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PNB Oriental Royal Mediclaim Insurance Policy
The PNB Oriental Royal Mediclaim policy, introduced by Oriental Health Insurance, provides comprehensive coverage to account holders of Pun…
- Covers family
- High sum insured
- Ambulance cover
Oriental Health Insurance
Individual Mediclaim Policy
Oriental Individual Mediclaim by Oriental Health Insurance is an affor ...Read More
Up to 2 Crores
Sum insured
1
No. of plans
1,000+
Pan India presence
91.62%
Claim settlement ratio
🛡️ IRDAI Approved
⭐ 4.4/5 · 2,700 reviews
🏥 4,000+ hospitals
📊 -1.03 solvency ratio
✅ 91.62% claim settlement
About Individual Mediclaim Policy
A quick read on what this Oriental Health Insurance plan covers and why it might be a fit for you.
Oriental Individual Mediclaim by Oriental Health Insurance is an affordable health insurance policy designed to cover all your medical expenses related to the hospitalization or domiciliary hospitalization of the policyholder under the following conditions:
- Sudden illness
- Accident
- Surgery to treat any disease that arises during the policy period.
This plan offers comprehensive coverage for hospitalization expenses, domiciliary costs, organ donors, and more, for individuals aged 18 to 65 years receiving treatment in India. You can also include your family under the same policy.
Plan at a glance
Eligibility, sum insured options and policy mechanics — pulled straight from the policy wording.
Entry age
18 to 65 Years
Plan type
Individual
Sum insured options
₹1 L, ₹2 L, ₹3 L, ₹4 L, ₹5 L, ₹10 L, ₹15 L, ₹20 L, ₹25 L, ₹35 L, ₹50 L
Waiting period
30 days
Renewability
Lifetime
Policy term
1 Year
*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
Pros & cons
A quick honest summary — the strengths and the trade-offs.
Pros
- Family discount
- Voluntary co-payment
- Daily hospital cash
Cons
- Alcoholism and drug abuse
- Obesity
- Cosmetic procedures
What's covered
Every CMS-driven coverage flag from the plan wording — only items with a published value render below.
Hospitalization
- Room rent Covered
- ICU charges Covered
- Pre-hospitalization Covered
- Post-hospitalization Covered
- Domiciliary hospitalization Covered
- Day-care treatment Covered
- OPD charges Covered
- Covid-19 treatment Covered
- Cataract Covered
Bonuses & restoration
- No-claim bonus Not covered
- Automatic restoration of SI Not covered
- Daily hospital cash Covered
Family & special care
- Maternity cover Covered
- New-born baby cover Covered
- IVF treatment Not covered
- AYUSH treatment Covered
- Organ donor expenses Covered
Modern & preventive care
- Modern treatment Covered
- Road ambulance Covered
- Air ambulance Covered
- E-consultation Covered
- Health check-up Not covered
- Second medical opinion Covered
- Vaccination Not covered
Conditions & global
- Co-payment Covered
- Sub-limits Covered
- Compassionate travel Not covered
- Global coverage Not covered
Video reviews
Walkthroughs from the PolicyX team — pros, cons, real claim experiences and who should buy.
Oriental Health Insurance
This video talks about Oriental Health Insurance in detail. It talks about the Solvency Ratio, and Claim Support Ratio which helps an individual to analyze the Claim settling ability of the Insurer.
Inclusions & exclusions
What the plan pays for, and what it doesn't.
Exclusions
- Hospitalization due to war, riot, strike, and nuclear weapons
- Intentional self-injury
- AIDS
- Miscarriage and abortion
- Congenital diseases
- Infertility and in vitro fertilization
- Polycystic Ovarian Disease: 1 year
- Calculus diseases: 2 years
- Diabetes: 2 years
- Gout and Rheumatism: 2 years
- Piles: 2 years
- Hypertension: 2 years
- Undescended Testes: 2 years
- Hydrocele surgery: 2 years
- Congenital internal diseases: 2 years
- Joint Replacement: 2 years
- Sinusitis and its related disorders: 2 years
- Osteoarthritis and Osteoporosis due to age: 2 years
- Surgeries related to gallbladder and bile duct: 2 years
- Surgeries related to the genitourinary system: 2 years
Who can buy this plan
Eligibility criteria pulled straight from the policy wording.
- Min entry age: 18 years
- Max entry age: 65 years
- Initial Waiting Period: 30 days
- Sum Insured: Up to 50 Lakhs
Other features & benefits
- Personal accident cover
- Medical second opinion
- Multiple SI options
Oriental Individual Mediclaim Health Insurance Policy: FAQs
The 5 most-asked questions about Individual Mediclaim Policy, answered.
Yes, the plan offers a Personal Accident Cover that covers death and permanent disability. The rider is available for the sum insured in multiples of Rs, 2,00,000 up to Rs. 10,00,000 above the age of 18 years. For less than 18 years of age - Maximum coverage of 4 lakhs is applicable.
No, you do not need to go for the medical examination up to the age of 55 years.
Under this optional benefit, one can opt for a co-payment of 10% or 20%, wherein they will get an eligible premium discount of 10% and 20% respectively.
Yes, you can increase the coverage. However, as per the terms and conditions of the plan maximum increase allowed at each renewal is Rs. 2 Lakhs per insured person up to the age of 45 years. After that, the maximum increase allowed at each renewal is Rs.1 Lakhs per insured person.
Yes, the plan offers family discounts of 10% if more than one person is covered under the policy.
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