LIC Arogya Rakshak (Plan 906)

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LIC Arogya Rakshak (Plan 906) is new health insurance policy by LIC. Arogya Rakshak is non-linked, non-participating regular premium fixed benefit health plan. This plan covers hospitalization and surgical cost. This plan is similar to LIC Jeevan Arogya policy. Earlier Jeevan Arogya Policy will be discontinued once LIC Arogya Rakshak policy is introduced. LIC Arogya Rakshak comes with multiple benefits. In this post, I would cover all features, benefits, positives and negatives of this plan.

LIC Arogya Rakshak

LIC Arogya Rakshak Key Features

  • Non-linked, non-participating plan available as individual health insurance as well as family floater plan.
  • As per Family floater plan definition head of family would be principal insured (PI) and he can include spouse, children and parents in to policy.
  • Defined benefit plan that provides decided amount irrespective of actual hospitalization or surgery expense.
  • You can get hospital cash benefit, major surgical benefit, day care procedure benefit, other surgical benefit, medical management benefit etc.
  • The initial day benefit is ranging between Rs.2500 to Rs.10000 per day.

Eligibility Conditions or Arogya Rakshak Policy

Condition Principal Insured Insured Spouse Insured Children
Minimum Age Entry 18 years 18 years 91 days
Maximum Age Entry 65 years 65 years 20 years
Cover Ceasing Age 80 years 80 years 25 years
Minimum Initial Daily Benefit Rs.2500 Rs.2500 Rs.2500
Maximum Initial Daily Benefit Rs.10000 Less or equal to PI Less or equal to PI
Cover Period 80 – (age at entry) 70 – (age at entry) 25 – (age at entry)

Benefits of LIC Arogya Rakshak Policy

Hospital Cash Benefits

Hospital Cash Benefit (HCB) is payable during policy coverage period. This benefit is payable incase of hospitalization for 24 hours or above due to body injury or sickness. Any period exceeding by 4 hours above 24 hours is considered as one day.

  • Hospitalization in General or Special Ward – Initial daily benefit would be payable for hospitalization for 24 hours or above.
  • Hospitalization in ICU of Hospital – Two times applicable daily benefit is payable for hospitalization for 24 hours and above.
  • Combined Stay in ICU and Non ICU – Amount will be paid as per the days admitted in each unit.

Above hospital cash benefit is applicable only if hospitalization occurs in India. Total number of HCB is payable in the first policy year is restricted to 30 days. For subsequent year HCB payable is restricted up to 90 days. Total HCB payable days cannot exceed 900 days in entire policy tenure.

Major Surgical Benefits

Major surgery benefit (MSB) is payable in case of major surgery. The benefit would be 100 times of HCB. The percentage of benefits payable varies based on category of surgery. The percentage varies from 20% to 100%. Premium waiver benefit is given for 1 year from the date of surgery.

Surgery should be performed in India. In case of more surgeries are performed, amount of most severe surgery shall be paid. Total MSB payable cannot exceed 100% of major surgical benefits applicable for that policy year.

In addition to major surgical benefit one can get ambulance benefit, premium waiver benefit and major surgical benefit restoration.

Medical Management Benefit

In case insured is undergoing inpatient hospitalization within the cover period due to disease like dengue, malaria, pneumonia, tuberculosis or viral hepatitis A one will get lump sum of 2.5 times of applicable daily benefits.

Extended Hospitalization Benefit

Extended Hospitalization benefit is an additional benefit payable apart from hospital cash benefit, major surgical benefit, other surgical benefit. This benefit is payable incase insured is undergoing inpatient hospitalization in excess of 30 days within cover period due to accidental injury or sickness.

Premium Review

In this policy premium review take place every 3 years. This means premium will not remain constant like your life insurance policy. The revised rate shall be guaranteed for the further period of 3 years. The premium rate of this policy would be based on age entry. In case of traditional health insurance offered by other companies premium is revised every 5 years. This means LIC is revising premium much earlier.

Should you buy LIC Arogya Rakshak Policy?

LIC Arogya Rakshak policy is defined benefit policy which is plus point about this policy. This means benefits will be paid to insured irrespective of amount spend on hospitalization, surgeries or medicines.

The biggest drawback of this policy is you will not get cashless benefit. This means you need to spend money in case of hospitalization. Once hospitalization is done you can claim this amount.

Another drawback of this plan is premium review which is done every 3 years. In other health insurance policies premium review take place every 5 years.

Looking at overall features and details it is advisable to go for traditional health insurance plan instead of LIC Arogya Rakshak.

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