Health is precious! And it is instinctive to take care of your health, no matter the expense.
However, it is also true that taking good care of your health requires robust financial backing. Medical expenses in India have risen consistently over the years and paying for those out of your pocket can wear you down financially and expose you to future contingencies.
Therefore, it is wise and recommended to secure an affordable health insurance policy when the going is good to save yourself from a financial upheaval when having to cover up medical bills of yours or your loved ones.
The Arogya Sanjeevani Policy from Liberty General Insurance ensures that you are not on your own and have a financial cushion to fall back on during medical hardships.
The key features of this health insurance policy are –
The sum insured for Arogya Sanjeevani Policy ranges from Rs.1 lakh to Rs.5 lakh, and you are privileged to choose any sum in between, provided it is a multiple of Rs. 50,000.
You can either go solo with the Individual insurance plan or include your loved ones under the Family Floater insurance Plan.
In case you find the insurance policy unsuitable to your needs after purchasing it, you can request for a policy cancellation within 15 days from the date of commencement.
You can pay your Arogya Sanjeevani Policy premium in monthly, quarterly, or semi-annual basis. Or else, you can prefer to pay annual premium in one go and save on extra premium.
Once you purchase the insurance policy, you can continue to renew it every year for a lifetime.
The Arogya Sanjeevani Policy was introduced by the “Insurance Regulatory and Development Authority of India (IRDAI) on 1st April 2020 to simplify and make health insurance plans more affordable for individuals.
Now, there are several reasons why you should go for this health insurance plan offered by Liberty General Insurance. Firstly, to ensure that medical crises do not have you struggle for finances when your sole focus should be to secure quality healthcare.
Secondly, with our extensive list of empanelled hospitals, you can avail cashless healthcare facilities and not worry about settling hefty medical bills. Therefore, it empowers you to alleviate your financial worries and face any health crisis head-on.
Thirdly, this health insurance plan allows you to choose from a wide range of sum insured amount, as per your requirements.
And finally, your family’s health is just as precious as yours. With the Arogya Sanjeevani health insurance plan, you can financially secure not only yours but your loved ones’ medical exigencies as well.
With the Arogya Sanjeevani Policy, expenses arising out of hospitalisation ranging from room rent, boarding charges to nursing expenses will be indemnified up to 2% of the sum insured subject to a maximum of Rs.5000/day. For ICU and ICCU, the sub-limit is 5% of the sum insured subject to a maximum of Rs.10,000/day.
You might prefer the Vedic way of treatment through Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy over modern ways. All such expenses related to AYUSH treatments will be covered under the insurance plan up to the sum insured, as mentioned in the Arogya Sanjeevani policy covenant.
You can avail coverage under your Arogya Sanjeevani for cataract treatment up to 25% of the sum insured or Rs.40,000, whichever is lower, per eye in one policy year.
Defray medical expenses related to plastic surgery or dental treatment that is necessary owing to any disease or injury with our health insurance plan.
In the event your treatment or surgery gets over within a day or 24 hours of getting admitted, the medical expenses will be covered under the Arogya Sanjeevani Policy. Getting discharged early is a matter to rejoice, so we take care of the medical bills arising out of it.
IThere is a string of medical expenses that precedes hospitalisation like doctor’s fees, diagnoses costs, medicinal bills, etc. We cover all the pre-hospitalisation expenses immediately before 30 days of hospitalisation under our Arogya Sanjeevani policy.
The period after hospitalisation also entails specific costs like doctor’s fees, rehabilitation expenses, etc. All such post-hospitalisation expenses up to 60 days from getting discharged is covered under this health insurance policy.
Expenses of availing a road ambulance will be covered under this policy subject to a maximum amount of Rs.2000 per hospitalisation.
Treatment methods are evolving, and so is our health insurance policy. We provide coverage for treatment like balloon sinuplasty, deep brain stimulation, oral chemotherapy, bronchial thermoplasty and other procedure as specified upto 50% of Sum Insured.
The additional Arogya Sanjeevani Policy benefits you can enjoy are –
For every claim-free year against your health insurance policy, you will be awarded an automated 5% hike in the sum insured amount subject to a maximum of 50% increase sans any change in the Arogya Sanjeevani policy premium.
Apart from No-claim bonus, you can also voluntarily increase your sum insured upon renewal of your insurance plan provided you do not make any claims in the previous policy year.
You are allowed a grace period of 30 days within which you can renew your Arogya Sanjeevani Policy. If you have opted for instalment premium option then you get 15 days of Grace period instead of 30 days available in Annual payment option.
If before purchasing the insurance policy, you were continually insured under any other standard health insurance policy from any other general insurance provider, then under the Portability rules of IRDAI, waiting period for pre-existing diseases will be reduced to that extent.
You can claim tax deduction under Section 80D for the Arogya Sanjeevani Policy premiums paid in an Assessment Year.
The eligibility criteria to avail coverage under this health insurance policy are –
Minimum age of entry
The minimum age mandated under this insurance plan for adults is 18 years, and 3 months or 91 days for children.
Maximum age of entry
The maximum age to be covered under this insurance plan for adults is 65 years, and for children, it is 25 years.
Renewability
The insurance plan can be continually renewed yearly till lifetime of an insured person.
Persons allowed under the Individual Plan
Policyholder or self, legally married spouse, financially dependent child, parent/s and parent(s)-in-law are entitled to avail coverage under the Arogya Sanjeevani Policy– Individual Plan. Maximum 5 members can be included in one Policy.
Persons allowed under the Family Floater Plan
Policyholder or self, legally married spouse, parents, financially dependent children within the eligible age limits, and parents-in-law are allowed coverage under the Family Floater insurance plan.
Children who are above the age of 18 and financially independent are not eligible for coverage under the health insurance plan.
Maximum number of children
A maximum of 3 children within the specified age limits who are financially dependent, can be included for coverage under the Family Floater insurance plan.
Co-pay
5% Co-pay is applicable on every claim across age bands.
A. Cashless claim process
With the cashless claim facility in place, you do not need to shell out anything from your pocket. All your medical bills relating to hospitalisation are taken care of by us, up to the sum insured as pre-specified in the health insurance policy covenant. You just need to avail treatment in one of the vast numbers of our network hospitals, see through some formalities. Upon claim approval, you will only need to settle your share of co-payment of 5%, while the rest will be covered by us.
The procedure for a cashless claim against your Arogya Sanjeevani Policy is discussed below –
To obtain authorisation:
Step 2 - Submit relevant documents like medical bills, doctor’s prescription necessitating hospitalisation, pre-hospitalisation diagnostic reports, ID proof, etc
• After verification of the documents and checking the legitimacy of a claim against policy wordings, Liberty General Insurance will issue a pre-authorisation letter to the concerned network hospital within 6 hours from receiving the last necessary document.
• Upon getting discharged, the concerned insured person shall verify the discharge papers and sign them and attach relevant documents for the final cashless settlement.
It is also necessary to attach the relevant documents to substantiate the claim against your health insurance policy. Few of such necessary documents might include –
• Diagnostic test results during hospitalisation.
• Relevant medical bills.
• Discharge summary.
• MLR and FIR if carried and registered.
• Claimant’s KYC details in case total claim settlement exceed Rs.1 lakh
B. Reimbursement process
In the case of reimbursement, all of the expenses related to healthcare will be first paid by you. Then upon due submission of documents within the prescribed time limit, Liberty General Insurance will initiate reimbursement up to the extent of the Sum insured or sub-limit applicable, as mentioned in the Arogya Sanjeevani Policy.
The time limits specified for sending necessary documents to claim reimbursement under this insurance policy are mentioned in the table below.
| Claim type | Pre-specified time limit |
|---|---|
| For reimbursement of hospitalisation expenses, pre-hospitalisation expenses, and day-care treatment | Shall submit relevant documents within 30 days from the date when the insured person was discharged from the hospital |
| For reimbursement of post-hospitalisation expenses | Shall submit relevant documents within 15 days from the date when post-hospitalisation treatment is completed. |
Some of the documents that you will submit for a reimbursement claim are –
• Furnished claim form.
• Photo ID of the insured person.
• Original medical bills.
• Notes from OT prepared by a surgeon if surgery was involved.
• NEFT details and a cancelled cheque.
• Doctor’s prescription necessitating hospitalisation.
• Receipts of payments.
• Diagnostic reports from before hospitalisation, during hospitalisation, and after hospitalisation.
The full set of documents can be learnt in due course.
Before you can subscribe to the Arogya Sanjeevani insurance policy, you need to undergo medical check-ups. However, you need not worry about carrying these check-up costs alone; Liberty General Insurance will bear 50% of the expenses incurred if your proposal is accepted by us.
The Pre-policy health check-up for this insurance policy will be conducted at our empanelled network providers according to the table mentioned below.
| Age group | Medical tests | Cost borne |
|---|---|---|
| 18 – 45 years | Nil | Nil |
| 46 – 55 years | Blood group, Routine Urine Analysis, Complete Blood Count (CBC), Serum Cholesterol level, Fasting Blood Sugar level, ESR, Electro Cardiogram (ECG), SGPT, and Creatinine | 50% borne for accepted cases |
| 56 – 60 years | Medical examination (ME), ECG, CBC, Serum Cholesterol level, Glycated Haemoglobin (HbA1c), Triglycerides | 50% borne for accepted cases |
| Above 60 years | ME, Serum Cholesterol level, HbA1c, CBC, Prostate-Specific Antigen (males) and Ultra Sonogram (females), Triglycerides, Tread Mill Test, Sr. Creat | 50% borne for accepted cases |
Pre-existing diseases
If at or before the time of buying the Arogya Sanjeevani policy, you are diagnosed with any disease, it will not be covered before the lapse of 48 months from the date of policy commencement.
Diseases/treatments subject to waiting periods
Treatments, surgeries, and diseases prescribed under the insurance policy wordings will not be covered before the expiry of either 24 months or 48 months, as applicable.
Medical bills within 30 days of policy commencement
Medical bills arising due to illness within the first 30 days of policy commencement will not be covered under the Arogya Sanjeevani Policy. However, Accidental medical expenses will get covered from Day 1 of the policy.
Adventure sports
Injuries sustained, or hospitalisation due to adventure sports is not covered under this insurance plan.
War
Injuries or hospitalisation caused due to war, or war-like situations are not covered.
Gender-reversal treatments
Medical bills related to gender-reversal treatments are excluded from the Arogya Sanjeevani policy.
Self-inflicted injuries
Hospitalisation or medical bills due to injuries you have inflicted on yourself are not eligible to be covered under the insurance policy.
Cosmetic or obesity surgery
Medical bills arising out of cosmetic surgeries and treatment for obesity or weight control are not entertained for coverage, according to the insurance plan wordings.
For a detailed list of exclusions refer to the Arogya Sanjeevani policy wordings.
A) Arogya Sanjeevani Policy is designed as mandated by the Insurance Authority of India, The IRDAI. As per the mandate, all General Insurance companies and Health Insurance Companies of India abide to offer standard covers. The difference is only the premium which would be payable as per the Company you select for your Insurance needs.
A) Yes, hospitalisation due to the novel coronavirus disease is covered under this health insurance policy.
A) The policyholder or self, legally married spouse, children within the age range of 3 months and 25 years, parents, and parents-in-law are eligible to be included under the Family Floater insurance plan. However, a child who is above 18 years of age and also financially independent cannot be included under this insurance policy.
A) The maximum age to be included in the Arogya Sanjeevani Policy for adults is 65 years and for children is 25 years. The minimum age to be included is 18 years for adults and 91 days for children.
A) The geographical location of the policyholder has no bearing over the premium of the insurance policy.
A) The premium for this insurance policy depends on the Sum insured & age of the members proposed for insurance.
A) Yes, the Pre-policy health check-up is mandatory before a health insurance policy can be purchased for age bands above 45 years and those having any adverse medical health.
A) 50% of the cost for Pre-Policy health check-up will be borne by Liberty General Insurance for accepted policies, while the other half shall be borne by the prospective policyholder.
A) Yes, the waiting period for pre-existing disease/s is 48 months or 4 years from the date of policy commencement.
A) Yes, there is a flat 5% Co-pay applicable across age bands and on every claim.
A) Arogya Sanjeevani Policy is designed as mandated by the Insurance Authority of India, The IRDAI. As per the mandate, all General Insurance companies and Health Insurance Companies of India abide to offer standard covers. The difference is only the premium which would be payable as per the Company you select for your Insurance needs.
A) Yes, hospitalisation due to the novel coronavirus disease is covered under this health insurance policy.
A) The policyholder or self, legally married spouse, children within the age range of 3 months and 25 years, parents, and parents-in-law are eligible to be included under the Family Floater insurance plan. However, a child who is above 18 years of age and also financially independent cannot be included under this insurance policy.
A) The maximum age to be included in the Arogya Sanjeevani Policy for adults is 65 years and for children is 25 years. The minimum age to be included is 18 years for adults and 91 days for children.
A) The geographical location of the policyholder has no bearing over the premium of the insurance policy.
A) The premium for this insurance policy depends on the Sum insured & age of the members proposed for insurance.
A) Yes, the Pre-policy health check-up is mandatory before a health insurance policy can be purchased for age bands above 45 years and those having any adverse medical health.
A) 50% of the cost for Pre-Policy health check-up will be borne by Liberty General Insurance for accepted policies, while the other half shall be borne by the prospective policyholder.
A) Yes, the waiting period for pre-existing disease/s is 48 months or 4 years from the date of policy commencement.
A) Yes, there is a flat 5% Co-pay applicable across age bands and on every claim.
A) You need to inform us of within 24hours in case of unexpected hospitalization and at least 48 hours before any planned hospitalization.
A) You can cancel the insurance policy by giving 15 days’ notice in writing to the company. If no claim is made during the policy then LGI shall from the date of receipt of notice to cancel the medical insurance policy and refund the premium for the balance policy as per the terms and condition laid in the health insurance policy document.
A) Yes, like most of the best medical insurance policies there is a 15 day free look period available. The period starts from the date of receipt of health insurance policy document and allows you to review the terms, conditions and exclusions of the policy.
A) Yes, the minimum entry age is 18 years for adult and 91 days for children. The maximum entry age is 65 years and children below 25 years of age can also be covered given that either of the parent is insured under the best medical insurance policy.
A) Yes, AYUSH treatments are covered under the health insurance provided you get the optional coverage by paying a nominal amount extra on your premium.
A) The health insurance has waiting period of 30 days from the commencement of the medical policy and will apply to all disease / illness contracted other than accidental bodily injury requiring hospitalization.
A) As the best health insurance policy in India, there is a clause that benefits the loyal customers. Health insurance provides for auto increase in sum insured by 10% on the sum insured for every claim free. This auto increase is capped at 100% of the sum insured and is only applicable if the health insurance policy is renewed with us without any break or within the grace period.
A) One of the best medical insurance policies, this health insurance policy also provides coverage for pre-existing conditions after 36 months of continuous coverage have elapsed, since inception of your first Policy with Us.
A) In our endeavor to offer the best health policy, we provide optional covers, to allow the customer to mould the policy as per his/her needs. As mentioned earlier, AYUSH treatments will be covered only if the optional cover is availed under the insurance policy. There are other optional covers too. You can read more about them in the policy wordings.