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Oriental Insurance

Oriental Insurance

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.

What's good here?

coPay

You’ll never have to split the bill

The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.

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prePost

Pre & Post hospitalization expenses covered

No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.

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ayush

Covers Alternative Medicine

Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.

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dayCare

Day Care treatments covered

If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.

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What's bad here?

special mention
warning
Be aware of

Restrictions on the rooms you can pick and much more

Your insurer won’t let you stay in a room whose rent exceeds 1% of the sum insured. If it’s an ICU they’ll bump it to 2% of the sum insured. And in the event you breach these limits, then you’ll have to pay a lot more - Read more here

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diseaseSublimit

Has disease wise sub-limits

Your insurance cover won’t be fully available in case you are treated for Modern treatments and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.

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What's okay here?

ped

Reasonable waiting period for pre-existing diseases

If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.

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domiciliary

Some coverage if you are forced to hospitalize at home

The insurer will pay up to ₹50,000 if you are forced to hospitalize at home due to a medical condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.

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What's lacking here?

restoration

No Restoration Benefit

Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.

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ncb

No Bonus for being healthy and not claiming insurance

Some policies offer you extra cover if you go an entire year without claiming your insurance. This policy, however, offers no such benefit.

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healthCheckup

Your insurer doesn’t provide free health check-ups

If you want to get a full-body checkup just to make sure you’re in fine working condition, be ready to pay for it yourself.

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Add-ons

Life Hardship Survival Benefit

With this add-on you get a lumpsum payment in the event you are diagnosed with critical illnesses outlined in the policy document.

Personal Accident cover

With this add-on, the insurance company will payout a lumpsum amount based on the cover chosen, in case the selected insured member encounters total or partial disablement or accidental death.

Waiver of Proportionate Deduction Clause

With this paid add-on, the insurer will enhance the clause of proportionate deduction of the room rent benefit by 50% or 100% based on the option chosen.

Geographical Extension To SAARC Countries

With this add-on, the insurer will extend the base coverage for insured members to SAARC countries without charging any additional premiums. The insured member needs to make a written request to the insurer to avail of this benefit.

Restoration

With the add-on, one-time restoration up to 50% or 100% of Sum Insured is available on a partial basis for the treatment of same or different illnesses.

Frequently Asked Questions

Yes. Happy Family Floater Policy Gold imposes 3 kinds of waiting periods -
  • 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
  • Specific Illness Waiting Period: There’s a 90 days to 3-year waiting period for a list of diseases which is a mandate before you can start claiming.
  • Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
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