Oriental Individual Mediclaim Insurance

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Oriental Individual Mediclaim Insurance Overview

Mediclaim Insurance takes care of medical expenses following Hospitalisation/Domiciliary Hospitalisation of the Insured in case of in case of a sudden illness/accident or any surgery.

Eligibility Criteria For Oriental Mediclaim Insurance

  • Minimum age- 18, maximum- 80 years for treatment taken in India.

Oriental Mediclaim Insurance Policy at a glance

  • The sum insured available ranges from Rs.50000/- to Rs.500000/-
  • Policy can be for individual or family members (discount of 10% in premium).
  • Early entry Discount: If a person takes the Policy before reaching the age of 45 years and has renewed itcontinuously then for each renewal 5% discount up to a maximum of 25% will be given till 55 years of age.
  • Free look period: 15 days is allowed for reviewing the policy from the date of receipt.
  • The premium under the policy is eligible for Income Tax benefit under section 80D.

Benefits of Oriental Mediclaim Insurance Policy

  • Inpatient hospitalization expenses are covered.
  • Pre-existing diseases are covered from the fifth year if the policy is maintained on a continuous basis.
  • Cost of Health Check-up: Expenses up to 1% of the average sum insured is covered.
  • Cashless facility for claim settlement in network hospitals.
  • Pre acceptance medical examination is not required if the insured is below 45 years of age. 50% cost is borne in case of a fresh proposal.
  • Ambulance services - 1% of the sum insured or Rs 2000/- whichever is less. Room and Nursing expenses up to a maximum of 1 % of the Sum Insured or Rs. 5000 /- per day whichever is less.
  • I.C. U expenses up to 2% of the Sum Insured or Rs. 10,000 /- per day whichever is less.

Documents required for Oriental Mediclaim Insurance Policy

  • Complete Proposal form and enrolment form in duplicate.
  • Coloured stamp size photograph.

Premium Details of Oriental Mediclaim Insurance Policy

SUM   3m-            
INSURED DOMICILLIARY 20 21-35 36-45 46-55 56-60 61-70 above70
50000 10000 609 677 809 1265 1799 2688 3600
75000 15000 883 981 1174 1836 2604 3886 5203
100000 20000 1179 1310 1566 2447 3483 5196 6960
125000 23750 1454 1615 1932 3026 4310 6436 8683
150000 27500 1728 1920 2295 3605 5136 7676 10405
175000 31250 1975 2194 2623 4142 5912 8846 12040
200000 35000 2221 2468 2951 4680 6687 10018 13678
250000 40000 2660 2956 3534 5672 8133 12222 16778
300000 45000 3100 3444 4117 6664 9581 14428 19878
350000 50000 3483 3870 4627 7573 10925 16494 22805
400000 50000 3867 4297 5138 8483 12267 18562 25735
450000 50000 4252 4724 5647 9392 13611 20628 28663
500000 50000 4635 5150 6157 10302 14955 22696 31590

 

How to cancel Oriental Mediclaim Insurance Policy

Misrepresentation, fraud, moral hazard or non-cooperation on behalf of the insured might lead to cancellation of policy making way for appropriate refund.

In such cases a notice period of 30 days is provided.

Period on risk Rate of Premium to be retained by the insurer
Up to 1 month 1/4th of annual premium
Up to 3 month 1/2 of annual premium
Up to 6 month 3/4th of annual premium
Exceeding 6 months Full annual premium

 

*The above rates may vary. Please check the policy wordings for more details.

Exclusions in Oriental Mediclaim Insurance Policy

  • All treatments within the first 30 days of cover excluding accidental injury.
  • Pre-existing condition is covered after a waiting period of a maximum of 4 years.
  • Expenses arising from HIV or AIDS and related diseases/Congenital diseases/Genetic disorders, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Hospitalization due to war/related situations.
  • Pregnancy, dental treatment, external aids and appliances.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens.