| 8- Family Floater Coverage -Oriental Insurance Company Limited |
|
| HappyFamily Floater Health Insurance from United India Insurance Company |
|
| |
| Plan |
Total amount payable |
Amount payable on survival for 180 days and above from the date of discharge from the hospital (the first discharge date in case of more than one hospitalisations are involved). |
Amount payable on survival for 270 days and above from the date of discharge from the hospital (the first discharge date in case of more than one hospitalisations are involved). |
| (A) |
15 % of Sum Insured under the policy |
5% of the sum insured |
10% of the sum insured |
| (B) |
25 % of Sum Insured under the policy |
10% of the sum insured |
15% of the sum insured |
|
|
| The limit of liability SHALL be applicable for all the insured persons severally or jointly. The benefit under this section shall be paid only once under this policy or subsequent renewals for the same disease for the same person. |
|
| 2.DEFINITIONS / OTHER MAJOR FEATURES: |
|
| AMBULANCE SERVICES: Means ambulance service charges reasonably and necessarily incurred in case the insured person is to be shifted from residence to hospital or from one hospital to another hospital. The ambulance service charges are payable only if the hospitalisation expenses are admissible. Further the ambulance service charges are admissible only if such expenses are paid to registered ambulance services providers. |
|
| INSURED PERSON: Means Person(s) named on the schedule of the policy which includes family comprising of the proposer, his /her legally wedded spouse, dependent unemployed children between 3 (three months) to the age of 25 years, unmarried daughters including divorcee, and widowed daughters and dependent Parents or parents-in-law (either of them only). The minimum number of persons to be covered under the policy shall be the proposer plus one family member. |
|
| ANY ONE ILLNESS: Any one illness SHALL be deemed to mean continuous period of illness and it includes relapse within 105 (one hundred and five) days from the date of discharge from the Hospital / Nursing Home / Day Care centre from where the treatment was taken. Occurrence of the same illness after a lapse of 105 (one hundred and five) days as stated above SHALL be considered as fresh illness for the purpose of this policy. |
|
| DAILY HOSPITAL CASH ALLOWANCE: When an insured member of the family is hospitalized and a claim is admitted under the GOLD plan of the policy, then the insured person SHALL be paid a daily cash allowance as specified in section 1.2 A f of the policy. |
|
| ATTENDANT ALLOWANCE: When an insured member of the family aged between three months to 10 years is hospitalized and a claim is admitted under the GOLD plan of the policy, a sum as mentioned in the table of benefit under 1.2 A g will become payable under the policy. |
|
| MIDTERM INCLUSION: Midterm inclusion of members is permitted for newly wed spouse only. Spouse can be included within three months of marriage or at the time of renewal of the policy. |
|
| NO CLAIM DISCOUNT / LOADING: A discount of 5% on the premium, in respect of each claim free year, subject to a maximum of 20 % SHALL be allowed provided the policy is renewed with the company without any break. In case any claim is admitted under the policy, the entire No Claim Discount earned SHALL be forfeited in the next renewal of the renewal of the policy. However, the No Claim Discount SHALL continue to accrue afresh from the next claim free year. |
|
|
| In case any claim is admitted under the policy, where No Claim Discount has not accrued or the earned No Claim Discount has been forfeited, a loading SHALL be levied on the renewal premium @5% for each claim occurred year subject to a maximum of 20%. |
|
| The position of No Claim Discount (NCD) / Loading on premium SHALL be as per illustration below: |
|
|
|
