The Life Insurance Corporation of India has launched a new non-linked health insurance plan -- Jeevan Arogya.
The plan offers comprehensive hospitalisation benefits for the whole family of the principal insured. A unique feature of this plan is that it also offers to cover the parents in-law of the principal insured besides spouse, minor children and parents.
There is a provision for inducting additional members or removal of existing members in case of any change in family circumstances of the principal insured.
This is a defined benefit policy meaning that benefits are fixed in terms of policy conditions and are payable irrespective of the actual amount spent on treatment.
Moreover, the benefits are payable regardless of the life insured getting reimbursement under any other scheme from his/her employer or any other insurance company, on the basis of certified photocopies of the original bills.
The minimum age at entry for principal insured is 18 years and maximum age at entry would be 65 years for self and spouse, while it is 75 years for parents and parents in-law. For children, the minimum age at entry is 91 days and the maximum age at entry is 17 years.
The plan provides for continuing health cover of major family members up to age 80 and for minor children up to age 25. It offers various benefits to cover the different hospitalisation needs of the insured's family.
Another unique feature of this plan is that it offers to cover all surgeries. 140 major surgeries are covered under major surgical benefits, another 140 surgeries which do not need overnight hospitalisation are covered under day care procedure benefit and all other surgeries are covered under special category of other surgical benefits.
Hospitalisation in case of non surgical treatment beyond twenty four hours is covered under hospitalisation cash benefit. In case, hospitalisation is for seven days or more, payment is made for these twenty four hours as well.
The policy can be taken for an initial daily benefit of Rs 1,000, Rs 2,000, Rs 3,000 or Rs 4,000 The major surgical benefit will be 100 times of the daily benefit.
The maximum life time benefit applicable to each insured is 8 times of major surgical benefit sum assured. day care procedure benefit will be five times of the daily benefit.
Maximum three surgical procedures in a year are covered subject to life time benefit of twenty four surgical procedures in respect of each insured.
The other surgical benefit in respect of each insured is two times of the daily benefit per day for up to 360 days during policy term.
To provide for increase in cost of medical treatment, the benefits shall increase by 5% every year up to a maximum of 1.5 times of the original benefit.
In case no claim is made under the policy for a period of three years, the benefits payable under the policy would be further enhanced by 5 % without any upper limit.
Quick cash facility allowing payment of 50% entitlement can be availed as advance, in case of 57 specified major surgeries.
Premium waiver benefit and ambulance benefit are also available in case of certain major surgeries.
The plan also offers the option of taking term assurance rider (up to 100 times of initial daily benefit) and accident benefit rider for the principal insured and spouse.
The premium will depend on one's age, gender, the health cover option one has chosen, whether one is principal insured or other insured life and the mode of payment. The premiums can be paid regularly at yearly, half-yearly, quarterly or monthly (ECS mode only) intervals over the term of the policy.
The plan offers very attractive rebates for higher sum assured and half-yearly / yearly mode of payment.