LIC Jeevan Arogya Review – Should you buy it ?

by Hemant Beniwal on June 12, 2011

When it comes to financial products no brand can be bigger than LIC. Recently LIC Launched LIC Jeevan Arogya & queries started showering:

  1. Deepak “kindly advise me of the new lic plan jeevan arogya. Whether I should purchase it.”
  2. Kiran “Please give me details for Jeevan arogya lic plan I want to take this”
  3. Anup “Suggest me about lic’s mediclaim policy jivan arogya……..”
  4. Munish “Query on lic Jeevan Arogya – can I go with this one or not.”

So go ahead and read its complete review – features, some special features, limitations, complications, comparison with other health insurance products & finally should you buy it.

Lic Jeevan Arogya LIC Jeevan Arogya Review   Should you buy it ?There’s nothing wrong if we say that Health Insurance should be purchased to “save your savings”. On one side there’s increase in Life expectancy due to improvement in medical facilities and on the other there’s deterioration in health due to life style changes. And accompanied with increasing medical costs and other healthcare expenses, keeping one self adequately insured with proper health insurance cover has become inevitable.

Though individuals start realizing the importance of health insurance but still they are more confused with number of products available in the market. Previously there were only general insurance companies that provide this insurance, then came Standalone health insurance companies and now Life Insurance companies has also started selling health insurance. This confusion is clearly visible among people as, whenever any new plan is launched in the market people gets excited and starts enquiring about the same. Recently LIC has launched a new Health Insurance Plan naming “Jeevan Arogya”.

So, we have tried to review this from a Financial Planning perspective and how does Jeevan Arogya stand against existing policies in the industry.

Who can be insured under LIC Jeevan Arogya ?

Under a single policy you can cover your complete family (which includes you, your spouse and children), your parents and your parents –in-law.

The Minimum and maximum age at entry is as under:

Minimum age at entry Maximum age at entry
Self/Spouse 18 years 65 years
Parents/Parents in law 18 years 75 years
Children 91 days 17 years

Features & benefits of LIC Jeevan Arogya

  1. LIC Jeevan Arogya is a defined benefit, non linked plan where the benefits are fixed and will be payable to you in full, irrespective of the actual amount spent on treatment.
  2. It covers the Hospital cash Benefit (HCB) which means that you will be paid a defined amount for the number of days you have stayed in the hospital. There are 4 variants available under this feature. Rs 1000 per day, Rs 2000 pr day, Rs 3000 per day and Rs 4000/- per day. Your premium and other features and sum assured will be dependent on the variant you have chosen under HCB.
  3. Jeevan Arogya covers some 140 defined major surgeries. In case you get operated for any surgery as defined under this policy feature you will be paid lump sum amount which is equal to 100 times the HCB chosen. Which means that if you have chosen a plan of Rs 2000/- per day HCB then your Sum assured under Major Surgical benefit (MSB) feature would be Rs 2 lakh. And this amount will be paid to you irrespective of your actual expenditure on the procedure.
  4. There is some 140 day care procedures defined under this plan. If you get operated under that specific procedure than you will be paid 5 times of HCB plan you have chosen. Which means if you have chosen a plan of Rs 2000/- per day HCB then your sum assured under day care Treatment feature would be Rs 10000/-. And this amount will be paid to you irrespective of your actual expenditure on the procedure.
  5. In the event of an Insured under this plan, undergoing any surgery not listed under MSB or day care treatment causing the insured hospitalization to exceed a continuous period of 24 hrs with in the cover period, then a daily benefit equal to 2 times the HCB shall be paid for each continuous period of 24 hrs.

Special Features of LIC Jeevan Aarogya

  1. Double benefit: If due to medical complications patient has to admit to ICU then he becomes eligible to claim 2 times of HCB as per the plan.
  2. Coverage for all: You can cover your Parents and Parents-in-law under the same single policy along with you, your spouse and children.
  3. Quick Cash Facility: Though this is a Reimbursement policy which means that you have to make claim of the policy benefits after getting the treatment done. But in special surgeries covered under MSB, insured can claim 50% of the Sum assured which may be paid during hospitalization period. This amount will be adjusted in the final settlement.
  4. Premium Waiver benefit: In case the procedure operated under special categories defined under the MSB then one year premium will be waived.
  5. Riders : There are 2 additional riders offered under the policy- Term assurance rider under which the maximum sum assured offered is 100 times of HCB and Accident benefit rider where the sum assured offered should be less than or equal to Sum assured under Term assurance rider.

Limitations of Jeevan Arogya

In this we’ve not covered the basic and general limitations and exclusions that are applicable to almost all the Health Insurance policy. But specific limitations as is there in the features of the policy.

  1. There’s annual and Lifetime limit imposed on the Daily cash benefit feature in LIC Jeevan Arogya. In the first year one cannot claim for more than 30 days in case of NON ICU stay and for ICU stay the LIMIT is 15 days. Second year onwards this limit will be increased to 90 days for NON ICU stay and 45 days for ICU stay. In lifetime you can claim maximum of 720 days in case of NON ICU stay and 360 days in case of ICU stay.
  2. In Major surgical benefit you can claim only once in one year and 8 times in lifetime.
  3. In day care Procedures you can claim maximum for 3 procedures in a year and limit is 24 for lifetime. Also, it’s not paid if you claim for Hospital Cash Benefit
  4. For Term assurance rider your Total Sum assured from other policies and riders should not exceed 25 lakh.
  5. For accidental Rider your total sum assured under all other individual and group policies should not exceed Rs 50 lakh.
  6. Maximum Sum Assured in the policy is Rs 4 lakh.

Complications in LIC Jeevan Arogya

Here we’ve covered those limitations which usually gets hide under the noise of benefits but comes to cover at the time of claim. As the Policy is Reimbursement policy so one must know what to be claimed for otherwise this will lead to unnecessary harassment afterwards.

  1. If both of the parents (father and mother) are alive and are eligible for cover, then either both of them will have to be covered or none of them will be covered. The PI will not have any option to choose one of them. The same condition will apply for parents-in-law also.
  2. All the benefits will become payable only if the Hospitalization or surgery has been performed in India
  3. If more than one major surgery is performed during the same surgical session, you can claim for only one surgery.
  4. If more than one day care procedure is performed during the same surgical session then you can claim for only one procedure.
  5. No benefit will be paid for first 24 hrs of stay in the hospital. Which means that if your stay in Hospital is for 5 days , you will be paid for only 3 days. But if your stay exceeds 7 days then afterwards you become eligible to be paid for first 24 hrs also.
  6. The HCB will be paid for continuous stay of 24 hrs in Hospital or part there of provided any such part exceed continuous period of 4 hrs ( after having completed 24 hrs as above).

Comparison of LIC Jeevan Arogya with other Health Insurance Policies

If you draw a comparison between existing policies from Apollo Munich, Bajaj Allianz and Tata AIG, you find these much simpler in terms than LIC. Also the desired benefits which an individual seeks from the policy are higher in certain areas.

lic jeevan arogya comparison LIC Jeevan Arogya Review   Should you buy it ?

Should you buy Lic Jeevan Arogya

Health insurance is a very specialized field and requires a good amount of knowledge to understand the jargons a company uses in the policy terms. LIC is a life insurance company and whether agents have equipped themselves to sell these kinds of product, time will tell. In the case of Reimbursement policies and that too from nationalized companies, role of agent increases as they don’t have the culture of customer service centers/ 24 hr service numbers.

As we have been debating, linking investments with Life Insurance in ULIPs, one can also debate that LIC has tried to bring in life and health benefits together through this product. This has only introduced complexity in the mind of consumers especially in areas where financial literacy is too low.

With regard to LIC Jeevan Arogya – it cannot be considered as an adequate health insurance policy as it does not cover actual hospitalization cost. Also the maximum SA of Rs 4 lakh available only in the case of major surgeries which in turn is too low for treatment costs related to heart, kidney or stroke etc. However, if you are adequately insured through other Health insurance policies but want to get cover of additional expenses like room attendant costs, expenses on food, travelling etc, then you can consider such policies. But again that insurance policy needs to be simpler. Now days many Health insurance providers have added Daily cash benefit feature with other benefits in their basic plans. Hence, our recommendation is to evaluate your needs first and after comparing the policy benefits in details (check policy wordings) with your basic policy, make your decision. Unawareness on terms of the policy can lead to dissatisfaction to your family during the claim settlement.

If you have any questions related to Health Insurance – feel free to ask.

This is a guest article by Jitendra Solanki & Manikaran Singal - they both are CERTIFIED FINANCIAL PLANNERCM

Disclaimer: This post represents the opinion of its author only, and does not in any way reflect the opinions of  The Financial Literates or the other authors who write content for this Website.

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{ 212 comments… read them below or add one }

1 Manikaran Singal

Thanks Hemant, For publishing this article and helping people make prudent decision in Health insurance space and not to get carried away with the brand name only.

Reply

2 Hemant Beniwal

Hi Manikaran,

When I started getting queries on Jeevan Arogya – I was bit confused to reply. Not because I don’t know about the product but the reason was why people are asking about it. Health Insurance is a clear cut need based product – people should analyse their need & buy product that satisfy it. Where is the question about running for a new product??
In investment – we can understand that people have a scope to add newer things.

Reply

3 Manikaran Singal

Hemant, This is the problem with Unplanned people. This product was launched with a Big bang…full page advertisement in most of the leading Newspapers….and moreover what to say of the huge agency network of LIC. Though I generally avoid gettig into the details of Health insurance products offered by Life Insurance companies, but suddenly start recieving queries on this. Even people who are are adequately Insured by Mediclaim policy but running short of there Investments target due to mis management of expenses ……called me and enquired about the same. So i decided to write on it along with jitendra…and try to make people a bit more literate through “The Financial Literates”

Reply

4 D BALCHANDER

Hi mani

First I Thanks to Hemant for giving e a good comparision chart. According to your analysis., what i understand is LIC is jeevan Arogy is best. And at the end of your conclusion part you said that this product is not good and at the same time you are blaming the LIC as well as their agents.

My dear friend pl go into the depth of health insurance concept. one side your saying that now a days the employer provided insurance is going to be high because of high claims. The general insurance companies is charging more high premiums now a days because of this reason. charging more is correct or change of concept is correct. I dont want to take names of companies they began with least primium and now their premium is high in the industry. hence my humble request is dont confuse the people.

As per my view one should have General insurance mediclaim policy at the same time LIC’s jeevan Arogya plan also. This both combination is gives his/her medical provision in future.

The reason is if any bed winner of the family member admitted due to an accident/major surgeries/long treatment for any deases like cancer/peralsis/kidneys failuer in this events the family savings almost to be exasusted. The family fall into the financial crises. Eventhough the medical treatment is free or the family well sound in financially. If this person a business man the business will effected/ if he is an pvt employee he may not get his salary for such a long time three to six months. At this stage this type of health insurance plans (LIC’s Jeevan Arogy) help their family financial needs.

Reply

5 Manikaran Singal

Mr. Balchander..

We have not confused people in any way….but with your reply you have confused me.
We have not written anywhere that this is a bad product, neither we have blamed LIC or agents anywhere.
U can very well name the companies which have started offering products with Less premiums and then after some years increased the rates, I know you are talking of Reliance Healthwise policy. But what’s the point in discussing about all these issues in this Review.
I Support your view of Considering This policy, but
1. After Buying adequate sum assurance through Health Insurance policy of General Insurance company or Stand alone Health Insurance co.
2. After Insuring yourself adequately with Life Insurance, Accident Insurance and Critical Illness.
3. After allocating adeqaute amounts for your Children Education, marriage, your Retirement and Other Goals
4. and also After taking into consideration and properly comparing all other Policies available of this sort.

Reply

6 Bhupendra

Hi Manikaran,

I am 35 yrs of AGE and an NRI. I don’t know if I will settle abroad or come back to India. So I do want to buy a Life Insurance. I was looking for Term Insurance but then got confused with three terms – Life Insurance, Accidental Insurance and Critical illness. Aren’t these all part of Term Insurance? If I die due to Accident or Critical illness, is it not covered in Term Insurance?
Does Term Insurance cover natural death only, if the policy doesn’t specificaly mention Accidental death?
My understanding was that if I don’t die but had an accident or illness, then for that I need medical insurance. But for death, be it by any mean out of my control, Term Insurance should be taken.

Please let me know as I need some clarification. Thanking you in advance.

Regards,

Reply

7 Manikaran Singal

HI Bhupender

Your understanding is very much right. Life Insurance provides coverage for death which can be due to illness, accident or natural. and Term Insurance is the cheapest way to cover yourself for this.
ACcident policies are those which gives coverage against the risk arises due to accident which could be death, disability( permanent, partial or temporary). Please note accident policy covers death only due to accident but term insurance will cover death due to any factor.
Critical illness policy supplements health Insurance coverage. It will help in the treatment of those major problems for which you may not be hospitalised. In this kind of policy 7-10 major illnesses are defined and once u get diagnosed for those and survives for next 90 days then company will pay you the full sum assured and cancel the policy. this way you can get the treatment done with no pressure on your finances.

Hope i have cleared your doubts

Reply

8 Bhupendra

Hi Manikaran,
thanks for your clarification. I came to know that NRIs who have taken foreign citizenship, can not apply for Term Insurance in India. I don’t know if this is entirely true, but please do let me know if you have some information regarding this.
I will speak to some agents when I am in India next. Seems it is bit complicated if NRI has acquired foreign citizenship and he might come back to live in India finally.

Reply

9 Hemant Beniwal

Hi Bhupendra,
Your status is PIO or OCI??

Reply

10 Bhupendra

HI Hemat,

My status is OCI.

Regards,

11 Ravikumar Badugu

hi balachander sir,
good information…
and i m working as SSM in star health insurance..
in my customer base..i have seen 20% this situation…

Reply

12 NITIN

Some of the important points not mentioned in article
The fixed benefits are payable even though the claim is paid under any other mediclaim policy
The premiums are linked to entry age so you are assured of stabel premium even at higher ages.
the benefit of Rs.4000 per day will increase by 5% every year for first 10 years irrespective of claim paid.
Combination of Normal mediclaim & jeevan arogya will be very good

Reply

13 Jitendra Solanki

Thanks to TFL for sharing this information with their readers.
This article not only highlights about LIC product but also give a basic ides on how to evaluate a health insurance product before you make your buying decision.

Reply

14 Hemant Beniwal

Hi Jitendra,

Thanks to you & Manikaran who have taken out some time to write this detailed review. And more important is telling readers that health insurance is not as simple as think – like paying premium & getting benefit.

I will be more thankful – if you guys can handle TFL reader’s queries. :)

Reply

15 Pankaj

Hi Hemant,
Thanks for the analysis.
I think that Jeevan Aarogya has an additional benefit that no other policy has and that is Parents/in laws are covered as well as spouse and kids.The entry age for parents is quite liberal at 80.

This provides a safety net even though quite shallow for the whole extended family and that is very relevant and needed for India.

Pankaj

Reply

16 Jitendra Solanki

Hi Pankaj,

LIC do have this additional benefit but as per LIC terms “If both of the parents (father and mother) are alive and are eligible for cover, then either both of them will have to be covered or none of them will be covered. The PI will not have any option to choose one of them. The same condition will apply for parents-in-law also.”
This is a very big setback for policyholders who wants to cover either of them.Also we have pointed out that it is not a complete health insurance policy but a supplement.Hence if you want to cover your parents through a mediclaim policy, the individual mediclaim or senior citizen policies will provide you wider and higher coverage.

Jitendra

Reply

17 rayabha ram

I think you have not gone through the litreture.Jeevan Arogya is a Defined Benefit and NOT to BE confused with mediclaim.
You have not mentioned THREE OF the POSITIVE FEATURES:
Incresing hcb 5 % increase in hcb irrspective of claim. It providesa small measure of support in face of inflation, esp medical inflation.
The premiums are guaranteed not to increase for 3 years whereas it is not the case with reimbursement type policies which are basically one-year term policies.
The premium review at end of every three years considers age at entry for which the premiums are calculated.
The limitations you havbe mentioned are not a barrier as only one in thousands will have that situation.
Also as day care surgical procedures are done in such a way that patients are discharged within hours of the operation. As hcb starts after 24 hrs( + 4 for hrs), the question of hcb for day care does not arise.
When irda has given the go ahead , what is wrong with life companies offering health insurance , that too with contrasting features.
Also if you read the fine print no health insurance policy is simple
i think the article has been written with a closed mindset.

Reply

18 Jitendra Solanki

Dear rayabha,

We are not discouraging any product here but only trying to differentiate from what most of the consumer percieve it.
Jeevan Arogya have some features which might not be there in any health insurance scheme but that cannot become the only criteria for buying this policy.One has to look at his/her requirements before making a decision.
IRDA giving a go ahead to life insurance companies for health insurance is a good step.However, more features in a single product add confusion in the mind of investors and many a times some gets neglected in buying the policy.The cost can be very high.
Our article is more towards creating awareness in the mind of consumers and is written after receiving lot of queries.Why such a product should be bought and How does it stand vis a vis other existing products?.If the product matches your requirement then it surely becomes a good product.However, factors like city of residence weigh heavily on the cost of treatment and so one has to look at all the features in detail to buy the right product.

I hope i am able to clear your doubts.If it still persist do write to us.

Reply

19 rayabha ram

You have still not said any about
A)The premiums are guaranteed for 3 years unlike reimbursement plans where premiums may change the very next year. Even at the Renewal date the Age at entry is reckoned , providing some relief for the customer.
BThe Yearly increase in Hospital Cash Benefit irrespective of claim and a further “No claim Benefit” after evry three years on review. The product claerly has these benefits factored in the cost of the policy.
If this policy is takenb by a young person 25-40 years, ,the cost factor would get rationalized inflation also taken into account. One knows that at Age 30 the life expectancy is around 70 years for males, also the chances of getting serious medical treatment within the next 15 years , barring accidents , is very low.
I also feel that no insurance plan is as simple as an FD, health Insurance is a complex product.
I feel it is better to have a product which spells what is given what is not given, even with full medical terminology, the issue will be relevant only in cases where claims arise.

Reply

20 Jitendra Solanki

Rabhya Ram,

Yes, the premium are guaranteed for next three years.But i am not sure how many companies are changing their premiums rates every year.Companies like Star Health, Apollo Munich, etc have kept their rates constant for the period.Consider the adverse situation when the claim exceeds the company probabilities and after three years the company decides to incrase the premium rates. The change can be very high.You know what happened to Reliance.So my view is it cannot be a factor to sell any mediclaim policy.The rates are revised basis on certain factors which actuaries has to take in consideration during review.If company decides to keep them constant inspite of the need, the rate rise in third year can be huge.So both probabilities are there and much will depend on number of claims LIC will have to face in next three years.

I think i have in my previous reply very well said that we are in no way against the policy.Our objective is to make customers aware what is the policy all about and how does it stands in comparison to similar existing policies. The final decision will be rest on the buyer based on his specific needs and requirement.We are just helping individuals to make a prudent decision.

Reply

21 vijay

Hi,
i intend taking health insurance policy for my parents.dad nearing 60 and mom in 54. After seeing option i was thoroughly confused on which one to choose and which is good for them. My mom has diabetes. Pl advise me to choose the right plan n right company.Thank u

vijay

Reply

22 Vandan Sharma

Hi,

My age is 33 years & earns around Rs 800000 in Mumbai. What should be sum assured of my medicalim policy & which policy should I buy??

Reply

23 D BALCHANDER

Hi Vandan Sharma

You said ur earnings only that is not suficieant for advising sum assured in medical policise u have to give these particulars also.

1) How many members are in your family ?
2) How old are there ?
3) What they are doing?

Reply

24 Manikaran Singal

@ Vandan – Unlike Life insurance we cannot calculate any particular figure for adequate Health Insurance Sum Assured. But Yes looking at the city you live and Cost of Medical Treatment There, you should be ideally covered. Buy atleast Rs 5 lakh of sum assured under Hospitalisation and Do top it up or purchaseSeperately a Critical illness Policy with the same or higher Sum Assured. You can go with Apollo Munich or Max Bupa for the same. but Pls go thro the Policy wordings first to check out the suitability to you.

Reply

25 Deepak R Khemani

Jeevan Arogya should not be treated as a stand alone Mediclaim Policy.
It should be an add on to your existing Mediclaim Policy wherein you get a predefined Daily cash benefit irrespective of the room/hospital you get admitted to(Please remember most Mediclaim policies have sub limits built into them regarding room rent,nursing,surgery charges etc). Also you get a fixed amount depending on the Surgery irrespective of the amount you have actually spent on it.
It is like Icing on the cake. You should buy it only if you have an existing Mediclaim Policy.

Reply

26 Jitendra Solanki

Deepak,

Rightly said by you.But do remember that even if you have existing policies, you need to check the scope of benefits you require. If its only daily cash allowance apart from a normal treatment you are looking at, then other policies might prove to be more beneficial.
There is hardly a single policy which can meet all your requirements.Hence you should always match your requirements with benefits available and then take a decision.

Jitendra

Reply

27 chandan

Dear Sir,

Please send the artical of Jeevan Arograya plan of LIC in Hindi Language in your TFL.

Regards with Thanks
Chandan sharma

Reply

28 Deepak R Khemani

“one can also debate that LIC has tried to bring in life and health benefits together through this product. This has only introduced complexity in the mind of consumers especially in areas where financial literacy is too low.”
Reproduced from the article above
I would like to say that what has been mentioned above is not actually correct in the sense that the term rider and accident benefit riders are optional, you can buy Jeevan Arogya as a standalone Health policy without these two riders and use it as a health Plan,
The new IRDA guidelines mandate that any Insurance policy launched by a life Insurer should have one of the three benefits namely life cover,health cover or Pension.
Regarding low financial literacy it is very important for the customer to know what he or she is buying and what are the benefits of the policy

Reply

29 Jitendra Solanki

Hi Deepak,

Health insurance is a very specialized area where a normal consumer do not understand the terms and conditions laid down in the policies.LIC has got a reach in rural areas too.

Seeing the benefits LIC has tried to provide through this policy, it seems to be a one fit for all product.Parents, In laws, MSB, Daily Cash, Day care, Other surgeries etc. the more features you add in a single product the more limitations it will have.I mentioned before, a single policy can not meet all the requirements.

We have always thrust on keeping your investment and insurance very simple so that at time of claim you do not face problems.How much will agent be able to understand the product and to what extent they will pass on the information to the consumer is the key? The kind of queries we are receiving this product is being projected as a unique policy with all the benefits and that too in competition with a normal mediclaim policy. That’s we have tried to highlight through this article. Even if riders are optional it creates a confusion in mind of consumers if the information received is half-baked.

IRDA guidelines do thrust on certain terms to life insurer but it should make things very simple and not complicated.

Reply

30 Paresh

Hi,

Thanks for the information. Can you please compare it with Oriental Insurance Happy Family Floater Silver plan?

-Paresh

Reply

31 Manikaran Singal

Oriental Insurance happy Family floater is simple Mediclaim policy, which cover your hospitalisation expenses. It also has features under which you get coverage of Day care Treatment, Domiciliary hopitalisation etc. and like this LIC policy it also provides some amount as daily hospitalisation allowance and Attendent allowance.( In gold plan)
If you are going to purchase Health Insurance for the first time than between LIC and Oriental, latter is no doubt a better policy.
But before going in for oriental , do understand the Co pay clause, Sub limits etc and also compare it with other Mediclaim policies.

Reply

32 Rahul LIC Surat SSE Dmkt

Thanks for providing us information about the plan and up s and cons of the same.

I would like to know u r kind attention by this platform that there is two things in Medical policies.
1. Benefits 2. Reimbursement. Today the cost of medical expenses is highly increases and the quality treatment is much more expensive. So if someone have mediclaim for his family he can take additional benefit by taking JA. He will get lum sum amt for his expenses from LIC.
for Ex a person whoes age is 30 takes JA for 4000hcb his premium is 7292/- for two year he deposit 7292*2 =14584. after two year he need some checkups and other thing for it he approach hospital he can do all these things and claim for one lum sum amt under day care benefit (DCPB) which is Rs 20000/- the cost he pay for it in two year is just 14584/- and he benefited more than that 20000-14584=5416 which he use for next year pre. I know by taking facility his charges of yly pre is increases but additinally at the same time he is covered 4lac for MSB and other benefits.

Reply

33 Manikaran Singal

Rahul, that is what we proposed here. If some one is already covered with adequate sum assured in Mediclaim , he/she can think of going for this kind of policy. But on the other side, if i advise from Financial Planning angle, then one should enter only after allocationg funds to different Investment options to save for their long/short term goals.This kind of policy is suitable to your finances if you really have surplus available.
Moreover as you said that after 2 years if a person wants to get some check up done then this policy will be helpful is completely wrong. This does not cover any kind of check up. The Term Day care Treatment means “where the procedure or surgery is taken by the Insured Person as an inpatient for less than 24 hours in a Hospital or standalone day care centre but not the outpatient department of a Hospital or standalone day care centre”.
I feel to cover this kind of expenses if one do a proper planning then he/she can create a proper medical emergency fund but for hospitalisation and critical care expenses one should be adequately covered.

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34 RAHUL

SIR,

I KNOW WHAT DAY CARE BENEFIT PROVIDES UNDER THIS PLAN. BUT HOW A PERSON CAN BE BENEFITED FROM THIS. TO GET BENEFIT FROM THIS IT IS ONE OF THE WAY I FOUND.

THE OTHER LIC PLAN 902 IS COMPARETIVELY GOOD THAN THIS AS THE PLAN PROVIDE DTB BENEFIT LIFE TIME UNDER THE PLAN

Reply

35 Vistasp

Am a little confused. Your table suggests max entry age for parents as 75 but then one reader here has stated a benefit that it is upto 80 and it has not be rebutted yet. So what is the max age for entry and up to what age can the benefit accrue for the parents / in-laws?

Reply

36 Jitendra Solanki

Dear Vistasp,

Maximum age at Entry is age up to which you can purchase a new policy.In this product 75 is maximum age for parents/in laws at which they can enter.So if someone has entered 76th year, he will not be eligible for purchasing this policy.However, do remember this limit is only for buying a new policy.
A benefit age is maximum age for renewing the policy.In this product at age 81 the policy ceases and you can no more renew it. What this means is that parents/in laws will be able to renew their LIC policy only up to age 80.Once they reach 81 they will no more be covered in this product.

Also, for consideration, LIC takes your last birthday for calculating the age.What this means? If your 76th birthday is on25th July,2011 and you are purchasing the policy on 10th July 2011, your age will be taken as per 25th July, 2010.Hence, you will be eligible for purchasing this policy.

I hope this clears your doubts.

Reply

37 Abhishek

HI Jitendra,

If I want to cover my parents who are more than 75 years of age.. I will take this policy and I am 49 yrs so will this cover my parents ??

Thanks
Abhishek

Reply

38 Jitendra Solanki

Hi Abhishek,

Yes this policy will cover your parents if they haven’t yet reached 76 as last birthdate is the deciding factor.

However, if they have reached 76 then this policy too will not cover them.

Reply

39 sushil kumar sharma

My wife age 64+ (D.O.B (13-3-48)@myself 61+(DOB 11-5-1951) want LIC JEEVAN AROGYA PLAN.Pl. let me know the premimum.per year.

Reply

40 Michelle

Hi!

I want a health insurance for my family (husband, wife, & kids in future). Pls tell me which one should I go for. There are so many options out there…it is extremely confusing.
Hoping that you will be able to guide me well.
Thanks!

Reply

41 Jitendra Solanki

Michalle,

A health insurance policy has many features which are covered instantly and others after a waiting period. Now companies are coming out with products where they are reducing waiting period for the benefits.Hence, its very necessary that you first identify your requirements and exclude features which is not required.

You have two options to cover your family -indiviual mediclaim and family floater.The advantage of family floater, where you cover your family in a single policy, is the low cost.But compared to individual policy, the cover is also low for the whole family.

For maximum benefits compare different options like individual or covering family through two policies (can be floater or floater and individual).Sometimes, the premium difference between a family floater and options mentioned is not too large. In that case you benefit by taking a high cover.

With regard to products, some products like Star Health,National have high sublimits (Cap on Room Rent, doctor Fees, specified illneses etc.) while other are very comprehensive.

You can compare products from Apollo Munich, Max Bhupa, Star Health for your requirements.

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42 Vistasp

Thank you so much for your detailed reply Jitendra.

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43 Jamshed

Hi Hemant,

I already have Bajaj Allianz hospital Cash, should I discontinue it & buy lic jeevan arogya.

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44 Manikaran Singal

Jamshed,
This is one of the biggest financial sin which people make when they shift between health insurance policies year on year. Every HI policy has some waiting periods 30 days, 1 year, 2 years etc. and if you have stayed in one policy for 2 years and then shift to some new policy then you have to start from scratch to cover up those waiting period.
Moreover, where the particular policy is concerned, if you already have bajaj then there’s no need to look at LIC policy but yes if you don’t have adequate hospitalisation or critical illness coverage then you can serach for policies to get those.

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45 Shailendra

Hi Jitendra/Manikaran,
Its very nice discussion and already have my few doubts cleared with above responses. Thanks to Hemant as well for sharing the details.

Added your query here
http://www.tflguide.com/2011/07/health-insurance-policy-group-medicalim-employer.html

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46 Manikaran Singal

Thanks Shailendra for appreciating the article.

Added it here
http://www.tflguide.com/2011/07/health-insurance-policy-group-medicalim-employer.html

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47 Shailendra

Thanks Manikaran for your valuable inputs.

I have decided to go for Apollo Munic family floater for my 2+1 family.
I was exploring am bit confused whther I should go for Standard option or should take with critical illness. In case of CI, there is waiting period of 30 days and the amount will be payble if you survived. But in case of critical illness, one may need the amount much before the 30 days to pay the hospital. I know its one’s choice but it will be helpful to decide if you can share your views about what should be considered, whether policy with CI or increased the sum insured without CI.
Thanks

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48 manikaran singal

Shailendra, i feel that you should buy exclusive version with CI. See CI benefit is not for hospitalisation expenses, but generally it is to cover the expenses occured after diagnosis of the critical illness for which you may not require to be hospitalised. As far as hospitalisation expenses are concerned that gets covered in the SA of the basic mediclaim policy.
Say for example . someone is diagnosed by Cancer for which he/she needs to get Chemotherapy ( i beg your pardon if i relate wrong treatment with wrong medical problem) on regular basis which has its own cost , so to manage the burden/increase of expenditure on family the critical illness SA plays a major role.

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49 sunil

dear sir,
kindly suggest me better health insuance family floter plan from lic jeevan arrogya,icici pru health saver, icici lombard comprehansive health insurance cover amount to rs 5,00,000/

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50 Manikaran Singal

Out of LIC Jeevan arogya and ICICI Health saver I would prefer Health saver but as it is a ULIP with allocation and other charges, so to get a comprehensive cover with less cost i would advise to go with ICICI Lombard

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51 subash

weather jeevan arogya is better then icicipruhealth saver,icicilombard health policy for age 33 year,32 year,10 year 5 year family floter,risk cover 3,00,000/
subash

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52 Manikaran Singal

If we have to take out the best out of the 3 as mentioned , the i would recommed to go with ICICI Lombard Comprehensive Health Insurance.

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53 Arvind Agrawal

Dear Hemant & Jitendra/Manikaran,
It is indeed a great service that you are providing by giving timely & insightful reviews on all financial products that are being launched regularly by different companies in a simple & easy to understand manner. Keep up the good work!

Regarding LIC Jeevan Arogya plan there is one component that you may have missed in its features – namely that the parents of insured are covered only if they are dependent on him financially. This means that if they are filing their own tax returns for interest/ MF gains etc. then they by definition would not be covered. Or am I mistaken?

Also in case of parents, pre-existing diseases are covered only on discretion of LIC, if disclosed prior. So supposing your father/mother has undergone cardiac trouble in past before taking the policy then claim will not be passed if it is submitted for future problem.

I feel such things should be clearly told to the common person before he can make a prudent decision.

Regards,
Arvind Agrawal

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54 Jitendra Solanki

Dear Arvind,

Very Thanx for the appreciation and the update.

For covering parents/in-laws the policy does not specifically states that they should be dependent.Hence you can cover them in either case.

Your second point on preexisting disease is right that it can be covered but is totally on the discretion of LIC.

Awareness is our main agenda from this article.The terms are so complicated that if policyholder is unaware on these the claim procedure will become very cumbersome.Hence, before buying it one should thoroughly identify his/her needs and then take a decision.

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55 Rohit Jadhav

Nice article regarding JEEVAN AROGYA. But now i am confused, which one to take so that my family and parents will be insured.
Please guide.

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56 Manikaran Singal

Rohit , The simple funda to buy Health Insurance is to go for simplicity i.e chose that plan which you find more simple as compared to others. The Health insurance provided by Life Insurance companies has just increased the confusion in this space.
Zero in on to any policy by General Insurance providers or stand alone health Insureres. My take is with latter like Apollo Munich, Max Bupa or Star Health Insurance.

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57 Sameer Thekedar

Hi Jitendra / Manikaran ,

Can you pls calrify if Jeevan Arogya enjoy the same IT benefit which the medclaim policy of any General Insurance co. I mean the rebate available under section 80D.

Regards
Sameer

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58 Jitendra Solanki

Dear Sameer

This plan offers tax benefits for the premiums as a deduction from the taxable income under section 80D of the Income Tax Act.

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59 Padmanabh

Dear Jitendra & Manikaran,

Thanks a lot for detailed review of this LIC health insurance policy. I was looking for the review and here you go :)

One query from my side:

I am planning to buy Medical insurance for my family and trying to find out best policy. I and my wife don’t have any major medical history and even though my company covers health insurance, I would like to buy one more for all the purposes you mentioned in one of the reply.

I tried to get some kind of ratings about the claims settlements for companies offering health insurance but could not get it. I think, it is very important as it will give you better picture. Companies can lure customers with lot of goodies and low premium but moment of truth will come at the claim settlement.

Can you please guide me about possible insurance policies which you think and really good in terms of coverage and also claim settlement records.

Appreciate your help.

Padmanabh.

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60 Jitendra Solanki

Dear Padmanath,

Very Thanks for appreciation.

Visit IRDA website for information regarding claim history of general/health insurance companies in India.Now a days, printmedia like ET Wealth also comes out with their rankings on health insurance products.You can also get lot of information on the web.

You can consider companies like Apollo Munich, Max Bhupa and Star Health as their products are quite comprehensive and service levels have been better.Also some of these companies do have very strong underwriting process during issuance of policy which eases claim settlement process.

What will be the good coverage amount- a lot depends on the city you are residing.In metros a minimum coverage of Rs 5 lakh is always advisable while in smaller cities a less coverage can be beneficial.Consider accident insurance policies of your travelling is high and add critical illness as you go higher in age.

while comparing look at the product features in detail and allign it with your requirement. The products which best matches your needs will be the product to choose.

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61 chain

what is the premium for complete family (me, my wife and 2 childred and mother, father)

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62 Jitendra Solanki

Kindly visit website of LIC for premium calculation.

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63 ALPESH

my father want to take a health policy & we have decided to take 2 policy one from national insurance & lic jeevan arogya of rs 2lac & 3lac respectively PLZ advice us.

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64 Jitendra Solanki

Dear Alpesh,

I hope you have very well looked at the detail features of the products.

Firstly, take a high cover in the general mediclaim policy as it will cover most of your needs and have a cashless benefits.If you are considering Jeevan Arogya, then take it only as a supplement to your existing policy.

Also, as we have said, do compare with other policies existing in the market and if you find benefits meeting your requirement then take your decision.

But first & foremost understand your requirement of when can a medical emergency arises and in what cases. You need to consider all kind of illnesses which can happen at your father age and whether is there an existing illness.Then search for products which can cover all these.You might have to go for combination.Once your hospitalization benefits are adequately covered then look for products which can cover extra expenses you might have to bear during hospitalization.Compare the benefits and select which closely matches your requirement.

Through this process you will be able to judge which product will suit your requirement.

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65 AU SIDDIQUI

A very good analysis.I am a doctor myself and my wife too is a doctor.We are planning for a health cover. Do you think Star Optima family floater /Tata Wellsurance is a better option than Jeevan Arogya

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66 Jitendra Solanki

Dear Siddiqui,

Thanx for the appreciation.

Firstly, Star Optima Floater or Tata Wellsurance are mediclaim policies with cashless benefits.It will not be wise to compare it with Jeevan Arogya as it does not have any such benefit and is primarily a daily cash benefit policy. Policies similar to Jeevan Arogya are Apollo Optima Cash and others give in the comparison chart in the Article.
With regard to a good mediclaim policy you can consider Apollo Munich and Max Bhupa along with Star Health.The benefit with these companies is that they do not have any sub limits like limit on room rent,ICU Charges.doctor fees etc. However, very much depend on the city you reside.In a small city, Star Health features can meet your requirement but in metros the sublimits may not help you in getting desired coverage.

Hence compare products from these companies and choose one which come closer to meeting your requirement.For getting higher coverage supplement your mediclaim policy with Super Surplus policies (e.g.Star Health Super Surplus).

I hope this will help you in making your decision.

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67 Byju

Hi Jitendra,
I read the star health super surplus. I could not understand the meaning of compulsory deductible on every hospitalisation. For e.g. they say for a SI of 10 lacs premium of only Rs. 4000/- the compulsory deductible on every hospitalisation is Rs. 3lacs/-.
I have almost finalised to buy an Individual cover of Rs. 3 lacs and floater of Rs. 15 lacs for my parents aged 58 years and 51 years from Max bupa when I say this post of yours.

Byju

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68 Jitendra Solanki

@ Byju

Compulsory deductible means the company claim will start only above Rs 3 lakh.for e,g. if insured gets hospitalized and the claim comes to Rs 5 lakh, first Rs 3 lakh will be born by the insured (Through any other insurance policy or any other mode), then the super surplus claim will be applicable which can go upto Rs 7 lakh.

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69 sanjay maheshwari

I am planing for buy a health insurance,so would like to compare with Star optima-floater plan,Bajaj All. star package and Lic Jeewan Arogya for ages–1) for male 38 yrs and female 36 yrs with 2 kids for 3 lakhs and second for,2) age 53 yr male and female 51 yrs .Please compare with premium amount and benefits.
Thanks,
Regards.

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70 Hemant Beniwal

Hi Sanjay,
Will suggest you to call bajaj & lic people – ask them to send their advisor. Ask both of them to bring this comparison – also ask them to add 2-3 other policies in similar category.
If you are ok with one of the policies – buy it from the same advisor. If you are confused ask both of them to come at same time – 3 of you should have a discussion. Then take your final call.

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71 sanjay maheshwari

Sir,
If for me 38 yrs,and my wife 36 yrs and for 2 kids,i opt for
Bajaj Allianz Star Package policy and take or choose 6 options including for Hospitalisation for 1 lakh, for critical illiness- 3 lakh, for accident-2 lakh and other 3 options and pay for 3 yrs,is that is comparable with Star Health optima and LIC jeewan arogya.

please guide me

thanks

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72 Hemant Beniwal

Same as above.

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73 kewal satra

If a person has claimed for a particular surgery under Major Surgical Benefit, then he cannot claim for the same surgery again in the remaining life of the policy.

Is the above fact true? Please confirm as I have read the same on the LIC’s official website under the Major Surgical Benefit section. I hope I have interpretted it in the correct sense.

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74 Jitendra Solanki

Hi Kewal,

With regard to LIC Jeevan Arogya,under Major Surgical Benefit You can claim only once for a particular surgery.That’s True.This is what the policy says “The Major Surgical benefit for any surgery cannot be claimed and shall not be payable more than once for the same surgery during the term of the policy”.Hence its once in a lifetime payment for any particular surgery.

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75 kewal satra

Thanks a lot for your prompt reply. I guess it now makes it a redundant choice in that case as one needs to undergo different surgeries each time to avail the benefit. Its a big disadvantage in that case. Isn’t it?

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76 Jitendra Solanki

Its very difficult to judge whether this feature is redundant for anyone or not.Criticall illness policies also work in the same way where the claim for any illness covered under CI is given only once.But that doesn’t mean a CI is a bad product because the illness it covers are not regular and probability of its happenning is less. Since surgeries do not happen every year its wiser to cover them also because the cost of treatment is too high.

Regarding LIC policy, only for MSB i do not think its a wiser choice.Weigh all the options and then take your decision.

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77 rajiv girhotra

Hi,

I had a Reliance Healthwise Policy (Floater Rs. 4.00 Lacs, 4 member family) which came up for renewal this month. When I went around renewing it, I was told that the premium payable will be Rs. 26,000 odd , as against Rs. 5000 odd last year. After all the arguements and chaos, I decided to dump it.

I have spent nearly 2 weeks looking for an alternative medclaim, and am totally confused with the products in the market – public vs pvt insurers , co-pay, and what else.

Would it be possible to advise a suitable mediclaim for a family of 4 (Self 41 yrs , spouse 36 yrs and kids 12 & 8) ? I also want a policy to cover my mother, she is 63 yrs old and suffering from Arthritis.

Thanks

Rajiv Girhotra

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78 Manikaran Singal

Rajiv, as far as product is concerned Reliance healthwise is a good product and comparable to all others available in this space. But with the recent huge hike in the premiums of the same this has lost trust among people.

Now as you have already dumped the policy, and searching for new one. I would advise you to go with stand alone Health Insurers policies like of Apollo Munich , Max Bupa or Star Health Insurance. While comparing the product features, you have to comapre the Sublimits if any, Co payment Clause, Pre existing coverage clause, Day care Treatments etc. If you don’t have any Pre existing disease you will get the coverage from any Insurer but if you have any then you can try with Public sector companies like Oriental , National etc.
For your Mother you can check for Senior citizens policy offered by Star Health , National Insurance or Oriental Insurance. If you can afford the premiums then you can also check with Max Bupa and Apollomunich . All the policies as i mentioned above will cover Senior citizen of 63 years of age.
Do ask for your doubts..if any.

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79 Byju

i checked oic alsoo says 4 years waiting period .

byju

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80 rajiv girhotra

thanks manikaran,

i have checked on oriental & icici, both are same pricewise. oriental strangely doesn’t covers some of the major hospitals…max, apollo, fortis, artemis.

so am doubtful if i should go for it

star is cheaper.
but i wonder if it is good on claim settlements.

any inputs ?

will check on max bupa & apollo also.

for my mother, i am going thru national & star in detail .

thanks

rajiv

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81 Ribhav Bajpai

To,
The Financial Panelists.
TFL Guide.

I have read it here and many other reviews that LIC Arogya policy should always be chosen as a add-on medical policy.

It would be very grateful of you guys, if you can tell me which medical policy to opt for along with the LIC Arogya.

Thanks,
Ribhav.

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82 Manikaran Singal

Ribhav, you should buy LIC aarogya along with other mediclaim and not other mediclaim with LIC aarogya.
You can buy any Health insurance policy from any general Insurer or stand alone health insurer. The main points of comparison are No. of day care treatments covered, waiting period for pre existing diseases, sub limits if any etc. Do read policy wordings before selecting the policy.

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83 The article was really good

Hello,

I want to go for a health insurance policy which covers only my parents as I am already covered by the health insurance policy of the compnay (it does not cover my parents). May parents are aged 61 and 59 respectively.

I want a policy which covers the complete hospitalisation cost during hospitalization and also other day care treatements. Please do suggest me the best insurance policy. thanks

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84 Jitendra Solanki

Hi,

Above 60 years of age in health insurance are considered senior citizena nd hence there are specific policies for them.You can check Star Health, National Insurance and Bajaj Allianz for these policies.
For your mother you can compare ApolloMunich,Star Health and Max Bhupa for the features you desire.

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85 Mihir Vora

Hello Hemant,

I m planning to buy Kotak e-Preferred Term plan for 30 years with a premium of Rs 922 Per month and insurance cover upto 1 cr…..

Please advise me whether this is a good plan for me at the age of 26 if not than provide me some good term plan as m planning to buy term plan.

i have already purchase 6 LIC policy so now m looking to one term plan policy to my portfolio…..

1) Jeevan mitra ( 2 policy with different plan)

2) Jeevan saral (3 policy) premium as 715,1021,1021 all these premium are on monthly basis.

3) Jeevan Aastha (5 years plan) 26500 premium paid lumsum

Regards
Mihir Vora

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86 Manikaran singal

Yes Mihir, Kotak e preffered term plan is a good one to buy. In fact all insurance plans are good if you have provided true information on everything they have asked for.

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87 Sanjeev Sangai

1 Under Jeevan Arogya people are under impression that premium is fixed for policy term. In fact it will be reviewed after every 3 yeas.
2. under Statr health policy Post Hospitalization Expenses are restricted. will this make huge difference when compared with other similar policies?

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88 Jitendra Solanki

Hi Sanjeev,

1. Premium are fixed for three years in Jeevan Arogya. If you look at history of general insurance companies, barring Reliance, companies have revised premium in gap of 4-5 years. So it should not have much of impact as the company may or may not revised and the process is followed across the industry.
2. Star Heath is considered to be one of the cheapest health insurance company.The primary reason is the sublimits they have imposed in their policies.Infact all companies who have sublimits like national insurance you will find premium cheaper.In comparison companies like Apollo Munich do not have sublimits and so are bit costlier.So the more features you have in any health insurance policy the more is the premium.Now whether the sublimits will impact your claims, yes it does.Cities like Delhi or Mumbai where cost of hospitalization is higher, any sublimits will strictly restrict your expenses which may not be possible in many situation.Hence when you buy any health insurance policy cost of your preferred hospitals should also be taken into consideration.

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89 salil

Hello sir,

I have recently purchares a mediclaim policy, (family floater Rs.3,00,000), from Indian Bank, which is tied up with United india Insurance. My Father is already covered with the mediclaim from National Insurance for the past two years. (Rs. 2,00,000). Premium paid Rs. 10,000 during last year for the above policies. I want to know if I can claim from both the insurance companies in case of emergencies or i am eligible to claim from only one insurer? Should I also buy Lic Jeevan Arogya as an additional cover for my family?

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90 Manikaran singal

Yes salil, in case of emergency you can claim from both policies. I understand that your father is also covered under the mediclaim policy of indian bank.

the point to consider is that you cannot make profit out of Mediclaim policy. If yoou have claimed from one insurance company then you cannot not claim from other for the same problem. But if claim amount is more than the sum assured than you can definitely ask the other insurer to pay the balance.

To buy or not to buy LIC jeevan aarogya is purely your decision. As we have explained in the above analysis that this policy is medi-benefit policy and not medi claim.

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91 NITIN

ONE SHOULD TAKE JEEVAN AROGYA POLICY ALONG WITH NORMAL MEDICLAIM,FOR FOLLOWING REASONS.
1.Mediclaim will reimburse as per the expenses incurred subject to sublimits.
Jeevan arogya plan will pay additional amount for the same operation or hospitalization irrespective of claim amount received from mediclaim.
2.If you are government employee and getting treatment at hospitals at subsidised rates mediclaim will pay you only to the extent of expenses made,however jeevan arogya will pay fixed amount based on number of days or type of surgery which makes big difference.
3.The benefit amount increases by 5% every year for first 10 years irrespective of claim paid.There is additional increase in benefit by 5% for evey three claim free years.
In mediclaim policy if there is claim your next year renewal premium will attract loading.This will not happen with Jeevan arogya
mediclaim+jeevan arogya policy is very good combination for optimum health cover.
Reply
- See more at: http://www.tflguide.com/2011/06/lic-jeevan-arogya.html

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92 Raghuprasad

Sir
I want a health insurance for my family (my self 37 years, wife 33 years, 1 kid 1 year and my mother 60 years). as my mother is suffereing from diabeteic since last 5 years Pls tell me which one should I go for. There are so many options out there…it is extremely confusing.

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93 Jitendra Solanki

Dear Raghuprasad,

Apollo Munich health insurance is a good policy with competitive rates.Star Health insurance has lower premium rates but many sublimits.You can select one of these as per your requirement.
For your mother, if diabeties is at stage 2, i.e., she is taking treatment like insulin then specific diabetic policies from star health or icici lombard will be the option available.However, if no treatment is being taken.i.e.it is at stage 1, then any health insurance company will cover her. Some like Apollo have exclusions and do not cover diabetic patients at all.So you will have to check with respective companies. Since she is at age 60 you can check Senior citizen policy from Star Health.

I hope this answer your query.

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94 chandu

Hi,
Thank You very much for the details.
I recently met an LIC agent but he has not disclosed most of the info which you have done. Well Done.
From the discussion with the LIC Agent, I haven’t got clarity in the following,
1. Is it Covered under Income Tax 80 D. And how is the break up. According to *80D – 20k (Senior Citizen) + 15k( spouse + children). So i include members in this pattern:
father – 61 Yrs
Mother – 55 Yrs
Myself – 32 Yrs
Spouse – 27 Yrs
Child – 100 Days
Whom should i make PI, so that i can avail tax benefit under 80D ?
2. No Bills, No Original Discharge Summary. Agent Suggests, Submit only Discharge Summary Xerox Copy to claim Jeevan Arogya and also submit Original Discharge Summary for benefit for any other Corporate Health Insurance like ICICI Lombard, UHC etc. We can avail claim from both insurance cos. Is this not illegal according to LAW?

pl. suggest for the 2 points above.
Thank You
Chandu

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95 Jitendra Solanki

@ Chandu,

1. This product gives benefit under section 80D as given in the IT act.This means you can avail benefit for your parents also. You will have to make yourself the proposer and PI if you want to avail the entire tax benefit.

2.Taking claim from two insurance companies is not illegal but surely the indemnity rule applies.However, policy like these are daily cash allowance policies which are taken to meet the expenses over and above the hospitalization like food, attendants cost etc.Hence, you can avail claim from ICICI Lombard and this policy.

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96 Arun

Hi,

Thanks for the information. Can you please compare it with SBI Hospital Cash?

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97 satya

Hi.

i would like to take Jeevan arogya plan . one thing in this policy i am not clear , if i insured for one lakh , if anything happend to PI like sudden death , what is the benifit to Insured spouse , agents said the SA is benifeted to insured spouse and the policy can be continued by IS , pl. let me know is that correct..

Thanx

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98 Manikaran Singal

Hi satya
On death of principal insured , the surviving Insured Spouse will become the Principal Insured provided the option is exercised at the beginning of the contract and the Policy will continue. Otherwise the policy will terminate.

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99 satya

hi..
Thank you ..and one more question is, on death of PI , IS will get any insured amount…? , for example if PI insured for one lakh..? or IS becomes PI only..

Thank you …
Satya

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100 Minaz

Hey Jitendra & Manikaran,
Thats a comprehensive article. It has helped me to understand ‘Jeevan Aarogya’ policy better. However, i do have few queries as mentioned below. I will be grateful if you can help me with answers:-
1) Accidental expenses – Does this policy cover expenses whcih will happen due to accident and hence hospitalization? If yes, how much?
2) If patient is hospitalised for 5 days, then first 24 hours’ expenses are covered? If patient is hospitalised for 6 days, then first 24 hours’ expenses are covered?
3) Is ‘Hernia’ illness covered under this policy?
4) Is ‘Dengue’ covered under this policy?
Thank you so much both of you.

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101 Jitendra Solanki

Minaz,

Accidental expenses are covered under accidental rider for which you have to pay extra premium.The base policy in Jeevan Arogya is a defined benefit policy and will give you daily cash benefit in case of hospitalization.

Regarding coverage of specific illnesses you should check policy wordings which gives more details on the terms and conditions.

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102 Kumar

Hi,
I have read quite a lot of reviews/articles on mediclaim/health insurance policies with a hope to find a policy that would meet my current requirement. Unfortunately, I havent come across any… Appreciate if you could help me with any useful information….
My wife had a brain hemorrhage 3 years back & she had to undergo a surgery. During this time, we were covered under our company’s medical insurance policy (~3L) which covered atleast a small portion of my expenses.
Now that my wife is recovering (since rehabilitation in such case is a slow process), without any further incidents, I am looking for a policy that would cover myself & my wife’s future health.
I discussed with few companies but my requests were turned down.
Aren’t there any policies that would cover people who have undergone medical procedures earlier?
Appreciate any info that you may have.
Regards,
Kumar

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103 Jitendra Solanki

Hi Kumar,

Any illness which is undergoing treatment during the time of taking a health insurance policy comes under pre-existing disease.In health insurance pre-existing coverage starts from 4th year of policy continuation in major policies.Even if a company covers it from first year there will be more exclusions.Also,if a company find any illness on a higher risk, they can exclude it permanently.
At present there is no policy which covers all preexisting illnesses from 1st year.You can check with Max Bhupa,National Insurance,Apollo Munich,Star Health.

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104 SHARAD

hi,
I took this policy a year back. It was told to me that the policy comes with a life cover and have sum assured of 2,00,000. At present the policy is in lapsed status, should i renew it and will I get any surrender value.

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105 Manikaran Singal

There’s no Surrender value in this policy.

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106 Naresh

Please let me know if I can have Group Health insurance for my Wife /Children and my Elder Brother and also let me know which category of insurance I should take which covers all major diseases as well as Hospitalization charges, if so cashless policy

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107 Manikaran Singal

Group Health Insurance is available to a group only…and generally it is provided by employer to its employees.
You can cover your wife and children in a single policy but not your elder brother. who has to buy a seperate policy for him. There’s one policy of Max bupa naming “Family First” where you can cover your elder brother along with other relations, you may try that.
All good health Insurance policies by general Insureres and Stand alone health insurers cover major diseases as well as hospitalisation charges along with cash less facility in network hospitals.

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108 Pallavi Ghosh

Hi Manikaran,
Thanks for this informative post. I am a working woman and I have an existing Mediclaim Policy with NIA for 5lacs(which I am told is the maximum limit one can have on any mediclaim policy). Now I want a critical illness cover. Someone had suggested LIC Jeevan Arogya but I see here that since I already have a mediclaim,this LIC policy will not add any value, moreover 4lacs is too small a amount for any major surgery. I want to be covered for atleast another 10lacs. Should I buy two more NIA mediclaim worth 10lacs or are there other policies available in the market which covers critical illness without a maximum limit of 5lacs? Please give your expert advise.Thanks

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109 Manikaran Singal

Pallavi, on a very first note , pl be informed that 5 lac is not the maximum sum assured which is avaialble under a single mediclaim policy. Apollo Munich, Max Bupa, Oriental etc. all provides coverages upto Rs 10 lacs. Max Bupa provides upto Rs 50 lacs.
For critical Illness you can check out with Apollo Munich which offers CI as a rider and you can get sum assured equal to 50% or 100% of the base policy coverage. Which means that in apollo you can have upto 10 lakhs of CI benefit. There are some stand alone CI policies by ICICI prudential and bajaj alliaz which offers higher sum assured.

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110 Pallavi Ghosh

Hi Manikaran,
Thanks a lot for your prompt reply,suggested Insurers and the enlightenment on 5lacs cap!! I have one more query, even though all Insurance Companies are regulated by IRDA, still a lot of people fear that private companies might close down(Bharti Axa) or will not settle the payments promptly while PSU Insurars are a safer bet when it comes to policy settlement. How far is this fear justified? In case any private Insurance Company closes down, what happens to the policyholders? please clarify.

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111 Manikaran Singal

Pallavi..very simple logic. These private players are there to compete and grow. If they don’t settle the claim timely, they would soon be out of business.
So this is very wrong notion that private players will not serve you properly. Infact in my experience it is other way round. Private companies have a culture of customer care which is not there in public sector. so the service level is quite fast then public players.
Moreover, Banking and Insurance are the 2 pillars of indian economy. If something happens to Insurer , it will be taken over by other big player. Take the example of AIG. Don’t worry about company…just look at the product and don’t hide anything about your health status. No company will deny the claim.

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112 Pallavi Ghosh

Hi Manikaran,

After much research I have zeroed on two health plans,specifically for critical illness cover. MaxBupa and ApolloMunich. Both the Companies are claiming that they dont have any loading charges but I saw in ApolloMunich website where they mentioned that the Company might charge a loading charge.in MaxBupa they pay only 80% of the claim after 65years of age.ApolloMunich has a rider clause which is not there in MaxBupa. In ETWealth they ranked Apollo as no.1 but MaxBupa does provide for annual checkups which is n0t there in Apollo.I am confused as to which one is better since I am planning to buy the insurance purely for critical illness.Please advise.

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113 Manikaran Singal

Pallavi, it seems that you are not aware of the features of crticial illness policies. In CI policy/rider , once you get diagnosed with any particular mentioned CI, and survives for next 60-90 days ( depends on diff policy conditions), you will be paid the complete SA of the policy and poilicy will stand cancelled. Pls note that this has nothing to do with hospitalisation benefit.
If your requirement is only CI Rider then there are stand alone policies by icici, bajaj, star etc. which you can consider. Otherwise just port your existing NIA policy to apollo Munich and add on CI rider to it. This will solve your purpose.
Max Bupa doesn’t offer any CI benefit.

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114 Pallavi Ghosh

Thanks a ton. Yes, I was not very clear about the distinction.Shall ask you further queries once I decide on the right policy:-)

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115 pallavi ghosh

Hi Manikaran,

I have decided to port out from NIA to ApolloMunich and add the CI rider as suggested by you. I am holding the NIA policy for the last 5years. Somewhere I read that the porting out happens without losing the benefit of existing insurance policy.Does that mean, after porting out , will ApolloMunich waive off all the waiting periods like 4years for maternity , 2years for specific deseases,90days initial waiting since I had the NIA policy for the last 5years?

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116 Manikaran Singal

Yes pallavi, you have read it right. If ported you can continue with all the benefits you are getting in the current policy related to waiting periods , pre existing etc. But pls note that it is not an obligation on the new insurer to accept your case. They will do this only if there underwriting guidelines permit.
So you need to start the process atleast a month in advance of expiration of your NIA policy. So that even if apollo does not accept your case due to any reason, you can continue with NIA.

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117 Manikaran Singal

Yes pallavi, you have read it right. If ported you can continue with all the benefits you are getting in the current policy related to waiting periods , pre existing etc. But pls note that it is not an obligation on the new insurer to accept your case. They will do this only if there underwriting guidelines permit.
So you need to start the process atleast a month in advance of expiration of your NIA policy. So that even if apollo does not accept your case due to any reason, you can continue with NIA.

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118 MALCOLM.BHIKHAJI.DHALU

I AM INTESTED TO GO FOR THE JEEVAN AROGYA MEDICLAM POLICY FOR MY FAMILY PLS. CONTACT ME ON 072993 CHENNAI.

Reply

119 Pritam

Hi,

If anyone interested to buy LIC Policy or have any query, then call me on: 8605111251

Regards
Pritam
Pune,Mahrashtra

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120 Pallavi Ghosh

After much research I have zeroed on two health plans,specifically for critical illness cover. MaxBupa and ApolloMunich. Both the Companies are claiming that they dont have any loading charges but I saw in ApolloMunich website where they mentioned that the Company might charge a loading charge.in MaxBupa they pay only 80% of the claim after 65years of age.ApolloMunich has a rider clause which is not there in MaxBupa. In ETWealth they ranked Apollo as no.1 but MaxBupa does provide for annual checkups which is n0t there in Apollo.I am confused as to which one is better since I am planning to buy the insurance purely for critical illness,I already have a basic mediclaim policy from NIA.Please advise.

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121 Deepak R Khemani

MaxBupa does not have any specific Critical Illness Policy.

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122 Ashwani

As you said that MSB 1 per year and Max. 8 for life time. If there are suppose 6 adult are covered under this plan then
MSB 8 for life time is all six or for individual ?
Like each one has MSB 8 for life time.

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123 Ashwani

My age is 25 working as S/w engineer . I have kideny stone problem(did not have any major treatment till now).So please suggest a good health insurance plan for me and also my parents age 51 and 45 .

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124 Kewal Satra

I can surely assist you with that. I would recommend you Family Floater policy from Start Health. You can contact me 9969700000 for further details.
I am based in Mumbai.

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125 ashwani

Hi Kewal,
I am looking for only govt. insurance companies like National Insurance, New India insurance,United india health insurance, Oriental health insurance and LIC.One more thing i want to tell you that i work in bangalore while my parents are in my home state.
So please suggest among these only.

Regards,
Ashwani

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126 pallavi ghosh

I have decided to port out from NIA to ApolloMunich and add the CI rider as suggested by you. I am holding the NIA policy for the last 5years. Somewhere I read that the porting out happens without losing the benefit of existing insurance policy.Does that mean, after porting out , will ApolloMunich waive off all the waiting periods like 4years for maternity , 2years for specific deseases,90days initial waiting since I had the NIA policy for the last 5years?

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127 Ashwani

Hi
Please explain about SBI Life – Hospital Cash policy ?Which one is better b/w LIC jeevan Arogya vs SBI Life – Hospital Cash.

Thanks,
Ashwani

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128 Inder

I wish to buy health insurance for my parents aged 59 each, with good health. As, I stay outside India because of my job in Navy, I want my parents to be fully secured in my absence also. For that, I am stuck between two options-

1)Buy individual mediclaim policy of Oriental Insurance company offered by PNB and OBC. SI around 5lacs each. Premiums are less also. But there are tappings in room rents and domicilary treatment under this plan. Kindly advice whether I should go with this option.
OR
2) I should buy apollomunich standard health floater plan for SI 3 lacs and also buy EXTRA CARE PLAN by Bajaj Allianz for 10lacs.
Is the EXTRA CARE plan is good? Are there any gray areas in this plan?

Which option will be better for me as per my necessity? I am searching various policies from last six months but could not finalize. Kindly advice.
Many Many Thanks Sir.

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129 byju

I took the Max Bupa Family first silver plan for my parents aged 59 yrs and 51 yrs. Till date, the customer care response is good. The medical team comprising of a doctor and assistants came to our house and performed the various checkups like ECG, blood, urine etc. Overall a comfortable experience.

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130 Jitendra Solanki

Inder,

Apollo Munich is good in respect of features and pricing is also competitive.You should go ahead with it.Bajaj Extra Care plan is a top up policy which starts only when the deductibles is exhausted. It is good for enhancement of coverage.But do remember that the deductible in Bajaj Care Plus is applicable at one go which means the top up policy will work only when your single claim exceeds the deductible in any respective year.Hence take care of this note.

You can also consider New Optima Restore from Apollo Munich health which has some unique features.

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131 Inder

Thanks Byju & J.Solanki Sir!
Max Bupa is having good plan and service, no doubt about it but premium amount rises abruptly from the age of 60 to 61, and then from 65 to 66, though the SI is merely 3lacs(floater). same is with Apollo munich.Apart from premium,I too feel, these both plans are best.
but in case of Oriental insurance, premium is around 6500 for SI 5lacs(individually). but services are not good comparatively, i feel.and network hospitals list is also short, some tappings are also there. But only advantage is that coverage is more for the low premium amount.
Please throw some light on the services of oriental insurance company and their cashless facility,if any.
What should I do?Kindly advice. I know, I m asking the same query. but i m in a dilemma. I m afraid dt I may tk wrong decision.
Also please provide me the link for New optima restore.
Many thanks.

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132 Jitendra Solanki

Inder,

Please understand that the policy of oriental you are talking is a group policy specifically for bank customers where they have kept the premium low & constant.As such the group policies benefits are reducing and so this policy have many cappings. Not sure if tomorrow Oriental discontinue the tie up how will the customer be serviced.
Rather going for a policy with some extra premium but having comprehensive coverage and a wide network of hospitals is a more wiser choice.You will not face problems if claim arises.

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133 Sunil

Hi there,

I was keen on taking the Max bupa gold heath insurance. The call center guy mentioned that the premiums increase 1-1.5% max every year and can be renewed lifelong. I dont see any mention of this in the policy document. Could you please confirm

thanks
Sunil

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134 Manikaran Singal

It is already there in the premium chart. Max Bupa doesn’t have premium blocks. It varies every year.

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135 Nidhi Khanna

Hello,

I needed some information regarding differences that you mention between critcial care and health insurance policy. E.g in most crici care policies if the amount is 5 lacks, then once claimed, the policy expires. However, something like Max Bupa, which also has 5-7.5-10 lakh etc sum assured, also includes Day care procedures etc and is life long. So in this case isnt a product like Max Bupa way better than criticare?

Many Thanks
- N

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136 Jitendra Solanki

Nidhi,

Criticare policies are exclusively for covering critical illnesses. Across all companies, there are 10-12 Critical illnesses like heart attack, cancer, stroke etc… which are covered through these policies.Since these are considered to be on higher risk you can claim only once or maximum 3-4 times in lifetime.Premium wise these will be more expensive.

Contrary to this Policies like Max Bhupa are made for covering hospitalization expenses. The hospitalization can be from various reason including these critical illnesses and hence is a more comprehensive policy.

You have an option of covering CI through rider with base policy also.One benefit which you get in riders (Like Apollo Munich) is that you can claim three times in a lifetime.However once claimed, the specific illness is excluded in subsequent renewals.

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137 Harish Walecha

Hi There..I want to buy one medical insurance policy. We are two adults (38yesrs)and have one child (7years). My wife is a diabitic patient since 3 years or so..I am looking for some plan which could soon cover this disease although I am not forecasting any major issue in near future as it is not chronic as of now.. …Please advice. Thanks in advance for your help.

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138 Jitendra Solanki

Harish,

For you and your kid, you can check with Apollo Munich, Max Bhupa for comprehensive coverage.
Companies like Apollo Munich do not cover diabetic patients and hence it will be difficult to get a policy for your wife from the same company.However, there are specific policies for these patients from Star Health & ICICI Lombard which you can consider.Do note that these cover hospitalization through diabetes only.
There might be some companies who can consider your wife case in a general health insurance policy if the illnesses is within their parameters.You can check with Start Health for this.

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139 amit chaturvedi

hi Mr single ,
i want to claim my hospitlaisation from jeevan aarogya so what should i do. is ther any form to fill and what are the document i need to submit in lic, please guid me.
With Regards
Amit chaturvedi
9911378787

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140 Manikaran Singal

Yes, there must be some documentation formality. Better to contact your LIC agent , with the records of hospitalisation etc.

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141 Kewal Satra

I am looking for two mediclaim policy for one of my friend:
1. to cover the health of his senior citizen father.
2. to cover his married sister for her pregnancy (second child).
Pls recommend some good options in this regards.

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142 Jitendra Solanki

Kewal,

If your father is below 65 then you can consider Apollo Munich Health Insurance.The premium can be on higher side due to age but features are good. Else, if premium is a constraint, there are senior citizen policies from companies like Star Health, National & Bajaj Alianz. However, these are co payment policies where 10-30% of expenses inured have to bear.Also some of the companies have sublimits.

Maternity expense is available in most policies after a waiting period of 4-5 years. Max Bhupa cover expenses up to two child from fourth year onwards.Some companies cover only first child birth in their policies.You can check with Max Bhupa for more details.

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143 Amit

Dear Jitendra /Manikaran

i have buy HDFC ergo health insurence sum assured of 3,00,000.
Now i want to cover critical illness sum assured 5 to 10 Lack.
i am worry from claim settlement process of pvt. company.
Please suggest me critical health insurence plan,
based on easy claim and best features. Thanks

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144 Manikaran Singal

Almost all general insurance companies has there critical illness policies, and almost every critical illness policy covers the 7-10 CI specifically mentioned. Better to have a look at the coverages before deciding onto the policy. You may check with Bajaj allianz or icici lombard policy for that matter. ICICI Prudential life and HDFC life has policies which covers around 30 illnesses under there CI policy. Do have a look at those also before deciding.

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145 ashu

hi manikaran, myself ajay i m 34 yrs old and my income are above 75000 pm and I am married , looking for pure term insurance policy, kindly suggest which one will be best for me….or can you provide me comparision with Lic pure term insurance plan.

I will be very greatful to you..

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146 Manikaran Singal

Ashu, its better to check out term insurance plans offered online like HDFC click 2 protect , icici i care policy etc. As there is no disctribution cost involved in this , so these plans are much cheaper as compared to other offline term plans.
The difference in pure term insurance plan is only in the terms of tenure of plan offered and premium cost. LIC pure term plans are the costliest among lot.

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147 Nitesh

Hi,
I am looking for Health Insurance Policy for
1. Myself Age:38 yrs
2. Spouse Age: 35 yrs
3. Kid (will go after few months)
3. Parents Age: 72yrs & 67 yrs
I have tried to look for many options. Apollo Munich i found very good in comparison to Starhealth & Max Bupa as compared to others for me & my wife. I took Apollo Munich for my wife only for 1 year. For parents, i am trying to find details about ‘National Varishtha Mediclaim Policy’ and need a comparison between National Varishtha & Star Health. Please suggest suitable health insurance policies for my family.

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148 Manikaran Singal

Nitesh, you have selected the right policy . But i could not understnad the reason of not covering your child in this. Also ..what does it mean by “taking policy only for 1 year”?
As far as your parents are concerned, both national and star are almost equal in features. The major difference is with amount of coverage offered. If you are looking for higher cover, you would have to go with star health only.
In this age , people are generally prone to health issues, so one requires to have adequate sum assured available.

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149 vaishali shinde

Hi,
I am looking for Health Insurance Policy for
1. Myself Age:41 yrs
2. Spouse Age: 52 yrs
3.Two : children 15& 17 yrs old
3. Mother : Age: 72yrs &
Thankful if you could guide me of taking LIC Jeevan Arogya? LIC Mediclaim /Apollo munich /max bhupa? its quite confusing .

Reply

150 Jitendra Solanki

Vaishali,

LIC Jeevan Arogya is best as a supplement to your basic health insurance plans.Hence you should buy a basic plan first.

For your mother it will be difficult as no company gives mediclaim at this age.Hence good to create an emergency fund for her.

For yourself and family Select from Apollo Munich or Max Bhupa based on your requirements and premium budget.Max Bhupa will be costlier.You can look at buying two policies.One with you and a child and other with your spouse and a child.This way you will able to cover for good amount.However, do remember that child coverage are upto specific age (21 or 25) and after that you will have to buy an individual policy for them.

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151 Amit

Dear Manikaran,
I want ot take a mediclaim policy for me(35) & my wife(30),i had taken last year LIC health care policy but after one year i didn’t renewed it as it was not pure mediclaim n i understood that pure policy is better than with units…so please now suggest me a policy for me n my wife n future child.My requirements from the policy are 1) presently low on premium as we both are healthy presently 2)Covers maximum of the age.3)Easy to understand 4) covers maximum of the expenses as few policies covers one thing n leave another 6)Accepted in maximum of hospitals.7)Cashless or non cashless i m confused.8)TPA or without TPA again confuesd.
Please suggest i need a pure medical policy not just for tax saving purpose,policy which once i buy i should not regrete again.
Thnx
Amit

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152 Manikaran singal

Phew!! Amit….you want everything, which is not possible.
Well your most of the requirements will be satisfied through policies by stand alone health insurers…pls check out the policies like Easy health/Optima restore by apollo munich, Care by Religare health insurance, Heart beat by Max bupa or comprehensive by star health

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153 Padmanabh

Dear Sir,

I am having health insurance provided by my company for 5lacks SI each. It is covering myself and my wife. Looking at the posts here, I inclined to buy a separate cover so that tomorrow if my company stops Insurance cover, I will be covered.

Myself – 38 years
Spouce – 41 years

Please suggest which policy should I buy. One of my friend suggested me United India Insurance policy.

Also, I need to buy Health Insurance cover for my parents:
Father – 67 years
Mother – 65 years

Any inputs to cover my parents would be great.

Best regards.

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154 Deepak

Dear Friends,

I am 32 years old lawyer. I am married and have a one year old baby girl. I also have parents staying with me having age of 65 yrs and 63 yrs resp. I want to have a comprehensive medical insurance cover for my family. Can learned friends/ field experts on this blog suggest me 2-3 good medical insurance plans, which are broad in coverage, efficient in settlement and competitive in premium.

Thanks and keep up the good work.

Deepak

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155 Anjan Dasgupta

Is Jeevaan Arogya(T-903) is rebatable under 80D?

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156 Jitendra Solanki

Anjan,

Yes you get benefit under Sec 80D in this policy.

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157 Reddy

Thanx for information,
We recently moved to India (arrived 2 months ago), I am very new to find good health Insurance policy. Now we are healthy but we are looking for longterm health Insurance with short waiting period maternity coverage, we are planning to have kids…

My details

1. Myself Age:34 yrs
2. Spouse Age: 29 yrs
3. Kid (will go after few months)
4. Parents Age (living in my village): 63yrs & 57 yrs

I have tried to look for many options. Apollo Munich i found very good in comparison to Oriental, Starhealth & Max Bupa as compared to others for me & my wife…. now I found LIC jevan arogya looks nice for longterm… if I understand correct its not cover maternity!!??? confused

Suggest me any good health insurance policy

Reddy

Reply

158 Manikaran Singal

LIC jeevan arogya is hospital cash and surgery benefit plan, its not a comprehensive health cover. If at all you wuld like to go for it. then take it as a supplement cover.
For your requirement, i feel that Max bupa will suit you. It covers maternity after 2 year of waiting period.

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159 sivashanmugam

Hi, I am 56 years old, I got stoke before 1 and half years before, now i have plan to opt good health Insurance policy to cover all my family members , my wife 45 years and my son 28 years old please suggest me a good one.

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160 Manikaran singal

You have to understand that once you get diagnosed with any serious illness it becoves difficult to get adequate health insurance coverage. So it is difficult in your case to get health Insurance coverage from good pvt health insurer, but you may try with Nationalised companies like National, oriental, new india. Oriental has good plan “Happy family floater”.
For your other family mmebers , if there health is fine then they may go with easy health/optima restore by apollo munich or Care by religare health insurance.

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161 Munendra Jain

Dear Sir , I need a policy of 3 Lac for 2 years , so could you suggest any health insurance plans which covers
(1) Two Adults ( in future children can be add )
(2) Critical illness cover
(3) Policy Top-up option
(4) Life Long renewal option
(5) duration of hospitalisation should be less ( 24 Hrs)
(6) Reimbursable expenditures if treatment held at without cashless hospital

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162 Manikaran singal

your requirement no.(2) has to be purchased as rider along with health insurance policy or take a seperate policy for this. No health Insurance has inbuilt feature of Critical Illness. But yes there is a policy by Reliance which doubles the cover in case hospitalisation is for Critical Illness.
Your requirement no. (5) can’t be fulfilled as the minimum hospitalisation requirement is of 24 hours. However there are some surgeries or treatment which doesn’t need 24 hours hospitalisation and covered in health insurance policy through Day care treatmnt coverage. The list has to be seen before buying any policy.
Your rest of requirements can be satisfied through policies by Standalone health Insureres like apollo munich, max bupa, start and Religare.

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163 Sameer Thekedar

Hi ,

I have the Jeevan Arogya plocy in force for the last 8 months.Now I am planning a surgery for my Father in law. PLease guide me as to how can I go about informing the TPA and intimating them in advance etc.

Regards

Sameer

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164 Deepak R Khemani

You must have received an ID card from the TPA, with the policy documents, the phone No and email are listed, Please inform them and not the LIC Branch where you bought the policy from, The health portfolio is handled separately by another department.
Please check whether the surgery your father is going in for is listed in the list of surgeries which this policy pays for, you may or may not get cashless facility, so see to it you inform the TPA about the surgery in time and send all the claim related papers to them in time to avoid possible rejections

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165 Sameer

Hi Deepak ,

Thanks for the quick reply, however I just received the policy document only.No id’s nor the TPA details.So are you sure whether the claim procedure is handeled by a TPA or is it done by LIC itself?? If you have personal experience on getting the claim then You could be right..

Regards
Sameer

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166 anand singh

Hi Manikaran singal,
I am working in a MNC company and my Med. Insurance is covered by company, but the thing here is I can work till 58 yrs or 60 yrs depending upon the company policy. And once I leave the company my Med. Ins. is also lost. My Father has taken UTI Senior Citizen Policy in the yearly years of his life and as per the policy the cover starts once my father crosses 60 yrs of age.
Can you suggest me such kind of policy where I have to pay now for few years and then when I reach 50 or 55 it starts. And I can use the benefits with good coverage amount above 5 lacs. Currently m 30yrs old. I want to cover myself and my spouse only.

Reply

167 Jitendra P.S.Solanki

Hi Anand,

There is no deferred policy in Health Insurance where you pay for a specific period and then the coverage starts. Now there is portability feature available where if you leave the company you can transfer the Group Insurance to a standalone insurance. However, the benefits continuation in the policy is decided by the company.
In my view you should look at creating a health fund by starting small contributions today. This health fund will supplement your health insurance which you will avail at higher age.

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168 rajendran

sir, I am a central govt. employee, Now I would like to join a medi. claim policy for my family. My wife is a diabetic& BP patient now both controlled with medicine .Four years back wife undergone a surgery for aneurysm( Right frontal craniotomy and clipping of aneurysm under GA on 10.11.2008 ) .and now she is alright. .She is doing day today work without any problem. Is she eligible to include medi. claim policy?. If she is eligible, please suggest which is the best policy in India getting tax benefit also. I am aged 58 years and my wife aged 53 years and my son 21 years. thanking you sir,

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169 Jitendra P.S.Solanki

Dear Mr. Rajendran,

Since your wife is a diabetic and BP patients, you will have to check with companies as not all companies cover. Mainly PSUs like National India Insurance gives coverage with additional premium. The only issue will be the surgery which company may cover with additional premium or may not cover. For this you will have to talk to their repesentatives as it will be decided by the underwriter. But i will suggest you to not to rely completely on health insurance for your wife and create some amount of health fund.
For you and your son you can choose any of the good comprehensive health plan fro Apollo Munich, Max Bhupa or any of the PSU which closely matches yoru requirement. But buy an individual policies since childrens are covered in a floater till age 22.

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170 Sameer

Sir ,
I am am aged 40 yrs and looking for a Health insurance policy which covers for the Diagnostic tests like x-rays, MRI scans etc. Please suggest a policy for myself, wife aged 38yrs and a kid aged 11 yrs. The sum assured will be Rs.500000.
Regards

Sameer

Reply

171 Jitendra P.S.Solanki

Hi Sameer,

Health insurance plans majorly cover hospitalization expenses wherein a min 24 hours hospitalization is there. In these plans there is also coverage for 30 -60 days pre-hospitalization and 60-90 days post hospitalization where these expenses will be covered. Apart from this the regular check up expenses you will not find in health policies or only after a certain waiting period, if there is.
In my view you should look at creating a fund for these check up if they are not going to be regular.
For family health insurance you can consider Apollo Munich, Max Bhupa or any other company which meet your specific requirement, if any.

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172 Mamta

Hi,

Me and My husband both are employed in private firm and are having the medical insurance from our companies. But i was thinking to buy an additional for the days after when we’ll be retired.. so i was thinking to buy the LIC Jevan Arogya.. so that we can start paying now with less premium are can take the benefit of the same after our retirement from private organizations..

Myself – 31 years
My husband – 34 years
Son – 2 years..

Just wanna advice..

1) do we start taking the lic plan now, if not then when we should start.
2) is there any other heath insurance plan which you can suggest

Reply

173 Jitendra P.S.Solanki

Hi Mamta,

Underatsnd that LIC Jeevan Arogya is not a comprehensive health plan. It is defined benefit plan and so more a supplement to your basic plans to cover additional expenses. If you are looking at covering health for your retirement years, you shoudl look at two options-

1. Buy a health insurance which is comprehensive enough. Apollo Munich, Max Bhupa, New Entrant Religare, ICICI lombard all have good enough policies.You can choose which best matches your requirement.
2. Since 30 years is a very long time, you should not rely on buying health insurance today. You can create a health fund by starting with small contributions now and enhancing it at specific period. The corpus of this fund after 30 years will in most probability exceed from any health insurance coverage amount.

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174 susweta

Hi Mani,

Thanks for your information. I would like have some more info, as I am looking for a health insurance policy only for my parents, which includes Inpatient facility as well as Outpatient.Another important feature I am looking for is, incase of hospitalisation, immediate cash deposit might be a problematic issue for us as my parents lives in India alone and we are staying abroad.So does LIC, provides cashless hospitalization card, and the names of hospitals that comes under its network.It would be nice if you can give me some feedback on this issue.I have looked into other policies available in the market.My parents stay at Jamshedpur, Jharkhand. I am looking for my parents-Inlaw also, and they are in late 60s. Which one will you suggest between Jeevan Arogya or Max Bupa, a better one to purchase. Or is there any other policies better than these 2 ?

Reply

175 Jitendra P.S.Solanki

Hi Susweta,

LIC Jeevan Arogya is more like a supplement with basic health plans. You should consider Apollo Munich or Max Bhupa. However,If your parents are in late 60s you will be able to avail only senior citizens policies for them. These policies have limitations in the cost of treatment you can claim and especially the co-payment clause where you have to bear 15-30% of the hospitalization cost.
In my view you should also look at creating an Emergency fund for them since health insurance at these age might no meet your complete objective.

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176 sharan kumar bose

Dear Mr. Manikaran,
I am 55 yrs. and wife 50 yrs.My elder son out of two is 25 yrs. and working.Regarding critical diseases( Cardiac, Kidney,Lever etc) as the age creeps it becomes critical to get cured after 10-15 days hospitalization with huge cash down without having any mediclaim type policy.
As in our age,premium is high ,I like to invest Rs.10,000 per year by opening a policy in the name of my son .and get medical coverage of parents and include his wife and sons after his marriage after few years.
If you kindly helpwith the best policy ,pl. cover explain with numerical figure:

Say,
1) I undergo Pace maker=Rs 03 lakhs in JAN-2013.

2) My wife Retina Detatchment Surgery = Rs.=1.5 Lakh in MAR-2013.

For this how much I have to invest at the time of surgery and what amt I will be paid from Medi Claim Type policy and that after how many days.Shall I have to stay in the Hospital till the POLICY Party clears all the dues regarding treatment.Because say I have started Pace maker surgery ( Rs.50000/=in my Bank account and no more in the account but depending on medical POLICIES help and as Heart problem can,t be delayed)
Please help me mathematically and suggesting the NAME OF THE POLICY too.
With Regards,
BOSE SHARAN KUMAR.

Reply

177 Jitendra P.S.Solanki

Dear Mr .Bose,

In a basic health insurance plan the forst and foremost condition is that the insured should have been hospitalized for min 24 hrs. Beyond it whatever days you are hospitalized you can claim expenses for. If you have a cashless facility to avail, which is there in across all companies, you won’t have to pay. When you will be hospitalized the hospital will take an approval from the company during your admission only. But if its a reimbursement then once you are discharged you will have to submit documents within 30 days to the company to get the claim.You can read the entire claim process in the policy document you receive.
How much amount you can claim? It can be the entire policy amount if there are no limitations in the policy wrt the treatment you have taken. Whether it is the full cost of your treatment will depend on the cost and your policy coverage amount.
You can consider Apollo Munich or Max Bhupa but do check your requirement with the company to ensure it matches.

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178 Tarasankar Pramanik

Thanks for valuable information. Which is better mediclaim policy?

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179 Jitendra P.S.Solanki

Hi Tarasankar,

There s no better policy. One which matches your specific requirement will be agood one.

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180 gaurav j tare

Dear Sir, First of all thanks for explaining LIC jeevan aarogya benifits , limitaions & its Comparisions to other medicle health insurance, right now i am looking for a good medicle health insurance policy for my parent which will consider most of critical surgerys, Hospital cash Benefit (HCB) & other major medicle benifits. my father age is 54 & my mother age is 48, my age is 25.my budget of premium is up to 12000 to 13000/year.Can you please suggest me a good medicle insurance plan as per mentioned my requirements. Your input will help me to decide a good insurance policy.
Thanks,
Gaurav Tare

Reply

181 Jitendra P.S.Solanki

Hi Gaurav,

For covering all the features you have mentioned you may have to buy two seperate policies.One which gives you basic coverage and the other for Hospital Cash Benefit. For basic coverage you can look at Apollo Munich Easy Health or Max Bhupa or the new entrant Religare with its restore benefit. The premium may be higher than what you have mentioned if you go for a higher coverage. If it goes beyond your budget you can consider some of the PSUs but they will have certain limitations. For HCB apart form Jeevan Arogya you have policies from other companies which you should compare.

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182 Raj K

Dear Hemant,I found this article very useful.I need suggestion for getting a mediclaim policy.i am 46 yrs and already having diabetes for last 2 yrs,which is well controlled.i want to buy a health insurance for me and my family including spouse and 2 kids,which you will suggest best suited for me considering my pre-existing illness?

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183 Pranay

Dear Sir,

I am adequately covered by health scheme provided by employer. Can i take this policy only for my mother who is 62 years of age ? If not suggest some other policies.

Reply

184 D B NAHAK

dear pranay

This is a health insurance not medi claim . so that if you are covered in any health scheme under any company you can take it and add ur parents also

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185 Gayatrinath Auti

Hi,

My age is 26 years, Wife’s age is – 26 years and my baby’s age is 3 mnths.
Should I go ONLY with Jeevan aarogya for all 3 of us.
Or should I take 2 policies, ( if yes then which ones in the market?).
I want accidental & medical cover for all 3 of us. Please advise.

Reply

186 D B NAHAK

jeevan aarogya(health insurance) and Amulya jeevan(normal & accdental)

Reply

187 Jitendra P.S.Solanki

Hi Gayatrinath,

As we have mentioned this is a Hospital Cash Benefit and not a comprehensive health insurance. In my view it can be added as a supplement but cannot replace basic health plans. You can consider Appollo Munich Easy Health, Max Bhupa or even Religare for your family. For accidental you have Accidental Insurance from Appollo and other companies which you can look into. You will have to buy two seperate policies for accidental and medical insurance.

Reply

188 Sandeep kamath

Hi Sir

Am sandeep kamath from hyderabad, am looking for health/medical insurance for my parents who are aged 62 & 68 respectively, with less premium and have more benefits. please advise

Reply

189 Jitendra P.S.Solanki

Hi Sandeep,

A age 62 you still have a choice of policies like Apollo Easy Health for covering your parent. But at age 68 there is only senior citizen policies which have limitations especially co-payment clauses to ensure the insured also bears certain % of total cost. Hence, you should not rely completely in health insurance for your parents. You can consider these policies but do have an emergency fund created for their health insurance need.

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190 D B NAHAK

Dear sir,
Please go for LICs jeevan aarogya policy

Reply

191 NITIN

ONE SHOULD TAKE JEEVAN AROGYA POLICY ALONG WITH NORMAL MEDICLAIM,FOR FOLLOWING REASONS.
1.Mediclaim will reimburse as per the expenses incurred subject to sublimits.
Jeevan arogya plan will pay additional amount for the same operation or hospitalization irrespective of claim amount received from mediclaim.
2.If you are government employee and getting treatment at hospitals at subsidised rates mediclaim will pay you only to the extent of expenses made,however jeevan arogya will pay fixed amount based on number of days or type of surgery which makes big difference.
3.The benefit amount increases by 5% every year for first 10 years irrespective of claim paid.There is additional increase in benefit by 5% for evey three claim free years.
In mediclaim policy if there is claim your next year renewal premium will attract loading.This will not happen with Jeevan arogya
mediclaim+jeevan arogya policy is very good combination for optimum health cover.

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192 Debkant Sahu

Hello sir… As you mention, Under a single policy you can cover your complete family (which includes you, your spouse and children), your parents and your parents –in-law. But Lic agent told me My mother (widow ) would not come under this plan.. is it true ??

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193 Jitendra P.S.Solanki

Debkant,

The features of the product says that you can cover parents. The condition of both or neither applies when both parents are alive.
In my view you should be able to cover your mother. You can check with some senior officer of LIC for knowing more about the coverage.

Reply

194 Vivek

Hi Jitendra Solanki & Manikaran Singal,
Thanks for wonder full insight & patient to reply approx every query.
Pl suggest me too –
1) Me(31) & My Mother(age 65) are covered in ICICI Group Claim from my Company, So does it will be suitable for me or mother?
2) Can I get simultaneous benefit from Mediclaim & this Policy.
3) Any Maturity benefit ?
4)

Reply

195 Jitendra P.S.Solanki

Vivek,

1. Yes you can take this policy.
2. You get simultaneous benefit from both. Jeeva Arogya is more as a supplement which gives you benefit for other expenses.
3. The policy has a maximum term of 35 years.

Reply

196 SK agrawal

Thanks to both of you for such a great article with an eye opener to the public. I am also a suffere of health insurance. I had a health insurance policy in the name of my wife for Rs. 100000 for one year, through United India Insurance Co. but did not get the policy document. Payment was made online on 31/10/2011. On 16th Oct 2012 I joined a company and the company provided family insurance (Group Medical) for Rs. 350000/- duly renewed next year. on 11 th Jan 2014 I had to admit my wife for acute pain in abdomen. Sonography revealed it to be gall bladder stone and Dr. suggested surgery. She was discharged on 14/1/2014 and surgery was to be planned next week. I applied for cashless facility but to my surprise, I was denied the facility as well as any expenditure done on this account on the grounds that this surgery can not be claimed befor 2 years of running the policy. I think this is cheating with the public. I have presented my case to the agent but as on date he has closed it with denial asking me for the policy that was never issued to me despite my complaint online several times. I never claimed any amount during this period of time on any of my family member.
What to do next, I dont know. However, due to sudden seriousness of the problem, I had to get my wife operated on 20/1/2014 at the Dr’s personal hospital instead of the hospital on penal to save around Rs. 15000/-.
Let me know if you can guide me in any way.
Regards
SK Agrawal

Reply

197 Jitendra P.S.Solanki

Dear Mr.Agarwal,

If the company cover the specific illness after two years , then it will be specifically mentioned in the policy wordings. This you get along with policy documents. If you haven’t received the documents and after repeated mails company did not respond then you can take up the matter with them. You can write to the concerned higher authorities and in case of no response can approach their grievance cell.

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198 SUDIPTA CHANDA

Hi sir.. I want to buy a health insurance for my family consisting of my wife,my son and my mother..I donot know any thing neither I have surveyed but the only thing which I did is reading your suggestions.. plz guide me also to get an health insurance

Reply

199 Jitendra P.S.Solanki

Sudipta,

If you don’t have any health insurance then first look at basic health plans which will cover your family from hospitalization expenses. Cover you and your spouse under a single health plan and your mother in a seperate plan. You should check with different companies on the coverage features and then select one which matches your requirement.

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200 sagar

Hi sir,
I am 30year old and A.P. state government employee. Very soon our government is going to provide cashless health card through which health services can be obtained up to rs.2 lakh per year. I want to go for a health policy to meet additional expenditure incurred at the time of major surgeries. Please suggest me a suitable health policy.

Reply

201 Jitendra P.S.Solanki

Sagar,

Many companies have daily cash hospital allowance policies where they aim to cover addition expenses which you bear during hospitalization. But prefer those where you do not have any savings element and go through policy wordings as these too have waiting periods and exclusions. Max Bupa, Apollo Munich, Bajaj Allianz have such policies to consider.

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202 Tirab Saikia

Hi Hemanth

This could sound like a typical query from an unplanned individual.
But still, I would like to put forth my query.
I am a 32 yr old employee, who is looking out for a Medi Claim policy that best suits my Parents. In my previous org, this was covered, so I didnt worry much. But in my current org, my parents are not covered under its mediclaim policy.
So I am looking out for a policy for my parents- Specifically for my father.
He is 69 yrs old, is diabetic and has high blood pressure. Is there any policy that will cover his case.If yes, what all aspects can I expect to be covered?How should I plan for instance which requires any medical attention for him ?

I would be truly grateful if you could guide me in this case.

Best Regards
Tirab

Reply

203 Jitendra P.S.Solanki

Tirab,

It’s difficult to get a health insurance policy at higher age when you have any existing illness. Even if covered, these are treated as pre-existing illness and get coverage only after 4 years of policy continuation. Also, you might be charged a higher premium than a general policy and premium at this age are too high.

In my view you should consider creating a health fund for your father. Being diabetic companies will be hesitant to issue health policy at this age.

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204 Alok.Nath

I would like to know since I have got a mediclaim policy & I wish to take LIC Jeevan Arogya,whether i will be able to claim from both sides for the same surgeries.Kindly let me know.

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205 Jitendra P.S.Solanki

Alok,

Yes you can claim from multiple insurance policies provided you are not claiming twice for the same illness. As i have illustrated you can claim from jeevan arogya additional expenses over and above hospitalization cost which you bear during the period.

Reply

206 SANTOSH KUMAR PANDA

I’m 60 year old, self employed, live with my wife 55 years old. I have a policy with LIC- table 901 since June2008 & valid up to 2019. I pay a premium of Rs 15000- per annum regularly. Of late, I ‘ve come to know that, this policy covers only 47 diseases , which are very uncommon & rare. My wife has to go for a spine surgery urgently which is not covered. Pl. suggest me a policy I should buy for future requirement to provide more coverage.
with kind Regards.

Reply

207 Jitendra P.S.Solanki

Dear Santoshji,

Health insurance at higher age will be costly. You have should look at covering you and your spouse seperately. Also companies may have some restrictions in health policy for your spouse due to her recent illness. You can look at Apollo Munich, Max Bhupa or even Religare Health.

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208 Ravindra Mishra

My age is 32 yrs. & My wife is 29 yrs ,both working in Govt. PSU.Medical claims from Office are old CGHS rates which are not enough to reimburse whole expenses.
I want to cover my parents (Age 62 & 60 yrs) also.Shud I go for LIC -Jeevan Arogya.Pre medical tests are required for parents or not b4 insuring?
And Can I claim from both my Office and LIC also? I mean , Is it possible to claim from both LIC & my Office to compensate whole expenses?
And Actual Invoices reqd. in LIC or Xerox copies. Plz suggest.

Reply

209 Jitendra P.S.Solanki

Ravindra,

Understand the product. This policy gives hospital cash benefit and so it is specifically for claiming additional expenses which you may bear over and above hospitalization.If your aim is to enhance your coverage for hospitalization expenses then wiser to look at general health insurance plans.
For multiple policies, post IRDA changes you can claim from both the policies.

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210 Dharmapala Pancha

I am informed by a Senior LIC Insurance Agent that, issuing insurance policy to an eligible applicant is the prerogative of LIC. My query is about an applicant of age 69 years who is a diabetic as well as a heart patient and intends to get a cover under LIC Jeevan Arogya. pl clarify.

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211 Jitendra P.S.Solanki

Dharmapala,

The maximum cage at entry is 65 years. Only if you include your parents or parents-in-law in the policy the age relaxation for them is 75 years. So if the applicant is only to be covered then he has exceeded the age limit and so won’t be eligible for this policy.

Reply

212 Dharmapala Pancha

no specific reply is observed to be received.

Reply

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