6.Conditions caused by a suicide attempt
7.Radioactive conditions
8.Conditions for beauty treatments 
9.Conditions of cosmetic treatments
10.Epidemic conditions pre-existing conditions
11.Cancer diagnosis detected within 180 days of the date of issue of the policy 
12.HIV-AIDS Donation of an organ of secure life Illnesses as a result of nuclear war / equipment

Some Important Facts about LIC Health Insurance Plan


  • The insurance policy covers the primary insured (IP). Your spouse, your children, your parents, and your spouse’s parents can all be covered under one policy.
  • Benefits provided under the LIC Health Insurance plan include: hospital allowance, large surgery allowance, daycare allowance, other surgery allowance, ambulance allowance and premium exemption.
  • There is no loan under the plan.
Insurance ForMIN AGEMAX AGE
For parents18 years75 years
For individual18 years65 years
For children91 days17 years
  • The total number of days for which each insured person would receive hospital allowance during an insurance year is limited to:

Minimum no. of days
maximum days for intensive
care
For first year30 days15 days
For second year90 days45 days

Children falling under this scheme have the right to take out new, appropriate LIC health insurance plan for family at the end of the defined retirement age or when the contract is renewed after 18 years (subscription required).

The new policy must be purchased within 90 days after termination of the child’s membership of the existing policy.

  • The insured may choose the amount of the initial daily allowance (ie the daily allowance for the hospital stay paid during the first year of insurance)
LIC Health Insurance Plans
AFFORDABLE HEALTH INSURANCE LIC

From the following options: Rs 1000 per day, Rs 2,000 per day, Rs 3,000 per day and 4,000 Rs per day.

  • This is the amount paid daily to the insured in case of hospitalization in the first year.
  1. The main surgical benefit for which you are insured is 100 times the initial daily allowance you have chosen.
  2. Thus, the initial amount of major insured surgical services is Rs. 1 lakh, Rs. 2 lakh, Rs. 3 lakh and Rs. 4 lakh, respectively.
  3. Other benefits, such as childcare allowance, other surgical services and premium exemptions, are also paid on the basis of the chosen daily allowance.
  4. Each insured person is insured against health risks for up to 80 years. Children are insured until the age of 25.

Also read: Top 6 Family Floater Health Insurance Plans In India


What is Surrender Value in LIC Health Insurance Policy?


Surrender value is the amount of money that an insurance company pays to a policyholder or annuity contractor if the contract is terminated voluntarily before maturity or if an insured event occurs.

Check the status of the LIC Health Insurance policy for present value: You can calculate the present value of your LIC Health Insurance policy using the following simple formula:

Formula:

Insured base amount (total number of premiums to pay / number of premiums to be paid) + total bonus you receive x surrender value factor.

Learn more about LIC Surrender Value and how to claim it here.

LIC Health Plan Brochures


2. LIC Cancer Cover Health Insurance Plan


LIC’s Cancer Cover health insurance plan for cancer is a regular health insurance premium that provides financial protection in the event that the insured person is diagnosed with early and / or severe cancer during a certain precarious stage of the policy.

The plan offers two performance options that allow you to initially select the type of primary insured.

Option I Sum insured: The basic sum insured does not change during the term of the policy.

Option II Increasing the sum insured: The sum insured will increase by 10% of the basic insurance amount per annum for the first five years from the first anniversary of the contract to the diagnosis of the first cancer, whichever comes first.

Eventualities. When diagnosing a particular cancer as referred to in paragraph 1, all claims for the increased principal amount must be based on the insurance anniversary that coincides with or before the diagnosis of the first claim.


Benefits of LIC’S Cancer Cover: LIC Health Insurance Plan


The benefits to be paid under the plan must be calculated on the basis of the insured nominal amount. The insured nominal amount corresponds to: the capital stock insured for the policies of option I; or Basic insurance amount increased in the first year and thereafter, as specified in Option II.

BENEFITS:

The following benefits are payable during the insurance year under an existing policy:

Early cancer: benefits paid at the first diagnosis of one of the indicated early cancers, provided that they are eligible, –

  • Lump-sum benefit: 25% of the sum insured must be paid
  • Premium Exemption Allowance: The premiums for the next three years of insurance or the balance of the insurance, whichever is lower, are exempt from the insurance anniversary which coincides with or follows the date of diagnosis.

Also read: Which Diseases are Covered and Not Covered Under Health Insurance ?


Covered Early Cancer:


The diagnosis of any of the conditions listed below should be made by histological evidence and confirmed by a specialist in the field concerned.

Carcinoma in situ (CIS): Carcinoma in situ is the presence of malignant cancer cells that remain in the group of cells from which they originated. It must touch the entire thickness of the epithelium, but does not pass through the basement membranes and does not interfere with the surrounding tissues or organs.

The diagnosis of what needs to be positively diagnosed is made by microscopic examination of the fixed tissue.

Prostate Cancer – Early Stage: Early stage prostate cancer, histologically described using the TNM classification as T1N0M0 with a Gleason score of 2 (two) to 6 (six). Thyroid cancer – early stage:

All thyroid cancers shorter than 2.0 cm and histologically classified as T1N0M0 according to TNM classification.

Bladder Cancer – Early Stage: All tumors of the bladder are histologically classified as TaNoMo according to the TNM classification. Chronic lymphocytic leukemia –

Early stage: Chronic lymphocytic leukemia is classified as stage 0 (zero) to 2 (two) according to the Rai classification.

Cervical intraepithelial neoplasia: Severe cervical dysplasia has been reported as cervical intraepithelial neoplasia 3 (CIN3) in cone biopsy.

Major cancer: Benefits paid at the time of initial diagnosis of a particular major cancer, if eligible

  • Fixed amount: 100% of the insurance amount applicable, less claims already settled as early as cancer, are payable.
  • Income Benefit: In addition to the lump sum benefit of income benefits of 1% of the sum insured is payable monthly contract after the payment of the principal during a specified period of ten years, regardless of the life of the insured and even if that period of 10 Years longer than the insurance period.
  • If the insured dies during this period, the remaining payments, if any, will be paid to the designated one.
  • Waiver of premium in service: all future premiums will be exempted from the next insurance year and the contract of liability, except in the scope of performance in terms of income, as stated above.

Large Stages Of Cancer Covered:


Malignant tumor characterized by uncontrolled growth and spread of malignant cells with invasion and destruction of normal tissues.

This diagnosis must be supported by histological evidence of malignancy. The term cancer includes leukemia, lymphoma and sarcoma.


Limits And Terms of Use: 


  • Early cancer benefit is paid only once for the first event, and Life Assured is not entitled to claim any other claim to early cancer, the same cancer, or any other cancer. However, coverage for the main stage of cancer under the policy will remain until the policy is terminated.
  • Once a major cancer benefit has been paid, no payment is eligible for future entitlements to early cancer or large-scale cancer.
  • The total amount of benefits under the policy, including those for early cancer and those for major cancer, as indicated above, may not exceed the maximum amount. the application, which corresponds to 220% of the sum insured.
  • If life insurance claims cover the same cancer for different phases of the same cancer at the same time, the benefit will only be paid for the highest claim allowed under the policy.
  • If more than one cancer is diagnosed in an event, the company pays only one benefit. This benefit equals the amount that corresponds to the stage of the cancer for which the level of benefit is highest

Also read: Claim Settlement Ratio and Incurred Claim Ratio in Health Insurance

2.Waiting Period: A 180-day waiting period applies from the date of issue of the policy or the date of recovery of the risk cover, whichever is later, until the first diagnosis of a cancerous condition.

“Every step” here means all stages of cancer that occur during the waiting period.

No benefit will be paid if one of the cancerous phases occurs within 180 days of the date of conclusion or resumption of the contract and the contract ends.

3.Survival Time: No benefit will be paid if the insured person dies within 7 days of the diagnosis of an early or serious cancer. The 7-day survival includes the date of diagnosis.

4.Eligibility:

  • Minimum age: 20 years (completed)
  • Maximum age at entry: 65 years (last birthday)
  • Minimum contract period: 10 years
  • Policy term: 30 years Minimum age at maturity: 50 years Maximum age at Due date: 75 years
  • Maximum insured sum: Rs. 50,000,000

The maximum basic sum insured under this scheme may to exceed a ceiling of Rs. 50 rupees, taking into account all existing LIC health insurance policies, including cancer coverage and the amount covered by the coverage proposed in the new proposal.

The basic insurance sum must be stated in multiples of rupees. Only 1,00,000 / -.


Exclusions In LIC’S Cancer Cover: LIC Health Insurance Plan


EXCLUSIONS: The Company is not obligated to pay benefits from this product. The LIC Health Insurance policy will be canceled if the conditions are directly or indirectly caused by:

  • An existing condition
  • If the cancer diagnosis was made within 180 days of the date of the policy or the date of recovery of the risk coverage, whichever is later;
  • For any medical condition sustained by an insured life or medical procedure, if that medical condition or intervention was directly or indirectly caused by acquired immune deficiency syndrome (AIDS), the complex is related to AIDS or human immunodeficiency Virus infection (HIV);
  • a medical problem or medical procedure resulting from the donation of one of the organs of Life Assured;
  • for a medical problem of the Insured or a medical procedure of the Insured, if the illness or act was directly or indirectly caused by alcohol or a drug (except under the direction of a licensed medical practitioner)
  • for a medical problem or medical procedure due to nuclear contamination; the
  • radioactive, explosive or dangerous nature of nuclear or nuclear fuel contaminated or accidents resulting from this

Also read: Section 80 D Tax Benefits In Health Insurance

  • All histologically characterized as carcinoma in situ, benign, premalignant , malignant, low malignant, unknown behavior of tumor or non-invasive.
  • But not limited to: carcinoma in situ of the breast, cervical dysplasia CIN-1, -2 and CIN CIN-3.
  • skin cancer other than melanoma, except for lymph node metastases or beyond;
  • Malignant melanoma that did not cause invasion beyond the epidermis;
  • All tumors of the prostate, unless histologically classified as Gleason score greater than 6 or at least progressing toward clinical TNM classification T2N0M0
  • All thyroid cancer classified histologically as T1N0M0 (TNM classification) or less;
  • Chronic lymphocytic leukemia, which is inferior to stage 3 RAI

SURRENDER VALUE: No surrender value will be available under this plan.

Q1. Is LIC Health Insurance Plan Cashless?

Ans: It does not provide cashless functionality that is standard in most health care policies today. For larger operations, you will receive an advance of 50%, but no full service without money.

Q2. What is Jeevan Arogya plan(health insurance LIC plan)?

Ans: LIC Jeevan Arogya is a non-committed health insurance company that helps individuals cope with rising medical costs. In this plan, you can assure yourself, your spouse, your children, your parents, your mother-in-law, and your father-in-law. It is a comprehensive health insurance for the whole family

Q3. What is the minimum age for the retirement of older people?

Ans: In India, the minimum age for most health insurance systems for the elderly is 60 and 80 years. However, it can differ between plans and insurance companies, up to 90 years and even the lifetime.

Q4. Which diseases are covered by LIC health insurance Plan?

Ans: Diseases such as cataracts, kidney stones, joint treatments and arthritis are considered to be pre-existing conditions and should best be reported at the time of purchase. Health insurance only covers hospital costs, and serious critical illnesses require critical health insurance.

Q5. What is notinsured under health?

Ans: The LIC health insurance company usually does not cover these costs, even though it has to pay for all the tests required for a diagnosis. However, this is one of the areas of treatment that varies from state to state. Prescription drugs are tested and approved for certain conditions such as autoimmune diseases.

Q6. Are operations insured?

ANS. Although most cosmetic surgeries are uninsured, some surgeries are generally considered medically necessary when performed in conjunction with a health-promoting surgery. Breast implants performed during or after breast cancer surgery are a good example.

Q7. Which types of insurance are not recommended?

Ans: Here are 5 types of insurance that you should think about:.
Some insurance agents will try to convince you that you need mortgage life insurance.
Identity theft insurance.
Cancer insurance.
Payment protection on your credit card.
Collision protection for older cars.

Q8. How can I satisfy medical needs?

Ans: Excellent documentation is needed to meet medical needs. Medical necessity is the concept that health services and services must be necessary and appropriate for the evaluation and treatment of a particular disease, condition, disease or injury.

Q9. What is a denial of medicare medical necessity?

Ans: A petition for payment of a test on a local or national list – without a specific diagnostic code indicating a medical need based on local or national guidelines – will result in denial of payment for these services.

Q10. What is the eligible amount in LICs?

Ans: If the premium paid during a financial year exceeds 20% of the actual insured capital, the tax credit only applies to the premium, up to 20% of the insured sum. According to Section 80CCC, the maximum amount of deduction that can be claimed is limited to Rs. 1,50,000.

Q11. What is the coverage of LIC cancer?

Ans: LIC Cancer Cover provides early and advanced protection against cancer. The LIC Cancer Cover Plan is a regular bonus plan where premiums can be paid once a year or every six months for a period of 10 to 30 years. The policy can be purchased offline and online.

Q12. What does surrender of life insurance mean?

Ans: This is the option to terminate the life insurance product before maturity, with the policyholder receiving the present value. A regular premium policy is eligible for repayment after the policyholder has paid the premiums continuously for 3 years.

Q13. How to calculate the surrender value of an insurance policy?

Ans: The longer an policyholder maintains a policy, the lower the percentage charged by the insurer for the redemption fees. The surrender value is then calculated from the full repurchase value and the deduction of the repurchase fee plus the capital of the outstanding loan or interest on the policy.

Q14. What happens if I no longer pay the LIC premium after 3 years?

Ans: If the policy is returned after three years, the insurer pays you a guaranteed present value of 30% of all premiums paid after deduction of the first annual premium. Special repurchase value = 80% of the sum insured when due, if you paid the premiums for 3 years or more but less than 4 years.

Q15. Is Jeevan Arogya good?

Ans: Regarding LIC Jeevan Arogya, this can not be considered a proper health insurance as it does not cover actual hospital costs. In addition, the maximum AS of Rs 4 lakh is available only for larger surgeries, which is too low for heart, kidney, or stroke costs.

Q16. What is the coverage of LIC cancer?

Ans: LIC Cancer Cover provides early and advanced protection against cancer. The LIC Cancer Cover Plan is a regular bonus plan where premiums can be paid once a year or every six months for a period of 10 to 30 years. The policy can be purchased offline and online.

Q17. in cancer insurance what is the survival period?

Ans: During the first waiting period, the policyholder can not assert his insurance cover against cancer. Survival: In order to be eligible for the insurance claim, the insured person must survive a specified number of days (in most cases 7 days) from the date of the cancer diagnosis, the so-called survival time.

This Article Is Written By:
Kajal Bhagat

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