Oriental Arogya Sanjeevani Policy

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      Oriental Arogya Sanjeevani Policy

      Oriental Arogya Sanjeevani is a simple insurance policy that is provided as per the IRDAI guidelines. Being a standard health insurance product the premium is affordable and the features and benefits are also regularized across the industry.

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      Oriental Arogya Sanjeevani policy is available to everyone up to the age of 65 years.  The sum insured options are wide as they go up to Rs 20 lakh. This plan covers inpatient hospitalization expenses, modern treatments, and Ayush treatments expenses incurred by the insured and their family members

      Eligibility Criteria

      Parameters

      Specifications

      Entry Age for Adults

      18-65 years

      Entry Age for Children

      3 months- 25 years

      Sum Insured

      Rs 1 lakh- Rs 20 lakh

      Policy Type

      Individual/Family Floater

      Policy Term

      1-year

      Room Rent Limit

      · For Rs 5 Lakh SI: up to 2% of the SI or Rs. 5000/day

      · For Rs 6/8/10 Lakh SI: up to 2% of the SI or Rs. 10,000/day

      · For Rs 15/20 Lakh SI: up to 2% of the SI or Rs. 20,000/day

      ICU Charges

      · For Rs 5 Lakh SI: up to 5% of the SI or Rs. 10,000/day

      · For Rs 6/8/10 Lakh SI: up to 5% of the SI or Rs. 20,000/day

      · For Rs 15/20 Lakh SI: up to 2% of the SI or Rs. 20,000/day

                 Note: (Sum Insured=SI)

      Features of Oriental Arogya Sanjeevani Policy

      Oriental Arogya Sanjeevani policy comes with the following features and benefits for the policyholders:

      • The policy sum insured ranges from Rs 1 lakh to Rs 20 lakh
      • No pre-medical screening is required up to the age of 55-years
      • The policy helps you pay for any daycare medical procedure during the policy term
      • 5% cumulative bonus is added for not filing a claim during the policy term
      • After completion of 48-months of the waiting period, you can file a claim for pre-existing disease treatment as well
      • The policy premium can be paid in installments
      • There is a free-look period of 15 days during which you can cancel or continue with the policy

      Inclusions of Oriental Arogya Sanjeevani Policy

      Oriental Arogya Sanjeevani policy provides the following coverage benefits to the policyholder:

      • In-patient hospitalization expenses are covered
      • The coverage limit for ICU and ICCU expense is Rs 10,000 or 5% of the sum insured
      • Cataract Treatment expenses are claimable up to Rs 40,000 or 25% of Sum insured
      • Ayush treatment expenses including Unani, Ayurveda, homeopathy, Siddha are covered up to the coverage amount
      • Pre- hospitalization expenses are covered for a maximum of 30 days and post-hospitalization expenses are covered for a maximum of 60 days
      • Ambulance charges for each hospitalization are payable up to Rs 2000  
      • The policy also covers dental treatment charges if required as a part of the treatment, accident or injury
      • Expenses incurred on Ayush hospitalization are covered up to the sum insured limit
      • The policy also includes coverage for modern treatments up to 50% of the sum insured as given below:
      • Balloon Sinuplasty
      • Intra vitreal injections
      • Oral chemotherapy
      • Deep Brain stimulation
      • Stem cell therapy ( as required in bone marrow transplant procedure)
      • Immunotherapy
      • Stereotactic radio surgeries
      • Robotic surgeries
      • Intra Operative Neuro Monitoring
      • Green laser treatment/ Prostate Vaporization
      • Bronchial Thermoplasty
      • Uterine Artery Embolization/High intensity focused ultrasound tests

      Exclusions of Oriental Arogya Sanjeevani Policy

      Oriental Arogya Sanjeevani Policy does not compensate for the following expenses:

      • Specific diseases till the waiting period of 24 months is over
      • Pre-existing diseases are not covered until the completion of 48 months
      • OPD charges and domiciliary treatment charges are not claimable
      • Obesity and weight control treatments are excluded
      • Rehabilitation, rest cure, and respite care expenses are also not paid by the insurer
      • War related and adventure sports-related medical emergencies are not covered

      Oriental Arogya Sanjeevani Policy Claim Process  

      For both cashless and reimbursement claims the process is given below:

      • You need to seek authorization and for that you need to fill the complete claim form, which is available with the network provider and the TPA
      • On getting the claim form for cashless treatment the TPA/Company sends the pre-authorization letter to the hospital after verification
      • For reimbursement claims of hospitalization, daycare treatments, and pre-hospitalization expenses you need to inform the insurer within 30 days of getting discharged from the hospital
      • For reimbursement of post hospitalization expense the insurer needs to be informed 15 days from post-hospitalization treatment
      • Please check with the hospital for any inadmissible expenses and do not forget to sign the hospital discharge form
      • Once all the documents are submitted your cashless claim will be processed else you can file for reimbursement also

      Documents Required

      For claim keep the following documents handy:

      • Complete and signed health claim form
      • ID proof of the patient/ medical bills/prescription of the doctor suggesting hospital  admission
      • Payment receipts
      • Medico legal report, if required
      • Diagnostic reports /OT notes/ Discharge summary/ Invoice of the implants
      • Customer KYC
      • NEFT Details
      • Any other documents as required

      To buy or know more about Oriental Arogya Sanjeevani policy you can write to us at care@policybazaar.com or speak to us at 1800-708-8787.

      FAQs

      Policybazaar exclusive benefits
      • 30 minutes claim support*(In 120+ cities)
      • Relationship manager For every customer
      • 24*7 claims assistance In 30 mins. guaranteed*
      • Instant policy issuance No medical tests*
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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

      ~Source: Google Review Rating available on:- http://bit.ly/3J20bXZ

      ##On ground claim assistance is available in 114 cities

      Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

      STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

      Policybazaar is a registered Composite Broker |Registration No. 742, Valid till 09/06/2024, License category- Composite Broker| Visitors are hereby informed that their information submitted on the website may be shared with insurers.

      Policybazaar Insurance Brokers Private Limited | CIN: U74999HR2014PTC053454 | Registered Office - Plot No.119, Sector - 44, Gurgaon, Haryana - 122001 Contact Us | Legal and Admin Policies

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