| 8- Oriental Insurance Company Limited - Family Floater Policy Wording |
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| Source: Website of The Oriental Insurance Company Limited |
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| 2.DEFINITIONS: |
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| 2.1 HOSPITAL/ 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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| OR |
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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 |
- 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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| The term ‘Hospital/ Nursing Home’ shall not include an establishment which is a place of rest and/ or recuperation, a place for the aged persons, a rehabilitation centre for drug addicts or alcoholics, a hotel or a similar place. |
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| Note: In case of Ayurvedic/ Homeopathic/ Unani treatment, the liability of the Company SHALL be restricted to 10% of the Sum Insured for the entire policy period for the family as a whole if the treatment is taken in hospitals other than Government hospitals and Medical college hospitals. |
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| 2.2 Surgical Operation means manual and/ or operative procedures for correction of deformities/ defects and injuries, cure of diseases, relief of suffering and prolongation of life. |
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| 2.3 HOSPITALISATION PERIOD: Expenses on Hospitalisation are admissible only if hospitalisation is for a minimum period of 24 (twenty four) hours.However, |
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| (A)This time limit SHALL not apply to following specific treatments taken in the Network Hospital/ Nursing Home where the Insured is discharged on the same day. Such treatment SHALL be considered to be taken under Hospitalisation Benefit. |
- Dialysis (haemo dialysis, Peritoneal dialysis)
- Parental Chemotherapy (injectible)
- Radiotherapy,
- Eye Surgery,
- Lithotripsy (kidney stone removal),
- Tonsillectomy,
- Dilation and Curettage (D&C)
- Dental surgery following an accident
- Hysterectomy
- Coronary Angioplasty
- Coronary Angiography
- Surgery of Gall bladder, Pancreas and bile duct
- Surgery of Hernia
- Surgery of Hydrocele
- Surgery of Prostrate
- Gastrointestinal Surgery
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