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Oriental Health Insurance
250+ Plans 18 Insurance Companies
₹ 5 Lakh Coverage @ ₹ 10/day
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Oriental Health Insurance

Oriental Health Insurance is one of the renowned health insurers in the Indian insurance market. The provider is well-known for offering some tailor-made and customer-friendly health insurance policies that can be customised as per one’s insurance needs. The flexibility of choosing sum insured from as minimum as Rs 5000, makes the policy worth buying.

What is Oriental Health Insurance?

Oriental health insurance plans offer comprehensive insurance coverage, which can be availed for individual, family, senior citizen etc. The insurer offers a range of health insurance products to cater to the various needs of an individual. In-patient hospitalisation expenses, Pre and post hospitalisation, domiciliary hospitalisation etc. are some of the unique features of this policy.

Why Should You Choose Oriental Health Insurance?

There are several major benefits for choosing Oriental health insurance policies, as it is a large and solid brand that can be trusted:

  • Cashless hospitalization: Due to its extensive network of hospitals throughout the country, the insured party can easily get cashless hospitalization benefits in a network hospital, no matter where they are.
  • Claims process: Oriental health insurance options are backed by a smooth and easy claims process and a settlement percentage that proves that the insured party can rely on the insurer.
  • Initial Screening: Most of the policies, such as Oriental’s Mediclaim policy, do not require an initial screening. This is true uniformly until the insured reaches the age of 55 years. Under some circumstances, however, even those who are not yet 55 may need to do an initial screening.
  • Lifetime Renewal: Many of Oriental’s health insurance policies support lifetime renewal so that even the elderly who cannot get new insurance policies can be reliably covered if they have previously kept up their premium payments.
  • Online Buying: With Oriental health insurance, it is easy to buy a policy online. You can merely log on to their website, choose the buy online option, choose the correct policy from the dropdown menu, and then fill in all the required details in the form. Or you can buy the policy through Paisawiki as well with no hassle.
  • Domiciliary Hospitalization: Many of Oriental’s health insurance policies or mediclaim policies allow for domiciliary hospitalization under certain circumstances, and even more allow for charges under pre-hospitalization and post-hospitalization costs.

Features of Oriental Health Insurance Plans

All of Oriental's Health Insurance plans have their unique features and benefits. To get an initial idea of what would be the best health insurance plan for you, first assess your needs according to the following narrowed down criteria for health insurance plans:

  • Coverage: The policy comes with an extensive coverage with multiple sum insured. The most crucial point is to know which illnesses and medical emergencies are covered, and which are in the list of exclusions.
  • Sub-limits: Many plans now have sub-limits for specific categories of costs or specific illnesses. In Oriental health insurance policies, this is largely true, where room charges, ICU charges, nurse charges, etc. all have sub-limits. which are typically expressed as percentages of the sum insured.
  • Co-payment Feature: High co-payments with low premiums may leave you at a disadvantage compared to high premiums and low co-pays, as co-pays could theoretically be much larger and are difficult to predict
  • Waiting period for Pre-existing Illnesses: Waiting periods can range from as little as 2 years after policy inception to as much as 4 years. If there is an urgent need for which the policy has been bought, a longer waiting period may not be suitable.
  • Domiciliary Treatment: Treatment if for more than 3 days, in case there is no space at the hospital, or the insured party cannot be shifted to a hospital, expenses incurred in availing treatment at home are covered up to 10% of the sum insured.
  • Pre and Post Hospitalisation: Pre and post hospitalisation expenses are covered for 30 and 60 days respectively.

Benefits of Oriental Health Insurance Policy

The below are the plan-wise benefits of Oriental Health Insurance:

  • Individual Mediclaim Health Insurance: This policy provides cashless hospitalization with prior Third Party Administrator approval. It also provides reimbursement for a health check-up as a no claim bonus after 4 consecutive years, to a limit of 1 percent of the sum assured. 25-day care procedures are also allowed under this policy.
  • Happy Family Floater Policy Silver and Gold Plan: This policy allows room charges and nursing charges, with a children’s attendant allowance. Add-ons such as Personal Accident cover, which can include dependents and Life Hardship cover for survival benefits, are also available.
  • Oriental Bank Mediclaim Policy: This policy allows room charges, nursing charges, ambulance charges, and funeral costs. The policy tenure is annual, but it is valid for renewing up until the insured party is 80 years of age.
  • PNB - Oriental Royal Mediclaim Insurance Policy: This policy will cover a family, including a female child until her marriage and a male child less than 26 years old. It will cover cashless hospitalization, health check-ups, ambulance charges, nursing charges, room charges. The upper age limit for renewability is 80 years. This has the specific eligibility criteria that the insured party must have an account with Punjab National Bank.
  • Jan Arogya Bima: This is aimed at underprivileged people, with premiums starting from Rs 70 for men and Rs 50 for women and dependent children. The upper age limit for adults is 70 years, starting from 5 years, and for children, they must be between the ages of 3 months and 5 years old. 
  • Nagrik Suraksha Policy: This can cover individuals or families with entry ages between 5 years and 70 years of age, or group packages between 18 years and 70 years of age. The benefits include cumulative bonus, funeral charges, education fund support, and hospitalization expenses. There is also a personal accident benefit in case of total or partial disability of the insured party.
  • Janata Personal Accident Policy: This is only to cover the requirements of the insured party in case of partial or full disability due to a personal accident. It covers 50% to 100% of the Sum Insured. Exclusions include any injuries received through extreme sports, injuries from attempted suicide, existing disabilities, war or nuclear peril, and injuries from criminal activities.
  • HOPE - Health of Privileged Elders: This policy is for senior citizens above the age of 60 years, and it has a mandatory co-payment of 20 percent. It covers needs such as hospitalization and domiciliary treatment charges, limb replacement or prosthetics charges, and others. However, it only covers limited diseases, and it only covers up to a certain maximum for each disease.

Types of Oriental Health Insurance Plans

The Oriental Insurance Company offers insurance in several areas, such as personal accident insurance, car insurance, fire insurance, and so on. Under health insurance as well, they have a wide range of offerings, from those who cannot afford to pay beyond the bare premium, to excellent options for senior citizens. Below are some of the types of Oriental Health Insurance and their comparison table:

Name of the plan

Sum Insured

Screening

Waiting Period for Pre-Existing Diseases

Individual Mediclaim Health Insurance

Rs 50,000 – Rs 5 lakh

Above 45 years

 

4 years

Happy Family Floater Policy Silver Plan

Rs 1.5 lakh with 10 percent co-payment

Above 60 years of age

4 years

Happy Family Floater Policy Gold Plan

Rs 6 – Rs10 lakh

Above 60 years of age

4 years

Oriental Bank Mediclaim Policy

Rs 1 lakh – Rs 5 lakh

-

3 years

PNB - Oriental Royal Mediclaim Insurance Policy

Rs 1 lakh – Rs 5 lakh

Not required for any applicant

2 years

Jan Arogya Bima

Rs 5000 per annum

-

Not Covered

Nagrik Suraksha Policy

Rs 1 lakh – Rs 5 lakh

-

-

Janata Personal Accident Policy

Rs 25,000 – Rs 5 lakh

-

NA

HOPE - Health of Privileged Elders

Rs 1 lakh – Rs 5 lakh

Not required

2 years

Oriental Health Insurance Plans Explained

Let’s know about the various health insurance plans offered by the insurer:

  • Individual Mediclaim Health Insurance: This Oriental insurance mediclaim policy is a general plan for an individual. It will handle all healthcare-related expenses apart from those that are excluded or in a waiting period. This policy is for a tenure of one year and can be renewed indefinitely. Exclusions include anything occurring during the waiting period, pre-existing diseases, maternity and childbirth expenses, psychiatric disorders, asthma, etc.
  • Happy Family Floater Policy Silver and Gold Plan: This plan is for the whole family, with the sum insured being for the whole family rather than per person, and the family being the insured party. This will usually cover spouses and children.
  • Oriental Bank Mediclaim Policy: This Oriental Mediclaim policy is solely for either employees or customers of the Oriental Bank of Commerce. It is a family rather than an individual plan. Several exclusions apply, including a waiting period for pre-existing diseases, outpatient treatment, genetic defects, some sexually transmitted diseases, sight-correction surgery, etc.
  • PNB - Oriental Royal Mediclaim Insurance Policy: This is solely for account holders at Punjab National Bank. This is a family floater policy. Exclusions include aesthetic dental surgery, a waiting period for pre-existing ailments, maternity care, some sexually transmitted diseases, sight-correction surgery, etc.
  • Jan Arogya Bima: This is a family floater policy aimed at an economically weaker section of society. Premiums can be as low as Rs 50.
  • Nagrik Suraksha Policy: This is a very flexible Oriental health insurance policy, as it can be utilized by individuals, families, or even groups. The tenure ranges from annual to every four years. The exclusions for this policy include any issues arising during aviation, sexually transmitted diseases, HIV or AIDS, pregnancy, and childbirth-related complications. As is usual in all such cases, committing a crime will also render the policy void.
  • Janata Personal Accident Policy: This is an individual accident insurance plan to support an insured party who suffers from disability due to an accident. The tenure is one year, and it can be renewed until the upper age limit. The exclusions are typical, such as breaching the law, any wartime issues, any harm due to suicide or attempted suicide, existing disabilities, and specifically notes that injuries due to extreme sports are not counted.
  • HOPE - Health of Privileged Elders: This Oriental health insurance is for senior citizens, above the age of 60 years can become insured. This plan only covers specified illnesses such as an accidental injury, a knee replacement, cancer, cardiovascular diseases, benign prostate, orthopedic diseases, ophthalmic (eye) diseases, Hepatobiliary disorders, chronic obstructive lung disease, and chronic renal failure. There is a maximum limit of coverage for each disease.

Eligibility Criteria of Oriental Health Insurance

The eligibility criterion for each policy is usually dependent on the policy itself. Most policies will have different age limits, the sum assured criteria, the number of people allowed to be insured on the policy, and so on. However, the minimum age can be 3 months to 25 years for children and 18 years to 70 years for adults.

Claim Process of Oriental Health Insurance

There are two types of procedures, usually for the claims process in health insurance policies. The first is a cashless claim, in case of treatment at one of Oriental's 4000+ network hospitals. In this case, prior Third Party Administrator approval is required. The second type of claim is a reimbursement claim, where treatment has occurred at a non-network hospital, or there is no cashless facility, and the patient has paid upfront and is claiming reimbursement of eligible costs.

  • Cashless Treatment Claim: The first step for a cashless claim is for the insured member to apply to the Third Party Administrator of Oriental health insurance, through a network hospital. The network hospital would submit their pre-authorization request to the Third-Party Administrator. In this case, the Administrator would examine the request and check whether the insured party is eligible for claims via their medical information. If the insured party is found to be eligible, then the insurer will authorize the request, and the hospital will directly settle bills with the insurer. In case of an emergency where prior notice is not possible, the Administrator should be informed within 24 hours of the insured party being admitted to the hospital.
  • Reimbursement Claim: The insured member should submit all of the duly filled documents within the given deadline, which is usually 15 days from the day of discharge from the hospital. This would include details such as the insured party, their policy document, the medical documents, and so on. The Third Party Administrator would have been informed within seven days from the insured party being hospitalized.

Claim Documents

Several documents are required when filing an insurance claim, including:

  • Duly filled Claim Form
  • Medical reports including the discharge report, original test reports such as X-Rays, Sonography, etc., and prescriptions
  • Copy of Claim intimation given to Company and copy of policy documents and proof of payment
  • All the bills of the medical expenses
  • Leave certificate from the employer
  • Details of the nursing home or hospital where the insured party was admitted. If it is not registered than the doctor’s certificate with the details of the qualifications of the nursing home, the staff, the nurses, and so on
  • In case of an accident claim, the first information report about the accident or the Police Panchnama

Renewal Process of Oriental Health Insurance

For Oriental insurance Mediclaim renewal you can renew the policy online through the website pf Paisawiki:

  • Go to paisaiwiki.com , and immediately at the top right, the option for 'Renewal' will appear, and you may click on it.
  • You may renew either your Oriental health insurance policy or any other company's policy, using the policy number.
  • Check your policy details and alter anything that needs altering, gets a premium quote.
  • Make the payment online.
  • Keep a copy of the payment and policy renewal confirmation.

It is absolutely this simple to renew your Oriental Health Insurance policy. Try it either for PNB - Oriental Royal Mediclaim Insurance renewal or renewal of other Oriental policies and enjoy how easy it is to use!

How to Buy Oriental Health Insurance?

For buying Oriental health insurance, the simplest method is to conduct all work online. The company has taken the effort to allow most policies to be bought and renewed from the comfort of your home or anywhere with a computer and a good internet connection. Also, you can buy it from Paisawiki as well. The steps for buying are:

  • Go to the website of paisawiki.com
  • Choose 'Buy Online' in the dropdown menu.
  • Select the type of insurance policy, then select the policy you want
  • A form will appear on your screen with 4 steps to finish buying your policy.
  • You may then fill in the details, including the current state of your health, your age, name, and other details and complete each step to get an estimated value of the premium amount.
  • You may confirm the details and make the payment online.
  • Keep either a printout or a downloaded copy of the confirmation page. You will need the policy details in the future for any communications, including renewal and claims.

It is wise to have all of your required documents on hand before beginning the process, including your address and ID proof, as well as any medical documents required.

Documents Required to Buy Oriental Health Insurance

There are majorly 6 documents that should be kept in hand while applying for a health insurance plan from Oriental Insurance:

  • Age Proof: As most policies will have upper and lower limits on who can buy, this is extremely important. You may use Voter ID Card, Pan Card, Aadhaar Card, Driving License, Passport, Birth certificate, mark sheets of your final school examination.
  • Identity Proof: You may use Aadhaar Card, Driving License, Passport, Voter ID, or any other government ID card with a photo of you.
  • Address Proof: You may use any of Ration card, Driving license, Passport, Rent agreement if applicable, PAN Card, Aadhaar Card, Utility bills like electricity bill, gas bill, or telephone bill.
  • Photograph
  • Medical report (if required)
  • Policy proposal form

FAQs

Written By: Paisawiki - Updated: 22 September 2020

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