lic health plus pped

8/14/2019 LIC Health Plus PpED

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LICs HEALTH PLUSLICs HEALTH PLUS

ByBy

G N Agarwal, E.D (Actuarial) &G N Agarwal, E.D (Actuarial) &

Appointed ActuaryAppointed Actuary

In Conference of RMs (Mktg) on 7.1.2008In Conference of RMs (Mktg) on 7.1.2008


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AGENDA

Introduction

Policy Fund

Eligibility Conditions

Benefits

Other salient features

Intermediaries Remuneration

Charges Tax opinion

Target Group


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INTRODUCTION

Pure Health Insurance, hence no

mortality cover

A unit-linked product Premium paid will be subject to allocation

charge

Balance credited to Policy Fund Account


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POLICY FUND A UNIT-

LINKED ACCOUNT

Policy Fund Account will be subject to

Health cover charge plus service tax

Policy charge

These charges shall be deducted onmonthly basis


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POLICY FUND A UNIT-

LINKED ACCOUNT (Contd)

Policy fund will be invested as per below

Not less than 50% in Govt. securities/Govt.guaranteed securities & Corporate debt

Not less than 10% & not more than 50% -

Equity

Balance Money Market instruments

Single fund - no choice of funds, no switching

NAV declared daily


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What is the cost?

MINIMUM PREMIUM

single life Rs.5000p.a (or)

6 times the HCB

2 lives Rs.7500p.a (or)

(6 times the HCB of PI +

3 times the HCB of others)

>2 lives Rs.10000p.a (or)

(6 times the HCB of PI +3 times the HCB of others)

WHICHEVER IS HIGHER.


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ELIGIBILITY CONDITIONS

Premium : Max. Premium No limit

Min. Premium (p.a)

Rs.5,000 for single life (6 times the HCB of PI)

- Rs.7,500 for 2 lives (6 times the HCB of PI & 3times the HCB of other insured)

- Rs.10,000 for more than 2 (same as above) -In multiples of Rs.500/-


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ELIGIBILITY CONDITIONS

Age :

Min. entry age : 18 for PI & Spouse (lbd)

3 months for children Max. entry age : 55 for PI & Spouse

17 years for children

Max. cover ceasing age : 65 for PI & Spouse25 for children

Max. premium ceasing age: 65 for PI


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BENEFITS

Following health covers shall be provided

Hospital Cash Benefit (HCB)

Major Surgical Procedures (MSP) Policy fund shall also provide

Domiciliary Treatment benefit (DTB)

Any excess spent on treatment than what isavailable on hospitalisation/surgical procedure


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BENEFITS (Contd) Covers can be taken for

self (Principal Insured (PI))

spouse

dependent children (no ceiling of number)

Any eligible existing spouse/children if not

covered cannot be covered in future

Any subsequent spouse (on marriage/remarriage) or children (on birth/adoption) can

be covered within one year from policy

anniversary


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BENEFITS (Contd)

On death of PI : - Premium stops

- If other lives are there

cover continues if at least,

3 years premiums have been paidotherwise balance in policy fund paid

On death of

other members : No change except

charges for them stop


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BENEFITS (Contd)

Benefits : Hospital Cash Benefit

(HCB) - Min. Rs.250/-Max. Rs.2,500 for PI & Rs.1,500

for others (in multiples of Rs.50)

-For others benefit cannot be

more than that of PI

-In case of ICU double


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BENEFITS (Contd)

HSB (Contd)

Inflation/Increase : 5% p.a. subject to max.

150% of initial benefit

1st year maximum : 18 days which may

include 9 days ICU

Subsequent year max.: 60 days which may

include 30 days ICU


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BENEFITS (Contd)

Maximum life time : 365 days

Waiting period: 180 days except

accident

Exclusions : Usual

Qualified per day: After 2 days every

day or part (4 hrs

or more)


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BENEFITS (Contd)

Max. life time : 3 times of S.AWaiting period : 180 days

Exclusions : Usual


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BENEFITS (Contd)

Domiciliary Treatment Benefit (DTB)

Benefit can be claimed after payment of 3rd

year premium (i.e. after 2 years) Not more than twice in a year

Equal to actual expenses subject to

minimum of Rs.2,500/- at a time

Not more than 50% of policy fund at a time

Leaving at least one annualized premium in

policy fund after payment


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OTHER SALIENT FEATURES Surrender equal to policy fund after

completion of 3 years

Partial withdrawals not allowed

Loan not allowed

Revival within 2 years of first unpaidpremium

Alteration not allowed


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OTHER SALIENT FEATURES Increase in premium permitted

without increase in benefits

Reduction in premium permitted

without reduction in benefits (within

conditions of minima/maxima) Premium holidays permitted subject

to conditions


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INTERMEDIARIES

REMUNERATION Commission to Agents : 10% (+4% Bonus)

in first year

5% thereafter

Commission to Brokers: 15% in first year

5% thereafter

LIC employees : 90% allocation in first

year & 100%

thereafter


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CHARGES

Allocation charge - 30% in F.Y

6% in SYs

Policy Charge - Rs.75/- p.m in FYRs.25/- p.m in SYs

HCB & MSB charges - Competitive rates

Service Tax - Actual (12.36%presently)

Fund Mgt. charges - 1.25% p.a. of unit fund


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TARGET GROUPTARGET GROUP

Young married/unmarried

Income tax payers

Covered/Not covered under a mediclaimpolicy


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TARGET GROUPTARGET GROUP

Policy provides complete health solution for the

family with/without mediclaim

Along with mediclaim, one may opt for lower

HCB/HSB so that maximum amount goes inpolicy fund from which expenses for DTB may

be claimed as and when needed.

If one is already covered under mediclaim, then

also the policy shall provide Benefit which will

take care of additional expenses incurred by the

family for which no bills might be available


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TAX OPINION

Premium paid under the policy shall

qualify for 80D

Benefits received under HCB, MSB andDTB not taxable


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T H A N K Y O U

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