LIC Health Protection Plans

IN THIS POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER

Health is a major concern on everybody?s mind these days. With sky rocketing medical expenses, the possibility of any illness leading to hospitalization or surgery is a constant source of anxiety unless the family has actively provided for funds to meet such an eventuality. Most families rarely provide for healthcare, and even if they do, it is grossly inadequate. Given this scenario, LIC has launched LIC?s Health Protection Plus plan, a unique long term health insurance plan that can combine health insurance covers for the entire family (husband, wife and the children) ? Hospital Cash Benefit (HCB) and Major Surgical Benefit (MSB) along with a ULIP component (investment in the form of Units) that is specifically designed to meet Domiciliary Treatment Benefit (DTB) / Out Patient Department (OPD) expenses for the insured members.

I. Vital Information

Accumulation period
1.Age	Principal Insured	Spouse Insured	Child Insured
Min Policy Entry Age ? Age Last Birthday	18	18	3months
Min Age ? HCB Cover ? Age Last Birthday	18	18	3months
Min Age ? MSB Cover ? Age Last Birthday	18	18	18
Maximum Entry Age Age Nearest Birthday	55	55	17

2. Premium Payment.
Mode of Payment: Yearly, Half-Yearly & Monthly (ECS Mode only)

Minimum Annual Premium Conditions
Number of Lives covered	Higher of the two conditions in each category listed below:
Single Life	6 times the HCB of the Principal Insured OR Rs.5000 p.a.
Two Lives	The arithmetic sum of 6 times the HCB of PI and 3 times the HCB of the second insured. OR Rs.7500 p.a.
More than two Lives	The arithmetic sum of 6 times the HCB of PI and 3 times the HCB of each of the others insured OR Rs.10,000 p.a.
Annualized Premiums are payable in multiples of Rs.500.

3. Sum Assured.
The Principal Insured must first choose the respective levels of HCB for each member to be covered under the policy. The sum assured for major surgical benefits will be 200 times of the HCB you choose.

Major Surgical Sum Assured	Principal Insured	Spouse Insured	Child Insured
	200 times the HCB applicable to each insured life under the policy.

4. Other Terms of the Policy.

Age Nearest Birthday	Principal Insured	Spouse Insured	Child Insured
Max. HCB and MSB Cover ceasing age	75	75	25
Premium Ceasing Age	65 Years Nearest Birthday of the Principal Insured
DTB ceasing age	No age limit	No age limit	25

5. Addition of New Members. It is important for the Principal Insured (the person taking the policy) to decide which of the existing family members are to be covered and include them at the beginning (proposal stage) itself. Eligible existing family members cannot be added at a later stage. New members can however be added under the following three situations.

Situation	When to include?	The cover starts from
Marriage/remarriage of the Principal insured after taking the policy	Within one year from the date of marriage	The following policy anniversary
A Child born or Legally adopted child less than 3 months after taking the policy	Health Cover starts from the policy anniversary falling immediately after the child completes 3 months
Legally adopted child is more than 3 months old	From the policy anniversary falling after date of adoption

The new members will be eligible for the cover only if they satisfy the conditions of minimum premium and benefits. New members must be included by the Principal Insured only. No new members will be allowed after the death of the principal insured. 6. Increase/Decrease of Premiums. Increase or decrease of premiums is allowed during the term of the policy. Increase in premium must be in multiples of Rs.500. In case of decrease, the minimum premium conditions must be satisfied. However, increase/decrease in premiums does not affect the level of health cover and HCB and MSB benefits. II. CONDITIONS & RESTRICTIONS 1. Premium Discontinuance and Revival. The policy will lapse if the premiums are not paid within the days of grace. The PI shall have the option to revive the policy any time within a period of two years from the due date of first unpaid premium by payment of arrears of premiums or by availing Premium Holidays. During the period of discontinuity, the charges for HCB and MSB covers will continue to be deducted (even beyond two years) from the policy fund till: i. the policy fund has sufficient balance, or ii.the lives covered reach the benefit ceasing age, or iii.the maximum lifetime benefits are exhausted, or iv.the policy is terminated due to death or any other reason, if any, whichever is earlier. In case the policy is not revived during the revival period and the balance in the Policy Fund is not sufficient to recover the charges i.e. if the Policy Fund exhausts, the policy shall compulsorily be terminated with a notice to the PI. All other charges will also continue to be deducted from the Policy Fund till the fund exhausts. 2. Premium Holidays. If the policy lapses after at least 3 years’ premiums have been paid the Principal Insured has the option of either paying all the due premiums in full or avail of premium holiday by just paying the latest instalment premium without any interest. The premium holidays can be availed only as long as the policy fund has a balance of at least one annualized premium at the time of revival. 3. Surrender. No surrender will be allowed. 4. Policy Loans. No policy loan will be available under this policy. 5. Assignment. No assignment will be allowed under this policy. 6. Tax Benefit. The premium payable under this product is eligible for Section 80(D) benefit of Income Tax Act, 1961. 7. Risks borne by the Policyholder: i)LIC’s Health Protection Plus is a Unit Linked Health Insurance product which is different from the traditional insurance products and is subject to risk factors. ii)The premium paid in Unit Linked Life Insurance policies are subject to investment risks associated with capital markets and the NAVs of the units may go up or down based on the performance of fund and factors influencing the capital market and the insured is responsible for his/her decisions. iii)Life Insurance Corporation of India is only the name of the Insurance Company and LIC’s Health Protection Plus is only the name of the unit linked health insurance contract and does not in any way indicate the quality of the contract, its future prospects or returns. iv)Please know the associated risks and the applicable charges, from your Insurance agent or the Intermediary or policy document of the insurer. v)The fund offered under this contract is the name of the fund and do not in any way indicate the quality of these plans, their future prospects and returns. vi)All benefits under the policy are also subject to the Tax Laws and other financial enactments as they exist from time to time. 8. Cooling off period: If you are not satisfied with the ?Terms and Conditions? of the policy, you may return the policy to us within 15 days. III. EXCLUSIONS 1. Common Exclusions in respect of HCB & MSB Benefits: No benefits are available hereunder and no payment will be made by the Corporation for any claim for Hospital Cash Benefit and Major Surgical Benefit under this Policy on account of Hospitalization directly or indirectly caused by, based on, arising out of or howsoever attributable to any of the following: a.“Pre-existing condition”- any medical condition or any related condition (e.g. illnesses, symptoms, treatments, pains and surgery) that have arisen at some point prior to the commencement of this coverage, irrespective of whether any medical treatment or advice was sought. Any such condition or related condition about which the PI or insured dependant know, knew or could reasonably have been assumed to have known, will be deemed to be pre-existing. The following conditions will also be deemed to be “pre-existing”: i.Conditions arising between signing the application form and confirmation of acceptance by the Corporation ii.Any Sickness, illness, complication or ailment arising out of or connected to the pre-existing illness b.Any Sickness that has been classified as an Epidemic by the -Central or State Government. c.Self afflicted injuries or conditions (attempted suicide), and/or the use or misuse of any drugs or alcohol. d.Any sexually transmitted diseases or any condition directly or indirectly caused to or associated with Human Immuno Deficiency (HIV) Virus or any Syndrome or condition of a similar kind commonly referred to as AIDS. e.War, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection military or usurped power of civil commotion or loot or pillage in connection herewith. f.Naval or military operations(including duties of peace time) of the armed forces or air force and participation in operations requiring the use of arms or which are ordered by military authorities for combating terrorists, rebels and the like. g.Any natural peril (including but not limited to avalanche, earthquake, volcanic eruptions or any kind of natural hazard). h.Participation in any hazardous activity or sports including but not limited to racing, scuba diving, aerial sports, bungee jumping and mountaineering or in any criminal or illegal activities. i.Radioactive contamination. j.Non-allopathic methods of surgery and treatment.