Oriental Individual Mediclaim Policy

What is the Plan all About?

The individual mediclaim policy offers salient features which help the insured to take care of multiple expenses during the course of hospitalization. This policy protects you from the financial burden and unnecessary stress during your treatment for the ailment/disease. A comprehensive health plan solution to lead a worry free life.

Key Features

Lifelong renewals allowed
No Medical examination upto the age of 55 years
Daily hospital cash allowance
Alternative treatments covered as per the policy conditions
Tax benefit under section 80 D
Cashless treatment in the network hospitals

Policy Benefits

Room Boarding, Surgeon’s cost, medical practitioners cost, nursing expenses,etc.are covered under this policy under inpatient hospitalization.
Pre and Post Hospitalization expenses are covered upto the limit of 30 days before hospitalization and 60 days after hospitalization.
Daily Hospital cash benefit allowance is given under this plan to combat the non medical expenses during hospitalization.
Domiciliary hospitalization or treatment at home is covered due to the unavailability of hospital rooms or considering the condition of the patient, etc.
Day care treatment or procedures are covered under this plan in hospital/day care centre but not in the outpatient department of the hospital.

Value Added Benefits

Organ Donor expenses are covered during organ transplant upto the limit of sum insured.
Ambulance service charges are also covered under this plan as per policy sublimit.
Personal Accident covering death and permanent disability can be opted as an additional cover.
AYUSH treatment hospitalisation expenses are covered only when the treatment is taken as an in-patient, in a Government Hospital or a hospital associated with a Medical College.
Treatment for Dog bite or bite other animal such as monkey, cat, etc. are covered upto the maximum as Rs 5,000 per incident under the head of domiciliary hospitalization.
Health check up benefit after every 3 claim free years.
Dental Treatment arising out of accident is covered.
Tax Benefit under section 80 D of Income Tax Act,1961.

Sub Limits

Room Rent not exceeding 1 % of the Sum Insured per day.
ICU expenses not exceeding 2 % of the Sum Insured per day.
Ambulance service charges Rs.2,000/- OR 1% of the sum insured whichever is less per hospitalization.
Daily Hospital Cash allowance 0.1% of the sum insured per day subject to maximum of 6 days per insured person for the policy period. Deductible of 2 days shall apply for each hospitalization.
Domiciliary hospitalization covered upto20% of the Sum Insured subject to maximum Rs.50,000 per Insured person during the entire policy period.
Co pay applicable as opted by the insured as voluntary co pay of 10% or 20% of admissible claim.

Waiting Period Clause

Initial Waiting Period: Any diseases contracted during first 30 days of the policy start date, except those arising out of accidents.
Specific Waiting Period: The waiting period of specific treatments as mentioned in the policy contract range from 1 year to 2 years of consecutive coverage.
Pre existing Disease Waiting Period: Silver variant of this plan has a waiting period of 48 months years to cover pre existing diseases.

Who can Buy the Plan?

Factor	Minimum	Maximum
Age (as on last birthday)	18 Years	65 Years
Sum Assured	1 Lac	10 Lacs
Cover Type	Individual	-
Policy Tenure	1 Year	1 Year
Grace Period	30 Days	-
Free Look Period	15 Days	-
Riders	Personal Accident Cover	-