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Claim Process For Oriental Health Insurance Plans

Updated On Jul 02, 2021

Knowing the process to claim your health insurance policy is as significant as purchasing it. You cannot buy and keep your health insurance policy. The real purpose of the policy is to incur your medical expenses and it must serve its purpose at the right time. Therefore, it is necessary that you know the process and documentation involved in the claim settlement process so that at times of an emergency you get the required amount on time without depending on others’ consultation for the same. 

Oriental Health Insurance provides customized plans and policies for its customers. It provides the policyholders 24X7 call assistance for the claim settlement process with the help of its effective and efficient team. The company is very well-known for its quality services and quick claim settlement process. 

About Oriental Health Insurance 

Oriental General Insurance is one of the oldest public sector firms which has been evolving since then and providing a wide range of products to its customers.  One of its popular and trusted products is health insurance. Oriental Health Insurance plans cover your medical expenses against critical illness, accidents, sickness, and many more. Headquartered in New Delhi it has 1,800 offices which are operating across the country in order to deliver their services to the policyholders effectively and on time. Let us look at some of the basic features of Oriental Health Insurance: 

  • The company has a network of 4,300+ linked hospitals to provide cashless treatment to its customers. 
  • The claim settlement ratio of the firm was 93.96% in FY 2019-20. 
  • It provides lifelong renewability of policies to its policyholders. 
  • Tax deduction benefits under section 80D of the Income Tax Act are available for the policyholders of the company. 

Claim Process For Oriental Health Insurance Plans

Claim Settlement Process At Oriental Health Insurance

Oriental Health Insurance is known to provide an experience of quick, smooth, and hassle-free claiming process to its customers. Renowned third-party administrators work with Oriental Health Insurance to make the whole claim settlement process a good experience for their customers. Both cashless and reimbursement claims can be processed at Oriental Health Insurance. Let us look at the steps involved in both ways: 

1. Cashless Treatment Claim Settlement Process 

You can claim cashless treatment at any of the network hospitals which is linked with the insurer. In such cases, the payments are made directly by the insurer to the hospital, which makes us less involved in it. The steps involved are: 

  • Get admitted to a network hospital 
  • Inform the insurer as soon as you are admitted to the hospital 
  • Carry your cashless card issued by the insurer and photo ID proof 
  • Collect pre-authorization form and submit it after filling in the required details. 
  • After proper verification by the insurer, the claim will be approved and the payment for your medical expenses will be made to the hospital directly by Oriental Health Insurance. 

2. Reimbursement Process 

If you receive treatment in a hospital that is not linked with the insurer, then you can make a reimbursement claim for the medical expenses involved. The steps involved are: 

  • After getting admitted to a non-network hospital inform your insurer about the hospitalization as soon as possible. 
  • Fill the reimbursement form which can either be collected physically from the insurer’s office or can be downloaded from their official website. 
  • Pay the dues and expenses before getting discharged. 
  • Collect all the documents, reports, and bills. 
  • Submit your form along with the bills to your TPA. 
  • After proper verification by the insurer, the claim will be approved and the payment for your medical expenses will be made to you by Oriental Health Insurance.

Conclusion 

Make sure you inform the insurer as soon as the hospitalization occurs. You must know the inclusions and exclusions of your policy before making the claim. Excluded treatments in the policy will not be paid for and the claim request will be rejected for that if made. 

Must Check: Easy Ways To Pay Premium For Oriental Health Insurance Policy Online

Oriental Health Insurance - A Superior Health Insurance Choice

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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