Group Insurance February 10, 2021

Oriental Insurance Group Mediclaim Policy can be suitable for any group, association, institution or corporate body wanting to secure the financial future of its members. One of the best things about this plan from Oriental Insurance is that an individual doesn’t need to undergo any pre-medical screening.

Here, we will be telling you different aspects of the Oriental Insurance Group Mediclaim Policy, such as its features, coverage, policy term, etc. Read on to know more!

Group Health Insurance

Striking Features of the Oriental Insurance Group Mediclaim Policy

Before choosing a policy, it is important to understand its features so that you can get full benefits. That’s why we are showing some of the top features of the Oriental Insurance Group Mediclaim Policy below. Do check them.

  1. With the Oriental Insurance Group Mediclaim Policy, any group/ association/ institution/ or corporate body of more than 50 persons or families can choose this plan. However, they must have a central administration point.
  2. Each insured should cover all eligible members (insured members) under one group policy. This means that different categories of eligible members cannot choose to get coverage under different group policies.
  3. This group policy from Oriental Insurance will be issued according to the guidelines set by the IRDAI in the name of a group, association, institution or corporate body (called insured) with a proper schedule of names of the members and their eligible family members. Here, the family will include a primary insured person, legal spouse, dependent children up to the age of 21 years, and dependent parents or parents-in-law.
  4. Policyholders can enjoy cashless facilities at network hospitals in case of any medical emergency. However, if an individual opts out of this facility, he or she can get a discount of 5% on premiums.
  5. Policyholders who are below 45 years of age don’t need to undergo any pre-medical screening test when choosing this plan from Oriental Insurance.

What is the Sum Insured for Oriental Insurance Group Mediclaim Policy?

In the case of Oriental Insurance Group Mediclaim Policy, the minimum sum insured amount stands at INR 50,000 and can go up to INR 2,00,000 in multiples of INR 25,000. However, if you want to choose a sum insured above INR 2 lakh, it can only be in multiples of INR 50,000, up to INR 5,00,000.

What is the Policy Term?

This policy from Oriental Insurance can be taken for one year only.

What can be Covered Under the Oriental Insurance Group Mediclaim Policy?

One of the most questions that people ask before choosing Oriental Insurance Group Mediclaim Policy is what exactly this policy covers. Well, you can know the same below. Have a look!

With the Oriental Insurance Group Mediclaim Policy, insured members can get reimbursement of the expenses related to hospitalization and domiciliary hospitalization for the illnesses or diseases during the policy period up to the limit of capital sum assured. The following are the expenses that this policy covers –

  1. Room, boarding and nursing expenses up to 1% of the sum insured or INR 5,000 per day (whichever is lower)
  2. ICU expenses up to 2% of the sum insured or INR 10,000 (whichever is lower)
  3. Fees of Surgeon, Medical Practitioner, Consultants, Specialist and Anesthetists
  4. Pre and post-hospitalization expenses
  5. Expenses related to Blood, oxygen, operation theatre charges, appliances, medicine & drugs, chemotherapy, artificial limbs, cost of prosthetic devices implanted during surgeries like a pacemaker, X-ray, etc.
  6. Ambulance Services up to 1% of the sum insured or INR 2,000 (whichever is lower)
  7. Maternity expenses and newborn child cover benefit which is an optional cover that can be taken by paying 10% of total basic premiums for all the insured persons under the policy

What are the Exclusions Under the Oriental Insurance Group Mediclaim Policy?

There are a few situations for which the policy does not provide any cover. Take a look below to know about such situations.

  1. A pre-existing health condition or diseases up to 4 years of policy from its commencement
  2. Cataract treatment
  3. Diabetes-related illnesses up to 2 years
  4. Calculus diseases with a waiting period of 2 years
  5. Cosmetic Surgery for correction of eyesight, cost of spectacles, contact lenses, hearing aids, etc.
  6. Circumcision unless necessary and prescribed by a doctor
  7. Injury or disease directly or indirectly caused by war, invasion, the act of a foreign enemy, warlike operations, etc.
  8. Convalescence or general debility
  9. Expenses on Vitamins and tonics etc.
  10. Genetic disorders and stem cell surgery
  11. Expenses on massages, steam bathing, etc.

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