Oriental Insurance Happy Family Floater Introduction
Oriental Insurance Happy Family Floater is a Health Insurance Policy which was introduced by Oriental Insurance Company. Oriental Insurance Happy Family Floater Health Policy covers medical expenses incurred by the entire family under a single sum assured. Family includes Self, Spouse, Children, Parents and Parents in-laws. Oriental Insurance Happy Family Floater Health Policy is available in two plans – Silver plan and Gold plan. Medical expenses incurred due to any illness/ injury/ accident that require hospitalization are covered under this Oriental Insurance Happy Family Floater Health Policy.
Oriental Insurance Happy Family Floater Eligibility Conditions
| Entry Age: |
|
| Policy Term: |
|
| Sum Assured for Silver plan: |
|
| Sum Assured for Gold plan: |
|
| Oriental Insurance Happy Family Floater Online Renewal: |
|
| Pre-medical check up: |
|
Oriental Insurance Happy Family Floater Key Features
- Covers the proposer and his/her family under single sum insured under one policy.
- Sum insured floats over all the beneficiaries under Oriental Insurance Happy Family Floater Health Policy policy.
- Available in two plans Silver plan and Gold plan.
- SILVER Plan is subject to 10% Co-payment.
- GOLD Plan offers an inbuilt cover, daily cash allowance and attendant allowance up to specific limits.
- Oriental Insurance Happy Family Floater Policy covers the hospitalization expenses for the covered diseases or accident up to limits specified.
- Personal Accident cover is offered as Add On Cover under both the covers (Gold and Silver).
- In addition GOLD cover offers add-on cover of life hardship survival benefit.
- Option of TPA ( Third Party Administrator) and non TPA services.
- Discount in premium if TPA services not opted.
- Discount in OMP (Overseas Mediclaim Policy) premium when family floater policy is taken.
- You can avail Tax Benefit under Section 80-D of the Income Tax Act. For more information regarding Income Tax Benefits, visit www.taxqueries.in.
- Ambulance charges:
- Rs.1000 or 1% of Sum Insured in Silver
- Rs.2000 or 1% of Sum Insured in Gold
Oriental Insurance Happy Family Floater Inclusions
- The following reasonable and necessary expenses are covered under Oriental Insurance Happy Family Floater Policy for various benefits:
| A. | HOSPITALIZATION BENEFITS | ||
|---|---|---|---|
| BENEFIT | SILVER PLAN (Limit of Reimbursement) |
GOLD PLAN (Limit of Reimbursement) |
|
| a. | Room, boarding and Nursing Expenses as provided by the Hospital/Nursing Home. | Not exceeding 1% of the Sum Insured per day | Not exceeding 1% of the Sum Insured per day. |
| b. | Intensive Care(IC) Unit Expenses as provided by the Hospital/Nursing Home. | Not exceeding 2% of the Sum Insured per day | Not exceeding 2% of the Sum Insured per day. |
| No of days of stay under a and b above should not exceed total number of days of admission in the hospital. | |||
| c. | Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees | As per the limits of the sum insured | As per the limits of the sum insured. |
| d. | Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines and Drugs, Diagnostic Material and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial limbs & similar expenses | As per the limits of the sum insured | As per the limits of the sum insured. |
| e. | Ambulane Services charges | Rs.1000/- per illness and limited to maximum 1% of the sum insured or Rs.3000/- whichever is less,for the entire policy period. | Rs.2000/- per illness and limited to maximum 1% of the sum insured or Rs.6000/- whichever is less,for the entire policy period. |
| f. | Daily Hospital Cash Allowance | NIL. | 0.1% of sum insured per day per illness per illness subject to a maximum compensation for 10 days per illness.The overall liability of the Company during the policy period will be limited to 1.5% of the sum insured |
| g. | Attendant allowance | NIL. | Rs.500/- per day of hospitalization per illness and up to 10 days per illness.The overall liability of the Company during the policy period will be limited to compensation for 15 days of hospitalization. |
| B. | DOMICILIARY HOSPITALIZATION | ||
| a. | Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines & Drugs, Diagnostic Material and Dialysis, Chaemotherapy, Nusing 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 rapid animal like monkey,cat etc.) | Reasonable expenses limited up to Rs.5000/- actually incurred for immunisation injections in any one policy | Reasonable expenses limited up to Rs.5000/- actually incurred for immunisation injections in any one policy. |
| NOTE: FOR THE PURPOSE OF THIS SECTION THE PRE_REQUISITE CONDITIONS FOR DOMICILIARY HOSPITALIZATION CLAIM SHALL NOT APPLY | |||
- Add On Covers: Add On Covers are optional, subject to extra premium.
| ITEM | SILVER PLAN | GOLD PLAN | |
|---|---|---|---|
| a. | Personal Accident as defined hereinafter | Sum insured in multiples of Rs.100,000/- and up to Rs.500,000/- per person aged 18 years and above.50% of this limit for persons less than 18 years. | Sum insured in multiples of Rs.200,000/- and up to Rs.10,00,000/- per person aged 18 years and above.50% of this limit for persons less than 18 years. |
| b. | Life Leader Ship Survival Benefit as defined hereinafter | NIL. | Plans Of benefit AS DEFINED HEREINAFTER |
Personal Accident Cover (World Wide):
| Benefit Covered | Description | Amount Payable |
|---|---|---|
| 1. | Accidental Death only | 100% of CSI (capital sum insured) |
| 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 |
Life Leader Ship Survival Benefit:
Diseases covered:
- Cancer-metastasis(Stage-IV)
- End Stage Renal Disease(ESRD)
- Stroke leading to paralysis or paraplegia
| Plan | Total amount Payable | Amount payable on survival for 180 days and above from the date of discharge from the hospital | Amount payable on survival for 270 days and above from the date of discharge from the hospital |
|---|---|---|---|
| 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 |
Oriental Insurance Happy Family Floater Exclusions
Exclusions under Oriental Insurance Happy Family Floater Plan are,
- Pre-existing diseases will be covered after waiting period of 4 years of continuous renewal of the policy.
- Initial waiting period of 30 days within which no claim will be admitted except accidental injuries.
- Death/disablement/injury of the insured from,
- Intentional self-injury.
- Suicide or attempted suicide.
- Abuse of intoxicant substance like drugs and alcohol is excluded.
- Directly / indirectly caused by insanity.
- Arising from the insured committing any breach of law with criminal intent etc.
Oriental Insurance Happy Family Floater 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 Insurance Happy Family Floater Buying Procedure
Documents and conditions required to buy Oriental Insurance Happy Family Floater Health Policy are,
- Proposal form and Self declaration form is to be filled in block letters and in duplicate.
- Attach two stamp size photographs of each insured person on the Enrolment form.
- The company will not be on risk until the proposal has been accepted by the company and communication of the acceptance has been given to the proposer in writing on receiving full payment of premium.
- The proposer aged above 45 years of age has to undergo pre health check up through company’s authorised diagnostic centre and cost of such expenses to be borne by him/her.
Oriental Insurance Happy Family Floater Claim Procedure
- Notice of claim should be given to the Company by Fax, Email with particulars relating to Policy Number, ID Card No., Name, Nature of disease etc.
- Claim form along with the medical certificate has to be submitted.
- In case of death claim, following documents should be submitted.
- A death certificate
- Original policy.
- Post Mortem Report.
- Legal heir certificate.
- FIR (First Information Report).
- Police Panchnama.
Oriental Insurance Happy Family Floater Premium Calculator
You can calculate the premium using Oriental Insurance Happy Family Floater premium calculator. Personal details, Policy period, Number of members, Age and Sum assured and other details are required to calculate the premium.
Oriental Insurance Happy Family Floater Premium Rates
Oriental Insurance Happy Family Floater SILVER Plan:
| A. Primary Member Premium | |||||
|---|---|---|---|---|---|
| Sum Insured | Age in Years | ||||
| 21-35 | 36-45 | 46-55 | 56-60 | 61-65 | |
| 100000 | 1320 | 1580 | 2470 | 3520 | 5240 |
| 150000 | 1940 | 2320 | 3640 | 5180 | 7750 |
| 200000 | 2490 | 2980 | 4720 | 6750 | 10110 |
| 250000 | 2980 | 3570 | 5720 | 8210 | 12330 |
| 300000 | 3480 | 4160 | 6730 | 9670 | 14560 |
| 350000 | 3910 | 4670 | 7640 | 11030 | 16640 |
| 400000 | 4340 | 5180 | 8560 | 12380 | 18730 |
| 450000 | 4770 | 5700 | 9480 | 13740 | 20820 |
| 500000 | 5200 | 6210 | 10400 | 15090 | 22900 |
The Entry age limit of the proposer is maximum 55 years
However, continuous renewals will be accepted till the proposer is 65 years old.
| B. Family Member Premium(Per Person) | ||||||||
|---|---|---|---|---|---|---|---|---|
| Sum Insured | Domiciliary Hos limit | Age Band | ||||||
| 3m-20 | 21-35 | 36-45 | 46-55 | 56-60 | 61-70 | above 70 | ||
| 100000 | 10000 | 240 | 260 | 320 | 490 | 700 | 1310 | 1760 |
| 150000 | 15000 | 350 | 390 | 460 | 730 | 1040 | 1940 | 2630 |
| 200000 | 20000 | 450 | 500 | 600 | 940 | 1350 | 2530 | 3450 |
| 250000 | 25000 | 540 | 600 | 710 | 1140 | 1640 | 3080 | 4230 |
| 300000 | 25000 | 630 | 700 | 830 | 1350 | 1930 | 3640 | 5020 |
| 350000 | 25000 | 700 | 780 | 930 | 1530 | 2210 | 4160 | 5750 |
| 400000 | 25000 | 780 | 870 | 1040 | 1710 | 2480 | 4680 | 6490 |
| 450000 | 25000 | 860 | 950 | 1140 | 1900 | 2750 | 5200 | 7230 |
| 500000 | 25000 | 940 | 1040 | 1240 | 2080 | 3020 | 5730 | 7970 |
| C. Personal Accident | |||||
|---|---|---|---|---|---|
| Sum Insured |
100000 | 200000 | 300000 | 400000 | 500000 |
| Premium Per Person | 60 | 120 | 180 | 240 | 300 |
Total premium will be the sum of A and B above. If add-on cover is taken, premium under C is also to be added.
Oriental Insurance Happy Family Floater GOLD PLAN(without add-on covers):
| I. Primary Member Premium | |||||
|---|---|---|---|---|---|
| Sum Insured | Age in Years | ||||
| 21-35 | 36-45 | 46-55 | 56-60 | 61-65 | |
| 600000 | 7140 | 8520 | 14210 | 20600 | 31220 |
| 700000 | 8320 | 9930 | 16570 | 24020 | 36410 |
| 800000 | 9500 | 11340 | 18920 | 27440 | 41600 |
| 900000 | 10670 | 12750 | 21280 | 30860 | 46790 |
| 1000000 | 11850 | 14150 | 23640 | 34280 | 51980 |
| II. Family Member Premium(Per Person) | ||||||||
|---|---|---|---|---|---|---|---|---|
| Sum Insured | Domiciliary Hos limit | Age Band | ||||||
| 3m-20 | 21-35 | 36-45 | 46-55 | 56-60 | 61-70 | above 70 | ||
| 600000 | 50000 | 1290 | 1430 | 1700 | 2840 | 4120 | 7800 | 10860 |
| 700000 | 50000 | 1500 | 1660 | 1990 | 3310 | 4800 | 9100 | 12660 |
| 800000 | 50000 | 1710 | 1900 | 2270 | 3780 | |||
| 900000 | 50000 | 1920 | 2130 | 2550 | 4260 | 6170 | 11700 | 16280 |
| III. Personal Accident | |||||
|---|---|---|---|---|---|
| Sum Insured | 200000 | 400000 | 600000 | 800000 | 1000000 |
| Premium Per Person | 120 | 240 | 360 | 480 | 600 |
For Oriental Insurance Happy Family Floater GOLD PLAN(with add-on covers) Premium rates please refer Oriental Insurance Happy Family Floater Prospectus or Oriental Insurance Happy Family Floater Brochure and Oriental Insurance Happy Family Floater Policy Wording pdf attached below.
Oriental Insurance Happy Family Floater FAQ’s
Can I know indetail about Daily Hospital Cash Allowance?
When an insured of the family is hospitalized and a claim is admitted under the Oriental Insurance Happy Family Floater GOLD plan, then a Daily cash allowance is payable to the insured person.
What is Attendant Allowance?
When an insured of the family aged between three months to 10 years is hospitalized and a claim is admitted under the Oriental Insurance Happy Family Floater GOLD plan, then Attendant Allowance will become payable.
When will the Migration be permitted?
Migration is permitted only if the current policy is an individual mediclaim policy or the Insured is covered under a Group Mediclaim Policy and is valid as on the date of migration. And it is permitted only at the time of renewal of the existing individual mediclaim policy/Group Mediclaim Policy with the Company.
Oriental Insurance Happy Family Floater Forms and Documents
Oriental Insurance Happy Family Floater Claim form
Oriental Insurance Happy Family Floater Proposal Form
Oriental Insurance Happy Family Floater Prospectus