Health Insurance
Oriental
Oriental Insurance is a government owned entity providing insurance for Health, Vehicles, business, farmers. It has three health policies, Individual, Family Senior Citizens with a decent range of benefits. A couple of them will even provide with Health check-ups once in a while.
Oriental Health insurance plans
Mediclaim Insurance Policy
A plain vanilla policy that won't hurt your pocket too much. But if you are looking for a policy with better benefits, lower waitings periods (for pre-existing diseases) and comprehensive coverage, this isn't it.
Happy Family Floater Policy Gold
Happy Family floater gold policy is expensive and it doesn't do a lot. In fact, considering it is exclusively meant for families, you'd expect it to have a restoration benefit. Because you know, multiple members in the family could fall sick in the same year. So it would be nice if your cover were restored fully once you exchaust it. However, it doesn't offer this benefit or any of the other nice features that you would want in a comprehensive policy.
Super Health Top-up
Offers a maximum cover of 30 lakhs and while you might think that's good enough, this plan also mandates that you stay in a room whose rent doesn't exceed 1% of the deductible amount. So if the super top kicks in after you pay the first 5 lakhs, then you can't stay in a room whose rent exceeds 5,000. If you do, get ready to pay a lot more.
Happy Family Floater Policy Platinum
The Happy Family Floater Policy Platinum is an okay pick with an interesting perk - coverage for maternity & assisted reproductive treatments up to ₹2 lakhs after a 3-year waiting period. This maternity coverage is one of the highest in the industry. On the other hand, the plan has some caveats including disease-wise sub-limits, no no-claim bonuses and no restoration benefits. Coming to the insurer, the provider has a solid track record across its Claim Settlement Ratio. However, the high numbers on its Incurred Claim Ratio reflect the insurer's issues with financial stability, which is a red flag when it comes to analysing a brand's future sustainability and future claim settlement potential. Additionally, the insurer's poor number of network hospitals doesn't add to the appeal either. Overall, the plan is an okay pick and if you are looking for a comprehensive health insurance plan, you might as well start shopping around for other options.
Happy Family Floater Policy Silver
It is a plain vanilla policy with a modest cover that won't hurt your pocket too much. But the insurer doesn't offer many benefits. They will make you split the bill each time you are hospitalized. And they'll ask you to wait 3 years before covering complications arising out of pre-existing diseases (like diabetes).
Health of Privileged Elders
This could be a decent choice if you’re 60+, with pre-existing diseases. After all, they'll start covering these pre existing complications after just 2 years (as opposed to 3 years). But if you have other choices this policy could be a letdown considering they'll make you split the bill each time you're hospitalized.
Happy Family Floater Policy Diamond
While Happy family floater diamond policy offers a decent cover and extends protection for maternity related complications (upto a certain limit), it is still a lot more expensive than other polices in its class. And it makes you wait 3 years before covering complications arising out of pre-existing diseases (like diabetes).
Oriental Health insurance claim process
Oriental claims can be of different types based on the hospital in which you are getting the treatment. If it’s part of Oriental's network hospitals, you can get a “Cashless claim” in which insurance company directly pays the bills to the hospital. But if your choice of hospital is not part of their network, then you have to pay the bills and apply for reimbursement claim. Here’s a brief process for both types of claims:
Cashless Claims
Inform the Hospital Desk
All network hospitals have an insurance desk. You can submit your policy copy (even soft copy works), ID proof, initial diagnosis report and the insurance desk will request the insurance company for “pre-authorization”. In case of planned treatments, you need to do this process 2 days before hospitalization
Insurer’s decision
Based on the provided documents, insurance company approve the claim and the hospital will start the treatment and they will co-ordinate with insurer for the treatment costs. In case of Cashless claim rejection, you can still go ahead with the treatment. In this case, you will need to pay the bills initially and can file for a reimbursement claim later
Discharge
If your cashless claim is approved, at the time of discharge, the insurance company will do the final settlement with the hospital and once that is sorted, you are good to go.
Reimbursement Claims
Inform the insurance company
For any planned treatments, you need to inform the insurance company 2 days before hospitalisation. In case of emergency, you can inform within 24 hours of admission. Insurance company will acknowledge the intimation.
Hospitalization
You need to submit a insurance claim form along with original copies of hospital bills, doctor consultation reports, and diagonstic reports.
File the claim
Within 30 days post discharge, you can initiate the claim online or at any of the registered offices of the insurance company. You need to fill a claim form and attach all the reports and bills.
Insurer’s decision
Based on the claim form and submitted documents, insurance company will settle the claims as per policy terms and conditions.
Oriental Health Insurance Renewal
Firstly, if you’ve purchased the policy online, you’ll always receive an intimation e-mail from the insurer around 30 days before the renewal date. The e-mail will have a renewal link that will directly take you to the page where you can make the payment and check policy details. And it’s done. You’ll receive the policy document via e-mail.
However, in case you choose to do it on your own, here’s what you need to do:
Visit the website
Visit the Oriental website and then go to the Renewal section here.
Enter details
You’d be asked to provide your current policy number which you can find in the policy soft copy. You may as well be asked to enter your mobile number, email ID, Date of Birth or policy expiry date.
Review and edit the policy details
Next, you’ll be able to see details of your new policy and the renewal premium you need to pay. Also, you’ll be given the option to make some changes related to sum insured, existing covered members, etc.
Complete the payment and it’s done
Once you confirm the details, you’ll be directed to the payment gateway. Once the payment is complete, you’ll receive your new policy soft copy via e-mail.
Few things to consider when renewing your Oriental health insurance policy
- If you want to increase your Sum Insured, now is the time. You can’t do it anytime during the year.
- If you didn’t make a claim in the past year, make sure you have been given a no-claim bonus if your policy offers it.
- If you want to add members like your spouse or kids, you have the option to do so only at the time of renewal. So do give this a thought.
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