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Home » Blog » General Insurance » Oriental Bank Mediclaim Policy

Oriental Bank Mediclaim Policy

April 1, 2016 By policydunia

Oriental Bank Mediclaim Policy
3.3 (66.15%) 13 votes

Oriental Bank Mediclaim Image

Policy Highlights

  • 1 Oriental Bank Mediclaim Policy Introduction
  • 2 Oriental Bank Mediclaim Policy Eligibility Conditions
  • 3 Oriental Bank Mediclaim Policy Key Features
  • 4 Oriental Bank Mediclaim Policy Inclusions
  • 5 Oriental Bank Mediclaim Policy Exclusions
  • 6 Oriental Bank Mediclaim Policy Customer Care
  • 7 Assistance: 
  • 8 Oriental Bank Mediclaim Policy Buying Procedure
  • 9 Oriental Bank Mediclaim Premium Payment:
  • 10 Oriental Bank Mediclaim Policy Claim Procedure
  • 11 Intimation:
  • 12 Claim Procedure to avail Cashless service:
  • 13 Documents to be submitted during claim:
  • 14 Oriental Bank Mediclaim Premium Calculator
  • 15 Oriental Bank Mediclaim Premium Rates
  • 16 Oriental Bank Mediclaim Policy FAQ’s
  • 17 Oriental Bank Mediclaim Forms and Documents
  • 18 About Oriental Gramin Personal Accident Insurance
  • 19 About Oriental Group Mediclaim Policy
  • 20 About Oriental Janata Personal Accident Policy
  • 21 About Oriental Nagrik Suraksha Policy
  • 22 About PNB – Oriental Royal Mediclaim Policy
  • 23 About Oriental Individual Mediclaim Policy
  • 24 About Happy family floater policy

Oriental Bank Mediclaim Policy Introduction

Oriental Bank Mediclaim Policy was launched on 3rd October 2011. Oriental Bank of Commerce signed an agreement with The Oriental Insurance Company Ltd. to sell mediclaim policies to its customers. Oriental Bank Mediclaim Policy is designed exclusively for the Account Holders of OBC (Oriental Bank of Commerce). It is available in all OBC (Oriental Bank of Commerce) Branches across the country. Oriental Bank Mediclaim Policy takes care of various medical expenses following hospitalization due to an accident/sudden illness/surgery during the policy period. Oriental insurance company reimburses the medical expenses incurred for the treatment taken by the policyholder. This Oriental Bank Mediclaim Policy is a health plan with Family Floater Option.

Oriental Bank Mediclaim Policy Eligibility Conditions

Entry Age:
  • Minimum: 3 months
  • Maximum: 79 years
Policy Term:
  • 1 Year
Sum Insured:
  • Minimum: 1 lakh
  • Maximum: 5 lakhs
Oriental Bank Mediclaim Renewal:
  • Company shall not be responsible for non‐renewal of policy after the due date of the proposal form.
  • You can renew your policy through online  by just entering your previous policy number, Insured Code and Policy expiry date.
Pre-medical check up:
  • Not required

Oriental Bank Mediclaim Policy Key Features

  • A family floater scheme covers 4 family members namely, Proposer, Spouse and 2 dependent Children aged 3 months to 26 years.
  • Pre – medical examination is not required, only declaration.
  • Cash less facility available at Oriental Bank Mediclaim Policy network hospitals.
  • Pre – Existing diseases are covered after 3 complete policy years without break.
  • Tax Benefit: Income Tax benefit is available under 80D of the Income Tax act. For more information regarding Income Tax Benefits, visit www.taxqueries.in.
  • Portability: If you are insured under any other health insurance policy of Non life insurer you can transfer to Oriental Bank Mediclaim policy with all your accrued benefits after due allowances for waiting periods. Request for portability has to be made at least 45 days prior to renewal date.
  • Pre hospitalization expenses for 30 days before the Insured Person was Hospitalised.
  • Post hospitalization expenses for 60 days after the Insured Person was discharged.

Oriental Bank Mediclaim Policy Inclusions

Inclusions under Oriental Bank Mediclaim Policy are given in below table,

HOSPITALIZATION BENEFITS
BENEFIT Liability under the policy
Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home Not exceeding 1 % of the Sum Insured per day
Intensive Care(IC) Unit Expenses as provided by the Hospital /Nursing Home. Not exceeding 2% of the Sum Insured per day.
Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees As per the limits of the sum insured.
Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Material and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs & and similar expenses. As per the limits of the sum insured.
Ambulance services charges For the entire policy period Actual or 1% of the sum insured or Rs.1000/- whichever less
Hospital Cash Reimbursement of incidental expenses during the period of hospitalization of the proposer i.e. the OBC Account Holder only – actual subject to a maximum of Rs.1000 during the entire policy period.
Reimbursement of Funeral Expenses In the event of death of the insured person due to an insured peril covered under the scope of the policy, the company shall reimburse actual funeral expenses subject to maximum of Rs. 1000 during the policy period.
DOMICILIARY HOSPITALIZATION
Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines & Drugs, Diagnostic Material and Dialysis, Chemotherapy, Nursing expenses. 10% of Sum Insured, Maximum Rs.25000/- during policy period.

Oriental Bank Mediclaim Policy Exclusions

Exclusions under Oriental Bank Mediclaim Policy are,

  • Pre-existing diseases will be covered after waiting period of 4 years of continuous renewal of the policy.
  • Injuries caused by War, civil war, revolution, invasion, act of foreign enemies, Nuclear energy, radiation, etc.
  • Surgery for correction of eye sight, contact lenses, cost of spectacles, hearing aids etc.
  • Any dental treatment which is corrective, cosmetic, filling of cavity, root canal including wear and tear etc.
  • HIV or any related illness including AIDS and/or mutant derivatives or variations there of however caused.
  • Massages, Steam bathing, Shirodhara and similar treatments under Ayurvedic treatment.
  • Any treatment received in convalescent(recovering) hospital, convalescent home, health hydro, nature care clinic or similar establishments.
  • Treatment arising from pregnancy, miscarriage, childbirth, caesarean section, abortion or complications of any of these are excluded.
  • Abuse of intoxicant substance like drugs and alcohol is excluded.
  • Expenses incurred in treatment of obesity and any other weight control programme, services or supplies etc.

For complete information about Exclusions please refer Oriental Bank Mediclaim prospectus and Oriental Bank Mediclaim Brochure attached below.

Oriental Bank Mediclaim Policy Customer Care

Assistance: 

For any grievance or complaint,
please write to – Mr. Masood Wahab,
Chief Manager,
Customer Service Department, Oriental House, A-25/27,
Asaf Ali Road, New Delhi-110002.
Contact details :
For all query, guidance use Toll free number: 1800 11 8485 Or 011- 33208485 (Normal Charges Apply )
Email:
For complaints/grievance related to insurance policy or claims: csd@orientalinsurance.co.in
For complaints/grievance related to online insurance policy: portal.support@orientalinsurance.co.in

Oriental Bank Mediclaim Policy Buying Procedure

Documents and conditions required to buy Oriental Bank Mediclaim Policy are,

  1. Proposal form to be filled in block letters.
  2. Submit two stamp size photographs of each insured person along with two copies of proposal form.
  3. Name and age of the insured must be written on the back of the photo.
  4. Family to include the proposer i.e., account holder/employee of the Oriental Bank of Commerce (OBC). His/Her spouse and two dependent children aged 3 completed months onwards up to 79 years as under:
    • Female child until she is married. Immediately consequent upon her marriage she shall be ceased to be covered under the policy and no claim shall be admissible.
    • Male child up to the age of 26 years if he is abonafide regular student and fully dependent on proposer i.e., the OBC account holder.

Oriental Bank Mediclaim Premium Payment:

  • Premium payable under this policy shall be paid in advance.
  • No receipt for premium shall be valid except on the official form of the Company signed by a duly authorized official of the company.

Oriental Bank Mediclaim Policy Claim Procedure

Intimation:

  • Notice of claim should be given to the Company / TPA by Fax, Email with particulars relating to Policy Number, ID Card No., Name, Nature of disease etc.
  • Notice should be given to the company within 48 hours of admission or before discharge from Hospital unless waived in writing.

Claim Procedure to avail Cashless service:

  1. Claim in respect of Cashless Access Services will be through the TPA provided admission is in a listed networked hospital and is subject to pre admission authorization.
  2. Upon getting the related medical details / relevant information from the insured person / Oriental Bank Mediclaim network Hospital, TPA shall verify that the person is eligible to claim under the Oriental Bank Mediclaim policy.
  3. After satisfying itself will issue a pre‐authorisation letter to the Hospital mentioning the sum guaranteed as payable, also the ailment for which the person is seeking to be admitted as in‐patient.
  4. The TPA may deny pre‐authorisation in case the hospital / insured person is unable to provide the relevant information or medical details as required by the TPA.
  5. In such circumstances the insured person may obtain the treatment and later on submit the full claim papers to the TPA for reimbursement within 7 days of the discharge from Hospital.
  6. Should any information be available to the TPA which makes the claim doubtful requiring investigations, the authorisation of cashless facility may be withdrawn.

Documents to be submitted during claim:

List of documents as listed below should be submitted to the Company / TPA within 7 days of discharge from the Hospital / Nursing Home.

  • Original bills, receipts and discharge certificate / card from the hospital.
  • Medical history of the patient recorded by the Hospital.
  • Original Cash-memo from the hospital (s) / chemist (s) supported by proper prescription.
  • Original receipt, pathological and other test reports from a pathologist / radiologist including film etc supported by the note from attending medical practitioner / surgeon demanding such tests.
  • Attending Consultants / Anaesthetists / Specialist certificates regarding diagnosis and bill / receipts etc.
  • Surgeon’s original certificate stating diagnosis and nature of operation performed along with bills / receipts etc.
  • Any other information required by TPA / Insurance Company.
  • All documents must be duly attested by the insured person.

Oriental Bank Mediclaim Premium Calculator

You can calculate the premium using Oriental Bank Mediclaim premium calculator. Personal details, Policy period, Number of members, Age and Sum assured and other details are required to calculate the premium.

Oriental Bank Mediclaim Premium Rates

Oriental Bank Mediclaim Premium Table Inclusive of service tax is as under,

Sum Insured

Premium(Including S. Tax)

Rs. 1 Lakh

Rs. 1749

Rs. 2 Lakhs

Rs. 3320

Rs. 3 Lakhs

Rs. 4620

Rs. 4 Lakhs

Rs. 5780

Rs. 5 Lakhs

Rs. 6830

Oriental Bank Mediclaim Policy FAQ’s

Give me information about cancellation of the policy?

  • Company may cancel the policy at any time, by sending the Insured 30 days notice by registered letter at the Insured’s last known address and in such an event the Company shall refund to the Insured a pro‐rata premium for un‐expired Period of Insurance.
  • Insured may cancel this policy at any time and in such event the Company shall allow refund of premium at Company’s short period rate only (table given here below ) provided no claim has occurred during the policy period up to date of cancellation.
Period on Risk Rate of premium to be charged
Upto 1 Month 1/4th of the annual rate
Upto 3 Months 1/2 of the annual rate
Upto 6 Months 3/4th of the annual rate
Exceeding 6 months Full annual rate

Can I get Ambulance Services?

The ambulance service charges are payable only if the hospitalization expenses are admissible. Further the ambulance service charges are admissible only if such expenses are paid to registered ambulance services providers.

What is meant by Domiciliary Hospitalization benefit?

“Domiciliary hospitalisation” means medical treatment for an illness/ disease which in the normal course would require treatment at a hospital but is actually taken while confined at home under any of the following situations:

  • The condition o f the patient is such that he/she is not in a condition to be removed to a hospital, or
  • The patient takes treatment at home on account of non availability of room in a hospital.

What is meant by TPA (Third Party Administrator)?

TPA means any Company who has obtained licence from IRDA to practice as a third-party administrator and is appointed by the Company.

Oriental Bank Mediclaim Forms and Documents

Oriental Bank Mediclaim Policy Guidelines

Oriental Bank Mediclaim Proposal Form

Oriental Bank Mediclaim Prospectus

About Oriental Gramin Personal Accident Insurance

About Oriental Group Mediclaim Policy

About Oriental Janata Personal Accident Policy

About Oriental Nagrik Suraksha Policy

About PNB – Oriental Royal Mediclaim Policy

About Oriental Individual Mediclaim Policy

About Happy family floater policy

 

Filed Under: General Insurance, Oriental Insurance

Comments

  1. Vijayanand says

    May 21, 2015 at 12:58 pm

    Need the list of network hospitals for the OBC family floater policy.

    Thanks,
    Vijay
    08800398113

    Reply
  2. GOURAB NAMTIRTHA says

    June 22, 2015 at 5:11 pm

    Need the list of network hospitals for the OBC family floater policy

    Reply
  3. R.MUNIRAJ says

    August 13, 2015 at 10:23 am

    Need the list of network hospitals for the OBC family floater policy

    Reply
  4. satya srinivas biyyapu says

    August 27, 2015 at 10:17 am

    Dear Sir,
    Can you pl.send me the list of network hospitals in Telanagana state which are covered by this policy.
    Regards
    Satya Srinivas B

    Reply
  5. panna chakraborti says

    August 30, 2015 at 2:19 pm

    pls tell us the name of hospitals & nursing home

    Reply
  6. HARVINDER SINGH says

    September 10, 2015 at 10:50 am

    Plz provide the List of Hospitals in Ludhiana

    Reply
  7. Vinod says

    October 5, 2015 at 12:53 pm

    Plz provide network hospitals in bangalore

    Reply
  8. babu says

    October 6, 2015 at 1:30 pm

    i need the list of network hospitals covered under this insurance in bangalore

    Reply
  9. Narender Kumart says

    October 31, 2015 at 9:40 am

    Can you please .send me the list of network hospitals in Punjab state which are covered by this policy.
    & also I want to know TPA name:

    I am a account holder of OBC Bank.

    Reply
  10. Bikramjit Singh says

    November 16, 2015 at 3:02 am

    please give details of hospital list in punjab

    Reply
  11. DHARMENDER SACHDEVA says

    November 29, 2015 at 1:04 pm

    I WANT TO PRINTOUT MY MEDICAL POLICY FOR INCOME TAX

    Reply
  12. surampudi venkata rama prasad says

    December 8, 2015 at 6:37 am

    sir, Please send the list of network hospitals in andhra pradesh

    Reply
  13. LATHA N.K says

    January 5, 2016 at 5:35 am

    PLEASE SEND THE NAME OF THE HOSPITALS IN MANGALORE. I RECEIVED THE POLICY 2 MOTHS BEFORE, DR, TOLDME ONE SMALL SURGERY. REGARDING THAT PLEASE GUIDE ME

    Reply
  14. Rohan shah says

    February 6, 2016 at 4:03 pm

    When will the risk start to cover?suppose I will pay a premium for mediclaim to oriental bank mediclaim the risk will be covered by company from starting first day of a premium?

    Reply
  15. J. sorout says

    February 27, 2016 at 4:26 pm

    Pl. Send hospital list asap.

    Regards

    Reply
  16. IShant says

    March 1, 2016 at 5:11 am

    Need list of.hospitals in.OBC bank policy.

    Reply
  17. jeewan aggarwal says

    March 21, 2016 at 5:29 pm

    pls send the list of your network hospitals….

    Reply
  18. Harvinder Singh says

    March 23, 2016 at 5:03 am

    Treatment for any type of disease

    Reply
  19. Laxman singh says

    April 6, 2016 at 2:05 pm

    I want to know Cass less hospital list of obc medicalam in up and NCR

    Reply
  20. E.T.Vivek King says

    August 22, 2016 at 5:35 am

    Dear Sir,
    Can you pl.send me the list of network hospitals in Telanagana state which are covered by this policy.
    Regards
    E.T.Vivek King
    9989695235

    Reply
  21. Suraj dagar says

    November 6, 2016 at 9:57 pm

    Obc medicare sbse third class or bakwas…insurence walo ne pyse nhi diye hospital ne 1.30 lakh bill bnaya or hme hi bhugatna pd rha h sbse bkwaas insurence h obc vaalo ka jo bukhar m bh nh chalaya unhone..mere father ko bukhar h or humne unhe guru nanak hospital palwal me admit kiya vahan k dr. Sirf bill bnane pe dhyaan de rhe the aaj 9 din ho gye unse bukhar bh nhi utra or jyda hi bimar laaye h papa ko ghar qki insurence vaalo ne pyse nhi diye..

    Reply
  22. ravindra gayake says

    November 7, 2016 at 10:57 am

    pls send list of hospital which is in network in Maharashtra

    Reply
  23. ravindra gayake says

    November 7, 2016 at 11:00 am

    pls name of hospital & Nursing home at maharashtra

    Reply
  24. Dharmesh Patel says

    January 10, 2017 at 4:18 am

    Dear Sir,
    Renewal Police with In cress Sum Assurance Amount Procedure for Sr. Citizen
    Plz suggest Procedure
    Thanking You

    Reply
  25. Jitendra Kumar Sethia says

    November 29, 2017 at 10:15 am

    Two separate policies of Rs. 5 lacs each can be purchased by the same person against his two separate OBC Accounts

    Reply

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