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Oriental Individual Mediclaim Health Insurance

23 reviews Rate This
Individual Mediclaim Policy
Claim SettlementDedicated Team
Claim Settlement Ratio93.96%
COVID-19 CoverYes
Network Hospitals4,300+
Policies Sold12,50,812

About Oriental Individual Mediclaim Health Insurance

Individual Mediclaim Policy is an affordable individual health insurance policy that takes care of medical expenses related to hospitalisation and domiciliary hospitalisation under several circumstances. These include emergency hospitalisation, accidental injuries, and hospitalisation required due to surgeries during the policy term. Any individual who is aged between 18 years and 70 years can be covered under this policy for several healthcare expenses. For instance, ambulance expenses, daily hospital cash allowance, domiciliary hospitalisation expenses, in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, organ donor expenses, etc. Apart from this, it offers two add-on covers namely personal accident cover and voluntary co-payment, which the policy buyers can include at the time of policy purchase. If covered under this policy, you can include a maximum of 7 family members.

The policy term for Oriental Individual Mediclaim Policy is one year, after which the policy needs to be renewed for continuous coverage. Other benefits that this medical insurance policy offers include a free look period for 15 days, 30 days grace period, a lifetime renewability benefit, and income tax benefits on the premium under Section 80D of the Income Tax Act, 1961. If you are aged below 45 years, then you would not be required to undergo a pre-policy medical test. The policy offers numerous sum insured options ranging between Rs. 1 Lakh and Rs. 10 Lakh which you can choose as per your requirements and budget. To avail of coverage benefits under the policy, you will be required to complete specific waiting periods after which you can avail coverage as per the policy terms and conditions.

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Key Inclusions and Exclusions of the Plan

What's Included

  • In-patient hospitalisation expenses
  • Ambulance expenses
  • Daily hospital cash benefit
  • Organ donor expenses
  • 30 days pre-hospitalisation and 60 days post-hospitalisation expenses

What's Not Included

  • Self-injury, suicide, or attempted suicide
  • Treatment due to venereal disease or insanity
  • Treatment for childbirth or pregnancy
  • Dental surgery
  • Treatment to insured commiting breach of law with criminal intent

Individual Mediclaim Policy User Reviews

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What users are saying
  • All
  • Better than other policies!

    This policy of Oriental Health is better than other health mediclaim plans available in India. I am saying thi...

    Read More
    By Mukesh Kumar
    On: Jan 30, 2020
  • Suited to my needs!

    It seems that the Individual Mediclaim Policy has been designed to suit my medical needs. I am glad to choose ...

    Read More
    By Sagar Jain
    On: Jan 21, 2020
  • Affordable plan for individual...

    I have purchased the Individual Mediclaim Policy after conducting thorough research. I chose this product...

    Read More
    By Amit Shah
    On: Jan 15, 2020
  • Star of all policies!

    For my personal need, I have taken the Individual Mediclaim Policy with Oriental Insurance. I have chosen...

    Read More
    By Ashish Saraswat
    On: Jan 09, 2020
  • Excellent coverage!

    In terms of coverage, Individual Mediclaim Policy is the best one for me. Right from covering Allopathic treat...

    Read More
    By Umesh Chandra
    On: Jan 08, 2020

Add-ons to Enhance Benefits

  • Voluntary Co-payment

    This add-on benefit can be purchased by people opting for this policy for a sum insured of Rs. 2 Lakh and above, to include a voluntary co-payment of 10% or 20%. Along with this, you can avail of a discount of 10% or 20% respectively on the premium. The co-payment is not selective and is uniform for every insured person under the policy. Every insured member is required to mandatorily opt for this except people choosing for a sum insured below Rs. 2 Lakh as the co-payment option is not available in that. The co-payment is applicable on each and every claim and the insured will be required to pay 10% or 20% as opted at the time of policy purchase, for every admissible claim.

  • Personal Accident Cover (World-Wide)

    This add-on offers personal accident cover to the insured for sum insured options in multiples of Rs. 2 lakh up to Rs. 10 Lakh. People aged more than 18 years can seek cover under his add-on, and people aged less than that can avail of maximum coverage of Rs. 4 Lakh.

Oriental Individual Mediclaim Policy Expert Review

  • Expert Review

    When it comes to affordable policies, Oriental Insurance has many to offer. Talking about Individual Mediclaim Policy, it is a superior health insurance product that ensures you don’t face shortage of funds in the middle of a medical emergency. The policy not only provides extensive cover, but also freedom from financial worries, and that too at an extremely affordable premium amount. 

    While the eligibility range for Individual Mediclaim Policy starts at 18 years and goes up to 70 years, the policy term is 1 year. Note that you can also get dependent children between the age of 3 months to 18 years covered. Coverage for family comprising of spouse, parents/parents-in-law (either of them), and unmarried siblings (in case financially dependent on the proposer), apart from dependent children is allowed as well. Lastly, when it comes to sum insured options, they are available from Rs. 1 Lakh to Rs. 10 Lakh. All in all, you can place your trust on this policy to help you gain financial and mental satisfaction, even in a medically critical situation.

  • Major Attractions

    Individual Mediclaim Policy is a complete package. The policy provides superior coverage for medical expenses related to hospitalisation as well as domiciliary hospitalisation in case of an accident, illness, or any surgery linked to disease which has occurred during the policy period. When you buy Individual Mediclaim Policy, you gain coverage for room; boarding and nursing expenses; ICU cost; fees of surgeon, anaesthetist, and others as well as cost of anaesthesia, blood, oxygen, etc. Moreover, the inclusions list includes -

    • 30 days pre-hospitalisation & 60 days post hospitalisation expenses
    • Specified/listed procedures requiring less than 24 hours hospitalisation (daycare)
    • No medical examination for persons up to the age of 55 years
    • In case of fresh covers, 50% of the pre-insurance medical check-up cost is reimbursed
    • Dental treatment arising out of accident
    • Emergency ambulance 
    • Organ donor expenses
    • Ayurvedic, Unani and Homeopathic treatment in govt. hospitals/colleges
    • Daily Hospital Cash allowance in case of more than 2 days of continuous hospitalisation
    • Add-on of Voluntary Co-payment & Personal Accident Cover
  • What’s More?

    Individual Mediclaim Policy is a great combination of multiple coverage features and benefits. A big helping hand for any individual, the policy doesn’t disappoint you at times of financial security. The prime features other than those related to medical expenses covered under the policy include -

    • Guaranteed policy renewal for life
    • Free look period - 15 days
    • Grace period - 30 days
    • Coverage for pre-existing diseases after 4 years of waiting period
    • Premium adjustment at renewal, for the period of OMP cover taken from the insurer
    • Family discount of 10% (including on PA cover) if more than one person is covered
    • 5.5% discount on premium if TPA services not opted for
    • Tax benefits under Section 80D of the Income Tax Act
  • Conclusion

    To conclude, Individual Mediclaim Policy is a beneficial policy you can think of buying to secure your health and financial state in the adverse times. The policy would definitely suit the best to your needs.

    If interested in opting for Individual Mediclaim Policy, make sure you choose the online mode to buy it as it will help you get the policy issued without any delay. Moreover, to reap benefits such as policy transparency, claim settlement support, policy portability, and others, you can place your trust in InsuranceDekho.

Oriental Individual Mediclaim Policy Brochure

  • 429.03 KB
  • PDF Document
  • Jul 18, 2019

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.

FAQs on Individual Mediclaim Policy Health Insurance Plan

  • What is the entry age under the policy?

    The entry age under the policy is between 18 to 65 years. However, the maximum entry age can be extended up to 70 years upon payment of additional premium.

  • Are there newborn and maternity benefits available under the plan?

    No. The policy does not provide cover for maternity and newborn treatment expenses. 

  • Are there any renewal benefits available?

    There is health check-up benefit of up to 0.75% of average SI, subject to maximum Rs. 3000 for every block of three claim-free policy years.

  • What is the cost-sharing option available under the plan?

    There is a voluntary co-payment option of 10% and 20% with the corresponding discount on the premium of 10% and 20% respectively on SI of Rs. 2 Lakh and above.

  • Are there any limit for room, boarding and nursing expenses cover?

    The room, boarding and nursing expenses are covered not exceeding 1% of the Sum Insured per day.

  • What is the limit for cover for ICU expenses?

    The ICU expenses are covered not exceeding 2% of the Sum Insured per day.

  • Does the company offer any discounts if more than one person is covered under this policy?

    If more than one person is covered, then there is a family discount of 10% (including on PA cover).

  • Is pre-acceptance medical check-up required to obtain this policy?

    There is no pre-acceptance medical examination required for persons up to the age of 55 years.

  • Is pre-acceptance medical check-up reimbursed by the company?

    In the case of fresh covers, 50% of the medical checkup cost is borne by the company, subject to acceptance of the proposal.

  • Are there any other discounts available under the policy?

    There is a discount of 5.5% in the premium amount provided if TPA services are not opted for purchase or renewal of the policy.

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