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. Policy FUND will be invested as per below - not less than 50% in Govt. Securities / Govt. Guaranteed securities and Corporate debt - not less than 10% and not more than 50% Equity - Balance Money Market instruments - single fund - no choice of funds, no switching - NAV declared daily.
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. Policy FUND will be invested as per below - not less than 50% in Govt. Securities / Govt. Guaranteed securities and Corporate debt - not less than 10% and not more than 50% Equity - Balance Money Market instruments - single fund - no choice of funds, no switching - NAV declared daily.
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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. Policy FUND will be invested as per below - not less than 50% in Govt. Securities / Govt. Guaranteed securities and Corporate debt - not less than 10% and not more than 50% Equity - Balance Money Market instruments - single fund - no choice of funds, no switching - NAV declared daily.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPT, PDF, TXT or read online from Scribd
AGENDA • Introduction • Policy Fund • Eligibility Conditions • Benefits • Other salient features • Intermediaries’ Remuneration • Charges • Tax opinion • Target Group 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 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 on monthly basis 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 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. 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 & 3
times the HCB of other insured)
- Rs.10,000 for more than 2 (same as above) -
In multiples of Rs.500/- 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 & Spouse 25 for children – Max. premium ceasing age: 65 for PI 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 is available on hospitalisation/surgical procedure 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 BENEFITS (Contd) • On death of PI : - Premium stops - If other lives are there cover continues if at least, 3 years’ premiums have been paid otherwise balance in policy fund paid • On death of other members : No change except charges for them stop 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 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 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) BENEFITS (Contd) – Major Surgical Benefit (MSB) : S.A = 200 times of per day HSB Minimum age for benefit eligibility : 18 : 40%, 60% and 100% for different procedures : Each surgery covered once only Per year maximum : 100% of SA BENEFITS (Contd)
Max. life time : 3 times of S.A
Waiting period : 180 days Exclusions : Usual 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 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 unpaid premium • Alteration not allowed 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 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 CHARGES • Allocation charge - 30% in F.Y 6% in SYs • Policy Charge - Rs.75/- p.m in FY Rs.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 TARGET GROUP • Young married/unmarried • Income tax payers • Covered/Not covered under a mediclaim policy TARGET 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 in policy 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 TAX OPINION • Premium paid under the policy shall qualify for 80D • Benefits received under HCB, MSB and DTB not taxable THANK YOU