According to many survey reports, a large percentage of the Indian population is still not covered by any health insurance plan. Considering the rising costs of healthcare services and lifestyle changes, it has become critical for everyone to be covered under some health insurance plan. To make health insurance more affordable and accessible, IRDAI has developed a standard health insurance policy which is uniform throughout the industry. The policy is called Arogya Sanjeevani Policy which all health insurers compulsorily offer.
Oriental Arogya Sanjeevani Policy offers a basic indemnity health cover up to Rs. 5 lakhs to individuals and families. The insurance plan offered by Oriental general insurance provides hospitalisation cover, including pre and post-hospitalisation expenses. Day-care procedures, AYUSH treatments and certain new-age procedures as listed in the policy are also covered under the plan. Let us have a look at the key features of the policy.
| Sum Insured | Rs. 1 lakh to Rs. 5 lakhs in multiple of Rs. 50,000 |
| Policy Type | Individual and Floater both. |
| Who is Covered? | Self, spouse, dependent children upto 25 years, parents and parents-in-law. |
| Eligibility | 18 to 65 years |
| Policy Term | 1 year with lifetime renewability |
| Premium Payment Options | Monthly, quarterly, half-yearly or yearly instalments |
| Cumulative Bonus | 5% for a claim-free policy year, subject to a maximum of 50% of the sum insured. |
| Portability | Portable as per IRDAI guidelines |
| Waiting Period |
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| Co-payment | 5% of the claim amount |
Oriental Arogya Sanjeevani policy is a safety cover to protect your finances in a medical situation. Here are reasons why you should buy this policy.
The policy offers comprehensive coverage for hospitalisation, daycare procedures and much more. Let us see what coverage under the policy includes
Hospitalisation Expenses - The policy covers hospitalisation expenses for in-patient care due to illness, injury or medical treatment during the policy term. The cover includes expenses like room rent, doctor fees, boarding charges, nursing charges, OT and ICU expenses.
Pre and Post-Hospitalisation - The policy covers medical expenses related to in-patient care before and after hospitalisation for 30 and 60 days, respectively.
Ambulance Charges - The policy covers ambulance charges upto a maximum of Rs. 2000 per hospitalisation.
Cataract Treatment - ataract treatment upto 40,000 or 25% of the sum assured, whichever is lower, is covered under the policy.
Dental Treatment and Plastic Surgery - Any dental treatment or plastic surgery required due to a disease or injury is covered under the policy.
Modern Specialized Treatment - The policy also covers listed new-age procedures upto 50% of the sum insured as inpatient care or daycare procedure.
The company is not liable to pay anything for the following
1). Young first-time buyers - The policy is recommended for young first-time buyers who are fit and therefore don’t require any medical checkups. Also, the policy is a standard product, so it is easier to buy without having to choose from an array of insurance plans.
2). Anyone looking for affordable health insurance - Arogya Sanjeevani Policy is known for its comprehensive coverage and affordable premiums. Hence it is the ideal choice for anyone looking for health insurance at an affordable cost.
3). Anyone who wants lifelong health coverage - The policy has restrictions on the entry age. However, it offers the facility of lifelong renewal. This policy provides health insurance coverage for your lifetime and secures you in those years when you most need it.
If you haven’t yet got a health insurance cover, purchase an Oriental Arogya Sanjeevani policy without any doubt. It will secure you and your family against any medical expenses at a very reasonable cost.
Ans: The company offers both cashless claims and claim reimbursement. For cashless claims, inform the company at least 48 hours before hospitalisation if it is planned. For emergency hospitalisation, you need to inform the company within 24 hours of the hospitalisation. After hospitalisation, provide your health card and photo id to the network hospital to seek a pre-authorization form. Fill out the form, and the hospital will send it to the company for approval. Once approved, your hospital bills will be settled by the insurance company. For reimbursement, a claim request is sent with a discharge summary to the company within 30 days of discharge. The company require many documents in a reimbursement claim. Once all the details are verified, the company reimburses the claim.
Ans: The following list of documents is needed for a reimbursement claim:
Ans: This sum insured can be changed at the time of the renewal or according to the underwriting by the company.
Ans: Yes. The policy covers pre-existing diseases after a waiting period of 48 months.
