For most of us Indians, life insurance is just the other name of LIC. You talk of insurance for any purpose, be it tax saving or investment or protection, the name LIC comes to mind instantly. So will it be any different if LIC comes up with any plan and project it to be as Medical policy? I think the first reaction of every Indian citizen would be to just go for this medical policy instead of any other mediclaim policy. So lets check, if the new offering by LIC Jeevan Arogya policy – really worth so much
Medical Policies, What Actually are They?
There are two types of medical policies in the market. One is reimbursement and the second type is defined benefit medical polciy. Reimbursement policies are what we know as mediclaim policies where the policyholder gets his hospitalization expenses reimbursed from the given hospital list – either as cashless mode or by payment from the company. Defined benefit policies are the ones, where it is pre-decided that company will pay certain fixed amount on happening of certain fixed medical events
LIC Jeevan Arogya Review– Defined Benefit Policy
This offering from LIC is actually defined benefit policy and the key features are
- Minimum sum assured is Rs 1 lakh and the maximum is Rs 4 lakh under this policy.
- Benefit amount or sum assured is payable irrespective of the actual cost incurred by the policyholder on happening of certain specified medical events.
- Provides pre-defined/fixed benefits for hospitalization and surgical procedures under the given LIC Jeevan Arogya hospital list
- Per day cash benefit is payable on specified days of hospitalization.
LIC Jeevan Arogya Plan Details
Other benefits of the policy can be
- Minimum entry age is 18 years and maximum is 65 years.
- LIC Jeevan Arogya Premium will be fixed for every slot of 3 years.
- Hospital cash benefit will be payable if the policyholder stays in the hospital for more than 24 hours.
- Policyholder undergoing surgery, as mentioned in the list of the policy, will be entitled for major surgical benefits (MSB).
- Policyholder undergoing surgery, not listed under major surgery list, will be entitled for other surgical benefits (OSB).
How This Plan Works
Under this policy, benefits are pre-defined. If Mr Sukhminder Singh takes this policy for Rs 3 lakhs, then he is entitled for this entire amount on happening of certain pre-decided medical conditions, irrespective of his actual bill for the hospital stay. Let us assume that Mr Singh has fallen ill due to an accident and has been hospitalized for 5 days. He finally recovered and got back from the hospital with the total bill amounting to Rs 2.25 lakhs. Even in this scenario, he will be paid complete cover amount and that is Rs 3 lakh. Mr Singh will also be entitled for some pre-determined cash benefit in accordance to number of days during his stay in the hospital.
Advantages and Disadvantages of Policy
Just like every product has its pros and cons, this product too is not perfect. It too has its share of good and bad points. Let us start with points against Jeevan Arogya
- If more than one surgery is performed during same surgical procedure, you can claim for any one of the surgeries.
- If more than one day care procedure is carried out, you can claim for any one of the day care procedures.
- Day care surgery expenses will not be paid if you also want to avail hospital cash benefit.
- If someone has taken it for lesser cover amount of Rs 1 or 2 lakh, that will be highly inadequate in case of major surgery, say heart surgery or paralysis.
- No pre or post hospitalization expenses are covered
A few points in favor of Jeevan Arogya would be
- If someone is already having a mediclaim policy, he can make claim from that company and define benefits from LIC as well.
- You can cover all family members in one same policy.
Let all our readers be very clear in this LIC Jeevan Arogya review that this product or any pre-defined product will be useful only as an add-on to mediclaim policy and not as stand -alone policy for an individual or family.
This policy has been offered by LIC which is a giant in field of life insurance but little or no expertise in Health insurance segment. So it would not be advisable again to leave an expert (say Max Bupa/Apollo Munich/National insurance etc) and opt for this. Please read LIC Jeevan Arogya brochure and other plan details for better understanding before deciding for this one.