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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