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Oriental Health Insurance

The Oriental insurance company offers a range of comprehensive general insurance products. The insurer has major operations in India but also operates in other countries such as Kuwait, Nepal, and Dubai. Apart from Oriental health insurance, the company also offers insurance products for chemical and petrochemical industries.

The customers can compare, buy and renew Oriental medical insurance plans online. It offers some of the best mediclaim policies to offer you and your family an enhanced coverage at an affordable price.

Oriental Health Insurance at a Glance

Key Features Highlights
Incurred Claim Ratio 112.22%
Network Hospitals 4300+
Waiting Period 4 years
Renewability Lifelong

Features of Oriental Health Insurance Policy

  • The policy is for Indian citizens only
  • Policy term is 1 year
  • Age criterion is 18 to 65 years (extendable to 70 years)
  • Lifelong mediclaim renewal
  • Pre-health check-ups required only for applicants who are 45 years of age
  • 15 days of free look period. It is not valid at the time of policy renewals
  • Get 10% of family discount ( in case more than 2 members are insured)
  • Pre-existing disease to be covered after 4 years of policy purchase
  • Free look period of 15 days in case you want to cancel or buy add-ons
  • A grace period of 30 days for payment of renewal premium
  • Voluntary co-payment option of 10% and 20%

Oriental Health Insurance Plans Comparison Table

Name of the Plan Sum Assured Entry Age Waiting Period Renewal
Oriental Individual Mediclaim Health Insurance Plan Rs 1 lakh to Rs. 10 lakhs 18  to 65 years ( extendable to 70 years) 4 years Lifelong
Oriental Insurance Happy Family Floater Plan Rs 1 lakh to Rs. 20 lakhs Children: 91 days

Adults: 18 to 65 years

4 years
Oriental Jan Arogya Bima Plan 5,000 5 to 70 years Not covered
OBC Oriental Mediclaim Plan Rs 1 lakh to Rs. 10 lakhs Up to 79 years 3 years Lifelong
Oriental Group Mediclaim Plan Rs. 50,000 to Rs. 5 lakhs Children: up to 26 years 48 months Yearly (subjected to the age limit)
Oriental PNB Health Insurance Plan Rs. 2 lakhs to Rs. 5 lakhs 79 years 3 years Up to 80 years
Oriental Overseas mediclaim Plan Rs. 50,000 to Rs. 5 lakhs
Oriental HOPE Plan Health of Privileged Elders Rs 1 lakh to Rs. 5 lakhs 60 years and above Yearly basis renewal

Types of Oriental Health Insurance Plans

  1. Oriental Individual Mediclaim Health Insurance Plan– This plan is designed to cover individual medical insurance needs. It can be acquired by all individuals between the ages of 18 years to 65 years.
  2. Oriental Insurance Happy Family Floater Plan- This plan is designed to cover you and your family. It is available in three different variants: Silver, Gold, and Diamond.
  3. Oriental Jan Arogya Bima Plan – Oriental medical insurance came up with this plan for the poorer section of the society. The idea is to provide health insurance coverage to the weaker section at a lower cost.
  4. OBC Oriental Mediclaim Plan- It is a family floater and individual plan that covers 116 daycare medical procedures.
  5. Oriental Group Mediclaim Plan – This plan is designed to cover an entire family and is also available for the corporate employees.
  6. Oriental PNB Health Insurance Plan – A specially designed plan for the employees or the account holders with the Punjab National Bank.
  7. Oriental Overseas mediclaim Plan- It is an all-inclusive plan for each and every person with the intent of visiting overseas countries. It covers both business and holiday trips for individuals. Apart from those visiting overseas for business and holidays, this plan also covers the students who are studying abroad.
  8. Oriental HOPE Plan Health of Privileged Elders- Buy this oriental senior citizen health insurance plan for your parents who are older than 60 years.

Claim Procedure of Oriental Health Insurance

Claim Settlement Process for Reimbursement-

  • It is your duty to inform The TPA department within seven days of hospitalization
  • Submit all the details including the name of the insured person and the policyholder, policy number, nature of illness or injury, name and address of the hospital or nursing home along with the doctor’s name
  • Send the claim documents with the hospital bills and invoices within the 30 days of discharge from the hospital.
  • Provide all the information and documents as mentioned by the TPA department or the insurance company for a seamless claim process
  • The documents can be sent to the registered office of Oriental health insurance or sent over email. It is the discretion of the insurer at that time.

Claim Process for Cashless Treatment/Hospitalization

In case of an emergency or planned hospitalization, the process is as follows –

  • For cashless payment, the claim form needs to be approved by the network hospital.
  • The insurer will verify all the information, documents and determine your eligibility for the claim.
  • If the information is found to be satisfactory then the pre-authorization letter will be sent to the registered hospital. This letter will include the amount that will be paid by the insurer.
  • In case all the necessary documents and the pre-authorization letter are not submitted, and the treatment is started, then you need to contact the TPA department for reimbursement of the claims.
  • The documents must be sent to the registered office of Oriental insurance or sent over email, as suggested by the insurer.

How to Renew Oriental Health Insurance? 

It is important that you timely renew your medical insurance else you will lose the cumulative bonus and the waiting period will also extend.

The process to renew Oriental health insurance policy is quick and simple-

  • Select if you want to go for renewal of the Oriental mediclaim policy or a non OICL policy
  • Enter the policy no.
  • Enter contact details with pin code
  • Select your Oriental health insurance quote
  • And make the payment online

It is suggested that you go through oriental health insurance reviews online and then go for renewal.

Inclusions of Oriental Health Insurance Plans

There are a host of plans with different coverage options; however, some of the common inclusions are listed below-

  • Ambulance charges up to a specified limit
  • Room charges, ICU charges, and nursing expenses are reimbursed
  • Fees charged by the medical practitioner, specialist, surgeon and anesthetists
  • Pre, post and medical expenses for in-patient hospitalization
  • Daycare surgeries/treatment
  • Organ donor expenses and domiciliary hospitalization ( in some plans)

Exclusions of Oriental Health Insurance Plans

Any of the Oriental mediclaim policies will not cover the following-

  • Self-inflicted injuries and suicidal attempts
  • Treatment required for health ailments resulting from an overdose of alcohol, drugs and other intoxications
  • Involvement in hazardous occupations and adventure sports like sky-diving, rock climbing, deep sea diving etc.
  • Involvement in the air force, military, and naval operations
  • Treatment for venereal diseases
  • Any hospitalization required due to loss or damage arising due to a breach of law or conduct
  • Hospitalization required in case of war conditions, hostilities, civil war, rebellion etc.
  • Health hazards resulting from nuclear radiations or from any nuclear waste
  • Treatment for HIV, AIDS, and STSs
  • Pregnancy and childbirth-related complications

Benefits of Oriental Health Insurance

Oriental medical insurance plans are designed to provide the policyholders with a much-needed financial cushion in case of a planned or even a sudden medical emergency. Let’s have a look at a few of the salient features of the Oriental Health Insurance Plans:

  1. Comprehensive Health Insurance Cover: Oriental Insurance Mediclaim plans are designed after considering the insurance needs of different individuals. Hence, the company is known for offering comprehensive health packages to offer all-inclusive health insurance cover to the insured members.
  2. Cashless Claim Settlement: One of the other major features of Oriental medical insurance plans is their cashless treatment facility which you can avail in any of the network hospitals registered under the company.
  3. Easy Portability: If you are facing issues with your current health insurance provider or feel that it is not providing you with up-to-the-mark services, you can switch to Oriental health insurance plans and avail of a better range of services and benefits.
  4. Pre-medical Screening: One of the major benefits of oriental health insurance plans is that a pre-medical screening is only required after 45 years and in some plans, it is required after 55 years of age.
  5. Quick Claim Settlement Process: Oriental Health Insurance understands the importance of the claim settlement ratio and its impact on an insurance company’s performance. Hence, the company is focused on providing its customers with a convenient and hassle-free claim settlement experience.
  6. Lifetime Renewal: Oriental health insurance plans give you an option for lifetime renewal.

Oriental Health Insurance Premium Calculation

The following information is required to calculate the Oriental medical insurance premium-

  1. Select the sum insured option
  2. Plan type – Individual/Family
  3. Number of family members to be covered
  4. Age of the members
  5. Enter name, mobile, and email
  6. Click submit

You can also use Oriental health insurance premium calculator to know your premium.

Following details are required to calculate medical insurance premium online-

  • Personal details- Date of birth, Gender, PAN number
  • Insurance Period – Policy start and end date
  • Sum Insured – Name of the nominee, Relationship with the insured, pre-existing diseases (if any)
  • Coverage for your spouse or the entire family
  • Details of the family physician
  • TPA
  • Period of Insurance
  • And click on calculate the premium

Why Buy Oriental Health Insurance?

Health issues are constantly on a rise and so is the medical inflation. Dealing with financial and emotional stress at the same time can be distressing for anyone. With Oriental medical insurance policy in place, you can keep the stress away and avail treatment in some of the best hospitals in your vicinity.

Oriental health insurance offers you a host of medical insurance plans and services at an affordable price. They provide an extensive coverage and there is no examination if you are below the age of 55 years. Also, it is always recommended to read all the terms and conditions before buying any plan.

Documents Required for Oriental Health Insurance Claims

All the documents, medical bills, reports, and cash memos should be provided to the TPA/company within 15 days of discharge from the hospital. The list of documents is as follows –

  • Original medical bills, discharge certificate, and receipts
  • All the documents related to the treatment including the consultation, test, and medical reports
  • Patient’s medical history as per hospital records
  • Cash-memo from the hospital or chemists along with prescription letters
  • Original receipts of pathological/ radiology tests with supporting letter from the Medical Practitioner or surgeon that it is required as part of the treatment
  • Original bills, receipts, and diagnosis report from attending anesthetists, specialists and consultants
  • Original certificate from the surgeon confirming diagnosis and nature of operation done
  • Death or disability certificate ( if any)
  • Discharge summary
  • Any other document demanded by the insurer and TPA
  • Once the documentation is complete, the TPA department will share the oriental insurance mediclaim status with you.

Oriental Health Insurance FAQs

Q1. What is the minimum age criterion to buy an Oriental mediclaim policy?

There are plans that provide coverage to children who are only 91 days old.

Q2. How to file an Oriental health insurance claim?

The procedure is described below-

  • Submit all the forms and documents as duly attested by you.
  • To claim post-hospitalization expenses incurred within 60 days of the discharge, make sure that all the required documents and papers are submitted to the T.P.A within 15 days of treatment.
  • Inform the insurer and TPA in advance for any post hospitalization treatments as prescribed by the doctor.
  • In extreme conditions, an extra time is provided to the insured for any delay or failure to submit the documents. But in most cases, failure to submit documents within the prescribed time limit increase the odds of your claim being

Q3. What are the benefits Oriental Individual Mediclaim policy?

Major advantages are listed below-

  • It offers you a daily allowance of cash required by the hospital if you have been admitted to the hospital for more than 2 days.
  • This policy can be acquired by all individuals between the ages of 18 years to 65 years. However, in a few special cases, the maximum entry age can be adjusted up to 70 years with an additional premium amount of 10 percent on applicable pricing.
  • You get an option to avail of a family discount of 10 percent which includes PA (Personal Accident) cover if you get coverage for more than one person under the plan.

Q4. Can students who are studying abroad buy an Oriental mediclaim policy?

Yes, you can buy Overseas Mediclaim-Employment and Study plan.  The minimum period under this policy is 2 months while the maximum period is 12 months.

Q5. Does oriental medical insurance provides cashless hospitalization facility?

Yes, you can avail cashless treatment in any of the network hospitals across India.

Q6. What are the benefits of benefits of Oriental happy family floater gold plan?

The happy family floater gold plan has the following advantages:

  • An attendant allowance of 500 Rupees is allowed per illness in case of hospitalization.
  • If a policyholder incurs ambulance costs, the insurance pays a total of 1% of the insured sum which is approximately between 2 lakhs to 6 lakhs.
  • All the domiciliary treatments are covered by a total of 5000 rupees. They include chemotherapy, radiotherapy, operation theatre charges, medicinal drugs, blood and oxygen among many others.

Q7. Can I avail tax benefits if I buy an Oriental medical insurance plan?

You will get tax exemption benefits as per the purview of the Sec. 80D of the Income Tax Act.

Q8. What are the benefits of buying Oriental Insurance Happy Family Floater Plan?

In contrast with the individual policy, it covers you and your family in a single plan. This policy is available in three different variants: Silver, Gold, and Diamond. For the gold plan, Oriental Insurance requires the policyholder to get a sum assured of about 6 to 10 lakhs on a floater basis. Under the silver plan on a floater basis, the total sum assured should be between 1 lakh to 5 lakhs. The Diamond Plan has a sum insured of Rs.12 lacs to Rs.20 Lacs.