Jeevan ArogyaPlan No: 904

Key highlights

Non-linked health plan which covers the principal insured male or female, spouse, children, parents and parents-in-law under the same policy.

4 Main benefits Hospital Cash Benefit (HSB) Major Surgical Benefit (MSB) Day Care Surgical Benefit (DCPB) Other Surgical Benefit (OSB)

Max 30 days hospitalization in year 1 including 15 days in for 1st policy year

for each one

Max 90 days and incl not more than 45 days in ICU in the 2nd 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

Initial HCB shall be in multiples of Rs.1000/-

Hospital Cash Benefit (HCB)Feature Principal

Insured (PI)

Insured Spouse(If any), Parents/In law

Insured Children

Min Initial Daily Benefit

Rs. 1000/- Rs. 1000/- Rs. 1000/-

Max Initial Daily Benefit

Rs. 4000/- Insured Spouse - Equal or less than PIInsured Parents/In law - Equal or less than Insured Spouse

Equal or less than Insured spouse

Max Age for Cover 80 yrs 80 yrs 25 yrs

Major Surgical Benefit (MSB)Feature Principal

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 benefit

100% of Sum Assured

100% of Sum Assured 100% of Sum Assured

Max Life Time 800% of MSB SA

800% of MSB SA 800% of MSB SA

Day Care Procedure BenefitFeature Principal

Insured (PI)Insured Spouse If any), Parents/In law

Insured Children

Lump sum benefit payable

5 times of ADB 5 times of ADB 5 times of ADB

Max Annual benefit 3 Surgical ProceduresMax Life Time 24 Surgical Procedures

Other Surgical Benefit (OSB)

OSB is payable from day one of hospitalization but minimum stay in hospital should be 24 hours

Feature Principal Insured (PI)

Insured Spouse If any), Parents/In law

Insured Children

Daily Benefit amount

2 times of ADB

2 times of ADB 2 times of ADB

Max Annual benefit

15 Days in Year 1 and 45 days per year thereafter

Max Life Time 360 days

Other Options

Term Assurance Rider (available only to PI & Insured spouse)

Min. S.A.: Rs. 100000Max. S.A.: Equal to MSBSA

Double Accident Benefits (DAB) Rider (available only to PI & Insured spouse

provided Term Assurance Rider has been opted for)

Min. S.A.: Rs. 25000Max. S.A.: Equal to T.A.

Other Benefits

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

Eligibility ConditionsFeature Principal

Insured (PI)/Insured

Spouse

Parents & Parents-in-law

Insured Children

Minimum Entry Age

18 Yrs LBD 18 Yrs LBD 3 Months (Completed)

Maximum Entry Age

65 Yrs LBD 75 Yrs LBD 17 Yrs LBD

Max Cover ceasing age

80 Yrs 80 yrs 25 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 Allowed

Assignments Not Allowed

Mode of Premium Yearly and Half Yearly

Revival Period 2 Years from due date of FUP

Points to be noted

Premium guaranteed for first 3 years and may be revised after every 3 years to take into account the corporation’s experience, subject to prior approval from IRDAService tax will be collected separately along with the premium

Quick Cash BenefitIf any of the insured lives undergoes any eligible surgery covered under Category I or II of MSB in any of the listed network hospitals, the PI will have an option to avail Quick Cash facility

Under this facility, 50% of eligible MSB amount would be made available even during the period of hospitalization instead of waiting for making a claim for the benefit after discharge

It will be only an advance payment to the PI in the event of hospitalization

This will be, however, subject to approval from the TPA (Third Party Administrator), and the advance amount will be adjusted from the final settlement of MSB claim amount

This facility of advance payment could be availed by submitting the Bank Account details of the PI in the prescribed format. The amount of advance shall be credited in the PI’s bank account directly

Thank You!!