THE ORIENTAL HEALTH INSURANCE

Oriental medical insurance is highly admired for its customised healthcare plans suitable for both urban and rural parts of India. It provides a wide range of coverage for individuals and also for entire families.

• 1.3 million+ policies already issued.
• Incurred claim ratio of 85.39%.
• Grievances addressed: 73.93%.
• Tax benefits under section 80D.
• Lifetime renewability.

Oriental health insurance from "The Oriental Insurance Company Ltd" serves millions across the country through its 4,300+ strong cashless hospital network and 24x7 claim assistance services.

 

Features & Advantages: Oriental Medical Insurance

• Comprehensive health insurance coverage.
• Plans cover a maximum of 7 family members (up to 3 children and 4 adults).
• Takes care of inpatient hospitalisation costs such as room rent, nursing and OT charges.
• Covers pre and post hospitalisation expenses (30 days before hospitalisation and 60 days after hospitalisation).
• Cashless treatment.
• Pre-existing diseases are covered after 4 years.
• Free health check-ups for the insured individual after every 4 consecutive claim-free years.
• Daily cash allowance as per your sum insured (when you are hospitalised).
• Hassle-free claim settlement.
• Domiciliary treatment costs are covered up to a specific period.
• Daycare procedures/treatments and organ donor charges are covered as per your chosen plan.
• Maternity coverage is also available.
• Low claim rejection record.
• Attractive discounts on premiums.
• Portability option.
• No initial screening for individuals up to the age of 55.

 

Oriental Health Insurance Plans

1] Oriental Insurance Individual Mediclaim Health Insurance

• Sum assured: 50,000 to 2 lakh rupees (in increments of 25,000 rupees) and 2 lakh to 5 lakh rupees (in increments of 50,000 rupees).
• Pre-hospitalisation (up to 30 days) and post-hospitalisation expenses (up to 60 days).
• Covers surgeon, doctor, anaesthetist, consultant charges, blood, oxygen, OT, surgical, diagnostic equipment, medicines, dialysis, radio, chemotherapy, prosthetic limbs/devices, pacemaker, laboratory tests and other hospitalisation expenses.
• Daycare procedures and domiciliary hospitalisation treatment.
• Pre-existing diseases: After 4 years.
• Ambulance charges: 2,000 rupees or 1% of the sum assured (whichever is lower).
• Reimbursement of health check-up expenses after every 4 successive claim-free years. (up to 1% of the sum assured).
• Medical screening is required for individuals over the age of 45.

 

2] Oriental Insurance Happy Family Floater Policy

• Available with two options: Silver and Gold Plans.
• Sum assured: 1.5- 10 lakh rupees (depending on your plan).
• Covers surgeons, anaesthetists, doctors, consultants, specialists, radio/chemotherapy, medicines, X-Rays, surgical/diagnostic equipment, prosthetic limbs/devices, pacemakers, dialysis up to sum assured.
• Pre-existing diseases waiting period: 4 years.
• Room/nursing charges: Applicable up to 1% of the sum assured for every day of hospitalisation.
• ICU charges: Up to 2% of the sum assured for every day of hospitalisation.
• Expenses for rabid animal bites: Up to 5,000 rupees.
• 5% discount on premiums (if TPA services not chosen).
• Domiciliary treatment: 10% of the sum assured (limit of 25,000 rupees).
• Ambulance charges: 1,000 rupees/illness (limit of 3,000 rupees or 1% of the sum assured, whichever is lower).
• Add-on cover (additional premium): Personal accident cover for the sum assured 5 to 10 lakh rupees.
• Medical screening is necessary for individuals above 60 years.

 

3] Oriental Bank Mediclaim Policy (for OBC’s account-holders)

• Family floater plan with 5 sum-assured options: 1 lakh to multiples of 5 lakh rupees.
• Cashless facility at network hospitals.
• Pre-hospitalisation (up to 30 days) and post-hospitalisation expenses (up to 60 days).
• Covers surgeon, doctor, anaesthetist, consultant charges, blood, oxygen, OT, surgical, diagnostic equipment, medicines, dialysis, radio, chemotherapy, prosthetic limbs/devices, pacemaker, laboratory tests and other hospitalisation expenses.
• Also takes care of daycare procedures, room charges/nurses expenses (up to 1% of the sum assured or 5,000 rupees, whichever is less) and ICU charges (up to 2% of the sum assured or 10,000 rupees (whichever is less, for every day of hospitalisation).
• Pre-existing conditions: Waiting period of 3 years.
• Daily cash allowance is limited to 1,000 rupees over the policy term.
• Ambulance charges: Lower of 1% of the sum assured or 1,000 rupees/illness.
• Funeral expenses: Limited to 1,000 rupees over the policy term.
• Renewability valid for an insured individual till 80 years of age.

 

4] PNB: Oriental Royal Mediclaim Insurance Policy

• A policy with an entry age of 79 years.
• Cashless claims.
• Pre-hospitalisation (up to 30 days) and post-hospitalisation expenses (up to 60 days).
• Covers surgeon, doctor, anaesthetist, consultant charges, blood, oxygen, OT, surgical, diagnostic equipment, medicines, dialysis, radio, chemotherapy, prosthetic limbs/devices, pacemaker, laboratory tests and other hospitalisation expenses.
• Also takes care of daycare procedures, room charges/nurses expenses (up to 1% of the sum assured) and ICU charges (up to 2% of the sum assured, for every day of hospitalisation).
• Pre-existing conditions: Waiting period of 3 years.
• Ambulance charges: Lower of 1% of the sum assured or 1,000 rupees/illness.
• Coverage: Until the insured individual completes 80 years.

 

5] Oriental Insurance Jan Arogya Bima Plan

• Entry age limit: 5 to 70 years [Children :3 months to 5 years (at least one parent should be covered under this plan)].
• Sum assured: 5,000 rupees per annum.
• Pre-hospitalisation (up to 30 days) and post-hospitalisation expenses (up to 60 days).
• Covers inpatient hospitalisation, domiciliary hospitalisation and treatment expenses for ailments/injuries.

 

6] Oriental Insurance Nagrik Suraksha Policy

• Eligibility: 5 to 70 years (for families) and  18 to 70 years (for individuals or group packages).
• Individual policy can also include family members, and the group policy can cover multiple employees.
• Sum insured: 1 lakh to 5 lakh rupees.
• Remuneration of hospitalisation expenses.
• Benefits: 40 to 100% of Personal Accident Benefit (in cases of partial or total disability), cumulative bonus, funeral/burial charges and education fund support for children.
• Renewable every year (subject to age limits).

 

7] Oriental Insurance Janata Personal Accident Policy

• Eligibility: 10 to 80 years.
• Sum insured options from 25,000 to 5 lakh rupees.
• Benefits: 50 to 100% of the sum insured (in cases of partial/total disability/death).
• Renewable every year subject to age limits.

8] Oriental Insurance HOPE: Health of Privileged Elders

• Entry age: 60 years and above.
• Sum insured: 1 lakh to 5 lakh rupees.
• Covers specific diseases/illnesses/injuries such as accidental injury, knee replacement, cancer, stroke, cardiovascular diseases, orthopaedic diseases, benign prostate, ophthalmic (eye), chronic obstructive lung disease, hepatobiliary disorders and chronic renal failure.
• Also covers hospital room, boarding/nursing expenses, ICU charges, emergency ambulance charges, doctor, surgeon, anaesthetist, consultant, specialists fees, cost of anaesthesia, blood, oxygen, OT charges, medicines, drugs, consumables, costs of artificial limbs, prosthetic devices and diagnostic tests (X-ray).
• The policy can be renewed after 1 year.
• Medical tests are not required.

 

General Exclusions of Oriental Health Insurance Policy

• Any hospital admission primarily for investigation or diagnostic purposes.
• Pregnancy (except ectopic), infertility, congenital or genetic conditions.
• Treatment outside India.
• Pre-existing diseases.
• STDs, HIV/AIDS.
• Circumcision, sex change, cosmetic or plastic surgery.
• Substance abuse.
• Self-inflicted injuries.
• Death/disablement during racing, shooting, big game hunting, mountaineering, ice hockey or winter sports.
• Breach of law with criminal intent.
• War/warlike operations.

 

Note: Please refer to detailed insurance product brochures for policy/plans-specific exclusions.

 

Oriental Health Insurance Premium

The Oriental health insurance premiumis based on factors such as your age, medical history, lifestyle habits, the sum insured and type of cover you choose. 

One can compare policies and plans by visiting Oriental Insurance’s official website. Alternatively, you may use established online insurance comparison portals such as www.Quickinsure.com to explore quotations, simplify and speed up the process of buying medical insurance.

 

Oriental Health InsuranceRenewal & Purchase

One can apply for/renew health insurance policy by viewing and comparing quotes online through insurance comparison platforms such as www.Quickinsure.com.

                                                      

Oriental Health Insurance Review

Oriental Insurance Company Limited is a Government of India public sector undertaking and a trusted name in the insurance space for more than seven decades. In addition to its competitive prices and comprehensive yet straightforward plans, it is also considered the go-to choice for those looking for excellent claim settlement record.

 

Oriental Health Insurance Policy: FAQs

Q: What are the benefits of a health insurance policy?

It covers all your expenses incurred due to hospitalisation, including inpatient treatments, pre/post hospitalisation, daycare procedures and domiciliary treatments.

Q: I already have life insurance. Do I need a health insurance policy?

Life insurance does not help you in paying rising medical bills. A health insurance cover protects you against unexpected health-related costs, enables you to deal with hospitalisation and takes care of your expenses.

Q: How can I avoid being underinsured?

By making a careful assessment of your needs, opting for an adequate sum insured, going through the exclusions/conditions thoroughly and seeking help from professional comparison portals such as www.Quickinsure.com.

Q: How can I file a claim with Oriental health insurance?

• Cashless claim: Get approval from the Third-Party Administrator of the insurer. Your hospital submits a pre-authorisation request to the TPA. After approval, the insured receives cashless treatment and the insurance company settlesthe bill directly with the hospital.
• Reimbursement: The insured individual submits a duly-filled claim form and all the original medical documents to the insurer within 15 days from the date of discharge. The reimbursement claim is then approved or rejected as per the policy terms and conditions.

 

Disclaimer: The information shared is purely indicative. Please refer to the policy wordings for most up-to-date and precise details.