Health Insurance 784 views February 13, 2021

Oriental Insurance Individual Mediclaim Policy is a one-year health insurance plan that can be renewed as long as you want. If your age is between 18 and 65 years, you are eligible for this policy. You can also get your family covered under this policy if you want; and by doing so, you can get a 10% discount on the premium payment. The maximum entry age is 65 years for Oriental Insurance Individual Mediclaim Policy as you know from the above. However, you can extend your entry age upto 70 years by paying an additional premium of 10% (this will apply to all future renewals as well). Oriental Insurance Individual Mediclaim Policy sum insured is available from INR 1 lakh to INR 10 lakh. If you have any pre-existing diseases, they shall be covered after four consecutive renewals. Read this page further and know more about Oriental Insurance Individual Mediclaim Policy.

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Coverages Under Oriental Insurance Individual Mediclaim Policy

The company will pay the following medical expenditure during the policy term if a risk arises-

  1. Room, Boarding and Nursing Expenses
  2. Intensive Care Unit (ICU) expenses
  3. Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees
  4. Cost of Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, cost of prosthetic devices like Pacemaker implanted during surgical procedures, relevant laboratory/diagnostic tests, X-ray and such other.
  5. Ambulance service charges
  6. Daily hospital cash allowance
  7. Pre and Post-hospitalization expenses up to 30 and 60 days, respectively
  8. Ayurvedic, Homeopathic, Unani treatment expenses if taken as an in-patient, in a government hospital or a hospital associated with a medical college.
  9. Daycare procedures/surgeries
  10. Under domiciliary hospitalization expenses – surgeon, medical practitioner, consultants, specialists fees, cost of blood, oxygen, surgical appliances, medicines & drugs, diagnostic material, dialysis, chemotherapy, nursing expenses, treatment for dog bite will be covered.
  11. Hospitalization expenses incurred for donating an organ

Exclusions from Oriental Insurance Individual Mediclaim Policy

The company shall not pay for death or disablement if it arises due to the following –

  1. Intentional self-injury, suicide or attempted suicide
  2. Influence of intoxicating liquor or drugs
  3. Participation in aviation, ballooning, speed contests, racing , bungee jumping, parasailing, parachuting, ski-diving, paragliding, hang gliding, mountain/rock climbing, potholing, abseiling, deep sea diving, polo, snow and ice sports
  4. Servicing in military, air force or naval operations
  5. Travelling in aircraft other than as a passenger
  6. Venereal disease(s) or insanity
  7. Committing a breach of law
  8. War, invasion, an act of a foreign enemy, hostilities, civil war, rebellion, revolution, insurrection, mutiny, military/usurped power, seizure, capture, arrest, restraints and detainments
  9. Ionizing radiations or contamination by radioactivity from any nuclear fuel, nuclear weapon material or any nuclear waste
  10. Childbirth or its consequence thereof

Things to Know About the Oriental Insurance Individual Mediclaim Policy

  1. There is an option of voluntary co-payment via which you can get a discount of 10% and 20%, respectively, on the sum insured of INR 2 lakh and above.
  2. No need to undergo medical examinations if you are aged up to 55 years
  3. A Personal Accident cover is available on this plan with a sum insured from INR 2-10 lakh
  4. A free look period of 15 days from the date of receipt of the policy will be given to you to review the terms and conditions of the policy
  5. A discount of 5.5% on premium payment if TPA services have not opted for
  6. Cashless claim facility at network hospitals only
  7. Notice of claim should be sent within 48 hours of admission but before discharge
  8. You are entitled to the reimbursement of the health check-up cost if there are no claims reported during the policy year. The health check-up cost shall not exceed the amount equaling 0.75% of the average sum Insured

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