Health Protection Plus – Health Insurance

“Health Protection Plus” is a Unit Linked Insurance plan form India’s top life insurance provider – LIC of India.

A person [Principle Insured (PI)] can take this policy covering

• himself / herself
• he spouse and/or
• dependent children.

“Health Protection Plus” provides for insurance cover against following health risks: 

1.   Hospital Cash Benefit (HCB) 

2.   Major Surgical Benefit (MSB) 

3.   Reimbursement of domiciliary treatment expenses 

Hospital Cash Benefit (HCB) is on per day basis.

MSB shall be a percentage of sum assured. 

Hospital Cash Benefit (HCB)  

• HCB is payable on per day basis. 
• This Benefit will increase at each policy anniversary by 5% till it reaches a maximum of 1.5 times the Initial Daily Benefit. 
• ICU Daily Benefit: Twice Applicable Daily Benefit of that policy year. 

Conditions for Hospital Cash Benefit

• For every hospitalization, no benefit paid for the first 48 hours (two days)
• Maximum. 18 days hospitalization & including not more than 9 days in intensive care unit in the 1st

  policy year for each insured. 

• Maximum. 60 days hospitalization. and including not more than 30 days in I.C.U. in the 2nd & subsequent policy years for each insured.
• Limited to a maximum of 365 days during entire policy term for each insured. 
• Insured Child up to age 5 yrs: Maximum period of 90 (ninety) days. 
• Applicable only within India. 
• Waiting period: 180 days for new policy & 90 days after revival. 
• Termination: After his/her reaching 75 years OR Maximum lifetime claim limit of 365 days. 

Major Surgical Benefit (MSB)  

• MSB shall be a percentage of sum assured. 
• The Corporation will pay the chosen Major Surgical Benefit Amount, as calculated as a % of Sum  Assured, regardless of actual costs incurred. 
• The Major Surgical Benefit shall be paid as a lump sum 
• A child included will be automatically covered after age 18 years. 

 

Conditions for Major Surgical Benefit

• Maximum Benefit payable in any Policy year for an insured person not exceeds 100% of the S.A. in 

  respect of each member. 

• Maximum limit of three times the Sum Assured. 
• Applicable for surgery conducted only within India. 
• Waiting period: 180 days for new policy & 90 days after revival. 
• Termination: After his/her reaching 75 years and/or Maximum lifetime claim limit of three (03) times S.A. 

Domiciliary Treatment Benefit.

1. Before the cessation of Hospital Cash Benefit and Major Surgical Benefit on all the Insured lives :  
   • If at least 3 years’ premiums have been paid, it is payable out of Policy Fund. This is paid over & above 

     those paid through hospital cash/surgical benefits. 

   • The claimed amount should be at least Minimum.Rs. 2,500. 
   • Maximum amount to be paid shall be 50% of the Policy Fund. 
   • Minimum one annualized premium left in the Policy Fund after the payment. 
   • During a year, not more than 2 payments shall be allowed. 
   • Benefit cease for child on the child reaching age 25 years
2. After  the cessation of Hospital Cash Benefit and Major Surgical Benefit on all the Insured
   • The payment shall be allowed, from the Policy Fund, equal to actual amount spent subject to a minimum of Rs. 2,500/-. Further, if the balance in the Policy Fund is less than Rs. 2,500/-, then the payment of entire amount shall be made in one lump sum only and the policy will be terminated.
   • If any child is covered under the policy, Domiciliary Treatment Benefit will also cease in respect of that life from policy anniversary on which the child reaches age 25 years nearest birthday.

DEATH BENEFIT:  

1.   If policy is issued on a single life: N.A.V. Payable to nominee.

2.   If one or more Insured lives (other than PI) are covered 

The payment of premiums will cease. However, the cover shall continue for the surviving Insured lives till the maximum benefit ceasing age or till the fund is sufficient to recover the charges for hospital cash cover and surgical benefit cover, whichever is earlier