The Oriental Insurance Company Limited

The name of the Oriental Insurance Company Limited stands out in the field of insurance and is renowned for devising covers for big projects like power plants, steel and chemical plants. Besides that, the company also offers a wide variety of insurance products in the field of automobiles, aviation, agriculture, marine cargo, accident, and healthcare.

The Oriental Insurance Company Limited came into existence in the year 1947 at Bombay. It was a wholly owned subsidiary of Oriental Government Security Life Assurance Company Limited and was involved in General Insurance business.

Oriental Insurance has come a long way from beginning with a premium of Rs. 99,946 in 1950 to a colossal one of Rs. 7561 crores in the year 2014-2015. Presently, it has its Head Office at New Delhi with 31 regional offices in the country and has overseas operations in Nepal, Kuwait, and Dubai.

Oriental Insurance offers various health insurance policies, which can be renewed online.

Individual Mediclaim Policy

Key Features

Cashless hospitalization at any of the network hospitals.
Sum assured ranges from Rs. 50000 to Rs. 500000.
Pre-acceptance medical check-up not required below 45 years of age.
Family discount of 10% on total premium.
Income tax benefits under section 80-D of Income Tax Act.

Eligibility

Age from 3 months to 80 years.

Benefits

Hospitalization Expenses - For any hospitalization more than 24 hours arising due to sickness, accident or surgery.
Pre and Post Hospitalization Charges - For a period of 30 days before and 60 days after hospitalization respectively.
Day Care Expenses - For any of the listed day care procedures, which do not require hospitalization for 24 hours.
Ambulance Charges - 1% of the sum assured up to a maximum of Rs. 2000.
Dental Treatment - That is necessitated due to an accident.
Organ Donor Expenses- In the case of an organ transplant.

Oriental Insurance Mediclaim Policy - Organ Donor Expenses

Domiciliary Treatment - Expenses for treatment at home for a period of more than 3 days, for a condition that would otherwise require hospitalization.
Ayush Expenses - For treatment under Ayurveda, Unani, Siddha or Homeopathy in government colleges/hospitals.
Pre-existing Conditions - Are covered after 4 years of policy, if renewed regularly without a break.
Health Check-up Benefit - After 4 continuous claim-free policy years, up to 1% of the sum assured.

Exclusions

Any pre-existing condition, for 4 years.
All medical conditions, for initial 30 days of the policy, except injury due to an accident.
Treatment related to pregnancy and childbirth.
Treatment of psychiatric disorders.
Treatment of cataract, benign hypertrophy of prostate, menorrhagia, fibromyoma, hysterectomy, hernia, piles, fistula, sinusitis, asthma and bronchitis.

Happy Family Floater Policy

This is a policy in which all the family members can be covered under the same plan with a common sum insured.

Key Features

The whole family is covered under one plan.
No medical check-up required up to 60 years of age.
The cover is available in two options - silver and gold.

Silver - Sum assured - 1 to 5 lakhs.
Gold - Sum assured - 6 to 10 lakhs.

Add on feature of accident cover.

Benefits

Benefits are available as per plan:

Silver Plan:

Room Charges - Including the nursing charges, not exceeding 1% of the sum insured, per day.
ICU Charges - Not exceeding 2% of the sum insured per day.
Doctor Fee - For anesthetist, surgeon, consultants, specialists.
Charges for - Anesthesia, blood, oxygen, operation theater charges, surgical appliances, diagnostic material, dialysis, chemotherapy, radiotherapy, cost of pacemaker, and prosthesis.
Treatment for an Animal Bite - Up to a maximum of Rs. 5000.
Ambulance Charges - At Rs. 1000 per illness, limited to a maximum of 1% of sum insured or Rs. 3000, whichever is less, for the entire policy period.
Domiciliary Treatment - For the treatment of a condition at home which would otherwise require hospitalization; 10% of the sum insured is admissible, up to a maximum of Rs. 25000.
Add-on Cover- Personal accident cover up to Rs. 5 lakhs as the sum insured, can be taken as an add-on feature, by paying an extra premium.

Note: There is a co-payment of 10% in all the claims under the silver plan.

Gold Plan:

Room Charges - Including the nursing charges, not exceeding 1% of the sum insured, per day.
ICU Charges - Not exceeding 2% of the sum insured, per day.
Doctor Fee - For anesthetist, surgeon, consultants, specialists.
Charges for - Anesthesia, blood, oxygen, operation theater charges, surgical appliances, diagnostic material, dialysis, chemotherapy, radiotherapy, the cost of pacemaker and prosthesis.
Treatment for an Animal Bite - Up to a maximum of Rs. 5000.
Ambulance Charges - Of Rs. 2000 per illness, limited to a maximum of 1% of sum insured or Rs. 6000, whichever is less, for the entire policy period.
Daily Hospital Cash Allowance - Of 0.1% of the sum insured (overall limit of 1.5 % of the sum insured) for a maximum of 10 days.
Attendant Allowance - For hospitalization of children between 3 to 10 years of age, attendant allowance is permissible at Rs. 500 per day.
Domiciliary Treatment - For the treatment of a condition at home which would otherwise require hospitalization. 10% of the sum insured is admissible, up to a maximum of Rs. 50000.
Add-on Cover - Personal accident cover, up to Rs.10 lakhs as the sum insured, can be opted for by paying an extra premium.
Life hardship cover is also available, on payment of extra premium, as Plan A (with 15% of sum insured) and Plan B (with 25% of sum insured). The benefit is given if a person survives hardship given, for 180 days or 270 days after discharge.
No co-payment is required.

Exclusions

The major exclusions under the policy are:

Any admission for diagnostic/investigation purposes.
Expenses related to pregnancy and childbirth.
Infertility treatments.
Treatment outside India.

Overseas Mediclaim Policy

This policy has been designed to safeguard the health and financial interests of people who are traveling outside the country for education, business or fun.

Key Features

Covers medical expenses incurred outside India.
Covers both inpatient as well as outpatient treatment.
Sum insured may range from Rs. 50000 to Rs. 500000.
The cashless settlement is provided through the company’s Overseas Services Provider.

The plans available under this policy are:

Overseas Mediclaim- Business and Holiday

This plan covers expenses for treatment of disease or injury sustained during foreign travel and which is primarily emergent in nature.

Eligibility

Indian residents traveling abroad for business/official purposes.
Indian residents traveling abroad for a holiday.

Benefits

Expenses for hospital and medical services and emergency ambulance transport.
Dental Expenses - Up to $ 225 per dental treatment for the immediate relief of pain alone. If necessitated by accident, dental treatment shall be covered up to limit of cover.
Medical Evacuation - Expenses on emergency medical evacuation ordered by a physician, if no suitable care is available locally.
Transport of Remains - Expenses borne on the transport of remains to India, if the person dies abroad.
Personal Accident - If the person meets with an accident during travel, he is entitled to the sum insured under personal accident, provided the accident, within 12 months, becomes the sole cause of:

Death, or
Permanent total disablement, or
Total and irrecoverable loss of both limbs/both eyes/one limb and one eye.

Loss of Baggage - Cover for total loss of checked baggage as defined in the policy.
Loss of Passport - Expenses incurred in obtaining emergency travel documents due to loss of passport outside India.
Personal Liability - Cover for any legal liability that may arise due to accidental bodily injury to Third Parties, due to an incident during travel.

Overseas Mediclaim - Employment and Study

This plan covers expenses for treatment of disease or injury sustained during foreign stay (for employment or study) and which is primarily emergent in nature.

The minimum period of policy is 2 months and the maximum is 12 months.

Sum insured is US $ 75000.

Benefits

Medical or Accident Treatment Expenses - That occurs during abroad stay, up to a maximum of

The amount mentioned in the policy, or
52 weeks after the onset of the sickness or accident, or
12 weeks after expiry date of insurance, Whichever occurs earlier.

Treatment of Mental Disorders - The cover is limited to 30 days of continuous in-hospital treatment, and insurance will be limited to 50% of these expenses.
Medical Evacuation - Expenses on medical evacuation.
Transport of Remains - To India in the event of death.
Contingency Insurance - In cases where the insured is not able to continue studies due to a sickness or accident occurring in the country of study resulting in death, permanent disability or loss of limb/sight, the company shall pay benefit to the nominated sponsor who supported the insured person financially, at the rate of $ 750 for every month of completed study.

Exclusions

The exclusions under Overseas Mediclaim policy are:

Any claims for treatment of congenital conditions.
Dental or cosmetic treatment, unless necessitated by accident.
Pregnancy and childbirth-related expenses.
Any claim arising from self-inflicted injury or harm.
Infertility treatments.

Oriental Insurance Overseas Mediclaim Policy Exclusion - Infertility Treatments

Any treatment given by the insured’s family member residing abroad.
Any claim arising out of travel in an aircraft other than a fare-paying passenger in a licensed aircraft.

Group Mediclaim

This policy is available to any group/corporate/institution with more than 50 members. The insured gets a group discount under this policy.

Key Features

Sum insured may range from Rs. 50000 to Rs. 500000.
No medical required for less than 45 years of age.
Cashless facility at network hospitals.
Add on optional cover for maternity and newborn expenses.
Group discount.

Eligibility

Minimum age at entry is 3 months.

Benefits

Hospitalization Expenses - Including room rent and nursing charges, up to 1% of the sum insured or Rs. 5000 (whichever is less).
ICU Charges - In cases of hospitalization in ICU, up to 2% of the sum insured or Rs. 10000 (whichever is less).
Pre and Post Hospitalization Charges - For a period of 30 days before and 60 days after hospitalization respectively.
Ambulance Charges - In the case of an emergency, up to 1% of the sum insured or Rs. 2000 (whichever is less).
Doctor Fee - For anesthetist, surgeon, consultant, and specialists.
Charges for - Anesthesia, blood, oxygen, operation theater charges, surgical appliances, diagnostic material, dialysis, chemotherapy, radiotherapy, the cost of pacemaker and prosthesis.
Optional Cover for Maternity and Newborn- Can be taken by payment of 10% of the total basic premium for all the insured persons under the policy.

Exclusions

Pre-existing diseases for 4 years of the continuous policy.
Injuries due to war, civil war, an act of foreign enemy etc.
Cost of contact lenses, spectacles, hearing aids.
Non-allopathic treatments.
Drug or substance abuse.
Treatment of obesity or weight management programs.

Oriental Insurance Group Mediclaim Exclusion - Obesity Treatment

Jan Arogya Policy

This policy is aimed at the weaker sections of the society so as to enable them to have health insurance at low premiums.

Key Features

Premiums as low as Rs. 70 for an adult and Rs. 25 for dependents.
Cover for hospitalization expenses.
Pre and post hospitalization expenses are covered too.
Tax benefits under section 80-D of Income Tax Act.

Eligibility

Applicants between 5 years and 70 years.
Children between 3 months and 5 years are covered if one or both parents are covered.

Benefits

Hospitalization Expenses - In the case of hospitalization for more than 24 hours.
Pre and Post Hospitalization Charges - For a period of 30 days before and 60 days after hospitalization respectively.
Day Care Expenses - For listed procedures not requiring hospitalization.

Exclusions

Pre-existing conditions.
Pregnancy and childbirth-related expenses.
Drug or substance use.
Any admission for diagnostic/admission purposes.
Treatment of HIV, AIDS or other sexually transmitted diseases.

Oriental Bank Mediclaim Policy

This policy is exclusive to account holders/ employees of Oriental Bank and is a family floater plan.

Key Features

Cashless hospitalization in network hospitals.
5 options for sum insured.
No pre-policy medical required.
Tax benefit under section 80-D of Income Tax Act.

Eligibility

Applicant must be an account holder in O.B.C.(Oriental Bank of Commerce).
Age should not be more than 79 years.
Children between 3 months and 26 years can be covered.

Benefits

Room Charges - Including the nursing charges, not exceeding 1% of the sum insured, per day.
ICU Charges - Not exceeding 2% of the sum insured, per day.
Doctor Fee - For anesthetist, surgeon, consultants, specialists.
Charges for - Anesthesia, blood, oxygen, operation theater charges, surgical appliances, diagnostic material, dialysis, chemotherapy, radiotherapy, the cost of pacemaker, and prosthesis.
Ambulance Charges - Of Rs. 1000 or 1% of sum insured, whichever is less.
Domiciliary Treatment - For the treatment of a condition at home which would otherwise require hospitalization. 10% of the sum insured is admissible, up to a maximum of Rs.25000.
Funeral Expenses - In the event of death, up to Rs. 1000.

Exclusions

Pre-existing conditions till 3 continuous policy years.
Treatment of AIDS, HIV or other sexually transmitted diseases.
Treatment of obesity.
Dental treatment.
Pregnancy and childbirth-related expenses.
Injuries due to adventure sports.
Some conditions are covered after 1-3 years (as mentioned in policy document) of coverage, like cataract, piles, diabetes, hypertension, joint replacement etc.

PNB Oriental Royal Mediclaim Policy

This policy is exclusive to the account holders and employees of P.N.B. i.e. Punjab National Bank.

Key Features

Family floater plan.
Sum assured option from Rs. 1 lakh to Rs. 5 lakhs.
No medical required.
Tax benefits under section 80-D of Income Tax Act.

Eligibility

Must be an account holder with PNB or an employee of the bank.
Age between 3 months and 80 years.
Cover for 2 children besides spouse.

Benefits

Room Charges - Including the nursing charges, not exceeding 1% of the sum insured, per day.
ICU Charges - Not exceeding 2% of the sum insured, per day.
Doctor Fee - For anesthetist, surgeon, consultants, specialists.
Charges for - Anesthesia, blood, oxygen, operation theater charges, surgical appliances, diagnostic material, dialysis, chemotherapy, radiotherapy, the cost of pacemaker, and prosthesis.
Ambulance Charges - Of Rs. 1000 or 1% of sum insured, whichever is less.
Hospital Cash - Reimbursement of incidental expenses during hospitalization, up to a maximum of Rs 1000.
Domiciliary Treatment - For the treatment of a condition at home which would otherwise require hospitalization. 10% of the sum insured is admissible, up to a maximum of Rs.25000.
Funeral Expenses - In the event of death, up to Rs. 1000.

Exclusions

Pre-existing conditions till 3 continuous policy years.
Treatment of AIDS, HIV or other sexually transmitted diseases.
Treatment of obesity.
Dental treatment.
Pregnancy and childbirth-related expenses.
Injuries due to adventure sports.
Some conditions are covered after 1-3 years (as mentioned in policy document) of coverage, like cataract, piles diabetes, hypertension, joint replacement etc.

Health of Privileged Elders (HOPE)

This product has been designed for senior citizens above 60 years of age. It provides cover for hospitalization due to specified conditions at a co-payment of 20%.

Key Features

Hospitalization expenses are covered.
Domiciliary treatment cover also provided.
Discount available on voluntary co-payment.
Sum insured from Rs. 1 lakh to Rs. 5 lakhs.
Policy term of 1 year.

Eligibility

Age above 60 years.

Benefits

Room Charges - Including the nursing charges, not exceeding 1% of the sum insured, per day.
ICU Charges - Not exceeding 2% of the sum insured, per day.
Pre and Post Hospitalization Charges - For a period of 30 days before and 60 days after hospitalization respectively.
Covers specified diseases only.
AYUSH Expenses - On treatment under Ayurveda, Unani, Siddha and Homeopathy in government colleges/hospitals.
Cashless Services - Of up to Rs. 1 lakh.
Discount on Premium - Of 5% for every claim free year, up to a maximum of 20%.
Health Check-up - After 4 continuous claim-free years.

Exclusions

Any hospital admission for investigation purposes.
Domiciliary treatment.
Cost of refractive surgery and cosmetic dental surgery.
Organ donor expenses.
Drug or substance abuse
Any self-inflicted injury/harm.

Pravasi Bharatiya Bima Yojana

This policy has been tailor-made for the emigrants who go out of the country in search of employment. This plan provides medical cover to such emigrants and even their families in India.

Key Features

Family floater plan.
Covers hospitalization for sickness and accident abroad.
Maternity cover.

Eligibility

Emigrant in the age group of 18 years to 60 years.
Spouse and two children are also covered.

Benefits

Hospitalization Expenses - For inpatient treatment in the country of treatment and in India.
Day Care Expenses - For procedures listed in the policy which do not require hospitalization.
AYUSH Expenses - On treatment under Ayurveda, Unani, Siddha and Homeopathy in government colleges/hospitals.
Repatriation and Transport Expenses - Due to termination of contract.
Maternity Cover - After a waiting period of 9 months.

Exclusions

Any admission for diagnostic purposes.
Treatment of infertility.
Treatment of congenital defects.
Drug or substance abuse.
Treatment of HIV, AIDS, and other sexually transmitted diseases.
War or war like situations.

Thana Janta Sahakari Bank Mediplus Policy

This policy is exclusive to the account holders/employees of Thana Janta Sahakari Bank.

Key Features

Family floater plan.
Hospitalization expenses are covered.
Cashless facility in network hospitals.

Eligibility

Must be an account holder with the bank, or
Must be an employee of the bank.
Spouse and 2 children are also covered.

Benefits

Room Charges - Including the nursing charges, not exceeding 1% of the sum insured, per day.
ICU Charges - Not exceeding 2% of the sum insured, per day.
Pre and Post Hospitalization Charges - For a period of 30 days before and 60 days after hospitalization.
Day Care Expenses - For procedures listed in the policy, which do not require hospitalization.
AYUSH Expenses - On treatment under Ayurveda, Unani, Siddha and Homeopathy in government colleges/hospitals.
Domiciliary Treatment - For the treatment of a condition at home which would otherwise require hospitalization.
Dental Treatment - Arising out of an accident.
Health Check-up - After a block of 4 consecutive claim-free years.

Exclusions

Any admission for diagnostic purposes.
Treatment of infertility.
Treatment of congenital defects.
Drug or substance abuse.
Treatment of HIV, AIDS, and other sexually transmitted diseases.
War or war like situations.

Accident Policies

Oriental Insurance Company also offers three accident protection policies that provide medical and financial cover in case of an accident.

Personal Accident Policy

It is an individual policy that provides for hospitalization due to injuries sustained in an accident.

Key Features

An individual policy.
No medical check-up is required.
Compensation for the education of dependent children in case of death/total disability.

Eligibility

Adult between 18 years and 75 years.
Children between 6 months and 18 years.

Benefits

Compensation for Injury - Within 90 days of the accident resulting in one of the losses as per schedule.
Medical Expenses - Incurred on the emergent treatment of an injury.
Compensation for Death - In the case of death due to an accident or any consequence of injury within 12 months of the occurrence of an accident, up to the full sum insured.
Funeral Expenses - For transportation of the dead body and funeral to a maximum of 2% of sum insured or Rs. 2500 (whichever is less).
Education Compensation - For a dependent child in case of death/total disability of the policyholder.
Employment Compensation - In the case of loss of employment due to permanent disability, equal to 1% of the sum insured.
Cumulative Bonus - Of 5% for every claim-free year, up to a maximum of 20%.
Free Look Period - Of 15 days to cancel the policy if not satisfied with any clause.
Grace Period - Of 30 days to renew the policy.

Exclusions

Intentional self-injury.
Suicide or attempted suicide.
Death or disability due to childbirth and pregnancy.
Accident under the influence of alcohol or drugs.
War and related dangers.

Janata Personal Accident Policy

It is a comprehensive accidental protection plan for any person irrespective of gender and occupation, between the age of 10 years to 80 years.

Key Features

Compensation for death/permanent partial disability/permanent total disability due to an accident.
Sum insured may range from Rs. 25000 to Rs. 500000.
Affordable premium rate.
Policy term is 1 year.

Benefits

Death - Compensation of 100 % of the sum insured.
Permanent total disablement benefit - Compensation of 100% of sum insured.
Total loss of both limbs/both eyes/one limb and one eye - Compensation of 100% of the sum insured.
Total loss of one limb or one eye - Compensation of 50% of the sum insured.

Exclusions

Any existing disability.
Any intentional self-harm or injury.
Death or disability due to adventure sports.
Insanity.
Breach of law with criminal intent.
War and related perils.

Nagarik Suraksha Policy

This policy offers Personal Accident cover and also reimburses hospitalization expenses incurred due to an accident.

Key Features

Provides compensation for hospitalization due to an accident.
Compensation provided for death/ permanent disability due to an accident.
Policy term is 1 year.

Eligibility

Age between 5 years and 70 years.

Benefits

Hospitalization Expenses - The amount payable during the 12-month period shall be up to 20% of the sum insured.
Death – Compensation of 100 % of the sum insured.
Permanent Total Disablement Benefit - Compensation of 100% of sum insured.
Total Loss of both Limbs/both Eyes/one Limb and one Eye - Compensation of 100% of the sum insured.
Total Loss of One Limb or One Eye - Compensation of
50% of the sum insured.
Cumulative Bonus - Of 5% for every claim free policy year, up to a maximum of 20%.
Funeral Expenses - On transportation of the dead body and funeral.
Education Fund - For dependent children in the event of death/permanent disability of policyholder.