Oriental Health Insurance FAQs

Oriental Health Insurance

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Highlights

4,300+ Network Hospitals

12,50,812 Policies Issued

Lifelong Renewability

94.28% Claim Settlement Ratio

Dedicated Claim Settlement

Coronavirus (COVID-19) Cover

Claim Settlement

  • How soon I need to inform about the hospitalisation to Oriental Health Insurance Firm?

    You should intimate Oriental Insurance Company as soon as you get hospitalised, either it is an emergency or a planned admission.

  • Where should I contact to seek claim related assistance?

    To seek details about the claim settlement procedure of the Oriental Insurance Company, you can connect with our team at 1800-120-5698.

  • How many claims can I make with Oriental Health Insurance policies?

    There is no restriction on the number of claims you can make in a policy year. However, it should not go beyond the sum insured amount specified in the policy document. 

  • For how long do I need to stay in the hospital to avail the claim?

    You need to stay for at least 24 hours in the hospital to be eligible for a claim. Only for a few daycare procedures and treatments as mentioned in the policy document, you can claim for the hospitalisation less than 24 hours.

  • What documents do I need to produce to settle the claim successfully?

    Here are the listed documents that you need to produce before the insurer for claim settlement:

    • Duly filled claim form
    • Diagnosis and test reports
    • Doctor’s reports and consultation notes
    • Medical recovery report
    • Pharmacy bills with the prescription
    • Nature of operation performed 
    • Surgeon's bills and receipts
    • Final hospital discharge summary
    • A valid photo ID proof

    If any other document is needed, the insurer can ask you to bring them.

Critical Illness

  • How many critical illnesses are covered by Oriental Insurance Firm?

    The Oriental Insurance Company offers the coverage for 11 listed critical illnesses defined under the Happy Family Floater Policy

  • Name the critical illnesses which are covered by the Oriental Insurance Firm?

    Here is the list of critical illnesses which are covered by the Oriental Insurance Company:

    • Cancer of specific severity
    • First heart attack of specific severity
    • Open chest CABG
    • Open heart replacement or repair of heart valves
    • Coma of specific severity
    • Kidney failure requiring regular dialysis
    • Stroke resulting in permanent symptoms
    • Major organ or bone marrow transplant 
    • Permanent paralysis of limbs
    • Motor neuron disease with permanent symptoms
    • Multiple sclerosis with persistent symptoms

  • What is the limit of sum insured under the plan covering the treatment of critical illness?

    The sum insured of the Happy Family Floater Policy ranges from Rs. 2 Lakh to Rs. 20 Lakh.

  • Does Oriental Insurance Company have a family floater health insurance policy?

    Yes. Oriental Insurance Company provides a health insurance policy, especially for families. The name of the policy is “Happy Family Floater.” The best feature of the policy is that it covers critical illnesses too.

  • Who all can get the coverage under critical illness plan by Oriental Insurance firm?

    People who fall between the age group of 91 days to 70 years are eligible for the coverage for critical illness under family floater plan. 

Family Floater

  • Does the family floater plan offered by the Oriental Insurance Company possess any variants?

    Yes, family floater plan of Oriental Insurance Firm, which is known as Happy Family Floater Policy owns 3 variants such as Silver, Gold and Diamond. 

  • Does Oriental Insurance Company have a family floater health insurance policy?

    Yes. Oriental Insurance Company provides a health insurance policy, especially for families. The name of the policy is “Happy Family Floater.” The best feature of the policy is that it covers critical illnesses too.

  • What are the sum insured amount of different variants offered under the family floater plan?

    Here are the sum insured amount of different variants:

    • Silver - Rs. 1 Lakh, Rs. 2 Lakh, Rs. 3 Lakh, Rs. 4 Lakh, and Rs. 5 Lakh
    • Gold - Rs. 6 Lakh, Rs. 7 Lakh, Rs. 8 Lakh, Rs. 9 Lakh, and Rs. 10 Lakh
    • Diamond - Rs. 12 Lakh, Rs. 15 Lakh, Rs. 18 Lakh, and Rs. 20 Lakh

  • Who all are covered under the family floater policy of Oriental Insurance Company?

    The family floater plan of Oriental Insurance Company covers legally wedded spouse, children (i.e. natural or legally adopted) between the age of 91 days to 18 years, dependent children up to 25 years (girl until she gets married, divorced  and widowed daughter), parents, and parents-in-law.

Feature

  • Does Oriental Insurance Company offer the coverage for organ donor benefit?

    Yes, insured individuals are covered with a lump sum payment of 10% of the sum insured.

  • What is the limit of room, boarding and nursing expenses, which are covered by the Oriental Insurance Company?

    The limit of coverage for the room, boarding and nursing expenses are segregated under different variants, which are as follows:
    Silver Plan - A coverage of 1% of the Sum Insured per day is offered
    Gold Plan - A coverage of 1% of the Sum Insured per day is offered
    Diamond Plan - A coverage of Rs. 10,000 + 0.5% of the sum insured above Rs. 10 Lakh per day is offered

  • Are expenses related to pre and post hospitalisation get the coverage under Oriental Insurance?

    Yes, the Oriental Insurance Company offers the coverage for the expenses of pre and post hospitalisation for 30 and 60 days, respectively.

General Information

  • Does Oriental Insurance Company offer any type of discounts to policyholders?

    Yes, Oriental Insurance Company provides discounts to the policyholders based on the plan you have bought. 

  • Is pre-policy medical checkup required to purchase an Oriental Health Insurance Policy?

    The requirement for pre-policy medical checkup varies from plan-to-plan and variant-to-variant. For e.g. if you are purchasing a family floater plan then under its Silver and Gold variant the pre-policy checkup is required for persons aged 60 years and above whereas under its Diamond variant the pre-policy medical check is required for persons aged 55 years and above. 

  • Does Oriental Health Insurance policy comes with lifelong renewability option?

    Yes, all the health insurance policies offered by Oriental Health Insurance comes with lifelong renewability benefit.

Help to Buy

  • Why should I buy a health insurance plan of Oriental Insurance Firm?

    Oriental Insurance Company helps policyholders live a healthier and successful lifestyle. Backed by 4,300+ leading hospitals in its network, dedicated TPA service and 30+ offices in India and abroad (Nepal, Kuwait, and Dubai), Oriental Insurance lets you have cashless treatment in network hospitals, an array of sum insured options, excellent discounts and loading options, etc. The company also offers comprehensive cover, maternity benefits, international coverage, critical illness cover, top-up plan, lifetime renewal, and many other benefits. Therefore, owning a plan of Oriental Insurance Firm is an ideal option to go with.

  • What is the toll-free number of Oriental Insurance Company?

    The toll-free number of Oriental Insurance Company is 1800 11 8485. 

  • How to apply for and buy an Oriental Health Insurance policy?

    You can apply and buy an Oriental Health Insurance policy online from the official website of the company. You can also contact InsuranceDekho at 1800-1205-698 to get all the details and purchase any policy of Oriental Insurance Company. 

Individual

  • Does Oriental Insurance Company offer any individual health insurance product?

    Yes, Oriental Insurance Company offers individual health insurance product by the name of Individual Mediclaim Policy.

  • What is the sum insured amount of Oriental Insurance individual plan?

    Oriental Insurance provides the sum insured option starting from Rs. 1 Lakh to Rs. 10 Lakh under its individual plan.

  • Is there any grace period option available under the individual policy of Oriental Insurance Firm?

    Yes, a 30-day grace period is available under the individual policy of Oriental Insurance Firm, on the occurrence of a delay in the policy renewal. However, no coverage shall be available during the grace period, and any disease/injury contracted during the break period shall not be covered and shall be treated as a pre-existing disease.

  • Does Oriental Insurance offer coverage for health check-up expenses under its individual plan?

    Yes, the cost of health check-up can be undertaken once at the expiry of a block of every 3 continuous claim-free years. The amount reimbursable will not be exceeding the amount equal to 0.75% of the average sum insured (SI for Personal Accident section is not to be considered), or Rs. 3000 per insured person, whichever is less, during the block of 3 continuous claim-free underwriting years. This benefit is available to the insured person after three claim-free years, till the expiry of the fourth year of the policy. If the benefit is not claimed in the fourth year of the policy, then in the future whenever the insured claims this benefit then the last three claim-free years preceding the year in which the benefit is claimed shall be taken into consideration.

Kids

  • Does Oriental Insurance provide a specific plan for children?

    No, Oriental Insurance doesn’t offer any specific health insurance plan for children. However, they can find coverage under different health policies of Oriental Insurance with their parents.

  • Does Oriental Insurance offer health insurance coverage for a newborn baby?

    Yes, Oriental Insurance provides the coverage for a newborn baby under the Diamond variant of Happy Family Floater Policy.

  • What is the basic age criteria for kids to get coverage under the plans of Oriental Insurance?

    The entry age of dependant kids under Oriental Insurance plans ranges between 3 months to 18 years. However, the male children are eligible to get the coverage up to the age of 25 years if he is financially dependent on the proposer or is a bonafide regular student. Female children are eligible to get the coverage until she gets married. In addition to this, divorced and widowed daughters are also eligible for coverage under the policy, irrespective of their age, provided they are financially dependent on the proposer. But, if any child above the age of 18 years is financially independent or if any girl child is married, he or she shall not be eligible for coverage in the subsequent renewals.

Maternity

  • What is the limit of the coverage offered for maternity expenses?

    Oriental Insurance offers an automatic cover for maternity expenses up to 2.5% of the sum insured.

  • How much waiting period I need to spend to avail maternity benefits under plan of Oriental Insurance?

    The Oriental Insurance offers the maternity benefits with a waiting period of 24 months under the Diamond plan of Happy Family Floater Policy.

  • Does any Oriental Insurance plan provide coverage for newborn baby hospitalisation expenses with maternity expenses?

    Yes, the Diamond plan of Happy Family Floater Policy by Oriental Insurance offers the coverage for newborn baby hospitalisation expenses with maternity cover. Newborn baby shall be covered from day one up to the age of 90 days and expenses incurred for treatment taken in the hospital as an inpatient shall be limited to 2.5% of the sum insured amount.

Parents

  • What is the maximum entry age for parents under Oriental Insurance plans?

    Under the Happy Family Floater Plan, the maximum entry age is of 65 years for all members. However, with a compulsory co-payment of 20% for each and every claim, persons above the age of 65 and up to 70 years of age can also be covered under the Silver or Gold Plan, but not under Diamond Plan of Oriental Insurance’s family floater policy.

  • If I enrol my parents under the family floater plan of Oriental Insurance, will they get cover for domiciliary hospitalisation?

    Yes, Oriental Insurance provides the domiciliary hospitalisation option for your parents under its family floater policy.

  • Will buying the health insurance plan from Oriental Insurance for parents make me earn the tax benefit?

    Yes, when you purchase the health insurance policy for your parents from Oriental Insurance, you become eligible for tax benefits under Section 80D of the Income Tax Act.

Plan Coverage

  • Does Oriental Insurance Company offer the coverage for pre and post hospitalisation expenses?

    Yes, medical expenses incurred 30 days prior to hospitalisation and up to 60 days post hospitalisation are covered by the Oriental Insurance Firm.

  • Who all are covered under the family floater policy of Oriental Insurance Company?

    The family floater plan of Oriental Insurance Company covers legally wedded spouse, children (i.e. natural or legally adopted) between the age of 91 days to 18 years, dependent children up to 25 years (girl until she gets married, divorced  and widowed daughter), parents, and parents-in-law.

  • Does Oriental Insurance Company provide the coverage for a medical second opinion for specified major illnesses?

    Yes, Oriental Insurance Company gives the coverage for a medical second opinion on specified major illnesses from up to Rs. 5,000 to Rs. 10,000, depending upon the variant you have chosen.

Portability

  • Does Oriental Insurance offer the feature of portability?

    Yes, Oriental Insurance offers the feature of portability to its policyholders. With the help of this feature, you can easily port your plan into an Oriental Insurance as per the IRDA norms, without losing any benefit in continuity. 

  • When should I apply to port into the Oriental Insurance?

    If you want to port into Oriental Insurance from any other insurer, you must apply with details of the health insurance plan and claims to us, at least 45 days before the date of expiry of the policy.

  • Can I port into Oriental insurance anytime within the policy year?

    No, you can apply to avail the portability feature only at the time of renewal and not any other time.

Premium

  • Will I get payment acknowledgement from Oriental Insurance after paying the premium?

    Yes, you’ll get the payment acknowledgement from the insurer at your registered email id. This acknowledgement serves as proof of the premium paid.

  • What is the minimum premium amount of Oriental health insurance plans?

    The starting premium amount of Oriental health insurance plans is Rs. 3,500 per year. The premium amount is subject to change from time-to-time.

  • What are the factors that determine the premium value of Oriental health insurance plans?

    Factors that determine the value of the premium of Oriental Health Insurance plans are as follows:

    a) Gender
    b) Sum insured
    c) Policy term
    d) Age of insured
    e) Number of members
    f) Medical history

  • Does Oriental health insurance offer any discount on the premium amount to its customers?

    Yes, Oriental health insurance firm provides different types of discounts to its customers such as:

     A) Voluntary co-payment discount where insured may opt to bear a part of the claim amount for which different discounts are applicable, subject to a maximum of 50%. 
    B) The insured shall be eligible for No-Claim Discount at the rate of 5% of the renewal premium payable after every claim-free policy year, subject to a maximum of 20%, provided the policy is renewed without any break. 

  • How can I make the payment for the premium of an Oriental Health Insurance policy?

    You can pay the premium of Oriental Health Insurance plans through different payment modes such as cash, cheque, credit or debit cards or through digital payment gateways.

Senior Citizen

  • Does Oriental Insurance Company provide any plan for senior citizens?

    Yes, Oriental Insurance Company provides a health insurance policy for senior citizens. 

  • What is the sum insured amount of senior citizen plan offered by Oriental Insurance?

    Minimum sum insured that can be selected starts from Rs. 1 Lakh and a higher sum insured amount can be selected in the multiples of Rs. 1 Lakh up to a maximum sum insured of Rs. 5 Lakh. 

  • What is the limit of premium up to which the tax benefit can be availed under senior citizen plan of Oriental Insurance?

    Rs. 50,000 is the highest premium amount up to which senior citizens are waived off from tax.

Tax Benefit

  • What is the maximum limit of premium up to which senior citizens can avail the tax benefits? 

    Rs. 50,000 is the highest premium amount up to which senior citizens are waived off from tax.

  • What should be mode of payment to gain tax benefit on premium of Oriental Health Insurance plans?

    To avail the tax benefit on the premium of Oriental health plans, the customers are required to pay their premium through any mode other than cash.

  • Can I be eligible for tax benefits under the health insurance plan of Oriental Insurance Company?

    Yes, you can be eligible for tax benefits by buying a health insurance policy of the Oriental Health Insurance.

Top-up

  • Does Oriental Insurance offer any top-up specific plan for its customers?

    Yes, Oriental Insurance offers a top-up health insurance plan known as the Oriental Super Health Top-up Plan.

  • What are the sum insured options available under the super top-up policy of Oriental Insurance?

    The sum insured amount of Oriental Super Health Top-up Plan ranges between Rs. 3 Lakh and Rs. 30 Lakh.

  • What are the deductible options available under Oriental Super Health Top-up Plan?

    The deductible amount ranges from Rs. 3 Lakh and Rs. 20 Lakh under Oriental Super Health Top-up Plan.

Woman

  • Can a woman customer get organ donor benefit under Oriental Insurance plans?

    Yes, women are provided with the feature of organ donor benefit under the Happy Family Floater Policy of Oriental Insurance.

  • What is the age criteria for women to get enrolled in any Oriental Insurance plan?

    The maximum entry age of women under the plans of Oriental Insurance is up to 65 years of age.

  • Does any plan by Oriental Insurance offer the coverage for the newborn baby hospitalisation expenses?

    Yes, the Diamond Plan of Happy Family Floater Policy offers the coverage for newborn baby hospitalisation expenses with maternity expenses to its women customers.

Oriental Health Insurance Plan List

Name of PlanSum Insured
Happy Family Floater PolicyMin: 91 Days; Max: 70 Years1 Lakh Get Quotes Now
Individual Mediclaim PolicyMin: 18 Years; Max: 70 Years1 Lakh Get Quotes Now
HOPE (Health of Privileged Elders)Min: 60 Years; Max: No Limit1 Lakh Get Quotes Now
Happy Cash Min: 3 Months; Max: No Limit 500/day Get Quotes Now
Arogya Sanjeevani PolicyMin: 3 months; Max: 65 years1 Lakh - 5 Lakh Get Quotes Now
Corona Kavach PolicyMin: 1 day; Max: 65 years50,000 - 5 lakh Get Quotes Now
Corona Rakshak Policy Min: 18 Years; Max: 65 Years50,000 - 2.5 lakh Get Quotes Now

Oriental Health Insurance Top Up List

Name of PlanSum Insured
Super Health Top-upMin: 91 Days; Max: 70 Years3 Lakh Get Quotes Now

Claim Process at Oriental Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation as soon as it occurs and for planned hospitalisation intimate as soon as it occurs prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation as soon as it occurs and for planned hospitalisation intimate as soon as it occurs prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

Oriental Health Insurance User Reviews

  • Useful Policy

    Oriental Arogya Sanjeevani Policy has proved to be a very useful policy for me and my family. I made a claim when my wife got hospitalised and got sav...

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    A
    Ajay Narang
    On: Jun 17, 2020 | Views
  • Good to have my entire family covered

    Oriental Arogya Sanjeevani Policy covers my entire family under a single sum insured. I purchased this policy last week from InsuranceDekho and I must...

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    R
    Rishabh Berlia
    On: Jun 16, 2020 | Views
  • Beneficial policy

    I was in search of an affordable health insurance plan for my family when my colleague referred Oriental Arogya Sanjeevani Policy to me. I brought it ...

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    Y
    Yoginder Yadav
    On: Jun 15, 2020 | Views
  • Several benefits offered

    I purchased Oriental Arogya Sanjeevani Policy from InsuranceDekho during lockdown. Not only the buying process was smooth, but I also got a perfect pl...

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    S
    Shivam Dubey
    On: Jun 14, 2020 | Views
  • Happy with InsuranceDekho’s services

    InsuranceDekho offered me the best services. They not only suggested my Oriental Arogya Sanjeevani Policy but also helped me buy it online as I was no...

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    Abhinav Roy
    On: Jun 13, 2020 | Views
  • Plan offered me reimbursement facility

    I was able to get a reimbursement facility under my Oriental Insurance Individual Mediclaim policy when last week I made a claim in the event of my wi...

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    S
    Sagar Takkar
    On: Jun 03, 2020 | Views
  • Great policy to buy

    Oriental Insurance’s Happy Family Floater Policy is the best as it not only covers me and my family against hospitalisation expenses but critica...

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    S
    Shreyans Jain
    On: Jun 01, 2020 | Views
  • Great Services!!

    I was thinking to take Oriental Health Insurance but did not know where I can get all the knowledge about this health insurance. I came to Insurancede...

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    S
    Surdarshan Singh
    On: May 29, 2020 | Views
  • Instant issuance

    I wanted to purchase Oriental Insurance’s Individual Mediclaim Policy so I called on the toll-free number of InsuranceDekho and the executives d...

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    F
    Farah Dhukai
    On: May 27, 2020 | Views
  • Liked the behaviour!

    I liked the behaviour of the staff of Orienal Health Insurance. Usually government staffs are known for their arrogance behaviour with customers. But,...

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    N
    Nikhil Shankar
    On: Jan 31, 2020 | Views

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