You need health cover regardless of what you take two at a time - pills or stairs.
  • Oriental Health Insurance

    Oriental Health Insurance
     4.0 / 5.0   by 152 users
    Used this product? Write a review >>

    Cashless Treatment

    Customer Service

    Medical Coverage

    Claim Experience

    The Oriental Insurance Company Ltd was incorporated at Bombay on 12th September 1947. The Company was a wholly owned subsidiary of the Oriental Government Security Life Assurance Company Ltd and was formed to carry out General Insurance business. ORIENTAL with its head Office at New Delhi has 30 Regional Offices and nearly 1800+ operating Offices in various cities of the country.


    Oriental Health Insurance at a Glance

    01
    02
    03
    Coverage for your most loved ones

    Total members covered

    Coverage for a maximum of 7 family members with up to 4 adults

    You get a choice of coverage tenure

    Pre and Post Hospitalization cover

    Medical expenses covered for 30 days before your hospitalization and 60 days for post hospitalization for related medical expenses

    The next best thing to having a doc in the family

    Health Check-ups

    Health check up undertaken once at the expiry of a block of every four continuous claim free underwriting years

    <
    * For a family health cover product.

    Critical Factors of the Plan

    01
    02
    03
    04
    Not a paisa goes from your own pocket!

    Co-Pay

    10% co-payment of the claim amount has to be made by the insured

    You?re covered for any future medical expenses

    Life long renewable

    Plans are lifelong renewable and covers you for your entire lifetime.

    Get essential cover for existing ailments

    Pre-existing Diseases

    Any pre-existing condition will be covered after a waiting period of 4 year

    Hospital room rent determines your treatment bill

    Room Rent

    Room rent not exceeding 1 % of the Sum Insured or Rs. 5000 /- per day whichever is less.

    *These Features may be included as part of different products and are subject to the insurer's terms & conditions.

    Additional Features of Oriental Health Insurance

    01
    02
    Good health offers multiple rewards

    Wherever family members are covered, a discount of 10% in premium is available.

    The world is your healthcare oyster

    Cashless facility for claim settlement available in network hospital

    *These add-ons may be included as part of different products and are subject to the insurer's terms & conditions.

    Overview

    Oriental Health Insurance Plans

    Oriental Health Insurance Co. Ltd. was founded in 1947. Since its inception it has constantly attracted new and varied customers, which has facilitated its steady growth. Its underwritten premium currently stands at over Rs.7,282 crores.


    It functions as an entirely independent company whose board of members consist of the likes of T.A.Pai, B.D. Pande, K.R.Puri and other prominent personalities, who have achieved considerable levels of success in their respective fields.


    The company is based out of New Delhi and has a pan-India presence. It has over 30 regional offices, in addition to over 1,800 operating offices, serving a rural and urban client-base across India.


    Its operations are not limited to the domestic boundaries of India alone; it has representation in overseas markets like Nepal, Kuwait and Dubai as well.


    With the rising cost of healthcare in India, unfortunate, unpredictable events in the form of illnesses or accidents, can result in a requirement for hospitalisation. This can cause great strain on a person’s finances.


    Oriental Health Insurance Co. brings to its clients the following policies devised to meet the needs of individuals as well as provide affordable healthcare to their families.


    • Individual Mediclaim Health Insurance (for the proposer)
    • Happy Family Floater Policy (for the proposer and his/her family)
    • Oriental Bank Mediclaim Policy (for OBC’s account-holders)
    • PNB - Oriental Royal Mediclaim Insurance Policy (for PNB’s account-holders)
    • Jan Arogya Bima (low cost, low coverage plans for the financially constrained)
    • Nagrik Suraksha Policy
    • Janata Personal Accident Policy
    • HOPE - Health of Privileged Elders

    The salient features of each of the plans are provided below.

    Individual Mediclaim Health Insurance

    This plan takes care of all healthcare-related expenses accrued by the insured during the policy tenure, which usually lasts for 1 year. Policy can be renewed indefinitely, subject to an upper age limit.

    Sum Assured Rs.50,000 to Rs.2 lakhs, in increments of Rs.25,000. Rs.2 lakhs to Rs.5 lakhs, in increments of Rs.50,000.
    Medical screening Required for persons over 45 years (50% of expenses will be reimbursed subject to a limit of 2)% of premiums if the person is accepted as a client).
    Basis Individual
    Expenses Covered Surgeon, Doctor, Anaesthetist, Consultant, Specialist Charges, Anaesthesia, Blood Oxygen, OT, Surgical and Diagnostic equipment, Medicines, Drugs, Dialysis, Radio/Chemotherapy, Prosthetic limbs or devices, Pacemaker, Laboratory Tests, Diagnostic Tests, X-Ray and other vital necessities,Organ donor hospitalisation expenses.
    Room expenses and nursing charges @Rs.5,000 or up to 1% of sum assured, whichever is lower, per day of hospital stay.
    ICU expenses @Rs.10,000 or up to 2% of sum assured, whichever is lower.
    Ambulance charges @ Rs.2,000 or 1% of the sum assured, whichever is lower.
    Day care procedures 25 allowed
    Domiciliary Hospitalisation Treatment, for a period beyond 3 days, provided at home in lieu of hospitalisation due to lack of space at the hospital or inability to transfer the insured person to a hospital.
    Pre-hospitalisation expenses Up to 30 days.
    Post-hospitalisation expenses Up to 60 days.
    Pre-existing diseases After completion of a 4 year waiting period from policy inception.
    Exclusions
    • Pre-existing diseases.
    • Expenses incurred during first 30 days since policy inception, unless due to accident.
    • Pregnancy and childbirth expenses.
    • Treatments such as sinusitis, piles, hernia, hysterectomy, cataract, bronchitis, asthma, psychosomatic or psychiatric disorders etc.
    Benefits Cashless facility, with TPA consent, at network hospitals. Reimbursement of expenses, up to 1% of sum assured, for health checks after every 4 successive claim-free years.

    Happy Family Floater Policy

    As opposed to the individual policy, here the proposer and his/her family, which includes his/her spouse and dependent children, are covered under one plan.Under this, the amount chosen as sum assured is applicable to all members equally i.e. the amount is not per insured member.

    Happy Family Floater Silver Plan
    Sum Assured Rs.1.5 lakhs.
    Co-payment 10%.
    Premiums for Proposer Rs.1,320 to Rs.10,400.
    Premiums for each family member Rs.240 to Rs.7,970.
    Add-On Cover Personal Accident - Rs.60 to Rs.300.
    Medical screening Required for persons above 60 years.
    Discounts 5% discount on premiums if TPA services are not chosen
    Room charges and Nursing Charges Up to 1% of the sum assured for each day of hospitalisation.
    ICU charges Up to 2% of the sum assured for each day of hospitalisation.
    Charges for the following Surgeons, Anaesthetists, Doctors, Consultants, Specialists, Blood, Oxygen, Anaesthesia, Radio/Chemotherapy, Medicines, Drugs, X-Rays, Surgical Equipment, Diagnostic Equipment, Prosthetic limbs and devices, Pacemakers, Dialysis up to sum assured.
    Pre-existing diseases Subject to a 4 year waiting period.
    Treatment expenses for rabid animal bites Up to Rs.5,000 for immunization.
    Domiciliary Treatment 10% of sum assured (overall limit of Rs.25,000).
    Ambulance charges Rs.1,000 per illness (overall limit of Rs.3,000 or 1% of sum assured, whichever is lower).
    Add-on Cover on payment of additional premium Personal Accident cover for sum assured up to Rs.5 lakhs, can include dependents.
    Happy Family Floater Gold Plan
    Sum Assured Rs.6 to Rs.10 lakhs.
    Co-payment Not applicable.
    Premiums for Proposer Rs.7,140 to Rs.23,640.
    Premiums for each family member Rs.1,290 to Rs.18,080.
    Add-On Cover Personal Accident: Rs.120 to Rs.600.
    Discounts 5% discount on premiums if TPA services are not chosen
    Medical screening Required for persons above 60 years.
    Room charges and Nursing Charges Up to 1% of the sum assured for each day of hospitalisation.
    ICU charges Up to 2% of the sum assured for each day of hospitalisation.
    Charges for the following Surgeons, Anaesthetists, Doctors, Consultants, Specialists, Blood, Oxygen, Anaesthesia, Radio/Chemotherapy, Medicines, Drugs, X-Rays, Surgical Equipment, Diagnostic Equipment, Prosthetic limbs and devices, Pacemakers, Dialysis up to sum assured.
    Treatment expenses for rabid animal bites Up to Rs.5,000 for immunization.
    Pre-existing diseases Subject to a 4 year waiting period.
    Domiciliary Treatment 10% of sum assured (overall limit of Rs.25,000).
    Daily cash allowance for hospital stay (maximum 10 day) 0.1% of sum assured, per illness (overall limit of 1.5% of sum assured).
    Attendant Allowance for hospitalisation of children between 3 years to 10 years (maximum 10 days) Rs.500 for each day of hospital stay, per illness (overall limit of 15 days).
    Add-On Cover on payment of additional premium Personal Accident cover for sum assured up to Rs.10 lakhs, can include dependents; Life Hardship cover for survival benefits.

    Oriental Bank Mediclaim Policy

    A health insurance policy extended to the customers (and employees) i.e. account-holders of Oriental Bank of Commerce.

    Basis Family floater plan
    Sum Assured 5 options for sum insured available between Rs.1 lac and Rs.5 lacs, in multiples of Rs.1 lac.
    Premiums Advance payment only
    Benefits Cashless Facility: At network hospitals.
    Renewability Cover is valid for an insured member till 80 years of age.
    Policy Period 1 year.
    Exclusions
    • Waiting periods apply for certain diseases/ailments as per the schedule.
    • Outcomes of war, terrorism and events of similar nature.
    • Ailments of or related to T-cell Lymphotropic Virus Types III or LAV or HIV.
    • Vitamins, tonics, circumcision, vaccinations, sex change or plastic surgery, dental procedures not forming part of admissible treatment.
    • Sight-correction surgery, glasses, contact lens, hearing aids etc.
    • Convalescence, congentinal ailments, fertility treatment, STDs including HIV and related diseases, self-harm, psychiatric treatment, misuse of intoxicants. obesity.
    • Maternity/Delivery/Termination and subsequent related illnesses.
    • Non-allopathic treatment.
    • Injuries from hazardous sports/hobbies.
    • Genetic defects, stem cell procedures.
    • Outpatient treatment.
    Day care procedures Hospitalisation for minimum of 24 hours.
    Room charges and Nurses expenses Up to 1% of the sum assured or Rs.5,000, whichever is less, for each day of hospitalisation.
    ICU charges Up to 2% of the sum assured or Rs.10,000, whichever is less, for each day of hospitalisation.
    Charges for the following Surgeons, Anaesthetists, Doctors, Consultants, Specialists, Blood, Oxygen, Anaesthesia, Radio/Chemotherapy, Medicines, Drugs, X-Rays, Surgical Equipment, Diagnostic Equipment, Prosthetic limbs and devices, Pacemakers, Dialysis up to sum assured, Domiciliary hospitalisation.
    Ambulance charges Lower of 1% of the sum assured or Rs.1,000 per illness.
    Daily cash allowance for hospital stay Actuals limited to Rs.1,000 over the policy term.
    Pre hospitalisation 30 days
    Post hospitalisation 60 days
    Funeral Expenses Actuals limited to Rs.1,000 over the policy term.
    Pre-existing conditions Subject to a waiting period of 3 years.

    PNB - Oriental Royal Mediclaim Insurance Policy

    Entry Age 79 years.
    Maximum renewability age Coverage is provided until the insured completes 80 years.
    Benefits Cashless claims
    Policy Period 1 year.
    Room charges and Nurses expenses up to 1% of the sum assured for each day of hospitalisation.
    ICU charges up to 2% of the sum assured for each day of hospitalisation.
    Charges for the following Surgeons, Anaesthetists, Doctors, Consultants, Specialists, Blood, Oxygen, Anaesthesia, Radio/Chemotherapy, Medicines, Drugs, X-Rays, Surgical Equipment, Diagnostic Equipment, Prosthetic limbs and devices, Pacemakers, Dialysis up to sum assured.
    Ambulance charges on basis of actuals or Rs.1,000 or 1% of the sum assured, whichever is lower.
    Pre-hospitalisation expenses 30 days
    Post-hospitalisation expenses Up to 60 days.
    Daycare treatment Subject to conditions
    Pre-existing conditions Subject to a waiting period of 3 years.
    Exclusions
    • Cover is effective for a certain number of treatments only after a certain period from policy inception.
    • Injuries/ailments resulting from war, terrorism and events of similar nature.
    • Vitamins, tonics, circumcision, vaccinations, cosmetic surgery including change of life, dental procedures not forming part of admissible treatment.
    • Sight-correction surgery, glasses, contact lens, hearing aids etc.
    • General enervation, STDs , HIV , AIDS, HTLD-III, LAV and similar diseases, psychiatric treatment, misuse of intoxicants, obesity.
    • Pregnancy/termination and consequential ailments; reproductive-assistance treatment.
    • Non-allopathic treatment.
    • Self-harm or injuries resulting from involvement in dangerous activities.
    • Birth defects/genetic defects
    • Treatment availed as an outpatient.

    Jan Arogya Bima

    This plan aimed to enable the poorer sections of the society get health insurance cover, this plan offers good sum insured at very low premium payments

    Entry Age 5 years to 70 years; Children – 3 months to 5 years; subject to at least one parent being covered under this plan.
    Sum Assured Rs.5,000 p.a
    Sub-limits None
    Premium Rs.70 upwards (men); Rs.50 upwards (women); Rs.50 (per dependent below 25 years).
    Covers
    • Inpatient hospitalisation.
    • Domiciliary hospitalisation.
    • Expenses of treatment for covered events/ailments/injuries.
    • Pre-hospitalisation up to 30 days.
    • Post-hospitalisation up to 60 days.

    Nagrik Suraksha Policy

    This policy can be for individuals, offering cover for family members and it can also be availed for groups. The basic features of these plans are listed below

    Basis Individual (covers dependents and family members) and Group
    Eligibility For family – 5 to 70 Years; Individual or Group packages – 18 to 70 Years
    Coverage Under individual policy, family members can be opted for cover as well. Group policy can cover many employees
    Policy term For a group, the policy term will be 1 year, while for individuals, it will be within 1 year to 4 years
    Renewability Renewable every year subject to age limits
    Sum Insured Could be from INR 1 lakh to INR 5 lakhs
    Benefits
    • 40% to 100% of Personal Accident Benefit in cases of Partial or Total Disability
    • Cumulative Bonus
    • Funeral or Burial Charges
    • Education Fund Support for children of Insured
    • Remuneration of Hospitalization expenses
    Exclusions
    • Illness due to HIV/AIDS
    • Death or disablement resulting from venereal disease or insanity
    • Death or disability resulting from pregnancy or childbirth, etc.
    • Committing any breach of law with criminal intent
    • Whilst engaging in aviation or while mounting into, dismounting from or travelling in any aircraft

    Janata Personal Accident Policy

    A unique insurance plan that covers personal accident insurance and provides for death and disability benefits for an individual

    Eligibility age 10 – 80 Years
    Basis Individual
    Policy term The policy is valid for one year and can be renewed till the time the age limits acceptable by the company are in force
    Renewability Renewable every year subject to age limits
    Sum Insured Could be from INR 25000 to INR 5 lakhs
    Benefits 50% to 100% of Sum Insured in cases of Partial or Total Disability or Death
    Exclusions
    • Any existing disability
    • Death injury or disablement due to intentional self-injuries, suicide or attempted suicide
    • Disablement or death under influence of liquor or drug
    • Death or disablement during racing, shooting, big game hunting, mountaineering, ice hockey, winter sports and/or the like
    • Insanity
    • Breach of law with criminal intention
    • War group of perils
    • Nuclear group of perils

    HOPE - Health of Privileged Elders

    Oriental Insurance HOPE - Health of Privileged Elders, is a health insurance policy designed for senior citizens above the age of 60. The policy offers a wide range of cover including specified diseases.

    Entry age Any individual of the age 60 years and above
    Basis Individual policy
    Policy period The minimum and maximum policy term for the policy is 1 year
    Renewability The policy can be renewed after 1 year if needed
    Medicals Not required
    Sum Insured Ranges from Rs.1,00,000 to Rs.5,00,000
    Discount
    • The policy offers discount on premium depending on the co-pay opted
    • For co-payment of 10%: 10% discount on premium
    • For co-payment of 20%: 20% discount on premium
    • For co-payment of 30%: 30% discount on the premium
    • For co-payment of 40%: 40% discount on the premium
    • For co-payment of 50% and above: 50% discount on the premium
    Co-payments The plan comes with a compulsory co-payment of 20%
    Coverage offered
    • The policy covers only the specified diseases / illness / injury and there is a maximum liability in respect of each disease - Accidental injury, Knee replacement, Cancer, Stroke, Cardiovascular diseases, Orthopedic diseases, Benign prostate, Ophthalmic (Eye) diseases, Chronic obstructive lung disease, Hepatobiliary disorders, Chronic renal failure
    • Hospital room, boarding and nursing expenses and ICU charges
    • Emergency ambulance charges
    • Doctor, surgeon, anesthetist, consultant or specialists fees
    • Cost of anesthesia, blood, oxygen, operation theatre charges, surgical appliances
    • Cost of medicines, drugs and consumables
    • Cost of artificial limbs, prosthetic devices like pacemaker
    • Cost of diagnostic tests like X-ray

    Oriental Health Insurance FAQs

    1. How much insurance cover do I need?
    2. Your insurance coverage depends upon a number of factors like age, way of life, city of residence, yearly income etc.


    3. What is the ideal age to get health insurance?
    4. A health insurance should be availed as soon as possible so as to avoid any medical emergency that may arise anytime and anywhere. Health Insurance takes care of hefty expenses that are made in case a sudden serious medical mishap strikes.


    5. What is meant by Family Package cover?
    6. Family Package cover refers to the family floater plan that covers the insurance needs of the full family namely, self, spouse, parents, children and parent-in-laws.


    7. What are the benefits of Family Package Gold scheme over the Silver Plan?
    8. Gold scheme has the following major benefits –

      • Daily Hospital Cash
      • Attendant Allowance for children aged between 3 months to 10 years

    9. Are there any sub-plans in the Family Welfare Package?
    10. Yes. The Family Welfare Package is available in two sub-plans namely, Plan Silver and Plan Gold.


    11. I have a Health Insurance scheme from my Employer, do I still need a personal Health Insurance policy?
    12. Yes. Your Employer-provided policy is usually non-transferrable, so it might be difficult when you change your job. Medical records too are maintained more proficiently in case a single health insurance policy is availed and then continued. Hence, it is advisable to have a private policy too in addition with the insurance scheme offered by your company.


    13. Is maternity/pregnancy covered as a part of Oriental Health Insurance Schemes?
    14. No. However, company provided group insurance schemes generally cover maternity expenses too.


    15. Will get any tax benefit on Oriental Health Insurance schemes?
    16. Yes. Tax exemption is available under section 80D of the Income Tax Act.


    17. What is the minimum entry age of Oriental Health Insurance Policy?
    18. The minimum age is 91 days.


    19. Can the sum-insured be changed?
    20. Yes. It can be changed on policy renewal at the end of annual terms.


    21. What is the maximum age of an applicant?
    22. Upper limit for the age of applicant for health insurance is 80 years.


    23. What are the documents required for applying for Oriental Health Insurance?
    24. A few basic documents like age proof, ID proof and residence proof. In some cases, a medical examination too may be required.


    25. Can I avail cashless hospitalization facility with this insurance?
    26. Yes. Cashless facility for claim settlement is available in various major hospitals of the nation.


    27. What is the range of sum insured that I can choose from?
    28. Sum insured varies between Rs.50000 to Rs.500000


    Examples of Network Hospitals in Major Cities

    CITY NAME OF HOSPITAL
    DELHI DHARAMSHILA CANCER HOSPITAL AND RESEARCH CENTRE
    MUMBAI ARYAN MEDICAL HOSPITAL AND ICU
    KOLKATA ADVANCE MEDICARE & RESEARCH INSTITUTE LTD
    BANGALORE APOLLO HOSPITAL
    CHENNAI AMMA HOSPITAL

    *Disclaimer - This is not an exhaustive list but an indicative representation of hospitals that form a part of the company's wider network.


    News About Oriental Health Insurance

    • Hike on Oriental Health Insurance Premium

      The state owned insurer Oriental Health Insurance has reportedly increased the rates of premium for its health insurance plans by 40%. The sudden spike in rates has incurred complaints from policyholders who own individual and family floater plans.

      People who haven’t made any claims over the past year have also encountered such hikes in the premium rates. The complaints have been reportedly more from policyholders who are in the senior citizen age group. The Insurance Regulatory and Development Authority of India allows revision of premium rates every three years and Oriental Insurance hasn’t been doing any such updates since 2009.

      The deferred rate changes have been brought in after careful calculation and adjusting of anomalies as per the insurer. The average increase of premium across insurers has been 25% per year as allowed by IRDAI. Compared to that, the 40% increase that has happened for Oriental Insurance is pretty standard as per the company. There were a few loopholes in the existing policy terminology which were being taken advantage of by policyholders who had floater policies active. Those loopholes have been sealed and now the insurer has a single premium table for all the members under a floater policy.

      15th April 2015

    • Qatar to have an Oriental Insurance Office!

      The public sector insurance player Oriental Insurance will soon be opening a new office in Qatar. As part of its overseas expansion plan, the insurance company has already opened offices in Dubai, Kuwait and Nepal.


      The company opened as many as 598 new branches all over the country in the year 2013-14, which is an exceptional achievement since almost all private players have been closing down many of their offices in the country.


      Private insurance players do not get much traction in small cities and as such public companies shoulder the responsibility of popularizing risk coverage and fulfilling insurance needs of the people. According to IRDA, Insurance Regulatory and Development Authority of India, around 700 insurance offices were shut down during the year 2013-14 while the number of new offices was just 150.


      28th January 2015

  • reTH65gcmBgCJ7k
    This Page is BLOCKED as it is using Iframes.