Oriental Health Insurance FAQs

You need to stay for at least 24 hours in the hospital to be eligible for a claim. Only for a few daycare procedures and treatments as mentioned in the policy document, you can claim for the hospitalisation less than 24 hours.

You should intimate Oriental Insurance Company as soon as you get hospitalised, either it is an emergency or a planned admission.

Here are the listed documents that you need to produce before the insurer for claim settlement:

• Duly filled claim form
• Diagnosis and test reports
• Doctor’s reports and consultation notes
• Medical recovery report
• Pharmacy bills with the prescription
• Nature of operation performed
• Surgeon's bills and receipts
• Final hospital discharge summary
• A valid photo ID proof

If any other document is needed, the insurer can ask you to bring them.

To seek details about the claim settlement procedure of the Oriental Insurance Company, you can connect with our team at 7551-196-989.

Here is the list of critical illnesses which are covered by the Oriental Insurance Company:

• Cancer of specific severity
• First heart attack of specific severity
• Open chest CABG
• Open heart replacement or repair of heart valves
• Coma of specific severity
• Kidney failure requiring regular dialysis
• Stroke resulting in permanent symptoms
• Major organ or bone marrow transplant
• Permanent paralysis of limbs
• Motor neuron disease with permanent symptoms
• Multiple sclerosis with persistent symptoms

The Oriental Insurance Company offers the coverage for 11 listed critical illnesses defined under the Happy Family Floater Policy

The sum insured of the Happy Family Floater Policy ranges between Rs. 2 lakh and Rs. 20 lakh.

People who fall between the age group of 91 days to 70 years are eligible for the coverage for critical illness under family floater plan.

The family floater plan of Oriental Insurance Company covers legally wedded spouse, children (i.e. natural or legally adopted) between the age of 91 days to 18 years, dependent children up to 25 years (girl until she gets married, divorced and widowed daughter), parents, and parents-in-law.

Yes, family floater plan of Oriental Insurance Firm, which is known as Happy Family Floater Policy owns 3 variants such as Silver, Gold and Diamond.

Here are the sum insured amount of different variants under the family floater policy offered by Oriental Insurance:

• Silver - Rs. 1 lakh, Rs. 2 lakh, Rs. 3 lakh, Rs. 4 lakh, and Rs. 5 lakh
• Gold - Rs. 6 lakh, Rs. 7 lakh, Rs. 8 lakh, Rs. 9 lakh, and Rs. 10 lakh
• Diamond - Rs. 12 lakh, Rs. 15 lakh, Rs. 18 lakh, and Rs. 20 lakh

Yes, the Oriental Insurance Company offers coverage for the expenses of pre-hospitalisation and post-hospitalisation for 30 and 60 days, respectively.

The limit of coverage for the room, boarding, and nursing expenses are segregated under different variants, which are as follows:

• Silver Plan - A coverage of 1% of the Sum Insured per day is offered
• Gold Plan - A coverage of 1% of the Sum Insured per day is offered
• Diamond Plan - A coverage of Rs. 10,000 + 0.5% of the sum insured above Rs. 10 lakh per day is offered

Yes, Oriental Insurance Company provides discounts to the policyholders based on the plan you have bought.

The requirement for pre-policy medical checkup varies from plan-to-plan and variant-to-variant. For e.g. if you are purchasing a family floater plan then under its Silver and Gold variant the pre-policy checkup is required for persons aged 60 years and above whereas under its Diamond variant the pre-policy medical check is required for persons aged 55 years and above.

The toll-free number of Oriental Insurance Company is 1800-118-485.

Oriental Insurance Company helps policyholders live a healthier and successful lifestyle. Backed by 4,300+ leading hospitals in its network, dedicated TPA service and 30+ offices in India and abroad (Nepal, Kuwait, and Dubai), Oriental Insurance lets you have cashless treatment in network hospitals, an array of sum insured options, excellent discounts and loading options, etc. The company also offers comprehensive cover, maternity benefits, international coverage, critical illness cover, top-up plan, lifetime renewal, and many other benefits. Therefore, owning a plan of Oriental Insurance Firm is an ideal option to go with.

Oriental Insurance provides the sum insured option starting from Rs. 1 lakh to Rs. 10 lakh under its individual plan.

Yes, a 30-day grace period is available under the individual policy of Oriental Insurance Firm, on the occurrence of a delay in the policy renewal. However, no coverage shall be available during the grace period, and any disease/injury contracted during the break period shall not be covered and shall be treated as a pre-existing disease.

Yes, the cost of health check-up can be undertaken once at the expiry of a block of every 3 continuous claim-free years. The amount reimbursable will not be exceeding the amount equal to 0.75% of the average sum insured (SI for Personal Accident section is not to be considered), or Rs. 3000 per insured person, whichever is less, during the block of 3 continuous claim-free underwriting years. This benefit is available to the insured person after three claim-free years, till the expiry of the fourth year of the policy. If the benefit is not claimed in the fourth year of the policy, then in the future whenever the insured claims this benefit then the last three claim-free years preceding the year in which the benefit is claimed shall be taken into consideration.

Yes, Oriental Insurance provides the coverage for a newborn baby under the Diamond variant of Happy Family Floater Policy.

The entry age of dependant kids under Oriental Insurance plans ranges between 3 months to 18 years. However, the male children are eligible to get the coverage up to the age of 25 years if he is financially dependent on the proposer or is a bonafide regular student. Female children are eligible to get the coverage until she gets married. In addition to this, divorced and widowed daughters are also eligible for coverage under the policy, irrespective of their age, provided they are financially dependent on the proposer. But, if any child above the age of 18 years is financially independent or if any girl child is married, he or she shall not be eligible for coverage in the subsequent renewals.

Oriental Insurance offers an automatic cover for maternity expenses up to 2.5% of the sum insured.

Yes, the Diamond plan of Happy Family Floater Policy by Oriental Insurance offers the coverage for newborn baby hospitalisation expenses with maternity cover. Newborn baby shall be covered from day one up to the age of 90 days and expenses incurred for treatment taken in the hospital as an inpatient shall be limited to 2.5% of the sum insured amount.

Yes, Oriental Insurance provides the domiciliary hospitalisation option for your parents under its family floater policy.

Yes, when you purchase the health insurance policy for your parents from Oriental Insurance, you become eligible for tax benefits under Section 80D of the Income Tax Act.

Yes, medical expenses incurred 30 days prior to hospitalisation, and up to 60 days post-hospitalisation are covered by the Oriental Insurance Firm.

Yes, Oriental Insurance Company gives the coverage for a medical second opinion on specified major illnesses from up to Rs. 5,000 to Rs. 10,000, depending upon the variant you have chosen.

If you want to port into Oriental Insurance from any other insurer, you must apply with details of the health insurance plan and claims to us, at least 45 days before the date of expiry of the policy.

No, you can apply to avail the portability feature only at the time of renewal and not any other time.

Factors that determine the value of the premium of Oriental Health Insurance plans are as follows:

a) Gender
b) Sum insured
c) Policy term
d) Age of insured
e) Number of members
f) Medical history

Yes, Oriental health insurance firm provides different types of discounts to its customers such as:

A) Voluntary co-payment discount where insured may opt to bear a part of the claim amount for which different discounts are applicable, subject to a maximum of 50%.
B) The insured shall be eligible for No-Claim Discount at the rate of 5% of the renewal premium payable after every claim-free policy year, subject to a maximum of 20%, provided the policy is renewed without any break.

Yes, you’ll get the payment acknowledgement from the insurer at your registered email id. This acknowledgement serves as proof of the premium paid.

You can pay the premium of Oriental Health Insurance plans through different payment modes such as cash, cheque, credit or debit cards or through digital payment gateways.

Yes, Oriental Insurance Company provides a health insurance policy for senior citizens.

Rs. 50,000 is the highest premium amount up to which senior citizens are waived off from tax.

To avail the tax benefit on the premium of Oriental health plans, the customers are required to pay their premium through any mode other than cash.

Rs. 50,000 is the highest premium amount up to which senior citizens are waived off from tax.

The sum insured amount of Oriental Super Health Top-up Plan ranges between Rs. 3 lakh and Rs. 30 lakh.

The deductible amount ranges from Rs. 3 lakh and Rs. 20 lakh under Oriental Super Health Top-up Plan.

Yes, the Diamond Plan of Happy Family Floater Policy offers the coverage for newborn baby hospitalisation expenses with maternity expenses to its women customers.

Yes, women are provided with the feature of organ donor benefit under the Happy Family Floater Policy of Oriental Insurance.