Oriental Health Insurance
Oriental Health Insurance plans can be chosen for individuals and an entire family. They offer health plans that are customisable to the preference of the customer. Policyholders have the added advantage of availing a number of offers and benefits.
Health insurance policy is one of the vital and significant investments that is preferred by most citizens as it covers the medical expenses of the insured due to an illness or accident by paying the premium amount. Health insurance provides medical coverage for critical illnesses, hospitalization expenses, daycare procedures, etc., along with cashless hospitalization and free medical check-ups.
One such health insurance company in India is Oriental Health Insurance company, which offers multiple benefits along with wide health coverage. Read on to learn more about the detailed plan structure offered by Oriental Health Insurance.
The following is the detailed overview of Oriental Health Insurance Company:
- The Oriental Health Insurance Company was founded in 1947
- The company was a subsidiary of Life Insurance Company till 1973
- Oriental Health Insurance started working as public sector insurance company after it was handed over to the Central Government in 2003
- The incurred claim ratio of Oriental Health Insurance Company in 2021-2022 was 139.86%.
Oriental Health Insurance Plans
The following are the health insurance plans offered by Oriental Health Insurance company:
Plan Name | Type | Key Benefits |
Saksham Swasthya Policy | Comprehensive Individual | Covers hospitalization, pre/post-hospitalization, OPD expenses, AYUSH treatments |
Happy Family Floater Policy-2021 | Family Floater | Covers 2 adults + 3 children, maternity cover, cumulative bonus, day care procedures |
Arogya Sanjeevani Policy | Standard Health Insurance | IRDAI standardized policy, covers pre-existing diseases after 3 years, cashless hospitalization |
Oriental Mediclaim (Individual) | Individual | Customizable sum insured (₹1L-₹25L), restoration benefit, no room rent limits |
Youth Eco Care Policy | Youth Focused | Discounts for young policyholders, wellness benefits, covers gym memberships |
Super Health Top-up | Top-up Cover | High sum insured options, covers expenses above base policy deductible |
Critical Illness Policy | Disease Specific | Lump sum payout for 15 critical illnesses including cancer, kidney failure |
Dengue Kavach | Vector-Borne Disease | Special coverage for dengue/chikungunya with 15-day waiting period |
Overseas Mediclaim (Business/Holiday) | International | Emergency medical treatment abroad, medical evacuation |
Health of Privileged Elders | Senior Citizens | No pre-medical screening up to age 75, chronic disease management |
Group Arogya Sanjeevani | Corporate | For employee groups, free health check-ups, customization options |
Hospital Cash Policy | Daily Benefit | Fixed daily cash payout during hospitalization (₹1,000-₹5,000/day) |
Diabetes Safe | Condition Specific | Covers diabetes-related complications, free glucose tests |
Bima Vistaar | Bundled Cover | Combines health and accident coverage, mental health benefits |
Cancer Protect | Disease Specific | Comprehensive cancer coverage including chemotherapy |
Maternity Cover Rider | Add-on Cover | Covers normal/C-section deliveries, newborn care |
Bank Saathi Policy | Group Policy | Low-cost cover for bank customers, basic hospitalization |
Jan Arogya Bima | Budget Policy | Affordable premium (₹500/year), basic hospitalization cover |
Overseas Mediclaim (E&S) | Expatriate | Covers emergency treatment abroad, repatriation benefits |
What is Covered?
The following are the details about what all covered under Oriental Health Insurance plans:
- Cataract
- Cancer
- Heart disease
- Mental illness
- Critical illness
- Dengue
- COVID-19
What is not Covered?
The following are the conditions that are not covered under Oriental Health Insurance plan:
- Alcohol consumption
- Health issue due to hazardous activity or adventure sport
- Criminal intent that breached the law
- Health problem due to intoxication, drug abuse, or substance abuse
- Health complication due to chemical war, biological injury, war, or nuclear
- Self-inflicted or intentional injuries
- Venereal diseases or insanity
- Injuries caused due to contamination by radioactivity or ionizing radiation
Oriental Health Insurance Premium Calculation
The following are the steps to calculate the Oriental Health Insurance premium:
- To calculate the premium of the Oriental Health Insurance online, first select the city you reside in
- Select who you want to insure under the health insurance plan, such as:
- Self
- Self and spouse
- Self, spouse, and one child
- Self, spouse, and two children
- Parents
- Senior citizens
- Select the age of the insured
- Select the cover amount
- Click on ‘Calculate’ option, to get the premium amount
How to Apply for Oriental Health Insurance Online?
The following are the steps to apply for Oriental HI online:
- Visit the official website of Oriental HI
- Select the health insurance
- Fill in the required details on the next page
- Calculate the policy premium amount
- Payment details will be visible on the screen
- Make the payment
- The policy document will be sent to the registered email address after successful completion of payment
Oriental Health Insurance Policy Renewal Process
The following are the steps to renew Oriental HI policy:
- Visit the official website of Oriental Health Insurance
- Click on ‘Renew Online’ option to submit your request online
- Enter policy number
- Click on ‘Renew Now’ button
- Mention the policy details
- Select the payment mode and make the premium payment
- After successful payment, policyholder will receive the policy renewal notification
Oriental Health Insurance Claim Process
The following are the claim process of Oriental HI:
Cashless Claim
The following are the steps for cashless claim of Oriental Health Insurance:
- Authorise claim application form by the network hospital
- The insurance company analyses the claim form to check eligibility
- The medical information is reviewed by the insurer to determine the eligibility of the policyholder for processing the claim form
- The policyholder can claim cashless treatment when the insurance company is satisfied
- The medical expenses are directly settled with the network hospital by the insurer
Reimbursement Claim
The following are the steps of reimbursement claim of Oriental Health Insurance:
- Fill in the reimbursement application form
- Attach all the medical documents
- Submit the required documents within 15 days of discharge from hospital
- The reimbursement claim gets processed after approval or rejection from the insurance company
Eligibility Criteria
The following are the eligibility criteria that should be fulfilled to avail Oriental Health Insurance plan:
- Age limit ranges between 18 years to 65 years
- Sum insured ranges between Rs.10,000 to Rs.50 lakh, approximately
- Policy tenure depends on the policy type
- Renewability of the policy may be from few years to lifelong
Documents Required
The following are the documents required to avail Oriental Health Insurance:
- Prescription of consulting doctor
- Report of medical recovery
- Report of medical treatment or hospital discharge
- Original test reports, such as MRI, X-ray, ECG, etc.
- Original medical bills and cash memo receipts
- Duly filled claim form
- Copy Oriental health insurance policy
- Copy of claim intimation letter
- Duly filled claim form
- Receipt copy of premium paid
- Leave certificate from the employer
- Registration number of nursing home or hospital
- In case of accidents, provide the FIR (First Information Report) or police panchnama
Benefits of Oriental Health Insurance
The following are the significant benefits of Oriental health insurance:
- Offers daily cash as per sum insured in case admitted to a hospital
- As per Section 80 (D) of Income Tax Act, provides tax benefits on premium paid
- Offers comprehensive health coverage to fulfil all medical treatment
- Provides the option of porting policy to another insurer
Oriental HI Contact Details
The following is the details of contact number and email address to reach out Oriental Health Insurance company for any queries related to health insurance:
- Toll-free No: 1800-11-8485
- Phone No: 011 3320 8485
- Email ID: csd@orientalinsurance.co.in portal.refunds@orientalinsurance.co.in (for refunds)
FAQs on Oriental Health Insurance
- Is Oriental Mediclaim beneficial?
Yes, Oriental Mediclaim is considered beneficial as it covers a wide range of medical expenses, including telemedicine expenses, in-patient hospitalization, ambulance charges, mental illnesses, domiciliary hospitalization and AYUSH treatment.
- What is the free look period under Oriental Health Insurance?
The free look period is 15 days under Oriental Health Insurance during which the policyholder can cancel the policy if they do not agree with the clause of the policy terms.
- What are the benefits of having a health card from Oriental Health Insurance?
The primary benefit of having a health card from Oriental Health Insurance is that it offers cashless hospitalisation. The insured person must display the card to the hospital and the cashless claim will be settled after the hospital completes the verification with Third Party Administrator (TPA).
- What are the premium payment options available under Oriental Health Insurance?
Oriental Health Insurance offers both offline and online payment modes, such as cash deposit at branch or payment through net banking and credit or debit cards.
- How many times can I make claims under Oriental Health Insurance?
There is no minimum and maximum limit for requesting claims in a year, but policyholder must ensure that the claim amount does not exceed the sum insured.
- Will I get tax exemption on premiums paid under Oriental Health Insurance?
Yes, you can get tax exemptions on premiums paid under the Oriental Health Insurance as per Section 80D of Income Tax Act 1961.
- Is there any child specific plan under Oriental Health Insurance?
No, there are no child specific plans covered under Oriental Health Insurance. Children of a family can be covered under family floater plans of Oriental Health Insurance plan.
- Where can I register my grievance under Oriental Health Insurance?
You can register your grievance under Oriental Health Insurance by contacting via Grievance Nodal Officers at Head Office. You can also contact the regional office via Smt. Anita Sharma, Chief Manager, Customer Service Department, 4th Floor, Agarwal House, Asif Ali Road, New Delhi- 110002.
- What will happen if I miss premium payment of Oriental Health Insurance policy?
In case you miss your premium payment of Oriental Health Insurance policy, you can make the payment within the grace period offered by the insurance company.
- How can I check the policy status of Oriental Health Insurance?
You can check the policy status of Oriental Health Insurance by logging into the e-portal with your ID and password, if you are a registered user. After successful login, check the policy related information, including policy status and other details.
- What kind of expenses are not covered in Oriental health insurance organ donor cover?
Under Oriental Health Insurance, the cost of organ and acquisition of the organ is not covered.
- What is the waiting period for Oriental Health Insurance?
The waiting period for Oriental health Insurance are 30 days, four years, one year to four years, 75 days, and two years as initial waiting period, pre-existing diseases waiting period, specific diseases or procedures waiting period, critical illness waiting period, and maternity expenses waiting period, respectively.
- Does Oriental insurance cover pregnancy?
Yes, under the Happy Family Floater and the Super Top-Up Insurance plans, Oriental unsurance covers pregnancy expenses.
- Where can I check the Oriental health insurance premium?
You can check the Oriental Health Insurance policy premium online at the company website at their premium charts to check the premium rates.
- Does Oriental insurance have a cashless facility?
Yes, all the plans covered under Oriental Health Insurance policies offer cashless claim facility at the network hospitals listed under Oriental Health Insurance policies.
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