Review Of Public Sector Health Insurance Policies

To be prepared is to stay ahead of any surprises lurking in the near or distant future.

Why take a chance when it comes to your health. In a pickle regarding which is the best

plan for you? Oriental Insurance Mediclaim offers a wide variety of options for different

needs. It has a plethora of options for its policyholders. 

Overview

The public sector medical insurance providers offer a cost advantage over private

health insurers. 

If you opt for a health plan from a public sector insurance company, you end up paying less for the health cover, even though you get similar benefits offered by a private sector insurance provider. 

New India assurance is a global insurance provider. The plans offered by them are New India Top-Up, Floater, and Asha kiran, Mediclaim 2012, Pravasi Bhartiya Bima Yojana, Senior Citizen plan, and an Overseas and Personal Accident policy. 

National Insurance is the oldest insurance company in India. It provides National Parivar, Parivar, and National Mediclaim Plans. In addition to these, it also offers Overseas Mediclaim Business & Holiday Plans, National Parivar Plus and National Mediclaim Plus Plans. 

The escalating networks of United Insurance company offers the following plans-

Family Medicare; Gold, Platinum, Senior Citizen, Top-up, and Super top-up, UNI Criticare, Personal Accident Policy, and an Individual Mediclaim Policy. 

Oriental Health Insurance Company is one of the prominent health care providers amongst insurance providers in the public sector. 

The diverse plans accessible to the public include Oriental Individual, Oriental Happy family Floater, and Oriental Overseas Mediclaim. 

Special mediclaim plans offered by the Oriental Insurance are Jan Arogya Plan, Health of Privileged Elders Plan, and Pravasi Bharatiya Bima Yojana plan. 

In the case of corporate setup or a bank account holder, they offer Oriental Bank Mediclaim, PNB Oriental Royal and Thana Janata Sahakari Bank Mediplus Plan. 

The comprehensive features of one such beneficial plan by the Oriental Insurance is the Individual Mediclaim Policy. The Oriental insurance mediclaim reviews highlights the features of this plan as: 

Minimum Entry Age	Maximum Entry Age	Minimum Premium	Minimum Sum Assured
18 years	65 years	10,000	1,00,000

 Wondering why to get yourself into the Individual Mediclaim Policy 

In keeping with the digital banking system, it offers the cashless facility. There will be no

need to get into the hassles of cash transactions when you opt for this health plan.

Subject to the upper age limit (80yrs) they offer lifelong renewability. Oriental Insurance

is associated with a large network of hospitals as well.

Features & Benefits 

In a predicament over the health insurance policies? The individual mediclaim policy is

here to help you out. 

The features of this incredible plan include: 

• Coverage for expenses incurred because of accident, sudden illness, or disease.
• Allowed for individuals from as early as 3 months of age up to 80yrs.
• The range of the sum insured is from Rs.1,00,000 to Rs.50,00,000
• Cover for pre-existing diseases after 4 th year, conditioned to the fact that the plan

has continued without any break.

• Cashless option for ailments in any of the network hospitals.
• You earn a 10% family discount on the total premium.
• Income tax rebate can be claimed under section 80D of the I-Tax Act.
• Does not require prior approval of medical check up, if the person is aged below

45 yrs. 

Eligibility 

This plan covers ages as young as 3 months old up to the ripe age of 80 yrs. 

Inclusions 

Hospitalization Expenses - Any hospitalization for more than a day because of

surgery, accident, or illness. 

Pre as well as Post Hospitalization Expenses - Charges incurred 30 days before

hospitalization and 60 days after discharge are covered. 

Day Care Charges - Any day care treatment that does not require admission to the

hospital. 

Ambulance Charges - It is calculated as 1 percent of the assured sum, capped at Rs.

2000. 

Expenses for Organ Donor- This is provided in cases of organ transplantation. 

Dental Treatment - If necessitated because of an accident. 

Domiciliary Treatment - Cost incurred for treatment that requires hospitalization but is

being taken care of at one’s home for over 3 days. 

Ayush Expenses - Treatment undertaken at government hospitals or medical colleges

under Homeopathy, SIddha, Unani, and Ayurveda. 

Pre-existing Illnesses - They are covered only after 4 continuous years of policy term.

That means that the policy was regularly renewed without any break. 

Medical Check-up Benefit - This benefit can be claimed after 4 continuous claim-free

years, for a maximum of 1% of the assured sum. 

Exclusions 

Any pre-existing disease, for up to 4 years. 

All medical ailments, for the initial 30 days after taking the policy. The only exception is in the case of an injury sustained because of an accident. 

Any expenses related to childbirth or pregnancy. 

Treatment of mental or psychiatric disorders. 

Any expenses related to the treatment of bronchitis and asthma, sinusitis, fistula, piles,

hernia, hysterectomy, fibromyoma, menorrhagia, cataract, and BPH. 

Documents Required

No need to bother with endless documentation works. All one needs to submit for

applying for the individual mediclaim policy is the complete proposal form and enrolment

form in duplicate along with coloured stamp size photograph. 

You may like to read : Cashless Mediclaim Policy Oriental Insurance

Claim Process

For you to be able to claim the benefits of the Oriental health plan, notice of the same

must be given to the company at the earliest. Mention the policy no., ID card no., name,

nature of the disease, and name & address of the hospital/ nursing home/ physician.

The time frame for submission of the same is 48hrs prior to the admission in the

hospital. 

In the case of cashless access services, the claim will be processed either through the

company or the TPA. The hospital chosen for the treatment should be among those included in the network of hospitals covered by the policy. 

In case reliable and relevant information are not submitted, the claim is subject to

denial. In such cases, it should not be interpreted as the denial of liability. 

The cashless facility can be drawn out if any information submitted to the company or

TPA is doubtful. If this question arises then, it warrants further enquiry. Hence the

cashless facility will be withheld. Further processing of the claim will depend on the

results of the enquiry.