Oriental Insurance Individual Mediclaim Policy
Product Overview
Oriental Insurance Individual Mediclaim Policy is an inpatient hospitalization policy which covers medical expenses following hospitalization/ domiciliary treatment due to Illness/ Diseases/ Accident.
Unique Features of Oriental Insurance Individual Mediclaim Policy
- Family discount of 10% in premium is available.
- There is No Medical Test for insured up to 55 years.
- Non-Allopathic Treatment like Ayurvedic, Unani and Homeopathic treatment will be covered under this plan
- Under this plan there is No Co-Payment clause
- Covers Hospitalization expenses incurred for donating an organ by the donor to the insured person during the course of organ transplant.
- Some Organ Specific are Covered after 1 year like ENT disorder etc
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OneInsure App Benefits
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Critical features of Oriental Insurance Individual Mediclaim Policy
- Room rent:
Limits imposed towards room and ICU rent expenses
- Room Rent - 1 % of sum insured or Rs. 5,000/- per day whichever is less.
- ICU - 2% of the sum Insured or Rs. 10,000/- per day whichever is less.
- Co-Pay:
Specific % of admissible claim amount to be borne by Insured
Has the option of choosing a Voluntary Co-payment of 10% or 20% on the admissible claimable expenses (Optional Cover). - No Claim Bonus:
Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal
This plan does not have no claim bonus benefit. - Pre-Existing Diseases:
Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer
48 months prior to the first policy issued by the insurer
Eligibility Criteria
- Minimum Age of Entry:- 91 days
- Maximum age of Entry:- 65 years or Extended up to 70 years by paying 10% extra premium
- Renewal Age:- Life Long Renewal
- Sum Insured:- 1 lakh to 10 lakhs
- Policy Tenure:- 1 year
- Family Definition:- Individual Plan - Self, Spouse, Children, Parent
- Premium Calculated on Basis of:- Age, (i.e. sum Insured Choosen)
Add-ons
- Personal Accident:
Sum Insured in multiples of Rs. 2,00,000 upto Rs. 10,00,000 per insured person above 18yrs of age. However for persons below 18 years of age, maximum coverage of Rs.4lacs is allowed.
Additional Discounts
- Family Discount - 10% discount of the total premium for more than one person under a single policy.
- Co-pay Discount - A discount of 10% for opting 10% Co-pay and a discount of 20% for opting a 20% Co-pay on the Policy
Exclusions
- Expenses attributable to self-inflicted injury (resulting from suicide, attempted suicide)
- Expenses arising out of or attributable to alcohol or drug use/misuse/abuse
- Medical expenses incurred for treatment of AIDS
- Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion and its consequences
- Tests and treatment relating to infertility and in vitro fertilization.
- War, riot, strike, nuclear weapons induced hospitalization.
- Vaccination, inoculation, cosmetic or aesthetic treatment of any description, plastic surgery
- Surgery for correction of eye sight, cost of spectacles, contact lenses, hearing aids etc
- Genetic disorders and stem cell implantation / surgery
- Treatment of obesity/participation in any hazardous activity
- Out patient Diagnostic, Medical or Surgical procedures or treatments, non-prescribed drugs and medical supplies
- Medical Expenses relating to any hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigations
Note: Any claims arising out of or attributable to any of the following is not covered, Please refer policy T & C for detailed list of exclusions.
Tax Benefits
When you pay the premium for your health insurance policy, you are liable to get a tax rebate under section 80D of the Income Tax Act, 1961.
Claim Process
In case you would like to know about the Claim Process or would like to register a Claim please click the link below
