1. स्वास्थ्य बीमा Health Insurance
LIC’s Cancer Cover ( Plan 905)

2. Benefit Options Option I - Level Sum Insured
Two benefit options are available which can be chosen by the proposer at the outset & premium rates vary depending on the option chosen
The Basic Sum Insured shall remain unchanged throughout the policy term
Option I - Level Sum Insured
The Sum Insured increases by 10% of Basic Sum Insured each year for first five years Or
until the diagnosis of first event of Cancer, whichever is earlier.
Option II - Increasing Sum Insured
11/13/2018

3. Applicable Sum Insured
Applicable Sum Insured shall be equal to –
The Basic Sum Insured for policies taken under Option I; or
Basic Sum Insured during first year and Increased Sum Insured thereafter, as per the provisions detailed in Option II above, for policies taken under Option II.
11/13/2018

4. Age Groups Eligibile
(a) Minimum age at entry:20 years (completed) (b) Maximum age at entry:65 years (last birthday) (c) Minimum Policy Term:10 years (d) Maximum Policy Term:30 years (e) Minimum age at maturity:50 years (f) Maximum age at maturity:75 years

5. Eligibility Minimum Premium: Rs. 2400/- for all modes
Premiums are guaranteed for a period of first 5 years from date of issuance of policy
Minimum Basic Sum Insured: Rs.10,00,000
Maximum Basic Sum Insured: Rs. 50,00,000
(Subject to an overall limit of Rs.50 lakhs taking all existing Critical Illness Cover policies including Cancer Cover and the new proposal under consideration).
The Basic Sum Insured shall be in multiples of Rs. 1,00,000/- only

6. Benefit Structure of Early Stage Cancer
Early Stage Cancer: Provided the policy is in force, on first diagnosis of any one of the Specified Early stage cancers
Lump sum Benefit of 25% of applicable Sum Insured is paid (only once for first event)
2. PWB : Premium Waiver Benefit for next three policy years

7. Benefit Structure of Major Stage Cancer
Major Stage Cancer: Provided the policy is in force, on first diagnosis of any one of the Specified Major stage cancers
Lump sum Benefit of 100% of applicable Sum Insured less any claims paid previously
PWB - Future Premiums shall be Waived
Income 1% applicable sum insured shall be paid monthly for next 10 years to life assured or nominee in case of death of LA.

8. Benefits Not Payable No Maturity Benefit is payable
No Death Benefit is payable

9. Assignments / Nominations
Assignments: Assignment is allowed under this plan
Nominations: Nomination by the holder of a policy of life assurance is required as per Section 39 of the Insurance Act, 1938
C) Policy Loan: No loan shall be available under this plan

10. Waiting Period Survival Period
A waiting period of 180 days will apply from the date of issuance of policy or date of revival of risk cover, whichever is later, to the first diagnosis of any stage cancer.
No benefit shall be payable if any stage of Cancer occur before expiry of 180 days from the date of issuance of policy or date of revival and the policy shall terminate.
Survival Period
No benefit shall be payable if the Life Assured dies within a period of 7 days from the date of diagnosis of any of the specified Early Stage Cancer or Major Stage Cancer. The 7 days survival period includes the date of diagnosis.

11. Exclusions
Any Pre-Existing Condition i.e. any cancer condition, precancerous condition where policyholder had signs or symptoms, and / or were diagnosed, and / or received medical advice / treatment within 48 months prior to the date of issuance of policy or revival of the policy.
If the diagnosis of any stage of Cancer was made within 180 days from the Date of issuance of policy or date of revival of risk cover whichever is later;
For any medical conditions or procedure was caused directly or indirectly by AIDS related complex or infection by Human Immunodeficiency Virus (HIV);
For any medical condition or procedure arising from the donation of any of the Life Assured’s organs;
For any medical conditions or procedure was caused directly or indirectly by alcohol or drug
(vi) For any medical condition or procedure arising from nuclear contamination; or accident arising from such nature.

12. Exclusions of Early stage Cancer benefits
All tumors which are histologically described as benign, borderline malignant, or low malignant potential
Dysplasia, intra-epithelial neoplasia or squamous intra-epithelial lesions
Carcinoma in-situ of skin and Melanoma in-situ
All tumors in the presence of HIV infection are excluded

13. Exclusions of Major stage Cancer benefits
All tumors which are histologically described as carcinoma in situ, benign, pre-malignant, borderline malignant, low malignant potential, neoplasm of unknown behavior, or non-invasive, including but not limited to: Carcinoma in situ of breasts, Cervical dysplasia CIN-1, CIN -2 and CIN-3.
Any non-melanoma skin carcinoma unless there is evidence of metastases to lymph nodes or beyond;
Malignant melanoma that has not caused invasion beyond the epidermis;
All tumors of the prostate unless histologically classified as having a Gleason score greater than 6 or having progressed to at least clinical TNM classification T2N0M0
All Thyroid cancers histologically classified as T1N0M0 (TNM Classification) or below;
Chronic lymphocytic leukaemia less than RAI stage 3
Non-invasive papillary cancer of the bladder histologically described as TaN0M0 or of a lesser classification,
All Gastro-Intestinal Stromal Tumors histologically classified as T1N0M0 (TNM Classification) or below and with mitotic count of less than or equal to 5/50 HPFs;
All tumors in the presence of HIV infection.

14. Claims process
Proof satisfactory to the Corporation Within 120 days from the date on which any of the contingencies under Early Stage Cancer or Major Stage Cancer shall be furnished as below:
Claim Form along with NEFT mandate from the Claimant
Original Policy document;
Treating doctor certificate filled by the doctor treating the Life Assured for the diagnosed ailment.
Hospital certificate/Discharge Summary duly filled by the hospital where Life Assured was admitted.
Confirmatory investigations including, clinical, radiological, histological & laboratory evidence;
Any other document or information as asked for by the Corporation

15. Claims process contd..
Claim Forms to be submitted at Branch office
Processing of claims by DHU – M(HI)
DMR opinion is sought on all claims for technical guidance
Payment is made from Branch office.

16. Termination Of Policy
The policy shall be terminated upon the happening of either of the first of the following events.
On the death of the Life Assured;
On the date of maturity;
On payment of the Major Stage Cancer, however, Income Benefit shall continue to be payable as and when due;
On the diagnosis of any stage cancer during the waiting period;
On cancellation of the policy by the Life Assured or insurer;
On expiry of revival period;
On grounds of misrepresentation, fraud, non-disclosure or non-cooperation of the insured;
In case the policyholder does not renew the policy after premium review, if any.