| Renewability | Lifelong Renewal |
| Oriental Insurance Network Hospital | 4300+ |
| Hospitalization Cover | Pre & Post hospitalization cover | Co-payment | 10% |
| Incurred Claim Ratio Year of 2022 | 139.86% |
| No. of members | Oriental Health Insurance plan covers maximum 7 members of your family with up to 3 children and 4 adults. | Health Check-ups | Offers health check-up for insured after every 4 continues claim-free year. |
| Pre-existing diseases | Pre-existing diseases are covered after 4 years of waiting period |
There are two ways to make a claim under a Health Insurance Policy on cashless basis and on reimbursement basis. In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of the insurance company servicing your policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form. In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for the claim on reimbursement are obtained after hospitalization.
Oriental Health Insurance has a well-defined claim processing system.
Cashless Service: Seeking Pre-Authorization
Reimbursement Claim: Claim Submission
In case of any emergencies, you need to inform Oriental Insurance within 24 hours of the admission. In case of planned emergencies, the notification has to reach the company 48 hours prior to the hospitalization. The claim intimation can be done via Oriental Insurance's toll free number 1800-118-485. The same could also be emailed to csd@orientalinsurance.co.in.
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Yes, oriental health insurance cover maternity costs under many of its health insurance plans, such as the happy family floater policy, super health top-up plan, optional cover in oriental group mediclaim plan, and diamond plan. However, there are certain conditions applicable to maternity cover.
To register a claim with Oriental health insurance company, a policyholder can visit the insurance company’s website and log in with the unique user ID and password given by the company. Once you log in, you will find the claim form under the ‘Claim’ tab. Enter your policy number in the claim form and provide other required details and submit. After you submit the claim form, the insurance company receives your claim intimation. Remember that a policyholder is required to visit the oriental insurance branch to submit the detailed claim form along with all the necessary documents for the registration of the claim with the company. After the claim is registered with the company, the claim appears on the user’s homepage. Also, note that claims should be sent to the company in writing either through emails or letters. Letters should be sent to the registered office of the Oriental insurance company. A policyholder can file a cashless or reimbursement claim.
A health insurance claim can only be accepted if all the relevant documents are provided. Hence submitting all the required documents on time is very crucial for a claim request to be approved. Here is a list of all the documents you will need to file a claim with Oriental health insurance company.
Health insurance is important to protect your savings and investments against unexpected medical expenses. Considering medical inflation, if you feel that your existing Oriental health insurance plan is not enough to cover the medical needs of your family, you can upgrade it easily. Some ways in which you can upgrade your health insurance are;
Once you register a claim, it is essential to keep track of the claim status. A policyholder can easily check the claim status through the official website of the Oriental insurance company. Claim status can be checked both online and offline.
To get uninterrupted medical coverage for life, it is important to renew your Oriental health insurance policy on time. You can enjoy renewal benefits for non-stop coverage such as cumulative bonuses, coverage for existing illnesses, and discounts. Renewing your Oriental health insurance policy is a simple process that can be done online by following the steps given below:
If you are an existing customer of Coverfox, you can renew your policy from Coverfox. Just log into your Coverfox account online and renew your policy. In case you want to make any changes or add optional benefits, you can do so at the time of renewal.
You can renew your policy offline if you are not comfortable with the online process. Call on the toll-free number of Oriental insurance and share your requirement, or visit the nearest branch of Oriental health insurance company.
Oriental health insurance company offers a variety of health insurance plans with numerous benefits, as given below;
Yes, a cashless health service is available at a network hospital of the Oriental insurance company. The company has tie-ups with many hospitals across India, known as network hospitals. A policyholder can get treatment in any network hospital without paying, as the insurance company directly settles the hospital bills. It is always better to check and confirm with the network hospital before admission. A third-party administrator (TPA) is responsible for helping with cashless treatment. Note that any expenses beyond the limits of the insurance policy have to be borne by the policyholder. The TPA pre authorises the claim request at the network hospital. The policyholder contacts a network hospital to avail of treatment. The hospital sends a duly filled pre-authorisation request to the TPA before hospitalisation. The TPA then processes the request as per the policy terms. If the request is approved, the policyholder has to pay only those expenses which are not covered under the Oriental health insurance plan.
The waiting period in health insurance is the period for which a policyholder has to wait before claiming any insurance benefits. No claim can be made during this period. The waiting period differs from one insurance company to another. There are various types of waiting periods applicable to a health insurance policy.
The Oriental insurance company is one of the leading public sector general insurance companies in India. The company offers a wide range of insurance plans not only in India but also in Dubai, Nepal, and Kuwait. There are a number of benefits offered by oriental health insurance plans.
What are the modes of payment available? - You can make the premium payment for Oriental Health Insurance via cash at the branch or do an online payment. Online payment can be made via net banking/credit or debit card.
If you are a registered policy holder, simply login to the e-Portal with your registered user ID and Password. Once logged in, you can check all the details of your policy.
You can cancel your existing Oriental Health Insurance Plan by submitting the policy documents at the nearest branch. The premium will be refunded post deduction of cancellation and other applicable charges.
