Health insurance has become a crucial part of smart financial plans which is a must for every individual. It covers your medical expenses whenever medical treatment is availed. Be it hospitalization, cost of medicine, or consultation fees, everything is covered under this plan. 

Introduction to LIC Arogya Rakshak plan:

The Indian government’s Ministry of Finance owns one of the most popular insurance companies, Life Insurance Company (LIC). Being one of the oldest, it caters to the changing needs of Indians and never fails to introduce beneficial plans. One such plan is LIC Arogya Rakshak

LIC Arogya Rakshak is a health insurance policy that was introduced by LIC on 19th July. It is a regular premium, non-linked, and non-participating health insurance plan. It is a long-term plan where you can have cashless claims.

Under this one policy, you can insure all your family members including your spouse, parents, and children. It assures you financial independence in critical times of medical emergencies. The LIC Arogya Rakshak policy gives you fixed benefits irrespective of the actual medical expense incurred. 

In this plan, the premium is paid to opt for an Initial Daily Benefit from INR 2,500 to INR 10,000 in multiples of INR 500 for self, spouse, dependent children as well as dependent parents. The other benefits are payable in proportion to the Initial Daily Benefit and are referred to as Applicable Daily Benefit or ADB.

Key features of the LIC Arogya Rakshak plan:

The following are the popular features of the LIC Arogya Raksha – 

  • You can choose the benefit limit as per your own choice. LIC offers a lot in this context. 
  • The premium payment option is also a choice that remains with the insured. 
  • As hospitalization costs are rising with every passing year, this plan covers your back with strong financial support. 
  • Insured members are also offered ambulance and health check-up benefits. 
  • The most popular feature of LIC Arogya Raksha is that it lets you enjoy a fixed amount of benefits. So, you don’t have to count your benefit as per the actual cost incurred. 
  • With Auto StepUp and No Claim Benefit, an insured person can avail of an Increasing Health cover. 
  • There is a Premium Waiver benefit under this policy. In case the Principal insured person dies, other insured members are waived off from the payment of premium. 
  • The premium waiver benefit (for 1 year) is also available in case any of the insured members need to undergo surgical treatment as recognized in the category I and II Major Surgical Benefit Annexure. 

Benefits of the LIC Arogya Rakshak plan

There are several benefits that you can enjoy by insuring yourself and your family under this new health insurance scheme-

  1. Death benefits

    In the case of the death of the Principal insured, Auto Heath Cover (AHC) is provided for the surviving members. The cover continues without any premium payment. 

    • For insured children, AHC will continue until they reach the age of 25 or for 15 years after the death of the Principal Insured, whichever is earlier. 
    • For insured spouses/parents, the AHC benefit can be available for 15 years or till they reach the age of 70, whichever is earlier.

    In case of the death of any other insured other than the Principal insured, there shall be no death benefit.

  2. Hospital cash benefit

    The insured can claim insurance after 24 hours of being admitted to the hospital. Be it in the general, special, or intensive care unit, the policyholder will receive an amount equal to the Applicable Daily Benefit. For ICU, the patient must cross 4 hours in the ward to avail of this benefit. The plan covers more than 1,000 diseases.

  3. Major Surgical benefit
    In case of serious surgical treatment, either due to an injury or a sickness, the assured sum will be paid no matter what the actual cost was. There will be benefits provided for the cost of an ambulance as well.
  4. Other Surgical Benefits

    If the insured member has to undergo a surgery that is not listed under the Daycare Procedure Benefit or the Major Surgical Benefit, he would receive a daily benefit that would be two and a half times the Applicable Daily Benefit.

  5. Day Care Procedure Benefit
    In case an insured undergoes any Day Care Procedure due to accidental injury or sickness, he shall be liable to receive an amount that is 5 times the Applicable Daily Benefit.
  6. Health Check-up Benefit
    This benefit is for all the insured persons under this policy. It can be availed once in 3 years in case the insured is undergoing any medical treatment. This benefit provides financial help on the actual cost incurred but it shall not be more than half the Applicable Daily Benefit. 
  7. Medical Management Benefit

    If an insured person is admitted for inpatient hospitalization due to these five diseases-

    1. Dengue
    2. Malaria
    3. Pneumonia 
    4. Pulmonary Tuberculosis 
    5. Viral Hepatitis A

    He shall be benefited with an amount that is 2.5 times the Applicable Daily Benefit. 

  8. Maturity benefit

    This policy has no maturity benefit. If everything goes well and the policy period is survived by the insured individual, the policy will be terminated without any payment to the insured. 

Inclusions under LIC Arogya Rakshak

LIC Arogya Rakshak being a fixed benefit plan provides lump sum benefit in case of any of the insured events happens such as:

 

Inclusion

Additional Benefit

Limit

Hospital Cash Benefit (HCB)

For hospitalization in normal bed> 24 hours, ADB would be paid for every 24 hours


For hospitalization in ICU > 24 hours, 2 X ADB would be paid for every 24 hours

Year 1: Maximum 30 days
Year 2 onwards: 90 days up to a maximum of 900 days in the entire lifetime of the policy

Major Surgery Benefit (MSB)

For any of the listed surgeries, a % of the MSB Sum Insured would be paid, up to a maximum of 100 X ADB in one policy year, irrespective of the actual cost incurred

+ Ambulance Cost of INR 1000
+ 1-year premium to be waived off for Category 1 or Category 2 Major Surgery (as per list)
+ 100% restoration of Major Surgery Benefit for any unrelated ailment
+ Hospital Cash Benefit as applicable

100% of MSB Sum Assured in one policy year up to 10 times the MSB in the entire lifetime of the policy

Day Care Procedure Benefit 

For any specified or accidental Day Care Procedure, 5 X ADB would be paid irrespective of the actual cost incurred

3 Daycare Benefit in one policy year up to 30 Daycare Benefits in the entire lifetime of the policy

Other Surgical Benefit

For any other non-listed surgeries + hospitalisation > 24 hours, 2.5 X ADB would be paid for every 24 hours, irrespective of the actual cost incurred

+ Hospital Cash Benefit as applicable

Year 1: Maximum 15 days
Year 2 onwards: 45 days up to a maximum of 450 days in the entire lifetime of the policy

Medical Management Benefit

For hospitalisation > 24 hours for treatment of Malaria, Dengue, Pulmonary Tuberculosis, Pneumonia or Viral Hepatitis A, 2.5 X ADB would be paid, irrespective of the actual cost incurred

+ Hospital Cash Benefit as applicable

Maximum of 2 times in one policy year up to a maximum of 20 times in the entire lifetime of the policy

Extended Hospitalisation Benefit

For hospitalisation > 30 days, 10 X ADB would be paid, irrespective of the actual cost incurred. This is paid over and above other benefits

+ Major Surgery Benefit/ Day Care Benefit/ Other Surgery Benefit/ Major Surgical Benefit as applicable
+ Hospital Cash Benefit as applicable

Paid only once in one policy year up to a maximum of 10 times in the entire lifetime of the policy

Auto Step Up Benefit

The ADB rises by 15% every 3rd policy anniversary on continuous renewal 

Up to maximum 1.5 times the IDB in the entire lifetime of the policy

No Claim Benefit

The ADB rises by 5% of the IDB for every 3 claim-free years

No Limit

Health Check-Up Benefit

For every 3 continuous renewals, 0.5 X ADB would be payable for the health check-up of every insured

Death Benefit 

For the death of the primary insured, the policy continues with Premium Waiver Benefit as Auto Health Cover would get triggered. The coverage would continue for a minimum tenure of 15 years or till:

  • Dependent children > 25 years
  • Dependent spouse/ parents > 70 years

No benefit provided for the death of the secondary insured, except that the premium would decrease proportionately

Quick Cash Facility

For any of the listed surgeries under Category 1 or 2, an advance payment of 50% of the eligible Major Surgical Benefit would be paid and later adjusted from the final settlement.

Eligibility criteria of LIC Arogya Rakshak plan:

There are several eligibility criteria prescribed for people looking forward to getting insured under this policy. 

Minimum Age of Entry

Principal Insured: 18 years 

Insured Children: 91 days

Insured Parents: 18 years

Insured Spouse: 18 years

Minimum Age of Entry

Principal Insured: 65 years 

Insured Children: 20 years

Insured Parents: 65 years

Insured Spouse: 65 years

Cover Period

Up to 80 years for parents or spouse

Up to 25 years for children

Sum Insured (Initial Daily Benefit)

Minimum INR 2,500 for self, spouse and dependent children/parents
Maximum INR 10,000 for self with <= coverage available for spouse and dependent children/parents

Exclusions under LIC Arogya Rakshak plan 

There are certain exclusions attached to the plan. If a policyholder falls under these conditions, he/she shall be liable to no benefits under the LIC Arogya Raksha

  • For treatment done outside India or for an unrevealed medical condition or a treatment that is not acknowledged by LIC.
  • If the treatment is covered by a non-experimental surgeon or physician. 
  • Any outpatient treatment is not subject to benefits. 
  • In case of the insured going for body organ donation. 
  • Any dental treatment availed excluding accidental necessity. 
  • Cosmetic or plastic surgery by the insured unless it is a medical emergency. 
  • In case the insured commits suicide. 

Before you Buy
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Conclusion

Health insurance plans are a strong backup for your medical emergencies and LIC Arogya Raksha is one such plan. It not only provides you with several medical benefits but gives you ample flexibility as well. The fact that it is different from other health policies, it has gained even more policyholders. You don’t have to worry about the expenses incurred and then file the claim. This policy offers you a fixed amount of claim no matter what the actual cost of the treatment will be. 

It is a great health plan that helps you cover your whole family under one scheme. So, if you are looking for an enhanced and smart plan, LIC Arogya Raksha could be the one.


FAQ’s

There are two riders in LIC Arogya Raksha

  • LIC New Term Assurance Rider, where the Term Assurance Rider Sum Insured would be paid on premature death of the insured within the policy tenure
  • LIC’s Accident Benefit Rider, where the Accident Benefit Rider Sum Insured would be paid on the premature accidental death of the insured within the policy tenure.


There is a 30-day Grace Period provided to the insured from the date of the first unpaid premium. If you do not pay the due premium before the expiry date, the grace period begins and once the 30 days are over the policy lapses. A claim made in the grace period is not accepted.