Is Jeevan Arogya the right cover for you?

Suresh Sadagopan

Ladder7 Financial Advisories

Anshuman was shocked when his brother Himanshu was admitted to the hospital. Himanshu was just 28 and no one in their family thought he would require medical attention.  Yet, he did. And it set them back by about Rs.50,000. He had a medical insurance policy from his company, but only to the extent of Rs.50,000. Since the medical expenses were double that, they had to cough up the balance.

For Anshuman, it was a rude wakeup call.  He never even thought he requires medical insurance, much less a sufficiently large cover. After this event, he started trawling for good medical cover options for himself.  That is when his friend and LIC agent Bishnu suggested to take Jeeven Arogya.

What Anshuman heard seemed interesting yet he wanted to validate it. He remembered the definition of a bikini- what it reveals is interesting and what it conceals is vital. He did not want to get tantalised by what seemed interesting on the face of it. He wanted my opinion.

Here is the analysis.

Medical Insurance policy: The first policy a person needs is a medical insurance which covers the expenses incurred. This kind of a policy also has many other features like cover for domiciliary hospitalization, daycare procedures, hospital daily cash, ambulance charge reimbursement, pre & post coverage for expenses pertaining to hospitalisation etc. There are various other benefits some policies offer like reimbursement of maternity expenses coverage, eyecare expenses, health checkup, dental expenses etc. subject to some conditions. This kind is an indemnity policy, which reimburses utmost upto the extent spent. Usually, it may be somewhat less, but it will cover most of the costs.

Jeevan Arogya: This is a benefit plan which offers a certain amount from Rs 1000 to Rs 4000 per day based on the plan chosen, for every day of hospitalization. Also, it covers major surgeries and other surgeries and offers lumpsum benefit of 100 times of daily benefit in case of Major surgery. For  other surgeries, it offers two times of the hospital daily benefit, for every day in hospital. Hence, one will get monies from this policy which may not have any bearing to the amount spent. 

Also, the payout amount will substantially differ based on what is defined as major surgery and what is defined as other surgery. Hence, the benefit obtained can be much less than what may be needed.  It covers daycare procedures too. For daycare procedures, the lumpsum payout will be five times the daily benefit.  The premiums will be constant for three years, after which LIC could review and change it. This policy can cover the nuclear family, along with parents of Principal Insured and parents-in-law. 

There are term insurance and  accident riders too in this policy, which one could opt for.

The limitations of this policy