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About Oriental Health Insurance

The Oriental Insurance Company Limited was formed in the year 1947 as a fully owned subsidiary of The Oriental Government Security Life Assurance Company Limited. Thereafter, from the year 1956 to the year 1973, the company operated as a subsidiary of the Life Insurance Corporation of India. Finally, in the year 2003,the company’s shares were transferred to the Indian Government and as of today the Government of India owns and controls the operations of Oriental Insurance.


Oriental Insurance is among one of the four public sector general insurance companies in India in the general insurance segment. The company offers general insurance policies for individuals as well as corporates. Oriental Insurance has a range of general insurance products to protect you against possible financial contingencies. Health insurance is one such product offered by the company.

Oriental Claim Settlement Ratio

90.18%

Oriental

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. Oriental has a claim settlement ratio of 90.18%, as compared to the industry average of 94.21%.

Oriental Health Insurance Plans Overview

Oriental health insurance offers 10 health insurance plans. The premium of these plans starts from Rs. 50/yr. The sum insured ranges from Rs. 500 - 50 Lakh. Details of the comprehensive coverage provided by the following 10 Oriental health insurance plans are listed below:

Arogya Sanjeevani Policy Oriental Insurance

Starting Premium- ₹ 2,281/yr

Arogya Sanjeevani Policy Oriental Insuranceis a standard health insurance policy issued under the guidelines of IRDAI

Available on a Family Floater as well as an individual basis, the plan is available at affordable premium rates. The plan is a straightforward health insurance plan that offers you financial support in case you or a covered family member has to be hospitalised for 24 hours or more.Its main features are as follows

  1. The plan offers coverage for the sum insured for a minimum of INR 1 lakh and a maximum of INR 25 lakhs.Up to INR 5 lakhs, the sum insured is available in multiples of INR 50,000. Above that, the sum insured amounts are: INR 6 lakhs, 8 lakhs, 10 lakhs, 15 lakhs and 20 lakhs
  2. Expenses on room rent, boarding and nursing are covered up to 2% of the sum insured
  3. ICU charges are covered up to 5% of the sum insured
  4. The premium of the policy remain the same all over the country
  5. You can cover your spouse and your dependent children who are in the age group of 3 months to 25 years
  6. Parents and parents-in-law can also be covered in this plan
  7. For each claim-free year, you can avail of a cumulative bonus of 5%, up to a maximum of 50%
  8. There is the option of lifelong renewability with no maximum age limit
  9. Per hospitalisation, an ambulance cover up to INR 2,000 is available
  10. You can avail of a 5% discount when you buy the policy online
  11. Expenses on dental treatment and plastic surgery are covered when necessitated after an illness or an injury
  12. Specified Modern treatments are covered up to 50% of Sum Insured
  13. The policy covers daycare procedures, specific modern treatments and AYUSH treatments as well
  14. The claim can be availed on a cashless as well on a reimbursement basis
  15. The plan comes with a 5% mandatory co-payment
  16. No pre-policy medical tests are required till the age of 55 years
  17. You have the option to increase the sum insured

Eligible Age

18 years - 65 years

PED Waiting Period

4 years

Coverage

1 Lakh - 20 Lakh

NCB

5% increase in cover;max upto 50%

Corona Kavach And Group Corona Kavach

Starting Premium- ₹ 303/yr

To help deal with the financial aspect of Covid-19, the IRDA advised the health insurance companies to offer pandemic-specific health plans to the public.Corona Kavach is standard health insurance and hence,the terms and conditions and premium rates of this plan are similar among different health insurance companies.The policy covers Covid-specific treatment expenses incurred due to hospitalisation of over 24 hours. Apart from the in-patient expenses, the policy also covers doctor prescribed home care treatments for up to 14 days. Apart from COVID, no other illness or injury is covered under this plan.

Given below are the main features of the Corona Kavach Policy:

  1. The policy covers hospital expenses due to in-patient care that includes:
    • Room rent, boarding and nursing
    • ICU and ICCU charges, along with Fee of Specialists, surgeons, medical practitioners, consultants
    • Blood, oxygen, OT charges, surgical appliances, ventilator charges, medicines
    • PPE kits and gloves, masks
    • Costs towards diagnostic investigations
    • Road ambulance expenses up to INR 2,000 of an insured for covid-related hospitalisation will be covered
  2. In-patient AYUSH treatment expenses taken in AYUSH hospitals are covered up to the sum insured, without any sub-limits
  3. You can take home-care treatment which is prescribed by a medical practitioner and otherwise requires hospitalisation of more than 24 hours.This benefit can be taken for a maximum period of 14 days
  4. As an add-on cover, you can get Hospital daily cash of 0.5% of the sum insured for every 24 hours on break-free hospitalisation
  5. There are no deductibles in this policy
  6. No medical screening is required before buying a fresh policy
  7. Pre and post-hospitalisation expenses, related to COVID-19, are covered for 15 and 30 days respectively
  8. There is a waiting period of 15 days from the policy inception date
  9. Claims can be made in the form of Cashless Claim or Reimbursement
  10. The following discounts can be availed of
    • 5% digital account when the policy is bought online
    • Health care workers are eligible for a 5% discount
    • If TPA services are not opted for, you can avail of a 5.5% discount on the premium

Eligible Age

18 years - 65 years

PED Waiting Period

15 days

Coverage

50,000 - 5 Lakh

NCB

NA

OBC Oriental Mediclaim Policy 2017

Starting Premium- ₹ 2,637/yr

This is a group health insurance policy designed for the account holders of the Oriental Bank of Commerce

The features of the policy are as follows

  1. Three types of policies can be taken under the plan – One account one policy,multiple accounts one policy and one person one policy
  2. No pre-policy health check-ups are required under the plan
  3. Daily hospital cash benefit of INR 200/day of hospitalisation is payable under the plan
  4. Funeral expenses of the insured are also covered
  5. You get coverage for more than 116-day care treatments

Eligible Age

91 days - 79 years

PED Waiting Period

3 years

Coverage

1 Lakh - 10 Lakh

NCB

NA

Oriental Top-up Plans

Oriental health insurance provides 1 top-up plan. The premium of these top-up plans start from Rs. 1,814/yr. The sum insured ranges from Rs. 3 Lakh - 30 Lakh. Oriental top-up plans provide enhanced coverage and added protection for your well-being. Explore the details of each Oriental top-up insurance policy below:

Oriental Super Health Topup Plan

Starting Premium- ₹ 1,814/yr

This is a super top-up health plan which pays the excess medical costs incurred if your base health insurance policy’s coverage is exhausted

The policy has a deductible limit.If the claim exceeds the deductible limit the policy pays the benefit.The salient features of the plan are as follows

  1. Coverage can be extended till 70 years of age if you pay 10% additional premium
  2. AYUSH treatments are also covered under the plan
  3. You can get coverage for organ donor expenses whether you are a recipient or a donor yourself
  4. Maternity and the newborn baby cover is available under the plan
  5. You can extend your coverage to avail hospitalisation in SAARC countries too without any additional premium

Eligible Age

91 days - 70 years

PED Waiting Period

4 years

Coverage

3 Lakh - 30 Lakh

NCB

NA

Top Features From Oriental Health Plans

Features and benefits of Oriental health insurance policies Health insurance policies offered by the Oriental Insurance Company are characterized by the following features and benefits

  • The company has its presence pan India with more than 29 regional offices, 1800+ offices and a wide distribution channel with about 13,500 employee
  • The company’s gross premium at the end of the financial year 2018-19 stood at INR 13,199 crores showing the popularity of the company’s products
  • Besides selling insurance in India, Oriental Insurance also offers insurance plans in Dubai, Nepal and Kuwait making it a multinational company

Benefits of Oriental health insurance policies :

  1. Pre-hospitalisation: The medical costs incurred before you are actually hospitalised for treatments are called pre-hospitalisation expenses. These expenses can be incurred on medical check-ups, diagnostics, doctor’s consultations, etc. Pre-hospitalisation costs are covered for a specific period before actual hospitalisation
  2. Inpatient hospitalisation : When you are admitted to a hospital for 24 hours or more, it is called inpatient hospitalisation. On such hospitalisation, the costs incurred towards room rent, doctor’s fee, surgeon’s fee, anaesthetist’s fee, nurse’s fee, medicine, oxygen, etc. are covered
  3. Post hospitalisation: After being discharged from the hospital you incur various medical expenses for monitoring the recovery. These expenses are called post hospitalisation expenses and they are also covered for a specified period
  4. Ambulance expenses:The expenses incurred on an ambulance to take you to the hospital for treatments are covered under Oriental health insurance plans up to specified limits
  5. Daycare treatments: If you undergo treatments which do not need you to be hospitalised for 24 hours because of advanced techniques, such treatments would be covered under this category of daycare treatments
  6. Organ donor treatments: Expenses incurred in harvesting an organ from a donor for your transplant treatments are covered under most Oriental health insurance plans
  7. Domiciliary treatments: Treatments which you take at home are called domiciliary treatments. These treatments are covered under some plans if the treatments are done because of non-availability of hospital beds or because you were not in a condition to be transported to the hospital
  8. Maternity treatments: Some Oriental health insurance plans cover expenses incurred on normal as well as Caesarean deliveries, prenatal care and postnatal care. The newborn baby can also be covered from birth
  9. Alternative treatments: Expenses incurred on non-allopathic means of treatments are also covered up to specified limits under many plans. These non-allopathic treatments include Ayurveda, Unani, Siddha and Homeopathy (AYUSH) Other benefits of Oriental health insurance plans

Exclusions Across Oriental Health Plans

There are some instances of claims for which you would not get coverage under Oriental health insurance plans. These are called exclusions and some of the common exclusions which you can find in all health plans of the company include the following

  • In the case of pre-existing illnesses, coverage is allowed only after a specified waiting period. Claims for pre-existing conditions occurring during the waiting period would not be covered
  • There are some specified illnesses for which coverage is allowed after a specified waiting period
  • Dental treatments, maternity and outpatient expenses are not covered under the plan unless otherwise mentioned
  • Mental disorders and related treatments are not covered
  • War, rebellion, mutiny, nuclear risks and other related perils are not covered
  • Cosmetic treatments are not covered under health insurance plans
  • Sexually transmitted illnesses and HIV/AIDS infections are excluded from coverage
  • Self-inflicted injuries attempted suicide and deliberate injuries are not covered
  • Congenital illnesses and debilitating conditions are not covered

Oriental Premium Calculator

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Oriental Customer Care

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Oriental Claim Process

Oriental supports both cashless claims and reimbursement claims. This section covers the information on how to check Oriental health insurance claim status, fill Oriental health insurance claim form, and the claim settlement process.

Cashless claims are when you seek treatment at a hospital which is tied-up with the insurance company. In this case, the company pays your hospital bills directly to the hospital.

Reimbursement claims are when you take treatments at a non-networked hospital. In that case, you would have to pay the medical bills yourself and then get them reimbursed from the insurance company. The claim process involves the below-mentioned steps

  1. You have to inform the TPA (Third Party Administrator) of the insurance company immediately about the claim
  2. If you are undergoing a planned hospitalisation, the information should be given 3-4 days in advance. In case of emergency hospitalisation, the TPA should be informed within 24 hours of your hospitalisation
  3. You would have to fill up a pre-authorisation form and submit it to the TPA. The TPA would forward this form to the insurance company based on which your claim would be approved
  4. Once the claim is approved by the insurance company, you can take treatments and the insurance company would handle the medical costs
  5. After you are discharged from the hospital, you should collect the discharge summary and all relevant medical bills and reports. You should, then, fill up the claim form and submit the form with all the documents so that the claim is settled

You can also make your health insurance claim through Turtlemint.Turtlemint has an internal claims department which handles customers claims.You just have to inform Turtlemint by calling up its toll-free number 1800 266 0101 or send an email at claims@turtlemint.com. Once the company is involved, its claim experts would get your claims processed so that you can get an easy and a quick settlement.

Oriental Health Insurance Renewal Process

Renewal Process for Oriental Health Insurance Policy - Online

Renewing your Oriental Health Insurance policy online is a straightforward process:

Step1: Go to the official Oriental Insurance website and choose ‘Renew’ option

Step 2: Enter your existing policy number when prompted and click ‘Renew Now’ to proceed with premium payment and Oriental health policy renewal

Step 3: After completing the online payment, you'll receive an email confirmation for your renewed health insurance policy

Renewal Process for Oriental Health Insurance Policy - Offline

For those preferring offline renewal, you have two options:

  • Call Oriental Insurance's toll-free number,1800-118-485, and communicate your renewal requirements or visit a Branch to renew your policy in person
  • Another way to renew is with the help of Turtlemint and our expert insurance advisors.For instant policy renewal, visit www.turtlemint.com or renew your Oriental Health Plan by downloading the Turtlemint App here

FAQs

At the time of buying a health insurance policy from Oriental Insurance, the following documents would be required

  • Identity proof
  • Age proof of yourself and the members being covered
  • Address proof
  • Photographs

Yes, you can buy as many health insurance plans as you like. There is no restriction on the number of policies that you can buy.

Dependent children are covered until 18 years or 25 years of age. Dependent daughters can be covered until they are married.

No, maternity cover is allowed after a waiting period. The policy might have a waiting period of 24 to 48 months depending on the policy.
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