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LIC's Health Insurance Plans - Features & Inclusions

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Written by Amit Jain

Updated Aug 07, 2024

LIC is an undertaking by the Government of India in the field of health insurance to provide a financial shield against medical emergency treatments in the face of growing economic inflation. It is a highly traditional insurance policy with comprehensive and revamped features customised to meet healthcare needs of modern times. 

Key Features Of LIC Jeevan Arogya Plan

The fact that LIC Jeevan Arogya medical insurance is not subject to market risks i.e it’s non-linked to market fluctuations and non-participating implying that it doesn't earn any extra bonus to the insured, makes it a unique plan offering timely financial assistance in medically critical times. Following are some key features of Jeevan Arogya given below:

  • Well covered and financially beneficial protection against expenses incurred on emergency medical treatment and services; hospitalisation; surgery etc
  • LIC Jeevan Arogya policy offers medical cover on both individual as well as family floater basis  
  • Lump sum medical coverage benefits regardless of the actual total medical expenses 
  • Enhanced health cover every policy year
  • It offers an array of choices for flexible benefit limit like daily benefits; surgical benefits; daycare benefits etc
  • Flexible payment options on premium amount
  • Generally, no waiting period is offered on emergency surgical procedures or hospitalisation
  • Benefit of no claim clause under the plan
  • No surrender value on this plan
  • No provision of loan facility under the plan
  • Very simple steps to buy your LIC Jeevan Arogya health plan 

Inclusions Of LIC Health Insurance Plan

LIC's Health Insurance Plans

Below mentioned are few inclusion clauses included under the LIC health insurance plan:

  • Individual And Family Floater Plan: LIC Jeevan Arogya Rakshak health plan offers cover against medical costs to not just the policyholder but extends the same for his spouse, dependant family members too under family floater plan
  • Surgical Benefit: If your surgical procedure falls in the enlisted category, then as an insured policyholder, you will be accorded an amount based on a percentage of the major surgical benefit sum assured which could range from 1 lakh to 4 lakhs
  • Hospital Cash Benefit: when an insured person or his family member covered under this plan get hospitalised in case of an emergency illness/bodily injury for more than 24 hours, LIC health insurance Co. pays them certain pre-decided benefits on expenses incurred from the second day of admission. 
  • Coverage Against Cancer: LIC cancer cover provides an insured patient with predetermined coverage benefits once he/she is diagnosed of early or late-stage cancer
  • Flexi Premium Payment Options: An insured policyholder can choose to pay his premium amounts in annual or bi-annual basis depending on the cover duration
  • Paramedical/Ambulance Service: You can claim benefits on ambulance and paramedical facility availed during hospitalisation period amid a major surgery. 

Exclusions under LIC Health Insurance Plan

Highlighted below are few exclusions on the LIC health insurance plan:

  • Pre-existing illnesses and conditions which have not been mentioned in the patient’s disclosure form 
  • Any experimental surgical procedure
  • Organ donation surgery
  • International hospitalisation undertaken by the insured person
  • Any natural disaster related accidental/ bodily injury
  • Conspiration in unlawful acts and criminal offence by the insured person
  • Diagnosis of cancer within 180 days of issuance of LIC health policy
  • AIDS/HIV condition
  • Substance abuse toxicity such as usage of prohibited drugs; alcohol etc

Types Of Health Insurance Plans Offered By LIC

There are two main health insurance plans offered by LIC Company:

  • LIC Arogya Rakshak: This policy offers coverage on expenses incurred on hospitalisation, surgeries, accidents and critical conditions/illnesses  
  • LIC Cancer Cover: The LIC Cancer cover plan covers for the insured financially against medical costs borne during various stages of cancer providing lump sum amount post diagnosis 

Top LIC Health Insurance Plans

While uncertainties in life in terms of being hit financially, medically or accidentally are innumerable and sufficient to disrupt not just the bank balance but also a family’s peace of mind, LIC offers a relief cover as a way to safeguard health savings. The corporation provides two main types of health insurance plans namely LIC Arogya Rakshak and LIC Cancer Cover policies each tailored to suit specific medical requirements.

From the perspective of covering against certain specified health conditions and medical risk for an insured individual and his family unit, the LIC Arogya Rakshak policy comes as a great boon and considered as one of the top health plans offered by the Co.

On the other hand, LIC Cancer cover plan specifically caters to providing health coverage against various stages of cancer. It is a Regular Premium Health Insurance Plan which is Non Linking and Non Participating type.  

Benefits under LIC Arogya Rakshak

  • Hospital Cash Benefit: If an insured person or his family member covered under the plan get hospitalised for an emergency illness/accidental injury for more than 24 hours, LIC health insurance Co. pays them a certain pre-decided Applicable Daily Benefit amount on the expenses incurred once the time of hospitalisation exceeds 24 hrs
  • Day Care Procedure Benefit: This is a lump sum amount 5 times the Applicable Daily Benefit amount which is paid to an insured policyholder who undergoes a Day Care procedure regardless of the actual medical costs incurred subject to T&C of the policy
  • Surgical Benefit: If the surgical procedure undertaken by an insured person is not listed under Day Care and Major Surgical procedure leading to hospitalisation which exceeds 24 hour period, then you will be accorded an amount which is two times the Applicable Daily Benefit amount  subject to T&C of the policy
  • Ambulance Service: Insured individual gets cover on the costs incurred on ambulance transport availed during hospitalisation amid a major surgery
  • Premium Waiver Benefit: In the event of a major surgery for which the insured policyholder has received Major Surgical Benefit, they can avail a Premium Waiver Benefit too in which they get a complete one year waiver of their premium amount commencing from the date of the surgery
  • No Claim Benefit: If the insured policyholder does not file for a claim within a policy year or between two auto renewal dates, he/she will be eligible for a No Claim Benefit wherein the No Claim Benefit amount would be 5% of the initial daily benefit for each insured person   
  • Tax Waiver: Insured policyholder who’re normal citizens are entitled to tax exemption for premium worth Rs 25000 while senior citizens get tax relief on 50,000 under section 80D of Income Tax Act

Documents Required For LIC Health Insurance Policy

To buy your LIC health insurance policy, you require the following documents:

  • Age proof
  • Address proof
  • Proof of Identity 
  • Medical lab tests/diagnostics and reports as prescribed by the medical practitioner

FAQs

Ques 1. What is the waiting period of LIC health insurance policy?

Ans. In case of LIC Mediclaim policy, the waiting period is of 90 days except when the insured undergoes hospitalisation or a surgery.

Ques 2. What is the limit on Major Surgical Benefit amount in LIC health insurance policy?

Ans. The initial Major Surgical Benefit cover in LIC health insurance policy ranges from 1 lakh to 4 lakh.

Ques 3. Do LIC health insurance plans come with any riders?

Ans. LIC health insurance plans offer two riders- term assurance rider and accident benefit rider. 

Wish

Written by Amit Jain

Amit is an upcoming name in the motor industry be it new cars/ bikes or used ones. Amit in his last stint worked as a consultant for major Fortune 500 companies across the globe.&Read More

Disclaimer

This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.
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