Overview of 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.
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Oriental Health Insurance Plans
Oriental health insurance plans can be purchased to obtain financial protection against a variety of medical adversities. Check out a list of health plans offered by the Oriental Insurance Company below:
*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply.
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Oriental Health Insurance Plans in Detail:
Oriental Happy Family Floater Plan
The Oriental Happy Family Floater policy has been designed to cover the medical expenses of the whole family. The plan comes with a sum insured amount ranging from Rs 1 lakh to Rs 50 lakh and is available in three types – Silver, Gold, Diamond and Platinum.
Features & 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
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Oriental Mediclaim Insurance Plan (Individual)
The Oriental Mediclaim Insurance plan covers an individual for medical expenses incurred for the treatment of an injury or illness. It is available for a sum insured amount ranging from Rs 1 lakh to Rs 10 lakh.
Features & 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
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Oriental Super Health Top-Up Plan
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. While the sum insured ranges from Rs 3 lakh to Rs 30 lakh, the deductible amount varies from Rs 3 lakh to Rs 20 lakh.
Features & 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
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Oriental Health of Privileged Elders Plan
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. The sum insured options under this plan ranges from Rs 1 lakh to Rs 5 lakh.
Features & 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
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Oriental Dengue Kavach Plan
The Oriental Dengue Kavach plan is a customized plan designed to cover the treatment cost of dengue fever. The plan is available for a sum insured of Rs 10,000 and Rs 20,000.
Features & 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
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Oriental Critical Illness Plan
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. The sum insured ranges from Rs 2 lakh to Rs 50 lakh under this plan.
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
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Oriental Cancer Protect Plan
Oriental Cancer Protect is a customized health plan designed to provide financial assistance for the treatment of cancer. The plan comes with a sum insured amount ranging from Rs 5 lakh to Rs 50 lakh.
Features & 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
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Oriental Happy Cash Plan – Nischint Rahein
The Oriental Happy Cash plan provides a daily cash benefit to the policyholder for each day of hospitalization. The plan offers a sum insured amount ranging from Rs 500 to Rs 3000 per day.
Features & 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
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Why Should You Buy Oriental Health Insurance Plans?
Check out some of the reasons why you should buy an Oriental health insurance plan:
- No Pre-Acceptance Medical Screening – Most Oriental health insurance plans do not require customers to undergo medical screening for up to 55 years before buying the policy.
- Free Health Check-up Facilities – Policyholders can avail free health check-up facilities under multiple health plans offered by the insurance company.
- Good Customer Team – The Oriental Insurance Company has a hands-on customer support team that efficiently answers all the queries of the customers.
- Tax Benefits – Customers can avail tax benefits on the premium of their Oriental health insurance policies under Section 80D of the Income Tax Act.
How to File a Claim with an Oriental Health Insurance Plan?
Take a look at the steps to file a cashless claim under the Oriental health insurance policy:
1
Inform the Insurance Company
Go to the TPA desk at the network hospital for claim intimation
2
Display Your Documents
Submit all the KYC and claim-related documents at the desk
3
Request for Pre-authorization
The TPA will send a pre-authorization request to the Oriental Insurance Company
4
Get Cashless Treatment Approval
After verifying the documents, the insurer will approve your cashless claim request
5
Claim Settlement
Once the treatment is complete, the insurer will pay the claim amount directly to the network hospital
In case of reimbursement claims, pay the hospital bill in full at the time of getting discharged and submit all the required documents to the insurance company. On receiving the documents, the insurer will verify them and will accordingly pay you the claim amount.
Documents Required for Oriental Health Insurance Claim
Submit the following documents to raise a reimbursement claim under Oriental health insurance:
- Copy Oriental health insurance policy
- Copy of claim intimation letter
- Duly filled claim form
- Copy premium receipt
- Hospital discharge report/ medical treatment report
- Medical recovery report
- Original test reports, such as X-ray, MRI, ECG, etc.
- Doctor’s prescriptions
- Original medical bills and cash memo receipts
- Police panchnama/ FIR (in case of accidents)
- Hospital/ nursing home’s registration number
- Leave certificate from the employer
Oriental Health Insurance Network Hospitals
All Oriental health insurance plans allow the policyholders to avail cashless hospitalization benefits at any of the network hospitals of the insurance company. Check out the city-wise list of network hospitals of the Oriental Insurance Company below:
How to Buy Oriental Health Insurance Plans?
The process of buying an Oriental health insurance policy online is given below:
Step 1: Visit the official website of Policybazaar Insurance Brokers Private Limited
Step 2: Click on the ‘Health Insurance’ icon and select the people to be insured
Step 3: Enter your age and other details like city, name, phone number, etc.
Step 4: Select if you have any pre-existing disease or medical history
Step 5: Choose the Oriental health insurance plan to be purchased
Step 6: Cross-check all the details and pay the premium online
Step 7: The insurer will issue the policy within a few minutes.
How to Renew Oriental Health Insurance Plans?
Take a look at the steps for Oriental Health Insurance renewal below:
Step 1: Go to Policybzaar.com and click on ‘Renew Your Policy’ at the top of the page
Step 2: Select ‘Health Renewal’ from the dropdown menu
Step 3: Enter your mobile number and the OTP to log in to your account
Step 4: If you are new to Policybazaar, you can click on the ‘Health Insurance’ icon
Step 5: Provide the required details to get the renewal quotes
Step 6: Choose the Oriental health insurance plan to be renewed and pay the premium
Step 7: Your health policy will be renewed on successful payment
How to Calculate Oriental Health Insurance Premium?
The Oriental health insurance premium can be calculated by entering basic details like the city, the desired sum insured, policy tenure, etc. in a premium calculator tool. Given below is the Oriental health insurance premium calculator that you can use to calculate the premium of your policy.
Contact Details of Oriental Health Insurance
Check out the contact details for Oriental 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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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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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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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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Ans: You can use an Oriental health insurance premium calculator online to check the premium of a health policy. You can also check the Oriental health insurance premium chart to check the premium rates.
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Ans: Yes. All Oriental health insurance plans offer cashless facilities at the network hospitals of the insurance company.
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