This is a Health Insurance Policy Floater implies single Sum Insured for entire family.

. Family includes Self, Spouse, Children, Parents and Parents in laws. Available in two plans Silver and Gold. Salient features of the policy
A floater covering the proposer and his / her family under one sum insured under one policy. The sum insured floats over all the beneficiaries under the policy. No medical examination for persons upto the age of 60 years. Pre-existing conditions cover after four consecutive renewals with the Company. Coverage under two options - SILVER and GOLD Covers. SILVER offers sum insured slabs of 1 to 5 lacs SILVER is subject to 10% Co-pay GOLD offers sum insured slabs of 6 to 10 lacs. Policy covers the hospitalisation expenses for the covered diseases / accident upto specific limits. GOLD plan offers as an inbuilt cover daily cash allowance and attendant allowance upto limits specified. Personal Accident cover is offered as add on cover under both the covers.In addition GOLD cover offers add on cover of life hardship survival benefit.

Discount in OMP premium when family floater policy is taken. Option of TPA and non TPA services. Discount in premium if TPA services not opted. Top

Coverage under the policy The following reasonable and necessary expenses (subject to limits) are payable under the policy for various benefits:
A. HOSPITALISATION BENEFITS BENEFIT Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. Intensive Care(IC) Unit Expenses as provided by the Hospital /Nursing Home. SILVER PLAN (Limit of Reimbursement ) Not exceeding 1 % of the Sum Insured per day Not exceeding 2% of the Sum Insured per day. GOLD PLAN (Limit of Reimbursement) Not exceeding 1 % of the Sum Insured per day. Not exceeding 2% of the Sum Insured per day.

a.

b.

No of days of stay under a and b above should not exceed total number of days of admission in the hospital. c. Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Material and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs & and similar expenses. Ambulance services charges as defined hereinafter under As per the limits of the sum insured. As per the limits of the sum insured.

As per the limits of the sum insured.

As per the limits of the sum insured.

d.

e.

Rs.1,000/- per illness and limited to maximum 1% of the sum insured or Rs. 3,000/- whichever is less, for the entire policy period.

Rs.2,000/- per illness and limited to maximum 1% of the sum insured or Rs. 6,000/- whichever is less, for the entire policy period.

DAILY HOSPITAL CASH ALLOWANCE, AS DEFINED HEREINAFTER under f.

NIL.

0.1% of sum insured per day per illness subject to a maximum compensation for 10 days per illness. The overall liability of the Company during the policy period will be limited to 1.5% of the sum insured. Rs.500/- per day of hospitalisation per illness and upto 10 days per illness. The overall liability of the Company during the policy period will be limited to compensation for 15 days of hospitalisation.

Attendant allowance as hereinafter defined under g.

NIL

B.

DOMICILIARY HOSPITALISATION (AS DEFINED HEREINAFTER) Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines & Drugs, Diagnostic Material and Dialysis, Chemotherapy, Nursing expenses. Treatment for Dog bite (or bite of any other rabid animal like monkey, cat etc.) 10% of Sum Insured, Maximum Rs.25000/- during policy period. Rs.50000/- during policy period.

a.

b.

Reasonable expenses limited upto Rs.5,000/- actually incurred for immunisation injections in any one policy period.

Reasonable expenses limited upto Rs.5,000/- actually incurred for immunisation injections in any one policy period.

NOTE: FOR THE PURPOSE OF THIS SECTION THE PRE-REQUISITE CONDITIONS FOR DOMICILIARY HOSPITALISATION CLAIM SHALL NOT APPLY.

Policy Details
Available in two plans- Silver and Gold Plan- SILVER BASIC PLAN 10% compulsory co-pay Sum Insured choice Rs.1.5 lakhs Inbuilt 10% compulsory co-pay Sum Insured choice Rs.1.5 lakhs Add On Add On Personal Accident cover for self and dependants. NIL Plan- GOLD Without Co-pay Sum Insured choice Rs.6-10 lakhs Cash allowance for the days admittedy Attendence allowance- If a child between 3m to 10yrs is admitted. Personal Accident cover for self and dependants. Life Hardship (Survival Benefit), diseases like cancer(IV) stage, End stage Renal Disease, Stroke leading to Paralysis or paraplegia.

Features Daily Hospital Cash - (Benefit in Gold scheme) Limit 0.1% of Sum Insured for max.10 days. Attendant Allowance - (Benefit in Gold scheme) If a child below 10 years is admitted, Rs.500 per day for max. 10 days. Ambulance charges
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Other Features Ambulance charges Rs.1000 or 1% of S.I in Silver

 Rs.2000 or 1% of S.I in Gold Discount on OMP Premium Discount of 15% on OMP policy Family Floater policy is suspended, if OMP taken. TPA Option to avail services or not. 5% Discount if opted out. New Features with Extra premium Personal Accident Available in Silver and Gold plans Personal Accident - Available in Silver and Gold plans In Silver up to Rs.5 lakhs. In Gold up to Rs.10 lakhs. Life Hardship - Benefits in Gold scheme with extra premium. Plan A with 15% of Sum Insured Plan B with 25% of Sum Insured Benefit given if Insured person survives Hardship given, for 180 days or 270 days after discharge.

Brief Description : Mediclaim Insurance is a Health cover which takes care of medical expenses following Hospitalisation/Domiciliary Hospitalisation of the Insured in respect of the following situations: (A) In case of a sudden illness (B) In case of an accident (C) In case of any surgery which is required in respect of any disease which has arisen during the policy period. Individual Mediclaim policy will be available to any individual between the age of 18 to 80 years for treatment taken in India. An individual can also get his family cover by way of family package cover. Now you can buy and renew policies Online. Buy a new Health Insurance policy, Renew an existing Oriental Insurance Mediclaim Health Insurance policy or renew policies bought from any other general insurance company by registering yourself on our Portal and paying online through your debit card / credit card or Net-banking. To check out various online facilities available, you may login on the Portal. The salient features of the policy are: Inpatient hospitalization expenses in India due to disease / accident. This health policy covers citizens aged from 3 months to 80 years. The sum insured available ranges from Rs.50000/- to Rs.500000/ Pre-existing diseases are covered from the fifth year policy provided the renewals are done without break in insurance and all the renewals are with Oriental Insurance Company. Cashless facility for claim settlement available in network hospitals if the services of Third Party Administrators are availed. A proposer can take the policy for himself and or for his family members. Wherever family members are covered, a discount of 10% in premium is available. Pre acceptance medical examination is not required if the beneficiaries are below 45 years of age. The premium under the policy is eligible for Income Tax benefit under section 80D.

Covered Risks: This Health cover is a hospitalisation cover and reimburse the medical expenses incurred in respect of covered disease /surgery while the insured was admitted in the hospital as an in patient. The cover also extends to pre- hospitalsation and posthospitalisation for periods of 30 days and 60 days respectively Major Exclusions: Any pre-existing disease, any expense incurred during first 30 days of cover except injury due to accident, all expenses incurred in respect of any treatment relating to pregnancy and child birth. Treatment for Cataracts, Benign prostatic hypertrophy,Hysterectomy, Menorrhagia or Fibromyoma, Hernia,Fitula of anus,Piles, Sinusitis, Asthma,Bronchitis, All Psychiatric or Psychosomatic disorders are excluded from the scope of the cover.