| 8- Family Floater Coverage -Oriental Insurance Company Limited |
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| HappyFamily Floater Health Insurance from United India Insurance Company |
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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 period. |
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 |
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 |
NIL |
Plans of benefit AS DEFINED HEREINAFTER |
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| PERSONAL ACCIDENT COVER: (WORLD – WIDE) |
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| SCOPE OF COVER: |
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| If at any time during the currency of the policy the insured sustains any bodily injury resulting solely and directly from accident caused anywhere in the world by external, violent and visible means, then the Company undertakes to pay the insured or his/her legal personal representative, as the case may be, the following sums : |
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| BENEFIT COVERED |
DESCRIPTION |
AMT. PAYABLE |
| (1) |
Accidental Death only |
100 % of CSI |
| (2) |
Loss of Two entire limbs, or sight of
two eyes or one entire limb and sight of one eye. |
100 % of CSI |
| (3) |
Loss of one entire limb or Sight of one eye |
50 % of CSI |
| (4) |
Permanent Total Disablement resulting in
The insured becoming in engaging in any
Employment or occupation whatsoever. |
100 % of CSI |
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| The overall liability in the event of one or more of the eventualities occurring SHALL be restricted to the CSI. |
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| CSI means capital sum insured opted for the personal accident section. |
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| LIFE HARDSHIP SURVIVAL BENEFIT: |
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| If this benefit is opted for (under the GOLD plan only), and if a claim for the specified diseases listed hereunder is admitted under section 1.2 A of the policy, then a survival benefit as mentioned hereunder, SHALL be paid the insured. |
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Diseases covered:
Cancer - metastasis (stage IV)
End Stage Renal Disease (ESRD)
Stroke leading to paralysis or paraplegia |
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