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The Oriental Insurance Company Ltd

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Individual Mediclaim Policy

Brief Description:-

Mediclaim Insurance is a cover for reimbursement of medical expenses following Hospitalization/Domiciliary Hospitalization of the Insured in respect of the following situations: (A) In case of a sudden illness (B) In case of an accident (C) In case of any surgery which is required in respect of any disease which has arisen during the policy period. The major benefit for taking a Group Mediclaim policy is that the insured gets a Group discount, hence the premium per person is lower.

Covered Risks:-

It is a hospitalization cover for reimbursement of the medical expenses incurred in respect of covered disease /surgery while the insured was admitted in the hospital as an in-patient. The cover also extends to pre- hospitalization and post- hospitalization for periods of 30 days and 60 days respectively.

Salient Features

• Product name - Individual Mediclaim Policy

• Coverage amount - Rs. 1,00,000

• Premium (cost of coverage) - Rs. 5,196/-

• Policy term (years) – 1 year

• Cashless facility - Yes

Coverage

• Hospitalization expenses – Yes

• Daycare hospitalization – Yes

• Pre hospitalization expenses – 30 days

• Post hospitalization expenses - 60 days

• Cost of health check up – Yes

Eligibility

• Medical test - After 45 years

• Max. entry age (years)- 55 years

• Eligibility conditions - Indian National only. No coverage for treatment outside India

Benefits

• Income tax benefit – Yes

• Sub-limits applicable- Yes

• Sub-limits description - The following provisions for reasonable & customary expenses, which are reimbursable under the policy have been introduced: Room, Board and Nursing Expenses as provided by the Hospital /Nursing Home not exceeding 1 % of the Sum Insured or Rs. 5000/- per day whichever is less.

• ICU expenses not exceeding 2 % of the Sum Insured or Rs. 10,000/- per day whichever is less (Room stay plus I.C.U. stay should not exceed total number of admission days). Ambulance services - 1% of the sum insured or Rs 2000/- whichever is less shall be reimbursable where the patient has to be shifted from residence to hospital in case of admission in Emergency Ward / I.C.U. or from one Hospital / Nursing home to another Hospital / Nursing Home for better medical facilities. These expenses are payable only when registered ambulance is used.

Pricing

• Family discount - Yes

• Cumulative bonus - Yes

• No Claim bonus – Yes

Other Details

• Provider type - PSU Companies
• List of permanent exclusions - i-Benign ENT disorders and surgeries i.e. Tonsillectomy, Adenoidectomy,  Mastoidectomy, Tympanoplasty etc. 1 year
• Polycystic ovarian diseases - 1 year
• Surgery of hernia- 2 years
• Surgery of hydrocele- 2 years
• Non infective Arthritis- 2 years
• Un-descended testes-2 Years
• Cataract.2 Years
• Surgery of benign prostatic hypertrophy- 2 Years
• Hysterectomy for menorrhagia or fibromyoma or myomectomy or prolapse of uterus -2 Years
• Fissure / Fistula in anus-2 Years
• Piles- 2 Years
• Sinusitis and related disorders-2 Years
• Surgery of gallbladder and bile duct excluding malignancy- 2 Years
• Surgery of genitor- urinary system excluding malignancy-2 Years
• Pilonidal Sinus-2 Years
• Gout and Rheumatism-2 Years
• Hypertension - 2 Years
• Diabetes-2 Years
• Calculus diseases-2 Years
• Surgery for prolapsed inter vertebral disk unless arising from accident-2 Years
• Surgery of varicose veins and varicose ulcers - 2 Years
• Congenital internal diseases -2 Years
• Joint Replacement due to Degenerative condition - 4 Years
• Age related osteoarthritis and Osteoporosis - 4 Years

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I want group mediclaim policy with accidentally covee
Ashok28 Friday, August 22, 2014
I want to take a oriental Insurance health/medicalim poliy. Pl. guide me where and to whom I should contact.

Lal Singh
IIT Delhi

lala523 Monday, June 09, 2014
I want to take insurance.
Guest Sunday, June 15, 2014
YOU CAN CONTACT ME AT 9910041099.
Guest Saturday, August 09, 2014
Hello ! I am 39 yrs age and want a good insurance scheme for my wife , 2 child of 10 yrs and 4 years and for parents.
digantarumi Tuesday, May 13, 2014
I am retired person from Punjab National Bank and have taken Medi-claim family floater policy of rupees five lakh. I also want to take another Medi-claim policy for the family of my elder son his wife and daughter if 1.9 yr. I want ti know the list of diseases which are not covered up to three years so that proper information be conveyed to my son and his wife.
rajesh21_pd Monday, March 03, 2014
it cover risk of pregnancy and abortion also if yes than how much
rachana1234 Thursday, January 09, 2014
Sir i want medical insuranc policy . so plz send detail yearly premiam and detail. thank you .
dashrathkumar Friday, October 25, 2013
I want mediclaim policy for me, my hubby and a child.
who is the contact person in Coimbatore city. I would like to join in the mediclaim policy.

sreejamurali Thursday, October 17, 2013
i wish to medical insurance for me and for my mother...

Regards
Koushik S

Koushik80 Tuesday, September 03, 2013
premium calculation
NIM_JHAN Monday, August 12, 2013
sir, i wish to know about the Family Floator Policy of Oriental Insurance Co Ltd Also the concern person contact details of Bangalore
raviblr05 Wednesday, June 19, 2013
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