Overview
Oriental Health Insurance is a health insurance company in India. It was established on 12th September 1947 and is one of the oldest health insurance companies in the country. Oriental Health Insurance has 29 regional offices with over 1800 operating offices nationwide. The company offers a wide range of health insurance products that cater to the different needs of individuals and families. Some of the health insurance products offered by Oriental Health Insurance include individual health insurance, family health insurance, senior citizen health insurance, and critical illness insurance. Oriental Health Insurance has a wide range of network hospitals nationwide where policyholders can get cashless medical treatment. The company also has robust customer care support, which helps policyholders with any queries or issues related to their health insurance policies. Moreover, Oriental Health Insurance was awarded the “Best General Insurance- Public Company” in the CNBC TV18 Best Bank and Financial Institution Award.
Oriental Health Insurance Company Specification
Below mentioned are the key specifications of Oriental Health Insurance Company:
| Particulars | Specifications |
|---|---|
| Network Hospitals | 4300+ |
| Incurred Claim Ratio (2022-23) | 130.09% |
| Claim Settlement Ratio (less than 3 hrs) (2021-22) | 90.18% |
| Number of Branches | 1800+ offices |
| Solvency Ratio (2022-23) | 0.68 |
| Gross Direct Premium (2022-23) | 15,992.61 crore |
*Data has been sourced from the annual report of IRDAI 2021-22, IRDAI 2022-23
Key Features of Oriental Health Insurance
Oriental Health Insurance is a public health insurance company that offers comprehensive health plans to its customers at an affordable premium. Moreover, we have evaluated the Oriental Health Insurance company based on various parameters such as network hospital, solvency ratio, claim settlement ratio, etc.:
Reputation and experience
Oriental Health Insurance is a well-established and reputable company with over 70 years of experience in the insurance industry. This gives customers confidence that they are dealing with a reliable and trustworthy company.
Network Hospital
Oriental Health Insurance has a wide range of network hospitals in India. Oriental Health Insurance has a tie-up with more than 4300 hospitals nationwide where the policyholders can avail of cashless medical treatment in case of an emergency.
Hassle-free claims process
Oriental Health Insurance has a simple and hassle-free claims process, which makes it easier for customers to file and settle claims. The company has a dedicated customer support team that is available 24/7 to assist customers with any queries or concerns they may have.
Claim Settlement Ratio
The claim settlement ratio is one of the most important parameters for evaluating the performance of any health insurance company. This shows us the claim settlement capability of the health insurance company. As per the annual report of IRDAI, Oriental Health Insurance has a claim settlement ratio of 90.18% in the year 2021-22.
Solvency Ratio
The solvency ratio shows the company’s ability to meet its financial obligations. Every health insurance company must maintain a solvency ratio of 1.5 in India. As per the annual report of IRDAI, Oriental Health Insurance has a solvency ratio of 0.68 in the year 2022-23.
Health Insurance Policy Offered Under Oriental Health Insurance
Oriental General Insurance offers various health insurance plans designed for individuals, families, senior citizens and critical illnesses. We "RenewBuy" have made a list of Oriental Health plans along with their coverage benefits and eligibility criteria and categorized them into various categories as given below:
Individual and Family Health Insurance
 |
Oriental Happy Family Floater Policy |
Coverage Benefits
- Room Rent
- ICU Cover
- AYUSH Treatment
Eligibility Criteria
Entry Age: 91 days to 65 years
Sum Insured: 2 Lakhs to 15 Lakhs
|
Oriental Individual Mediclaim Policy |
Coverage Benefits
- Domiciliary Hospitalization
- AYUSH Treatment
- Daycare Treatment
Eligibility Criteria
Entry Age: 18 Years to 65 years
Sum Insured: 1 Lakh to 10 Lakhs
|
PNB Oriental Royal Mediclaim Insurance Policy |
Coverage Benefits
- ICU Charges
- Daycare Treatment
- Domiciliary Treatment
Eligibility Criteria
Entry Age: 91 days to 79 years
Sum Insured: 1 Lakh to 10 Lakhs
|
OBC Oriental Mediclaim Policy |
Coverage Benefits
- Ambulance Charge
- Daily Hospital Cash
- Organ Donors
Eligibility Criteria
Entry Age: 91 days to 79 years
Sum Insured: 1 Lakh to 10 Lakhs
|
Oriental Arogya Sanjeevani Policy |
Coverage Benefits
- Dental Treatment
- Ambulance Charges
- AYUSH Treatmente
Eligibility Criteria
Entry Age: 18 Years to 65 Years
Sum Insured: 1 Lakh to 20 Lakhs
|
Oriental Jan Arogya Bima Policy |
Coverage Benefits
- Domiciliary Treatment
- Pre and Post Hospitalization
- Room Rent Cover
Eligibility Criteria
Entry Age: 91 days to 70 Years
Sum Insured: INR 5K per person
|
Oriental Happy Cash Nishchint Rahein |
Coverage Benefits
- Convalescence Benefit
- Daily Cash Benefits
- Increased daily Cash Benefit for females
Eligibility Criteria
Entry Age: 18 Years to 65 Years
Sum Insured: 5K to 20K
Senior Citizen Health Insurance
|
Oriental Health of Privileged Elders (HOPE) |
Coverage Benefits
- Room Rent
- Nursing Expense
- Ambulance Charges
Eligibility Criteria
Entry Age: 60 years to No-limit
Sum Insured: 1 Lakh to 5 Lakhs
Critical Illness Health Insurance
|
Oriental Critical Illness Policy |
Coverage Benefits
- 22 Critical Illness Covered
- Second Medical Opinion
- Midterm Inclusiond
Eligibility Criteria
Entry Age: 18 Years to 65 Years
Sum Insured: 2 Lakhs to 50 Lakhs
|
Oriental Corona Kavach |
Coverage Benefits
- Ambulance Charges
- AYUSH Treatment
- Pre and Post Hospitalization
Eligibility Criteria
Entry Age: 18 Years to 65 Years
Sum Insured: 2 Lakhs to 50 Lakhs
|
Oriental Dengue Kavach Policy |
Coverage Benefits
- One Premium for every age
- Lumpsum Benefit
- Medical Advice
Eligibility Criteria
Entry Age: 18 Years to 70 Years
Sum Insured: 10K to 20K
Oriental Super Health Top-up
|
Pre and Post Hospitalization |
Coverage Benefits
- Organ Donor
- ICU Expenses
- Pre and Post Hospitalization
Eligibility Criteria
Entry Age: 18 Years to 70 Years
Sum Insured: 2 Lakhs to 30 Lakhs
Why Buy Oriental Health Insurance Plans?
Oriental health insurance plans can provide you with peace of mind and financial protection against unexpected medical expenses. Moreover, there are several reasons why you might consider buying an Oriental health insurance plan:
Comprehensive coverage
Oriental health insurance plans offer comprehensive coverage for various medical expenses, including hospitalization, surgery, and other medical procedures.
Affordable premiums
Oriental health insurance plans are known for their affordable premiums, making them accessible to many.
Cashless hospitalization
Oriental health insurance plans offer cashless hospitalization, which means that you do not have to pay anything for your medical treatment.
Lifetime Renewability
Oriental health insurance plans do not have an age limit for renewal of Oriental Health Plans, so you can continue to renew your policy even as you get older.
Additional benefits
Oriental health insurance plans often include additional benefits such as ambulance services, health check-ups, and wellness programs.
Tax benefits
You can also claim a tax deduction for the premium paid for your Oriental health insurance plan under Section 80D of the Income Tax Act.
Oriental Health Insurance Premium Calculation s
To calculate the premium for an Oriental health insurance plan, you can use the online premium calculator available on the Oriental Insurance website. You will need to enter your age, sum insured, and other details to get an estimate of the premium. Moreover, the premium for Oriental health insurance plans depends on several factors, such as:
- Age of the policyholder
- Medical history of the policyholder
- Selected sum insured amount
- Type of plan
- Add-on riders
- Lifestyle of the policyholder
- Policy Tenure
Oriental Health Insurance Add-on Riders .
Add-on riders are used to enhance your coverage benefits by paying a little extra premium amount. Oriental Health Insurance offers various add-on riders under their health plans. Below are some of the add-on riders offered under Oriental Health Insurance plans:
Critical Illness Rider
Insured persons will get coverage against critical illnesses such as cancer, heart attack, kidney failure, and more. Under this rider, policyholders will get a lump sum if the insured is diagnosed with any of the covered critical illnesses.
Personal Accident Rider
The insured will get coverage against accidental injuries that result in permanent or partial disability or death. In case of permanent or partial disability, the policyholders will get a lump sum amount, and in case of the death of the policyholder, the nominee will get this amount.
Hospital Cash Rider
The policyholder will get a fixed daily allowance during hospitalization. The allowance can be used to cover expenses such as food, travel, and other incidental expenses.
Maternity Benefit Rider
This rider covers the expenses related to maternity, including pre and post-natal care, delivery, and hospitalization expenses for the newborn.
It's important to note that the availability of these riders and their features may vary depending on the specific health insurance plan offered by Oriental Health Insurance. It's always a good idea to carefully review the policy documents and consult our RenewBuy advisor before deciding.
Oriental Health Insurance Exclusions
Below are the standard conditions not covered under Oriental Health Insurance plans, but they may vary from plan to plan.
- Suicide or attempted suicide
- Sexually transmitted diseases (STDs) like HIV
- Alcohol or drug abuse
- Intentional/self-inflicted injury
- Plastic Surgery
- Breach of law with criminal intent
- Cosmetic Surgery
- Injuries happened due to participation in adventurous sports
- Weight reduction treatment
- Insanity or venereal disease
- Medical expenses incurred due to war or similar conditions
Oriental Health Insurance Buying Process
The policyholders can buy an Oriental health insurance plan from the official website of Oriental Health Insurance and "RenewBuy.com". Below are both the buying processes for Oriental health insurance plans:
Buy from "RenewBuy.com"
- Visit the official website of "RenewBuy".
- Click on the "Health Insurance Plan" tab.
- Select the desired plan.
- Fill in all the required details.
- Click on the "Buy Now" button.
- Make payment.
- We will send the policy documents to your registered email ID.
Buy from the official website of Star Health Insurance
- Visit the "Oriental Health Insurance" official website.
- Click on the "Products" button from the header menu.
- Then, click on the “Health Insurance Policy” button and then click on the “Health Products” button.
- Select your desired Oriental health insurance plan.
- Fill out the form that shows on the next page.
- Click on the "Buy Now" button
- A pop-up will show you the plan details and the add-on rider information.
- Click on the "Proceed to Buy" button.
- Make an online payment, and the insurance company will send the policy documents to your registered email address.
Oriental Health Insurance Claim Settlement Process
Oriental Health Insurance offers two types of claim processes, i.e. cashless claims and reimbursement claims. Look at the below section to learn more about both claim processes in detail:
Cashless Claim Process
- Policyholders must fill out the claim form and authorise it from the network hospital.
- Submit the claim form along with the Oriental claim form to the hospital authority.
- The hospital authority will send these documents to the TPA of the insurance company.
- The TPA will verify the documents and then approve or disapprove the claim.
- If the TPA approves the claim, then the insurance company will bear the treatment cost.
Reimbursement Claim Process
- Reimbursement claims can be filled in both non-network and network hospitals.
- Get admitted to any hospital.
- Intimate the insurance company within 48 hours of hospitalization.
- Once the treatment is done, collect all the documents, such as the discharge summary, original bills, etc.
- Download the claim form from the official website of Oriental Health Insurance.
- Fill in the claim form and submit it to the TPA along with all the documents.
- Once the documents are received, the TPA will verify them.
- Once the verification is done, they will approve the claim if they find everything correct.
- The claim payment will be transferred to your bank account.
Documents Required to File Reimbursement Claim
Below-mentioned documents are required that you need to submit for a reimbursement claim under Oriental health insurance plans:
- Duly filled claim form
- A valid photo ID proof
- Hospital discharge summary
- Recovery report
- Original pharmacy bills, receipts,
- Original discharge reports, along with the prescription
- Indoor case papers and duly filled claim form
- Original Test Reports
- Copy of claim intimation given to the Company
Oriental Health Insurance Renewal Process
The Oriental Health Insurance renewal process can be done online or offline. Here are the steps to renew your Oriental Health Insurance policy:
Online Renewal Process
- Visit the official website of “Oriental Health Insurance”.
- Go to the "Renew" section on the home page.
- Select the type of policy you want to renew.
- Enter your policy number and other required details.
- Check the premium amount and select the payment mode.
- Pay the premium online using a debit/credit card or net banking.
- Once the payment is successful, you will receive a confirmation message on your registered mobile number and email.
Offline Renewal Process
- Visit the nearest Oriental Health Insurance branch or contact our “RenewBuy” advisor.
- Fill in the policy renewal form.
- Submit the form along with the renewal premium amount.
- Once the payment is made, you will receive a confirmation message on your registered mobile number and email.
It is advisable to renew your Oriental Health Insurance policy before the due date to avoid any lapse in the policy coverage.
Oriental Health Insurance Contact Details
Oriental Health Insurance has 24/7 customer care support for its customers. You can connect with Oriental Health Insurance using the details below:
Registered Office: Oriental House, A-25/27, Asaf Ali Road, New Delhi - 110002
Email-ID: csd@orientalinsurance.co.in
Phone number: 011-43659595, 1800118485 Or 011- 33208485