- About Coverfox
Oriental Health Insurance
For children : 91 days
Minimum : 18 years
Maximum : 65 years
Maximum Members : 7
Maximum Adults : 4
Maximum Children : 4
Silver: 1 lakh to 5 lakh
Gold: 6 lakh to 10 lakh
Above 60 years
Covers about 24 day-care procedure that does not require a minimum of 24 hours hospitalization.
You are entitled to a no-claim bonus of 5% up to a maximum of 20% on the premium if you renew the policy without any break.
You can claim for hospitalization, nursing home charges, surgery, medicines, drugs, pathological tests, and so forth during an organ transplant.
The insurance company will compensate you for the medical expenses related to your hospitalization 30 days before the hospitalization.
The insurance company will pay you for the medical expenses related to your hospitalization 60 days post hospitalization.
Does not offer any restore benefit.
You cannot claim for any OPD treatments.
In Gold Plan, you get a daily hospital cash up to 0.1% of sum insured per day to a maximum for ten days. The maximum liability is restricted to 1.5% of the sum insured.
Complimentary health check-up is not available in this plan.
You can claim for the costs towards a treatment at home, provided it satisfies the defined conditions.
This plan does not cover costs arising out of non-allopathic treatment.
Under this benefit, you can claim for the ambulance charges as per the below:
In Gold plan, you can claim Rs.500/- per day of hospitalization per illness up to ten days. The maximum liability is limited to payment for 15 days of hospitalization.
Under this benefit, you can claim the reasonable expenses up to Rs.5,000/- incurred for immunization injections.
The plan has pre-determined limits for room rents and is equal to:
Gold plan does not have any co-payment clause. However, Silver plan has a 10% co-payment.
A 30 days cooling off period for all claims except any arising out of accidental injuries.
The policy covers some specific diseases/treatments only after 24 months. These include Cataract, Hysterectomy, Myomectomy for Fibroids, and so forth.
You can claim for any pre-existing conditions after 48 months from the policy start date.
At an added premium, you can opt for the below cover.
At an extra premium, you can also opt for this benefit in Gold Plan.
This plan does not provide any compensation towards eye cover.
This plan does not cover maternity costs.
This policy does not cover for any cosmetic/corrective dental treatment.
This plan does not offer any recovery benefit.
This policy does not provide any additional cover for critical illness.
For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within 15 days from the date of receipt of the policy document.
The Plan will not cover any liabilities towards the treatments of following conditions-
If you are looking to buy a health plan mainly to cover your entire family including your parents and parents-in-laws, Oriental’s Happy Family Floater plan is one to consider. With some decent benefits on offer like personal accidental cover and survival benefit, the policy is tailor-made to provide comprehensive health cover. When you weigh the pros and cons of both Silver and the Gold plan, the latter scores the brownie point.**Reviews and ratings are based only on Benefits and Conditions. Things like Claim Settlement Ratio, Hospital Network have not been covered under product ratings. These are covered under Company ratings.