Health insurance is a vital part of securing your future against unexpected medical expenses. In India, Oriental Insurance has been a trusted provider of comprehensive health insurance policies. With a long-standing history since its inception in 1947, Oriental Insurance offers a wide range of health insurance plans tailored to meet the needs of individuals, families, senior citizens, and those with specific health concerns. In this blog, we’ll explore Oriental Insurance’s various plans, benefits, claim process, network hospitals, and more.
Overview of Oriental Insurance
Founded in 1947, Oriental Insurance has gained significant recognition in India’s insurance market. Originally a subsidiary of the Oriental Government Security Life Assurance Company, it became part of the central government in 2003. The company’s growth and success are evident in its high claim settlement ratios and extensive customer base.
In the 2021-2022 financial year, Oriental Insurance achieved an incurred claim ratio of 139.86%, showing their commitment to ensuring claims are paid out efficiently. With a diverse set of health insurance plans, Oriental Insurance meets the needs of policyholders ranging from individual coverage to critical illness and family plans.
Health Insurance Plans Offered by Oriental Insurance
Oriental Insurance offers a variety of health insurance plans to ensure comprehensive coverage for every individual or family. Here’s a detailed look at the offerings:
1. Youth Eco Care Plans
These plans are designed for young adults looking to secure their health with affordable premiums. The two variants under this category are:
- Youth Eco Care Premium: Offering coverage up to ₹5 lakh, with premiums starting at ₹526 per month. It includes features like a No Claim Bonus and Single Private AC Room coverage.
- Youth Eco Care Basic: Starting at ₹469 per month, this plan provides similar coverage with slightly fewer benefits.
2. Family Health Insurance Plans
Family plans are ideal for those looking to cover the medical expenses of their loved ones under a single policy. The Oriental Happy Family Floater Plan provides coverage from ₹1 lakh to ₹50 lakh, with the option to choose from Silver, Gold, Diamond, and Platinum plans.
3. Senior Citizen Health Plans
The Oriental Health of Privileged Elders (HOPE) Plan is tailored for senior citizens aged 60 years and above, offering coverage from ₹1 lakh to ₹5 lakh, providing financial security to the elderly.
4. Critical Illness Plans
The Oriental Critical Illness Plan provides coverage for up to 22 critical illnesses, including cancer, kidney failure, stroke, etc. The coverage ranges from ₹2 lakh to ₹50 lakh.
Additional Health Plans and Coverage Options
In addition to the main plans, Oriental Insurance also offers specialized policies for specific health concerns:
- Oriental Super Health Top-Up Plan: Provides additional coverage beyond the base policy with deductibles ranging from ₹3 lakh to ₹20 lakh.
- Oriental Dengue Kavach Plan: Covers treatment costs for dengue fever, with coverage ranging from ₹10,000 to ₹20,000.
- Oriental Cancer Protect Plan: Specifically designed to help with the treatment costs of cancer, offering coverage from ₹5 lakh to ₹50 lakh.
- Oriental Happy Cash Plan – Nischint Rahein: Provides daily cash benefits during hospitalization, ranging from ₹500 to ₹3,000.
Key Benefits of Oriental Health Insurance
Here are some of the significant advantages of choosing Oriental Health Insurance:
- No Pre-Acceptance Medical Screening: No medical screening is required for individuals up to the age of 55, making it easier to secure a policy.
- Free Health Check-up Facilities: Policyholders are entitled to free health check-ups under certain health plans.
- Tax Benefits: Premiums paid for Oriental health insurance policies are eligible for tax deductions under Section 80D of the Income Tax Act.
- Strong Customer Support: Oriental Insurance has a dedicated team that efficiently handles customer queries and claims.
Oriental Insurance Claim Process
Oriental Insurance offers two primary claim processes: Cashless Claim Process and Reimbursement Process.
Cashless Claim Process
- Step 1: Find a Network Hospital
- Locate the nearest Oriental network hospital.
- Get admitted to the hospital for treatment.
- Step 2: Inform Oriental
- Notify the insurance company about your hospitalization.
- For pre-planned hospitalization, inform Oriental before admission.
- Step 3: Get Pre-authorization
- Fill the pre-authorization form and submit it to the hospital staff.
- The form will be sent to Oriental for approval.
- Upon approval, proceed with treatment.
- Step 4: Hospital Discharge
- Sign all medical documents during discharge.
- Pay for any services not covered under the policy.
- Step 5: Claim Settlement
- The hospital sends the bill to Oriental.
- Oriental reviews and settles the bill directly with the hospital.
Reimbursement Process
- Step 1: Get Hospitalized
- Get admitted to a non-network hospital of Oriental.
- Step 2: Inform Oriental
- Notify Oriental about the hospitalization.
- For planned hospitalization, inform the insurer beforehand.
- Step 3: Hospital Discharge
- Pay the hospital bill in full.
- Collect all medical documents, bills, and receipts.
- Step 4: Submit Documents
- Submit all documents (claim form, medical records, bills) to Oriental.
- Step 5: Settlement of Claim
- Oriental reviews the submitted documents and settles the claim amount after approval.
Documents Required for Oriental Health Insurance Claim
When filing a claim, the following documents are required:
- Claim Form: Duly filled and signed claim form.
- Health Card/Policy Copy: Copy of the health card or policy document.
- Medical Documents: Discharge summary, doctor’s prescriptions, test reports, etc.
- Medical Bills & Receipts: Hospital and pharmacy bills with payment receipts.
- KYC Documents: For claims above ₹1 lakh, submit KYC documents such as Aadhaar or Passport.
How to Buy and Renew Oriental Health Insurance
To Buy a New Policy:
- Visit the Health Insurance Section: Go to the Oriental health insurance section on a reliable insurance platform.
- Fill Personal Details: Enter essential details such as age, medical history, contact information, etc.
- Pay the Premium: Choose your preferred plan and pay the premium online to finalize your policy.
To Renew a Policy:
- Go to the Renewal Section: Navigate to the ‘Renew Your Policy’ section.
- Verify Your Identity: Enter the registered mobile number and OTP.
- Pay the Renewal Premium: Select the policy to renew and pay the premium online.
Contact Details for Oriental Health Insurance
For any queries or assistance, you can contact Oriental Health Insurance at:
- Toll-free Number: 1800-11-8485
- Phone Number: 011 3320 8485
- Email Id: csd@orientalinsurance.co.in, portal.refunds@orientalinsurance.co.in (for refunds)
Oriental Health Insurance Reviews & Ratings
Rating: 4.5/5 (21 Reviews)
Customer Service: Highly rated for its quick and helpful responses.
Policy Benefits: Comprehensive coverage and affordable premiums.
Frequently Asked Questions (FAQ) About Oriental Health Insurance
- What is Oriental Health Insurance?
- Answer: Oriental Health Insurance is a type of health coverage provided by Oriental Insurance, offering various plans for individuals, families, senior citizens, and critical illness protection. The plans cover medical expenses like hospitalization, treatment, surgeries, and more.
- What health insurance plans does Oriental offer?
- Answer: Oriental offers several health insurance plans, including Youth Eco Care Plans, Family Health Insurance Plans, Senior Citizen Health Plans, Critical Illness Plans, and specialized plans like Dengue Kavach and Cancer Protect.
- How do I buy an Oriental Health Insurance policy?
- Answer: To buy a policy, visit an insurance platform, choose the desired plan, fill in necessary personal details, and make an online payment to complete the purchase.
- What is the claim process for Oriental Health Insurance?
- Answer: The claim process includes two options: Cashless Claims, where treatment is covered directly with the network hospital, and Reimbursement Claims, where you pay the bill upfront and submit documents to get reimbursed later.
- What is a cashless claim?
- Answer: A cashless claim allows you to receive medical treatment at network hospitals without paying upfront. The insurance company settles the bill directly with the hospital after pre-authorization.
- How can I renew my Oriental Health Insurance policy?
- Answer: To renew your policy, go to the renewal section on the insurance platform, verify your identity, and pay the renewal premium online to continue your coverage.
- Is there any medical screening required to purchase an Oriental Health Insurance policy?
- Answer: For individuals up to 55 years old, most Oriental health insurance plans do not require medical screening before purchasing the policy.
- What are the benefits of Oriental Health Insurance?
- Answer: Benefits include no pre-acceptance medical screening (for individuals under 55), free health check-ups, tax benefits under Section 80D, and a robust customer support team to help with queries and claims.
- How many network hospitals does Oriental Insurance have?
- Answer: Oriental Insurance has a network of 2,774 hospitals across the country, ensuring that policyholders have easy access to quality medical care.
- What documents are required to file a claim with Oriental Health Insurance?
- Answer: To file a claim, you will need the claim form, health card or policy copy, medical documents (hospital discharge card, prescriptions), medical bills and receipts, and KYC documents (for claims above ₹1 lakh).
Conclusion
Oriental Insurance provides an array of health insurance plans that cater to diverse needs, from individual and family coverage to specialized policies for senior citizens and critical illnesses. With a user-friendly claim process, a strong customer support team, and extensive network hospitals, Oriental Insurance ensures that policyholders receive timely support when needed the most. Whether you’re looking for a basic health plan or comprehensive coverage, Oriental Insurance is a reliable option to consider for your health security.