LIC’s Health Protection Plus: Conversation Between Advisor & Customer
bijay-lifeinsurance.blogspot.com/
Advisor : Good moning sir. I thank you for giving me this appointment and the
opportunity to talk about our new product- LIC’s Health Protection Plus
Customer: Tell me more about the plan
Advisor : This is a long term Unit linked Health Insurance Plan. All the
Members of Your family can be covered under one single policy. The person
taking the policy is called the Principal \Insured and the others are
the insured members.
Customer: Member of family means?
Advisor : Spouse and Children of the Principal Insured (PI). There is no limit
on the number of members that can be insured besides newly
eligible members can also be added when they become eligible for
the scheme. bijay-lifeinsurance.blogspot.com/
Customer : You said this is a long term policy? How long is the cover available?
Advisor : This is a long term plan because the premiums can be paid upto 65
years of age and the benefits for you and your spouse are available
upto 75 years of age i.e. even after you stop paying the premiums
the risks are covered and the benefits are available.
Childrens from 3 Months to 17 years can be covered under the plan
and they are entitled to the benefits upto 25 Years of age.
Customer : What are the benefits Available under This plan?
Advisor :There are three types of Benfits Under this plan i.e.
· Hospital Cash Benefit
· Major Surgical Benefit
· Domiciliary Treatment Benefit bijay-lifeinsurance.blogspot.com/
Customer : How can premiums be paid under this Policy?
Advisor : Premium can be paid Yearly, Half-Yearly Or through Monthly-ECS.
Minimum premium payable is Rs 5000/- and thereafter there is
increase as per number of persons covered and insurability of life.
Customer : What if I am not able to pay the premium?
Advisor : The charges for daily Hospital cash Benefit and Major Surgical
Benefit will be deducted till the policy fund has sufficient balance
to recover the charges. As for revival the policy can be revived by
payment at any time between the ‘Revival period’ which is two
years from the date of First Unpaid Premium. The policy can be
revived by payment of arrears without Interest and without
requirement of DGH or Medical provided fund is sufficient.
Customer : What if I cannot pay all the arrears of premiums but only one
Installment. bijay-lifeinsurance.blogspot.com/
Advisor : It is advisable to pay premiums regularly to prevent compulsory
termination of the policy. However if you are not able to pay
arrears of premium, we have provision of a premium Holiday. The
facility of premium Holiday can be availed only if premiums are
paid of 3 years and your fund has balance of atleast one
annualized premium, you can pay the least instalment without
interest.The policy continues as long as the fund is sufficient to
deduct health risk charge under the policy and the policy can be
kept in force only by
the Principal Insured. If funds are not sufficient the policy
terminates.
Customer: Will my premium increase with age?
Advisor : No, Whatever premium is fixed at the outset will remain the
same. However charges will increase according to age and not according
to the benefit. The same rate per benefit will be applicable.
Customer: You said charges will be deducted from my premium. What are
these charges? bijay-lifeinsurance.blogspot.com/
Advisor : Sir this is a unit linked policy. The charges are simply the portion
of the premiums utilized to provide Risk cover for yourself and
your family members, other charges are for Allocation, Policy
Administration, Service Tax and for management of funds. The
balance that remains after deduction of all these charges is used to
purchase units from the Health Plus Fund. This amount is invested
in Government Guaranteed Securities. Money Market Instruments
and to small extent in Equity Shares. The no. of units allocated will
depend on the NAV of the fund on the date of purchase. The
amount is invested prudently to maximize returns.
Customer: If any member is excluded, what will happen?
Advisor : The health charges recovery will stop automatically.
Customer: What about Income Tax Benefit?
Advisor : Your premium under this plan is eligible for IT rebate under section
80(D)
Customer: What is the risk cover and amount of benefit?
Advisor : We provide risk cover against two events : Hospitalization and
major Surgeries. The charges for these covers are deducted every
month from the premium you pay.
Customer: When is hospital benefit paid? bijay-lifeinsurance.blogspot.com/
Advisor : Hospital benefit is paid when a person is hospitalized on account of
sickness or accident for a period of more than 48 Hours i.e. 2 days.
The benefit is paid for the period of admission that exceeds 48
hours. The amount will be daily Hospital Cash benefit for ICU. For
the purpose of claim a continues perid of 24 hours is treated as 1
day. If the insured continues in hospital for only a part of the day
and then period more than 4 Hours over completed no. of day is
treated as 1 day for the purpose of payment.The minimum amount
of initial Daily benefit for Principal insured is in the range of Rs.
250 to 2500/- and for others IDB is Rs 250 to 1500.
Customer : Well, you say the product is a long term one.But Medical costs will
increase with inflation how does your product take care of that?
Advisor: Yes, The initial Daily Benefit increases @5% subject to maximum of
1.5 times Initial Daily Benefit.
Customer: How many times can I avail Hospital Cash Benefit?
Advisor : The hospital cash benefit can be availed fot 18 days in the first
Year which includes a stay of maximum 9 days in ICU. From the
second year onwards the HCB can be availed for 60 days
thereafter inclusive of 30 days in ICU. The maximum no. of days
for which HCB can be availed during the policy period is 365 days
in case of PI and Spouse whereas for child below 5 it is 90 days.
Customer: Tell me more about Major Surgical Benefits.
Advisor : Major Surgical Benefits payable fot 49 specified surgical
precedures. bijay-lifeinsurance.blogspot.com/
MSB Sum assured is 200 times the initial Daily Benefit payable for
the respective Insured.The maximum benefit that can be availed
during 1 year is equal to 100% of the Sum Assured and the
maximum benefit available during the lifetime is 3 times the Sum
Assured.
Customer: Do I get the benefits immediately on takin the policy.
Advisor : No, there is a wait period of 180 days after commencement of the
policy and 90 days from revival. There is however no wait period
for MSB and HCB in case of Accidents.
Customer: You are talking about only two benefits Hospital Cash Benefit and
Major Surgical benefit but you mentioned one more benefit at the
beginning of the talk what is this accident. Are you deducting
charges fot this benefit?
Advisor : The third benefit is Domiciliary Treatment Benefit. No Charges are
deducted for this benefit. It is purely Utilised from the fund that is
accrued to your credit. It can be used to pay your OPD bills. If
atleast three years premiums have been paid then you can avail
Domiciliary Treatment Benefit forwhenever amount spent is Rs.
2500 of more, subject to satisfaction of other eligibility conditions
fot the payment. bijay-lifeinsurance.blogspot.com/
Customer: But what will be the fate of the policy. If any thing happens to me
during the term of the policy, since the policy is such long term…….
Advisor : The premiums will cease and the policy will continue on the life of
T he other insureds till the time the fund is sufficient to recover the
charges. If the policy is on a single life or if there is no other
surviving insured then the fund value is paid to the nominee or legal
heirs.
Customer: But I am sufficiently covered through my Employers scheme….
Advisor : Sir, Through your employees Scheme you will be getting your
expenditure reimbursed. Through LIC’s policy you will get our fixed
Benefit that you are entitled to over and above the benefit you
receive from any other scheme. Aren’s these features
complementary to the scheme? Beside Health Protection plan HCB is
paid irrespective of the reason fot the hospitalization and we are
also offering benefits for Domiciliary Treatment Twice a year.
Customer: That’s OK.. You are covering my risk upto 75 Years of age so my
policy ends there for all of my family members.
Advisor: The policy doesnot come to an end on your attaining 75 years of age.
At 75 only your hospital Cash Benefit and major Surgical Benefit
ceases. But if you have Fund value in your policy you can utilize the
same even after 75 fot the payment of Domiciliary treatment
benefit. The amount you have accumulated in your younger ages
when you are healthy will take care of your medical benefits in your
advance ages.
Customer: Can my wife take out a policy in her name?
Advisor :Yes, why not, as long as she is eligible to take out this policy she can
opt this policy and include you and your children as beneficiaries.
When she takes the policy she will be the principal Insured.
Customer: Why should I choose the policy when I do not need Health Insurance
right now? bijay-lifeinsurance.blogspot.com/
Advisor : Sir at a younger age you are buying the same product at a cheaper
rate…. The health risk charges are less. So the balance of fund
accumulation will be more.
Customer: Fine, can you please give a quote for me and my family members.
My affordability for premium is Rs. 15000 as I would like to avail the
IT benefits in full through this \policy.
Advisor : Here is the proposal form and here is the quote.
Customer : OK and here is the Cheque.
Advisor : Thanks.
POST by Bijay Thapa. bijay-lifeinsurance.blogspot.com/
I want to purchase LIC policy. Can you please tell me the best plan for the family insurance?
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"Dear Admin,
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