Health Insurance
Oriental
Oriental Insurance is a government owned entity providing insurance for Health, Vehicles, business, farmers. It has three health policies, Individual, Family Senior Citizens with a decent range of benefits. A couple of them will even provide with Health check-ups once in a while.
Oriental Health insurance plans
Happy Family Floater Policy Diamond
The Oriental Insurance Happy Family Floater Diamond plan offers ₹12–20 lakh coverage with sum insured restoration, medical second opinion reimbursement, and SAARC country coverage. It has no co-payment and lifelong renewability, providing strong family protection. The Diamond and Platinum variants include maternity coverage after a 24-month waiting period, reimbursing up to 2.5% of the sum insured. Newborns are covered immediately up to the full sum insured. These features make it ideal for families seeking comprehensive health coverage with maternity and newborn benefits.
Happy Family Floater Policy Silver
The Oriental Insurance Happy Family Floater Silver plan is a family floater health insurance policy designed to cover the proposer, spouse, dependent children, parents, and parents-in-law under a single sum insured ranging from ₹1 lakh to ₹5 lakhs. The Silver plan offers essential hospitalization coverage and includes a 30-day waiting period for illness and a 3-year waiting period for pre-existing diseases, making it a modest, budget-friendly option for families seeking basic health protection.
Health of Privileged Elders
The Oriental Insurance Health of Privileged Elders (HOPE) plan is designed exclusively for senior citizens aged 60 and above, offering sum insured options from ₹1 lakh to ₹5 lakhs. It covers specific diseases such as knee replacement, cancer, stroke, and cardiovascular conditions. The policy also features a relatively short two-year waiting period for pre-existing diseases, compulsory 20% co-payment, and cashless claims up to ₹1 lakh, making it a focused solution for elderly individuals with existing health concerns.
Super Health Top-up
The Oriental Insurance Super Health Top-up plan offers a maximum sum insured of up to ₹30 lakhs, with deductibles starting from ₹3 lakhs. It includes telemedicine benefits, maternity coverage (up to 10% of sum insured), and optional riders. It is designed to bridge the gap between basic health insurance and high-cost medical expenses, offering comprehensive protection for unforeseen health emergencies.
Mediclaim Insurance Policy
The Oriental Insurance Mediclaim policy is a basic health insurance plan offering sum insured options from ₹1 lakh to ₹50 lakhs for individuals aged 18 to 65 years (extendable to 70). The policy includes benefits like daily hospital cash allowance and free health check-ups every three claim-free years. With lifelong renewability and cashless treatment across a wide hospital network (4,000+), it is a budget-friendly option for essential health coverage.
Happy Family Floater Policy Platinum
The Oriental Insurance Happy Family Floater Platinum plan is a family health insurance policy offering sum insured options from ₹25 lakhs to ₹50 lakhs. Its distinct features include outpatient dental and ophthalmic care reimbursements, additional sum insured for critical illnesses, and personal accident cover. With lifelong renewability and cashless treatment at network hospitals, it aims to provide enhanced protection for families.
Happy Family Floater Policy Gold
The Oriental Insurance Happy Family Floater Gold plan is a mid-tier family floater health insurance policy offering sum insured options from ₹6 lakhs to ₹10 lakhs. The policy includes no co-payment and extends coverage to family members including parents and in-laws. It aims to provide balanced health protection for families seeking moderate coverage.
Oriental Health insurance claim process
Oriental claims can be of different types based on the hospital in which you are getting the treatment. If it’s part of Oriental's network hospitals, you can get a “Cashless claim” in which insurance company directly pays the bills to the hospital. But if your choice of hospital is not part of their network, then you have to pay the bills and apply for reimbursement claim. Here’s a brief process for both types of claims:
Cashless Claims
Inform the Hospital Desk
All network hospitals have an insurance desk. You can submit your policy copy (even soft copy works), ID proof, initial diagnosis report and the insurance desk will request the insurance company for “pre-authorization”. In case of planned treatments, you need to do this process 2 days before hospitalization
Insurer’s decision
Based on the provided documents, insurance company approve the claim and the hospital will start the treatment and they will co-ordinate with insurer for the treatment costs. In case of Cashless claim rejection, you can still go ahead with the treatment. In this case, you will need to pay the bills initially and can file for a reimbursement claim later
Discharge
If your cashless claim is approved, at the time of discharge, the insurance company will do the final settlement with the hospital and once that is sorted, you are good to go.
Reimbursement Claims
Inform the insurance company
For any planned treatments, you need to inform the insurance company 2 days before hospitalisation. In case of emergency, you can inform within 24 hours of admission. Insurance company will acknowledge the intimation.
Hospitalization
You need to submit a insurance claim form along with original copies of hospital bills, doctor consultation reports, and diagonstic reports.
File the claim
Within 30 days post discharge, you can initiate the claim online or at any of the registered offices of the insurance company. You need to fill a claim form and attach all the reports and bills.
Insurer’s decision
Based on the claim form and submitted documents, insurance company will settle the claims as per policy terms and conditions.
Oriental Health Insurance Renewal
Firstly, if you’ve purchased the policy online, you’ll always receive an intimation e-mail from the insurer around 30 days before the renewal date. The e-mail will have a renewal link that will directly take you to the page where you can make the payment and check policy details. And it’s done. You’ll receive the policy document via e-mail.
However, in case you choose to do it on your own, here’s what you need to do:
Visit the website
Visit the Oriental website and then go to the Renewal section here.
Enter details
You’d be asked to provide your current policy number which you can find in the policy soft copy. You may as well be asked to enter your mobile number, email ID, Date of Birth or policy expiry date.
Review and edit the policy details
Next, you’ll be able to see details of your new policy and the renewal premium you need to pay. Also, you’ll be given the option to make some changes related to sum insured, existing covered members, etc.
Complete the payment and it’s done
Once you confirm the details, you’ll be directed to the payment gateway. Once the payment is complete, you’ll receive your new policy soft copy via e-mail.
Few things to consider when renewing your Oriental health insurance policy
- If you want to increase your Sum Insured, now is the time. You can’t do it anytime during the year.
- If you didn’t make a claim in the past year, make sure you have been given a no-claim bonus if your policy offers it.
- If you want to add members like your spouse or kids, you have the option to do so only at the time of renewal. So do give this a thought.
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