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LIC Jeevan Arogya Plan No 904 Review, Features, and Benefits

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LIC Jeevan Arogya Plan

LIC Jeevan Arogya Plan is a Non-linked Health Insurance Plan. This plan covers the health insurance in unfortunate/ crucial cases. LIC Arogya Plan has modified and relaunched on 16th November 2013. LIC 904 plan covers the Principal Insured and his/ her family, Spouse, Children, Parents, and in-laws. For every generation, it is the perfect plan to cover their Medical Problems. Everyone has to face some medical problems in their life. There are some Health issues which we cannot afford financially. At those situations, LIC Health Plan will give you a financial support to you and your family. The Unique Identification number of LIC Jeevan Arogya Health Plan is 512N266V02.

This is a non-linked plan which provides fixed amount of Benefits for hospitalisation. It covers almost all types of surgical procedures irrespective of actual cost incurred and the benefit is in addition to any other health insurance cover that insured lives may have, subject to certain terms and conditions.

LIC’s Jeevan Arogya Policy 904 Features and Benefits

The LIC India has modified some key features and Benefits for this Jeevan Arogya Plan. These features are helpful the people who want to buy Health Insurance to provide Medical security to their family.

The Key Features involved in the LIC Jeevan Arogya Plan are

  • Lump sum benefits irrespective of actual medical costs.
  • Flexible premium payment options.
  • Financial protection in case of surgery, hospitalisation, etc.
  • Increasing health cover every year.
  • No claim benefit.

Benefits of LIC Jeevan Arogya 904 Health Plan

As every policy has some benefits, Jeevan Arogya Policy also has some benefits which attract you buy this policy. There are mainly two benefits under this policy.

  • Death Benefit.
  • Maturity Benefit

Death Benefit:

  • No Death Benefit will be provided under this policy unless the Term Assurance Rider along with or without the Accidental Benefit Rider opts.
  • On the death of the Principal Insured, the spouse will become the Principal Insured if this option is exercised at the beginning of the contract. If this option is not opted at the beginning, the policy will terminate.
  • It the insured spouse died before the PI and had not given any option to continue the policy as new PI then the will terminate, and other insured can take the new policy in respect of this other Insured:
    1. If the new policy has taken within the 90 days of termination of the plan, then the new policy will be issued without any underwriting conditions.
    2. The maximum age entry of the basic policy will not apply for this new policy.
    3. However, the outstanding waiting period and outstanding period of any exclusions are applicable under this plan.
    4. Other Terms and Conditions are applicable as per the new policy.
  • In the death of any insured other than the Principal insured the policy will continue by removing the insured. The change in premium will apply from instalment premium due date.

Maturity Benefit:

On survival to the end of the Policy Term, no Maturity Benefit will be provided.

Benefits Payable on Hospitalization:

The Benefits are useful for the life assured who wants to get the complete knowledge about this health plan. There are four types of Benefits under this plan. These are the benefits payable on hospitalisation.

  • Hospital Cash Benefit (HCB)
  • Major Surgical Benefit (MSB)
  • Day Care Procedure Benefit (DCPB)
  • Other Surgical Benefit (OSB)
Hospital Cash Benefit:

If the Principal Assured or any other insured is hospitalised, an amount of Applicable Daily Benefit(ADB) will be payable. The amount will be paid depends on the HCB chosen.

  • The minimum HCB paid for the Insured, or Principal Insured is Rs.1000/-.
  • The Maximum amount paid for the differ for the Insured Spouse and others.
    1. For PI: Rs. 4000/-. 
    2. For Insured Spouse: Less than or equal to PI.
    3. For Insured Parents/ Parents In Law: Less than or equal to Injured Spouse.
  • During the first year of cover ADB shall be the Initial Daily Benefit amount (i.e., Rs. 1,000, Rs. 2000, Rs. 3000 or Rs. 4000 per day) which is chosen by the policyholder.
  • For the next years, ADB increases by 5% and will continue until it attains a maximum amount of 1.5 times the initial daily benefit (i.e. 150%).
  • Benefits will be payable only after the first 24 hours of hospitalisation. If the insured is hospitalised for seven consecutive days, then the amount of the first 24 hours of hospitalisation also be paid.

Limits of HCB(Hospital Cash Benefit):

  • Maximum Annual Benefit:
    • For the first year of the policy, the HCB will be payable for 30 days of HCB including 15 days of I.C.U.
    • For the next years of the Policy, the HCB will be payable for 90 days of HCB including 45 days of I.C.U.
  • Maximum Life Time Benefit: 

The HCB will be payable for 720  days of HCB including a stay in I.C.U. The maximum days of staying of ICU is restricted to 365 days.

Major Surgical Benefit(MSB):

The LIC India Corporation will pay for Surgeries if the PI or any other insured undergoes any surgery. The percentage of MSB paid for the Major Surgical are as follows

  • Quick Cash facility is available where 50% of the cash will be paid in advance.
  • In the case of surgery, a total one-year premium will be waived from the instalment due date following the surgery date.
  • An additional lump sum of Rs. 1000/- will be paid for Ambulance service.

Limits of MSB:

  • MSB will be payable if the surgery will occur in India.
  • If more than surgery is performed through the same incisions, during the same surgical sessions, the corporation will pay maximum pay for that the surgery performed.
  • It will be paid as the lump sum by providing proof of surgery to the company.
  • The amount payable for MSB should exceed the 100% of the MSB Maximum Sum Assured.
  • Total amount payable under the MSB during the cover period (i.e. maximum lifetime benefit) shall not exceed 800% of the MSB SA.
  • The amount of Ambulance Expenses will be payable for any insured only once in any policy year. This will be payable is subject to providing satisfactory evidence to the Corporation.
Day Care Procedure Benefit:

Under this LIC Jeevan Arogya Plan, Day Care Procedure will be provided. If any PI or any insured under this policy undergoes Day Care Procedure Benefit, a lump sum amount is equal to 5 times of ADB(Applicable Daily Benefit) will be payable.

Limits of DCPB:

  • DCPB will be payable if the surgery occurs in India only.
  • The company will pay the Lump sum if they provide the proof of surgery.
  • The maximum Annual Benefit of for the PI or any insured covered under the policy is three Surgeries. Which means the maximum of three surgeries the company will pay the MAB.
  • The maximum Lifetime Benefit of for the PI or any insured covered under the policy is 24 Surgeries. Which means the maximum of 24 surgeries the company will pay the MLB.
Other Surgical Benefits(OSB):

Other Surgical Benefits are provided under this policy. A lump sum amount equal to 2 times of ADB will be payable for Principal Insured and any other insured covered under this policy.

Limits of OSB:

  • DCPB will be payable if the surgery occurs in India only.
  • The company will pay the Lump sum if they provide the proof of surgery.
  • The maximum Annual Benefit of for the PI or any insured covered under the policy is 15 days for the first year and 45 days for the next years.
  • The maximum life Benefit of for the PI or any insured covered under the policy is 360 days.

No Claim Benefit:

No claim Benefit will be payable under this LIC’s Jeevan Arogya Plan for insured covered under this policy. This benefit will be paid during the period between the date of commencement and next Automatic Renewal Date or between 2 Automatic Renewal dates of policy.

No Claim Benefit= 5% of the Initial Daily Benefit.

LIC Jeevan Arogya Plan Eligibility Criteria and Conditions

LIC’s Jeevan Arogya Plan has some eligibility conditions regarding the entry age, sum assured, policy term, etc. Check the Eligibility conditions for the Jeevan Arogya Health Insurance Plan.

Sum Assured Minimum Not Specified
Maximum Not Specified
Age at Entry Minimum Children 3 months (completed)
Parents/ Spouse/ Parents In Law 18 Years(Completed)
 

Maximum

 Chidren 17 Years
Parents/ Parents In Law 75 years
Principal Insured/ Spouse 65 Years

Maximum Cover Ceasing Age

Children

 25 Years
Parents/ Spouse/ Parents In Law 80 Years

Premium Payment Mode

Yearly/ Half Yearly/ Quarterly/ Monthly

LIC Jeevan Arogya 904 Plan Rebates

A rebate is an amount paid by way of reduction, return, or refund on what has already been paid or contributed. LIC India provides Rebates under this policy. There are three types of Rebates covered under this policy. They are

  • Mode Rebate.
  • HCB Rebate.
  • CEIS Rebate.

Mode Rebate:

The Mode Rebate rates provided under this policy are

  • For Half Yearly Mode: 2% of the tabular premium.
  • For Yearly Mode: 1% of tabular Premium.

HCB Rebate:

If HCB is more than Rs.1000/-, then the premium arrived at in respect of the member covered under the policy will be reduced by an amount is given below

HCB (Rs) For PI For each insured member other than PI
2000 500 250
3000 1000 500
4000 1500 750

CEIS Rebate:

This Rebate applicable only for the Employees of the LIC Corporation as 10% of the tabular premium.

LIC Jeevan Arogya Plan 904 Riders

A rider is an add-on provision to a basic insurance policy that provides additional benefits to the policyholder at an additional cost. Rider Benefits are provided under the policy. There are two types of Riders available in this Jeevan Arogya Plan.

  • Term Assurance Rider.
  • Accident Benefit Rider.

Term Assurance Rider:

The Term Assurance Rider is available only for Principal Insured and Insured Spouse only.

Sum Assured Minimum 1,00,000
maximum Amount equal to MSB sum assured a maximum of Rs. 25 lakh overall limit of existing policies.(SA should be in multiples of Rs. 25,000/-)
Age at Entry Minimum 18 years (completed)
Maximum 50 years (nearest birthday)

Maximum Cover Ceasing Age

 60 Years(Nearest birth)

Policy Term

 35 Years

Premium Payment Mode

Same as the Basic Policy

Accident Benefit Rider:

This Rider is available for PI and Insured Spouse provided for the Term Assurance Rider has opted.

Sum Assured Minimum Rs. 25,000/-.
maximum Amount equal to MSB sum assured, the maximum of Rs. 50 lakh overall limit of existing policies.(Accident Benefit SA should in multiples of Rs. 5,000/-)
Age at Entry Minimum 18 years (completed)
Maximum 50 years (nearest birthday)

Maximum Cover Ceasing Age

 60 Years(Nearest birth)

Policy Term

 35 Years

Premium Payment Mode

Same as the Basic Policy

Options under LIC Jeevan Arogya Plan

LIC Jeevan Arogya Plan provides various options for the life assured. Check the options under this LIC 904 health Policy. The options under LIC Health Plan are

Option to Migrate:

Under this LIC Jeevan Arogya 904 Policy, there is an option to migrate. Children covered under this plan may have the option to take new policy at the end of the particular exit age. Or you can also migrate when the policy is at renewal stage. New LIC India Jeevan Arogya Policy should buy within the 90 days of the termination of the child membership.

Changing the Plan:

No alteration from this plan to any another plan will be allowed.

Cover to new Additional Members:

Under this LIC Jeevan Arogya Plan, PI have the option to add new members. There are some particular conditions when you are going to add new members to your policy.

  • If the Policyholder or PI gets married or remarried during the policy term, the spouse can be added within the six months of the marriage. But cover will start to form the policy anniversary.
  • If a child born or you legally adopted the child after taking the policy, you can add the child after three months age for a newborn baby or after three months of the adoption.

In any other cases, new members cannot be added to the existing policy. Which means existing Spouse/ Parents/ parents-in-law cannot cover under this policy. At the time of taking new policy, PI can add Spouse/ Parents/ Parents-in-law.

  • If both the parents(Father & Mother) are alive and are eligible for the policy then either both of them are covered under the LIC Jeevan Arogya Plan, or none of them is covered under this plan.
  • Principal Insured can only add the new members. After a death of the PI, no addition will be allowed.
Quick Cash Facility:

If any insured covered in this LIC Jeevan Arogya and he undergoes any surgery under the category of MSB I & II in the listed network hospitals, then PI will have the option to have Quick Cash Facility. In this facility, 50% of the Eligible MSB amount will be provided even during the hospitalisation. Principal Insured or any insured under this LIC Jeevan Arogya Plan will get the amount in the period of hospitalisation. There is no need of waiting for the claiming process after the discharge.

Sample Premium Rates for LIC’s Jeevan Arogya Plan

The Sample Rates for LIC Jeevan Arogya Plan are

Principal Insured:

Age at entry

Premium (`)

20

1922.65

30

2242.90

40

2799.70

50

3768.00

Spouse (Female) / Parent (of Pi/Spouse) (Female)

Age at entry

Premium (`)

20

1393.15

30

1730.65

40

2240.60

50

2849.10

Child

Age at entry

Premium (`)

0

792.00

5

794.75

10

812.35

15

870.75

These premiums indicated here are exclusive of Service Taxes.

LIC Jeevan Arogya Plan

Buying procedure for LIC Jeevan Arogya Policy No 831

The policyholder can visit the nearest LIC Branch Office to buy the Proposal form. Or you can go through the online to purchase the Policy. You can also get the LIC Jeevan Arogya 904 Plan through the Agent.

Documents needed for LIC India Jeevan Arogya

  • Application form/ Proposal form along with a photo.
  • Address Proof.
  • Age Proof.
  • Medical reports (If required).

Note: Proposal form No. 300 and 340 will be applicable under this plan.

How to Claim for LIC 904 Jeevan Arogya Plan?

Nominees can claim for the Jeevan Arogya Plan after the death of the policyholder or after the successful completion of the premium.

The documents required to claim for the LIC Arogya Plan are

  1. Original Policy Document.
  2. Proof of title.
  3. Death Proof.
  4. Medical treatment documents before death.
  5. Age proof.

Additional Information on LIC Jeevan Arogya Plan No 904

Grace Period:

The grace period for the LIC’s Jeevan Arogya Plan is as follows. For payment of yearly, half-yearly or quarterly, rider premiums grace period of one month but not less than 30 days will be allowed and 15 days for monthly premiums.

Revival Period:

If the Principal Insured doesn’t pay the premium within the grace period, then the Policy will be the lapse. A lapsed Term Plan can be revived within the two consecutive years from the date of first unpaid premium. This Term plan will be revived before the expiry period of Policy term.

Surrender Value: 

If the insured candidate wants to return the policy within the Minimum Policy Term, no surrender value will be paid to the policyholder.

Cooling Off Period: 

If you are not satisfied with the Terms and Conditions of the Policy, you can return the LIC Jeevan Arogya Plan within the 15 days from the Date of receipt of the Policy.

Back Dating:

No Back Dating Interest will be available under this policy.

Policy Stamping:

Policy Stamping will be at the rate of Rs. 0.20 per thousand of total MSB SA.

Assignment/ Nominations:

No Assignments/ Nominations are available under this plan.

Waiting Period:

The Waiting period is available under this plan. The Waiting periods are

  • General Waiting Period.
  • Special Waiting Period.
General Waiting Period:
  • There is no General Waiting Period in the case of hospitalisation or surgery due to Accidental Bodily Injured.
  • General Waiting period is available if the hospitalisation or surgery occur due to the following reasons.
    1. There will be general waiting period of 90 days from the Date of Cover Commencement in respect of each Insured.
    2. For a Revived Policy the following conditions will apply on General Waiting Period.
      • If the policy revived within the 90 days from the first Unpaid Premium then a general Waiting Period of 45 days for each insured covered under the policy.
      • If the policy revived beyond the 90 days from the first Unpaid Premium then a general Waiting Period of 90 days for each insured covered under the policy.
Special Waiting Period:
  • The Special Waiting Period will be two years from the Date of Cover Commencement in respect of each insured.
  • There will be no benefits under this policy if the PI or insured covered under the following treatments.
    1. Treatment for benign uterine disorders like fibroids, uterine prolapse, dysfunctional uterine bleeding, etc.
    2. Treatment for Piles.
    3. Treatment for benign enlargement of prostate gland.
    4. Treatment for adenoid or tonsillar disorders.
    5. Treatment for slip disc.
    6. Treatment for benign thyroid disorders.
    7. Treatment for anal fistula or anal fissure.
    8. Treatment for degenerative joint conditions.
    9. Treatment for benign breast disorders e.g. fibroadenoma, fibrocystic disease, etc.
    10. Treatment for kidney or urinary tract stones.
    11. Treatment for Carpal tunnel syndrome.
    12. Treatment for sinus disorders.
    13. Treatment for varicose veins.
    14. Treatment for Cataract.
    15. Treatment for hydrocele.
    16. Treatment for Gallstones.
    17. Treatment for Hernia.

Reinsurance:

Reinsurance is available under this plan. Our Retention limits are as follows:

  • Hospital Cash Benefit: Rs. 500/- Daily Hospital Cash Benefit.
  • Major Surgical Benefit: Rs. 50,000/- Major Surgical Benefit Sum Assured.
  • Day Care Procedure Benefit: Rs. 2,500/- Day Care Procedure Benefit.
  • Other Surgical Benefit: Rs.1,000/- per day Benefit.

FAQ’s on LIC Jeevan Arogya 904 Policy

Who can be insured?

Principal Insured can add their Spouse, Parents, and Parents-in-law to your policy at the time of buying a fresh policy.

Minimum age at entry Maximum age at entry
Self / spouse 18 years 65 years (last birthday)
Parents / parents-in-law 18 years 75 (last birthday)
Children 91 days 17 years (last  birthday)

Is there any Death Benefit under this policy?

There is no Death Benefit under this policy unless you have added any Term Assurance Rider with or without Accident Benefit Rider opts.

How long is each insured under this policy?

Each of the insured is covered for Health risks up to age (80). Children are insured up to age 25 years.