PNB-Oriental Royal Mediclaim Policy is a family floater scheme that is especially designed for PNB accountholders below the age of 79 years. It is a comprehensive mediclaim policy that covers the policyholder, his/her spouse and up to three dependent children. It offers an extensive range of features and benefits like hospital cash, pre and post hospitalization, domiciliary hospitalization, daily hospital cash allowance, ICU and nursing expenses, at affordable premiums.
Below are the features and benefits offered by PNB-Oriental Royal Mediclaim Policy:
PNB-Oriental Royal Mediclaim Policies offers family floater schemes that cover up to 4 family members under a single health insurance policy.
They offer affordable and flexible premiums for applicants and policyholders below the age of 79 years.
A single premium paid towards a PNB-Oriental Royal Mediclaim Policy covers the policyholder, his/her spouse and up to three dependent children.
Sum Insured ranges from Rs. 1 lakh to Rs. 10 lakhs
It offers features like cashless hospitalization, ICU, pre and post hospitalization expenses, emergency ambulance charges, Daily Hospital Cash Allowance, Domiciliary Hospitalization for certain illnesses and medical treatments, etc.
Hospital room and nursing expenditures are covered up to 1% of total sum insured per day of hospitalization.
ICU expenses are offered up to a maximum of 2% of the pre-decided sum insured on a per day basis.
Medical expenses incurred 30 days before hospitalization and 60 days after being released from the hospital are covered by the policy.
Other medical expenses that are covered include fees of surgeons, consultants, anaesthetist, etc.
Medical check-ups are not mandatory at any stage of application or renewal of the policy.
Policyholders are eligible for tax benefits on annual premiums paid towards the policy as per Section 80D of the Income Tax Act, 1961. The deductions are subject to a maximum of Rs. 25,000 for individuals and Rs. 50,000 for senior citizens.
Organ Donor expenses are covered when the individual covered by a PNB-Oriental Royal Mediclaim Policy is the recipient. It covers medical expenses incurred towards in-patient hospitalization in respect of organ donation as per Transplantation of Human Organs Act 1994 (amended) or any other extant Act, Central/State Rules/regulations.
Certain specific illnesses or injuries or health condition, as specified in the policy document, which have been existing before the inception of a PNB-Oriental Royal Mediclaim Policy are covered after the waiting period.
Waiting period for certain pre-existing illnesses or health condition, as mentioned in the policy document, ranges from 1 to 3 years, depending on the illness or medical condition.
Any individual who meets these criteria is eligible for applying for a PNB-Oriental Royal Mediclaim Policy:
Maximum entry age is 79 years for all members to be covered under the policy.
The policyholder must be a PNB accountholder.
For the Group Mediclaim Policy, the policy covers self, legally wedded spouse and up to three dependent children. The policyholder has to be a PNB accountholder and at least 18 years in age. The dependent children have to be between 91 days and 18 years.
A male child can be covered up to 26 years, provided he is financially dependent or a bonafide student.
A female child can be covered till she gets married.
Some exclusions of the PNB-Oriental Royal Mediclaim Policy are:
Pre-existing diseases are not covered before the completion of 3 years from the inception of the policy.
Expenses towards certain treatments and surgeries like aesthetic dental treatment, plastic surgery, etc. are not covered since they are considered to be cosmetic surgeries.
Sexually transmitted diseases like HIV, AIDS, etc.
Expenditures towards treatments or surgeries due to accidents caused during adventure sports, massages.
Treatments such as hernia, polycystic ovarian diseases, non-infective arthritis, cataract, piles, sinusitis, hypertension, diabetes, joint replacements etc. are covered after one or two years since the policy inception, as mentioned in the policy document.
Following are the documents that you will be required to submit at the time of purchasing PNB-Oriental Royal Mediclaim Policy:
Proof of Identity: Aadhaar, PAN, Voter ID, Driving License, Passport, etc. are accepted documents
Proof of Address: Aadhaar, Passport, Driving License, Voter ID, electricity bill, telephone bill, water bill, gas bill, Ration Card, bank statement, copy of insurance policy, etc. are acceptable documents
Proof of Age: Aadhaar, School Leaving Certificate, etc. are valid proofs
Passport sized photographs
PNB-Oriental Royal Mediclaim Policy can be renewed through these simple steps:
Visit the official website of Oriental Insurance and enter your existing policy number and then click on the ‘Renew Now’ tab
Mention the required policy details
Your premium will be calculated as per your insurance objectives and other parameters
Next, you have to enter the required personal details
Complete your premium payment online
You will be notified on your registered email id about the successful renewal of your policy within 48 hrs
The cashless claim process for PNB-Oriental Royal Mediclaim Policy can be made by following these steps:
Intimate the insurance company or TPA about the treatment or surgery of the insured at least 72 hours prior to hospitalization
Fill up the pre-authorization form with accurate details and submit it before hospitalization as another proof of identity
Show your PNB-Oriental health card or Policy Number along with proof of identity - Passport, Voter ID, PAN Card or Driver's Licence to the relevant authorities at the time of hospitalization
Insurer informs the network hospital about the acceptance of your treatment.
The treatment expenditure, up to the pre-decided sum insured, is directly reimbursed to the network hospital.
Below are the documents that you will be required to submit at the time of initiating the claims process:
Claim form, duly filled and signed by the policyholder
Receipts and bills of medical tests, hospitalization, doctors’ consultation charges, etc. as proofs of hospitalization and other medical expenses along with hospital discharge card
Prescription of doctor advising the treatment
Detailed report from the attending physician about your previous medical records and surgical history
PNB-Oriental Royal Mediclaim Policy is suitable for individuals and families. It is a family floater plan which is customized to cover the policyholder, his/her spouse and up to three dependent children. This ensures that it is a versatile plan that covers and financially protects the entire family against health and medical expenditures up to the age as late as 79 years.
“The wide range of features and benefits offered by PNB-Oriental Royal Mediclaim Policy had made me buy this plan. When I had to get hospitalized due to an illness, the benefits that I could avail made the policy worth it. I got covered not only for hospital room and surgery expenses, but for various pre and post hospitalization medical facilities too.” – Garima Singh
“One of the reasons why I decided to opt for PNB-Oriental Royal Mediclaim Policy is because it offers coverage till the 79 years, which is comparatively higher than most other mediclaim policies of its kind.” – Satish Malhotra
“Quick and easy cashless claims benefit was of great help when I had to get hospitalized after an accident. Without this benefit, I have no idea how my family would have got me admitted to the hospital and financed my treatment without any prior notice.” – Rekha Malhotra
