Jeevan Arogya (Table No : 903)
Table Summary :
A non-unit linked Health Insurance plan; it provides cover against following health risks:
(1) Hospital Cash benefit (HCB)
(2) Mejor Sergical Benefit (MSB)
(3) Day care procedure Benefit (DCPB)
(4) Other Surgical Benefit (OSB).
These are in addition to any other health insurance cover. Two riders : Term Assurance and Accident Benefit Rider available for PI (Personal Insured) & Insured Spouse only. The PI can take the policy himself/herself. The spouse, children, parents and parents in law can also be covered the under the same policy.
(1) HCB -:
a) HCB (With India only) is payable on per day basis.
b) Maximum 30 days hospitalization & not more than 15 days in ICU (2 times HCB) for 1st policy year for each
c) Maxi. 90 days and including not more than 45 days in I.C.U. in the 2nd year onwards for each insured.
d) Limited to a maximum of 720 days and 365 days for ICU during entire policy term for each insured.
e) This Benefit to increase 5% till it reaches a maximum of 1.5 times the HCB. And arithemetic addition of an amount equal to “No Claim Benefit”.
f) Stay in hospital exceeds a continuous period of 24 hours or part thereof thereafter. Stay more than 7 days, even for 1st 24 hours also payable.
(2) MSB -:
a) Quick Cash facility : 50% of eligible MSB amount payable subject to approval from the TPA.
b) MSB shall be a percentage of sum assured.
c) Major Surgical Benefit Amount, as calculated as a % of Sum Assured, payable regardless of actual costs incurred.
d) Rs. 1000/- payable in lump sum towards Ambulance expenses.
e) Applicable for surgery conducted only within India.
(3) DCPB -:
a) An Insured under this Plan undergoing any specified Day Cared Procedure mentioned in the Day Care Procedure Benefit Annexure.
b) If a Day Care Procedure Benefit is performed no Hospital Cash Benefit shall be paid.
(4) OSB -:
An Insured under this plan, due to medical necessity, undergoing any surgery no listed under Major Surgical Benefit or Day Care Procedure Benefit, and the stay in hospital exceeds a continuous period of 24 hours.