Arogya Sanjeevani Policy – What are its Features and Benefits?

Arogya Sanjeevani Policy – What are its Features and Benefits?

Arogya Sanjeevani Standard Health Insurance Policy is announced by IRDAI.

You may be getting a headache in understanding the features and benefits of the health insurance products available in the market.

then, This Standard health insurance policy will be a solution for you.

In addition, this product is labeled as “Arogya Sanjeevani Policy <Name of the Insurer>.

For example, If Star Health is offering this Policy, then it called an Arogya Sanjeevani Policy Star Health.

This product is not company-specific.

In addition, this policy features and benefits are universal and standardized.

As a result of this, you can easily understand its features and benefits.

Basically, This policy provides three types of benefits to the policyholders (buyers of this policy).

  1. This policy will take care of the basic health insurance requirements of the public.
  2. In addition, it will have common wording across all the industries ( in all health insurance companies).
  3. This policy has a seamless portability option.

What are the features and benefits of Arogya Sanjeevani Policy?…

  • This policy offers Individual health insurance as well as family floater health insurance.
  • Here, Family means spouse ( wife or husband), parents, parents – in – law and dependent children from age 3 months to 18 years.
  • Floater Policy will not allow Individual children whose age is above 18 years to get included.
  • This policy offered as an Indemnity insurance policy without any riders like critical illness etc.
  • In this policy for yearly premium, 30 days grace period and for other modes 15 days grace period is available.
  • The minimum sum assured is Rs.1,00,000 and the maximum sum assured is Rs.5,00,000.
  • The policy period is 1 year.
  • You can pay premiums Yearly or Half Yearly or Quarterly or monthly.
  • The minimum for the principal policyholder is 18 years and maximum age is 65 years.
  • This policy has a life long renewable option.
  • A 5% co-payment clause is applicable to all ages.
  • Co-payment means out of the total claim amount, 5% should be born by the policyholder.
  • Cataract Surgery has sub-limits.
  • In addition, i.e actual expenses, 25% of sum assured or Rs.40,000. ( whichever is lower).
  • Two types of waiting periods in this policy.
  • one is for 24 months and another one is for 48 months.
  • This policy has a portability option too.
  • The premium in this policy India based, and it is not zone based or geography-based.
  • This policy covers hospitalization expenses like room, boarding, Nursing expenses.
  • But it is limited per day 2% of the sum assured or a maximum of  Rs.5,000.

More Benefits of Arogya Sanjeevani Policy are…

  • ICU/ICCU expenses up to 5% of the sum assured or the maximum of Rs.10,000 in this policy.
  • This policy also covers Ayush treatment.
  • It covers 30 days of pre-hospitalization expenses.
  • In addition, this policy covers 60 days of post-hospitalization expenses.
  • No Claim Bonus (NCB) for 5% of the sum assured will be given every year.
  • But it is limited to a maximum of 50% of the sum assured.
  • You can buy this product from 1st, April 2020.
  • You have to wait for 30 days to claim after you purchased this policy.
  • Some exclusions in this policy are like plastic surgery, gender change, weight loss, hazardous sports activity breach of law due to law, etc not allowed.
  • Maternity benefit is not available in this Arogya Sanjeevani Policy.
  • Third-Party Authority (TPA) feature is available.
  • In addition, Cashless benefit also available.
  • No deductibles in this policy.
  • You can have an “N” number of Arogya Sanjeevani Policies.
  • In addition, In the above case, the policyholder has the right to chose the insurance company or policy to claim.
  • You cancel this policy within 30 days to get 75% of the premium paid.
  • In addition, If you cancel between 31 days to 90 days 50% of the premium, 3 months to 6 months 25% of the premium paid and if you cancel 5 months to 1 year 0% of the premium paid is refunded.
  • You can switch to other products of the same health insurance company.

Should you consider this health insurance Policy?…

should you buy this standard health insurance policy
should you buy this standard health insurance policy?

As per my knowledge, this policy features and benefits are good and you can consider buying it from any General Insurance Company.

Here, the features and benefits of this policy will remain the same in all insurance companies.

However, the premium for this policy may vary from company to company.

In addition, It seems like a premium to charge for this policy is left to the insurance companies.

One negative point is this policy has 5% co-payment whereas other insurance products available with no co-payment.

In addition, one more negative is there is a room rent cap of 2% of sum assured or Rs.5,000 per day and Rs.10,000 maximum cap for the ICU and ICCU.

But one good benefit is that the premium will not be decided based on zone or geographic location, the premium will be the same across India.

In addition, there are no daycare treatment listings.

So, We can assume that all daycare treatments are available.

Restricting Sum Assured to 5 lakh is one more big disadvantage.

But You can buy multiple Arogya Sanjeevani policies.

IRDAI has removed a controversial previous sentence in Standard Health Insurance guidelines on 10-02-2020.

This new amendment will help this Standard Health Insurance Policy buyers.

What is the contravercial statement?
What is the controversial statement?

Let’s assume that you have taken a health insurance policy on 1st January 2020.

In addition, You do not have a heart or kidney or diabetes at the time of taking the policy.

As a result of this, you have not mentioned the above problems in the policy.

But after 4 months of taking the policy, you are identified as diabetic.

If after 5 years, If there is a heart attack due to diabetes.

In addition, the doctors mentioned in the claim form that you are diabetic since year 2020.

Here, in this case the health insurance companies can easily reject your claim using above controversial statement.


These guidelines will apply to all health insurance companies which are offering indemnity based health insurance.

However, these guidelines are not applicable to travel, personal accident and daycare policies that offer hospitalization, domiciliary treatment, and daycare treatment.


Conclusion about this health insurance policy…

Finally, These policy features and benefits look fine.

In addition,  You can consider it to buy once the premium charts come out from the insurance companies.

Read the article about How the Life Insurance Agents are making a better profit than you? Click this link to read.

Also, read the article Why Jeevan Anand kind of policies are not good for you?… Click this link to read.

Also, read article Lic vs Pli – Which is good for you? Click this link to read.

The source for this article is economic times.












Share With Friends and Family

Leave A Comment

Your email address will not be published. Required fields are marked *