Oriental Nagarik Suraksha Policy
Life is full of uncertainties. Accidents can occur without any prior notice. In such distress, an accident insurance plan comes handy. It will save the family from financial instability by providing a lump-sum amount and pays for hospitalization charges. One such policy is the Oriental Health Nagarik Suraksha Policy offered under the category of Oriental health insurance. The policy has multiple options to suit the needs of individuals, families, and groups of people.
What is Oriental Health Nagarik Suraksha Policy?
Oriental Health Nagarik Suraksha Plan is a comprehensive insurance policy that provides coverage against hospitalization that can include family as well as an individual. This plan can only purchase for a group. Nagarik Suraksha Plan is flexible as it can cater to the different needs of policyholders related to accidental insurance plans. It also provides benefits like cumulative bonuses.
This insurance plan provides reimbursement of hospitalization expenditure due to accidents. Further, this plan also covers death due to an accident, loss of limbs, or in case of total disablement or partial disablement. The plan is affordable as compared to other accident plans. It is divided into two sections.
Features of Oriental Insurance Nagarik Suraksha Policy
The features of Oriental Insurance Nagarik Suraksha Plan are:
Under Section - I
This policy has two sections. Under the first section, the plan pays the claims related to personal accidents only.
The features under Section I are as follows:
- Suppose the person insured dies due to an accident within a year of the purchase of the policy. In that case, the sum insured under the policy will be paid to the insured's nominee or if the policyholder's legal heir mentions no nominee.
- Suppose the person insured suffers from loss of his/her both eyes or both limbs due to an accident. In that case, the policyholder will get 100% of the insured sum on the condition that the disability occurs within 12 months of the accident.
- Further, the person insured is also eligible for a 100% claim if he/she permanently loses one eye and one of the limbs, i.e., one hand or one foot due to the accident. The disability has occurred within 12 months of the accident.
- Due to an accident, if the policyholder suffers from loss of sight of one eye and permanent damage to one of the limbs within 1 year of occurrence of the accident, then the person insured can avail 50% of the insured sum.
- A fixed amount of the insured sum will be paid if the policyholder suffers from any permanent injury or disability that one is rendered in a condition in which he/she cannot work or is in an employable condition.
- A certain amount is paid to the policyholder if there is a physical separation or injury due to the accident, which could lead to a 40% disablement in the person insured.
Under Section - II
Under this section, the policy covers the insured's hospital and medical bills due to surgical or medical treatment leading to hospitalization due to an accident. There are different percentages of sum insured that are paid for various medical treatments of the policyholder, as mentioned in the policy document. But the total liability of the insurance company cannot exceed the insured sum chosen by the insured.
Benefits of Oriental Insurance Nagarik Suraksha Policy
Following benefits are offered under this Oriental health insurance policy:
For every claim-free 12 months (1 year), there is a 5% increase in the reimbursement amount, which is paid by the insurer due to hospitalization of the policyholder resulting from an accident on the sum insured. This increase in the sum insured can be up to a maximum of 20% only. For a person to get a cumulative bonus, one must ensure the policyholder meets the following conditions:
- Condition 1: The policy must be renewed within 30 days from the expiry date of the policy, i.e., the grace period. If the policy is not renewed within 30 days, the cumulative bonus will be lost.
- Condition 2: The plan must be an individual plan, not a group plan or family plan.
On the unfortunate death of the policyholder resulting from an accident, the expenditures incurred due to carrying the body of the person insured to his/her residence place and funeral charges are paid by the insurer. The insurance company will reimburse it up to a maximum of 2% of the insured sum or Rs 2500 whichever is less as mentioned in the policy document.
On the unfortunate death or total permanent disability of the policyholder arising out of an accident, the policy provider company will compensate for the education of the children of the person insured. The plan has a specific benefit to pay the education fund plus sum insured, as mentioned in the policy document. This will be paid irrespective of the number of accidental insurance policies a person has. It is paid as follows:
- If the person insured has a dependent child below 23 years of age as on the date of an accident, then a sum equal to 10% of the insured sum or up to a maximum of Rs 5,000 will be paid by the policyholder as mentioned in the policy document.
- If the policyholder has 2 or more dependent children who are below 23 years of age, then a sum equal to 10% of the insured sum or up to a maximum of Rs 10,000 will be paid by the policyholder as mentioned in the policy document.
This amount will be paid to the nominee or the policyholder. This benefit will be paid only in case of an individual policy.
Suppose the policyholder has a total permanent disability due to the accident rendered unemployable. In that case, the person insured is paid 1% of the sum insured plus the claim amount, as mentioned in the policy document. This is paid to only individual policyholders.
A free-look period of 15 days is given to the policyholder to read the policy documents and review them thoroughly. If, during this period, the policyholder is not satisfied with the policy conditions, then he/she can return the policy. On returning, all premiums will be paid back to the person insured if no claim has been made. This benefit is available for an individual policy only.
The person insured is liable to get tax benefits under 80C of Income Tax Act, 1961, on the policyholder's premiums.
Exclusions of Oriental Health Nagarik Suraksha Policy
The exclusions of the policy are:
- Any injury resulting from the consumption of drugs, liquor, or any other intoxicating article
- Any injury occurred while aligning or getting down from an aircraft except when one is on a flight
- Any illness like HIV/AIDS or any related illness, a derivative, or a mutant variation of HIV/AIDS
- Any disablement or injury borne out of an activity that arises due to breach of law
- Any pre-existing condition before the insurance policy was received, whether the insured was aware of the same or not
- Any injury owing to an activity ordered by any person by the government or person of authority
- Any injury resulting from the use of nuclear materials or weapons
- Any dental surgery or treatment unless hospitalization is necessary
- Complications arising out of conditions that are pre-existing
- Cosmetic or aesthetic vaccination or aesthetic surgeries
- Congenital defects or disease and sterility that are external
- Diagnostic examination, laboratory, and X-Ray unless needed for treatment
- Disablement or death during pregnancy, childbirth, insanity, or venereal disease
- First-aid and OPD that is unrelated to the hospitalization
- General disability, convalescence, run-down conditions, rest cure, or general debility
- Money used on a contact lens, spectacles, or hearing aids
- Naturopathy or yoga therapy
- Plastic surgery and circumcision unless required for healing of an injury
- Pre- and post-hospitalization expenses from rebellion, war, civil commotion, invasion, etc.
- Suicide, self-injury, or any injury borne out of an attempt to kill oneself
- Tonics and vitamins needed unless prescribed by the physician for the treatment of the injury
*This list is only indicative and not exhaustive. It is recommended to refer to the policy document for the complete list of exclusions
Eligibility Criteria of Oriental Insurance Nagarik Suraksha Policy
The eligibility criteria for Oriental Insurance Nagarik Suraksha Plan are:
For individual or group policies:
- Minimum entry age of the applicant - 18 years
- Maximum entry age of the applicant - 70 years
For family plans:
- Minimum entry age of the applicant - 18 years
- Maximum entry age of the applicant - 70 years
- Minimum entry age of a child - 5 years
- Maximum entry age of a child - 21 years
- Sum insured for Individual, Group, and Family policy - From Rs 1 lakh to Rs 5 lakh
- Premium - The premium amount depends on the tier in which the company has its office, group size, number of individuals to be insured, age, and other such factors.
- Coverage - The plan covers:
- Individual sum insured: Family members can be covered as well.
- Family – Complete family can be covered.
- Group - For employees of an organization can be covered.
- Policy tenure -
- For individuals & family - the policy tenure is 1 to 4 years
- For groups, it is one year.
- Renewal - The policy can be renewed every year but depends on age.
*The above information is subject to change as per the norms of insurance providers.
Claim Process of the Oriental Insurance Nagarik Suraksha Policy
The claim process for Oriental Insurance Nagarik Suraksha Plan:
For Section I: Claim Amount
In case of an accident, the policyholder must inform the insurer within 24 hours of the accident. For the claim process, the policyholder, after getting treatment, must get a medical report of his/her condition if the person is suffering from any permanent or partial disablement and submit it along with other necessary documents to the insurance company. The insurance company will verify the documents and approve the claim accordingly.
For Section II: Reimbursement
For accidental hospitalization, the person insured or his/her family must inform the insurer about the same within 24 hours. After paying hospital bills and getting discharged from the hospital, the insured needs to fill up a claim form, attach all the necessary documents and send it to the insurance company. Once verified, the insurer will reimburse the amount through NEFT.
Required Documents to Apply for the Oriental Insurance Nagarik Suraksha Policy
The required documents for Oriental Insurance Nagarik Suraksha Plan are:
- KYC documents - Aadhar Card, Voter Card, PAN card or any other proof
- Address proof - Electricity bill, Water bill, Telephone bill or Bank Account Passbook
How to Buy the Oriental Insurance Nagarik Suraksha Plan?
One can buy this plan thorough paisawiki.com easily. The process to buy this plan is:
- Step 1:After visiting the official website of paisawiki.com and fill up the online application by entering basic details like phone number, birth date, and policy type needed.
- Step 2:The website will show a list of policies. Choose Nagarik Suraksha Plan. One can also choose to compare online with other similar policies.
- Step 3:After comparison with other accidental insurance plans, select the policy.
- Step 4:One is required to enter various details like email address, name, home address, lifestyle details, age, and other details, as asked by the insurer.
- Step 5:After entering the required details, one can choose from a variety of plan options: individual, family, or group. After selection, enter the details of all the members such as name, age, etc. to be included in the policy.
- Step 6:After addition, enter the nominee details.
- Step 7:Upload KYC documents.
- Step 8:Agree to the terms and conditions of the policy and go to the payment page.
- Step 9:Enter bank details asked for payment.
- Step 10:Pay the premium amount, which is calculated after entering the individual's details.
The policy documents will be mailed to the customer on a successful payment. One can also buy the policy through an offline option by visiting the branch office of the Oriental Insurance Company Ltd.
Renewal Process of the Oriental Insurance Nagarik Suraksha Plan
For renewing the policy follow the below steps:
- Step 1:Visit the official website of paisawiki.com and go to the renewal page.
- Step 2: On the renewal page, enter the date of birth and policy number or mobile number & policy number.
- Step 3: Select the 'Proceed' option. If the policy is up for renewal the premium amount along with necessary details will be shown.
- Step 4: Once can add or remove members. The premium changes accordingly. Choose the policy tenure.
- Step 5: Pay the premium amount by filling up bank details.
The new policy documents will be sent to the email address.
FAQs About Oriental Nagarik Suraksha Policy
Ans: No, pre-medical tests are not required.
Ans: The online payment options are:
- Credit Card
- Debit Card
- Online transfer
- Net banking
Ans: No, this plan doesn't cover for pre or post-hospitalization charges.
Written By: Paisawiki - Updated: 09 April 2021