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Oriental Mediclaim Insurance Policy
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*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply

Oriental Mediclaim Insurance Policy

Oriental Mediclaim Insurance Policy one of the most popular insurance policies to be availed. Health insurance is a boon for overcoming the financial stress one can face during a medical emergency. Among many health insurance providers, Oriental Insurance Company has been serving the industry with multiple innovative products.  Oriental mediclaim policy is one such popular choice amongst investors.

What is Oriental Mediclaim Insurance Policy?        

Oriental mediclaim insurance plan is a basic health insurance scheme, specially designed to offer coverage to individuals and their families in case of hospitalization for various illnesses. There are different types of Oriental mediclaim insurance policies one can avail depending on their requirement, and they are available in the following options:

  • Oriental Individual Mediclaim Policy– This policy offers financial coverage in case of accidents, various diseases, surgeries as well as many other unexpected medical emergencies. As the name suggests, this policy is especially designed for individuals only.
  • Oriental Overseas Mediclaim policy– During a trip abroad, this Oriental mediclaim plan safeguards the investing individual's health and family's health hazards. With this policy in motion, one can travel without worrying about unbearable expenses that might occur abroad due to an unprecedented mishap.
  • Oriental Insurance Group Mediclaim policy– This Oriental mediclaim policy is a group plan and is available for associations, institutions, and larger groups of no less than 50 people.

Key Features of Oriental Mediclaim Insurance Policy

Oriental mediclaim plans are the epitome of convenience in relation to medically induced expenses. The key features are as follows:

  • Minimum age of entry ranges from 18 years – 65 years.
  • Oriental Mediclaim policy is only available to Indian citizens.
  • A voluntary co-payment between 10% - 20% is available.
  • The duration of the policy is 1 year.
  • Room rent, nurse charges, and boarding expenses during hospitalization are covered.
  • Up to 1% of the sum insured can be charged to ambulance expenses.
  • Pre-hospitalization charges up to 30 days prior to the hospitalisation can be claimed.
  • Post hospitalization charges up to 60 days after discharge can be claimed.
  • A personal accident cover add-on rider is available.
  • Doctor's fees, surgeon's charges, and additional medicine costs are also covered.
  • Daily hospital cash allowance is provided for a maximum of 6 days.
  • Anaesthesia, blood, oxygen, etc. can be claimed.
  • The maximum age limit is up to 79 years.
  • Donor charges in case of organ donation are also covered.

Benefits of Oriental Mediclaim Insurance Policy

The policy provides a large number of benefits as stated below;

  • Claim settlements are quick and hassle-free.
  • Covers the individual as well as his/her family members up to 7 people under the same policy.
  • A pre-existing illness that goes back to 4 years before the inception of policy is also covered
  • A grace period of 30 days is offered for renewals.
  • On a minimum sum insured of Rs 2 lakh, one can avail of a 10% - 20% savings on premium (*Savings offered by the insurer are as per the IRDAI approval. Standard terms and conditions apply)
  • Ensures financial protection against unprecedented emergencies.
  • A free look period of 15 days is offered with all the Oriental mediclaim insurance plans.
  • One can save tax under Section 80D of the income tax act.
  • The lifelong option of renewing the policy is available.
  • No initial screening will be required for individuals up to the age of 55 years to avail the policy.
  • Oriental mediclaim insurance plansare designed to offer the maximum sum insured.
  • In case of any displeasure with the policy, one can choose the portability option and shift out to another provider.
  • A daily cash allowance is provided during hospitalization depending on the sum insured.
  • One can avail cashless treatments during hospitalization at the 4300+ network hospitals.

Exclusions of Oriental Mediclaim Insurance Policy

Despite the vast range of ailments covered under the policy, a few exclusions as stated below stand true:

  • Suicide attempt
  • Self-inflicted injuries
  • Treatments for sexually transmitted diseases, HIV and AIDS
  • Child birth-related complications
  • Pregnancy-related complications
  • Any type of injury or medical health arising out of unlawful acts
  • Hospitalizations incurred due to rebellious activities such as war, protests, etc.
  • Injuries inflicted due to adventure sports such as sky diving, bungee jumping, rock climbing, etc.
  • Any venereal disease treatments
  • Injuries arising out of military operations, naval operations and air-force
  • Issues occurring due to a drug overdose or abuse of alcohol in addition to any other intoxicating substance use
  • Any health complications incurred due to nuclear radiation

Eligibility for Buying the Oriental Mediclaim Insurance Policy

The eligibility criteria for the plan is as follows;

Minimum age of entry

18 years (for adults) and 3 years (for children)

Maximum age of entry

65 years - 79 years

Sum Insured

Rs 1 lakh to Rs 10 lakh. And a maximum of Rs 50 lakh for group medical insurance plans

Rs50 lakhs to Rs. 1 crore for Royal Mediclaim policy  

Number of members Covered

6 members. (self, spouse, unmarried siblings, dependant children and parents) For groups, this number is unlimited.


Claim Process of the Oriental Mediclaim Insurance Policy

The claim process of the Oriental Mediclaim plans is made easy and hassle-free to provide the utmost convenience when applying. However, it is a good idea to know the steps to be taken for the same. To claim the policy, one needs to adhere to the below-mentioned steps:

  • Inform the insurer at the earliest possible date.
  • Submit the duly signed and completed claim form.
  • Submit the required documents along with the form.
  • All the authentic reports, certifications, medical certificates need to be submitted with honesty.
  • The cashless transaction will require the approval of the claim form by the hospital.
  • If treatment has commenced prior to the submission of the said documents, one can contact the TPA for the claim reimbursement.
  • The documents should be sent to the official registered office of the provider.
  • Oriental company will then verify the eligibility and all the necessary documentation submitted to start the claim proceedings.
  • After due verification, the company will release the claimed amount within the stipulated time.

Documents Required for the Claim Process

To avail the claim amount smoothly, one requires the below-mentioned documents:

  • Original medical bills, certificates and receipts
  • Discharge summary
  • Death certificate if applicable
  • Disability certificate if applicable
  • Original proof of payment with a letter from a doctor who has performed the treatment
  • All medical documents including test reports, health reports, and consultation fee receipts
  • Chemist bills for medicines purchased
  • Medical prescriptions for the medicines purchased
  • Diagnostic reports and original bills from the attending specialists such as anesthetists, consultants, nutritionists, etc.
  • Original certificate from the surgeon stating the diagnosis and subsequent treatment
  • Any other documents which might be demanded by the provider or TPA

How to Buy Oriental Mediclaim Insurance Plans?

The best and easiest way to purchase Oriental mediclaim policies as required is online. Paisawiki has a dedicated website offering all the relevant steps and details to be able to purchase this policy. One can choose to visit the website and make the purchase directly online following the simple steps or alternatively call the helpline number. The customer care executives work round the clock and are always happy and eager to help.

If an online purchase is an issue, one can visit the nearest official branch of the company along with the documents and cheque to be able to buy it offline.

Renewal Process of Oriental Mediclaim Insurance Policy

As always, renewing the policy online saves time and serves in a much more efficient manner of offering convenience. It is imperative to note that the renewal process must be done before the deadline to avoid an undue lapse and tedious proceedings to revive it thereafter. The following steps need to be taken to do the needful if renewing the policy through Paisawiki.com

  • Visit the official website of Paisawiki.com and navigate through the ‘renewal’ option.
  • Follow the easy steps as stated on the website and fill in all the required details.
  • Select the policy renewal tab.
  • For an instant renewal, adding the policy number is mandatory.
  • Make the payment as per the link and ensure that there is no mistake in the policy number.
  • Once the payment is made, the procedure is successful.
  • A soft copy of the renewed policy along with the payment receipt will be sent to the registered email address instantly.

FAQs

Written By: Paisawiki - Updated: 12 February 2021

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