health protection plus
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LICS HEALTH
PROTECTION PLUS
PLAN 902
A LONG TERM UNIT LINKED PLAN WITHALL TYPES OF HEALTH RISK COVER
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USP Long term unit linked Health Insurance policy
Single Policy for all family members
No restriction on number of members
Addition of newly eligible members during the currency of thepolicy.
3 types of benefits viz., Hospital Cash Benefit, Major SurgicalBenefit and Domiciliary Treatment benefit.
Fixed Benefit schemes: irrespective of expenses forhospitalization and Surgeries
Escalation in Hospital Cash benefits with no increase inpremium.
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USP: ( Continued..)
Extended Hospitalization and major surgical risk coverageafter premium paying term
Health Risk cover for hospitalization and Major Surgeries up to75 years for Adults and 25 years for minor lives
No age limit for Domiciliary Treatment Expenses claim
Automatic recovery of risk charges from fund, in case of nonpayment of premiums
No lapse no foreclosure Policy will continue as long as fundis available.
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USP: ( Continued..) Fund grows with the market
Scheme continues for the family members on the death of thePremium Paying Person as long as the fund is available.
Compulsory savings for age related ailments .
Income Tax Rebate under Section 80(D)of the Income Tax Act1961 for full premium paid up to Rs.15000/=
Any time, Any where premium payment facility
Service through Fully Automated Systems.
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The benefits offered:1. Hospital Cash Benefit: (Double for ICU admissions)
Minimum Rs. 250/- Maximum Rs.2500/- for Principal Insured Rs.1500/- for other Insured. HCB of all Insured children are equal. In multiples of Rs.50/- HCB escalates at the rate of 5% per annum subject to a
maximum of 1.5 times.
2. Major Surgical Benefit:
200 times the Hospital Cash Benefit.
3. Domiciliary Treatment Benefit:
Reimbursement of the Domiciliary Treatment Expensesapplicable from the fund value.
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Benefit structure and the limits
Benefit Annual Limit Maximumlimitfor
theentireterm
HOSPITAL CASH
BENEFIT
(excluding first 48
hours and in excess of
subsequent 4 hours)
18 days in first year
including 9 days of
ICU
60 days in subsequent
years including 30days of ICU
365 days
For minor child up to
age 5: 90 days
MAJOR SURGICAL
BENEFIT
200 times Hospital
Cash Benefit
600 times Hospital
Cash Benefit
DOMICILIARY
BENEFIT
(REIMBURSEMENT)
2 times per year after
payment of at least 3
full years premiums.
Benefit starts from 3rd
policy year if mode is
yearly.
No Limit. During HCB
and MSB coverage
period. Up to the
balance of 50% of the
policy fund and one
annualised premium
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Who can be covered?
Proposer From Age : 18 years last Birthday to 55 years
Nearest Birthday. He/She pays the premium and is
Principal Insured
Spouse From Age: 18 years last Birthday to 55 years
NearestB
irthday
Children Children including adopted children from 3 months
to 17 nearest birthday years are admitted. Risk
cover for MSB starts at 18. No restriction in the
number of children to be covered.
Spouse after marriage/remarriage, new born children/ newly adopted
children can also be included after the commencement of the policy.
Cover commences from next policy anniversary after intimation.
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Risk cover up to
Principal Insured Uptotheageof75 yearsnearerbirthday.
Insuredspouse Uptotheageof75 yearsagenearer
birthday
Insured Children Uptotheageof25 yearsnearerbirthday
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Risk cover ceases, when?. On attaining the maximum age
On death of the any of the insured other than Principal Insured(for that insured only)
On non payment of premiums and fund is in-sufficient to coverthe risk.
On exhaustion of maximum limits for each of the benefits foreach of the insured.
Insured spouses cover terminates on the date of divorce/ legalseparation
Benefits are independent for their cessation.
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If premium paying person (Principal
Insured) dies.. No death benefit is payable. However if the Principal Insured
alone is insured then unit fund value is payable to thenominees.
In other cases, On death of the Principal Insured, the policycontinues on other lives till their maximum age or the fundvalue is available to cover the risk or the limit on the risk coveris exhausted whichever is earlier.
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The waiting Period for availing the
benefits. 0 days for accident claims
180 days for Hospital Cash Benefit and Major Surgical Benefitfrom the Date of Commencement
90 days for Hospital Cash Benefit and Major Surgical Benefitafter revival of the policy
Payment of 3 full years premium for reimbursement ofDomiciliary Treatment Benefit.
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The premiumPrincipal Insured alone
to be covered
Rs.5000/= per annum and six times the
Hospital Cash Benefit whichever is higher.
Principal Insured and
Insured Spouse are to be
covered
Rs.7500/= per annum and Six times the
Hospital cash benefit of Principal Insured
plus three times the Hospital cash benefit of
the spouse whichever is higher.Principal Insured, spouse
and Children are to be
covered
Rs.10000/= per annum and Six times the
Hospital cash benefit of Principal Insured
plus three times the Hospital cash benefit of
the spouse plus three times the hospital
cash benefit of all the insured children
whichever is higher.
Mode allowed : Yearly, Half Yearly and ECS
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The premium for Sub-standard lives
Principal Insured alone
to be covered
Rs.5000/= per annum and nine times the
Hospital Cash Benefit whichever is higher.
Principal Insured and
Insured Spouse are to be
covered
Rs.7500/= per annum and nine times the
Hospital cash benefit of Principal Insured if
the Principal Insured is sub-standard plus
five times the Hospital cash benefit of thespouse if the spouse is sub-standard ,
whichever is higher.
Principal Insured, spouse
and Children are to be
covered
Rs.10000/= per annum and nine times the
Hospital cash benefit of Principal Insured
plus three times the Hospital cash benefit ofthe spouse plus five times the hospital cash
benefit of all the insured spouse/children if
the insured spouse/children is Substandard,
whichever is higher.
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The charges from Premium
Allocation charges 30% in the first year
6% from second year onwards
Policy Administration
Charges
Rs.75/= per month during first year
Rs.25/= per month on subsequent years
Fund Management
charges
1.25% of NAV. (NAV declared is net of these
charges)
Health Insurance
Charges
Separate charges for each insured for each of
the benefits viz., HCB and MSB. Depends onthe age nearer birthday on each policy
anniversary. Recovered on monthly basis
Service Charges 10.3% Charges on Allocation charges, HCB
and MSB Charges, Policy Administration
charges and Fund Management Charges
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The policy lapses
If during the first three years if the premium is not paid within days of
grace, the policy lapses. It can be revived within two years from thedate of first unpaid premium on payment of premiums in full.
Deduction of charges will be made as long as the fund is available.
If lapsation continues after two years and fund is insufficient, policy isforeclosed with a simple Notice to the Principal Insured!
After three years, Principal Insured can pay all the premium or availpremium holidays subject to a balance of one annualised premium in
the fund.
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Addition of members
Situation When to
include
The cover starts
from
Marriage/remarriage ofthe Principal insured aftertaking the policy
Within one yearfrom the dateof marriage
The following policyanniversary
A Child born or Legallyadopted child less than 3months after taking thepolicy
Health Cover starts from the policyanniversary falling immediately afterthe child completes 3 months
Legally adopted child is
more than 3 months old
From the policy anniversary falling
after date of adoption
yThe new members will be eligible for the cover only if they satisfy theconditions of minimum premium and benefits.
yNew members must be included by the Principal Insured only. Nonew members will be allowed after the death of the principal insured.
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The policy does not have..
Surrender value
Policy loan
Assignment
Maturity Value
End for the Term as long as fund is available
Death Benefit
Addition of new member after the death of PI. Extension of cover to already existing members
after commencement
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The attractive features of this
policy Extended risk cover after cessation of premiums at the age of 65 of PI. Once HCB and MSB benefits are exhausted, there is no restriction on
the Min. balance for DTB. DTB can be availed on one lumpsum at anyinterval. One can bring an end to their policy.
Contrarily if one wants to continue their policy endless..willcontinue for DTB alone.
Benefits are independent of their cessation
Premium can be increased/decreased depending on the financial
circumstances subject to the conditions of no alternations in minimumpremium requirements and benefits opted .
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Policy servicing
Premium payment facility through any mode : ECS, NetworkedBranches .
All services viz., Change of address, Inclusion of member, Change ofbank account, Deletion of member, Revivals etc, through automatedsystems. Request Process is initiated at Branch level.
Issuance of Health ID cards by Third Party Administrators
Hospital Cash Benefits and Major Surgical Benefits Claims servicesthrough Third Party Administrators
All payments including Claims through LICs Centralized Systems.
Simplest procedure for domiciliary treatment benefits through yournearest offices.
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A comparison with Medi-claim
Charges for a Male Aged 42 years for
300000 SA under a Medi-claim scheme
Rs.4373/= per annum
Charges for a Male Aged 42 years under
LICs Health Plus I: HCB amount of 1500
X 365 = 547500 upto the end of the term
for MSB of Rs.300000/= is Rs.1631.50
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Additional features
Proposer can take this policy for additional5 lakhs SA if already Plan 901 is taken for5 lakhs.
Major students can be covered based ontheir parents income for a max of 5 lakhSA.
Female lives falling under all threecatergories can be covered under thisplan.