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Oriental Individual Mediclaim Plan

Oriental Health Insurance

3/5 based on 18 User Reviews

Oriental Insurance is a pathfinder in setting methods for the smooth and systematic conduct of the insurance business in India. The strength of the company lies in its expert and highly motivated workforce that includes several disciplines having deep expertise.

Oriental's Individual Mediclaim Policy is basic health insurance plan which offers coverage in case of hospitalization for individuals.

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Highlights of Oriental Individual Mediclaim Plan

  • Any person between the age of 18 to 80 years is eligible to opt for Individual Mediclaim policy
  • 10% discount for enrolling more than two members
  • 5% additional discount on renewal if you buy the plan before the age of 45 years
  • Pre-policy health check-up only after the age of 45 years

Scope of cover

Indivdual Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18 years

Maximum : 65 years

Number of Members Covered

Maximum Members : 7

Maximum Adults : 4

Maximum Children : 4

Sum Insured

50,000 to 5 lakh


discount

10% Family Discount


Policy Periods Available

1 year


Pre-Policy Medical Check-up

More than 45 years


Important Features

Day Care Treatments

Covers day-care treatments.

No-Claim Benefits

Does not offer any no-claim bonus.

Organ Donor Cover

Does not cover expenses towards organ donor.

Pre Hospitalization

The insurance company will compensate you for the medical expenses related to your hospitalization 30 days before the hospitalization.

Post Hospitalization

The insurance company will pay you for the medical expenses related to your hospitalization 60 days post hospitalization.

Restore Benefits

Does not offer any restore benefit.

Good to Have Benefits

OPD Expense Cover

You cannot claim for any OPD treatments.

Daily Hospitalization Allowance

This policy does not offer any daily hospital cash.

Health Check-up

Offers complimentary health check-up that covers some listed tests, once every four claims-free underwriting years, not exceeding 1% of the average basic sum insured.

Home Hospitalization/ Domiciliary Hospitalization

You can claim for the expenses towards a treatment at home, provided it meets the defined conditions.

Non- Allopathic Treatment Expense Cover

This plan does not cover expenses related to non-allopathic treatment.

Emergency Ambulance

This plan provides ambulance cover in the range of Rs. 2,000 or 1% of the sum insured, whichever is less.

Value Adds

Eye-cover

This plan does not provide any special eye cover.

Maternity Cover

This plan does not cover maternity costs.

Dental Coverage

This policy covers for dental treatment only following an accident.

Recovery Benefit

This plan does not offer any recovery benefit.

Critical Illness Cover

This policy does not provide additional cover for critical illness.

FREE LOOK PERIOD

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.

Terms & Conditions

Room Rent / Room Category

The plan has defined limits for room rents and is equal to:

  • 1% of sum insured for sum insured or Rs. 5,000 per day, whichever is less
  • ICU expenses not exceeding 2% of the Sum Insured or Rs. 10,000 /- per day, whichever is less

Co-Payment

The plan does not have any co-payment clause.

Waiting Period

Cooling Off Period

A 30 days cooling off period for all claims except any arising out of accidental injuries.

Specific Illnesses

The policy covers some specific diseases/treatments only after 24 months. These include Cataract, Hysterectomy, Myomectomy for Fibroids, and so forth.

Pre-Existing Illnesses

You can claim for any pre-existing conditions after 48 months from the policy start date.

Permanent Exclusions

The Plan will not cover any liabilities towards the treatments of following conditions-

  • whose signs or symptoms first occur within 30 days of the policy period
  • attempted suicide
  • use of alcohol or drug
  • AIDS
  • pregnancy, childbirth, miscarriage, and abortion
  • Congenital disease
  • infertility and in vitro fertilization.
  • hospitalization out of war, riot, strike and nuclear weapons

Review of Oriental Individual Mediclaim Plan

While buying a health policy, you must carefully assess the pros and cons it offers. Oriental's Individual plan does not provide features like lifelong renewability and no claim bonus. It also has a highest waiting period of 4 years along with sub-limits imposed on room rent & ICU. On a brighter side, the plan extends broad coverage with some decent benefits like family discounts with the reasonable premium.

**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.

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