Oriental Insurance Company Limited
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HAPPY FAMILY FLOATER HEALTH INSURANCE POLICY
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This is a Health Insurance Policy for entire Family

  • Floater implies single Sum Insured for entire family residing in India.
  • Family includes Self, Spouse, Children, Parents and Parents in laws.
  • Available in two plans Silver and Gold.

  • Now you can buy and renew policies Online. Buy a new Family Health Insurance plan or Renew an existing Oriental Insurance Happy Family Floater Health Insurance policy by registering yourself on our Portal and paying online through your debit card / credit card or Net-banking. To check out various online facilities available, you may login on the Portal.
    Salient features of the policy
      A floater providing Health Care solution to the proposer and his / her family under one sum insured under one policy.
      The sum insured floats over all the beneficiaries under the policy.
      No medical examination for persons upto the age of 60 years.
      Pre-existing conditions cover after four consecutive renewals with the Company.
      Coverage under two options - SILVER and GOLD Covers.
      SILVER offers sum insured slabs of 1 to 5 lacs
      SILVER is subject to 10% Co-pay
      GOLD offers sum insured slabs of 6 to 10 lacs.
      This Health Care Policy covers the hospitalization expenses for the covered diseases / accident upto specific limits.
      GOLD plan offers as an inbuilt cover daily cash allowance and attendant allowance upto limits specified.
      Personal Accident cover is offered as add on cover under both the covers. In addition GOLD cover offers add on cover of life hardship survival benefit.
      Discount in OMP premium when Happy family floater Health Insurance policy is taken.
      Option of TPA and non TPA services.
      Discount in premium if TPA services not opted.
     
    Coverage under the Family Floater Health Insurance policy
    The following reasonable and necessary expenses (subject to limits) are payable under the policy for various benefits:
    A. HOSPITALISATION BENEFITS
      BENEFIT SILVER PLAN
    (Limit of Reimbursement )
    GOLD PLAN
    (Limit of Reimbursement)
    a. Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. Not exceeding 1 % of the Sum Insured per day Not exceeding 1 % of the Sum Insured per day.
    b. Intensive Care (IC) Unit Expenses as provided by the Hospital /Nursing Home. Not exceeding 2% of the Sum Insured per day. Not exceeding 2% of the Sum Insured per day.
      No of days of stay under a and b above should not exceed total number of days of admission in the hospital.
    c. Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees As per the limits of the sum insured. As per the limits of the sum insured.
    d. Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Material and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs & and similar expenses. As per the limits of the sum insured. As per the limits of the sum insured.
    e. Ambulance services charges as defined hereinafter under Rs.1,000/- per illness and limited to maximum 1% of the sum insured or Rs. 3,000/- whichever is less, for the entire policy period. Rs.2,000/- per illness and limited to maximum 1% of the sum insured or Rs. 6,000/- whichever is less, for the entire policy period.
    f. DAILY HOSPITAL CASH ALLOWANCE, AS DEFINED HEREINAFTER under NIL. 0.1% of sum insured per day per illness subject to a maximum compensation for 10 days per illness. The overall liability of the Company during the policy period will be limited to 1.5% of the sum insured.
    g. Attendant allowance as hereinafter defined under NIL Rs.500/- per day of hospitalization per illness and upto 10 days per illness. The overall liability of the Company during the policy period will be limited to compensation for 15 days of hospitalization.
       
    B. DOMICILIARY HOSPITALISATION (AS DEFINED HEREINAFTER)
    a. Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines & Drugs, Diagnostic Material and Dialysis, Chemotherapy, Nursing expenses. 10% of Sum Insured, Maximum Rs.25000/- during policy period. Rs.50000/- during policy period.
    b. Treatment for Dog bite (or bite of any other rabid animal like monkey, cat etc.) Reasonable expenses limited upto Rs.5,000/- actually incurred for immunization injections in any one policy period. Reasonable expenses limited upto Rs.5,000/- actually incurred for immunization injections in any one policy period.
    NOTE: FOR THE PURPOSE OF THIS SECTION THE PRE-REQUISITE CONDITIONS FOR
    DOMICILIARY HOSPITALISATION CLAIM SHALL NOT APPLY.
    Policy Details
    Happy Family Floater Health Insurance Policy is Available in two plans- Silver and Gold
      Plan- SILVER Plan- GOLD
    BASIC PLAN 10% compulsory co-pay

    Sum Insured choice Rs.1.5 lakhs
    Without Co-pay

    Sum Insured choice Rs.6-10 lakhs
    Inbuilt 10% compulsory co-pay

    Sum Insured choice Rs.1.5 lakhs
    Cash allowance for the days admittedy

    Attendence allowance- If a child between 3m to 10yrs is admitted.
    Add On Personal Accident cover for self and dependants. Personal Accident cover for self and dependants.
    Add On NIL Life Hardship (Survival Benefit), diseases like cancer(IV) stage, End stage Renal Disease, Stroke leading to Paralysis or paraplegia.
    Features
  • Daily Hospital Cash - (Benefit in Gold scheme) Limit 0.1% of Sum Insured for max.10 days.
  • Attendant Allowance - (Benefit in Gold scheme) If a child below 10 years is admitted, Rs.500 per day for max. 10 days.

  • Other Features
    Ambulance charges
  • Rs.1000 or 1% of S.I in Silver
  • Rs.2000 or 1% of S.I in Gold
  • Discount on OMP Premium
  • Discount of 15% on OMP policy
  • Happy Family Floater Health Insurance policy is suspended, if OMP taken.
  • TPA
  • Option to avail services or not.
  • 5% Discount if opted out.
  • New Features with Extra premium Personal Accident - Available in Silver and Gold plans
    Personal Accident - Available in Silver and Gold plans
  • In Silver up to Rs.5 lakhs.
  • In Gold up to Rs.10 lakhs.
  • Life Hardship - Benefits in Gold scheme with extra premium.
  • Plan A with 15% of Sum Insured
  • Plan B with 25% of Sum Insured
  • Benefit given if Insured person survives Hardship given, for 180 days or 270 days after discharge.
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