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HDFC ERGO Claim Settlement Ratio

99 percent
99 percent

HDFC ERGO Claim Settlement Ratio over the years

Are you planning to purchase an insurance policy offered by HDFC ERGO or are you already an existing customer? Then, it would be cognizant of you to know about the claim settlement ratio of HDFC ERGO.

Knowing the claim settlement ratio of a company can give you an accurate idea of the claim servicing temperament of an insurance company, and is an important metric that potential policyholders should keep their eye on.

In this article, we will talk in detail about:

  • Meaning of Claim Settlement Ratio and its Importance
  • HDFC ERGO Health Insurance Claim Settlement Ratio
  • HDFC ERGO Car Insurance Claim Settlement Ratio
  • How to file a claim with HDFC Ergo Health Insurance?

Meaning of Claim Settlement Ratio and its Importance

In simple terms, a claim settlement ratio means the percentage of total claims paid by the insurance provider out of the total claims reported during the financial year. A claim settlement ratio or CSR is one of the most crucial indicators to keep in mind when deciding on an insurance company as this ratio indicates how dedicated and reliable the company is in settling genuine claims.

Higher the claim settlement ratio of the insurance company, the more likely it is to settle the claims of its policyholders. The claim settlement ratio or CSR applies to all insurance-related plans and policies like term insurance, health insurance, motor insurance, and so on.

A claim settlement ratio or CSR higher than 75% is considered to be a good claim settlement ratio.  A claim settlement ratio above 90% is deemed to be an excellent ratio signifying that the company is highly efficient in settling the claims of its customers. A claim settlement ratio below 50% indicates that the insurance provider is strict in processing, assessing claims and underwriting standards.

For instance, if an insurance company  has received a total of 10,000 claims out of which it settles 8,500 claims, then the CSR of that company for that financial year is 85%.

HDFC ERGO Health Insurance Claim Settlement Ratio

HDFC Ergo has an in-house claim settlement team that is dedicated to processing and settling the claims of its customers. You can now easily register your claim with the company in a matter of minutes. The in-house claim settlement team will direct and guide you in every step of the process. Below mentioned is the claim settlement ratio (CSR) of HDFC ERGO for the following years:

Financial yearClaim settlement ratio
FY 2021-202286.52%
FY 2018- 201962%

HDFC ERGO Motor Insurance Claim Settlement Ratio

As mentioned earlier, the company’s in-house team provides dedicated service to its customers during the claim settlement process. The company takes up to a period of seven working days from the date of submission of all documents to process claims.

Below provided is the claim settlement ratio of HDFC ERGO Motor Insurance for the following years:

Financial year

Claim settlement ratio

FY 2022- 2023

99.8%

FY 2020 – 2021

91.23%

FY 2018- 2019

75.90%

How to file a claim with HDFC ERGO Health Insurance?

Follow these simple steps laid down by us to file your claim with HDFC ERGO Health Insurance:
There are two ways a policyholder can file a claim. You can opt for a cashless or reimbursement claim process. First, let us tell you about the cashless claim process.

Cashless Claim

  • Step 1: Find the nearest network hospital of the insurer to avail of treatment. The company has more than 10,000 network hospitals where you can opt for medical assistance.
  • Step 2: Inform the company within 24 hours in case of an emergency or 48 hours before planned hospitalization.
  • Step 3: Submit your HDFC ERGO cashless card to the insurance department in the hospital.
  • Step 4: Duly fill and sign the pre-authorization form available at the hospital. The hospital will send all the documents to the insurance company for verification.
  • Step 5: After thorough verification, the company will approve the claim.

Note: In case, the claim has not been approved the company will state the reasons for the same in writing.

Reimbursement Claim

The policyholder can file for a reimbursement claim when admitted to a non-network hospital of the company. In such a scenario, the policyholder will have to avail of the treatment and pay the hospital bill from his own pocket. The insurance company will then reimburse the policyholder after initiation and proper submission of documents.

Follow these simple steps laid down to initiate a reimbursement claim:

  • Step 1: Get admitted to the nearest hospital and avail of treatment.
  • Step 2: Inform the company within 24 hours in case of an emergency or 48 hours before planned hospitalization.
  • Step 3: Post-discharge submit all the required documents like bills, reports, etc to the insurance company.
  • Step 4: After thorough verification, the company will reimburse the claim amount directly into your bank account.

Documents Required

Below provided are a few important documents that you need to submit in order to file for a claim:

  • Original bills
  • All original test reports, x-ray scans, prescriptions, etc
  • Original discharge summary
  • Death certificate (if applicable)
  • FIR (if applicable)
  • KYC

Conclusion

It is always advisable for customers to be vigilant and check the claim settlement ratio of an insurance company before purchasing its plans. The whole purpose of buying an insurance product is to protect oneself during tough times. Therefore, it is recommended to purchase a plan from an insurance company that has a high claim settlement ratio even if the insurance company charges a marginally higher premium compared to its competitors.

Author Bio

This article is written by Team InsuranceLiya.com, an independent website that writes about insurance, finance, health, and more. Our writers have a wealth of knowledge, experience, and degrees in the fields of insurance, finance, economics, and beyond.

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HDFC ERGO Travel Insurance (A Simple Guide)

HDFC ERGO Travel Insurance (A Simple Guide)

Are you planning to take a trip abroad for work or pleasure? Getting a travel insurance policy is imperative. Certain countries even mandate their visitors travel insurance policies. Want to know about HDFC ERGO travel insurance? Well, you have come to the right place. In this article, we will talk in detail about HDFC ERGO travel insurance, its features, plan benefits, types of travel insurance plans, and much more.

  • What is Travel Insurance?
  • Travel Insurance in India.
  • HDFC ERGO Travel insurance.
  • Features of HDFC ERGO Travel Insurance plans.
  • HDFC ERGO Travel Insurance Plan benefits.
  • Travel Insurance Plans by HDFC ERGO.
  • How to purchase HDFC ERGO Travel Insurance Plans?
  • How to renew HDFC ERGO Travel Insurance Plans?
  • How to file a claim with HDFC ERGO Travel Insurance Plans?
  • Exclusions under HDFC ERGO Travel Insurance Plans.
  • How to file a claim with HDFC ERGO Travel Insurance Plans?

What is Travel Insurance?

Travel insurance is an insurance product that financially compensates the policyholder against various risks while traveling abroad or in the country. In simple terms, the insurance company will indemnify the policyholder in case of any unforeseen events like any medical emergency, loss or theft of baggage, flight cancellations, etc, depending on the terms of the policy.

Travel insurance in India

According to a survey conducted by a leading insurance company travel insurance in the country has skyrocketed post-COVID-19.
As per the survey reports only 50% of international travellers bought a travel insurance policy. Post the COVID-19 outbreak this number has drastically increased to 76%.
Another finding from the survey suggests that awareness of purchasing travel insurance plans has increased up to 90% from 76% post-pandemic.

HDFC Ergo Travel Insurance

HDFC ERGO offers a plethora of travel insurance plans that provide comprehensive coverage to both domestic and international travelers. The company offers a vast range of travel plans for families, individuals, students, and people who frequently travel due to work.

HDFC ERGO travel plans offers cashless facility in over 1 Lakh hospitals worldwide. Plans offered by the company provide coverage in more than 20 Schengen countries and 18 other countries.

Features of HDFC ERGO Travel Insurance plans

  • Cashless Hospitalization: HDFC ERGO has more than 1 Lakh network hospitals all around the world which will provide cashless facilities to the policyholder in case of any emergency hospitalization while traveling.
  • Countries Covered: Plans offered by the company provide coverage in 25 Schengen countries and various other countries.
  • COVID-19 Coverage: Travel plans by HDFC ERGO provide coverage against COVID-19. In case the policyholder contracts COVID-19 while traveling abroad the hospitalization expenses for the same will be taken care of by the company.
  • Customizable Plans: HDFC ERGO plans are customizable according to the preference and needs of the individual. The policyholder can choose from a range of cover options such as flight cancellations, lost luggage, medical expenses, etc while traveling. Certain policies also allow you to select the sum insured or the coverage limit needed for the trip.
  • 24/7 Customer Support: HDFC ERGO provides 24-hour customer support for quick assistance to its customers in case of any emergency like theft, loss of baggage, etc in all covered countries.
  • In-house Claim Settlement: The company provides in-house claim settlement for its customers which means there’s no involvement of any third-party administrator (TPA). HDFC Ergo has a dedicated team of experts who looks after the claim settlement process providing a smooth experience for its customers.


HDFC ERGO Travel Insurance Plan benefits

Below provided are some general plan benefits of HDFC Ergo travel insurance plans. These benefits may vary from policy to policy.

  • Medical Expenses: HDFC ERGO’s travel plan cover medical expenses like inpatient, and outpatient care, therapies, diagnostic tests, and so on due to any illness or injury suffered while traveling.
  • Accidental Death Cover: Travel plans by HDFC ERGO also provide accidental death coverage in which the company provides financial compensation to the nominee of the policy in case of accidental death of the policyholder.
  • Accidental Disability Cover: The company also provides accidental disability coverage which provides compensation in case of total permanent disablement suffered by the policyholder due to an accident.
  • Emergency Medical Evacuation: HDFC ERGO travel plans offer a unique benefit that provides coverage for an emergency medical crisis such as medical evacuation by air or road to the nearest hospital for treatments.
  • Coverage for Loss of Passport: The plans also offer to cover the cost of a passport and other crucial documents in case of loss or theft.
  • Coverage for Flight Delay: Plans by HDFC ERGO travel insurance also offer reimbursement in case the policyholder’s flight is delayed for more than 12 hours from the scheduled departure time.
  • Worldwide Coverage: Travel plans offered by the company provide comprehensive worldwide coverage that protects you and your loved ones while traveling on vacation or for any work-related purposes.

Travel Insurance Plans by HDFC ERGO

Below provided are the notable plans offered by the company:

1.) Student Travel Insurance Plan

The student travel policy is designed for students who are planning to travel abroad for higher education. This plan will secure a prolonged stay abroad so that the student can solely concentrate on their studies without worrying about the losses caused due to any unforeseen incidents. Any Indian student already residing overseas can also purchase this plan. This plan offers sum insured options starting from $100000 up to $250000.
This plan is available in five variants: Platinum, Gold, Silver, Bronze, and Standard.

Plan Benefits

  1. This plan covers all medical, evacuation, and repatriation expenses of the insured student studying abroad.
  2. Worldwide coverage is provided to the insured student starting from one month up to 2 years.
  3. This plan also covers the risk of theft or loss of a passport.
  4. This plan also provides financial compensation in case of study interruption due to personal reasons such as the death of a family member.
  5. This policy also indemnifies the payment of the bail amount of the student in case of incarceration of the student for any offense.
  6. Medical tests are not mandatory to purchase this policy.

Plan Eligibility

  • Age: From 16 years up-to 35 years.
  • All Indian students studying abroad are eligible to purchase this plan.

2.) HDFC ERGO Family Travel Insurance Plan

This type of travel plan is ideal if you are planning a vacation with your family members. It is an affordable option allowing you to insure all your family members under a single travel policy at an affordable premium. This plan offers a wide range of sum insured options starting from $ 50,000 up to $ 500,000. This policy is available in five variants: Platinum, Gold, Silver, Bronze, and Standard.

Plan Benefits

  1. This plan offers cashless treatment in more than 1 lakh hospitals all around the world in case of a medical emergency.
  2. The policy provides financial compensation in case of any total permanent disability suffered while traveling.
  3. This plan also covers the cost of any accidental dental injury suffered while traveling.
  4. The plan covers the cost of baggage or personal documents lost or stolen up to the sum insured.
  5. The company will provide financial compensation to the nominee of the policy in case of the accidental death of the policyholder.
  6. The plan will also financially compensate in case of hijack of the airplane or train in which the insured has travelled.

Plan Eligibility

  • Single trips: 6 months to 70 years.
  • Multi trips: 18 years up to 70 years.

3.) HDFC ERGO Multi-trip Travel Plan

This plan is ideal for individuals who have to travel frequently due to work or any other purpose. In this plan, the policyholder can avail of coverage for multiple trips under the same cover. HDFC ERGO‘s Multi-trip plan is available in four variants; Platinum, Gold, Silver, and Asian Region. The plan offers a wide range of coverage options from USD 5,00,000 to USD 25,000.

4.) HDFC ERGO Individual Travel Insurance Plan

This plan is designed for individuals who travel solo offering a wide range of benefits at an affordable premium. HDFC ERGO’s travel plan is available in five variants; Platinum, Gold, Silver, Bronze, and Asian region. The sum insured ranges from USD 5,00,000 to USD 25,000.

Plan Benefits

  1. The policy covers cashless hospitalization in network hospitals worldwide.
  2. This plan provides financial compensation in case of loss or theft of baggage.
  3. This plan covers accidental death while traveling.
  4. Any accidental disability while traveling will be compensated.

How to purchase HDFC ERGO Travel Insurance Plans?

Follow these simple steps laid down by us to purchase a travel insurance policy with HDFC ERGO.

  • Step 1: Visit the official website of the company i.e https://www.hdfcergo.com/
  • Step 2: Click on the “BUY” option at the header of the page and select travel insurance.
  • Step 3: Select the type of travel insurance plan you wish to purchase.
  • Step 4: Fill in all the required details like destination, number of passengers, and so on.
  • Step 5: You will be redirected to the quotes page where you will be offered the right plan for your requirements.
  • Step 6: You can make the payment directly via a debit or credit card. Your policy will be instantly generated or you can also purchase an HDFC Ergo travel plan by visiting the nearest official branch of the company.

How to renew HDFC ERGO Travel Insurance Plans?

Follow these simple steps to renew your travel insurance plan with HDFC ERGO:

  • Step 1: Visit the official website of the insurer and click on the “Renew” option.
  • Step 2: Fill in the requested details like policy number or registered mobile number to log in.
  • Step 3: Verify all the policy details and make the premium online.
  • Step 4: Your policy will be instantly renewed and you will receive a confirmatory email on your registered email address, or you can also renew your travel insurance policy by visiting the nearest branch of HDFC ERGO.

How to file a claim with HDFC ERGO?

As mentioned earlier, HDFC ERGO has a dedicated in-house claim settlement team that looks after providing an efficient claim settlement experience for its policyholders.

Note:

  • You must immediately inform the insurer in case of an emergency on its claim intimation number i.e +91 22 6234 6234/+91 120 6234 6234.
  • You can also contact the insurer on its claim’s intimation India landline number +91-120-4507250.
  • You can also intimate the insurer on an official email address i.e travelclaims@hdfcergo.com.

Follow these simple steps to facilitate a claim with HDFC ERGO Travel Insurance:

  • Step 1: You must immediately inform the insurance company in case of any emergency.
  • Step 2: Please visit travelclaims@hdfcergo.com and get a list of network hospitals to avail treatment.
  • Step 3: The claims team will share the required documents for a cashless claim.
  • Step 4: You can also download the digital claim form available on the official website of the company.
  • Step 5: Send the dully filled digital claim form with all the necessary documents to the company.
  • Step 6: After verification by the company the claim will be approved.

Exclusions under HDFC ERGO Travel Insurance Plans

Following are some general exclusions under HDFC Ergo travel plans. These exclusions may vary from policy to policy.

  • Pre-existing Conditions: Travel plans by HDFC ERGO will not cover any pre-existing conditions suffered by the policyholder before traveling.
  • Self-inflicted Injury: Any self-inflicted harm or injury caused to the policyholder like suicide, etc will not be covered under the policy.
  • Injury due to Adventure Sports: Any injury suffered due to participation in any kind of adventurous sport like rock climbing, scuba diving, paragliding, bungee jumping, etc is not covered under the plan.
  • Cosmetic Procedures: Any cosmetic treatments like botox, lip augmentation, etc will not be covered the plans.
  • Obesity Treatment: Any cost of treatments arising due to an obesity procedure or surgery will not be covered under the plan.
  • Health hazard due to breach of law: Any coverage for health problems that insured individual may experience due to illegal activities on their part like smoking illegal substances or drug abuse will not be covered by the insurer.

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Frequently asked questions about HDFC ERGO Travel Insurance

  • How to decide the best plan for my travel?

    This truly depends on the requirements, preferences, and budget of the individual. For example, If you are traveling with your family, it’s best to choose a family floater plan that covers your entire family in a single policy. Also, you can avoid the irritant of buying travel insurance for every trip by opting for a Multi-trip plan if you are a frequent traveller. If you are traveling abroad for higher studies, then a student plan is the best option for you.

  • What is not covered in travel insurance policies?

    Travel insurance plans generally do not cover any pre-existing conditions, mental illnesses, cosmetic procedures, and so on.

  • What is the maximum age to enter HDFC ERGO’s Travel Insurance plans?

    70 years is the maximum age to buy a travel insurance plan with the company.

  • Can I change the travel dates in my HDFC ERGO travel plan?

    Yes, you can alter the travel dates in your policy before the policy commencement date to a later date.

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    What is iPartner by ICICI Lombard? (Simply Explained)

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    What is iPartner by ICICI Lombard? (Simply Explained)

    So, are you looking to sell insurance to your prospects but are wondering about how to get going? Well, ICICI Lombard has come up with their iPartner program. What is the ICICI iPartner program? This article will attempt to talk about the most important aspects of the iPartner program, such as:

    • ICICI Lombard iPartner explained
    • Features and benefits of iPartner
    • How to become an iPartner with ICICI Lombard
    • Eligibility criteria
    • ICICI iPartner Pro Mobile App

    ICICI iPartner Explained

    To understand how the ICICI Lombard iPartner program works, you will first have to understand ‘what is PoSP and its workings?’ PoSP stands for Point of Salesperson. A PoSP has the ability to sell insurance and related products to their clients. He or she essentially acts as an insurance agent.

    To become a PoSP, a person has to complete a 15-hour certification program as per IRDA regulation. Once this is done, a PoSP can begin selling insurance on their own. The ICICI Lombard iPartner program is essentially ICICI Lombard’s version of a PoSP program where you can sell ICICI Lombard insurance products to your customer base and get a commission from it.

    Features and Benefits of iPartner

    • Brand value of ICICI Lombard: Partnering up with ICICI Lombard through their iPartner program and selling ICICI Lombard insurance policies is ought to be a pleasant experience, as ICICI Lombard has a favorable brand image in the eyes of prospective customers. The sales conversion is likely to be high due to this brand value.
    • Flexible timings: You are your own master after enrolling in the iPartner program. You can select your own work hours and do not have to adhere to any deadlines. Work as much as or as little as you wish.
    • Commissions: As a PoSP, you will be eligible to receive a commission on insurance sales and renewals. The commission rate depends on the type of policy sold.

    Type of policy sold

    Commission rate

    Health insurance

    15%

    Business insurance

    10%

    Car insurance

    15%

    Bike insurance

    15%

    Data taken from: https://www.icicilombard.com/become-posp-insurance-agent

    • Paperless: As a PoSP, you do not need to collect or deal with any paper work. The entire sales process is online and the customer documents need to be uploaded directly to the ICICI portal. This leads to streamlining of process and ease of management.
    • Online claims: Your customers can directly initiate online claims, they do not need to come to you to initiate a claims request. This saves a lot of time and effort.

    How to become an iPartner with ICICI Lombard

    You can enroll in the ICICI Lombard iPartner program by following these simple steps:

    Step 1: Download the ICICI Lombard iPartner Mobile App

    Step 2: Upload your KYC documents

    You will now need to upload the following KYC documents to the App:

    • Cancelled check (to setup bank payments)
    • Aadhar Card
    • PAN Card
    • Education certificate

    Step 3: Document verification
    The company will then verify your documents and accept or decline your application.

    Step 4: Sell insurance
    Once accepted, you can now sell ICICI Lombard insurance products through the iPartner program.

    Eligibility Criteria

    Age

    Qualification

    18+

    SSC

    ICICI iPartner Pro Mobile App

    The iPartner Pro Mobile App has the following features:

    • You can generate insurance quotes through the App.
    • These insurance quotes can be directly sent to your customers.
    • Your customers can directly buy insurance through the sales link generated through the App.
    • You can raise a pay-out request through the App.

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    How Oriental Insurance’s Corona Kavach Policy Can Protect You from COVID-19

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    How Oriental Insurance’s Corona Kavach Policy Can Protect You from COVID-19

    Corona Kavach by Oriental Insurance is a robust health policy that will protect you and your loved ones against the financial burden arising from COVID-19.  In this article, let us show you how this health insurance policy is suitable to fulfill the health requirements of you and your family members. In this article we will talk about the following:-

    • What is covered under the Oriental Corona Kavach policy?
    • Key features of Oriental Corona Kavach Policy
    • What are the exclusions under the Oriental Corona Kavach policy?
    • Oriental Corona Kavach claim settlement procedure
    • Oriental Corona Kavach policy eligibility
    • Oriental Corona Kavach frequently asked questions (FAQs)

    What is covered under the Oriental Corona Kavach policy?

    Below given are the general inclusions that will be covered or paid for under this policy:-

    • Hospitalization expenses: Oriental’s Corona Kavach plan covers hospitalization expenses of in-patient care arising due to COVID-19. Hospitalization expenses like room, bed charges, nursing, doctor’s fees, etc will also be covered under the policy.
    • Intensive care: This policy covers all Intensive Care Unit (ICU), and Intensive Cardiac Care Unit (ICCU) expenses.
    • Homecare treatment expenses: The plan also covers home care treatment of the policyholder suffering from COVID-19 up to the sum insured for 14 days. Diagnostic tests, doctor’s consultation fees, nursing charges, prescribed medicines, etc are covered under the plan. This plan also pays for medical equipment like PPE kits, oxygen cylinders, pulse oximeters, nebulizers, and so on.
    • AYUSH coverage: Alternative treatments like AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) are covered up to the sum insured limit under the policy.
    • Pre and Post hospitalization: Oriental’s Corona Kavach policy covers 15 days of pre-hospitalization and 30 days of post-hospitalization expenses.
    • Ambulance charges: The policy also pays for road ambulance charges for transferring the patient to the hospital up to Rs 2000 per hospitalization.
    • Daily cash optional benefit: This plan also offers a daily cash benefit as an optional rider which provides extra cushion to the policyholder during a financial crisis. Under this optional rider, the policyholder will receive 0.5% of the sum assured as a daily cash payout during hospitalization.
    • Co-Morbidity coverage: This plan also covers any pre-existing conditions suffered by the policyholder in conjunction with COVID-19. All medical tests, procedures, treatment, etc of the existing medical ailment triggered by COVID-19 shall be covered up to the sum insured.

    Key features of Oriental Corona Kavach Policy

    Below given are some important key features of Oriental’s Corona Kavach Policy.

    • Sum insured limit: Oriental’s Corona Kavach policy provides a wide range of sum insured options starting from Rs 50,000 up to Rs 5 lacs.
    • Family floater benefit: The company also offers the option to avail of a family floater benefit under which all the members of the family can be protected against COVID-19 under a single policy.
    • Policy tenure: This plan has a tenure of three and half months (3 ½ months), six and half months (6 ½ months), and nine and half months (9 ½ months).
    • Waiting period: This policy has a waiting period of 15 days after which it shall cover hospitalization and medical expenses for COVID-19.

    What are the exclusions under the Oriental Corona Kavach policy?

    Below provided are a few general exclusions under the Corona Kavach policy:-

    • Experimental/Unproven treatments: Any unproven treatments or experimental procedures that lack medical authentication to prove their effectiveness will not be covered. However, treatments authorized by the government only shall be covered under this policy.
    • Cosmetic procedures: Any cosmetic procedures or surgeries shall not be covered under the policy.
    • Dietary supplements: Any dietary supplements purchased without a doctor’s prescription will not be covered under this policy. However, multivitamins and mineral supplements prescribed by the doctor shall be covered.
    • Treatment outside India: Any treatment availed outside the geographical limit of India will not be covered.
    • Investigation and evaluation tests: Expenses related to any admission primarily for diagnostics and evaluation purposes will not be liable to be paid by the company. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment shall not be covered under this policy.

    What is Oriental’s Corona Kavach claim settlement procedure

    There are two ways the policyholder can file for a claim with Oriental Health Insurance I.e the Cashless claim and reimbursement claim.

    For cashless claim

    Follow these simple steps laid down for availing cashless treatment:

    • Step 1– The policyholder can avail of cashless treatment when admitted to a network hospital of the company. In case of an emergency inform the insurance company within 24 hours of hospitalization or 72 hours prior to planned hospitalization.
    • Step 2– You will have to duly fill out the claim form available at the hospital and submit it to the TPA department at the network hospital.
    • Step 3– The insurance company will verify all the information and after thorough verification, the company will approve your cashless claim request.
    • Step 4– In case your cashless claim request is not approved by the company due to reasons like unsatisfactory submission of documents, etc, you can avail of the treatment and then apply for reimbursement of the hospital bills from the insurer.

    For reimbursement claim

    The policyholder will have to avail of a reimbursement claim when admitted to a non-network hospital.

    Follow these steps to avail of a reimbursement claim

    • Step 1:- In case of an emergency inform the insurance company within 24 hours of hospitalization or within 72 hours prior to planned hospitalization.
    • Step 2:- Submit all the required documents to the company within 15 days of the discharge date to initiate the claim process.
    • Step 3: The insurance company will then evaluate the claim’s authenticity.
    • Step 4: Once all the supporting documents relating to the claim are proven authentic, the claim will be accepted and the amount shall be reimbursed to the policyholder.

    Documents to be submitted for claim

    Submit the following documents within 15 days from the date of discharge to the company to initiate the reimbursement claim process.

    • Dully signed and filled authorization form
    • All original medical bills, prescriptions, receipts, reports, etc
    • Original copy of medical reports like x-ray, scans, etc.
    • Photo identification proofs
    • Discharge summary
    • Death certificate ( if applicable)
    • FIR ( if application)

    Oriental Corona Kavach policy eligibility criteria

    Individuals between the age groups of 18 years and 65 years can opt for Oriental’s Corona Kavach plan. However, under the family floater plan dependent children from day 1 up to 18 years of age shall be covered.

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    Frequently asked questions about Oriental Health Insurance Corona Kavach

  • What is the minimum age criterion to opt for the Oriental Corona Kavach policy?

    The minimum age to enter the policy is from 1 day for children up to 18 years of age.

  • What is the waiting period under the Oriental Corona Kavach plan?

    There is a waiting period of 15 days from the policy purchase date after which the policy will cover all hospitalization expenses for COVID-19.

  • Is AYUSH treatment covered under the Corona Kavach policy?

    Yes, alternate treatments like Ayurveda, Yoga, Unani, Siddha, Homeopathy, Naturopathy, etc are covered under the plan.

  • Can I avail of tax benefits under the Oriental Corona Kavach policy?

    Yes, you can avail of tax benefits under Section 80 D of The Income Tax Act, 1961, on the premiums paid by you.

  • Is a medical check-up needed before purchasing this policy?

    No, a pre-policy medical check-up before purchasing this policy is not required.

  • Is worldwide coverage available under this plan?

    No, this policy provides coverage for medical treatment availed within the country.

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    Oriental Health Insurance

    Oriental Health Insurance Plans (Top 15 Plans)

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    Oriental Health Insurance Plans (Top 15 Plans)

    Oriental health insurance offers a variety of plans to safeguard you and your family’s future. Listed below are the various health insurance plans offered by the Oriental Health Insurance company.

    1. Happy Family Floater Policy
    2. Mediclaim Insurance Policy (Individual)
    3. PNB- Oriental Royal Mediclaim
    4. OBC- Oriental Mediclaim Policy
    5. Mediclaim Insurance Policy (Group)
    6. Oriental Happy Cash – Nischint Rahein
    7. Oriental Super Health Top-up
    8. Pravasi Bharatiya Bima Yojana
    9. Health of Privileged Elders
    10. Arogya Sanjeevani Policy-Oriental Insurance
    11. Overseas Mediclaim Policy (E&S)
    12. Jan Arogya Bima Policy
    13. Oriental Dengue Kavach
    14. Oriental Critical Illness Policy
    15. Corona Kavach and Group Corona Kavach

    1.) Oriental Happy Family Floater policy

    Orientals Happy Family floater policy is a family floater plan that offers coverage to you and your family members under a single sum assured. This plan covers inpatient hospitalization expenses,multiple daycare treatments,pre and post hospotalization charges and much more. You can choose to cover yourself,legally wedded spouse, children and dependent parents under this policy. This plan is available in 3 variants- Silver, Gold and Diamond Plan.

    Key Features

    • Takes care of in-patient hospitalizations expense,multiple daycare treatments, pre and post hospitalizations, ambulance charges and more.
    • Benefit of cover restoration if you exhaust your coverage because of previous claims.
    • Organ donor benefit of up to 10% of the sum insured.
    • Benefit of second medical opinion for 11 major illnesses all round the world between Rs.5,000- Rs. 15,000 depending on the plan selected.
    • Receive daily cash and Attendant allowance benefit of Rs. 600 – Rs. 1000. (for Gold and Diamond plan)
    • Compulsory 10% co payment on ever claim only in the Silver plan.

    Oriental Happy Family Floater policy

    Age Entry

    91 days – 65 years

    Sum Insured

    Rs. 1 lakh – 20 lakh

    2.) Mediclaim Insurance Policy (Individual)

    This is a health insurance plan that provides comprehensive coverage to the insured that safeguards them from hospital related expenditure incurred due to any sickness,illness or any injury.
    You can also cover yourself,your spouse,your children and parents under this policy under family floater basis.

    Key Features

    • Covers reasonable and customary costs in respect of Hospitalization
    • Covers ICU charges,room rent,boarding & nursing expenses,emergency ambulance costs,etc
    • Pays towards anesthesia, Blood, Oxygen, Operation Theater costs,medicines & drugs,etc.
    • Pays 30 days pre and 60 days post hospitalization.
    • Daily cash allowance up to maximum 6 days of hospitalization
    • Covers inpatient Ayush Treatment and Organ donor expense.

    Mediclaim Insurance Policy (Individual)

    Age Entry

    18 years- 70 years

    Sum Insured

    Rs.1lakh- Rs 10 lakh

    3.) PNB- Oriental Royal Mediclaim

    This policy is designed for any account holders of Punjab and National Bank at a low premium cost o protect the from healthcare related expenses.
    This policy can be taken for self along with his family members.

    Key Features

    • Benefit of daily cash benefit during hospitalization only for the primary holder of the policy up to Rs 1,000.
    • The plan covers In-patient Hospitalization expenses in respect of the organ donor provided that the organ donation is for the Insured Person
    • Covers 116 daycare procedures,Ambulance charges, Funeral expense in case of death of the insured max up to Rs 1,000.
    • Covers up to 30 days pre and 60 days post hospitalizations expenses.
    • Covers doctors, surgeons fees, chemotherapy, radiotherapy, medicines, blood, oxygen, etc.

    PNB- Oriental Royal Mediclaim

    Age Entry

    18years -79 years

    Sum Insured

    Rs.1lakhs -10 lakhs

    4.) OBC- Oriental Mediclaim Policy-2017

    Oriental’s Insurance’s OBC Mediclaim policy is made for the account holders of Oriental Bank of Commerce at a affordable premium costs. This particular plans is in 3 variants One account one policy,one person one policy and multiple accounts- one policy.
    This policy can be taken either for the self alone or along with the family under single sum insured.

    Key Features

    • The policy covers inpatient hospitalization,domiciliary hospitalization for the necessary illness or injury
    • Covers 30 days pre and post hospitalization expense along with emergency ambulance costs.
    • Covers for Operation Theater Charges,Chemotherapy,Radiotherapy,Cost of pacemaker,etc.
    • Organ donor expenses can be covered in this policy
    • Daily cash allowance benefit when hospitalized for 24 hours and above

    OBC- Oriental Mediclaim Policy

    Age Entry

    Years 18- 79 years

    Sum insured

    Rs. 1lakh – Rs10 lakh

    6.) Mediclaim Insurance Policy (Group)

    Oriental Insurances mediclaim policy can be purchased by any Corporate group, Organization or company provided there are at least 50 members in the group. This plan provides extensive health coverage to the insured members of the groups safeguarding them from medically related expenses. The members can also choose to extend their coverage to their family members including spouse, children, parents.

    Key Features

    • This policy covers the necessary and customary hospital expenditure of the policyholder.
    • Covers room rent,nursing and boarding,ICU charges
    • Provides Emergency Ambulance cover up to Rs.2000.
    • The plan also covers for Mental illness and HIV
    • Covers advanced and modern technological treatments such as Deep brain stimulation,Oral chemotherapy,Balloon Sinuplasty,etc.
    • Optional Maternity cover along with New born cover available at low premium.
    • Cover In-patient Ayush hospitalization and pre and post hospitalization charges.

    Mediclaim Insurance Policy (Group)

    Age Entry

    18 years onward

    Sum insured

    Rs. 1lakh – Rs10 lakh

    7.) Oriental Happy Cash – Nischint Rahein

    This is a daily cash benefit plan that pays the insured daily lump sum cash allowance when he/she is hospitalized for a maximum period of 24 hours.

    Key features

    • Receive daily cash benefit towards convalescence,when your hospitalization exceeds more than a period of 30 to 60 days.
    • Cash benefit toward in-patient Ayush treatment.
    • 25% additional cash benefit on the hospitalization of a insured female member
    • No medical tests mandatory to avail this policy.
    • The policyholder will receive daily cash upon multiple hospitalizations in the same year.

    Oreintal Happy Cash policy

    Age Entry

    3months – 60 years

    Sum insured

    Rs500 – Rs 3000

    8.) Oriental Super Health Top-up

    This is a Super Top-Up plan which starts covering your medical expenses once you have exhausted the sum insured of your base health insurance policy.

    Key Features

    • Covers inpatient hospitalization expenditures
    • Covers organ donor expense when the insured is the recipient
    • Benefit of Maternity and New born baby cover available
    • Mental illness coverage also available in the policy
    • The plan also covers Modern day advanced treatments like Robotic surgeries, Stereo-tactic radio surgeries, etc
    • Policy coverage can be extended after 70 years of age with paying 10% additional premium

                                                                                    Oriental Super Top-Up plan

    Age Entry

    3 months- 65 years

    Sum insured

    Rs3 lakh  – Rs.30 lakhs

    9.) Oriental Pravasi Bharatiya Bima Yojana

    This plan is designed for any Indian Emigrants going overseas for work related purpose,as well as Indian Citizens who have applied and obtained an emigration clearance as per the Emigrant Act,1983.
    This plan provides accidental death and disability coverage to the insured while working overseas.

    Key Features

    • Lump sum payout of 100% sum insured in case of accidental death of the individual.
    • Lump sum payout of 100% sum insured when suffering from permanent total disablement due to accident.
    • This plan also covers the cost of hospitalization under family floater basis in the event of accident related hospitalization.
    • Maternity coverage available to the insured female under the policy.
    • The policy covers the repatriation expenses in the event of demise of the insured individual.
    • Air transportation cost of the attendant and insured covered in case of death or disability.

    10.) Oriental Health of Privileged Elders (HOPE)

    Oriental’s Health of Privileged plan is exclusively designed for individuals above the age 60 of years,this plan provides coverage towards specific illnesses or conditions in the policy that are prone due to old age.
    The plan provides coverage for accidental injury and multiple treatments such as cardiovascular diseases,chronic renal failure, cancer, orthopedic diseases and more.

    Key Features

    • Covers in-patient hospitalization,domiciliary hospitalization,ambulance expense,etc
    • This plan also covers alternative treatments like Ayush.
    • Covers 30 days pre and 60 days post hospitalization expenditure
    • This policy covers only specified illness in the policy and pays a percentage of Sum assured on the covered condition or illness.

    Oriental Insurance Health of Privileged Elders (HOPE)

    Age Entry

    60 years onward

    Sum insured

    Rs 1 lakh – Rs 5lakh

    11.) Arogya Sanjeevani Policy-Oriental Insurance

    This is a standard Health Insurance policy that is designed to cover Hospitalization Expenses for In-Patient Care or Day Care Treatment incurred for treatment of an Illness/ Injury sustained.
    This plan can be availed on an individual or a family floater basis as well.

    Key Features

    • Covers inpatient hospitalization,multiple daycare treatments, pre and post hospitalization charges, etc.
    • Cumulative bonus of 5% of Sum Insured,Max up to 50% during claim free years.
    • Specified modern and advanced treatments up to 50% of sum insured.
    • Dental treatment and plastic surgery covered, if medically necessitated due to disease and injury.
    • AYUSH Treatment covered up to sum insured.
    • Life-long renewals allowed with no exit age.

                                         Arogya Sanjeevani Policy-Oriental Insurance

    Age Entry

    3months – 65 years

    Sum insured

    Rs. 1 lakh – Rs 20 lakhs

    12.) Overseas Mediclaim Policy (E&S)

    This plan is designed for individuals who are traveling abroad for Education or Employment ,it protects them against any travel or health hazard that can happen overseas.

    Key Features

    • Covers medical expenses in case of an accident or illness
    • Coverage for mental, nervous and emotional disorders is limited to 30 days continuous in-hospital expenses
    • Coverage against accidental death or Permanent Total Disablement due to accident.
    • Covers the cost of repatriation in case of death of the insured.

    13.) Oriental Jan Arogya Bima Policy

    This is a special plan designed for lower income families of the country to provide them with standard health car coverage at a low premium cost.

    Key Features

    • Covers medical expense and inpatient hospitalization
    • Cover domiciliary treatment expenses
    • Pays Diagnostic Materials and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs & Cost of organ
    • Coverage for room rent,ICU charges, nursing and boarding charges.
    • The policy term is of 1 year

    Oriental Jan Arogya Bima Policy

    Age Entry

    3months – 70 years

    Sum insured

    Rs. 5,000/

    14.) Oriental Dengue Kavach

    Oriental’s Dengue kavach policy provides the insured individual lump sum benefit of 100% sum insured on the first positive diagnosis of Dengue fever.
    You can also include to cover your family under this policy.

    Note:- this is only a benefit based policy,it does not cover the cost hospitalization.

    Key Features

    • Receive lump sum benefit on the first positive diagnosis of dengue
    • Waiting period of thirty days from the beginning of the policy

    Oriental Dengue Kavach policy

    Age Entry

    18 years-65 years

    Sum insured

    Rs. 10,000 – Rs. 20,000

    15.) Oriental Critical Illness Policy

    As the name suggests, this policy is crafted to secure the insured against listed critical illnesses or conditions in the policy. Under this the insured will receive 100% lump sum benefit on his first diagnosis of any of the specified life threatening illnesses or conditions such as cancer of specified severity, first heart attack, open heart surgery, paralysis, stroke and more

    This plan comes under 2 variants- plan A and Plan B

    • Plan A- covers 11 critical illnesses
    • Plan B- covers 22 critical illnesses

    Key Features

    • 100% sum insures on first diagnose of any of the specified illness or conditions
    • Medical Second Opinion Benefit max of up to Rs. 10,000

    Oriental Critical Illness Policy

    Age Entry

    18 years – 65 years

    Sum Insured

    Rs 2 lakh- Rs 50 lakh

    16.) Oriental Corona Kavach and Group Corona Kavach

    Corona Kavach policy offers to safeguard you against hospital expenditure incurred due to the treatment of Covid-19.
    This plan can be availed on family floater as well as individual basis.

    Key Features

    • This plan covers inpatient Hospitalizations,home care treatment incurred for treatment for Covid-19 during the policy period.
    • Covers inpatient Ayush treatment.
    • Covers 15 days pre and 30 days post hospitalization expenses.
    • Daily cash benefit for each 24hours of hospitalization for treatment of corona virus.
    • Covers room rent,ICU,oxygen,ventilator costs, etc.

    Author Bio

    This article is written by Team InsuranceLiya.com, an independent website that writes about insurance, finance, health, and more. Our writers have a wealth of knowledge, experience, and degrees in the fields of insurance, finance, economics, and beyond.

    Experience the power of Artificial Intelligence (A.I)

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    Categories
    Health Insurance

    Oriental Health Insurance (Plans, Benfits, and more)

    deal

    Learn about Oriental Health Insurance (Simple Guide)

    About the company

    • The Oriental Insurance Company was established in 1947, the year of independence. The company was initially a subsidy of the General Insurance Corporation of India until 2003, when it separated itself from the parent company and was set up as an independent insurance company.
    • Oriental Insurance Company, headquartered in New Delhi, currently has over 1800 branches and offices across the country and employs over 13,000 people. The company also operates in Nepal, Kuwait, and Dubai.
    • Oriental Insurance offers a suite of insurance products like the unique Corona Kavach Policy, the overseas Mediclam Policy, the family floater health insurance policy, the Arogya Sanjeevni Policy, motor insurance, and travel insurance plans, among others.
    • The company had a robust claim settlement ratio of 93.96% in FY 2019–2020.

    Highlights of the company

    Oriental Health Insurance

    Network Hospitals

    4000+

    Claim settlement Ratio

    93.96% FY 2019-2020

    Incurred Claim Ratio

    108.80%

    Renewal

    Lifetime

    Website

    https://orientalinsurance.org.in/

    Contact

     1800118485/011-33208485

    Types of health insurance plans offered by Oriental Health Insurance

    Here are the 15 types of plans offered by the Oriental Insurance Company.

    Plan Name

    		 

    Happy Family Floater Policy

    This is a family floater plan that covers you and your family under a single policy. You can cover yourself, legally wedded spouse, dependent children and parents.

    Mediclaim Insurance Policy (Individual)

    This is a health insurance plan which offers extensive coverage to the insured that safeguards them from hospital related expenditure incurred due to any sickness, illness or any injury

     Oriental Royal Mediclaim PNB

    This plan is only available for account holders of Punjab and National Bank, with the purpose to safeguard them from medically related expense at a affordable premium.

     Oriental Mediclaim Policy- OBC

    This plan is available for account holders of Oriental Bank of Commerce,to provide them essential healthcare coverage at a low premium cost.

     This particular plans is in 3 variants One account one policy,one person one policy and multiple accounts- one policy.

    Oriental Mediclaim Insurance Policy (Group)

    Oriental’s Mediclaim insurance policy is programmed to offer comprehensive coverage against hospitalization expense.

    This plan can be purchased by any members of corporate group, Organization or company

    Oriental Happy Cash-Nischint

    This is a cash benefit plan which provides daily cash to the insured during hospitalization.

    Oriental Super Health Top-up

    This plan is a Super Top-Up plan which will come into action after you have exhausted the coverage of your base health insurance policy.

    Super Health Top-up comes with wide range of sum insured with flexible sum deductible option.

    Pravasi Bharatiya Bima Yojan

    This policy is made for Indian  emigrants working in abroad. This plan provides accidental death and disability coverage to the insured while working overseas

    Health of Privileged Elders

    This is a health Insurance plan exclusively for senior citizens,offering them coverage for specified illnesses and conditions. Individuals above the age of 60 can purchase this policy.

    Arogya Sanjeevani Policy-Oriental

    Arogya Sanjeevani policy provides standard health coverage at a affordable premium.

    This plan covers in patient hospitalization and multiple listed modern and advanced treatments.

    This plan is available on individual or Family floater sum insured basis.

    Overseas Mediclaim Policy (E&S)

    This plan is an ideal plan for individual who travel abroad for education or employment.

    It covers Covers medical expenses in case of an accident or illness abroad.

    Jan Arogya Bima Policy

    The aim of this plan is to provide standard health coverage to weaker sections of the society at affordable premium rate. The plan covers basic and necessary hospital expenditure incurred in the treatment of any illness or accident

    Oriental Dengue Kavach

    This is a benefit based policy,which provides lump sum payout of 100% sum insured when the insured is positively diagnosed with Dengue fever.

    Oriental Critical Illness Policy

    Under this the insured will receive 100% lump sum benefit on his first diagnosis of any of the specified life threatening illnesses or conditions specified in the policy.

    This policy comes in 2 variants – Plan A and Plan B

    Corona Kavach and Group Corona Kavach

    This policy covers all medical and hospital expenditure incurred in the treatment of COVID-19.

    Why should you select a health insurance policy from Oriental Health Insurance?

    Here are a few reasons why you could choose to buy health insurance plans from Oriental Health Insurance.

    • Robust settlement ratio: the company has a robust claim settlement ratio of 93.96%, which signifies that the company is very supportive and efficient in settling legitimate claims without depriving the customers of their rights.
    • Network Hospitals: The company has a solid network of more than 4500 hospitals associated with them, where you can avail hassle-free cashless treatment without worrying to pay the hospital bills from your own pocket.
    • Affordability: Oriental Insurance Company offers plans that provide you with extensive coverage and many other valuable benefits at a very affordable premium.
    • Portability Feature: All plans offered by the company come with a portability feature, which means that you can easily switch to another plan with another health insurance company in case you are not satisfied.

    Some Key Features of Oriental Health Insurance

    • Comprehensive Coverage: The plans offered by the company provide comprehensive coverage, protecting you from expenses related to inpatient hospitalization, daycare procedures, pre and post-hospitalization, domiciliary treatments, and much more.
    • Cumulative Bonus: Many plans offered by the company provide you with the benefit of a cumulative bonus, which increases your coverage up to a certain percentage in the event of no claims.
    • Reviewability: The plans come with a lifelong renewal option, which means that you can renew the policy without any restrictions or age bar, provided you pay the premium on time.
    • Cover Restoration: Various health plans by Oriental Health Insurance come with the benefit of cover restoration. This means that the company will provide you with additional coverage at no cost in case you exceed your sum insured by making a claim during the policy year.
    • Tax Benefit: Get a deduction on the health insurance premium paid by you to the company under Sec. 80 of the Income Tax Act of 1961.
    • Value Added Benefits: Oriental Insurance plans include numerous value added benefits such as maternity and new-born baby coverage, daily cash benefit, convalescence benefit, personal accident and disability coverage, and so on.

    How do I purchase Oriental Health Insurance policies?

    Online Method:-

    Follow the easy steps provided to buy Oriental Health Insurance Plans online.

    Step 1: Visit the company’s official website (www.https://orientalinsurance.org.in/).
    Step 2: Click on the “Buy Online” tab and select the health policy you wish to purchase.
    Step 3: Fill out all the details accurately, and then click Calculate Premium.
    Step 4: Once again, check all the details and make the premium payment.
    Step 5: Once the premium is paid, your policy will be generated instantly within 10-15 minutes, and soft copies of the policy document will be sent to the registered email address.

    Offline Method

    • You can also purchase the policy by visiting the nearest branch of the company
    • You can also contact the customer care executive on their toll-free number: 1800-118485 or 011-33208485.

    How to File a Claim with Oriental Health Insurance

    A health insurance claim can be filed in two ways: cashless claim settlement and reimbursement claim.

    cashless claim settlement

    When you are admitted to a company network hospital, you can file for a cashless claim settlement.

    Here are a few steps that you can follow to file for cashless claim settlement:

    • Step 1: Inform the company 72 hours before in the case of a planned hospitalization or within 24 hours in the case of an emergency hospitalization.
    • Step 2: Completely fill out and submit the pre-authorization form to the hospital, along with the health card and photo ID proofs.
    • Step 3: The hospital will send your pre-authorization claim form and other documents to the company to initiate the cashless treatment process.
    • Step 4: The company will further assess your claim with the terms and conditions of the policy and intimate their decision to the hospital.
    • Step 5: Once the company is satisfied with their investigation and gives the hospital the green light, you can begin receiving cashless treatment.
    • Step 6: In the event that the company rejects your claim. The reasons for this will be provided to you in writing.

    Reimbursement claim settlement with Oriental Health Insurance

    When you are admitted to a company non-network hospital, you must file a reimbursement claim.

    Follow the steps provided by us to file a reimbursement claim with Oriental Health Insurance.

    • Step 1: Inform the company 72 hours before a planned hospitalization or within 24 hours in case of an emergency hospitalization.
    • Step 2: After your discharge, get the reimbursement claim form from the company. You can simply do so by visiting their website and downloading the form there.
    • Step 3: Completely fill out the claim form and submit it to the company or its third-party administrator with all the required documents to initiate the claim process.
    • Step 4: Once you have submitted all the necessary documents, the insurance company will verify your request with your policy benefits.
    • Step 5: Once the company has assessed your claim, The reimbursement amount will be deposited directly into your linked bank account.

    Note: The policyholder or his or her relatives need to submit the duly filled claim form along with the necessary documents to the insurance company within 15 days from the date of discharge.

    Documents required to file a claim:

    • A dully filled and signed pre-authorization claim form
    • Photo identification proof
    • All original bills, reports, and receipts
    • All original test reports, scans, diagnoses,x-rays,ECG,MRI,etc
    • Original chemist and pharmacy bills, receipts, and prescriptions
    • Original doctors’ certificates, surgeons’ reports, etc.
    • FIR (if applicable)
    • Death certificate (if applicable)

    Renewal Process for Oriental Health Insurance

    You can easily renew your health insurance policy with Oriental Health Insurance online with the following steps provided by us:

    • Step 1: Go to the official website of the company.
    • Step 2: Click on the “Renew” tab.
    • Step 3: Enter your existing policy number and policy details.
    • Step 4: Click on “Renew Now” and verify your policy premium.
    • Step 5: Review your premium and any no-claim bonus to be credited, if any, and pay your premium online.
    • Step 6: Once you have made the payment, you will receive a confirmation email along with the premium receipt at your registered email address.

    Offline Renewal Process

    You can visit the nearest branch of Oriental Insurance Company to renew your policy, or you can also get in touch with their customer care executive at Toll Free: 1800-118485 or 011-33208485 and state your request.

    How to Calculate the Premium for Oriental Health Insurance

    You can now easily calculate your Oriental Health Insurance premium online by using the calculator available online and providing certain details.

    • Choose whether you want to purchase a health plan on an individual or family floater basis.
    • Select your sum insured.
    • Number of individuals to be insured
    • Age, name, mobile number, email address, and other details
    • Pan-India coverage (if requested).
    • Medical history (if any)

    Your premium will be displayed immediately after you enter these details into the calculator.

    Author Bio

    This article is written by Team InsuranceLiya.com, an independent website that writes about insurance, finance, health, and more. Our writers have a wealth of knowledge, experience, and degrees in the fields of insurance, finance, economics, and beyond.

    Experience the power of Artificial Intelligence (A.I)

    Chat with our super-intelligent A.I model and ask it anything about insurance and related products.

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    Frequently asked questions about Oriental Health Insurance

  • When was Oriental Insurance incorporated?

    12 September 1947

  • What is Oriental Insurance Company's IRDA registration number?

    IRDA registration no: 556

  • Is Oriental Insurance regulated by IRDA?

    Yes, Oriental Insurance is regulated by the IRDA.

  • Who is the Managing Director of Oriental Insurance?

    Mrs. Sunita Tuli Nagpal

    Shri R. R. Singh

    (As of 2022)

  • What is Oriental Insurance's solvency ratio?

    1.52 (As of 2021)

  • What is Oriental Insurance's customer care number?

    1800118485 / 011-33208485

    • Categories
    Health Insurance

    How to port a health insurance policy? (Easy Steps)

    deal

    How to port a health insurance policy? (Easy Steps)

    A health insurance policy is a contract between an insurance company and the insured. Even though it is usually a long term contract, it is not mandatory for the insured person to continue with the health insurance company in perpetuity. The insured can easily replace his old insurance provider with a new one; This process is called insurance porting and this feature was introduced by the IRDA of India.

    Let us now address some of the most important questions with respect to porting your health insurance policy:

     

    • Why would you want to port your health insurance policy?
    • What are the benefits of porting your health insurance policy?
    • What are the steps of porting your insurance policy?
    • What are the documents required to port an insurance policy?
    • What are some special points to keep in mind?

    Why would you want to port your health insurance policy?

    There are a variety of reasons why a person would want to port their health insurance policy. It is possible that he or she may be getting a better premium rate, he or she may be unhappy with the customer support, or he or she may be getting better bang for their buck with another insurance provider. All of the above are valid reasons for a person to port their health insurance policy.

    What are the benefits of porting your health insurance policy?

    Let us talk about some of the most pertinent benefits in porting a health insurance policy:

     

    • Lower premium rates: The IRDA of India has created an environment of high competition among insurance companies in India. Due to this, insurance companies are constantly looking to get more customer by slashing premium rates. A policyholder can leverage this situation and look to port their policy to another insurer.
    • Better coverage: Similar to the tactic of reducing premium rates, insurance companies also provide additional services, perks and additional coverage to attract customers. You can take advantage of this.
    • Better service: At times, a customer may be satisfied with the premium rates and the coverage provided by his current insurer but he may be highly dissatisfied by the kind of service provided to him. This is where he may opt to port his policy from his current provider to another company that has a track record for providing better customer service and satisfaction.
    • Higher claim settlement ratio: The claim settlement ratio is the percentage of claims a health insurance company settles. For instance, if a health insurance company receives 100 claims, and settles only 95 claims, the company’s claim settlement ratio is 95%. A high claim settlement ratio should be of paramount importance while considering buying a health insurance policy.

    What are the steps of porting your insurance policy?

    Let’s now understand the steps of porting your insurance policy.

    Step 1) Intimate your new health insurance provider

    Once you have zeroed in on your new health insurance provider, initiate a portability request with them. Ensure that you have placed this portability request 45 days prior to the renewal date of your current policy.

    Step 2) Fill-up and submit the portability form

    The insurance company will now provide you with a portability form and a proposal form. You will need to fill-up these forms accurately and honestly and furnish them to your new insurance provider.

    Step 3) Port to your new insurance provider

    The insurance company will now take a maximum of 15 days to decide on your application. If the new insurance company decides to port your account, you will now have an insurance contract between yourself and your new insurer. The old insurance contract will now be terminated.

    What are the documents required to port an insurance policy?

    The following documents will be required to initiate a porting request:

    • Policyholder’s identification documents and address proof (Aadhar Card, PAN Card, etc)
    • Old policy bond
    • Details pertaining to any previously made claims
    • proposal form and portability form

    What are some special points to keep in mind?

    There are 2 important points that you need to keep in mind before porting your health insurance policy, they are:

     

    • No claim bonus: It is imperative to keep in mind that your No Clam Bonus (NCB) if any is carried on from your last insurer to your new insurer. You do not want to miss out of any NCB coverage that you may have accumulated in your last insurance policy.
    • Coverage: Another very important aspect to keep in mind is if there is any divergence in the level of coverage provided by your old insurer and your new insurer. If your new insurance provider provides additional coverage, then that is fine but there should not be less coverage than before. Check the policy brochure and policy bond in detail before taking the leap.

    Author Bio

    This article is written by Team InsuranceLiya.com, an independent website that writes about insurance, finance, health, and more. Our writers have a wealth of knowledge, experience, and degrees in the fields of insurance, finance, economics, and beyond.

    Experience the power of Artificial Intelligence (A.I)

    Chat with our super-intelligent A.I model and ask it anything about insurance and related products.

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    Frequently asked questions

  • Can you port your health insurance policy in India?

    Yes, you are eligible towards insurance portability as per the IRDA of India.

  • How many days prior do I need to inform my new insurance provider about portability?

    You must ensure that you inform your new insurance provider 45 days prior to your current insurance policy's renewal date.

  • Is NCB carried forward after portability?

    Yes, NCB is generally carried forward. But you must verify this with your new insurance provider.

    • Categories
    Health Insurance

    Park Mediclaim TPA (Role, Features, Customer Care, and More)

    TPA

    Learn about Park Mediclaim TPA (A Simple Guide)

    Park Mediclaim Insurance TPA is an Indian Third Party Administrator (TPA) Company, which acts as a link between insurance companies and policyholders. It is the role of the TPA Company to provide customer support, customer education, and claim management.

    Let us now talk about some of the main aspects of Park Mediclaim Insurance TPA, such as:

    • Role of Park Mediclaim Insurance TPA
    • How to login and register?
    • How to submit a claim?
    • Important Downloads
    • Empaneled Hospitals
    • Customer Support

    Role of Park Mediclaim Insurance TPA

    Customer Enrollment: The company engages in the enrollment and education of potential insurance buyers. Once educated, the company then offers the best possible insurance products to their clientele.

    Customer Support: Once enrolled, it is the role of Park Mediclaim Insurance TPA to provide quality customer support to policyholders, both during hospitalizations as well as pre and post hospitalization.

    Health Card: It is the job of the TPA company to furnish the policyholder with his/her Insurance Health Card. The policyholder can avail treatment only once they furnish this Health Card to the hospital.

    Claims Management: All claim related queries, grievances, and support will be extended by the TPA Company to the policyholder.

    How to login and register?

    Some of the benefits and features of Park Mediclaim Insurance TPA can be accessed by registering and logging into their official website. How can you do this? Here’s how:

    Step 1) Visit the official website of Park Mediclaim TPA

    https://www.parkmediclaim.co.in/

    Step 2) Navigate to the ‘Login’ section on the top bar

    Step 3) Select your ‘Login Type’

    Here, you will have to select your login type. There are various types of logins, such as:

    • Agent Login
    • Corporate Login
    • Broker Login
    • RO Login
    • Branch Login
    • Hospital Login
    • Admin Login
    • Employee Login

    Once selected, enter your Username and Password and click on ‘Login.’

    How to submit a claim?

    Submitting an insurance claim is one of the most important aspects. Let us now understand how you can submit an insurance claim with Park Mediclaim TPA

    How to submit cashless claim?

    Step 1) Inform the TPA Company or Insurance Agent

    First, you will need to inform your TPA Company or Insurance Agent.

    Step 2) Submit your Health Card to the hospital

    Your hospital will request your Health Card or your Policy Bond, you will have to submit this during the admission process.

    Step 3) Fill-up the forms

    Now, you will have to fill-up and submit the Pre-authorization form, attached your ID and address proof, and submit it to the hospital. Post submission, the hospital will verify your details with the TPA company, and upon verification they will accept your cashless request.

    Once your cashless request is accepted, all hospital payments will be paid by the insurance company directly to the hospital.

    How to submit reimbursement claim?

    Step 1) Inform the TPA company or Insurance Agent

    First, you will need to inform the TPA company or the Agent.

    Step 2) Submit your Health Card to the hospital

    Your hospital will request your Health Card or your Policy Bond, you will have to submit this during the admission process.

    Step 3) Keep all original documents

    After admission, you will have to ensure that you store all hospital related documents like admission summary, discharge summary, bills, reports, receipts, etc. All of these documents will have to be submitted to the TPA company after discharge.

    Step 4) Submit all documents after discharge

    Upon discharge, fill-up the claim form and attach all of your medical documents. Now, submit these documents to the TPA company. Your claim will now be registered.

    Step 5) Follow-up after your claim

    You will also have to follow-up on the status of your claim on a timely basis.

    Important Downloads

    Important insurance related downloads can be accessed through the Park Mediclaim TPA website here. Important downloads include:

    • Pre-auth Form
    • Hospital Agreement
    • Claim Forms
    • PPN Declaration Letter
    • TPA Information Sheet
    • Empaneled Hospitals List

    Empaneled Hospitals

    If you want to avail cashless treatment, then the policyholder will have to get admitted to an empaneled hospital. Check a list of empaneled or network hospital here. Once on this page, enter your city, state, hospital name, and then press on ‘Submit.’

    Customer Support

    Type

    Contact Details

    Phone Number

    (+91) 11-43191000-100 / 1800-11-55-33

    Email Support

    park@parkmediclaim.co.in

    info@parkmediclaim.co.in

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    Categories
    Health Insurance

    Does Health Insurance cover Dental Treatment?

    dental

    Does Health Insurance cover Dental Treatment?

    With the increasing penetration of health insurance, health insurance companies have begun introducing more comprehensive coverage. However, in the case of dental insurance, most companies do not offer dental coverage as a standalone policy but can be purchased as an additional cover or an optional rider.

    In this article we will talk about the following:

     

    • What does dental insurance cover?
    • Importance of dental insurance coverage
    • Companies offering dental insurance coverage
    • Inclusions and exclusions under dental coverage

    What does Dental Health Insurance cover?

    In simple terms, in dental cover, any dental treatment related to illnesses, accidents, or injuries will be covered under the plan. To cover the cost of these treatments it is always advisable to buy a dental cover keeping in mind the cost of medical inflation.

    Importance of Dental Insurance

    1.) Protect your finances

    Nowadays dental treatment is expensive due to inflation, innovation, usage of high-tech set-ups, etc. Hence to avoid having to spend your hard-earned money on these expensive treatments it is always safer to buy a dental cover along with a standard health plan.

    2.) Routine dental check-ups

    Many health insurance companies provide the policyholder free dental health check-ups to take necessary care of the individual’s oral hygiene.

    3.) Free consultations

    The policyholders will receive a number of free consultations under the cover depending on the policy scope.

    4.) Teeth whitening

    Some health insurance companies also provide compensation for teeth whitening treatments or procedures.

    5.) Tax benefit

    Avail of tax benefits on your health insurance premiums under Section 80D of the Income Tax Act.

    Companies offering Dental Insurance coverage

    Following are the health insurance companies that offer dental coverage

    Sr. No

    Company Name

    Plan Name

    1

    Care Health Insurance

    Care Plus Plan

    2

    TATA AIG

    TATA AIG Medicare Premier Plan

    3

    Digit Health Insurance

    Digit Care Plus Plan

    4

    Future Generali Health Insurance

    Future Total Health Plan

    5

    Chola Ms Health Insurance

    Chola Ms Privilege Healthline Plan

    6

    Kotak Mahindra Health Insurance

    Health Premier Plan

    7

    ManipalCigna Health Insurance

    ProHealth Insurance

    8

    Oriental Insurance

    Oriental Mediclaim Policy

    9

    Reliance Health Insurance

    Digital Care Management Policy

    10

    SBI Health Insurance

    SBI Arogya Plus Plan

    11

    Star Health Insurance

    Star Comprehensive Plan

    12

    Aditya Birla Health Insurance

    Activ Health Platinum Plan

    Activ Health Enhanced Plan

    13

    Raheja Health Insurance

    QUBE Health Insurance Plan

    14

    IFFCO Tokio Health Insurance

    Individual Medishiled Plan

    15

    Edelweiss Health Insurance

    HealthPlus Plan

    Inclusions and Exclusions under Dental Coverage

    Following below are some of the general inclusions and exclusions under dental health cover in India. It is always advisable to thoroughly check the scope and terms of the policy before opting for one.

    Inclusions

    Exclusions

    Dental surgery/Implants

    Cosmetic procedures

    Oral consultations

    Dentures

    Root canal treatments

    Jaw alignment /correction

    Treatment of gum illnesses

    Orthodontic treatments

    Decayed tooth treatments

    Placement of dentures

    Filling of cavity

    Prosthesis

    Accidental damage or injury to tooth/teeth

    Implants

    Author Bio

    This article is written by Team InsuranceLiya.com, an independent website that writes about insurance, finance, health, and more. Our writers have a wealth of knowledge, experience, and degrees in the fields of insurance, finance, economics, and beyond.

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    Frequently asked questions

  • How to select the right dental insurance coverage?

    It is advisable to always compare various dental plans based on their features, benefits, coverage, and premium. Comparing these factors will assist you in purchasing the right dental plan suitable for your needs

  • Can you buy dental health insurance coverage online?

    Yes, you can easily purchase a dental cover online in the comfort of your home. However, we advise you to thoroughly read the terms and conditions of the policy and get your doubts cleared before buying the policy.

  • Is root canal treatment covered under dental insurance coverage?

    Yes, root canal treatment is covered under dental health insurance cover.

  • Does dental health insurance pay for braces?

    No, generally dental insurance does not offer coverage for braces, but many health insurance companies have started offering coverage for the same. It is advisable to check the same in the policy wording.

  • Do all health insurance plans offer dental coverage?

    Health insurance companies do not offer dental insurance as a general standalone policy. However, you can buy it as an additional cover or a rider policy bundled up with a general health plan.

    • Categories
    Health Insurance

    Does Health Insurance cover alternative treatments in India?

    ayush

    Does Health Insurance cover alternative treatments in India?

    With the increasing trend in awareness because of its benefits, coverage for holistic treatments like Ayurveda, Ayush, Unani, etc are now widely offered by many health insurance companies.  Many lifestyle illnesses and also chronic diseases have been cured with the help of alternative treatments. Because of the increase in demand for alternate treatments, popularly known as AYUSH treatment, many health insurance companies now offer coverage for the same.

    In this article let us talk about the following:

    • What are alternative health treatments in India?
    • Scope of coverage
    • Plans that offer Ayush coverage
    • What benefits of Ayush coverage?
    • Frequently asked questions

    What are alternative treatments in India?

    In 2013, The Insurance Regulatory and Development Authority of India (IRDA) issued new guidelines which advised health insurance companies to provide plans that cover alternative treatments. Alternative or AYUSH includes treatment like Ayurveda, homeopathy, naturopathy, Unani, and Siddha, in India.

    Scope of Coverage

    Although AYUSH cover is available under a health plan, the same is bundled with a comprehensive health plan. Health insurance companies solely do not offer AYUSH coverage.

    Companies that offer coverage for alternative treatments

    Company Name

    Plan Name

    Care Health Insurance

    Care Plus Plan

    TATA AIG Health Insurance

    Medicare Policy

    HDFC Ergo Health Insurance

    My-health Suraksha Plan

    Optima Secure Plan

    Bajaj Allianz Health Insurance

    Covers AYUSH in most plans

    Kotak Mahindra Health Insurance

    Group Smart Cash Plan

    Group HealthCare Plan

    Chola MS Health Insurance

    Health Line Plan

    Individual HealthLine Plan

    Future Generali Health Insurance

    Health Total Plan

    Oriental Insurance Company

    Super Top Up Plan

    Star Health Insurance

    MediClassic Insurance Plan

    Bharati AXA Health Insurance

    Smart Health Insurance

    Smart Super Health Assure Plan

    Health Advantage Plan

    IIFCO Tokio Health Insurance

    Individual Medishied Plan

    ManipalCigna Health Insurance

    Pro Health Plan

    Super Top-Up Pan

    New India Assurance

    New India Mediclaim Policy

    SBI Health Insurance

    Arogya Premier Health

    Arogya Plus Plan

    Digit Health Insurance

    Digit Health Care Plus

    Universal Sampoo

    Healthcare Plus Plan

    Niva Bupa Health Insurance

    Health Companion Plan

    Apollo Munich Health Insurance

    Easy Health Exclusive Plan

    Relaince Health Insurance

    Health Infinity Policy

    What are the benefits of AYUSH cover?

    Now let us discuss the advantages that you will gain from opting for an AYUSH cover.

    1.) Covers different treatments

    Along with covering allopathy, your plan will also pay for treatments like Ayurveda, homeopathy, Unani, Siddha, and so on, giving more options to the policyholder while deciding the line of treatment.

    2.) Affordable treatment

    AYUSH treatment is highly affordable compared to allopathy treatment hence it is advisable to buy a plan that provides coverage for the same.

    3.) Treatment for cancer

    According to proven studies, alternative treatments like Ayurveda, Siddha, etc have proved to be beneficial in the cure of cancer.

    4.) Widely available

    As opposed to allopathy, AYUSH treatment is easily accessible in remote areas across the country, especially in villages and small towns.

    5.) Inpatient hospitalization

    Expenses incurred from inpatient hospitalization under AYUSH will also be covered as per the terms and conditions of the policy.

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    Frequently asked questions

  • What is covered under AYUSH cover?

    Alternative and holistic treatments like Ayurveda, Yoga, Unani, homeopathy, Siddha, naturopathy, and so on is covered under the AYUSH.

  • What is not covered under AYUSH coverage?

    The following are the exclusions under Ayush:

    • Pre and post-hospitalization expenses.
    • Beauty or rejuvenation procedure.
    • Daycare procedures that require less than 24 hours of hospitalization.
  • What are the important reasons for choosing an AYUSH cover?

    The following are the valid reasons to keep in mind while opting for an Ayush cover.

    • AYUSH treatment is comparatively more affordable than allopathy treatment.
    • It is ideal for senior citizens and individuals as the chances of side effects are lesser.
    • Ayush treatment is easily obtainable in rural and urban locations.
    • Highly effective in curing ailments like high blood pressure, sugar, and also in some cases cancer.
  • Who is eligible for AYUSH health coverage?

    Everyone is eligible for coverage if the health insurance company offers its coverage under the policy’s condition.

  • How can you claim AYUSH claim settlement?

    The policyholder can avail of both cashless and reimbursement options in case of a claim.  In case the policyholder is admitted to a network hospital of the company they can avail of cashless option.

    OR

    In case the policyholder is admitted to a non-network hospital of the insurer they will have to opt for reimbursement claim settlement.

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