Oriental Health Insurance

The Oriental Insurance company was formed in 1947 and was a subsidiary of Life Insurance Corporation of India till 1973. In 2003, the control of Oriental Insurance was given to the central government and from then, it started working as a public sector insurance company.

Oriental health insurance policy promises to offer financial assistance against medical emergencies, including hospitalization costs, health checkups, critical illness, etc. Apart from health insurance, the company deals in other types of insurance products including travel, motor, home, personal accident, among others. Oriental Health Insurance has been recognized as Best General Insurance- Public in the CNBC TV18 Best Bank and Financial Institution Award.

Key Features Of Oriental Health Insurance

Nowadays health insurance has become a necessity for you and your family by helping you overcome the rising medical bills incurred at the time of hospitalization. Besides, having a medical insurance plan offers you peace from financial burdens and stress. However, with the availability of several options in the market, people often get confused and buy the wrong policy due to a lack of awareness.

To provide in-depth information on policy plans, we have listed some key features of the company.

1. Lifetime Renewability

   Oriental Health Insurance provides the option of lifetime renewability that saves your pocket from financial burdens.

2. Network Hospitals

   Nowadays, having health insurance along with a cashless facility is a blessing in disguise during medical emergencies. Oriental Health Insurance is empanelled with 2500+ network hospitals across India that will ensure you cashless hospitalization without any financial stresses. With a cashless treatment facility, all medical bills get settled upon the completion of the treatment or after the discharge, which means you can get yourself treated without paying any money from your pocket and you do not have to arrange funds at the time of medical emergency. We have prepared a graph below for the comparison between Oriental Health Insurance and other top insurance companies based on network hospitals. Let's have a look.

   Comparison between Oriental Health Insurance with other top insurance companies based on network hospitals

   

   You can now check the Oriental health Insurance network hospital list with PolicyX.com as per your state and your city.

   In case you are not admitted to a non- network hospital, Oriental offers a reimbursement option, allowing you to file for the reimbursement of the treatment cost you have paid in the hospital.

3. Claim Support (Within 3 Months)

   Claim support is another crucial factor to consider while selecting a reliable insurance company. The claim support ratio helps determine the claim settling ability of the insurance provider and how the insurance company settles the claims of the insured person at the time of a medical emergency.

   IRDAI publishes it annually in the first month of every year. As per the reports of IRDAI 2019-20, Oriental Health Insurance settles 92.71% of claims within 3 months.

   Comparison between Oriental Health Insurance with other top insurance companies based on the claim support

   

   **Data from IRDAI Annual Reports

   It is important for you to analyse the Claim Support Ratio of a company.

   Please take a look at the graph which shows the Claim support (within 3 months) of Oriental Insurance for 2016-2020

   

   **Data from IRDAI Annual Reports 2019-20

4. Solvency Ratio

   The solvency ratio of a company helps determine the ability of a company to meet its financial obligations, thus providing financial protection to you and your family. Additionally, it also determines the company's size. The solvency ratio is published in IRDAI Annual reports for four months.

   IRDAI mandates maintaining a healthy solvency ratio of 1.5 for every insurer. As per IRDAI Annual Report 2019-20, the solvency ratio of Oriental Health Insurance Company is 1.38.

   Solvency Ratio of Oriental Insurance Company from FY 2016- 2020

   

   **Data from IRDAI Annual Reports

   As we have discussed above that IRDAI publishes solvency ratio of four months for a year. Let's discuss the solvency of 2019-20 from June 2019-March 2020.

   Solvency Ratio of Oriental Insurance of FY 2019-20

   

   **Data from IRDAI Annual Reports 2019-20

5. Market Share

   Market share is the parameter that one considers while selecting an insurance company. It determines the business volume that refers to the total number of policies sold by an insurer. As per the IRDAI Annual report 2019-20, the annual gross premium is 4642.63 Crores whereas, for 2018-19, it was 4047.71 crores. We have prepared a graph that compares the annual gross premiums of Oriental Health Insurance Company from 2016 to 2020.

   Annual Gross Premium of Oriental Health Insurance for FY-2016-20

   

   **Data from IRDAI Annual Reports

   The bar graph shows the Annual premium of Oriental Health Insurance from the Financial year 2016-20. Oriental Insurance Company shares 9.1% of the insurance market.

   We have summarized the above information in the table below:

   Head Office	New Delhi
   Regional Offices	29
   Total Number of Employees	13500
   Network Hospitals	2300+
   Annual Gross Premium (2019-20)	4642.63 Crores
   Market Share 2019-20 (in%)	9.1
   Claim Support (within 3 months)	92.71
   Renewability	Lifelong
   Solvency Ratio	1.38

   **Last Updated on August, 2021

Benefits of Oriental Health Insurance

This comprehensive health insurance policy protects you and your family by offering various benefits to provide you relief from additional financial expenses.

Before buying this policy, it is always recommended to go through all the terms and conditions of the policy. Here are the major benefits:

1. Comprehensive Coverage

   Oriental health plans provide comprehensive health insurance coverage options to fulfill all your medical requirements.

2. Daily Cash Benefit

   When you are admitted to a hospital, you are eligible for daily cash as per your sum insured amount.

3. Portability Option

   If you are not satisfied or happy with the services then, Oriental provides you with the option to port your policy to the other insurer.

4. Tax Benefits

   Get the tax benefit on the premiums paid under section 80(D) of the Income Tax Act 1961.

What Are The Types of Oriental Health Insurance Plans?

To cater to the different needs of the customers, the company has come out with a wide range of health insurance plans.

**Last Updated on August, 2021

Let's discuss each plan in detail.

1. Happy Family Floater Policy

   Happy Family Floater Policy is for all Indian citizens as well as SAARC country citizens who want to secure their families from future medical costs arising due to inevitable hospitalization or medical issues. The plan is offered in three variants-

   • Silver
   • Gold
   • Diamond

   Key features:

   • In-patient hospitalization occurred during the time of treatment of any investigated illness in a hospital is covered.
   • The plan offers coverage for pre-hospitalization and post-hospitalization expenses.
   • A daily hospital cash allowance (Rs. 600 to Rs. 1000 per day) for the diamond plan and Rs. 600 to Rs. 1000 per day for a gold plan is provided to the policyholder.
   • Domiciliary hospitalization expenses are also covered.

   Eligibility Criteria:

   Minimum Age of entry	18 years for adults 3 months for children
   Maximum Age of entry	65 years
   Sum Insured	Rs. 1 lakh to 20 lakhs

   **Last Updated on August, 2021

2. PNB Oriental Royal Mediclaim Insurance Policy

   PNB Oriental Royal Mediclaim Insurance Policy focuses on securing the health of Oriental Bank of Commerce (OBC) account holders and their families at an affordable rate of premium. The policyholders can include their spouse, dependent children, and widowed/divorced daughters.

   Key features:

   • Daily hospital cash allowance is available only for the proposer of policy. The per-day limit would be Rs. 200 whereas the total cash allowed is Rs. 1000 in a policy period.
   • Organ donor expenses coverage for transplantation of organs where insured is the recipient. The insured must show that transplantation has been suggested by the doctor.
   • Post-hospitalization expenses that occur after getting treatment in a hospital and the issue of discharge are covered for up to 60 days.
   • Domiciliary hospitalization benefits where the insured can have the facility of the medical practitioner, consultants, blood, oxygen, surgical appliances, diagnostic equipment, medicines & drugs, surgeon and dialysis, chemotherapy, and nursing at home is provided.

   Eligibility Criteria:

   Minimum Age of entry	18 years for adults 3 months for children
   Maximum Age of entry	79 years
   Sum Insured	Rs. 1 Lakh to 10 Lakhs

   **Last Updated on August, 2021

3. Group Mediclaim Policy

   If anybody wants to cover a target group, association, institution, or corporate batch can purchase Oriental Group Mediclaim. The cover can be bought for a group of 50 families or 50 persons or more.

   Key Features:

   • The total value of in-patient hospitalization expenses that popped up for a detected illness/injury will be covered.
   • Domiciliary hospitalization where treatment can be taken at home with the permission of a medical practitioner will also get covered (up to the limit of the sum insured).
   • Pre-hospitalization expenses that cover diagnostic tests, medicines, doctor consultation, etc. appearing before going to a hospital are covered. Reimbursement of expenses is done for 30 days (maximum ending on the date of admission).
   • Maternity expenses for the female insured members are paid by the company for normal child delivery.

4. Individual Mediclaim Policy

   Individual Mediclaim Policy health insurance policy is designed for individuals and their family members who wish to get coverage from unpredictable hospitalization and medical emergencies.

   Key Features :

   • For pre-hospitalization, the expenses occurring for 30 days are reimbursed whereas, for post-hospitalization, the expenses will be covered for 60 days.
   • Under this plan, organ transplantation will be liable to get the cover. The plan will also cover the organ cost along with the treatment.
   • Domiciliary hospitalization, which allows the insured to operate treatment at home only on the recommendation of a medical expert or due to unavailability of the hospital bed. The insured can claim 20% of the sum insured or Rs. 50,000 (per insured member).
   • The plan also offers a family discount of 10% (including on PA cover) if more than one person is covered under the policy.

   Eligibility Criteria:

   Minimum Age of entry	18 years for adults 3 months for children
   Maximum Age of entry	65 years
   Sum Insured	Rs. 1 Lakh to 10 Lakhs

   **Last Updated on August, 2021

5. Oriental Happy Cash Policy- Nischint Rahein

   The Happy Cash Policy will keep your worries at bay (during the whole term of the policy) through a constant supply of cash during hospitalization that will not affect your pocket savings.

   Key Features:

   • Daily cash benefit for each day of hospitalization is provided, and if the policyholder is a woman, 25% additional daily cash benefit will be provided.
   • The plan grants convalescence benefits for the treatment taken at home, which lasts for 30/60 consecutive days.

   Eligibility Criteria:

   Minimum Age of entry (dependent children)	3 months - 18 years
   Maximum Age of entry	65 years
   Daily Cash Benefit Option	Rs. 500, Rs. 1000, Rs. 2000 & Rs. 3000

   **Last Updated on August, 2021

6. Oriental Super Health Top Up

   It is a premium health insurance plan, which covers all the significant medical expenses associated with the required treatment if the hospitalization expenses exceed the SI under the base policy.

   Key Features:

   • Transplantation of the organ in the insured's body where coverage is reserved for in-patient hospitalization of the donor and transplanting the same in the recipient body. The insured will receive 10% of the sum insured.
   • In-patient treatment at Ayurvedic, Yoga and Naturopathy, Unani, Siddha, and Homeopathic centres (registered under government councils) is reimbursed as per the specified limit.
   • Pre and post-hospitalization expenses (30 & 60 days) are covered by the plan.

   Eligibility Criteria:

   Minimum Age of entry	18 years
   Maximum Age of entry	65 years

   **Last Updated on August, 2021

7. Pravasi Bhartiya Bima Yojana Policy

   The Pravasi Bhartiya Bima Yojana Policy is made to facilitate the people who migrate to foreign countries for employment and have obtained an emigration clearance for the same.

   Key Features:

   • In case of the death of the insured during the policy tenure in India or abroad, the plan will offer the required cover (up to 10 lakhs).
   • The plan pays 10 lakhs (as compensation) against permanent disability arising during the period of living as an emigrant abroad where disability resulted in the loss of employment due to the inability to engage in business activities.
   • Hospitalization covers family members residing in India if the policy is taken on a floater basis. This is valid for the death and disability of any member where Rs. 50,000 is a fixed amount for payment.
   • Maternity benefit to female insured emigrants in case she conceives during the time abroad. For normal delivery, a maximum of Rs. 35,000 is provided and for cesarean delivery, a maximum of Rs. 50,000 is paid out.

8. Health of Privileged Elders

   Health of Privileged Elders is designed to offer helpful health insurance cover to senior citizens aged 60 years and above. The plan offers coverage to specified diseases only and it comes out with a compulsory co-payment of 20%.

   Key Features:

   • The plan reimburses the cost of hospitalization and domiciliary hospitalization expenses for the specified diseases sustained by the insured.
   • The plan will also offer coverage against surgical treatments, which include treatment of an illness or injury, diagnosis, and cure of diseases, correction of deformities and defects, performed in a hospital or daycare centre by an expert.
   • The plan grants post-hospitalization cover (up to 60 days) under which all expenses associated with the treatment (after getting discharged) will be liable to get the required cover.

   Eligibility Criteria:

   Sum Insured	Rs. 1- 5 lakhs
   Cashless service through TPA	Up to Rs. 1 lakh

   **Last Updated on August, 2021

9. Jan Arogya Bima Policy

   The policy reimburses the expenses incurred during hospitalization/domiciliary hospitalization for illness or injury sustained.

   Key Features:

   In-patient hospitalization coverage for the following:

   • Boarding room expenses
   • Nursing expenses
   • Surgeon, anaesthetist, consultants, medical practitioner, and specialists fees
   • Cost of a pacemaker, blood, operation theatre charges, diagnostic materials and X-ray, dialysis, surgical appliances, oxygen, chemotherapy, anaesthesia, radiotherapy, artificial limbs, medicines & drugs & cost of organs, and similar expenses

   Pre-hospitalization expenses (up to 30 days) are covered. Post-hospitalization expenses are also covered (for a maximum of 60 days) and will be settled only when you submit related reports/ bills/ tests/ doctor statements.

   Eligibility Criteria:

   Entry age (Adults)	5 years - 70 years
   Sum Insured	Rs. 5000

   **Last Updated on August, 2021

10. Arogya Sanjeevani Policy- Oriental

    Arogya Sanjeevani is a standard health insurance plan that covers hospitalization expenses and comes with a wide range of useful benefits.

    Key Features:

    • One can include his/her family members like spouse, dependent children, parents, and parents-in-law.
    • The plan comes with a lifelong renewable option.
    • The plan covers ambulance charges (up to Rs. 2000 per hospitalization).
    • Grab coverage for the expenses incurred on dental treatment and plastic surgery due to disease or injury.

    Eligibility Criteria:

    Entry Age	18 years - 65 years
    Policy Period	1 year
    Sum Insured	Rs. 1 lakh to 5 lakhs

    **Last Updated on August, 2021

11. Overseas Mediclaim Policy (B&H)

    Overseas Mediclaim Insurance Policy (B&H) is a combination of travel and health insurance that contains health benefits and offers coverage against loss during travel abroad.

    Key Features:

    • Sustenance of any physical injury that has visible and external traces on the body of the insured will be covered. The injury is eligible for compensation only if it has appeared from an accident.
    • Loss of checked-in baggage (like any article/property/valuable material) will be compensated by the company.
    • The insured will receive reimbursement of real expenses incurred for the acquisition of emergency travel documents as a replacement for the lost passport.

12. Overseas Mediclaim Policy (E&S)

    The Overseas Mediclaim Employment and Studies policy covers various travel and health emergencies faced by the policyholder while traveling abroad.

13. Corona Kavach Policy

    Corona Kavach Policy is available on both individual and family floater basis, which protects the policyholder from the expenses incurred due to COVID-19 treatment.

    Key Features:

    • The policy provides coverage against road ambulance charges and AYUSH treatments incurred at AYUSH hospitals.
    • The plan also covers pre and post-hospitalization expenses up to 15 & 30 days.

    Eligibility Criteria:

    Entry Age (Adults)	18 years - 65 years
    Sum Insured	Rs. 50,000 - Rs. 5,00,000
    Policy Period	3.5 months, 6.5 months, and 9.5 months

    **Last Updated on August, 2021

14. Corona Rakshak Policy

    Corona Rakshak Policy offers a lump-sum benefit (equal to 100% of the SI) on a positive diagnosis of COVID-19, provided the insured is hospitalized for a minimum period of 72 hours.

    Key Features:

    • The plan comes with a waiting period of 15 days from the commencement of the policy date.
    • The plan offers all India coverage and is available on an individual basis.

    Eligibility Criteria:

    Entry Age (Adults)	18 years - 65 years
    Sum Insured	Rs. 50,000 - 2,50,000
    Policy Period	3.5 months, 6.5 months, and 9.5 months

    **Last Updated on August, 2021

15. Oriental Critical Illness Plan

    A critical illness can bring emotional and financial stability to your life. This plan is specifically designed for the earning member of a family who is diagnosed with Critical illnesses such as Tumor, cancer, etc. Add-on covers are available under this plan.

    Key Features:

    • This plan provides portability options. You can migrate your plan to the other plan.
    • Get the cashless treatment under this plan and no need to pay single money to the hospital at the time of medical emergency.
    • Option for personalized health advice from a doctor or a medical practitioner.
    • The critical illnesses covered under this plan are:
      • Coma of particular severity
      • CABG
      • Bone marrow transplant
      • First heart attack
      • Cancer with specified severity

Exclusions

• Intentional/self-inflicted injury
• Drug abuse/substance abuse/intoxication
• Alcohol consumption
• War/biological injuries/nuclear/chemical war
• Breach of law with criminal intent
• Insanity or Venereal disease
• Adventurous sport or any hazardous activity
• Injuries arising from ionizing radiations or contamination by radioactivity

How to Buy Oriental Health Insurance?

Oriental has made the process of buying health insurance easy and convenient.

• Visit the official website of Oriental Insurance Company.
• Scroll down and choose the health policy you wish to buy.
• On the next page, fill in the required details and calculate the premium.
• Once done, you will get the payment details.
• Make an online payment and your policy document will be sent to your registered email address.

What is the Claim Process of Oriental Health Insurance?

There are two processes to register a claim: Cashless and Reimbursement process.

Cashless Claim

In case if you want to avail of a cashless claim and are admitted to a network hospital then follow the below steps:

• For availing of cashless treatment, the Oriental health insurance claim application form is required to be authorized by the network hospital.
• The insurance company checks the information related to the medical condition and then analyzes if the claim is eligible for you or not.
• After which the insurer reviews the medical information and determines whether that policyholder is eligible or not.
• When the insurance company is satisfied with the information, at that time, the policyholder can avail cashless treatment. The insurer settles all the medical expenses directly with the network hospital.

Reimbursement Claim

In case of emergency hospitalization, the insurer must be informed within 24 hours of hospitalization or getting admitted to the hospital.

• Fill the claim application form.
• Attach all the medical documents and submit all other required documents to the insurance company within 15 days of discharge from the hospital.
• Then, after the approval or the rejection from the insurer, the reimbursement claim is processed.

What is the Renewal Process Of Oriental Health Insurance?

The oriental health insurance must be renewed every year to enjoy its benefits. The company has come out with an online process, which makes it easy to renew your plan from the comfort of your home. The Oriental health insurance renewal process is mentioned below.

• Visit Oriental Insurance's website and submit your request online by clicking on the 'Renew Online' option displayed on the menu bar.
• Enter the policy number and click on the 'Renew Now' button to proceed further.
• Specify the policy details.
• Deposit the premium via available payment modes. A policy renewal notification will be shared with you.

How to Contact Oriental Health Insurance?

Oriental House, A-25/27, Asaf Ali Road,

New Delhi - 110002

Phone No's:011-43659595