| Renewability | Lifelong Renewal |
| Oriental Insurance Network Hospital | 4300+ |
| Hospitalization Cover | Pre & Post hospitalization cover | Co-payment | 10% |
| Incurred Claim Ratio Year of 2022 | 139.86% |
| No. of members | Oriental Health Insurance plan covers maximum 7 members of your family with up to 3 children and 4 adults. | Health Check-ups | Offers health check-up for insured after every 4 continues claim-free year. |
| Pre-existing diseases | Pre-existing diseases are covered after 4 years of waiting period |
There are two ways to make a claim under a Health Insurance Policy on cashless basis and on reimbursement basis. In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of the insurance company servicing your policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form. In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for the claim on reimbursement are obtained after hospitalization.
Oriental Health Insurance has a well-defined claim processing system.
Cashless Service: Seeking Pre-Authorization
Reimbursement Claim: Claim Submission
In case of any emergencies, you need to inform Oriental Insurance within 24 hours of the admission. In case of planned emergencies, the notification has to reach the company 48 hours prior to the hospitalization. The claim intimation can be done via Oriental Insurance's toll free number 1800-118-485. The same could also be emailed to csd@orientalinsurance.co.in.
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Oriental Health Insurance policy includes maternity coverage in several of its plans, such as the Happy Family Floater, Super Health Top-Up, optional coverage in the Oriental Group Mediclaim Plan, and the Diamond Plan. However, certain conditions apply:
To register a claim with Oriental Health Insurance plans, policyholders should visit the company’s website and log in using their unique user ID and password. Find the claim form under the ‘Claim’ tab, enter your policy number and required details, and submit the form. After submission, you must visit an Oriental Insurance branch to provide the detailed claim form and necessary documents. Claims can be submitted via email or letter to the registered office. You can file either cashless or reimbursement claims. For planned hospitalizations, inform the TPA at least 48 hours in advance; for emergencies, notify them within 24 hours. Cashless treatment is available at network hospitals if approved. For reimbursement claims, submit the claim form and documents within 7 days of discharge. Approved claims will be reimbursed within 30 days.
Here is a list of all the documents you will need to file a claim with Oriental health insurance company.
Increase Sum Insured: Upgrade when you’re young and healthy to avoid higher costs later. You can raise your sum insured at renewal without any waiting periods.
To check the oriental insurance claim status, you can utilize several convenient methods:
To get uninterrupted medical coverage for life, it is important to renew your Oriental health insurance policy on time. You can enjoy renewal benefits for non-stop coverage such as cumulative bonuses, coverage for existing illnesses, and discounts. Renewing your Oriental health insurance policy is a simple process that can be done online by following the steps given below:
If you are an existing customer of Coverfox, you can renew your policy from Coverfox. Just log into your Coverfox account online and renew your policy. In case you want to make any changes or add optional benefits, you can do so at the time of renewal.
You can renew your policy offline if you are not comfortable with the online process. Call on the toll-free number of Oriental insurance and share your requirement, or visit the nearest branch of Oriental health insurance company.
Oriental Health Insurance policy offers a diverse range of health insurance plans packed with numerous benefits. As one of the oldest public-sector insurance companies in India, it has an extensive presence nationwide and a strong reputation in the industry, featuring several popular products.
Yes, cashless health services are available at network hospitals of Oriental Insurance, which has partnerships with many hospitals across India. Policyholders can receive treatment without upfront payment, as the insurance company directly settles the bills. It’s advisable to confirm with the network hospital before admission. A third-party administrator (TPA) manages the cashless treatment process. The policyholder should contact a network hospital, which will send a pre-authorization request to the TPA. The TPA processes the request according to policy terms. If approved, the policyholder only pays for expenses not covered by the insurance plan.
Types of Waiting Periods
If you are a registered policy holder, simply login to the e-Portal with your registered user ID and Password. Once logged in, you can check all the details of your policy.
You can cancel your existing Oriental Health Insurance Plan by submitting the policy documents at the nearest branch. The premium will be refunded post deduction of cancellation and other applicable charges.
Oriental Health Insurance covers in-patient hospitalization, pre- and post-hospitalization expenses, daycare procedures, ambulance charges, organ donor expenses, personal accident cover, mental illness coverage, maternity expenses, newborn baby cover, and Ayush treatment. The specific coverage and benefits may vary depending on the chosen plan and policy terms.
It generally falls within the range of 75-90%.
The minimum premium for Oriental health insurance depends on factors like sum insured, age, health conditions, and policy type. For an accurate quote, use our premium calculator or consult an agent.
To download your Oriental Insurance policy as a PDF:
