Health Insurance Oriental Health Insurance Super Health Top-Up
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Oriental Super Health Top-Up Policy
The Oriental Super Health Top-Up plan is a specialised health insurance program that is necessary for unforeseen medical emergencies or illnesses to provide oneself with speedy access to top-notch healthcare and hospitalisation facilities. Therefore, the plan can offer extra security for any financial instability brought on by medical problems. An Oriental Super Health Top-up plan from Oriental company can be purchased to cover all medical and hospitalisation costs as well as maternity benefits.
The repayment of covered expenses up to predetermined limitations and/or set sums upon the occurrence of an insured event serves as the foundation for payment under this policy. If you are insured by this plan, you can benefit from lifetime renewability. Read on to know more about the Oriental Super Health Top Up’s eligibility criteria, coverage information, features & benefits, exclusions, premium illustration, renewal process, claim procedure, and more.
Eligibility Criteria
Here are the eligibility criteria for the Oriental Super Top-Up plan.
Parameters | Details |
Age | Minimum- 18 Years Maximum- 65 Years |
Sum Insured | Rs.3 lakhs to Rs. 30 lakhs |
Deductibles | Rs.3 lakhs to Rs. 20 lakhs |
Policy Term | 1 Year |
Coverage Details
Here are the coverage details for the Oriental Super Top-Up plan.
Parameters | Details |
Family Discount | of 10% is available if more than one person is covered under the policy |
Loyalty Discount | of 10% in premium is available for the persons who are also covered under a base health insurance policy |
Staff Discount | of 33% on the premium is available to the employees (serving or retired) |
Portal Discount | 10% discount on premium, subject to a maximum of Rs.2000 |
Pre and Post Hospitalization | 30 days before hospitalization-related Medical Expenses incurred within 60 days from the date of Discharge. |
Maternity coverage | up to 10% of the Sum Insured. |
New Born Baby | Up to 5% of the Sum Insured |
Major Benefits of Considering the Oriental Super Health Top-Up Insurance Plan
The following are the key features and benefits of choosing the Oriental Super Health Top-Up Insurance Plan.
- Organ Donor Expenses- When Insured Person Is the Recipient: If the donation complies with the Transplantation of Human Organs Act of 1994, the policy will pay for the inpatient hospitalisation costs of the individual giving the insured person’s organ.
- Maternity Expenses: According to the policy, maternity costs are automatically covered by up to 10% of the Sum Insured. For a maximum of two deliveries or terminations of pregnancy (or either) throughout the policy year, the Company will reimburse the Medical Expenses incurred as an inpatient for either a delivery (including a caesarean section) or a legal medical termination of pregnancy.
- New Born Baby Cover: This benefit is only accessible if the insured person and his or her spouse are both covered by the family floater plan or individual plan of the Policy, as applicable. Up to 90 days after the baby’s birth, the insurance automatically covers the newborn up to 5% of the Sum Insured. Only after paying the required additional premium is coverage for periods longer than 90 days available for the entire Sum Insured.
- Telemedicine: Costs associated with the diagnosis and treatment of a sickness or ailment covered by the policy using telemedicine or teleconsultation with a licensed physician.
- Coverage To SAARC Countries: The policy automatically extends coverage to insured individuals travelling to SAARC nations, including Afghanistan, Bangladesh, Bhutan, the Maldives, Nepal, Pakistan, and Sri Lanka. However, for treatment received outside of India, Cashless service will not be offered, and such claims would only be taken into account on a reimbursement basis upon the insured person’s return to India.
- Family Discount: If more than one person is covered by the policy with separate Sums Insured per person (i.e. in respect of an Individual plan), the policy provides a discount of up to 10%.
- Loyalty Discount: The policy offers 10% off the premium that is given to those who are already insured by an Oriental basic health insurance policy at the time of purchase (retail or bancassurance only). This base health insurance plan from Oriental must still be in effect at the time of renewal to qualify for this discount. Even with a Family Floater Plan, the loyalty discount would only apply to the individual(s) who already have such a policy with Oriental and not to the entire insurance premium.
- Staff Discount: A discount of 33% on premiums is provided to all current and former employees of Oriental Insurance Company Ltd. However, where the Staff discount is used, no commission and no additional discounts (apart from the Portal discount, if applicable) are permitted.
- Portal Discount: If the Policy is purchased online via our Portal and there is no involvement of a middleman, a 10% premium discount is offered, up to a maximum of Rs. 2000. This discount is only available the first time this policy is purchased; renewals are not eligible.
- Free Look Period: The free look period shall only apply to new individual health insurance plans; it shall not apply to renewals or when a policy is ported or moved. From the date of receipt of the policy document, the insured has fifteen days to evaluate the terms and conditions and return the document if they are not acceptable.
- Grace Period: If the policy renewal is delayed, a grace period of 30 days is permitted. But during the grace period, there won’t be any coverage.
What’s Not Covered Under the Oriental Super Health Top-Up Plan?
The Company shall have no obligation to pay under this insurance for any expense of any kind incurred by any Insured Person in connection with or in respect of:
Pre-Existing Diseases:
- Before the expiration of 48 months of continuous coverage following the date of the initial policy’s inception with the insurer or the policy’s reinstatement, costs associated with the treatment of a pre-existing disease (PED) and its immediate complications shall be excluded.
- If the amount insured is increased, the exclusion will once again apply to the new amount insured.
- The waiting period for the same would be shortened to the extent of the prior coverage if the insured individual maintains continuous coverage without a break as indicated by the portability standards of the current IRDAI (Health Insurance) Regulations.
- Any pre-existing condition must be disclosed at the time of application, approved by the insurer, or reinstated for it to be covered under the policy after the first 48 months have passed.
Specified Disease/Procedure Waiting Period:
- Until the end of the required waiting time of the continuous coverage from the date of the beginning of the first policy with the company, expenses associated with the treatment of the mentioned conditions; surgeries/treatments shall be excluded. Claims resulting from accidents are not subject to this restriction.
- If the amount insured is increased, the exclusion will once again apply to the new amount insured.
- The lengthier of the two waiting periods will be used if any of the indicated diseases or procedures fall under the pre-Existing disease waiting period.
- Even if the mentioned circumstances are contracted after the policy is issued, or if they are stated and accepted without a particular exclusion, the waiting period will still apply.
Premium Illustration Of Oriental Super Health Top-Up Insurance Plan
Let’s use Mr. Anup Singh Thakur as an example. He is a young professional from New Delhi who works for a software firm. A specialised top-up health plan that would shield him against a variety of medical situations was what he was trying to purchase. Additionally, because he is the only provider for the family and medical expenses are on the rise, he does not want to take any chances. After doing a lot of research, he ultimately opted for the Oriental Super Health Top-Up Insurance Policy.
Age | Plan Type | Deductible | Sum Insured | Do you wish to opt for TPA services? | Suffering from Pre-existing disease? | Premium Amount |
30 Years | Individual Plan | Rs. 10, 00, 000 | Rs. 10, 00, 000 | No | No | Rs. 1525 (Including GST) |
30 Years | Individual Plan | Rs. 15, 00, 000 | Rs. 15, 00, 000 | No | No | Rs. 2132 (Including GST) |
How to Buy the Oriental Super Health Top-Up Insurance Plan?
The top-up plan enables you to cover your medical costs even after your base health insurance policy’s maximum insured amount has been reached. Most experts agree that a top-up plan is a wise complement to preexisting health insurance. With a top-up plan, you can easily obtain comprehensive coverage for your medical institution. If you are interested in buying a top-up plan like Oriental Super Health Top-up Insurance Plan, then listed below are the steps you need to follow.
- Visit the official website of Oriental Insurance.
- The “Buy Online” button is displayed in an orange banner at the top. Put the mouse over it to reveal “Super Health Top-Up Policy” under “Health Policies.” Just click it.
- As soon as you click on it, blanks will appear where you must enter your birthdate, choose your plan type, gender, policy start date, sum insured, add a nominee, their name, and state, and upload a photo of them (only JPG, JPEG, and PNG files are supported).
- Once you have successfully provided all the necessary information, you may need to scroll down a little bit and click “Calculate Premium” after selecting the “yes” button.
- The premium information and potential premium payment amount will then be displayed. After that, a little farther down, click the “Continue” option.
- You then need to finish your KYC. Enter your email address and complete the form with your information as well as the information for your nomination, including your occupation, address, state, city, and pin code. Make sure you accurately fill out all the fields. Once you have verified all the information, select “Agree” in the declaration area. Next, select “Continue” from the menu.
- When you click it, a payment page will open where you may complete the transaction using your credit/debit card, Net Banking, EMI, or UPI.
- Choose your preferred option. Next, click “Proceed to Pay”. The last step is to send you a message and the policy documents through email and your registered mobile number.
How to File a Claim for Oriental Super Health Top-Up Insurance Plan?
For any policyholder, receiving payment for a claim is probably the most crucial component of insurance. After all, if the worst occurs, a person who has paid a premium should anticipate that a claim will be honoured to make things right.
- Inform TPA in writing as soon as you become aware of any illness or injury, no later than 48 hours before hospitalisation.
- In case of hospitalisation due to a medical emergency, notify within twenty-four hours of the time of admission.
- Within seven days of the hospital discharge date, provide the following supporting documentation to the third-party administrator (TPA) for the claim.
- A hospital discharge card or certificate, as well as a bill and receipt.
- Cash Memos from the hospitals or pharmacies, accompanied by valid prescriptions.
- A receipt and the pathologist’s test results are backed up by a note from the attending physician or surgeon, such as abnormal exams or pathological recommendations.
- A surgeon’s certificate outlining the procedure’s nature, together with the surgeon’s invoice and receipt.
- The invoice and receipt from the attending doctor, the consultant, the specialist, and the anaesthetist, as well as the certificate of diagnosis.
- Within seven days following the conclusion of any post-hospitalization therapy (limited to sixty days), submit all claim documentation.
- Give TPA permission to request medical records and other records from any hospital, laboratory, or other institution.
The insured person must provide any original invoices, receipts, and other supporting documentation to the TPA, along with any other information and assistance that the TPA or the company may need.
Any physician authorised by the TPA or the company may examine the insured person at their expense if they determine that it is medically necessary for connection with any claim.
Renew Oriental Super Health Top-Up Insurance Policy By Following These Steps
You can guarantee tax savings on your premium amount by timely renewing your policy. A greater premium is to be avoided by renewing your health insurance coverage before it expires. A new health insurance premium may be higher if your current coverage expires. If you want to renew your Oriental Super Health Top-Up Insurance Plan, then listed below are the steps you will need to follow.
- Visit the official website of Oriental Insurance.
- The banner’s “Renew” section is at the top. Simply click it.
- A new page will then open where you must input your policy number. Ensure that you type it in correctly. Choose “Renew Now” from the selection next.
- The insurance renewal premium will then need to be paid. At that moment, you can use a credit or debit card to renew your insurance.
- Your registered phone number and email address will receive a message with information about your insurance when you make the payment.
Frequently Asked Questions
Yes, the super top-up policy includes coverage for mental illness. Everyone is asked to read over the terms and conditions under which the coverage is offered, nevertheless. This plan does not cover mental illnesses brought on by drug or alcohol addiction, retardation, or illnesses that call for counselling or therapy.
Yes, the policy qualifies for an income tax exemption under the IT Act’s current regulations.
Anyone with a negative medical history or who is above 55 must undergo a pre-acceptance medical examination before purchasing Oriental Health Insurance.
The policy has a one-year base term and is completely renewable for further terms.
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