Presentation on Health Insurance with A New Perspective

India- The Next Big Market for Health Insurance Growth in GDP : 8.5% - 9% Annually Government Support for Healthcare on the Increase Demographic Drivers - Growth of the Middle Class - Rise in Incomes . Estimated Market for Healthcare : $ 110 Bn - $ 130 Bn : INR 3,80,000- INR 4,60,000 Cr.

The New Insurance Scenario De- tarrifed Premium Structure- Jan 1, 2007 No more Cross- Subsidization Innovative, New Products replacing Plain Vanilla Covers Heightened Competition from Pvt. Sector & Stand-Alone Health Insurance

Drivers of Growth Increased Government Spend on HealthCare Increase of Private HealthCare in Urban Areas Increased Medical Costs resulting in Increased Demand for Insurance Changes in Disease Patterns Increase in Insurance Awareness (Mainly Urban Areas) Increase in Disposable Incomes Employee HealthCare Benefits as a HR Tool Enhanced Tax Incentive on Health Insurance

What do these figures mean? Growth in Health Insurance outstripping Overall Growth of the Insurance Sector High Annual Growth Rates Indicative of High Demand Increase of Health Insurance in Insurers’ Portfolio Mix Increasing Market Share of Private Insurers Health Insurance- A Key Growth Driver of the Non-Life Insurance Sector

The Cost of Health care shooting up exponentially Present Generation spends more on Health Care

Irrespective of your existing plan Health Insurance Health Insurance plan must take care…… Daily Expenses in Hospital Surgical Expenses Out Patient expenses All expenses in and out of Hospital Waiver of premium during stay at Hospital Risk Coverage in case of any exigencies Irrespective of your existing plan

LIC’s Jeevan Arogya

LIC’s Jeevan Arogya offers…… Valuable financial protection in case of hospitalization, surgery etc Increasing Health cover every year Lump sum benefit irrespective of actual medical costs No claim benefit Flexible benefit limit to choose from Flexible premium payment options

Benefits Under Jeevan Arogya Hospital cash benefit (HCB) Major Surgical Benefit (MSB) Day Care Procedure Benefit Other Surgical Benefit Other Optional benefits (PWB)

Benefits Under Jeevan Arogya Hospital cash benefit (HCB)

Benefits Under Jeevan Arogya Major Surgical Benefit (MSB))

Benefits Under Jeevan Arogya Day Care Procedure Benefit

Benefits Under Jeevan Arogya Other Surgical Benefit

Hospital Cash Benefit (HCB) Feature Principal Insured (PI) Insured Spouse (If any), Parents/In law Insured Children Min Initial Daily Benefit Rs. 1000/- Max Initial Daily Benefit Rs. 4000/- Equal or less than PI Max Age for Cover 80 yrs 25 yrs HCB (Within India only) is payable on per day basis. Double the cash benefit for ICU. Max 30 days hospitalization & not more than 15 days in ICU (2 times HCB) for 1st policy year for each one Max 90 days and incl not more than 45 days in ICU in the 2nd year onwards for each insured Limited to a max of 720 days (incl of 360 days for ICU) during entire policy term for each HCB to increase 5% till it reaches 1.5 times And arithmetic addition of an amount equal to “No Claim Benefit” Stay in Hospital exceeds a continuous period of 24 yrs or part thereof thereafter. Stay more than 7 days even for 1s 24 hours also payable.

Major Surgical Benefit(MSB) Feature Principal Insured (PI) Insured Spouse(If any), Parents/In law Insured Children Sum Assured (MSB SA) 100 times ADB of PI 100 times of ADB of insured Spouse 100 times of ADB of each child Max Annual benefit 100% of Sum Assured Max Life Time 800% of MSB SA Quick Cash facility: 50% of eligible MSB amount subject to approval from TPA in select Hospitals MSB shall be a percentage of Sum Assured and is payable regardless of actual costs incurred Rs. 1000/- towards Ambulance expenses Premium Waiver benefit for next one year Surgery within India.

Day Care Procedure Benefit (DCPB) Feature Principal Insured (PI) Insured Spouse(If any), Parents/In law Insured Children Lump sum benefit payable 5 times of ADB in HCB 5 times of ADB IN HCB Max Annual benefit 3 Surgical Procedures Max Life Time 24 Surgical Procedures If a DCPB is performed, no HCB shall be paid DCPB is payable as one lump sum and proof of surgery is required All surgical procedures should be done by a Physician or Surgeon, to the satisfaction of the Corporation No transfer of left over benefit to other insured Surgery within India

Other Surgical Benefit (OSB) Feature Principal Insured (PI) Insured Spouse(If any), Parents/In law Insured Children Daily Benefit amount 2 times of ADB Max Annual benefit 15 Days in Year 1 and 45 days per year thereafter Max Life Time 360 days OSB is payable as daily benefit Proof of surgery done by a Physician or Surgeon, is subject to the satisfaction of the Corporation No transfer of left over benefit to other insured Surgery required but not listed under MSB or DCPB

Other Options Term Rider Benefit Accident Benefit Rider Min AB SA: Rs. 25000/- Max AB SA: Equal to Term Assurance SA AB SA shall be in multiples of Rs. 5000/- Term Rider Benefit Min Term Assurance SA: Rs. 100000/- Max Term Assurance SA: Equal to MSBSA Min Entry Age: 18 Years completed Max Entry Age: 50 Years NBD Max Maturity Age: 60 Years NBD Max Term: 35 Years (SA be in multiples of Rs. 25000/-)

Other Benefits Contd……. Death Benefit: No death benefit unless TA Rider benefit is opted for On death of the Principal Insured (PI) Surviving Insured Spouse will become PI, if already option given at the beginning of contract If the Insured Spouse had predeceased the PI, Then the other Insured will have the option to take new policy on following conditions The new policy will be issued without any underwriting if the new policy is bought within 90 days of the termination of the existing policy The maximum entry age will not apply for the new policy The outstanding Waiting periods and outstanding period of any Exclusion will however apply under the new policy Other terms and conditions including premium rates will be as applicable for the new policy Maturity Benefit: No benefits are payable at the end of the cover period

Eligibility Conditions Feature Principal Insured (PI)/Insured Spouse Parents & Parents-in-law Insured Children Minimum Entry Age 18 Yrs LBD 3 Months(Completed) Maximum Entry Age 65 Yrs LBD 75 Yrs LBD 17 Yrs LBD Max Cover ceasing age 80 Yrs 80 yrs 25 yrs Date of cover expiry in respect of each Insured covered under the plan Policy anniversary on which the Insured life attains Maximum cover ceasing age Nominations Assignments Allowed Not Allowed Mode of Premium Grace Period Revival Period Yearly, Half Yearly and Monthly(ECS Only) 30 days for Yearly , Half Yearly mode and 15 days for Monthly Mode 2 Years from due date of FUP s even for 1s 24 hours also payable.

Points to be noted Premium guaranteed for first 3 years and may be revised after every 3 years based on Health conditions All existing members must be added in first instance. New members can be added through Child birth (Children)-3 Months, Marriage (Spouse, Parents-in-law)- 6 Months from next Policy anniversary

Points to be noted Contd……… Waiting Period 90 days from DOC other than accidental bodily injury 45 days from DOR, if request for revival recd within 90 days from the due date of FUP 90 days from DOR, if request for revival recd beyond 90 days from the due date of FUP Specific Waiting Period (treatments) 2 years from Date of Cover Commencement 2 Years from DOCC, if request for revival recd within 90 days from the due date of FUP 2 Years days from DOR, if request for revival recd beyond 90 days from the due date of FUP

Treatments in respect of Specific waiting period i. Treatment for adenoid or tonsillar disorders ii. Treatment for anal fistula or anal fissure iii. Treatment for benign enlargement of prostate gland iv. Treatment for benign uterine disorders like fibroids, uterine prolapse, dysfunctional uterine bleeding etc v. Treatment for Cataract vi. Treatment for Gall stones vii. Treatment for slip disc viii. Treatment for Piles ix. Treatment for benign thyroid disorders x. Treatment for Hernia xi. Treatment for hydrocele xii. Treatment for degenerative joint conditions xiii. Treatment for sinus disorders xiv. Treatment for kidney or urinary tract stones xv. Treatment for varicose veins xvi. Treatment for Carpal tunnel syndrome xvii. Treatment for benign breast disorders e.g. fibroadenoma, fibrocystic disease etc

Points to be noted Contd……… Termination of Policy If policy is issued on a single life Non Payment of premium within revival period On death On Date of cover expiry On exhausting all the life time maximum Benefits Limits as specified above If policy is issued on more than one life On death or Date of cover expiry of the PI and if the Policy does not continue with the IS as the PI On death or Date of cover expiry of IS after Policy continues with the IS as the PI after the PI dies or reaches his/her Date of cover expiry On PI exhausting all the life time maximum Benefits Limits as specified above

How does it differ from Medi-claim? Pre defined benefit- No reimbursement, but lump sum paid based on pre-defined benefit Not based on expenses incurred This will tend to indirectly reduce the Health care cost, which is rising due to cash less medi-claim benefit All benefit is dependent on HCB

Commission & Credit Agency Commission like Table 14 25% + 10% Bonus Commission in Year-I 7.5% Commission in Year II & III 5% Commission in Year IV onwards 27

Arogya Dhan Combination of : Jeevan Tarang Whole Life Jeevan Arogya “Pay premium only for 15 years and get all the benefit of Jeevan Arogya free till 80, and also get 3 times of your premium at the age 80 with life long risk cover”

Premium : Jeevan Arogya : 7665 Jeevan Tarang : 12420 Whole Life : 4544 PI age: 35 Spouse age:32 HCB: 2000 (Both) Jeevan Tarang178/15/15:SA 175000 Whole Life 5/15: SA 100000 Premium : Jeevan Arogya : 7665 Jeevan Tarang : 12420 Whole Life : 4544 Total Premium : 24629

Benefits Risk Cover: 275000 DAB: 550000 Total premium paid in 15 year: Rs.369435 After 15th year will receive 178 bonus: Rs.115500 Net premium paid : Rs.253935 After 15th year 178 & 5 premium will stop Survival benefit from 178 : Rs. 9625 Premium of 903 : Rs.7665 Balance (will use for 903 increasing premium) :Rs.1960

Benefits Risk cover of SA 175000 will continue life long with Rs.4200 increasing every year At age of 80 receive maturity of Rs. 724625 from whole life At age 100 also receive maturity of Rs. 406000

Thank you!!