Oriental Insurance Jan Arogya Bima Plan

• 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**

Oriental Insurance is one of the state-owned general insurance service providers in the country. In the health insurance domain, the company focuses on providing affordable health insurance plans for people who belong to the low-income category. Jan Arogya Bima is a policy by Oriental Insurance that provides limited health coverage at an extremely affordable premium cost. Premium costs for this cover start as low as Rs.70. This policy ensures that people below the poverty line have some level of insurance protection against various health hazards.

Eligibility for Oriental Insurance Jan Arogya Bima Plan

In order to avail this medical insurance cover, potential customers must fit within the following eligibility criteria.

• Anyone between the age of 5 years and 70 years can enter this cover.
• Dependent children between the age of 3 months and 5 years can be covered on condition that their parents are concurrently covered.

Features of Oriental Insurance Jan Arogya Bima Plan

Some of the key features of Oriental Insurance Jan Arogya Bima Plan can be given as follows.

• This is a limited insurance cover where the maximum sum insured amount is Rs.5,000 per person.
• This policy cover is valid for a period of one year, and it must be renewed annually for continuous coverage.
• Expenses incurred following a minimum of 24 hours of hospitalisation will be covered up the sum insured limit.
• Certain day care treatments such as dialysis, chemotherapy, radiotherapy, eye surgery, tonsillectomy, etc. can be covered under this policy.
• Domiciliary hospitalisation benefits are available under this cover. However, this benefit will not be provided for certain conditions such as asthma, bronchitis, epilepsy, hypertension, diabetes, etc.
• Pre-existing diseases can be covered only after 48 months of continuous policy coverage.
• There is a general waiting period of 30 days for all illnesses from the date of commencement of the policy. This waiting period does not apply for accidental hospitalisation.
• Pre-hospitalisation medical expenses are covered for up to 30 days prior to the date of admission in a hospital.
• Post hospitalisation medical expenses are covered for up to 60 days after discharge from the hospital.
• There is a free look period of 15 days for policyholders to review the terms and conditions of the policy.
• The premium amount paid for this medical insurance policy is eligible for tax benefit as per section 80D of the Income Tax Act.

Benefits of Oriental Insurance Jan Arogya Bima Plan

The benefits offered by Oriental Insurance Jan Arogya Bima Plan can be given in the following table.

Exclusions of Oriental Insurance Jan Arogya Bima Plan

There are certain exclusions for which the company will not provide any compensation to the insured. Some of the exclusions of Oriental Insurance Jan Arogya Bima Plan can be listed as follows.

• Injuries or illnesses attributable to war, invasion, or warlike activities
• Injuries or illnesses attributable to nuclear weapons or materials
• Circumcision unlesses necessary for the treatment of a disease
• Cost of accessories such as spectacles, contact lens, hearing aids, etc.
• Dental treatment or surgery unless necessitated by an accident
• Convalescence, general debility, or run down condition
• Any expenses related to the treatment of HIV, AIDS, or sexually transmitted diseases
• Hospitalisation for the purpose of examination or diagnostics
• Expenses related to the treatment of pregnancy and childbirth
• Any expenses related to the voluntary termination of pregnancy
• Costs incurred due to naturopathy treatment
• Expenses related to vitamins or tonics unless forming the core part of a treatment

Claim Procedure

Following an event that may give rise to a claim, the company must be notified immediately without fail. While notifying the company, it is necessary to include details such as policy number, name of the insured, name and address of the medical practitioner or hospital, etc. These details must be provided within a period of 7 days.

In order the claim reimbursement, the insured must submit various documents including medical bills, cash memos, diagnostic reports, etc. along with the claim form. All these documents must be submitted within 30 days of discharge from the hospital. Following the submission of all documents, the company will process the request and verify the validity of all the documents. Once the submitted documents are all verified, the company will provide the claim settlement amount to the insured.