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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 2 health insurance plans. The premium of these plans starts from Rs. 1506/yr. The sum insured ranges from Rs. 1 Lakh - 50 Lakh. Details of the comprehensive coverage provided by the following 2 Oriental health insurance plans are listed below:

Oriental Happy Family Floater Policy

Starting Premium- 1,506/Yr

Oriental Happy Family Floater Plan is a comprehensive health insurance plan which comes in three different variants: Silver, Gold and Diamond having different Sum Assured ranges and benefits which makes the plan quite flexible. This plan is available on floater basis for family members including self, spouse, children, parents and parents-in-laws as well.

Eligible Age

91 days - 70 years

Coverage

1 Lakh - 50 Lakh

Oriental Individual Mediclaim Policy

Starting Premium- 2,637/Yr

Oriental Individual Mediclaim Health Plan is a standard health insurance plan designed especially for individuals having different Sum Assured ranges, benefits and discounts which makes the plan quite flexible.

Eligible Age

18 years - 65 years

Coverage

1 Lakh - 10 Lakh

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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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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