Oriental Happy Family Floater Policy

Apart from the above benefits and facilities, this plan has come up with a bunch of special advantages that have made the plan unique and popular among consumers. Those mentions are as follows.

New Born Baby cover:

This is subject to the claim being admitted under Maternity Expenses cover. This benefit is only available with the Diamond and Platinum Plans. Medical expenses incurred on treatment taken in the Hospital as an In-patient in respect of the newborn baby from day one up to the age of 90days are covered. Liability of the Company is limited to 2.5% of the Sum Insured. Coverage beyond 90 days can be availed of only on payment of the requisite premium.

Assisted Reproduction Treatment (ART):

For the scope of this policy, ART will be covering any treatment or procedure that involves the in-vitro handling of human oocytes and sperm or embryos for the purpose of establishing a pregnancy. A waiting period of 36 months is applicable, and the maximum liability of the Company for such treatment shall be limited to Rs. lakhs. This benefit is only available with the Platinum Plan.

Restoration of Sum Insured:

It is an optional benefit that can be availed of on payment of an extra premium. This benefit is available only with the Silver and Gold Plans. You will get two options – (I) 50% of the Sum Insured, and (ii) 100% of the Sum Insured.

Air Ambulance Cover:

This benefit is available only with the Platinum Plan. This cover is available only for life-threatening medical emergency condition/s which require immediate and rapid ambulance transportation to the hospital/medical center that ground transportation cannot provide. The cover will be available in case of the following ailments – Cardio – Vascular diseases, Central nervous system-related cases, and Accidental Trauma Cases. The maximum limit is up to 5% of the policy sum insured.

Accidental Death Benefit and Total Permanent Disability cover:

If an insured person suffers an Accident during the policy period and this is the sole and direct cause of his death, or total permanent disability within 365 days from the date of the accident, then the policy will pay a fixed amount of 10% of the base sum insured. This benefit is only applicable to the Platinum Plan.

Additional Sum Insured for critical illnesses:

If an insured person suffers from any critical illness during the policy period and the selected basic sum insured is exhausted in the treatment of that critical illness, then the basic sum insured will be increased by 10%, only for the treatment of the critical illness. This facility is only available with the Platinum Plan.

Telemedicine:

Expenses incurred by an insured on telemedicine/Teleconsultation with a registered medical practitioner for Diagnosis & treatment of a disease/illness are covered under the Policy. The limit amount payable for telemedicine is a maximum of Rs. 2,000 per family, for a policy period.

Waiver of proportionate deduction clause:

By paying an additional premium, the proportionate deductions related to the room rent category will be waived as under:

• For Silver Plan, the room rent limit can be enhanced by a maximum of 50% on payment of an additional premium.
• For the Gold, Diamond, and Platinum Plans the room rent limit can be enhanced by 50%, or 100%, as selected by the insured.

Life hardship survival benefit:

If during the Policy Period, any Insured Person is

diagnosed with any of the 11 critical Illnesses defined here under and which results in the admissibility of a claim under the Policy, then a survival benefit as mentioned below will be payable to the Insured Person.