Oriental offers two types of claim settlements – cashless and reimbursement. Follow the steps to raise a claim:
- Find the nearest network hospital of Oriental
- Get admitted to the hospital
- Notify the insurance company about the hospitalization
- In case of pre-planned hospitalization, intimate the insurer before hospital admission.
- Fill up the pre-authorization form and submit it to the hospital staff
- The pre-authorization form will be sent to Oriental for approval.
- Once approved, obtain medical treatment.
- At the time of discharge, sign all the medical documents.
- Pay for the items/services not covered under the Oriental policy
- The network hospital will send the hospital bill to Oriental.
- After review, the insurance company will pay the bill amount directly to the network hospital.
- Intimate Oriental about the hospitalization
- In case of planned hospitalization, inform the insurance provider before hospital admission.
- Obtain medical treatment
- During discharge, pay the hospital bill in full.
- Collect all the medical documents, hospital bills and receipts
Our Claim specialists in below cities will reach your hospital or home in 30 minutes to support your health insurance claim
About Oriental Health Insurance
Oriental health insurance plans are offered by the Oriental Insurance Company. The company started its operations in September 1947 as a subsidiary of the Oriental Government Security Life Assurance Company but was later transferred to the central government in 2003.
The Oriental Insurance Company also offers specific health insurance plans for diseases like dengue, cancer, critical illness and COVID-19. Moreover, the company has earned an incurred claim ratio of 139.86% in the financial year 2021-22.
Types of Oriental Insurance Plans
The Oriental Happy Family Floater policy has been designed to cover the medical expenses of the whole family. The plan is available in three types – Silver, Gold, Diamond and Platinum.
Features and Benefits:
- Coverage for in-patient, pre-hospitalization and post-hospitalization are available
- Costs of maternity expenses, newborn baby expenses and assisted reproduction techniques are covered
- Coverage for mental illness and HIV/ AIDS are also available
- Costs of medical second opinions and teleconsultations are covered
- OPD benefit, critical illness cover and accidental death & disability are covered under the Platinum plan
- No pre-acceptance medical check-up is required for up to 55 years
The Oriental Mediclaim Insurance plan covers an individual for medical expenses incurred for the treatment of an injury or illness.
Features and Benefits:
- Costs of hospitalization, domiciliary treatment and AYUSH treatment are covered
- Coverage for telemedicine expenses and mental illnesses is available
- Both pre-hospitalization and post-hospitalization expenses are covered
- No pre-acceptance medical check is required for up to 55 years
- Free health check-up facility is available after every three claim-free years
- Personal accident cover is available as an add-on cover
The Oriental Super Health Top-Up plan provides medical coverage to the insured in addition to the base policy and comes with a mandatory deductible.
Features and Benefits:
- Both in-patient hospitalization and day care procedures are covered
- Coverage for modern treatments and mental illnesses are available
- Maternity expenses and the newborn baby cover are also covered
- Organ donor expenses as well as the organ donor benefit are available
- No pre-acceptance medical check-up is required up to 55 years
The Oriental Health of Privileged Elders (HOPE) plan has been tailor-made to suit the health needs of senior citizens of age 60 years and above.
Features and Benefits:
- Coverage for in-patient, pre-hospitalization and post-hospitalization expenses are available
- Costs of in-patient AYUSH treatment and domiciliary hospitalization are covered
- Coverage for specified diseases, such as knee replacement, cancer, stroke, etc. are covered
- Ambulance expenses and telemedicine expenses are also covered
- Free health check-up benefit available after every four claim-free years
- 20% co-payment is applicable on all claims
The Oriental Dengue Kavach plan is a customized plan designed to cover the treatment cost of dengue fever.
Features and Benefits:
- Lump sum benefit is paid on the first diagnosis of dengue fever
- No sub-limits or co-payment is applied
- No pre-policy medical check-up is required
- Sum insured enhancement after every claim-free year
The Oriental Critical Illness plan has been specially designed to cover the treatment cost of up to 22 critical diseases, including kidney failure, cancer, stroke, etc.
Features & Benefits:
- Lump sum benefit is paid on the diagnosis of the critical disease
- Cost of a medical second opinion is also covered
- No pre-acceptance medical check-up is required for up to 45 years
- Sum insured can be enhanced at every two claim-free year
- A survival benefit of 30 days is also applicable
Oriental Cancer Protect is a customized health plan designed to provide financial assistance for the treatment of cancer.
Features and Benefits:
- Coverage for in-patient, OPD and day care treatment of cancer are available
- Cost of hospitalization and emergency medical evacuation are covered
- Lump sum amount of up to 50% of the sum insured is paid on the first diagnosis of cancer
- Both road ambulance and air ambulance costs are covered
- No pre-policy medical check-up is required
- 5% cumulative bonus for up to 50% is granted at every claim-free year
- Sum insured enhancement after every 3 claim-free years
The Oriental Happy Cash plan provides a daily cash benefit to the policyholder for each day of hospitalization.
Features and Benefits:
- Hospitalization benefit as well as convalescence benefit are available
- 25% additional daily cash benefit is granted to women
- Both in-patient and AYUSH treatment is covered
- No pre-acceptance medical check-up is required
Key Benefits of Oriental Health Insurance
or select from popular citiess In case of emergency we are just a call away. Take care of your family, we will do the rest. Our claim specialists will reach your location & complete the formalties from filing the claim to documentation to coordinating with insurer, TPA & hospital. Available in New Delhi and 114+ cities View cities list ›Search Oriental Cashless Network Hospital list
Policybazaar Claim Process
Here is the list of documents required to file a Oriental Health Insurance claim:
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Claim FormDuly filled and signed Oriental Health Insurance claim form
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Health Card/Policy CopyHealth card or a copy of Oriental Health Insurance policy
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Medical DocumentsHospital discharge card, doctor’s prescriptions, test reports, etc.
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Medical Bills & Payment ReceiptsAll medical bills, including hospital bills and pharmacy bills, along with payment receipts
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KYC DocumentsKYC documents to be submitted for claims above ₹1 lakh
Note: The exact list of claim documents varies from case to case. Contact the customer support team for the complete list.
The process to buy a Oriental Health Insurance plan is given below:
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Visit the Health Insurance SectionGo to the ‘Health insurance’ section on Policybazaar.com
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Fill in Personal DetailsProvide necessary details like age, mobile number, city, medical history, gender, etc.
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Pay the Premium OnlineChoose your preferred Oriental Health Insurance policy and pay the premium online
The process to renew a Oriental Health Insurance plan is given below:
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Go to the Renewal SectionNavigate to the ‘Renew Your Policy’ tab on Policybazaar.com and select ‘Health Renewal’
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Verify Your IdentityEnter your registered mobile number and the OTP sent to your device
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Pay the Renewal Premium OnlineSelect the Oriental Health Insurance policy you want to renew and pay the premium online
Here are the contact details of Oriental Health Insurance Company:
| Categories | Contact Details |
|---|---|
| Toll-free No | 1800-11-8485 |
| Phone No | 011 3320 8485 |
| Email Id | csd@orientalinsurance.co.in portal.refunds@orientalinsurance.co.in (for refunds) |
Oriental Health Insurance: FAQs
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Q1. What is the waiting period for Oriental Health Insurance?
Ans: The Oriental health insurance plans come with the following waiting periods:
- Initial waiting period – 30 days
- Pre-existing diseases waiting period – 4 years
- Specific diseases/ procedures waiting period – 1 year to 4 years (depending on the disease)
- Critical illness waiting period – 75 days
- Maternity expenses waiting period – 2 years
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Q2. Is Oriental mediclaim good?
Ans: The Oriental mediclaim policy is considered good because it covers a wide range of medical expenses, including in-patient hospitalization, mental illnesses, telemedicine expenses, ambulance charges, domiciliary hospitalization and AYUSH treatment. Besides, the company has an impressive claim settlement ratio.
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Q3. Does Oriental insurance cover pregnancy?
Ans: Yes. The Oriental health insurance policy offers coverage for pregnancy expenses under the Happy Family Floater and the Super Top-Up Insurance plans.
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Q. What is the advantage of selecting a policy with a duration of more than 1 year?
Ans: If one buys Aditya Birla Health Insurance for more than a year, one can save 7.5 % and 10% on the 2 and 3 years premium, respectively.
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Q. How is an Individual cover different from a Floater cover?
Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Q. How is an Individual cover different from a Floater cover?
Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Q. What is a waiver of a mandatory co-pay cover?
Ans: This benefit is covered on payment of an additional premium. Therefore, any mandatory co-payment that is applicable under the Aditya Birla Activ Health Essential Plan will be waived off.
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