LIC’s Arogya Rakshak Plan

Arogya Rakshak plan includes a plethora of benefits, the majority of which is listed below: 

Core Benefits:

• Hospital Cash Benefit 

The injured is entitled to Hospital Cash Benefit in the event of sickness or accidental bodily injury causing the injured to opt for in-patient hospitalization services exceeding the period of 24 hours on or after the effective date of cover or during the cover period. However, benefits will be paid from hemodialysis and radiotherapy even if the stay in hospital is less than 24 hours. The insured will receive Daily Benefit in the case of: 

• Hospitalization in general or special ward. 
• Hospitalization in Intensive Care Unit of a hospital 
• Combined stay in non-ICU and ICU ward room.

The total number of days for which the benefit will be payable is limited to: 

• A maximum of 30 days of hospitalization inclusive of stay in an Intensive Care Unit in the first policy year 
• A maximum of 90 days of hospitalization, including stay in an Intensive Care Unit, in the second and subsequent policy year. 

The benefit will be payable for a total number of 900 days of hospitalization, including the days in the Intensive Care Unit. On the completion of 900 days of hospitalization, the mentioned benefit will cease to exist immediately. 

• Major Surgical Benefits 

If the insured meets with accidental bodily injury or sickness as a result of which he has to undergo any specific surgery, the LIC Arogya Rakshak plan pays off the Major Surgical Benefit. The sum assured for the benefit is equal to 100 times the applicable daily benefit for each insured in each policy year. 

The following benefits are available under Major Surgical Benefits: 

• Ambulance benefit, an additional lump sum of Rs 1,000
• Premium waiver benefit, where the total annualized premium will be waived if any Major Surgical Benefit falls under Category 1 or 2 
• In the event that 100% Major Surgical Benefit is exhausted in a policy year, the next Major Surgical Benefit in that policy year will be covered. 

The plan will pay 100% of the eligible amount as per the category in case of the most severe surgery performed and 25% of the amount in case of other surgeries. 

• Day Care Procedure Benefits 

In case the insured undergoes any specific Day Care Procedure due to injury or sickness on or after the effective date of cover, the Day Care Procedures which equal to 5 times the daily benefit will be payable. 

• Other Surgical Benefits 

In case the insurer undergoes a surgery which is not included under Major Surgical Benefits or Day Care Procedure Benefits owing to bodily injury or sickness, it will be covered under Other Surgical Benefits and the insured will be entitled to 2.5 times the applicable daily benefit. 

Other surgical benefits will not exceed a lifetime maximum limit of 450 days. 

• Medical Management Benefit 

In the event that the insured undergoes in-patient hospitalization during the cover period with certain major medical conditions manifesting itself on or after the effective date of cover, then the insured will be eligible to receive 2.5 times the applicable daily benefit. The list of major medical conditions covered under the benefit are as follows: 

• Malaria 
• Dengue 
• Pneumonia
• Viral Hepatitis A 
•  Pulmonary Tuberculosis

The medical management benefit shall be payable 2 times in each policy year and a lifetime maximum of 20 times. 

• Extended Hospitalization Benefit

Extended Hospitalization Benefits are payable when the insured undergoes a single period of continuous hospitalization extending a period of 30 days. In such an event, a lump sum of 10 times of the applicable daily benefit is payable irrespective of the actual cost incurred. 

The extended hospitalization benefit will be payable up to a maximum of 1 time in each policy year during the cover period. The maximum lifetime limit to receive extended hospitalization benefit is 10 times.

Other Benefits:

• Health Check-up Benefits 

Health Check-up Benefits provides the insured with one-half of applicable daily benefit towards expenses incurred against health check-up once in every three policy years. 

• Death Benefit under the Base Policy 

In the event of the death of a principal insured, Auto Health Cover (AHC) will be available to each of the eligible insureds. The cover shall continue without any premium payments. The eligibility for each individual insureds is given below: 

• For insured children, the AHC will continue until they reach the age of 25 years or 15 years after the death of the principal insured, whichever is earlier. 
• For insured parents/ spouse, the AHC benefit will be available for 15 years or till policy anniversary coinciding with the age of 70 years, whichever is earlier.

Rider Benefits:

LIC Arogya Rakshak Plan offers two rider benefits for additional premium. These two rider benefits are: 

• LIC’s New Term Assurance Rider 

The Term Assurance Rider on LIC Arogya Rakshak Plan is available on the life of the Original Principal Insured and/ or Insured Spouse. 

• LIC’s Accident Benefit Rider 

LIC’s Accident Benefit Rider can be opted for provided that the New Term Assurance Rider has been opted for. The maximum Accident Benefit Rider sum insured is equal to the New Term Assurance Rider sum insured.