Oriental Insurance Happy Family Floater Policy

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:	Minimum: 3 Months Maximum: 70 Years
Policy Term:	1 Year
Sum Assured for Silver plan:	Minimum: 1 Lakh Maximum: 5 Lakhs
Sum Assured for Gold plan:	Minimum: 6 Lakhs Maximum: 10 Lakhs
Oriental Insurance Happy Family Floater Online Renewal:	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 for persons up to the age of 60 years.

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,

1. Proposal form and Self declaration form is to be filled in block letters and in duplicate.
2. Attach two stamp size photographs of each insured person on the Enrolment form.
3. 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.
4. 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

About Oriental Gramin Personal Accident Insurance

About Oriental Group Mediclaim Policy

About Oriental Janata Personal Accident Policy

About Oriental Nagrik Suraksha Policy

About Oriental Bank Mediclaim Policy

About PNB – Oriental Royal Mediclaim Policy

About Oriental Individual Mediclaim Policy