Oriental Happy Family Floater Plan for Pregnancy

An incredibly easy method that works for maternity-seeking women and all family members “ORIENTAL HAPPY FAMILY FLOATER PLAN PLAN FOR PREGNANCY” which shelters as a roof of safety and financial assistance

Maternity Health Insurance from Oriental Insurance

Happy Family Floater Policy from Oriental Insurance is available as maternity insurance. Happy Family Floater Policy, which includes coverage for both maternity and newborn baby expenses under its Diamond variation, is a superior option for all expectant women. The coverage guarantees appropriate medical support without sacrificing the standard of care, assisting women in managing their financial situation at the most critical period in their lives. Without a doubt, Happy Family Floater Policy is a better option for maternity insurance.

The best shift in a woman’s life is becoming a mother. Every woman aspires to become a mother because it is a very wonderful experience. However, this wonderful adventure also comes with a lot of obligations and costs starting the day you become pregnant. Your happiness will suffer if you do not properly organize your finances. You should get maternity insurance, which will cover all maternity-related costs, to help in avoiding financial turbulence.

Maternity insurance is a special kind of insurance that pays out costs related to the delivery up to a predetermined cap. Both regular and C-section deliveries are acceptable for this kind of coverage. Even termination costs resulting from specific health issues are sometimes covered by insurance policies. Some insurance companies additionally cover pre- and post-natal costs as well as newborn baby costs.

Some Key Aspects of the Happy Family Floater Policy in Oriental

  • The range of the sum insured is between Rs. 12 lakh and Rs. 20 lakh sum insured range

  • The policy length is one year

  • You can renew the policy for as long as you live, regardless of  age

  • The program covers 11 serious illnesses.

If TPA services are not selected, you will receive a 5.5% premium discount (no discount is given for PA premiums). You are also entitled to tax benefits under Section 80D of the Income Tax Act. Optional coverage options include Personal Accident and Life Hardship Survival Benefits.

Key Features- Takeaway

  • One-year policy term

  • Lifetime renewal

  • Sums insured between Rs. 12 lakh and Rs. 20 lakh

  • Protection against 11 serious illnesses (on a benefits basis)

  • A 5.5% premium discount if TPA services are not selected (no discount on PA premium)

  • Optional coverage such as Personal Accident and Life Hardship Survival Benefits under Section 80D of the Income Tax Act

Scope of Coverage

  • Newborn infant coverage up to 2.5% of the insured amount and maternity expenditures up to 2.5% of the insured amount (Diamond Plan) (Diamond Plan)

  • Hospitalization for at least 24 hours

  • Expenses for 30 days before and 60 days following hospitalization

  • Ambulance costs range from Rs. 1,000 to Rs. 3,000 per illness, with a cap of Rs. 3,000 to Rs. 8,000 per policy period. Attendant Allowance is Rs. 500 & Rs. 1000 per day of hospitalization, in Gold & Diamond Plans, respectively, with a maximum of 10 days per illness. Daily Hospital Cash Allowance benefit is 0.1% of the sum insured on a per-day basis.

  • Treatment options include Ayurveda, Unani, Siddha, and homeopathy

Eligibility

The minimum and maximum entrance ages for the Happy Family Floater Policy are 91 days and 65 years, respectively. It is significant to remember that, under certain circumstances, the policy’s maximum entrance age can be raised to 70 years.

Exclusions

The following are exclusions from this plan:

  • Any hospital admission primarily for investigation or diagnostic purposes

  • This plan is not appropriate in case of any hospital admission primarily for investigation or diagnostic purpose

  • This plan is not applicable for refractive error correction and hearing aids

  • This plan won’t provide coverage for external congenital/genetic conditions

  • This plan won’t reimburse the treatment of STDs and HIV/AIDS

  • This plan won’t cover you in case of substance abuse and self-inflicted injuries

Benefits of Oriental Health Insurance

One of India’s biggest general insurance businesses in the public sector is Oriental Insurance Company. The business provides a variety of affordable health insurance plans that safeguard the insured against a range of medical expenses. Only a few of the significant advantages that the insured can get from its health insurance policies include cashless treatment, coverage for pre-hospitalization and post-hospitalization expenses, ambulance charges, No Claim Bonus, maternity coverage, tax benefits, and other advantages.

Additionally, by offering a variety of comprehensive health insurance policies for individuals, families, parents, parents-in-law, children, women, senior citizens, etc., the insurer has developed a solid reputation. Critical illness coverage, specialized customer care, a grace period to renew the policy, portability, and the opportunity to renew the policy for the duration of its term are additional advantages of acquiring a health insurance package from Oriental Insurance Company.

Additional Benefit of Free Health Checkups

Every three consecutive underwriting years at the end of a block, Oriental Insurance Company reimburses the costs of a single health examination. However, during the block, no claims should be reported.

Additional Protection over Employer Coverage

Indeed, an employer’s health insurance plan does not provide coverage for all illnesses and conditions. By acquiring a suitable health insurance policy from Oriental Insurance Company, you can expand the scope of your plan’s coverage and benefit from additional security.

Cashless Benefit

The benefit of cashless treatment is accessible at all network hospitals. As a result, you won’t experience financial difficulty when you need medical attention.

Claim Settlement Ratio

The ratio of settled claims to all claims lodged within a fiscal year is known as the claims settlement ratio (CSR). In 2019–20, Oriental Insurance Company’s CSR is 93.96%*. CSR occasionally undergoes adjustments.

Coverage against Medical Expenses

The health insurance policies are offered by Oriental Insurance Company offer comprehensive protection for both individuals and families. The plans cover inpatient treatment, pre- and post-hospitalization, childcare treatments, ambulance coverage, and home health care.

Incurred Claim Ratio

When compared to the total amount of premiums collected, the Incurred Claims Ratio, or ICR, shows you the aggregate value of all claims that an insurer has paid. The Oriental Insurance Company’s Incurred Claims Ratio, according to IRDA, is 113.86%*. Periodically, the ratio is updated.

Tax Benefit

You are eligible for tax benefits under section 80D of the Income Tax Act if you pay the premium for a health insurance policy issued by Oriental Insurance Company.

Claim Settlement of Oriental Health Insurance

The way a firm handles claims is what determines how well-liked it is. The Oriental Insurance Company guarantees a simple, hassle-free claim settlement process. Through a reputable Third Party Administrator, Oriental aims to provide claim settlement services (TPA). You can choose to settle your claims as a policyholder either through a reimbursement facility or a cashless option. To make the process easier and more comfortable, you must adhere to the instructions below while registering a claim.

Oriental Health Insurance Claim for Maternity

Maternity insurance claims are settled 93.96% of the time under Oriental health insurance. The company’s claim settlement procedure is practical, simple, and hassle-free. The business provides its policyholders with both cashless and reimbursement claim methods.

Claim Process for Cashless Treatment

 Cashless claims are available if you receive care at a network hospital. How to submit a cashless claim is detailed below:

  • Find a network hospital in the city where you want to receive treatment.

  • Inform Oriental Insurance Company as soon as possible in case of an emergency.

  • Carry your cashless card and one photo ID proof when visiting the hospital.

  • Collect the pre-authorization form from the hospital.

  • Fill it out.

  • The hospital verifies your identity and sends the pre-authorization form to the TPA of Oriental Insurance Company.

  • The TPA of Oriental Insurance Company verifies the information on the pre-authorization form.

Reimbursement Treatment

Both network hospitals and hospitals outside the network can submit reimbursement claims. The following are the steps in the reimbursement process:

  • Obtain the reimbursement claim form from the insurer or download it from their website

  • Fill out the form with the necessary information

  • When you are discharged, pay the hospital bills

  • Gather all original bills, documents, and reports

  • Notify Oriental Insurance Company as soon as possible about your hospitalization.

When the documents are received, the TPA service provider investigates the documents. When they find everything to be correct, the insurer settles the claim by the terms and conditions of the policy. Payment will be made in the insured’s name. Sign all documents and send them to the TPA service provider along with the claim form.

 Documents Needed

 The paperwork needed to submit a reimbursement claim is listed below.

  • Original bills, receipts, and discharge reports.

  • A properly completed claim form.

  • A medical recovery report.

  • Original investigation reports.

  • A final hospital discharge summary.

  • Original pharmacy bills with the prescription.

  • Original test reports (such as x-rays, sonograms, ECGs, etc.) and indoor case documents are also required. A valid picture ID proof is also required.

  • The kind of the procedure conducted, the surgeon’s bill, and the receipt

  • A copy of the claim notification was sent to the company along with a photocopy of the policy and premium receipt.

Incurred Claim Ratio (ICR) of Oriental Health Insurance

The most reliable method for deciding whether or not to purchase health insurance coverage from an insurance provider is the Incurred Claims Ratio or ICR. It provides information about the speed of the claims process and the insurer’s revenue productivity. For the fiscal year 2018–19, Oriental Insurance Company’s ICR is 113.86%.

 A Happy Family Floater Policy from Oriental Insurance will satisfy all your needs if you’re looking to buy the greatest maternity insurance to protect your future. Is maternity covered by Oriental Health Insurance? Yes, under its Diamond variation, Oriental Maternity Health Insurance covers both maternity and newborn baby costs. For all expectant women, Chinese maternity health insurance (the happy family floater policy) may be the best option. Women can better manage their expenses at this critical stage of life with the assistance of this Oriental health insurance maternity cover. This policy guarantees the best possible medical care without lowering the standard of service. Without a doubt, when compared to other plans on the market, our Happy Family Floater Policy is the greatest maternity plan.

Oriental Health Insurance Maternity Benefits

  • Up to 2.5 percent of the insured amount is covered for maternity expenditures under this insurance policy (Diamond Plan)

  • The plan (Diamond plan) additionally offers coverage for newborns up to a maximum of 2.5% of the insured amount.

  • Admission to a hospital for at least 24 hours

  • Pre- and post-hospitalization expenses are covered under this plan (30 days and 60 days respectively)

  • The plan provides policyholders with a daily cash allowance equal to 0.1% of the sum insured daily.

  • The plan offers attendant benefits (Rs. 500 & Rs. 1000 per day of hospitalization, in Gold & Diamond Plans, respectively) for 10 days per illness

  • The plan also offers ambulance charges (Rs. 1,000 to Rs. 3,000 per illness) limited to Rs. 3,000 to Rs. 8,000 per policy period

  • The plan also covers alternative treatment options, such as Ayurvedic, Unani, Siddha, and homeopathic treatment

  • With this plan, you can take advantage of cashless facilities at

People under 55 years old are exempt from pre-health examination requirements, and the plan offers enticing premium discounts. If you are dissatisfied with your Oriental health insurance plan, you can switch to another insurer of your choosing.

 The minimum entrance age for the Happy Family Floater Policy is 91 days. On the other hand, this policy plan’s maximum entry age is 65. However, you should be aware that, under some circumstances, the policy’s maximum entry age can be raised to 70 years. 

The Conclusion

Every intending couple now lives with maternity insurance. This kind of insurance will not only lessen your financial load but will also keep you safe from rising healthcare costs. However, read the policy materials carefully and discover what services are covered by the maternity insurance plan before you agree.