Faq’s on Health/ Mediclaim Insurance

Will Mediclaim reimburse my expenses related to the disease which I am already suffering before the inception of the plan?
Insurance company will not cover any illness/ailment which already existed at the time of first obtaining the insurance cover. However, some companies cover such conditions after, two or four continuous renewals; they start covering the pre-existing illness after that.

What is Mediclaim Policy and what does it cover?
The policy provides for reimbursement of hospitalization/ domiciliary hospitalization expenses for illness/diseases suffered or accidental injuries sustained by the insured during the policy period.

Does Mediclaim cover any expenses besides hospitalization costs?
Mediclaim covers pre-hospitalisation (30 days) and post-hospitalisation (60days) expenses also if they are connected with the sickness / accident for which the hospitalisation takes place.

What is considered as “domiciliary hospitalization” under Mediclaim?
It is that condition of the patient in which he cannot be moved to the hospital or if there is no bed available in any of the hospitals, then the treatment is taken at home and if it is given like the treatment given at the hospital, then in such situation, it is reimbursable.

What is a Cashless Facility?
Cashless Facility is a service wherein the insured can get admitted and can settle all hospitalization expenses at the time of discharge from hospital. The settlement is done directly by the insurance company, that’s why it’s a cashless facility where you are provided with the claim there and then at the time of settling the bills, the hospital directly contacts with the insurance company and settle the claim.

What is a Health Card?
A Health Card is that card which comes along with the policy which would entitle you to get cashless claim at any of the company’s network hospitals.

Am I entitled for cover immediately after I take my policy?
For the first 30 days after your policy is activated, you would not be entitled for any cover for sickness but you can avail of accidental cover immediately.

Do I have to undergo medical Check up while taking health insurance policy?
Medical tests is required after 45 years of age.

Is a Medical check up again required at the time of renewal of the policy?
No, the medical check up has to be taken only once, during the inception of taking a policy and only if you are 46 years of age or above.

What is the Critical Illness policy? And what does it cover?
It is that policy which covers Illness; it is complimentary to a mediclaim policy, being an additional policy which can be taken along with Mediclaim. The Critical Illness policy covers five major illnesses • Cancer.
• Kidney failure.
• Organ transplant.
• Multiple sclerosis and.
• Coronary artery surgery (20 percent of Sum Insured)

When does the Critical Illness policy cover all the five illnesses?
As long as the policyholder was not suffering from any of the illnesses, the pre-existing illness exclusion applies to the Critical Illness policy also.

What is a Floater Policy?
A floater Policy is issued with a single sum insured covering number of individuals. The family is covered for a fixed amount and anyone in the family can avail of the benefit till the limit is exhausted. In short, it is one single policy which takes care of the hospitalization expenses of your entire family.

Do I get a No Claim Bonus under my health insurance if I do not make a claim?
Yes, some plans offer a discount in premium. Others offer an increase in your benefit amount for every claim-free year.

What are the benefits of renewing my health insurance policy?
There should be continuous renewal of the policies. If there is a break in insurance, the insured would lose the benefits of insurance in the event of any contingency. You will be prevented from the benefits of No claim Bonus in a claim free year. Moreover you will not be covered for Pre-existing diseases.

Why should I take Individual health plan or a Family Floater plan if I already have health insurance from my employer?
You are covered with the health insurance policy as long as you are in the employer’s services. If tomorrow, you change your job, then you and your family will be barred of any medical emergency arises when you have not arranged for an alternative health insurance policy. It is at this point of time that an Individual or Family Floater Health Insurance policy will come to your rescue.

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Overseas Insurance Policy

The Overseas Mediclaim Travel Insurance policy protects the insured party against medical expenses that he/she might have to incur during his/her overseas trip. Any Indian resident traveling abroad can take this policy. Group/Individuals can apply for this Oriental Insurance & ICICI Lombard Policy INDIA.

Benefits:

• The policy is basically provides for medical expenses of the insured during his/her stay abroad.
• The policy also covers personal accident, total loss of checked baggage, delay of checked baggage, loss of passport and personal liability, at no additional premium.
• The policy can be taken for a period of 0 to 180 days, with an option to extend further.

Repatriation Benefits: If the insured is required to be sent back to the home country on account of sickness suffered, the expenses incurred therewith are also paid.

All the expenses are reimbursed in the local currency of the country visited.

 Exclusions:  This insurance policy will not pay any claims arising from

• Any treated or existing diseases prior to one year of commencement of risk, whether undeclared or not.
• Travel against medical advice, travel for treatment, terminal prognosis or awaiting special treatment.
• Cosmetic surgery, pregnancy-related costs, AIDS.
• War or nuclear perils are not include.
• Suicide or attempted suicide is not include.
• Benefits recoverable from any other scheme.
• Examination/ treatment in India are not include.
• Expenses incurred outside country of study or posting. However this does not prejudice emergency evacuation on medical grounds. compare online premium here.

 For FAQ’s on Overseas Insurance Click Here.

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Personal Accident Insurance

Personal Accident Insurance: Personal accident Group/ Individual policy protects the individual against the consequences of unforeseeable daily accidents by Oriental Insurance & ICICI Lombard.

A personal accident policy indemnifies the insured in case of accidents by taking into account the disability, the accident may have caused to his earning capacity.

Features:

A personal accident policy is an Annual Policy.
It covers death or bodily injury due to accident. The Sum insured is based on earnings and capacity to pay premiums.

Compensation:

The policy is divided into various risk categories and the compensation is awarded to the insured depending on the category that is applicable to him.

Exclusions:

Services on duty with any armed Force.
Intentional self-injury, suicide or attempted suicide, insanity, venereal diseases or the influence of intoxicating drugs.
Medical or Surgical treatment (except in cases where such treatment is necessary within the scope of the policy).
Nuclear radiation or nuclear weapons materials.
Any consequence of war, invasion, act of foreign enemy, hostilities (whether war be declared or not), Civil war, rebellion, revolution, insurrection, mutiny, military or usurped power, seizure, capture, arrests, restraint and detrainments of all kinds, princes and people of whatsoever nation condition or quality.
Childbirth, pregnancy or other physical caused peculiar to the female sex.
Whilst committing any breach of law with criminal intent.online premium comparision.

The Oriental Insurance has a various types of Personal Accident Policy for Death, Disability & Compansation Insurance Cover. How much Maximum and Minimum Sum Assured or Premium Required for purchasing a new Personal Accident Insurance Policies on your All the Family Members cover for Father, Mother, Spouce, Childrens, Dependents Life visit our Contact us page to type your querry.

Contact us for Premium Rates on Personal Accident Insurance Policies for The Oriental Insurance & ICICI Lombard General Insurance Company India.

The Policy Covers : If at any time during the currency of the policy the insured person shall sustain any bodily injury solely & directly from accident caused by external violent and visible means then Company shall pat to insured or his legal personal representative as the case may be sum or sums as per terms / condition of the policy. 

ADDITIONAL BENEFITES FREE OF COST AVAILABLE UNDER ALL TABLES : 

Expenses incurred for carriage of dead body of Insured Person (death due to accident only) to place of residence subject to a maximum of 2% of the CSI or Rs. 2500/- Whichever is less.

EDUCATIONS GRANT :In the event of death or permanent total disablement of the insured du e to accident as defined in the policy, the policy shall also pay following amount as education grant for dependent children. 

 Note :

 (1) Limit of Age is 5-702 years.
(2) The aforesaid limits would apply cumulatively in the event of there being more than one policy on the life of the       insured person.
(3) The Proposer may choose any one or more the above tables.
(4) The Cover is worldwide.
(5) Cumulative Bonus : The Sum payable under item 1 to 4 is increased by 5% each year on renewal of Policy upto a limit       of 50 percent. Earned cumulative bonus will not be lost if the Policy is renewed within 30 days of its expiry.

Family Package Cove :

Family Package Cover can be granted on the following pattern :

 Note :

1. For Children the maximum cover shall be limited to Death and Permanent Disablement (total and partial)i.e. upto Table B benfits only.
2. A discount of 10% may be granted on the gross premium under the Family Package Cover.
3.Where Sum Insured petaining spouse works out to less than the Sum Insured allowable, if such spouse was not earning the Later Sum Insured may be allowed.

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