Oriental Insurance HOPE - Health of Privileged Elders
Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
10,000+ hospitals for cashless treatment
Claim up to Rs. 55,000 deduction under section 80D**
This unique health insurance plan has been designed to cater to the medical needs of senior citizens. The cover is provided for certain specified treatments and diseases mentioned in the policy.
Eligibility of HOPE - Health of Privileged Elders
Senior citizens i.e. persons above the age of 60 years can avail this policy.
A pre-acceptance medical checkup should be conducted in an authorised diagnostic centre as listed by the insurer. The list of medical reports required include physical examination, urine test, glycosylated haemoglobin test, ultrasonography examination, X-ray of both knees, complete eye test, and stress test.
Sum Insured
The sum insured is the total amount payable by the insurer to the insured towards medical expenses.
Features of Oriental Insurance HOPE- Health of Privileged Elders
The policy is exclusively for senior citizens above the age of 60.
Cashless hospitalisation can be availed in any of the network hospitals upto an amount of Rs.1 lakh.
Pre-hospitalisation expenses incurred upto 30 days prior to admission in the hospital are covered.
Post-hospitalisation expenses upto 60 days from the day of discharge from the hospital are covered.
In-patient and day-care treatment is covered by the policy.
Only diseases specified in the policy will be covered.
Ayurvedic, Homeopathic, and Unani treatments in government hospitals and colleges are also covered.
Hospitalisation and domiciliary treatments will be covered only within India.
Claim documents including receipts, bills, cash memos, etc. should be submitted to the insurer within seven days from the date of discharge of the policyholder.
The insurer can cancel the policy if the policyholder has misrepresented facts. The insurer will send a 30-day notice to the insured in such circumstances.
The insured can cancel the policy and the insurer will refund the premium with a certain rate of premium levied, provided no claim was made during the policy period.
Policyholders can avail a tax benefit under Section 80D of the Income Tax Act, 1961.
Benefits of Oriental Insurance HOPE- Health of Privileged Elders
Room, Boarding and Nursing Expenses
An amount equal to 1% of the sum insured can be claimed per day
ICU Charges
Expenses upto 2% of the sum insured is covered by the policy
Ambulance Service Charges
Ambulance charges upto Rs.1,000 is reimbursable
Other medical expenses
Surgeon, Consultant, Anaesthetist, Specialist, and Medical Practitioner fees along with operation theatre charges, chemotherapy, medicines and drugs, surgical appliances, etc. are covered
Domiciliary treatment
Treatment charges upto Rs.20,000 will be covered by the policy
Exclusions of Oriental Insurance HOPE- Health of Privileged Elders
Any health condition that is not enlisted in the policy.
Any pre-existing ailment during the first two policy years.
Any disease mentioned in the policy but contracted in the first 30 days of the policy term.
Treatment of certain specific ailments mentioned in the policy.
Injuries resulting from war, invasion, or nuclear materials.
Circumcision, vaccination, change of life, cosmetic or aesthetic treatment, or hair transplant.
Plastic surgery unless required due to an accident.
Correction of eyesight; spectacle and contact lens expenses.
Convalescence, rest cure.
Congenital external diseases or defects, sterility, fertility or sub-fertility procedures, assisted conception procedures, and venereal diseases.
Intentional self-injury, suicide, and psychiatric disorders.
Treatments arising from substance abuse.
Expenses and complications arising from HIV/AIDS and other sexually transmitted diseases.
Evaluation or diagnostic procedures not followed by hospitalisation.
Expenses on mineral water, vitamins, allied items, and tonics unless utilised for the treatment of a disease or injury.
Naturopathy, experimental treatments, or alternative medicine like acupressure.
Treatment expenses incurred that is unrelated to the disease hospitalised for.
External durable and non-medical equipment like ambulatory devices. These include walkers, belts, crutches, slings, braces, etc. Also, glucometer, nebuliser, etc.
Non-medical expenses related to convenience and comfort.
Change in the system of treatment unless agreed by the TPA or company.
Any weight-reduction or obesity-related treatments.
Treatment arising from participation in hazardous activities.
Service charges, registration fees, surcharges, file charges, etc. charged by the hospital.
Doctor’s consultation charges while insured is treated at home. Nursing charges incurred during pre-hospitalisation and post-hospitalisation.
Other Key Features
Cost sharing
The policyholder has to pay 20% of the claim as compulsory co-payment.
The policyholder may opt for voluntary co-payment upto 50%. Discounts are applicable for voluntary co-payment.
No-claim discount
A no-claim discount of 5% of the renewal premium payable can be availed after each policy year. The maximum no-claim discount that can be availed is 20%.
Free-look period
A 15-day free-look period is offered. On cancellation of the policy during the free-look period, a refund of the premium paid will be made unless a claim was made during the period.
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Oriental Insurance HOPE - Health of Privileged Elders
Reviews
I have taken a health insurance with Oriental Insurance through PNB and it covers 4 members. It was a good experience and I don't have any claims. The representative explained me about the benefits and have opted for one year will renewing it every year. I need to pay the premium of 6,900 approx for one year. The medical coverage is 5L per person.
I also used the services of Oriental insurance for my health policy. The experience is good. I had a claim experience and the process is smooth and fast. The medical coverage value is also fine. The premium cost is also normal. I had no difficulty.
My health insurance policy is with Oriental insurance. The customer services are good. I got the policy details on time. It is a family floater. There is a medical coverage of four to five lakhs for each person. The premium cost is normal. There is no cash less facility.
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SONU KUMAR VERMA
, ghaziabad
Reviewed on Nov 10, 2018
My company has covered the health insurance policy with Oriental. I was not calling to the customer care since the company has provided the medical card and i have not availed any service so far. I have not seen the hospital list but they have offered the policy for my entire family with the coverage amount of Rs. 3 lakhs.
My employer provided Oriental Insurance they got tie up with many hospitals, I got the medical card on time. I used it once, during my wife's delivery, I gone for the cash less service, they done all the process on time. There was no hassle faced with them.
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TARUN BALACHANDRAN
, bangalore
Reviewed on Oct 29, 2018
Oriental insurance handling the claim process very well, when my mother admitted for the surgery within couple days they approved the request. Finally we got cash less service in Sun shine hospital at Hyderabad. I am very satisfied with my corporate insurance benefits.
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0
SRAVANI VEERAMALLA
, guntur
Reviewed on Oct 29, 2018
Comparatively Oriental insurance health policy is good, I got 90% of claim amount on time, when I use this policy for the delivery of my first kid. once I raised the request, the insurer done all the process on time. I didn't much interacted my company taken care of it because its a corporate policy.
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0
GOPAL SIKHAWAL
, bangalore
Reviewed on Oct 25, 2018
Before 10 years, i have purchased my health insurance with Oriental. I have paid a premium amount of Rs. 8000 in a year. I have not made any claim so far with oriental. They are covering a pre-existing. They are covering all kind of disease. They have offered the policy for my family also. They are offering a claim amount of Rs. 5 lakhs.
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HARSHITA CREATION
, jodhpur
Reviewed on Aug 22, 2018
My health insurance is with Oriental Insurance. I been a customer with them for the last 10 to 11 years. I have had three to four claims and the process has been smooth every time I used their service. I have the medical card and I have used the cashless treatment. The medical coverage is for two lakhs for five members which is my family and I.
The previous year I had my health insurance with Oriental insurance. It was a corporate policy and fortunately I had no claim experience. The medical coverage was good. It was for my family and I. The benefits were good too. In all no hassles in the process.
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PRADEEP ANALDAS
, hyderabad
Reviewed on Jun 22, 2018
The total policy coverage is for 6 lakhs for the health insurance from Oriental Insurance. Its a family floater were all the family members are included in the policy. Its a corporate insurance were i can opt for cashless treatment.
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AWDHESHKUMAR SINGH
, new delhi
Reviewed on Jun 11, 2018
With Oriental health insure i get a coverage of 3 lakhs. Its the corporate insurance which i have not claimed. They are providing family floater. As my family can also get treated with this insurance policy. Its a good policy.
I have taken a health insurance policy with Oriental insurance. I had to physically purchase this policy as there is no online process. The coverage offered is for one lakh. I have taken this policy for my son. They need to improve on their services.
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RAJASHEKAR BANDAM
, hyderabad
Reviewed on Jun 07, 2018
My experience with Oriental Insurance was excellent. They always follow up in time, providing me with sufficient details about the claim information. I never experienced any delays with their communication. The claim process was really easy at the Kauvery hospitals. They're really aware about what's happening and always keep me posted which help me to avail their service in time.
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VEDAKALAYANI VIJAYARAGAVAN
, chennai
Reviewed on Apr 16, 2018
The guy who manages my finance , suggested me this Oriental because of the max cover. But I am not sure about the complete benefits of the policy, but I believe they gave me total medical cover of Rs. 8 lakhs for my entire family as totally there are three members in my family.
I had applied and got a Health Insurance from the insurer ORIENTAL INSURANCE. I have been using this policy since five years. But i didn't have any claim experience so i cant able to commit on it. But they are providing me no claim benefits. But i can recommend their product to friends and relatives which are looking for a perfect completed Health policy.
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SUBASH CHANDRA BISWAL
, silvassa
Reviewed on Feb 17, 2018
I had an accidental injury before four year. I made a claim of Rs. 80,000 with Oriental Insurance. It got my reimbursement within 15 days but I didn't get the cash less. I submitted all the bills, medical file to them. They done the claim without any hassles, total medical cover was around Rs. 3 lakhs floater for the premium Rs. 4200.
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1
JAIMIN PATEL
, gandhinagar
Reviewed on Jan 08, 2018