Oriental Insurance Happy Family Floater Policy
This is an online policy that can cover entire family for the sum required by policyholder.
This is a family floater policy that can cover self, spouse, children, parents and parents in laws under a single policy.
What does it do?
It is a floater policy where sum insured can be utilized by any member of the insured family, for illnesses or conditions covered under the policy. This policy becomes active when a member uses medical services. It is available in two variants- silver plan and gold plan. Both plans cover hospitalisation benefit and domiciliary treatment costs. Additionally, gold plan offers personal accident cover and life hardship survival benefit. Personal accident benefit covers accidental death and permanent total disability. Life hardship survival benefit covers three fatal diseases and pays a pre-specified sum insured if any insured member contracts a listed illness. Daily cash allowance and attendant’s fees is useful and can be used to cover other subsidiary expenses.
This policy can be bought online from company's website.
It offers a wide range of sum insured to choose from.
Premium paid towards this policy will be exempt from tax under Section 80D of Income Tax Act.
Biggest disadvantage is that this policy can be renewed only upto 65 years of age.
There are sub-limits on the policy benefits.
Co-payment clause under silver plan is another limitation.
The sub-limits on the policy benefits, co-payment under Silver plan, narrow coverage under life hardship survival benefit and an incomplete personal accident cover are a few drawbacks that make this policy less preferable over its peers in the market. Life hardship survival benefit covers lesser number of critical illnesses which may not serve the real purpose of such a benefit. Always prefer a health insurance policy that offers lifelong renewals, no sub-limits and least number of exclusions.
|Entry Age (years)|
|Maximum Policy Renewal Age (years)||65|
|Coverage Type||Family floater|
|Sum Insured (Rs)|
|Policy Term (years)||1|
|Discount||5% on premium if insurer opts out of Third Party Administrator services|
|No Claim Bonus||Discount of 5% on premium for each claim fre year subject to maximum of 20%|
|Pre Policy Medical Check Up||Not required for persons upto 60 years of age|
|Co Payment Clause||10% of admissible claim under Silver plan|
A-25/27, Asaf Ali Road,
New Delhi - 110002
|Mail to||[email protected]|
|Call to||1800 11 8485 (toll free), 011-33208485(non toll free)|
|Network Hospitals||List is available on company's website under Customer Services head.|
Additions to the Plan
|Scope Of Cover|
|Silver Plan||Gold Plan|
|Cashless facility||available if treatment availed in a network hospital|
|Reimbursement facility||available if treatment availed in a non-network hospital|
|Room, Boarding expenses as provided by the Hospital/Nursing Home||covered upto 1% of Sum Insured per day|
|ICU expenses||covered upto 2% of Sum Insured per day|
|Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees, Nursing Expenses||covered as per the limits stated in the policy document|
|Anesthesia, Blood, Oxygen, OT charges, Surgical appliances (any disposable surgical consumables subject to upper limit of 7% of Sum Insured), Medicines, drugs, Diagnostic material & X-Ray, Dialysis, Chemotherapy, Radiotherapy, cost of pacemaker, artificial limbs, Cost of stent & implants|
|Daily Hospital Cash Allowance||not allowed||0.1% of sum insured per day per illness subject to a maximum of 10 days upto maximum of 1.5% of the sum insured during a policy period|
|Attendant Allowance (if a child below 10 years of age is admitted)||not allowed||Rs.500 per day of hospitalisation per illness for a maximum of 10 days per illness upto maximum of 15 days during the policy period.|
|Ambulance charges||Rs.1000/- per illness and limited to maximum 1% of the sum insured or Rs.3000/-whichever is less, for the entire policy period.||Rs.2000/- per illness and limited to maximum 1% of the sum insured or Rs.6000/-whichever is less, for the entire policy period.|
|Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines & Drugs, Diagnostic Material and Dialysis, Chemotherapy, Nursing expenses.||covered upto 10% of sum insured ; maximum Rs 25000 during the policy period||covered upto Rs 50000 during the policy period|
|Treatment for Dog bite (or bite of any other rapid animal like monkey, cat etc.)||pays upto Rs 5000 for immunization injections in any one policy||pays upto Rs 5000 for immunization injections in any one policy|
|Organ donor's hospitalisation expenses||covered|
|Add On Covers (require extra premium)|
|Personal Accident for self and dependents||Sum insured upto Rs.500,000 per person aged 18 years and above. 50% of this limit for persons less than 18 years||Sum insured upto Rs.10,00,000 per person aged 18 years and above. 50% of this limit for persons less than 18 years|
|Accidental death||pays 100% of sum insured|
|Loss of Two entire Limbs, or sight of two eyes or one entire limb and sight of one eye|
|Loss of one entire Limb or sight of one eye||pays 50% of sum insured|
|Permanent Total Disablement resulting in the insured becoming in engaging in any Employment or occupation whatsoever||pays 100% of sum insured|
|Life Hardship Survival Benefit||not allowed||covers Cancer-metastasis (Stage-IV), End stage Renal disease (ESRD), Stroke leading to paralysis or paraplegia|
|Plan A||15% of Sum Insured|
|Plan B||25% of Sum Insured|
|Exclusions and Waiting Period|
|Pre-existing illnesses||will be covered after 4 consecutive renewals with the company|
|Survival period in case of Life Hardship Benefit||180 days or 270 days after discharge for Life Hardship Benefit available only with Gold Plan.|
|General exclusions||AIDS or related ailmentsTreatment of any mental or related diseaseBeauty and cosmetic treatments|
Cost Details not available on the company's website.