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Oriental Happy Family Floater Health Insurance Policy

Oriental Happy Family Floater Health Insurance Policy - Happy Family Floater Health Policy offered by Oriental Insurance covers medical expenditures incurred by the whole family under a single sum assured. The family comprises of Self, Spouse, Children, Parents, and Parents-in-laws. There are two plans available in Family Floater– Silver and Gold. With this plan, you can claim for medical costs owing to any ailment/ injury/ accident that necessitates hospitalization.

Highlights - Oriental Happy Family Floater Health Insurance Policy

  • One sum insured for the whole family including parents and parents-in-laws
  • No pre-policy medical test for individuals up to the age of 60 years
  • Based on the benefits, policy is available in two options – Silver & Gold
  • Personal Accident Cover and Life Hardship Survival Benefit available at extra premium
  • If you do not prefer the TPA services, you can get additional 5% discount on the premium

Entry Age - Oriental Happy Family Floater Health Insurance Policy

For children : 91 days

Adults :

  • Minimum : 18 years
  • Maximum : 65 years

Number of Members Covered

  • Maximum Members : 7
  • Maximum Adults : 4
  • Maximum Children : 4

Sum Insured

  • Silver: 1 lakh to  5 lakh 
    Gold: 6 lakh to  10 lakh 

Policy Periods Available

  • 1 year

Pre-Policy Medical Check-up

  • Above 60 years

Important Features - Oriental Happy Family Floater Health Insurance Policy

DAY CARE TREATMENTS

  • Covers about 24 day-care procedure that does not require a minimum of 24 hours hospitalization.

NO-CLAIM BENEFITS

  • You are entitled to a no-claim bonus of 5% up to a maximum of 20% on the premium if you renew the policy without any break.

ORGAN DONOR COVER

  • You can claim for hospitalization, nursing home charges, surgery, medicines, drugs, pathological tests, and so forth during an organ transplant.

PRE HOSPITALIZATION

  • The insurance company will compensate you for the medical expenses related to your hospitalization 30 days before the hospitalization.

POST HOSPITALIZATION

  • The insurance company will pay you for the medical expenses related to your hospitalization 60 days post hospitalization.

RESTORE BENEFITS

  • Does not offer any restore benefit.

Benefits - Oriental Happy Family Floater Health Insurance Policy

OPD EXPENSE COVER

  • You cannot claim for any OPD treatments.

DAILY HOSPITALIZATION ALLOWANCE

  • In Gold Plan, you get a daily hospital cash up to 0.1% of sum insured per day to a maximum for ten days. The maximum liability is restricted to 1.5% of the sum insured.

HEALTH CHECK-UP

  • Complimentary health check-up is not available in this plan.

HOME HOSPITALIZATION/ DOMICILIARY HOSPITALIZATION

You can claim for the costs towards a treatment at home, provided it satisfies the defined conditions.

  • Silver: 10% of sum insured up to a limit of Rs. 25,000
    Gold: 10% of sum insured up to a limit of Rs. 50,000

NON- ALLOPATHIC TREATMENT EXPENSE COVER

  • This plan does not cover costs arising out of non-allopathic treatment.

EMERGENCY AMBULANCE

Under this benefit, you can claim for the ambulance charges as per the below:

  • Silver: Rs.1,000 per illness up to a maximum of Rs.3,000 or 1% of sum insured
    Gold: Rs.2,000 per illness up to a maximum of Rs.6,000 or 1% of sum insured

ATTENDANT ALLOWANCE

  • In Gold plan, you can claim Rs.500/- per day of hospitalization per illness up to ten days. The maximum liability is limited to payment for 15 days of hospitalization.

TREATMENT FOR RABID ANIMAL BITE

  • Under this benefit, you can claim the reasonable expenses up to Rs.5,000/- incurred for immunization injections.

Terms & Conditions - Oriental Happy Family Floater Health Insurance Policy

ROOM RENT / ROOM CATEGORY

  • The plan has pre-determined limits for room rents and is equal to:

1% of sum insured per day

  • ICU expenses not to exceed 2% of the sum insured per day

CO-PAYMENT

  • Gold plan does not have any co-payment clause. However, Silver plan has a 10% co-payment.

Waiting Period - Oriental Happy Family Floater Health Insurance Policy

COOLING OFF PERIOD

  • A 30 days cooling off period for all claims except any arising out of accidental injuries.

SPECIFIC ILLNESSES

  • The policy covers some specific diseases/treatments only after 24 months. These include Cataract, Hysterectomy, Myomectomy for Fibroids, and so forth.

PRE-EXISTING ILLNESSES

  • You can claim for any pre-existing conditions after 48 months from the policy start date.

Add-on Covers - Oriental Happy Family Floater Health Insurance Policy

DAY CARE TREATMENTS

  • At an added premium, you can opt for the below cover.

LIFE HARDSHIP SURVIVAL BENEFIT

At an extra premium, you can also opt for this benefit in Gold Plan.

  • Plan A: 15% of sum insured payable to anyone who survives 180 days from the hospital discharge date
    Plan B: 25% of sum insured payable to any person who survives 270 days from the hospital discharge date

Value Adds - Oriental Happy Family Floater Health Insurance Policy

EYE-COVER

  • This plan does not provide any compensation towards eye cover.

MATERNITY COVER

  • This plan does not cover maternity costs.

DENTAL COVERAGE

  • This policy does not cover for any cosmetic/corrective dental treatment.

RECOVERY BENEFIT

  • This plan does not offer any recovery benefit.

CRITICAL ILLNESS COVER

  • This policy does not provide any additional cover for critical illness.

FREE LOOK PERIOD

  • For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within 15 days from the date of receipt of the policy document.

Permanent Exclusions - Oriental Happy Family Floater Health Insurance Policy

The Plan will not cover any liabilities towards the treatments of following conditions-

  • whose signs or symptoms first occur within 30 days of the policy period
  • attempted suicide
  • use of alcohol or drug
  • AIDS
  • pregnancy, childbirth, miscarriage, and abortion
  • Congenital disease
  • infertility and in vitro fertilization.
  • hospitalization out of war, riot, strike and nuclear weapons

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