1. What is the situation today What New

2. Next The Cost of Health care shooting up exponentially Present Generation spend more on Health Care 7/2/2015Ajay Kumar Kurup

3. Health Insurance Health Insurance plan must take care…… 1)Daily Expenses in Hospital 2)Surgical Expenses 3)Out Patient expenses 4)All expenses in and out of Hospital 5)Waiver of premium during stay at Hospital 6)Risk Coverage in case of any exigencies Whether your existing plan offers all the above 7/2/2015Ajay Kumar Kurup

4. LIC’s Jeevan Arogya 7/2/2015Ajay Kumar Kurup

5. LIC’s Jeevan Arogya gives you…… Valuable financial protection in case of hospitalisation, surgery etc Increasing Health cover every year Lump sum benefit irrespective of actual medical costs No claim benefit Flexible benefit limit to choose from Flexible premium payment options 7/2/2015Ajay Kumar Kurup

6. Benefits Under Jeevan Arogya Hospital cash benefit (HCB) Major Surgical Benefit (MSB) Day Care Procedure Benefit Other Surgical Benefit Other Optional benefits(PWB) 7/2/2015Ajay Kumar Kurup

7. Benefits Under Jeevan Arogya Hospital cash benefit (HCB) Major Surgical Benefit (MSB) Day Care Procedure Benefit Other Surgical Benefit Ambulance Benefit Premium waiver Benefit (PWB) 7/2/2015Ajay Kumar Kurup

8. Benefits Under Jeevan Arogya Hospital cash benefit (HCB) Major Surgical Benefit (MSB)) Major Surgical Benefit (MSB) Day Care Procedure Benefit Other Surgical Benefit Ambulance Benefit Premium waiver Benefit (PWB) 7/2/2015Ajay Kumar Kurup

9. Benefits Under Jeevan Arogya Hospital cash benefit (HCB) Major Surgical Benefit (MSB) Day Care Procedure Benefit Other Surgical Benefit Ambulance Benefit Premium waiver Benefit (PWB) 7/2/2015Ajay Kumar Kurup

10. Benefits Under Jeevan Arogya Hospital cash benefit (HCB) Major Surgical Benefit (MSB) Day Care Procedure Benefit Other Surgical Benefit 7/2/2015Ajay Kumar Kurup

11. Benefits Under Jeevan Arogya Hospital cash benefit (HCB) Major Surgical Benefit (MSB) Day Care Procedure Benefit Other Surgical Benefit Ambulance Benefit Premium waiver Benefit (PWB) Other Optional benefits 7/2/2015Ajay Kumar Kurup

12.  HCB (Within India only) is payable on per day basis. Double the cash benefit for ICU.  Max 30 days hospitalization & not more than 15 days in ICU (2 times HCB) for 1 st policy year for each one  Max 90 days and incl not more than 45 days in ICU in the 2 nd year onwards for each insured  Limited to a max of 720 days (incl of 360 days for ICU) during entire policy term for each insured  HCB to increase 5% till it reaches 1.5 times And arithmetic addition of an amount equal to “No Claim Benefit”  Stay in Hospital exceeds a continuous period of 24 yrs or part thereof thereafter. Stay more than 7 days even for 1s 24 hours also payable. Hospital Cash Benefit (HCB) FeaturePrincipal Insured (PI) Insured Spouse(If any), Parents/In law Insured Children Min Initial Daily Benefit Rs. 1000/- Max Initial Daily Benefit Rs. 4000/-Equal or less than PI Max Age for Cover80 yrs 25 yrs Next 7/2/2015Ajay Kumar Kurup

13. Major Surgical Benefit(MSB) FeaturePrincipal Insured (PI) Insured Spouse(If any), Parents/In law Insured Children Sum Assured (MSB SA) 100 times ADB of PI 100 times of ADB of insured Spouse 100 times of ADB of each child Max Annual benefit100% of Sum Assured Max Life Time800% of MSB SA  Quick Cash facility: 50% of eligible MSB amount subject to approval from TPA in select Hospitals  MSB shall be a percentage of Sum Assured and is payable regardless of actual costs incurred  Rs. 1000/- towards Ambulance expenses  Premium Waiver benefit for next one year  Surgery within India. Next 7/2/2015Ajay Kumar Kurup

14. Day Care Procedure Benefit (DCPB) FeaturePrincipal Insured (PI) Insured Spouse(If any), Parents/In law Insured Children Lump sum benefit payable 5 times of ADB in HCB 5 times of ADB IN HCB Max Annual benefit 3 Surgical Procedures Max Life Time 24 Surgical Procedures  If a DCPB is performed, no HCB shall be paid  DCPB is payable as one lump sum and proof of surgery is required  All surgical procedures should be done by a Physician or Surgeon, to the satisfaction of the Corporation  No transfer of left over benefit to other insured  Surgery within India Next 7/2/2015Ajay Kumar Kurup

15. Other Surgical Benefit (OSB) FeaturePrincipal Insured (PI) Insured Spouse(If any), Parents/In law Insured Children Daily Benefit amount2 times of ADB Max Annual benefit 15 Days in Year 1 and 45 days per year thereafter Max Life Time 360 days  OSB is payable as daily benefit  Proof of surgery done by a Physician or Surgeon, is subject to the satisfaction of the Corporation  No transfer of left over benefit to other insured  Surgery required but not listed under MSB or DCPB Next 7/2/2015Ajay Kumar Kurup

16. Other Options Term Rider Benefit Min Term Assurance SA: Rs. 100000/- Max Term Assurance SA: Equal to MSBSA Min Entry Age: 18 Years completed Max Entry Age: 50 Years NBD Max Maturity Age: 60 Years NBD Max Term: 35 Years (SA be in multiples of Rs. 25000/-) Accident Benefit Rider Min AB SA: Rs. 25000/- Max AB SA: Equal to Term Assurance SA AB SA shall be in multiples of Rs. 5000/- 7/2/2015Ajay Kumar Kurup

17. Other Benefits Contd……. Death Benefit: No death benefit unless TA Rider benefit is opted for On death of the Principal Insured(PI) Surviving Insured Spouse will become PI, if already option given at the beginning of contract If the Insured Spouse had predeceased the PI, Then the other Insured will have the option to take new policy on following conditions – The new policy will be issued without any underwriting if the new policy is bought within 90 days of the termination of the existing policy – The maximum entry age will not apply for the new policy – The outstanding Waiting periods and outstanding period of any Exclusion will however apply under the new policy – Other terms and conditions including premium rates will be as applicable for the new policy Maturity Benefit: No benefits are payable at the end of the cover period 7/2/2015Ajay Kumar Kurup

18.  s even for 1s 24 hours also payable. Eligibility Conditions FeaturePrincipal Insured (PI)/Insured Spouse Parents & Parents-in- law Insured Children Minimum Entry Age18 Yrs LBD 3 Months(Completed) Maximum Entry Age65 Yrs LBD75 Yrs LBD17 Yrs LBD Max Cover ceasing age 80 Yrs80 yrs25 yrs Date of cover expiry in respect of each Insured covered under the plan Policy anniversary on which the Insured life attains Maximum cover ceasing age Nominations Assignments Allowed Not Allowed Mode of Premium Grace Period Revival Period Yearly, Half Yearly and Monthly(ECS Only) 30 days for Yearly, Half Yearly mode and 15 days for Monthly Mode 2 Years from due date of FUP 7/2/2015Ajay Kumar Kurup

19. Points to be noted Premium guaranteed for first 3 years and may be revised after every 3 years based on Health conditions All existing members must be added in first instance. New members can be added through Child birth (Children)-3 Months, Marriage (Spouse, Parents-in-law)- 6 Months from next Policy anniversary 7/2/2015Ajay Kumar Kurup

20. Points to be noted Contd……… Waiting Period 90 days from DOC other than accidental bodily injury 45 days from DOR, if request for revival recd within 90 days from the due date of FUP 90 days from DOR, if request for revival recd beyond 90 days from the due date of FUP Specific Waiting Period (treatments)(treatments) 2 years from Date of Cover Commencement 2 Years from DOCC, if request for revival recd within 90 days from the due date of FUP 2 Years days from DOR, if request for revival recd beyond 90 days from the due date of FUP Next 7/2/2015Ajay Kumar Kurup

21. Treatments in respect of Specific waiting period i. Treatment for adenoid or tonsillar disorders ii. Treatment for anal fistula or anal fissure iii. Treatment for benign enlargement of prostate gland iv. Treatment for benign uterine disorders like fibroids, uterine prolapse, dysfunctional uterine bleeding etc v. Treatment for Cataract vi. Treatment for Gall stones vii. Treatment for slip disc viii. Treatment for Piles ix. Treatment for benign thyroid disorders x. Treatment for Hernia xi. Treatment for hydrocele xii. Treatment for degenerative joint conditions xiii. Treatment for sinus disorders xiv. Treatment for kidney or urinary tract stones xv. Treatment for varicose veins xvi. Treatment for Carpal tunnel syndrome xvii. Treatment for benign breast disorders e.g. fibroadenoma, fibrocystic disease etc Enter Please 7/2/2015Ajay Kumar Kurup

22. Points to be noted Contd……… Termination of Policy If policy is issued on a single life Non Payment of premium within revival period On death On Date of cover expiry On exhausting all the life time maximum Benefits Limits as specified above If policy is issued on more than one life Non Payment of premium within revival period On death or Date of cover expiry of the PI and if the Policy does not continue with the IS as the PI On death or Date of cover expiry of IS after Policy continues with the IS as the PI after the PI dies or reaches his/her Date of cover expiry On PI exhausting all the life time maximum Benefits Limits as specified above 7/2/2015Ajay Kumar Kurup

23. What is different from Mediclaim Pre defined benefit- No reimbursement, but lump sum paid based on pre-defined benefit Not based on expenses incurred This will tend to indirectly reduce the Health care cost, which is rising due to cash less mediclaim benefit All benefit is dependent on HCB 7/2/2015Ajay Kumar Kurup

24. 7/2/2015Ajay Kumar Kurup