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Oriental Insurance Happy Family Floater Policy

Eligibility  
Entry Age (years)  
Minimum 18
Maximum 55
Maximum Policy Renewal Age (years) 65
Coverage Type Family floater
Sum Insured (Rs)  
Maximum 10 lakh
Minimum 1 lakh
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
Customer Service  
Address Oriental House,
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.
Scope Of Cover
Silver PlanGold Plan
Cashless facilityavailable if treatment availed in a network hospital
Reimbursement facilityavailable if treatment availed in a non-network hospital
Section A
Hospitalisation expenses
Room, Boarding expenses as provided by the Hospital/Nursing Homecovered upto 1% of Sum Insured per day
ICU expensescovered upto 2% of Sum Insured per day
Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees, Nursing Expensescovered 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 Allowancenot allowed0.1% 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 allowedRs.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 chargesRs.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.
Section B
Domiciliary Hospitalisation
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 periodcovered 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 policypays upto Rs 5000 for immunization injections in any one policy
Other benefit(s)
Organ donor's hospitalisation expensescovered
Add On Covers (require extra premium)
Personal Accident for self and dependentsSum insured upto Rs.500,000 per person aged 18 years and above. 50% of this limit for persons less than 18 yearsSum insured upto Rs.10,00,000 per person aged 18 years and above. 50% of this limit for persons less than 18 years
Accidental deathpays 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 eyepays 50% of sum insured
Permanent Total Disablement resulting in the insured becoming in engaging in any Employment or occupation whatsoeverpays 100% of sum insured
Life Hardship Survival Benefitnot allowedcovers Cancer-metastasis (Stage-IV), End stage Renal disease (ESRD), Stroke leading to paralysis or paraplegia
Plan A15% of Sum Insured
Plan B25% of Sum Insured
Exclusions and Waiting Period
Pre-existing illnesseswill be covered after 4 consecutive renewals with the company
Survival period in case of Life Hardship Benefit180 days or 270 days after discharge for Life Hardship Benefit available only with Gold Plan.
General exclusionsAIDS or related ailmentsTreatment of any mental or related diseaseBeauty and cosmetic treatments