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Hospital Cash Benefit
                                      ¾                t                      }
          ¯{¢                         Žƒ §         t ~     yž          v        ~
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24    Ž          {   ‚”       ƒ                                        „      }²t”
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Major Surgical Benefit
            ¯          ²                   v     t               }
    140            Ž           ¯ ²            v                  ~ ž
                             ƒ   ”          ž ¶t” !


Heart      ˆ
  ¾,   kidney,                                          °.1 y 
stomach,liver,                                           « ƒ 4 y 
brain, lungs
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                       | ~     }       |       žt” HCB
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Day Care Procedure Benefit
   ¯   „      ¯{¢            §          yž              ~ ž
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140
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               | ~   }       |       žt” HCB
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              ”         ~        ²{ ¢         ƒ   !!
Other Surgical Benefit
     MSB   ‚² DCPB   yœ       ƒ                      ²
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      ‚²
 v                                               °.2000 « ƒ
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 v     „
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“   }                  t
                  ~©         u „ !
                              Hospital Cash
  Hospital Cash                 Benefit
    Benefit                             Ž}
            Ž}                   z       
« ƒ        ¯                ¯  « ƒ
 30      y „                 90      y „
  (     ƒ 15                  (     ƒ 45
  y „                          y „
 ICU      } =                ICU      } =
2    u” HCB)                2    u” HCB)


        …    „ «¸¢            y  720
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“    }                         t
                     ~©        u „ !
Major Surgical                    Major Surgical
  Benefit                           Benefit
¯      zœƒ                              …        ƒ
                                                y           ¯
        y 
                                                            ¯ 
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 HCB     Ž}                                               „¶ œ!
100      u”!                      800           u”!


                      u   ¾t ~ y
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          u ~ ž !           ©   }ˆ                  º
                     °1000    y      !!
“     }                  t
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                                 Day Care
    Day Care                 Procedure Benefit
Procedure Benefit
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      DCPB          u ~ ž    ¢,   HCB       }
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                           Other Surgical
Other Surgical                Benefit
   Benefit                       z             Other Surgical
     « ƒ                          zž               Benefit
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        y                           y 
15     y „                  45    y „             t     ~ yž

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“    }                    t
                            Underwriting Rules
     SUC:      |   2       zž ¶t”„         ž{¢„        T901,902,903
              y {      }   …     „   MSB Sum Assured      yž. (Term
            Rider SA       ¢)
     Age Proof: Standard & NSAP I
     Female: All 3 Categories.
i.    Housewives can be Principal Insured: Equal to Husband’s MSB SA
      or MSB 2 lacs (without Husband’s MSB SA)
ii. Widows with Income Proof MSB 5 lacs; without proof 2 lacs


      Major students can be Principal Insured; MSB allowed is equal to
      parents health insurance cover or 2 lacs (without parents HI cover)
“      }                             t
                               Underwriting Rules
            SUC      Upto 35     36 - 45       46 - 50        51 - 55        >55
Non                                                                                         Non
            Upto     NM          NM            NM             FMR,FBS,RUA    FMR,FBS,
Medical                                                                      RUA,ECG,       Medical
            2 lacs                                                           S.CREATININE   Genl
Special
---------   Upto     NM          FMR,FBS,      FMR,           FMR, FBS,      FMR,FBS,       -------------
                                 RUA           FBS,RUA.       RUA,ECG,       RUA,ECG,
Upto        4 lacs                                            S.CREATININE   LIPIDOGRAM,    Upto Age
Age 45:
                                                                             S.CREATININE   35: 5 lakhs
                                                                             LFTs,HBSAG,
5 lakhs                                                                      HAEMOGRM,      -------------
--------
                                                                             HBA1.          36 to 50
46 -50      Upto     NM          FMR, FBS,     FMR, FBS,      FMR, FBS,      FMR,           : 2 lakhs
                                 RUA, ECG ,    RUA,ECG,       RUA,ECG,       FBS,RUA,ECG,
: 4lakhs    5 lacs               S.CREATININ   S.CREATININE   LIPIDOGRAM     LIPIDOGRAM,
                                                              S.CREATININE   S.CREATININE
                                                              LFTs, HBSAG,   LFTs,HBSAG,
                                                              HAEMOGRM,      HAEMOGRM,
                                                              HBA1C.         HBA1C,CTMT

            More     FMR,        FMR, FBS,     FMR,           FMR,           FMR,
                     FBS,RUA     RUA, ECG,     FBS,RUA,ECG,   FBS,RUA,ECG,   FBS,RUA,ECG,
            than     ECG,        S.CRTN        LIPIDOGRAM,    LIPIDOGRAM,    LIPIDOGRAM,
            5 lacs   S.CRTN                    S.CREATININE   S.CREATININE   S.CREATININE
                                               LFTs, HBSAG,   LFTs, HBSAG,   LFTs, HBSAG,
                                               HAEMOGRM,      HAEMOGRM,      HAEMOGRM,
                                               HBA1C,         HBA1C,         HBA1C,
                                               CTMT           CTMT           CTMT
“    }                                t
          Example                               

    °1000          HCB             ¯            Ž¾          
              z                                         z
     ¢             Ž¾                  ¢                   Ž¾      
 20                 1884            20                       1689
 30                 2198            30                      2004
 40                2744             40                      2488
 50                3693             50                      3072

          „        Ž¾                              ,           ¢
      {       ‚”        ´{¢       Ž¾           {        ž
~ Žyž         ¯u „.            |   Ž¾           {       ‚”
z              } „         ž{       t {             ƒ....
­„        ~ yœ‚”
            ’              ž{¢          u           }
¯{¢            ~ yœ‚
                 ’                          !
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                    Illustration                  ž{¢t                 yž
          Nature of Benefit                                                                 y 
 °.1000 HCB     |    žt”             ¢    «      zž         z  
                                                (Rs)         zž (Rs)                          
                   t”     } „                                               «¸         ¢     (Rs)

Hospital Cash Benefit (HCB) including ICU
Benefit                                     45,000          1,41,750            16,20,000

Major Surgical Benefit (MSB)                1,00,000        1,05,000            12,00,000
Other Surgeries Benefit (OSB)               30,000           94,500              10,80,000
Day Care Procedure Benefit (DCPB)           15,000           15,750               1,80,000
Maximum Benefit under the policy per
insured                                                        40,80,000

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

Premium Waiver Benefit                                      One Year Premium

No Claim Benefit                                          Increase in HCB by 5%
          ~            !

                ~             !!

“   }               t           ’   Žƒ

                   |¢....

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    œ. ˆ.      }, ƒ. . ., °
             94431 56829
       tsr.iyengar@gmail.com

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LIC's Jeevan Arogya in tamil

  • 1. … ” ‚ ƒ  ! ƒ, ­‚ … ~ {¢ Žž!!
  • 2. | ~  ! ’ • Žƒ ,  ƒ {¢ Ž‚ { ¶t t . • { {¢ ƒ ¯t ?
  • 3. { ! • Ž { Ž ‚ ž ¢ ¯ { € ž ¯{¢ v º }§ ¶ Ž{¢ Žž ƒ ­² t ¢.
  • 4. | t Ž¯|¢ Žž } ? • ¯{¢ {¢ «} ¯ ¢. • {¢ € ¶t” v « „ ¢. • ƒ ‚ ~   „ ?
  • 5. | ~ ! ’ ° 40000 ° 200000 ~©„ ~©„ ¯ t ¯t { ‚ }™ }ˆ }™ }ˆ Ž¾  Ž¾  ° 9000 ° 1500
  • 6.  ƒ ....! •  ƒ ‚ ž ¯{¢ v º ¶t”  ´{ zœ Ž¾  † ! •  ”ž { ƒ „ ¾} ¯{¢ v º ¶t ~ ž ’ zž ?
  • 7. « ! ƒ. . Ž} “ } t ... u „ t … Ž‚” ‚© ¯{¢ t ~ yž ’ y  ! u „ ƒ ~ Žt t œ t ~ y y !
  • 8. } t
  • 9. ¯{¢ t ~ yœ} ’ } „ 1) ¾ ¯{¢ º 2) ² v v º 3) v Ž} ¢ Ž¾  „¶ œ 4) © }ˆ º 5) ¯ ¯  ¾t” t ~ } 6) Ž¯~ { ‚ ‚ ­„ + Ž {¢ ~ ž ’
  • 10. Hospital Cash Benefit ¾ t } ¯{¢ Žƒ § t ~ yž v ~ zœ € ¶t ¾ ~ } 24 Ž { ‚” ƒ „ }²t” § t ~ ž °.1000/2000/ † ¯ ¶t”..! 3000/4000 ICU Žƒ HCB º: ( y ) ¯| ƒ ¯t” °.2000/4000/ Žt”, ¯t” 6000/8000 ‚ t”. | ~ } | žt” HCB ~ ²{ ¢ ! ” ~ ²{ ¢ ƒ !!
  • 11. Major Surgical Benefit ¯ ² v t } 140 Ž ¯ ² v ~ ž ƒ ” ž ¶t” ! Heart ˆ  ¾, kidney, °.1 y  stomach,liver, « ƒ 4 y  brain, lungs ‚² ² v | žt” „ y 140 HCB Ž} 100 u” | ~ } | žt” HCB ~ ²{ ¢ ! ” ~ ²{ ¢ ƒ !! ( } 20% « ƒ 100% ² v ²{¢)
  • 12. Day Care Procedure Benefit ¯ „ ¯{¢ § yž ~ ž ² v t } 140 ² °.5000 « ƒ v „ 20000 yœ ƒ. ¯ | žt” „ yž HCB Ž} 5 ˆ { ¾ Žƒ u” u zœ ! | ~ } | žt” HCB ~ ²{ ¢ ! ” ~ ²{ ¢ ƒ !!
  • 13. Other Surgical Benefit MSB ‚² DCPB yœ ƒ ² v t } ‚² v °.2000 « ƒ ² v 8000 v „ {¢ | žt” HCB Ž} 2 u” | ~ } | žt” HCB ~ ²{ ¢ ! ” ~ ²{ ¢ ƒ !!
  • 14. } t ~©  u „ ! Hospital Cash Hospital Cash Benefit Benefit Ž} Ž} z  « ƒ ¯  ¯  « ƒ 30 y „ 90 y „ ( ƒ 15 ( ƒ 45 y „ y „ ICU } = ICU } = 2 u” HCB) 2 u” HCB) … „ «¸¢ y  720 y „ ( ƒ 360 y „ ICU } = 2 u” HCB)
  • 15. } t ~©  u „ ! Major Surgical Major Surgical Benefit Benefit ¯ zœƒ … ƒ y  ¯ y  ¯  HCB Ž} Ž¾  HCB Ž} „¶ œ! 100 u”! 800 u”! u ¾t ~ y ¯{¢ ƒ v ~ ‚ ƒ 50% œ u ~ ž ! © }ˆ º °1000 y !!
  • 16. } t ~©  u „ ! Day Care Day Care Procedure Benefit Procedure Benefit … ƒ ¯ zœƒ y  y  24« 3« DCPB u ~ ž ¢, HCB } ¢!
  • 17. } t ~©  u „ ! Other Surgical Other Surgical Benefit Benefit z  Other Surgical « ƒ zž Benefit zœƒ « ƒ ¾ y  y  15 y „ 45 y „ t ~ yž yž! yž! u ~ ž! … ƒ y  360 y „!
  • 18. } t «t ” ~© ! ƒ ƒ œ~ Žƒ  ¯{¢ v } ¢ 80 ¢ ¯ ˆ ¤ º º „ ¯{¢ t ¢! ~ yž{ ’ yž Ž} … y  ! u ~ ž « º u”v | !! ~©{ ¢ !! ¢! ¢! Ž¯~ ~ y ƒ yž ­„ ~ ž ’ ‚² Ž {¢t ~ ž! ’
  • 19. } t «t ” ~© ! } „ ¢º Ž¾  y { ƒ ¬} zœ‚” ¯ « † ¯ yž ¬} zž ¾ t ~ ž 5% HCB !! t { ! † ¯ zž HCB 5% { ~ ž! y  50%
  • 20. } t «t ” ~© ! EXCLUSIONS ~ yœ¯|¢ ’ Ž t” „ 23 u } œ~ Žƒ ‚ „¶ v ¶t” ~ ž ’ ¢. ‚²„ ... ‚ „ Ž „ ¢ ¯{¢ ¾ (General Check up) Routine Medical Check up ” ž{¢ ‚ v (cosmetic surgery) Ž Žt ² AIDS „ y ƒ Ž € „ ~ ²  v „( € ‚² €)
  • 21. } t «t ” ~© ! Waiting Period { ¯~©  Ž { } ƒ t Ž¾  ” Ž‚ ´{ ƒ 90 ~ ž Ž} y ¶t”„ v t” } „ ©¢~ Ž{ ƒ 45 } „ u y „! Ž} t Ž |¢ 90 90 y ¶t”~  ¯| y ¶t” Ž} ©¢~ Ž{ ƒ zž! Ž}! 90 y „! ´ yœ ~ yž„ 17 v ¶t” { ¯~©  2 ¯ ! !
  • 22. } t    ? ”ž  – 18 « ƒ 55 ¢ (Principal Insured) t” yž ƒ ¢ } Ž(18 -65 ¢), ” | „ (3  – 17 ¢), ‚  ‚² Ž Ž} ‚  (75 ¢ ) ­ {  ~ ž «œº² ’ ¢: ” | (25 ¢)  80 ¢
  • 23. } t ‚  u „ « : zž, zž, zž ‚² (ECS « ) ´ y „: Q / H / Y : 30 days AND ECS: 15 days ©¢~ Ž{ ƒ: Ž¾  ´{ Ž¯|¢ 2 ¯ { ‚”„ } }, z: ƒ t Ž} „¶ (Dating Back) ƒ ”ž { ƒ ¯ ¾} } ‚ t” ‚ «œ ¢ ”ž { ƒ „ ²~ Ž  « {¢t „ zž. ¯   „ yž Ž ” {¢t „ .
  • 24. } t ~©  u „ | y { } … } „ ¯{¢ v v t }² } ƒ (Certified photocopies) ¢ ¢. ‚ y u } … } ‚ ´ ƒ z } „ •ž ~ . ‚ ´{¢ Ž¾  ¯ ¾ y { } Ž¾º 80D Ž} … °15000 Ž´ ‚  { ¯| ƒ °30000 Ž´ Ž t” .
  • 25. } t Underwriting Rules SUC: | 2 zž ¶t”„ ž{¢„ T901,902,903 y { } … „ MSB Sum Assured yž. (Term Rider SA ¢) Age Proof: Standard & NSAP I Female: All 3 Categories. i. Housewives can be Principal Insured: Equal to Husband’s MSB SA or MSB 2 lacs (without Husband’s MSB SA) ii. Widows with Income Proof MSB 5 lacs; without proof 2 lacs Major students can be Principal Insured; MSB allowed is equal to parents health insurance cover or 2 lacs (without parents HI cover)
  • 26. } t Underwriting Rules SUC Upto 35 36 - 45 46 - 50 51 - 55 >55 Non Non Upto NM NM NM FMR,FBS,RUA FMR,FBS, Medical RUA,ECG, Medical 2 lacs S.CREATININE Genl Special --------- Upto NM FMR,FBS, FMR, FMR, FBS, FMR,FBS, ------------- RUA FBS,RUA. RUA,ECG, RUA,ECG, Upto 4 lacs S.CREATININE LIPIDOGRAM, Upto Age Age 45: S.CREATININE 35: 5 lakhs LFTs,HBSAG, 5 lakhs HAEMOGRM, ------------- -------- HBA1. 36 to 50 46 -50 Upto NM FMR, FBS, FMR, FBS, FMR, FBS, FMR, : 2 lakhs RUA, ECG , RUA,ECG, RUA,ECG, FBS,RUA,ECG, : 4lakhs 5 lacs S.CREATININ S.CREATININE LIPIDOGRAM LIPIDOGRAM, S.CREATININE S.CREATININE LFTs, HBSAG, LFTs,HBSAG, HAEMOGRM, HAEMOGRM, HBA1C. HBA1C,CTMT More FMR, FMR, FBS, FMR, FMR, FMR, FBS,RUA RUA, ECG, FBS,RUA,ECG, FBS,RUA,ECG, FBS,RUA,ECG, than ECG, S.CRTN LIPIDOGRAM, LIPIDOGRAM, LIPIDOGRAM, 5 lacs S.CRTN S.CREATININE S.CREATININE S.CREATININE LFTs, HBSAG, LFTs, HBSAG, LFTs, HBSAG, HAEMOGRM, HAEMOGRM, HAEMOGRM, HBA1C, HBA1C, HBA1C, CTMT CTMT CTMT
  • 27. } t Example  °1000 HCB ¯ Ž¾  z z ¢ Ž¾  ¢ Ž¾  20 1884 20 1689 30 2198 30 2004 40 2744 40 2488 50 3693 50 3072 „ Ž¾  ,  ¢ { ‚” ´{¢ Ž¾ { ž ~ Žyž ¯u „. | Ž¾ { ‚” z } „ ž{ t { ƒ.... ­„ ~ yœ‚” ’ ž{¢ u } ¯{¢ ~ yœ‚ ’ !
  • 28. } t Illustration ž{¢t yž Nature of Benefit y  °.1000 HCB | žt” ¢ « zž z  (Rs) zž (Rs)  t” } „ «¸ ¢ (Rs) Hospital Cash Benefit (HCB) including ICU Benefit 45,000 1,41,750 16,20,000 Major Surgical Benefit (MSB) 1,00,000 1,05,000 12,00,000 Other Surgeries Benefit (OSB) 30,000 94,500 10,80,000 Day Care Procedure Benefit (DCPB) 15,000 15,750 1,80,000 Maximum Benefit under the policy per insured 40,80,000 Ambulance Charges incurred Rs.1000/- per insured per year Premium Waiver Benefit One Year Premium No Claim Benefit Increase in HCB by 5%
  • 29.  ~ !  ~  !! “ } t ’ Žƒ |¢.... }© } œ. ˆ. }, ƒ. . ., ° 94431 56829 tsr.iyengar@gmail.com