| 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 |
csd@orientalinsurance.co.in
|
| 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 Plan | Gold Plan |
| Cashless facility | available if treatment availed in a network hospital |
| Reimbursement facility | available if treatment availed in a non-network hospital |
| Section A |
| Hospitalisation expenses |
| 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. |
| 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 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 |
| Other benefit(s) | | |
| 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 |
