|Sr No||Name of Disease||Maximum Limit of Liability per illness (including domiciliary hospitalisation benefit, if any)|
|1||Accidental Injury||100% of Sum Insured|
|2||Knee Replacement||70% of Sum Insured|
|3||Cardio Vascular Diseases||50% of Sum Insured|
|4||Chronic Renal Failure||50% of Sum Insured|
|5||Cancer||50% of Sum Insured|
|6||Hepato-BilliaryDisorders||50% of Sum Insured|
|7||Chronic Obstructive Lung Diseases||50% of Sum Insured|
|8||Stroke||20% of Sum Insured|
|9||Benign Prostrate||15% of Sum Insured|
|10||Orthopaedic Diseases||15% of Sum Insured|
|11||Ophthalmic Diseases||10% of Sum Insured|
|Cost sharing (Co–Pay)||
|Renewal Benefits||5% discount on renewal premium for every claim free year, subject to a maximum of 20%|
|Free Health Check-up||For every block of 4 claim free policy years, free health check up for the insured persons subject to maximum 1%of average sum insured.|
|Pre Hospitalisation Expenses||Related Medical Expenses incurred during the period upto 30 days prior to the date of admission to hospital|
|Post Hospitalisation Expenses||Related Medical Expenses incurred for a period upto 60 days post discharge from the hospital|
Oriental Insurance has an extensive network of 4,300+ network hospitals across India. One must get admitted to a network hospital in order to avail cashless treatment for their illness. One can get the Oriental health Insurance top network hospital list which is available on the website
There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured, unless the chosen plan has a Sum Insured Refill benefit, which provides additional coverage even after filing a claim.
Till the age of 55 years, Medical checkup is not required for buying Individual Health Insurance. Above 55 years a medical checkup is required at the time of first purchase of the policy. Medical checkups are usually not needed for renewal of policies.
When you get a new Oriental Health Insurance Policy, there will be a 30 day waiting period starting from the policy start date, during which period any hospitalization charges will not be payable. However, this is not applicable to any emergency hospitalization occurring due to an accident. This 30 day waiting period is not applicable when the policy is renewed. Some specific ailments have a specific waiting period of one or two years. Some of the covers have specific waiting periods.
Factors for medical insurance in India, How much is the premium and the coverage offered by India health insurance plans..Click here to read more