Oriental Health Insurance

About Oriental Insurance

Oriental Insurance Company is a public sector general insurance company of India that commenced its operations in the year 1947 in Mumbai. The company has developed various types of insurance solutions like health, motor, personal accident, shopkeeper, aviation, marine, traders, industry, animals/birds, and agriculture/poultry and cater to various insurance-related needs of different sections of the society. It is a vibrant and dynamic leading general insurance of India that has a highly trained and motivated workforce that has a vast experience in the sector. Headquartered in New Delhi, the company has 29 regional offices and more than 1,800 operating offices in different parts of the country. 

One of the most popular products of the leading non-life insurer is health insurance. Oriental Health Insurance plans offer its customers the much needed financial cushion to individuals and families in case a medical emergency arises. The plans offer comprehensive coverage and protect the insured from various healthcare expenses arising due to illness, sickness,  disease, or injury. Out of the many health insurance plans offered by Oriental Insurance, you can pick that suits you the best. 

How to Purchase Oriental Health Insurance Policy at InsuranceDekho?

InsuranceDekho offers you two modes in which you can purchase Oriental Health Insurance plans. These are Online mode and Offline mode. Both are convenient ways of buying health insurance.  

Buy Oriental Health Insurance Plan Online At InsuranceDekho

Buying Oriental Health Insurance plan at InsuranceDekho in the online mode is easy. You can purchase one by following the simple steps given below: 

Step 1: Visit insurancedekho.com. Click on the tab given for ‘health’.
Step 2: Select your Gender. You will be required to enter your personal details like Name and Mobile Number. You will receive a One Time Password on the provided mobile number. Please enter that. 
Step 3: Answer for us ‘When do you want to buy the policy’ by choosing one of the options from the drop-down menu. Click on the ‘View Quotes’ button. 
Step 4:  Select your family members whom you want to be covered under your policy. Click ‘Continue’.
Step 5: Select the age of the selected family members. 
Step 6:  Enter your Email ID and City. Click on ‘Submit and View Quotes’. You will see the most relevant quotes on your screen. Choose the one you want to purchase.
Step 7: Select the term you wish to buy the shortlisted policy. Fill the required details. Pay the premium online via a secured payment gateway. 

Buy Oriental Health Insurance Plan Offline At InsuranceDekho

You can purchase Oriental Health Insurance plan in the offline mode at InsuranceDekho. All you need to do is contact the customer care executives by calling on the toll-free number 7551-196-989 and sharing your insurance-related requirements with them. You can call us any day between 9:30 AM to 6:30 PM. 

In case you require further support, then you can also connect with us via email. Our email ID is customersupport@insurancedekho.com.      

Top Oriental Health Insurance Plan Types 

Oriental health Insurance offers various health insurance plans to protect the insured against several health conditions. Listed below are the top 5 Oriental Health Insurance plans along with their features that will help you make an informed decision. 

1. Oriental Individual Mediclaim Policy: Oriental Individual Mediclaim Policy can be purchased by individuals for themselves and their family members including legally wedded spouse, dependent children, parents or parents-in-law, and unmarried siblings if they are financially dependent. The maximum entry age for the policy is 65 years. Available for sum insured options ranging between Rs. 1 lakh and Rs. 10 lakh, the policy provides you cover for in-patient hospitalisation expenses, domiciliary hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, and road ambulance expenses. You can also avail of daily hospital cash allowance under the policy.   

2. Oriental Super Health Top-Up Policy: Oriental Super Health Top-Up Policy offers extra coverage when the sum insured of your existing policy gets exhausted due to the claims made in the previous year. The policy is available with sum insured options of Rs. 3 lakh to Rs. 30 lakh with deductibles ranging between Rs. 3 lakh and Rs. 20 lakh which you can choose as per the requirement. You can be covered under this policy if you are aged up to 70 years. The policy covers you for several medical expenses such as in-patient hospitalisation expenses, maternity, and newborn baby expenses, daycare expenses, pre-hospitalisation, and post-hospitalisation expenses, in-patient hospitalisation expenses for AYUSH treatments, and organ donor expenses.  

3. Oriental Happy Family Floater Policy: As the name suggests, Oriental Happy Family Floater Policy is a family floater policy that covers you and your family members aged between 91 days and 65 years. The policy is available in three variants viz., Silver, Gold, and Diamond for sum insured options ranging between Rs. 2 lakh and Rs. 20 lakh. The policy offers you several coverage features such as in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, daily hospital cash allowance, critical illness cover, attendant allowance, ambulance expenses, organ donor expenses, medical second opinion, maternity, and newborn expenses. The policy also offers optional covers like life hardship and survival benefit, restoration or sum insured, and personal accident.

4. Oriental Arogya Sanjeevani Policy: Oriental Arogya Sanjeevani Policy is an affordable plan that covers you and your family against medical costs related to hospitalisation due to illness, sickness, disease, or an accident. Available for a term of 1 year, the policy needs to be renewed thereafter. You can be covered under this policy if you are aged between 3 months and 65 years for sum insured options ranging between, Rs. 1 lakh and Rs. 5 lakh in multiples of Rs. 50,000. The policy offers you several coverage benefits such as cover for in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, new age treatments, daycare expenses, road ambulance expenses, and AYUSH treatment. 

5. Oriental Health of Privileged Elders (HOPE) Policy: Health of Privileged Elders is a senior citizens specified diseases insurance that covers the senior citizens for accidental injury and several treatments including knee replacement, cardiovascular diseases, chronic renal failure, cancer, stroke, benign prostate, orthopaedic diseases, Hepato-Biliary Disorders, Chronic Obstructive Lung Diseases, and Ophthalmic Diseases. The policy offers cover to senior citizens for in-patient hospitalisation expenses, ambulance expenses, domiciliary hospitalisation expenses, and so on.   

What Is A Health Insurance Top-up Plan and Why Should I Buy It?

Health Insurance top-up policy is like a regular health insurance policy except for the fact that it only kicks in when the medical expenses exceed the sum insured of your existing health insurance policy due to a single claim made for hospitalisation. Similar to top-up health insurance plans are super top-up health insurance plans. But super-top up plans pay claim amounts of cumulative healthcare expenses within a policy term after it exceeds the sum insured of the existing health insurance policy.    

Oriental Health Insurance offers a super top-up policy named Super Health Top-Up Policy. It can be purchased for sum insured options ranging between Rs. 3 lakh and Rs. 30 lakh and deductible options ranging between Rs. 3 lakh and Rs. 20 lakh. The policy offers many coverage features to you including cover for in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, organ donor expenses, etc. The policy comes with an initial waiting period of 30 days.  

Why Choose Oriental Health Insurance?

Oriental Health Insurance works with the aim of offering the utmost customer satisfaction. Listed below are the reasons that make the insurer a preferred choice for many:

• Variety of Health Insurance Plans: Oriental Health Insurance offers a variety of health insurance plans for individuals, families, senior citizens, disease-specific, and super top-up policy thereby offering a wide choice to the customers. Some plans even have variants under them to offer further choices to the customers. 
• Excellent Claim Settlement Ratio: Oriental Health Insurance has an excellent Claim Settlement Ratio of 94.28% which has let the insurer make it to our list of top 5 health insurance companies on the basis of claim settlement ratio. 
• Products Available at Digilocker App of Government of India: Oriental Health Insurance products are available in the Digilocker app of the Government of India. It is a cloud platform for storage, issuance and verification of documents and certificates. 
• Industry Experience of More Than 70 Years: Oriental Health Insurance was established in the year 1947 and has been offering a diverse range of insurance products since then. The great industry experience has helped the insurer know the insurance sector more intimately and gain specialisation in product offerings. 
• Cashless Hospitalisation at Over 4,300 Hospitals: Oriental Health Insurance has a strong network of 4,300 hospitals where you can avail cashless hospitalisation without paying anything from your own pocket.

Benefits of Oriental Health Insurance Plans

Oriental Health Insurance plans offer several benefits to the insured. Here is a rundown to some of them:

• Portability Benefit: You can switch to an Oriental Health Insurance plan if you are not satisfied with your existing health insurance policy without losing the continuation benefits such as No Claim Bonus or waiting period benefits. This means you can transfer your existing health insurance policy to Oriental Health Insurancewithout any hassle at the time of renewal. 
• Wide Range of Sum Insured Options: Oriental Health Insurance plans offer a wide range of sum insured options starting from as low as Rs. 1 lakh up to as high as Rs. 30 lakh thereby fulfilling varied requirements of different sections of the country. 
• Lifetime Renewability Benefit: Oriental Health Insurance plans offer you lifetime renewability benefit. This means that you can continue availing the benefits under your Oriental Health Insurance plan for a lifetime provided you pay the renewal premium on time. 
• Restoration of Sum Insured: Oriental Health Insurance plans provide you the benefit of restoration of the sum insured. This means, your sum insured gets restored in case it gets exhausted on the claims made during a policy term.  

Oriental Health Insurance Claim Settlement Ratio

Claim Settlement Ratio or CSR is the ratio of the number of claims settled by an insurance company against the total number of claims received during a financial year. For instance, if an insurance company has a Claim Settlement Ratio of 70%, then it means that the company is able to settle 70 claims out of 100 claims received during a financial year. Higher the Claim Settlement Ratio, the better it is. To know the Claim Settlement Ratio of Oriental Health Insurance, refer to the table below:

(Source: IBAI’s General Insurance Claim Insights Handbook For Policyholders - 3rd & 4th Edition) 

Network Hospitals of Oriental Health Insurance

A network hospital is a hospital that has a tie-up with the insurance company and lets the insured individuals avail cashless treatment on the basis of deferred payment. Oriental Health Insurance has more than 4,300 network hospitals where you can avail cashless treatment. This means you will not be required to pay anything for the medical expenses incurred on your treatment except for the non-payable items like food, telephone bills, etc. as per the terms and conditions of your policy. In a network hospital, you can avail of the required medical treatment which can be either emergency or planned in nature.  

Oriental Health Insurance Policy Terms

Oriental Health Insurance plans are available with the following terms:

Note that the terms and conditions vary with different Oriental Health Insurance plans. 

Oriental Health Insurance Claim Process

Oriental Health Insurance offers a smooth, quick, and transparent claim settlement process. Under Oriental Health Insurance plans, you can make a claim in two ways. These are cashless claims and reimbursement claims. To understand the process for both, read below.

How To Make A Oriental Health Insurance Cashless Claim?

You can make cashless claim under Oriental Health Insurance plan by following a few simple steps given below:

Step 1: Get Hospitalised at a Network Hospital
Get hospitalised at a network hospital. Inform the TPA of the hospital about the hospitalisation.  
Note that you are required to inform the insurer within 48 hours of hospitalisation in case of planned or emergency hospitalisation. 

Step 2: Fill the Pre-Authorization Form 
Fill the pre-authorization form at the hospital and submit it to the TPA cell along with other relevant documents at the hospital. 

Step 3: Document Verification
The TPA will check your documents and inform the insurer about the event. 

Step 4: Claim Settlement
The insurer will settle the claim at the hospital if it is in accordance with the terms and conditions of the policy. 

How To Make A Oriental Health Reimbursement Claim?

To make a reimbursement claim under Oriental Health Insurance plan, follow the steps given below:

Step 1: Get Hospitalised at a Non-Network Hospital
Get hospitalised at the network hospital of your choice and avail the required treatment. 

Step 2: Settle the Bills for the Treatment Availed
Settle the bills for the expenses related to treatment availed at the hospital.  

Step 3: Collect Relevant Documents from the Hospital
Get original bills and the documents required.  Submit them to the insurance provider. 

Documents Required for Reimbursement Claim Settlement

You are required to submit the following documents for reimbursement claim under Oriental Health Insurance plan:

• Duly filled Claim Form
• Copy of Claim intimation provided to the Company along with a copy of policy and premium receipt
• Original discharge report from the hospital
• Original test reports like ECG, X-Rays, and Sonography reports
• Medical recovery report
• Original bills of medical expenses, prescriptions, and cash memos

Step 4: Claim Settlement 
The insurer will approve your claim and pay you for the medical expenses incurred on your treatment if your claim is in accordance with the terms and conditions of your health insurance policy.

Oriental Health Insurance Renewal Process

Health insurance renewal is as important as buying a health insurance policy is. You are required to renew your health insurance policy after the policy period before expiration in order to continue availing benefits under your health insurance policy. Timely renewal of your health insurance policy allows you to avail of the continuation benefits such as No Claim Bonus, waiting period benefits, etc. 

Oriental Health Insurance provides a grace period to the insured during which he/she can pay the renewal premium and keep on enjoying benefits under the policy. You can renew your Oriental Health Insurance policy by following the steps given below: 

Step 1: Visit the official website of Oriental Insurance. Click on the Renew Online tab. 
Step 2: Enter the existing policy number and click on ‘Renew Now’.  
Step 3: Renewal quotes will be displayed on your screen. Select your quote as per the requirement. 
Step 4: Pay the renewal premium online via a secured payment gateway. 

Oriental Health Insurance Tax Benefits 

The premiums you pay in order to avail the benefits under your Oriental Health Insurance policy are subject to tax deductions under Section 80D of the Income Tax Act, 1961. See the the table below to understand the deductions better:

Oriental Health Insurance Premium Calculation

Health insurance premium is the amount that you are required to pay to avail benefits under a particular health insurance policy. You are required to pay a premium after every policy term if you wish to continue with the coverage. Health insurance premiums may vary with different health insurance plans and for different individuals on the basis of certain factors. To calculate the health insurance premium that you will be required to pay under Oriental Health Insurance plan(s), you can use the health insurance premium calculator available at InsuranceDekho. It helps get an idea of the premium you will be required to pay under Oriental Health Insurance plans and help you manage finances accordingly. 

Following are the factors that affect your health insurance premium under Oriental Health Insurance plans:

• Age: Age is an important factor that decides the health insurance premium that you are required to pay. It is true that you are at a lower risk of major health issues when you are young. Therefore you are required to pay a lesser health insurance premium if you buy health insurance when young and vice versa.
• Pre-Existing Conditions: You are more likely to make a claim in the subsequent years of buying a health insurance policy if you are already suffering from a disease at the time of purchasing it. Thereby, creating a greater liability on the insurer. So, you are required to pay a higher health insurance premium in that case. 
• Body Mass Index (BMI): If you have a higher Body Mass Index than normal, then you are more vulnerable to health issues than others. This increases your chances of getting hospitalised and making claims under your health insurance policy, therefore, you are required to pay a higher premium in that case. 
• Lifestyle Habits: People who smoke, drink, chew tobacco, or consume any other addictive substance are more prone to getting ill. This is because these lifestyle habits affect your health adversely and increase the chances of you being hospitalised. Therefore, you will be required to pay a higher premium for a Oriental Health Insurance plan if you are habitual to them.   
• Number of Members Covered Under the Policy: The more members you cover under your health insurance policy, the greater will the coverage be, and hence higher the premium you will be required to pay for your health insurance policy.   

What All Is Covered Under Oriental Health Insurance Plans?

Oriental Health Insurance plans cover you against the following healthcare expenses:

• In-Patient Hospitalisation Expenses: Oriental Health Insurance plans cover you for hospitalisation expenses incurred during hospitalisation of at least 24 hours. These include room rent charges, ICU/ICCU charges, nursing and boarding expenses, fee of the Surgeon, and expenses for blood, anaesthesia, operation theatre, surgical appliances, and medicines.
• Road Ambulance Expenses: Oriental Health Insurance plans offer you coverage for road ambulance expenses incurred during the transportation of the insured to the nearest hospital. 
• Pre-Hospitalisation And Post-Hospitalisation Expenses: Oriental Health Insurance plans cover you for pre-hospitalisation and post-hospitalisation expenses for 30 days and 60 days respectively. These include expenses related to tests, medicines, doctor’s consultation, etc. before and after the hospitalisation. 
• Daycare Procedures: Oriental Health Insurance plans cover you for day care procedures. Daycare procedures are those which require hospitalisation of less than 24 hours. For example, chemotherapy, radiology, dialysis, and cataract. 
• AYUSH Treatment: Oriental Health Insurance plans cover you against in-patient hospitalisation expenses incurred on AYUSH systems of medicines. These include Ayurveda, Unani, Sidha, and Homeopathy systems of treatment.  

What All Is Not Covered Under Oriental Health Insurance Plans? 

Oriental Health Insurance plans do not cover you against the following expenses:

• Sexually Transmitted Disease: Oriental Health Insurance plans do not protect you from Sexually Transmitted Diseases like HIV, AIDS, etc. 
• Alcohol or Drug Abuse: Oriental Health Insurance plans do not offer you coverage for expenses incurred on the treatment of illnesses due to use, misuse, or abuse or alcohol, or any other addictive substance.  
• Injury Due to Participation in Adventure Sports: Oriental Health Insurance plans do not provide for expenses if incurred on any injury due to participation in adventure sports. For example, injury due to paragliding skiing, mountain biking, etc.
• Injury With an Intention of Self-Harm: Oriental Health Insurance plans do not cover you against any expense incurred on the treatment of injury or illness due to attempting or committing any action with an intention of self-harm. For instance, suicide. 
• Injury Due to War or Warlike Situation: Oriental Health Insurance plans do not offer you cover for any injury caused due to any act of war, invasion, mutiny, revolution, or nuclear power damage. 

Note that the inclusions and exclusions vary with different Oriental Health Insurance plans.