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Health Plus Medical claim

(2 posts)
  1. Anonymous

    Unregistered

    HI sir/madam,

    My mother had a health plus policy and she has recently undergone a laproscopic surgery.
    the surgery costed us aroun 75k, wanted to know if we can claim this amount from LIC if yes how much amount can we claim and if no kindly advice me on for the non eligibilty

    Posted 2 years ago #
  2. devanand

    senior admin
    Joined: Jun '09
    Posts: 94

    No, lapraoscopies is not covered under eligible Major Surgical Benefit list vide Health Plus policy of LIC.

    Note:
    Health Plus plan of LIC is a Cash benefit policy only. In other words, this policy does not cover or reimburses for expenses incurred on medical treatment whether sickness or surgical in nature.

    However, a lump sum payment against chosen Major surgical benefit amount, calculated as a % of the sum assured as specified against each of the “eligible surgeries” become payable to the insured members. At a random check, it is found that Laparoscopies is not included in the list of the eligible surgeries.

    Hence, you may further check-up with LIC office, if, any revision of the eligible surgeries list has been made in the recent past including laparoscopies and accordingly you can proceed with your claim.

    IBS
    Posted 2 years ago #

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