Oriental Personal Accident Policy

Insurance policies are financial instruments that safeguard the personal wealth of the individual against unfortunate events so that the individual need not burn a hole in his/her expenses during such times of crisis. Oriental Personal Accident plan is one such undertaking by the Oriental Insurance Company Ltd., which takes care of finances in case the insured meets with an unfortunate accident critical to his/her life.

By choosing an accidental plan like this, a person can ensure that, although such events are unprecedented or unpredictable, they are not left unplanned.

What is Oriental Personal Accident Policy?

Oriental Insurance is one of the famous health insurance providers in India, with many customers across their multi-targeted policies. The Oriental Insurance Company Ltd. has many personal accident plans designed to safeguard various segments of customers.

Various personal accident plans under Oriental Insurance Company are:

• Janata Personal Accident plan
• Gramin Accident Insurance plan
• Nagarik Suraksha Plan
• Personal Accident- Individual plan
• Personal Accident- Group plan

Each of the plans mentioned above is discussed in detail below with their key features and exclusions.

Gramin Accident Insurance Plan

This plan provides for financial protection to customers living in rural sections.

The key features of the plan are:

• The Gramin Accident Insurance plan is available for rural customers covering death or permanent total disablement, loss of limbs, or permanent partial disablement.
• The cover is available for individuals up to 70 years of age.
• Since its policyholders would be residing in rural areas, the premium is at a very affordable price and provides cover for individuals as well as family.
• The policy tenure is 1 year, with a grace period of 30 days, and free look period of 15 days.
• The policy covers domiciliary hospitalization and also reimburses claims post-treatment.
• Additionally, there is no waiting period applicable under the policy.

The main exclusions of the Gramin Accident Insurance policy are:

• Any injury sustained as a consequence of war, foreign invasion, civil war, etc.
• Any bodily injury sustained due to order by government, local, or public authority
• Any injury due to radiation or ionization
• Any claim made due to an injury sustained as a result of participation in adventure sports of any kind
• Dental treatments/implants or any aesthetic procedure of cosmetic surgery

Janata Personal Accident Plan

The Janata Personal accident plan is tailor-made to provide accident benefit to individuals between 10-80 years regardless of their income or profession.

The main features of the plan are-

• The entry age of Janata Personal Accident plan is 10 years, while the maximum age is 80 years
• The plan covers death or permanent total disablement, loss of limbs, or permanent partial disablement
• Wide range of sum insured, ranging from Rs 25,000 to Rs 5,00,000 per individual per annum
• For a cover of more than Rs 2,00,000, income proof is necessary to be furnished by the life insured
• Affordable premium rates with Rs 15 for a policy cover of Rs 25,000
• 15-days free look period

Exclusions under the Janata Personal Accident plan are:

• Any pre-existing illness/injury
• Death or disablement due to intentional self-harm, suicide, etc.
• Injuries resulting out of intoxication of liquor, drugs or substance abuse
• Insanity
• Breach of law
• War Group & Nuclear Group of perils
• Death or disablement due to adventure sports, racing, hunting, shooting, etc. 

Nagrik Suraksha Plan

The Nagarik Suraksha plan provides compensation and reimbursement in hospitals due to accidental injuries. Individuals aged 5-70 years of age are eligible, while family group Insurance can be bought for all individuals between 18-70 years.

The key features of the plan are:

• Coverage for death or permanent total disablement, loss of limbs or permanent partial disablement
• The benefits cover during a claim made due to an accident is subject to the degree of disability, which should not be less than 40% of the total sum assured under the policy
• Only Indian citizens can avail this plan
• The policy also covers all funeral expenses and costs due to carriage of dead body from the hospital to the place of residence, up to 2% of the sum assured or Rs 2,500/-, whichever less
• Compensation provided for the continuance of education of the children of the life assured in case of death or permanent total disability. The amount will be 10% of the sum assured or Rs. 5,000/- for single dependant child, whichever is higher. In case the life assured has more than 1 dependant child, the education compensation will be Rs. 10,000/- or 10% of the sum assured, whichever is higher
• Policy tenure is one year, with lifelong renewability
• The policy also provides for compensation if the life assured suffers a loss of income due to permanent total disability, subject to 1% of the original sum insured
• 15 days free-look period

Exclusions under Nagarik Suraksha Plan are:

• Any injury sustained as a consequence of war, foreign invasion, civil war, etc.
• Any bodily injury sustained due to order by government, local, or public authority
• Any injury due to radiation or ionization
• Any claim made due to an injury sustained as a result of participation in adventure sports of any kind
• Dental treatments/implants or any aesthetic procedure of cosmetic surgery.

Personal Accident Group Plan

This plan is available as individual and family floater, but also can be taken for a small group of employees engaged within a business. The personal accident group plan compensates against death due to an accident and total/irrecoverable loss of eyesight or separation of hands or legs.

The features of the plan are:

• The plan is designed to offer financial protection during a medical crisis suffered by the life insured included in a group such as a family, businesses, Small Housing Groups, associations, etc.
• Family to include spouse and 2 children aged between 3 months to 79 years
• Lucrative savings offered on premiums for group cover plans

Exclusions under Personal Accident plan are:

• Any injury sustained as a consequence of war, foreign invasion, civil war, etc.
• Any bodily injury sustained due to order by government, local, or public authority
• Any injury due to radiation or ionization
• Any claim made due to an injury sustained as a result of participation in adventure sports of any kind

Personal Accident Plan-Individual

The Personal Accident individual plan under Oriental Personal Accident policy forms a health cover for individuals suffering from physical disability or death due to an accident.

The features of the plan are as follows:

• A simple cover for an individual without any medical check-up
• Available for adult individuals up between 18-75 years and minors between 6 months and 18 years
• Lifelong renewability
• 15 days free-look period, along with a grace period of 30 days
• A proportionate compensation available in case of injuries arising within 90 days of an accident
• Coverage of death occurring within 12 months due to an accident up to the full amount of sum insured
• The plan also covers emergency medical service costs incurred as a result of an accident
• Coverage for all funeral expenses and costs due to carriage of dead body from the hospital to the place of residence, up to 2% of the sum assured or Rs 2,500/-, whichever less
• Compensation for the continuance of education of children of the life assured in case of death or permanent total disability. The amount will be 10% of the sum insured or Rs 5,000/- for single dependant child, whichever is higher. In case the life assured has more than 1 dependant child, the education compensation will be Rs 10,000/- or 10% of sum insured, whichever is higher
• Cumulative bonus of 5% of death and disability benefit offered for every no-claim year, subject to a maximum of 20% of the total sum insured

Exclusions under the plan are:

• Any injury sustained as a consequence of war, foreign invasion, civil war, etc.
• Any bodily injury sustained due to order by government, local or public authority
• Any injury due to radiation or ionization
• Any claim made due to an injury sustained as a result of participation in adventure sports of any kind

Eligibility Criteria for Oriental Personal Accident Insurance Plan

The policy comes with the following eligibility criteria:

Claim Process of Oriental Personal Accident policy

If the insured suffers any illness or injury resulting from an accident, then he/she needs to inform the insurer at the earliest and lodge the claims per the due process.

To file an Oriental health insurance claim, one needs to:

• Give notice to the policy issuing department or claim office regarding the illness/injury sustained.
• A duly filled claim form should be submitted along with medical bills and certificates and other necessary documents.

Apart from the claim form, the nominee needs to submit the following documents in case of the death of the insured:

• Death certificate
• Post mortem report
• Original policy documents
• Claim form
• The police report, if a complaint is lodged.
• Final Investigation Report
• Duly notarized affidavit
• Medical certificate and all medical expenses
• Wage certificate from the employer
• Proof of age

If the accident results in permanent disability, the following documents are to be submitted:

• Medical certificate and details of all medical expenses
• Police First Information Report/ Final Investigation Report
• Duly filled claim form
• Leave & Wage certificate from the employer

In the case of temporary total disablement, the insured needs to submit the following documents to make a claim:

• Premium receipt and claim intimation form
• Police First Information Report/ Final Investigation Report
• Medical report
• Leave certificate from the employer

How to Buy Oriental Personal Accident Policy?

The Oriental Personal Accident plan can be bought online as well as offline. The policy also can be bought through aggregator websites such as Paisawiki.com. The buying steps are:

• Visit the official website of Paisawiki.com
• Once the website opens, go to the ‘health’ tab and click on 'buy online.'
• From the sub-options listed select 'buy now.'
• A new pop-up window will then list multiple plans. The customer needs to select the personal accident plan and fill in the details.
• One has to provide some personal information such as age, email id, members to be added, city of residence etc. and submit.
• Once the premiums are calculated, the same has to be paid online using debit/credit card or net banking.
• On successful payment, the policy soft copy will be mailed to the registered email ID.

Renewal of Oriental Personal Accident policy

The Oriental Personal Accident policy has to be renewed on a yearly basis for its benefits to be continuously enjoyed by the insured. The policy can be renewed online by following the below steps:

• Submission of Request

Upon visiting the official website of Paisawiki, one must click on ‘Renew Online' on the menu bar.

• Details

The applicant seeking renewal must furnish his/her policy number and click on 'Renew Now'. Subsequently, the person will need to fill in all policy details, including the personal ones.

• Premium Deposit

The final step for renewing the policy is to make payment of the premium as displayed on the screen. Once the payment is made, the policy is renewed.

FAQs