LIC’s Arogya Rakshak is a non-linked, non-participating, regular premium, individual health insurance plan that offers fixed benefit coverage for specific health risks. It ensures timely financial support during medical emergencies, enabling you and your family to maintain financial independence during challenging times.
Benefits
LIC’s Arogya Rakshak policy offers the following benefits in a single policy:
- Flexible benefit limit selection
- Various premium payment options
- Valuable financial protection for hospitalization and surgeries
- Lump sum benefit, regardless of actual medical costs
- Health cover increases through Auto Step-Up Benefit and No Claim Benefit
- Premium Waiver for other insured members in the unfortunate event of the original policyholder’s death (for policies covering multiple members)
- Premium Waiver Benefit for one year if any insured undergoes surgery in Category I or Category II (as listed in Major Surgical Benefit Annexure)
- Ambulance Benefit included
- Health Check-up Benefit provided
You can choose the Initial Daily Benefit, which is the Hospital Cash Benefit applicable in the first year, for each family member covered under the same policy. This amount can range from ₹2,500 per day to ₹10,000 per day (in multiples of ₹500) based on your needs. This amount is paid on a per-day basis during hospitalization in the first three policy years. The Hospital Cash Benefit increases automatically through Auto Step Up Benefit and No Claim Benefit.
The Major Surgical Benefit, which you will be covered for, is 100 times the Hospital Cash Benefit. Therefore, the initial Major Surgical Benefit Sum Assured can range from ₹2.5 lakh to ₹10 lakh in multiples of ₹50,000. Other benefits like Day Care Procedure Benefit, Other Surgical Benefit, Medical Management Benefit, Major Surgical Benefit Restoration, Extended Hospitalization Benefit, and Health Check-up Benefit depend on the chosen Hospital Cash Benefit.
Your premium as the Principal Insured depends on your age, gender, chosen Initial Daily Benefit, and the payment mode. Premiums for other insured members, including your spouse, children, and parents, depend on their age, gender, chosen Initial Daily Benefit, and the age of the Principal Insured.
Eligibility Conditions
| Minimum age at entry | ||
| Principal Insured: | [18] years (last birthday) | |
| Insured Spouse/ Parents | [18] years (last birthday) | |
| Insured Children | [91] days (completed) | |
| Maximum age at entry | ||
| Principal Insured | [65] years (last birthday) | |
| Insured Spouse/ Parents | [65] years (last birthday) | |
| Insured Children | [20] years (last birthday) | |
Payment Options Available
| Mode of Instalment payment | Minimum instalment amount | |
| Monthly | Rs 5,000/- | |
| Quarterly | Rs 15,000/- | |
| Half-Yearly | Rs 25,000/- | |
| Yearly | Rs 50,000/- | |
Exclusion:
The Corporation will not make any payments for claims under this policy if the hospitalization or surgery is directly or indirectly related to the following:
- Pre-Existing Conditions unless disclosed and accepted before the Effective Date of Cover or the Date of Revival.
- Treatment or surgery not performed by a Physician/Surgeon or of an experimental nature.
- Experimental pharmacological regimens, unproven treatment devices, or conditions arising from their use.
- Hospitalization, diagnosis, or treatment outside India, or routine examinations, preventive check-ups, and vaccinations.
- Surgery purely for diagnosis, screening, or investigation.
- Cosmetic, plastic, aesthetic surgery or related treatments, unless medically necessary due to illness or injury within 6 months.
- Organ donation by the donor.
- Dental examinations, surgeries, or treatments not necessitated by accidents.
- Convalescence, debility, congenital diseases, sterilization, infertility treatment, sanatoriums, spa, or physiotherapy for preventive or recuperative purposes.
- Claims related to suicide, self-inflicted injuries, or the influence of drugs, alcohol, narcotics, or psychotropic substances.
- Removal or correction of material/prosthesis/medical devices implanted before the policy’s Effective Date or Date of Revival.
- Diagnosis or treatment arising from pregnancy, childbirth, and related care.
- Claims related to war, terrorism, or acts of terrorism.
- Claims due to military, para-military, or police service or participation in operations involving the use of arms.
- Claims related to natural disasters.
- Claims resulting from participation in professional sports, hazardous pursuits, or certain high-risk activities.
- Claims related to exposure to radioactive, explosive, or hazardous nuclear materials.
- Claims related to criminal or unlawful acts.
- Claims arising from failure to follow reasonable medical advice.
- Claims related to flying activities (except as a passenger in a licensed aircraft).
- Supply or fitting of eyeglasses, hearing aids, and specific vision correction procedures.
- Sterility, fertility, or sexually transmitted disease treatment.
- Sex change operations, stem cell therapies, and hormone replacement therapy.
- Treatment for sleep disorders, obesity, weight control, and other non-specified conditions.
- Pre and post-hospitalization treatment.
- Hospital confinement less than 24 hours (except for day care procedures and hemodialysis/radiotherapy).
- General waiting period of 90 days/45 days as specified.
- Specific waiting period of 24 months for certain conditions and procedures, including complications.
