A lump-sum benefit is payable for specified major surgical procedures.
The Major Surgical Benefit Sum Assured is equal to 100 times the Applicable Daily Benefit. The amount payable depends upon the category of eligible surgery.
Hospital Cash Benefit may also be payable in addition to the Major Surgical Benefit, subject to policy conditions.
Day-Care Procedure Benefit
For specified eligible day-care procedures, a lump-sum benefit equal to five times the Applicable Daily Benefit is payable.
Other Surgical Benefit
For eligible surgeries not covered under the Major Surgical or Day-Care lists, a benefit equal to 2.5 times the Applicable Daily Benefit may be payable for each eligible day of hospitalisation.
Medical Management Benefit
A fixed benefit may be payable for eligible inpatient hospitalisation arising from specified medical conditions, including:
- Dengue
- Malaria
- Pneumonia
- Pulmonary Tuberculosis
- Viral Hepatitis A
Extended Hospitalisation Benefit
For a single continuous inpatient hospitalisation exceeding 30 days, an additional lump-sum benefit equal to 10 times the Applicable Daily Benefit may be payable.
Increasing Health Cover
A No Claim Benefit equal to 10% of the Initial Daily Benefit may be added after every block of three consecutive claim-free policy years, subject to policy conditions.
Health Check-up Benefit
After completing the first three policy years, a Health Check-up Benefit may be available once every three years while the policy remains in force, subject to the prescribed limit and conditions.
Premium Waiver Benefits
- Base-policy premiums may be waived for one year when an insured undergoes an eligible Category 1 or Category 2 major surgery.
- On the death of the Original Principal Insured, future base-policy premiums for surviving insured members may be waived under the Auto Health Cover Benefit, subject to policy conditions.
Eligibility at a Glance
- Principal Insured: Entry age 18 to 65 years
- Spouse and parents: Entry age 18 to 65 years
- Children: Entry age 90 days to 20 years
- Policy term: 15 years
- Initial Daily Benefit: ₹2,500 to ₹10,000, in multiples of ₹500
- Premium-paying term: 15 years
- Maximum cover-ceasing age: Subject to the insured member’s category and policy conditions.
Important Information
LIC’s Health Shield is a fixed-benefit health plan. It is not a hospital-expense reimbursement or indemnity Mediclaim policy.
- General waiting period for sickness: 90 days
- No general waiting period for eligible hospitalisation or surgery arising from an accidental bodily injury occurring after the effective date of cover
- A two-year specific waiting period applies to specified treatments and medical conditions
- Pre-existing diseases and other exclusions are governed by the policy conditions
- No maturity benefit is payable under the base plan
