LIC: Health Protection Plus Details

LIC (Life Insurance Corporation of India) after success of "Jeevan Varsha" has come out with another United linked plan targeting health insurance sector in India named “LIC Health Protection Plus” which will provide long term health insurance for Husband, Wife and a Child in family either this plan covers two adults and one child.

Benefits of Health Protection Plus
  • Hospital Cash Benefit
  • Major Surgical Benefit
  • Domiciliary treatment Benefit
  • Income Tax benefits under U/S 80D
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One of the major added advantages of this plan is that being unit linked it helps in meeting Domiciliary treatment and OPD (Out Patient Department) charges, Whereas the main plan helps in hospital cash settlement and other major surgical treatment benefit. Till now a very limited information is made available to the market we have to wait for the official terms and conditions of plan which includes premium calculation, types of diseases covered or not covered, procedure for claiming, List of hospitals which they have tie up with etc.

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  • Uncle Scoorge

    how is health protection plus better than health plus of LIC?

    • anurag

      cover continues upto 75 under health protection plus,80-d benefit is available in health protection plus

    • Anonymous

      health protection plus provides tax benefits u/s 80 d,extended risk cover upto age 75,premiums are payable only upto age 65

  • vinod kumar

    If any one want this policy then please contact me on my mail ID

    • jitendra

      please let me know how it works

  • krkkgupta

    pls send me details of LIC Health protection policy to cover me and my wife and two children to my above mail id.

    gupta krkk

    • sarathi

      Health Protection Plus

      IN THIS POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER

      Health is a major concern on everybody?s mind these days. With sky rocketing medical expenses, the possibility of any illness leading to hospitalization or surgery is a constant source of anxiety unless the family has actively provided for funds to meet such an eventuality. Most families rarely provide for healthcare, and even if they do, it is grossly inadequate. Given this scenario, LIC has launched LIC?s Health Protection Plus plan, a unique long term health insurance plan that can combine health insurance covers for the entire family (husband, wife and the children) ? Hospital Cash Benefit (HCB) and Major Surgical Benefit (MSB) along with a ULIP component (investment in the form of Units) that is specifically designed to meet Domiciliary Treatment Benefit (DTB) / Out Patient Department (OPD) expenses for the insured members.

      I. Vital Information
      Accumulation period
      1.Age Principal Insured Spouse Insured Child Insured
      Min Policy Entry Age ? Age Last Birthday 18 18 3months
      Min Age ? HCB Cover ? Age Last Birthday 18 18 3months
      Min Age ? MSB Cover ? Age Last Birthday 18 18 18
      Maximum Entry Age Age Nearest Birthday 55 55 17

      2. Premium Payment.
      Mode of Payment: Yearly, Half-Yearly & Monthly (ECS Mode only)
      Minimum Annual Premium Conditions
      Number of Lives covered Higher of the two conditions in each category listed below:
      Single Life 6 times the HCB of the Principal Insured OR Rs.5000 p.a.
      Two Lives The arithmetic sum of 6 times the HCB of PI and 3 times the HCB of the second insured. OR Rs.7500 p.a.
      More than two Lives The arithmetic sum of 6 times the HCB of PI and 3 times the HCB of each of the others insured OR Rs.10,000 p.a.
      Annualized Premiums are payable in multiples of Rs.500.
      3. Sum Assured.
      The Principal Insured must first choose the respective levels of HCB for each member to be covered under the policy. The sum assured for major surgical benefits will be 200 times of the HCB you choose.
      Major Surgical Sum Assured Principal Insured Spouse Insured Child Insured
      200 times the HCB applicable to each insured life under the policy.
      4. Other Terms of the Policy.
      Age Nearest Birthday Principal Insured Spouse Insured Child Insured
      Max. HCB and MSB Cover ceasing age 75 75 25
      Premium Ceasing Age 65 Years Nearest Birthday of the Principal Insured
      DTB ceasing age No age limit No age limit 25
      5. Addition of New Members. It is important for the Principal Insured (the person taking the policy) to decide which of the existing family members are to be covered and include them at the beginning (proposal stage) itself. Eligible existing family members cannot be added at a later stage. New members can however be added under the following three situations.
      Situation When to include? The cover starts from
      Marriage/remarriage of the Principal insured after taking the policy Within one year from the date of marriage The following policy anniversary
      A Child born or Legally adopted child less than 3 months after taking the policy Health Cover starts from the policy anniversary falling immediately after the child completes 3 months
      Legally adopted child is more than 3 months old From the policy anniversary falling after date of adoption

      • The new members will be eligible for the cover only if they satisfy the conditions of minimum premium and benefits.
      • New members must be included by the Principal Insured only. No new members will be allowed after the death of the principal insured.

      6. Increase/Decrease of Premiums. Increase or decrease of premiums is allowed during the term of the policy. Increase in premium must be in multiples of Rs.500. In case of decrease, the minimum premium conditions must be satisfied. However, increase/decrease in premiums does not affect the level of health cover and HCB and MSB benefits.
      II. CONDITIONS & RESTRICTIONS
      1. Premium Discontinuance and Revival. The policy will lapse if the premiums are not paid within the days of grace. The PI shall have the option to revive the policy any time within a period of two years from the due date of first unpaid premium by payment of arrears of premiums or by availing Premium Holidays. During the period of discontinuity, the charges for HCB and MSB covers will continue to be deducted (even beyond two years) from the policy fund till:
      i. the policy fund has sufficient balance, or
      ii.the lives covered reach the benefit ceasing age, or
      iii.the maximum lifetime benefits are exhausted, or
      iv.the policy is terminated due to death or any other reason, if any,
      whichever is earlier.

      In case the policy is not revived during the revival period and the balance in the Policy Fund is not sufficient to recover the charges i.e. if the Policy Fund exhausts, the policy shall compulsorily be terminated with a notice to the PI.
      All other charges will also continue to be deducted from the Policy Fund till the fund exhausts.

      2. Premium Holidays. If the policy lapses after at least 3 years’ premiums have been paid the Principal Insured has the option of either paying all the due premiums in full or avail of premium holiday by just paying the latest instalment premium without any interest. The premium holidays can be availed only as long as the policy fund has a balance of at least one annualized premium at the time of revival.

      3. Surrender. No surrender will be allowed.

      4. Policy Loans. No policy loan will be available under this policy.

      5. Assignment. No assignment will be allowed under this policy.

      6. Tax Benefit. The premium payable under this product is eligible for Section 80(D) benefit of Income Tax Act, 1961.

      7. Risks borne by the Policyholder:
      i)LIC’s Health Protection Plus is a Unit Linked Health Insurance product which is different from the traditional insurance products and is subject to risk factors.
      ii)The premium paid in Unit Linked Life Insurance policies are subject to investment risks associated with capital markets and the NAVs of the units may go up or down based on the performance of fund and factors influencing the capital market and the insured is responsible for his/her decisions.
      iii)Life Insurance Corporation of India is only the name of the Insurance Company and LIC’s Health Protection Plus is only the name of the unit linked health insurance contract and does not in any way indicate the quality of the contract, its future prospects or returns.
      iv)Please know the associated risks and the applicable charges, from your Insurance agent or the Intermediary or policy document of the insurer.
      v)The fund offered under this contract is the name of the fund and do not in any way indicate the quality of these plans, their future prospects and returns.
      vi)All benefits under the policy are also subject to the Tax Laws and other financial enactments as they exist from time to time.

      8. Cooling off period: If you are not satisfied with the ?Terms and Conditions? of the policy, you may return the policy to us within 15 days.
      III. EXCLUSIONS

      1. Common Exclusions in respect of HCB & MSB Benefits: No benefits are available hereunder and no payment will be made by the Corporation for any claim for Hospital Cash Benefit and Major Surgical Benefit under this Policy on account of Hospitalization directly or indirectly caused by, based on, arising out of or howsoever attributable to any of the following:
      a.“Pre-existing condition”- any medical condition or any related condition (e.g. illnesses, symptoms, treatments, pains and surgery) that have arisen at some point prior to the commencement of this coverage, irrespective of whether any medical treatment or advice was sought. Any such condition or related condition about which the PI or insured dependant know, knew or could reasonably have been assumed to have known, will be deemed to be pre-existing. The following conditions will also be deemed to be “pre-existing”:
      i.Conditions arising between signing the application form and confirmation of acceptance by the Corporation
      ii.Any Sickness, illness, complication or ailment arising out of or connected to the pre-existing illness
      b.Any Sickness that has been classified as an Epidemic by the -Central or State Government.
      c.Self afflicted injuries or conditions (attempted suicide), and/or the use or misuse of any drugs or alcohol.
      d.Any sexually transmitted diseases or any condition directly or indirectly caused to or associated with Human Immuno Deficiency (HIV) Virus or any Syndrome or condition of a similar kind commonly referred to as AIDS.
      e.War, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection military or usurped power of civil commotion or loot or pillage in connection herewith.
      f.Naval or military operations(including duties of peace time) of the armed forces or air force and participation in operations requiring the use of arms or which are ordered by military authorities for combating terrorists, rebels and the like.
      g.Any natural peril (including but not limited to avalanche, earthquake, volcanic eruptions or any kind of natural hazard).
      h.Participation in any hazardous activity or sports including but not limited to racing, scuba diving, aerial sports, bungee jumping and mountaineering or in any criminal or illegal activities.
      i.Radioactive contamination.
      j.Non-allopathic methods of surgery and treatment.

      2. Additional Exclusions in respect of Hospital Cash Benefit:
      No benefits are available hereunder and no payment will be made by the Corporation for any claim for Hospital Cash Benefit under this Policy on account of Hospitalization directly or indirectly caused by, based on, arising out of or howsoever attributable to any of the following:
      a.Hospitalization due to illness within the first 180 days from the Date of Cover commencement or 90 days from the date of revival/reinstatement if revived after discontinuance of the cover.
      b.Removal of any material that was implanted in a former surgery before Date of Cover commencement
      c.Any diagnosis or treatment arising from or traceable to pregnancy (whether uterine or extra uterine), childbirth including caesarean section, medical termination of pregnancy and/or any treatment related to pre and post natal care of the mother or the new born.
      d.Hospitalization for the sole purpose of physiotherapy or any ailment for which hospitalization is not warranted due to advancement in medical technology
      e.Any treatment not performed by a Physician or any treatment of a purely experimental nature.
      f.Any routine or prescribed medical check up or examination.
      g.Medical Expenses relating to any hospitalization primarily for diagnostic, X-ray or laboratory examinations
      h.Circumcision, cosmetic or aesthetic treatments of any description, change of gender surgery, plastic surgery (unless such plastic surgery is necessary for the treatment of Illness or Accidental Bodily Injury as a direct result of the insured event and performed with in 6 months of the same).
      i.Hospitalization for donation of an organ.
      j.Hospitalization for correction of birth defects or congenital anomalies
      k.Dental treatment or surgery of any kind unless necessitated by Accidental Bodily Injury.
      l.Convalescence, general debility, nervous or other breakdown, rest cure, congenital diseases or defect or anomaly, , sterilization or infertility (diagnosis and treatment), any sanatoriums, spa or rest cures or long term care or hospitalization undertaken as a preventive or recuperative measure.

      3. Additional Exclusions in respect of Major Surgical Benefit:
      No benefits are available hereunder and no payment will be made by the Corporation for any claim for Major Surgical Benefit under this Policy directly or indirectly caused by, based on, arising out of or howsoever attributable to any of the following:
      a.Surgeries not listed in the Surgical Benefit Annexure I
      b.Surgery triggered by health related causes (and not by Accident) within the first 180 days from the commencement date or 90 days from the date of revival/reinstatement if revived after discontinuance of the cover.
      c.Any Surgery for which claim has already been made and paid by the Corporation.
      d.Any treatment not performed by a Physician/Surgeon.
      e.Any treatment including Surgery that is performed un-conventionally under experimental conditions and purely experimental in nature.
      f.Circumcision, cosmetic or aesthetic treatments of any description, change of life surgery or treatment, treatment (including surgery) for obesity, plastic surgery (unless necessary for the treatment of Illness or accidental Bodily Injury as a direct result of the insured event and performed with in 6 months of the same).
      g.Surgery for donation of an organ.
      h.Removal or correction or replacement of any material that was implanted in a former Surgery before Date of Cover commencement
      i.Surgery for correction of birth defects or congenital anomalies.
      j.Any diagnosis or treatment or surgery arising from or traceable to pregnancy (whether uterine or extra uterine).
      IV. INVESTMENT OF FUNDS
      The premiums allocated to purchase units will be strictly invested in a Health Protection Plus Fund (Income and Growth – Low Risk) as follows:
      A. Government/ Government Guaranteed/ Corporate Securities/ Debt Not less than 50%
      B. Short term investments: Money Market instruments including A above Not more than 90%
      C. Investment in listed equity shares Not less than 10% & Not more than 50%

      1. Method of Calculation of Unit price: Units will be allotted based on the Net Asset Value (NAV) on the date of allotment. There is no Bid-Offer spread. The NAV will be computed on daily basis and will be based on investment performance, Fund Management Charge and whether the fund is expanding or contracting.
      a. Applicability of Net Asset Value (NAV): The premiums received up to 3 p.m. (as per IRDA guidelines) by the servicing branch of the corporation by a local cheque or by a demand draft payable at par at the place where the premium is received, the closing NAV of the day on which premium is received shall be applicable. The premiums received after such time by the servicing branch of the corporation by a local cheque or by a demand draft payable at par at the place where the premium is received, the closing NAV of the next business day shall be applicable.
      b. Redeeming of Units: In respect of valid applications received for reimbursement of medical expenses, death claim, etc up to such time by the servicing branch of the Corporation closing NAV of that day shall be applicable. For the valid applications received in respect of Domiciliary Treatment Benefit, death claim etc after 3 p.m. (as per IRDA guidelines) by the servicing branch of the Corporation the closing NAV of the next business day shall be applicable.
      2. Charges under the Plan:
      a. Premium Allocation Charge: This is the percentage of the premium appropriated towards charges from the premium received. The balance known as allocation rate constitutes that part of the premium which is utilized to purchase (Investment) units for the policy. The allocation charges are as below:
      First year thereafter
      30% 6%
      The above allocation charges shall be applicable for all premiums including any additional premium paid in that particular policy year.
      b. Health Insurance Charge: There will be two separate charges for the following benefits:
      i) Hospital Cash Benefit
      ii) Major Surgical Benefits.
      These charges will be taken every month in respect of all the members covered by canceling appropriate number of units out of the Policy Fund.
      These charges, during a policy year, will be based on the age nearer birthday, of each of the members covered, as at the Policy anniversary coinciding with or immediately preceding the due date of cancellation of units and hence may increase every year on each policy anniversary. The charges will also depend on whether the person covered is male or female and standard or sub-standard as per the underwriting decision.
      If more than one member is covered under the policy then the total charges shall be based on the individual ages of all the members and the amount of cover for each such member.
      In case of Hospital Cash Benefit, the charges will be applied on the Initial Daily Benefit as mentioned in the Policy Schedule.
      The charges for Hospital Cash Benefit and/or Major Surgical Benefit will not be deducted once the benefit terminates.
      Specimen charges for Rs. 100/- per day for HCB and Rs. 1000/- SA for MSB for standard lives are given as under:
      Age HCB MSB
      5 24.43 20.43 0 0
      15 20.71 20.71 0 0
      25 31.39 24.34 1.02 1.38
      35 33.59 29.96 1.58 1.75
      45 49.29 53.20 3.54 2.64
      55 76.08 72.53 7.28 5.16
      b. Health Insurance Charge:
      Policy Administration Charges Rs.75 per month during the first year and Rs. 25 per month during the subsequent years.
      Fund Management Charges Levied @ 1.25% per annum of the unit fund, at the time of computation of NAV which will be done on daily basis.
      Bid/ Offer Spread Nil

      Service Tax Charge A service tax charge shall be levied on the following charges:
      i)Policy Administration charge and Health Insurance charges – by canceling appropriate number of units out of the Policyholder’s Fund Value on a monthly basis as and when the corresponding Policy Administration and Health Insurance charges are deducted.
      ii)Premium allocation charge – at the time of allocation of premium.
      iii)Fund Management charge– at the time of computation of NAV on daily basis.
      The level of this charge will be as per the rate of service tax as applicable from time to time. Currently, the rate of service tax is 10% with an educational cess at the rate of 3% thereon and hence effective rate is 10.30%.

      d. Right to revise charges-The Corporation reserves the right to revise all or any of the above charges except the Premium Allocation charge. The modification in charges will be done with prospective effect with the prior approval of IRDA.
      Although the charges are reviewable, they will be subject to the following maximum limit:
      Policy Administration Charge-Rs. 150/- per month during the first policy year and Rs.50/- per month thereafter, throughout the term of the policy.
      Fund Management Charge-The Maximum for Fund will be 2.5% p.a. of Unit Fund
      Hospital Cash Cover charges and Major Surgical Benefit charges shall not exceed by more than 200% of the current rate.
      Disclaimer : For more details on risk factors , terms and conditions please read sales brochure carefully before concluding a sale .

      Nandagopal.R
      Chief Life Insurance Advisior For Agents, ( LIC )
      ICICI Lombard General Insurance ( For Motors ),
      Star Health Insurance Consultant ( For mediclaim Insurance ),
      Plot.No.37,1st Cross Street,
      Prakash Nagar,Ponniamman Medu
      Chennai – 600110,
      TamilNadu,
      India.
      +919841003871,

  • hemendra bansal

    i want to know about health protection plan
    my age is 40 years i am a diabetic class 1 what will be my premium for Rs 250000 sum insured

  • vinod rathod

    hi i want to all the details of LIC Health Protection Plus as soon as possible for my self wife & my 4 month baby

    • anurag

      please mail a test mail and ur age ,ur wife's age to anurag_harit@rediffmail.com.a personalised brochure would be sent to ur id soon.

    • http://www.facebook.com/people/Deepak-Khandelwal/100000045032670 Deepak Khandelwal

      hi, vinod for getting the health protection plus detail first you have to please tell me your age and what are you right now . my email id is blueakashindia@gmail.com/ymail.com. my cell no. 9314603777- deepak khandelwal

  • LIC Agent

    All those who wish to secure your Health with this unique policy can mail to bijal.veera@gmail.com. Let us help you get your health protected with LIC,.

  • rakesh

    SIr please send details of health plus detials

    • anurag harit

      dear mr rakesh please send ur e mail id for recieving a personalised copy of health plus and health protection plus brochure

      • bijal

        i am sobha, my email id is sobha_shajan@yahoo.com. please send a copay of a personalised copy of health plus and health protection plus brochure

    • sarathicivil

      IN THIS POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER

      Health is a major concern on everybody?s mind these days. With sky rocketing medical expenses, the possibility of any illness leading to hospitalization or surgery is a constant source of anxiety unless the family has actively provided for funds to meet such an eventuality. Most families rarely provide for healthcare, and even if they do, it is grossly inadequate. Given this scenario, LIC has launched LIC?s Health Protection Plus plan, a unique long term health insurance plan that can combine health insurance covers for the entire family (husband, wife and the children) ? Hospital Cash Benefit (HCB) and Major Surgical Benefit (MSB) along with a ULIP component (investment in the form of Units) that is specifically designed to meet Domiciliary Treatment Benefit (DTB) / Out Patient Department (OPD) expenses for the insured members.

      Nandagopal.R
      Chief Life Insurance Advisior For Agents, ( LIC )
      ICICI Lombard General Insurance ( For Motors ),
      Star Health Insurance Consultant ( For mediclaim Insurance ),
      Plot.No.37,1st Cross Street,
      Prakash Nagar,Ponniamman Medu
      Chennai – 600110,
      TamilNadu,
      India.
      +919841003871,

  • shail_7877

    please send me the plan details of the health protection plus.

  • Meera

    Please sent me the details of Health Protection Plus policy of LIC. I am 40 years old.

    • sarathicivil

      mam pls sent your Contatct Number.I cal u & explain.

      My dad s an LIC agent For past 20 years.

      He s ZONAL MANAGERS CLUB.

      will serve u d best.

  • kannans

    please send me the plan details of the health protection plus.

  • d82eepak

    hiii my name is deepak
    i would like to know more about health protector plus scheme

  • SANJOY MISRA

    AFTER GETTING A POLICY OF HEALTH PROTCTION CAN I GET A MEDICAL CARD?

  • SANJOY MISRA

    AFTER GETTING A POLICY OF HEALTH PROTCTION CAN I GET A MEDICAL CARD?

  • Murali

    Please send me the plan details of the health protection plus.

  • anil

    send me details of health protection plus policy 902

    • sarathicivil

      Sir,pls sent ur mail id to sarathicivil@gmail.com or 9840128386.So i can sent u personalized Brochure on 902

  • skpandey

    how much amount of money will get tax exemption if this policy is taken which includes both health as well as investment.

  • nileshamahajan

    my friends mother is of 60 year old. He want to be any health protection for his mother.

  • skgarg

    pls send me the complete detail of health protection plus 902 policy,actually i would like to take helth as well as investment policy.pls reply

  • Tapas Raj

    pls send me the complete detail of health protection plus 902 policy,actually i would like to take helth as well as investment policy.pls reply

  • Joseprofiles

    on march i taken this poicy i want to take another one or i want to extend my sum assured .whats the procedure

  • mukesh raghu sonawane

    pls send me details of the plan on my mail

  • Anupamathakur77

    is their any maturity value?

  • Birla_sunil

    in year 2006 i got L.I.C helth policy my problem is my wife is ill by deseage call bellsspicy so how could i apply for claim (12/6/2010)

  • Srddharma

    why the insurance sector details are not aviable in ther own internet ( say LIC.com) ? coverage,hospitals, claming procdure etc….(always through agents) y y y ………………..

  • Avkunhi

    pls send me details of the plan on my mail

  • Meena Wadhwa

    Please send me the plan details of the health protection plus on my email

  • Dr Babitha kb

    plz send me policy details for my family{30 yr old}

    • abhishek

      @ dr babitha kb hello, myself Abhishek agrawal, i am an LIC agent and investment consultant, for any queries please contact me 09770779747 or mail me at agrawalabhilic@gmail.com

  • Krishnakalkani

    Please send me the details of decease covered and not covered in the Health protection + policy

  • susanta

    hi iam susanta please give the details of health plus policy details

  • musnow88

    After applying for health protection plus 902 policy and payment of the first premium amount,from when on wards would the client [say aged 25 yrs] be insured?