LIC Jeevan Arogya Calculator Plan 903 And 904

The LIC Jeevan Arogya Calculator is an online tool that is helpful for people who already have an LIC Jeevan Arogya policy. It provides an estimate of the fixed benefit that may be available for hospital admission, ICU admission, a major surgery, a listed day care procedure or another eligible surgery.

LIC Jeevan Arogya is a withdrawn health insurance plan. It is not available for a new purchase. However, an existing policy may continue according to the conditions written in its policy bond. For this reason, the calculator does not show a new-policy premium, investment return or maturity amount. Its main purpose is to help an existing policyholder understand a possible claim benefit.

Jeevan Arogya is a defined-benefit health policy. This means its payment is based on the fixed benefits and limits written in the policy. It does not simply repay the complete hospital bill. The estimated benefit can therefore be lower than, equal to or higher than the actual medical expense.

What Is LIC Jeevan Arogya Plan?

LIC Jeevan Arogya is a non-linked and non-participating health plan. In simple words:

• It was not linked to the share market;
• It did not earn a bonus;
• It did not build a maturity amount; and
• It paid set benefits for covered medical events.

It was a fixed-benefit plan, not a normal mediclaim plan. A mediclaim policy usually pays eligible hospital expenses up to the policy limit. Jeevan Arogya paid the amount fixed under its rules, even if the hospital bill was higher or lower.

The policy could cover one person or eligible family members under one policy. Benefits and limits applied to each insured member as stated in the policy.

Plans Included in the LIC Jeevan Arogya Calculator

The calculator supports the following policy versions:

• LIC Jeevan Arogya Plan 903 – UIN 512N266V01
• LIC Jeevan Arogya Plan 904 – UIN 512N266V02
• LIC Jeevan Arogya Plan 904 – UIN 512N266V03

The correct plan and UIN must be selected because benefit rules can differ between policy versions. These details are normally printed on the first page of the policy bond.

Important Calculator Highlights

The calculator can estimate:

• Applicable Daily Benefit
• Normal hospital cash benefit
• ICU cash benefit
• Major Surgical Benefit
• Day Care Procedure Benefit
• Other Surgical Benefit
• Eligible ambulance benefit for a major surgery
• Annual benefit limits for the selected claim

LIC Jeevan Arogya Plan 903 vs Plan 904

Both plans are almost the same. Plan 904 mainly introduced updated policy rules, rider versions, and a longer revival period.

Details Required to Use the Calculator

Policy Plan and UIN

Select Plan 903 or Plan 904, which plan you have or want to calculate. The UIN should match the number shown in the policy bond. Selecting the wrong version can produce an incorrect calculation.

Initial Daily Benefit

The Initial Daily Benefit is the hospital cash amount selected when the policy started. The available choices in the calculator are:

• ₹1,000 per day
• ₹2,000 per day
• ₹3,000 per day
• ₹4,000 per day

This amount is the starting point for calculating other benefits.

Completed Policy Years

Enter the number of complete policy years finished before the claim. Do not count a policy year that is still running.

For example, if the claim occurs after five full policy anniversaries, enter 5.

Completed Claim-Free Blocks

A claim-free block means three continuous policy years completed without an eligible claim. The calculator uses these blocks to estimate the no-claim increase.

The number of claim-free blocks cannot be more than the number of completed three-year periods. For example, six completed policy years can contain a maximum of two three-year blocks.

Current Applicable Daily Benefit

The calculator can estimate the current Applicable Daily Benefit automatically. However, a policyholder may already have an amount confirmed by LIC. In that case, select:

Enter the current Applicable Daily Benefit shown by LIC

The confirmed amount entered here will replace the calculator’s automatic estimate. This is the better option when an updated policy record or LIC communication is available.

Formula Used in the Calculator

Applicable Daily Benefit

The basic calculation is:

Estimated Applicable Daily Benefit
= Initial Daily Benefit
+ Annual increases
+ No-claim increases

The calculator restricts the estimated amount to 150% of the Initial Daily Benefit. Plan 903 and Plan 904 use their respective no-claim increase settings in the calculator.

The estimate may not match LIC’s record when previous claims, policy changes or version-specific conditions affect the increase. The LIC-confirmed Applicable Daily Benefit should be entered whenever it is known.

Normal Hospital Benefit

Normal Hospital Benefit
= Payable General-Ward Days × Applicable Daily Benefit

The first continuous 24 hours are normally not payable when hospitalisation lasts for fewer than seven days. If the continuous stay reaches seven days or more, the calculator includes the first day.

ICU Benefit

ICU Benefit
= Payable ICU Days × 2 × Applicable Daily Benefit

An ICU day is paid at twice the normal Applicable Daily Benefit, subject to policy conditions and limits. The same hospital day is not counted once as an ICU day and again as a general-ward day.

Major Surgical Benefit

Major Surgical Benefit Sum Assured
= Applicable Daily Benefit × 100

Payable Major Surgical Benefit
= Major Surgical Benefit Sum Assured × Surgery Percentage

The calculator provides surgery percentages of 100%, 60%, 40% and 20%. The correct percentage must be taken from the Major Surgical Benefit annexure belonging to the selected policy version.

An additional ₹1,000 ambulance benefit is included only when the option is selected for an eligible Category 1 or Category 2 surgery. A premium waiver is not shown as a cash payment.

Day Care Procedure Benefit

Benefit for One Eligible Day Care Procedure
= Applicable Daily Benefit × 5

The calculator applies the normal limit of three eligible day care procedures in one policy year. The procedure must appear in the policy’s Day Care Procedure annexure.

Other Surgical Benefit

Other Surgical Benefit
= Eligible Days × 2 × Applicable Daily Benefit

This section should be used only when the surgery is not included in the Major Surgery or Day Care Procedure lists.

How to Use the LIC Jeevan Arogya Calculator

1. Select the plan number and exact UIN shown in the policy bond.
2. Select the Initial Daily Benefit.
3. Enter the completed policy years.
4. Enter the completed three-year claim-free blocks.
5. Enter the LIC-confirmed Applicable Daily Benefit if it is known.
6. Select the required claim type.
7. Enter the hospital days, ICU days, surgery percentage or procedure details requested by the calculator.
8. Add previous benefit use when applicable.
9. Press Calculate to view the estimated benefit and calculation breakdown.
10. Press Reset to clear all entries to start a new calculation.

Real Calculation Example

Assume an existing policy has an Applicable Daily Benefit of ₹2,500. The insured person remains in a hospital for eight complete days, including two ICU days. No hospital benefit has already been used in that policy year.

Because the continuous stay is at least seven days, all eight days are considered in this estimate.

General-ward days = 8 − 2 = 6 days
General-ward benefit = 6 × ₹2,500 = ₹15,000

ICU benefit = 2 × 2 × ₹2,500 = ₹10,000

Estimated hospital benefit
= ₹15,000 + ₹10,000
= ₹25,000

The calculator would therefore show an estimated benefit of ₹25,000. The final amount can still change after LIC checks the policy status, waiting periods, exclusions, hospital records and previous claims.

Annual Benefit Limits

For hospital and ICU calculations, the tool applies the following commonly applicable limits:

• First policy year: up to 30 hospital days, including up to 15 ICU days
• Later policy years: up to 90 hospital days, including up to 45 ICU days

Previously claimed days entered in the calculator are deducted from the relevant annual limit. Lifetime limits are not calculated because complete claim history may not be available. They must be checked from LIC’s records or the policy bond.

The calculator also applies:

• Up to three eligible day care procedures in a policy year
• Up to 15 Other Surgical Benefit days in the first policy year
• Up to 45 Other Surgical Benefit days in later policy years

How This LIC Jeevan Arogya Calculator Helps

The calculator turns policy terms into a simple benefit estimate. It helps an existing policyholder understand how the Applicable Daily Benefit affects hospital, ICU and surgical benefits. It also shows the formula used for every result instead of displaying only one final amount.

The result can be useful for checking a possible claim, understanding annual limits and preparing questions before contacting LIC. It should not be treated as claim approval.

Important Points to Remember

• Jeevan Arogya is withdrawn and cannot be purchased as a new policy.
• An existing policy is governed by its exact policy bond and UIN.
• The plan pays fixed benefits and does not simply reimburse the complete medical bill.
• This policy does not provide a normal savings-plan maturity amount.
• A surgery or procedure must appear in the relevant policy annexure to qualify under that benefit.
• Waiting periods, exclusions, policy status and previous claims can affect payment.
• The LIC-confirmed Applicable Daily Benefit should be used when available.
• The calculator provides an estimate and does not approve or guarantee a claim.

Who Could Be Covered in Jeevan Arogya Policy?

Jeevan Arogya was made as a family health plan. Depending on the version and policy terms, one policy could cover:

• The Principal Insured;
• Spouse;
• Children;
• Parents; and
• Parents-in-law.

The Principal Insured is the main policyholder named in the policy. Each covered person has a separate date of entry, benefit level and claim limit. The policy schedule shows the people who are actually insured. A family member is not covered only because the relationship is eligible; the person’s name must appear in the policy records.

What Is the Initial Daily Benefit?

The Initial Daily Benefit, or IDB, is the starting daily hospital cash amount chosen when the cover began. In Plan 904 UIN 512N266V02, the choices were ₹1,000, ₹2,000, ₹3,000 or ₹4,000 per day.

The IDB is the base for many other benefits. For example, the initial Major Surgical Benefit Sum Assured was 100 times the IDB in that version.

If the IDB was ₹2,000:

Initial Major Surgical Benefit Sum Assured = ₹2,000 × 100 = ₹2,00,000

The IDB should not be guessed. It is shown in the policy schedule.

What Is the Applicable Daily Benefit?

The Applicable Daily Benefit, or ADB, is the daily benefit available in a particular policy year. It may be higher than the original IDB because of increases allowed under the policy.

For Plan 904 UIN 512N266V02, the ADB could rise through:

• a yearly increase equal to 5% of the IDB, up to the stated limit; and
• a No Claim Benefit when the full policy met the no-claim rule.

The current ADB should be taken from LIC records whenever possible. A calculator can estimate it, but the final figure depends on policy history and earlier claims.

How to Make a Claim

The claim should be reported to LIC as soon as possible. The branch or current LIC instructions will confirm the form and documents needed.

Common documents may include:

• Completed health claim form;
• Policy number and identity proof;
• Hospital admission and discharge record;
• Doctor’s notes and diagnosis;
• Test reports;
• Operation or procedure record;
• Original or certified bills when asked;
• Bank details; and
• Any other paper needed to check the claim.

Documents can be checked on LIC’s Health Insurance Forms page or with the servicing branch. Can also contact with LIC agents to get brief details. Keeping copies of all submitted papers and the acknowledgement is useful.

Tax Benefits

Premium paid for eligible health insurance may qualify for a deduction under Section 80D of the Income-tax Act, subject to the tax law and personal eligibility for that financial year. The premium receipt should be kept as proof. Current tax rules should be checked before claiming a deduction.

LIC Jeevan Arogya Diseases Covered

LIC Jeevan Arogya does not have one fixed list of covered diseases. It provides fixed benefits when an illness or accident causes an eligible hospital stay, surgery, or listed day-care procedure.

Conditions Covered After a Two-Year Waiting Period

Under Plan 904 V02, the following treatments had a two-year waiting period:

• Adenoid or tonsil disorders
• Anal fistula or anal fissure
• Benign prostate enlargement
• Uterine fibroids or uterine prolapse
• Cataract
• Gallstones
• Slipped disc
• Piles
• Benign thyroid disorders
• Hernia
• Hydrocele
• Degenerative joint conditions
• Sinus disorders
• Kidney or urinary tract stones
• Varicose veins
• Carpal tunnel syndrome
• Benign breast disorders

Major Treatment Categories

The policy also listed 140 major surgeries covering areas such as:

• Heart and blood vessels
• Brain and nervous system
• Lungs and respiratory system
• Stomach and digestive system
• Thyroid and endocrine system
• Ear, nose and throat
• Eyes
• Liver, gallbladder and pancreas
• Bones and joints
• Kidneys and urinary system
• Reproductive system
• Cancer-related surgeries
• Burns and reconstructive surgery

A general 90-day waiting period applied to sickness-related claims. This waiting period did not apply to eligible accidental injuries. The exact covered surgery or procedure must appear in the annexure attached to the correct Plan 903 or Plan 904 policy. Check Official LIC Jeevan Arogya Plan 904 details

Conclusion

The LIC Jeevan Arogya Calculator helps existing Plan 903 and Plan 904 policyholders understand fixed hospital and surgery benefits. It can estimate Hospital Cash, ICU, Major Surgery, Day Care and Other Surgery benefits in one place.

The most important details are the correct UIN, Initial Daily Benefit, current Applicable Daily Benefit, eligible medical event and benefits already used. Since all versions are withdrawn, the original policy bond remains the main source for rules. The calculator makes the numbers easier to understand, while LIC’s policy and claim records decide the final payment.