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For Comparative Insurance Quote: Om Plaza, 430/7, 1st Floor, Sant Nagar, East of Kailash, New Delhi-65
Phone: 011-41324957, 41623784, Mob:+91-8447757651 & 53 Email: ria1@surekhae.com
Senior Citizens Health Insurance (Mediclaim Policy) in India
 
(1) Senior Citizen Mediclaim Policy over 60 years   (2) Premium Comparative Chart of Senior Citizens
(3) Policy Wording/ Proposal Form/ Brochure Senior Citizens   (4) Senior Citizens Policy Coverage
(5) Required Medical Test List (Pre Acceptance Health Checkup)      
(6) Product details of Various Companies for Senior Citizens Health Insurance
 
General/ Health Insurance Companies Products
6- Senior Citizens Mediclaim Policies - The Oriental Insurance Co. Ltd.
SENIOR CITIZEN SPECIFIED DISEASES INSURANCE
2. DEFINITIONS:
2.1 “HOSPITAL/NURSING HOME:means any institution in India established for indoor care and treatment of sickness and injuries and which either
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.
OR
b) In areas where licensing and registration facilities with appropriate authorities are not available, the institution must be one recognized by local authority as Hospital/ Nursing Home and should comply with minimum criteria as under:
i.  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.
ii. 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.
iii. Fully equipped operation theatre of its own, where surgical operations are carried out.
iv. Fully qualified nursing staff under its employment round the clock.
v. Fully qualified Doctor(s) should be physically in-charge round the clock.

The term ‘Hospital/Nursing Home’ shall not include an establishment which is a place of rest, a place for the aged, a place for drug addicts or a place for alcoholics, a hotel or a similar place.
Note: In case of Ayurvedic/ Homeopathic/ Unani treatment, Hospitalisation expenses are admissible only when the treatment is taken as in-patient, in a Government Hospital/ Medical College Hospital.
.2 Surgical Treatment means manual and/ or operative procedures for correction of deformities/ defects and injuries, cure of diseases, relief of suffering and prolongation of life.
2.3 HOSPITALISATION PERIOD: Expenses on Hospitalisation are admissible only of hospitalisation is for a minimum period of 24 (Twenty Four) hours. However,
(A) This time limit shall not apply to following specific treatments taken in the Networked Hospital/ Nursing Home where the Insured is discharged on the same day. Such treatment shall be considered to be taken under Hospitalisation Benefit.
i. Haemo Dialysis,
ii. Parentral Chemotherapy,
iii. Radiotherapy,
iv. Eye Surgery,
v. Lithotripsy (kidney stone removal),
vi. Dental surgery following an accident
vii. Coronary Angioplasty
viii.Coronary Angiography
ix. Surgery of Gall bladder, Pancreas and bile duct
x. Surgery of Prostrate.
xi. Treatment of fractures/ dislocation excluding hair line fracture, Contracture releases and minor reconstructive procedures of limbs which otherwise require hospitalisation.
xii. Arthroscopic knee surgery.
xiii. Labroscopic therapeutic surgeries.
xiv. Surgery under General Anaesthesia.
xv. Or any such procedure agreed by TPA/Company before treatment.
(B) Further if the treatment/ procedure/ surgeries of above diseases are carried out, in Networked specialized Day Care Centre which is fully equipped with advanced technology and specialized infrastructure where the insured is discharged on the same day, the requirement of minimum beds shall be waived provided following conditions are complied with.
i. The operation theatre is fully equipped for the surgical operation required in respect of sickness/ ailment/ injury for which treatment is being taken.
ii. Day Care nursing staff is fully qualified.
iii. The doctor performing the surgery or procedure as well as post operative attending doctors are also fully qualified for the specific surgery/ procedure.
(C) This condition of minimum 24 (Twenty Four) hours Hospitalisation shall also not apply provided:
I)  The treatment is such that it necessitates hospitalisation shall the procedure involves specialized infrastructural facilities available only in hospitals,
BUT
II) Due to technological advances hospitalisation is not required for 24 (Twenty Four) hours.
AND / OR
III) Surgical procedure involved has to be done under General Anaesthesia.
ABOVE ARE ADMISSIBLE SUBJECT TO TERMS & CONDITIONS OF THE POLICY.
NOTE: PROCEDURES / TREATMENTS USUALLY DONE IN OUT- PATIENT DEPARTMENT ARE NOT PAYABLE UNDER THAT POLICY EVEN IF CONVERTED TO DAY CARE SURGERY / PROCEDURE OR AS IN- PATIENT IN THE HOSPITAL FOR MORE THAN 24 ( Twenty Four) HOURS.
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