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| Family Floater Health Insurance Products in India (for your entire family) |
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| Policy information of health insurance products for families including comparison rates, policy language, coverage etc. |
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| 8- Family Floater Coverage -Oriental Insurance Company Limited - Policy Wording |
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THE ORIENTAL INSURANCE COMPANY LIMITED,
Regd. Office: Oriental House, P.B. No. 7037, A-25/27, Asaf Ali Road, New Delhi- 110 002 |
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| B. DOMICILIARY HOSPITALISATION (AS DEFINED HEREINAFTER) |
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| DOMICILIARY HOSPITALISATION (AS DEFINED HEREINAFTER) |
| (a) |
Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines & Drugs, Diagnostic Material and Dialysis, Chaemotherapy, Nursing expenses. |
10% of Sum Insured, Maximum Rs.25000/- during policy period. |
Rs.50000/-,during policy period. |
| (b) |
Treatment for Dog bite (or bite of any other rabid animal like monkey, cat etc.) |
Reasonable expenses limited upto Rs.5,000/- actually incurred for immunisation injections in any one policy |
Reasonable expenses limited upto Rs.5,000/- actually incurred for immunisation injections in any one policy |
| NOTE: FOR THE PURPOSE OF THIS SECTION THE PRE-REQUISITE CONDITIONS FOR DOMICILIARY HOSPITALISATION CLAIM SHALL NOT APPLY. |
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| 1.3. Hospitalization / nursing home charges, surgery, medicines, drugs, pathological tests etc. incurred for donating an organ by the donor to the insured person during the course of organ transplant shall also be payable under this policy. However, cost of organ is not payable / reimbursable under the policy. |
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| 1.4 Company’s overall Liability in respect of all claims admitted under sections 1.2 and 1.3 during the Period of insurance shall not exceed the Sum Insured per Family mentioned in the Schedule. |
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| 1.5 REGISTRATION CHARGES: are not payable under either silver or gold plans. |
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| 1.6 ADD ON COVERS (OPTIONAL,SUBJECT TO EXTRA PREMIUM) |
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| ITEM |
SILVER PLAN |
GOLD PLAN |
| (a) |
PERSONAL ACCIDENT as defined hereinafter 3.22 |
Sum insured in multiples of Rs.1,00,000/- and upto Rs.5,00,000/- per person aged 18 years and above . 50% of this limit for persons less than 18 years. |
Sum Insured in multiples of Rs.2,00,000/-, and
upto Rs.10,00,000/- per person aged 18 years and above. 50% of this limit for persons less than 18 years. |
| (b) |
LIFE HARDSHIP SURVIVAL BENEFIT AS DEFINED HEREINAFTER 3.21 |
NIL |
Plans of benefit AS DEFINED HEREINAFTER |
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| 2.DEFINITIONS: |
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| 2.1HOSPITAL/NURSING HOME: means any institution in India established for indoor care and treatment of sickness and injuries and which either |
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| (a)Is duly licensed and registered as a Hospital or Nursing Home with the appropriate authorities and is under the supervision of a registered and qualified Medical Practitioner. |
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| (b) In areas where licensing and registration facilities with appropriate authorities are not available, the institution must be one recognised in locality as Hospital / Nursing Home and should comply with minimum criteria as under |
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- It should have at least 15 in-patient medical beds in case of Metro cities, A Class cities & B class cities or 10 in- patient medical beds in case of “C class” cities. Classification of cities shall be as per Govt of India Notifications issued in this respect from time to time.
- Should have fully equipped and engaged in providing Medical and Surgical facilities along with Diagnostic facilities i.e. Pathological test and X-ray, E.C.G. etc for the care and treatment of injured or sick persons as in-patient.
- Should have fully equipped operation theatre of its own, wherever surgical operations are carried out.
- Should have fully qualified Doctor(s) under its employment for 24 (twenty four) hours.
- Should have fully qualified nursing staff under its employment 24 (twenty four) hours.
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