Introducing JEEVAN AROGYA Table 903: New Health Benefit Plan

Jairam Gopalan Aiyer, 9223391469 / 9323186228 insuranceinindia@gmail.com

Comprehensive

insurance for a

n

entry level car in

India is

approximately

Rs.12000/- a

nd goes

up to Rs.2

0000/- for

mid level cars

Comprehensive insurance for a motorcycle is

approximately Rs.1500/-

That is all it takes for you and your family to be free from all hospitalization worries every year with LIC’s

Jeevan Arogya

YES

Total family hospitalization & surgical insurance for the price of your car insurance…

Because we believe you love your family more than your vehicle

A little bit

Special Attractions• Benefit payout is fixed irrespective of actual

expenses incurred. • Can be availed along with Medi-claim for the

same Hospitalization/ Surgery• On the basis of Xerox copies of Bills• Guaranteed Premium for 3 years. • Auto Renewal Date (ARD) after each 3 Yrs to

revisit Premium depending on experience. • New Premium rate applicable on age at entry

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Special Attractions1. Hospitalization Cash Benefit (HCB) : Rs.1000, 2000, 3000, 4000 PER DAY

• Up to Rs. 4000 per day for maximum no. of 720 days• Up to Rs. 8000 per day for max. no. of 360 days in ICU

2. Major Surgical Benefit (MSB) :100 times HCB/ADB• No of Surgeries increased to 140• MSB available for Minors also• MSB Benefit is in addition to MSB under Plan 901/ 902

3. Day Care Procedures (DCPB) : 5 times HCB/ADB• Addition of 140 Surgeries, 3 in a year, 24 in life-time

4. Other Surgical Benefit (OSB) : 2 times HCB/ADB• All other Surgeries covered

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USPsOther Benefits:

5. Premium Waiver Benefit : One annualized premium

w.e.f next instalment Premium following Surgery

• PWB under 57 Surgeries (15 Surgeries 100% + 42 60% S.A.)

6. Ambulance Expense @ Rs.1000 p.a per person

for 57 Surgeries (15 Surgeries 100% + 42 60% S.A.)

7. Auto increase @ 5% in both HCB & MSB up to 50%

even if there is any claim to take care of inflation

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USPs 8. Quick Cash :

• 50% Advance Payment under 57 Surgeries

• (15 Surgeries 100% + 42 60% S.A under MSB only)

• Performed in Net Work Hospitals

9. No Claim Benefit• 5% of Initial HCB on ARD is added without any upper limit

10. Term Assurance & Accident Benefit Riders : (Optional )• Up to 25/ 50 lacs respectively till age 60 years

Maximum term 35 years. S.A.= MSB S.A.

Minimum S.A. for Term Rs.1 lac, For A.B. Rs.25,000

Special Attractions• Age at entry for PI and Spouse from 18 to 65 Yrs

• For Parents/ Parents-in-laws 18 to 75 Yrs• For Children 91 days to 17 Yrs

• Maximum Health cover for every one up to 80 Yrs • Except up to max. 25 Yrs for dependent Children

• Risk cover up to 4 lacs per insured Subject to overall limit of 10 lacs

• (All our Health Policies put together)

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HCB limits for each Insured

• P.I As per his/her choice

• Spouse < or = P.I

• Children < or = Spouse / < or = P.I if no spouse

Children to have equal HCB

• Parents < or = Insured• Parents in law < = Insured • Parents/ Parents in law to have equal HCB

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HCB : Benefits at a glance HCB increases by 5% every year Up to1.5 times.

Eg. Rs 1000/- after 1 Yr becomes Rs.1050 and in the 11th Year becomes Rs.1500/-(Max) • Hospitalization eligibility condition:

Fraction of 4 Hours treated as a day

First 28 hrs eligible for 1 day benefit

First 24 hours : No benefit

Exception: When hospital stay exceeds continuous

period of 6 days and 4 hours, HCB for 7 days

(including 1st day also) is allowed

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HCB : Benefits at a glanceAnnual limit

for each insured

Maximum limit for each insured during entire

policy term

1st policy year

30 days of hospitalization of which 15 days of ICU is allowed.

subsequent years

Each year- 90 days of hospitalization of which 45 days of ICU is allowed.

720 days .

of which

360 days of ICU

allowed

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MSB- Benefits at a glance

• MSB allowed for 140 surgical procedures

• 100% SA 15, 60% SA 42, 40% SA 60, 20% SA 23 Annual Limit • 100 times of HCB in a policy year (Max. 4 lacs)

Life time Limit • 800 times HCB in full policy term (Max. 32 lacs)

Day Care Procedure Benefit (DCPB)

• DCPB = 5 X HCB

• 140 Listed day care procedures

• 3 Day care Procedures per year

• 24 Day care Procedures in Policy Life time

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Other Surgical Benefit (OSB)

OSB = 2 x HCB

• Any surgery other than MSB, DCPB

• At least 24 hours stay in Hospital required

• Annual limit : 15 days in 1st policy year• 45 days in each subsequent years

• Life time limit : 360 days per Insured14

Term Assurance Benefit Rider Minimum Term Assurance SA : Rs. 1,00,000 Maximum Term Assurance SA : Equal to initial

MSB-SA (i.e.,100 X HCB ) Term Assurance SA : in multiples of Rs.25000/-

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Minimum Entry Age 18 Yrs completed

Maximum Entry Age 50 Yrs (NBD)

Maximum age for cover 60 Yrs (NBD)

Maximum Term 35 Years

Accident Benefit RiderThis benefit available if Term Assurance Benefit rider opted

Minimum Benefit : Rs. 25,000 Maximum Benefit : Equal to initial MSB-SA

( i.e.,100 X HCB) AB Sum Assured shall be in multiples of Rs.5000/-

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Minimum Entry Age 18 Yrs completed

Maximum Entry Age 50 Yrs completed

Maximum age for cover 60 Yrs completed

Maximum Term 35 Years

Quick Cash facility

• Advance 50% of MSB amount to PI

• Category I or II Surgeries

• Hospitalized in a ‘Net work’ Hospital

• PI/ Relative informs LIC/TPA

• TPA processes request/ advices LIC on payment

• LIC credits eligible amount to PI Bank account

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Ambulance charges

• Rs. 1000/- reimbursed per insured per Year towards Ambulance charges

• Ambulance charges incurred for transportation of the insured to undergo Major Surgeries under category 1 or 2

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No Claim BenefitDuring the period between two Automatic Renewal

Dates or from DOC to next Automatic Renewal Date, if there are no claims in respect of any insured, No claim Benefit is payable

No claim benefit would be equal to 5% of initial Daily Benefit

Effective from the immediately following automatic renewal date

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USPsPremium rate may be reviewed

for every 3 years

If revised, the new rate corresponding to

the age at entry of each insured will be

the new premium

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Illustration-1 Example

PI takes a Policy in 2011

Age of PI in 2011 = 36

If premium revised in 2014

The new premium rate of PI will

be the revised premium corresponding

to age 36 in the new table.

Rebates available on Tabular premiums

Mode Rebate

Rebate for HCB Opted

Hly Yly

2000 HCB 3000HCB 4000HCB

PI others PI others PI others

1% 2% Rs.500 Rs.250 Rs.1000 Rs.500 Rs.1500 Rs.750

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Addition of members

ConditionWhen to include

The cover

starts from

Marriage/remarriage of the Principal Insured after DOC

Within 1 Year from the date of marriage

The following policy anniversary

A Child born or Legally adopted child after DOC

Health Cover starts from the policy anniversary falling immediately after the child completes 3 months

Legally adopted child is more than 3 months old

From the policy anniversary falling after date of adoption

New members must be included by the Principal Insured only. No new

members will be allowed after the death of the principal insured.

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The policy lapses…

• When premium is not paid within days of grace, the policy lapses and no benefits will be payable there after .

• Policy can be revived within 2 years from the date of first unpaid premium subject to payment of outstanding premiums with interest and underwriting.

• Others : Loan Facility is not there

• Assignment facility is not there

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The waiting Period foravailing the benefits……………….

0 days for accident claims 90 days from the Date of Commencement for HCB

& MSB

45 days after revival, if revived within 90 days from FUP of the policy. for Hospital Cash Benefit and Major Surgical Benefit

90 days if revived after 90 days from FUP

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Nature of Benefit1st Pol

Year (Rs)2nd Pol Year (Rs)

Max. eligible

During the Policy term (Rs)

Hospital Cash Benefit (HCB) including ICU Benefit

45,000 1,41,750 16,20,000

Major Surgical Benefit (MSB) 1,00,000 1,05,000 12,00,000

Other Surgeries Benefit (OSB) 30,000 94,500 10,80,000

Day Care Procedure Benefit (DCPB)

15,000 15,750 1,80,000

Maximum Benefit under the policy per insured

40,80,000

Ambulance Charges incurred Rs.1000/- per insured per year

Premium Waiver Benefit One Year PremiumNo Claim Benefit Increase in HCB by 5%

Benefit Illustration – for HCB 1000

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Total Premium (Rs.) Total Maximum Benefits(Rs)Insured/ Age/ Term 4000 HCB1. Male-PI-45/35 3,90,622 (4 lacs) 1,68,72,000 (1.7 cr.)2. Spouse-40/35 2,81,160 1,68,72,0003. Son-17/8 22,983 1,21,92,0004. Daughter-10/15 36,516 1,59,20,0005. Parent1-70/10 2,34,146 1,43,48,0006. Parent2-65/15 2,16,900 1,59,20,0007. Parent inlaw M-65/15 3,06,208 1,59,20,0008. Parent inlaw F-60/20 2,62,293 1,59,20,000Total Premium Paid Rs.17,50,829  Less IT Rebate Rs.2,47,163  Net Premium Paid / Total Maximum Benefits Rs.15,03,666

Rs.12,39,64,000

Total Premium/ Benefit  Rs.15 lacs Rs .12.5 crore

Cost/ Benefit Illustration : 8 lives

Product Positioning

• Vis-à-vis Medi-claim • As no Maturity/ Saving/ Unit Investment/ Withdrawal

element• Long term up to 80 yrs cover

• Auto Renewal Premium after each 3 years applicable on age at entry throughout term of policy

• Market Segment :Everyone & Anyone

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Call JAIRAM919223391469919323186228

Email:insuranceinindia@gmail.com

THANK YOU