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The PNB-Oriental Royal Mediclaim Policy is a health insurance plan that is exclusively catered towards employees and account holders of Punjab National Bank (PNB). The plan can be extended to cover the proposer’s immediate family, i.e., his/her spouse and two children. By way of this policy, insured members can eliminate or reduce expenses that they might have to incur due to an unplanned hospitalisation or medical emergency.
In order to be eligible to subscribe to this plan, one must ensure that he/she meets the eligibility criteria that is set by the insurance company.
The sum insured is the maximum amount of money that the insurer is liable to pay in case one meets with a certain eventuality. The premium, on the other hand, is what the insured member pays to the insurer in order to enjoy the policy’s coverage. Certain particulars related to your sum insured and premium rates are listed in the table below.
|Policy tenure||1 year|
|Sum Insured||Rs.1 lakh – Rs.5 lakh|
|Premium||Rs.1,749 – Rs.6,830|
|Room, Boarding, and Nursing Expenses||Up to 1% of the sum insured or Rs.5,000 per day, based on whichever is the lesser of the two|
|ICU Charges||Up to 2% of the sum insured or Rs.10,000 per day, based on whichever is the lesser of the two|
|Ambulance Charges||Up to 1% of the sum insured or Rs.1,000, based on whichever is the lesser of the two|
|Other Expenses Covered||Insurer covers consultant, medical practitioner, and surgeon’s fees. In addition, charges for oxygen, chemotherapy, medicines, blood, anaesthesia, etc. are covered as per the limits of the sum insured|
|Hospital Cash||Insurer will reimburse incidental expenses which are incurred by the insured when hospitalised, up to a maximum of Rs.1,000 during the entirety of the policy term|
|Reimbursement of Funeral Expenses||Up to Rs.1,000 will be reimbursed by the insurer|
|Domiciliary Hospitalisation||Up to a maximum of Rs.25,000 or 10% of the sum insured|
The premium is required to be paid in advance before the purchase of the policy. The renewal premium can be paid the following year before the premium payment due date. The company generally sends the renewal notice and it will contain details of the premium amount to be paid. The company may or may not revise the premium amount to be paid by the individual. The premium payment is not automatic and should hence be paid in time to continue enjoying the benefits under the plan.
The insurance company requires the policyholder to notify them about any possible claims within 48 hours of admission to the hospital or before discharge from the hospital, whichever is earlier. The intimation needs to be given in writing through fax or e-mail with the following information:
To get a reimbursement of the expenses incurred on your treatment, you can submit the following documents to the insurer/TPA:
The documents should be duly attested by the insured person and submitted to the insurer/TPA within 7 days from the date of discharge from the hospital. In case the insurer/TPA asks for any other information, the same will need to be provided at the earliest.
You can avail cashless services under your Royal Mediclaim policy from any network hospital or nursing home. You will have to get a pre-authorisation letter to avail the service. Once you submit all relevant information regarding your policy and the treatment you are going to avail, the insurer/TPA will verify the details and either approve or reject the request. If the request is denied, you can always pay the hospital bill yourself and apply for a reimbursement within 7 days from the date of discharge from the hospital.
Yes, you can cancel your policy if you need to. The company may even permit a refund of the premium paid by you, provided no claims have been made from the start of the policy up to cancellation.
The insurance company has two contact numbers:
Yes, you can visit the official website of Oriental Insurance to renew your health insurance plan.
You can find a list of network hospitals of Oriental Insurance on the official website of the company. Once you open the website, click on ‘Locator’ found in the main menu and click ‘Network Hospitals’. You can then select the state and city in which you are looking for the network hospital.
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