Tuesday, 28 November 2017

Oriental Mediclaim Insurance Policy: Everything You Need to Know

Oriental Insurance is one of the pathfinders in ensuring smooth conduct of the insurance business in India. The company has continuously been recognised among the pioneering insurance companies due to excellent service and motivated workforce.

Among various insurance products offered by the company, Oriental insurance mediclaim is worth buying. Named as Oriental Individual Mediclaim Policy, it is similar to health insurance plans that provide coverage to the policyholder in case of hospitalisation.

Highlights of Oriental Individual Mediclaim Plan

  • ·         Individual between 18 to 80 years is eligible to buy this mediclaim policy
  • ·         Company offers 10% discount on enrolling for more than two members
  • ·         In case you buy the plan before the age of 45, an additional 5% discount on renewal will be offered.
  • ·         Pre-policy health check-up is applicable only after the policyholders enters the age of 45.

Oriental Individual Mediclaim Insurance: Policy Detail

Entry Age
Number of Members Covered
Sum Insured
Policy Period
Pre-policy Medical Check up
Children- 91 days
Maximum members- 7
Rs. 50,000 to Rs. 5,00,000
1 year
If the insurance seeker is more than 45 years old.
10% family discount
Adult- from 18 years to maximum 65 years
Maximum adults- 4
Maximum children- 4

Policy Coverage and Benefits

  • ·         Day-care Treatment:  Day-care treatment is offered for the surgical process conducted using local or general that doesn’t require 24 hours of hospitalisation owing to technically advanced healthcare facilities.

  • ·         Pre-hospitalisation: The insurer will reimburse you for the medical expenses used before the policyholder is hospitalised up to 30 days. This is applicable only after the insurance company accepts the claim for in-patient hospitalisation

  • ·         Post-hospitalisation: This facility covers medical expenses immediately after the insured discharged from the hospital. One can avail this benefit only with an approved in-patient hospitalisation claim by the insurer. Medical expenses up to 60 days are covered.

  • ·         Home hospitalisation: The insured can claim for the expenses incurred towards a treatment availed at home, however, insurer applies its terms and conditions accordingly.

  • ·         Emergency Ambulance Cover: Coverage of around Rs. 2000 or 1% of the sum insured is offered towards emergency ambulance expenses under this plan.

  • ·         Dental Treatment: Any dental treatment owing to an accident is covered.

Is There Any Free-look Period?

Yes, the free-look period facility is there. In case, whatever the reason, you decide not to continue with the policy, you can surrender the same and request the insurer for a refund within 15 days from the policy initiation date.

Other Conditions:

  • ·         Treatment for some specific illness like Cataract, Myomectomy for Fibroids, Hysterectomy is covered only after 24 months.

  • ·         The policyholder can claim for ant pre-existing illness only after 48 months from the policy start date.

  • ·         A cooling period of 30 days is applicable on every claim except that arises out of accidental injuries.

Permanent Exclusions

The insurer will not accept any claim under this plan arising from below conditions:

  • ·         Intentional injury like suicide attempt
  • ·         Symptoms of illness occurs within 30 days of the policy tenure
  • ·         Any injury under the influence of alcohol or drug
  • ·         AIDS-related claim
  • ·         Maternity, childbirth, miscarriage, abortion etc.
  • ·         Congenital disease
  • ·         infertility and in vitro fertilization.
  • ·         hospitalization out of war, riot, strike and nuclear weapons

Well, considering the facilities offered by this plan and reviewing the present scenario when healthcare expenses are sky-high, having a mediclaim plan is imperative. However, one has to be careful at the time of purchasing a plan. If talking about oriental medcliam insurance, it doesn’t cover lifelong renewability and no claim bonus.  Also, the insured will have to serve a waiting period of 4 years to along with sub-limits pre-decided on room rent & ICU. But on a brighter side, it covers some decent benefits including family discount that is alluring. We suggest, always compare the plans online and only take the one that meets your requirement.

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