Oriental Insurance Happy Family Floater Plan

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Brief Overview

Oriental Insurance Company is a public sector general insurance company, which has been a pioneer in the insurance sector. The company has made a name for itself when it comes to health insurance. Oriental Insurance has launched various health insurance products with the aim to cover its customers against ever-increasing health treatment costs. It offers health coverage to individuals, family members, senior citizens and groups. One very popular plan by Oriental Health Insurance is Oriental Insurance Happy Family Floater Plan. 

As the name suggests, it is a health plan that covers medical expenses of your whole family under a single sum assured. This means that other than yourself, you can include your spouse, parents, children, dependent siblings and parents-in-law. The expenses on the treatment of an illness or injury that requires hospitalisation of more than 24 hours, will be covered under this policy.

Best Features of Oriental Insurance Happy Family Floater Plan

  1. The plan comes with three variants:
    • Silver
    • Gold
    • Diamond
  2. The policy comes with a lot of optional covers
  3. You have the option to extend the coverage to SAARC countries
  4. Sum insured options start from INR 2 lakhs and go up to INR 20 lakhs
  5. Covers-spouse, dependent children below 18 years, parents/ parents-in-law, unmarried siblings
  6. You can include your whole family under one policy
  7. Entry age can be extended from 65 years to 70 years
  8. 5% discount when purchased online

Benefits of Oriental Insurance Happy Family Floater Plan

  1. In Hospital Benefits
    With Oriental Insurance Happy Family Floater Plan, you get a cover for your expenses due to hospitalisation, this includes room charges, nursing, boarding etc.
  2. Ambulance Charges
    The ambulance charges you incur during medical transportation of an insured member would be covered as per the plan conditions.
  3. Hospital Cash
    Depending on the plan variant that you have opted for, you can receive a specified daily cash benefit when you or an insured member is hospitalised.
  4. In-Patient Benefits
    The Happy Family Floater Plan covers the hospitalisation expenses that arise due to any illness or injury during the policy tenure.
  5. Pre and Post-Hospitalisation 
    The treatment-related expenses before and after the hospitalisation are also covered under Oriental Insurance Happy Family Floater Plan for 30 days and 60 days respectively.
  6. Day-Care procedures
    Some treatments require less than 24 hours of hospitalisation, such treatments are called Day Care Treatments. Oriental Insurance Happy Family Floater Plan covers such procedures.
  7. Organ Transplant Benefit
    When the insured member is the recipient, the organ donor expenses will be covered as per the sum insured limit. When the insured member is the donor, the expenses will be covered till 10% of the sum insured.
  8. Domiciliary Treatment
    Coverage up to INR 25,000 to INR 50,000 will be provided when you seek domiciliary treatment for an insured member.
  9. Maternity and Newborn Baby Cover
    Coverage up to 2.5% of the sum insured will be provided in the Diamond variant of the plan. The newborn baby cover is also offered till 90 days.
  10. Second Opinion
    You can get a medical second opinion on the diagnosis of specified illnesses. As per the variant you will be offered maximum INR 5,000 to INR 15,000 in a policy period.
  11. Optional Covers
    The following covers can be taken by paying an extra premium:
    • Restoration of Sum Insured
    • Personal Accident
    • Life Hardship Survival Benefit

Plan Details of Oriental Insurance Happy Family Floater Plan

Entry Age18 years to 65 years (Up to 70 years with Compulsory Co-Payment of 20% in Silver and Gold variants)
Tenure of Policy1 year 
Type of PolicyFamily Floater
Pre-existing Disease Waiting Period4 years

Waiting Period

  • A waiting period of 12 months is applicable for Organ Donor Expense when the insured is the donor
  • Pre-existing diseases have a waiting period of 4 years
  • Illness/ treatments have a waiting period of 30 days from the inception of the policy

Free Look Period
Oriental Insurance Happy Family Floater Plan provides you with a 15-day free-look period, which is applicable only at the inception of a new policy. If a claim has not been made in this period, you can return the policy to the company and your premium will be refunded. The refund will be payable after deduction of stamp duty charges, medical examination charges (paid by the company) and the proportionate risk premium.

What is not Covered in Oriental Insurance Happy Family Floater Plan?

Oriental Insurance Happy Family Floater Plan has a wide coverage, but there are certain situations for which the hospitalisation is not covered. If hospitalisation occurs due to the following reasons, the expenses will not be covered:

  1. Injuries which are self-caused, suicide or suicide attempts
  2. When under influence of an intoxicant
  3. When participating in war/ warlike activities
  4. Participation in criminal/ illegal activities
  5. Optometric therapy, cost of contact lenses, hearing aids, spectacles
  6. Treatment for alopecia, wigs, baldness
  7. Re-shaping/ weight loss treatments

Renewal Process of Oriental Insurance Happy Family Floater Plan

Investing in a health insurance policy is a wise step, however, paying your premiums regularly and on time is equally important. Oriental Insurance Happy Family Floater Plan is valid for the period of one year, and after the expiry date, the policy will enter a 30-day grace period, during which it must be renewed. Keep in mind that if you make a claim during the grace period, it would not be accepted.

To renew the policy, you can visit the company website, go to “renew” and make the required payment. Your policy would be renewed instantly. You may click the given to reach the page directly https://orientalinsurance.org.in/web/guest/renew?isSelected=renew&isRefresh=true 

Claim Process of Oriental Insurance Happy Family Floater Plan

When a health insurance claim has to be made, you need to inform the company at the earliest. Call customer care or send them an email. You must inform the company at least 48 hours prior to the hospitalisation and within 24 hours in case of emergency hospitalisation.

  • Cashless Claim 
    When you purchase Oriental Insurance Happy Family Floater Plan, you are issued a Health Card/ Policy ID Card. This card helps you to avail the cashless facility at a network hospital. When you reach the hospital, you need to get in touch with the TPA. The company/ TPA executives would guide you about the procedure for the cashless treatment. You would have to submit the Pre-Authorisation form. Your bills will be settled once all the formalities are complete.
  • Reimbursement Claim
    In case of a non-network hospital, you would have to make the bill payment on your own. Make sure to inform the company and the TPA in time. After the discharge, you can request for reimbursement. You would have to submit the original hospitalisation related documents along with the Claim Form and other documents listed below. Once all the paperwork is verified, you will get a reimbursement.

Required Documents

The list of the documents is given below: 

  • Claim Form
  • Health ID Card
  • Valid Photo ID document
  • Patient’s Discharge Summary
  • Doctor’s prescription that advises hospitalisation
  • All investigations reports, medicine prescriptions, consultations etc
  • Treatment-related bills
  • Bill of Ambulance Service, if used
  • A Medico-Legal Certificate in case it was an accidental injury
  • Bank Account details, cancelled cheque

Oriental Health Insurance - Network Hospitals

When you invest your hard-earned money in a health insurance plan, the aim is that if you ever face a medical emergency in life, you would be able to afford quality treatment for yourself and your loved ones, without putting yourself in a financial crisis. With Oriental Insurance Happy Family Floater Plan, you get the benefit of getting hospitalised in a network hospital, where you can get cashless treatment. 

As discussed earlier at a network hospital, the bills are directly settled by the company. As you do not have to run around arranging money for the treatment, the claim process becomes very quick and convenient. 

Review of Oriental Insurance Happy Family Floater Plan

In a time when COVID-19 has turned the world upside, it has become all the more important to invest in a comprehensive health insurance policy.  With Oriental Insurance Happy Family Floater Plan, you can ensure that if you ever face a medical contingency, you would not have to dig out from your hard-earned savings. The policy would act as a protective blanket over your loved ones.
Oriental Insurance Happy Family Floater Plan not only covers your hospitalisation expenses but also covers day-care procedures, pre and post hospitalisation expenses and organ donation. The sum insured options are from INR 2 lakhs to INR 20 lakhs, so you have the freedom to pick an option that suits you the most. The plan also comes with some additional covers that help you to further increase the coverage. 

If you are looking for a health insurance plan that can cover your whole family, then Oriental Insurance Happy Family Floater Plan might be the best option for you.

Oriental Health Insurance - Customer Care Details 

Official Websitehttps://orientalinsurance.org.in/
Email ID

das.gupta@orientalinsurance.co.in

csd@orientalinsurance.co.in 

Phone Number011-43659595
Toll-Free Number1800 118 485
Company Address Oriental House, A-25/27, Asaf Ali Road, New Delhi - 110002

Oriental Insurance Happy Family Floater Plan FAQs

  • What is the latest ICR for Oriental Insurance Company?

    In the financial year 2018-19, Oriental Insurance Company recorded an Incurred Claim Ratio of 106.10%.

  • Can I increase my sum insured after purchasing Oriental Insurance Happy Family Floater Plan?

    Enhancement of sum insured is possible after the approval of the company. Keep in mind that the increase can be to a maximum of 2 slabs higher.

  • From where can I download the Oriental Insurance Happy Family Floater Plan brochure or pdf?

    You can visit the company website for the same or click this link to go to the document: https://orientalinsurance.org.in/documents/10182/4798831/HFF-2015+Policy.pdf/43e00725-050c-4015-b7ee-845fd9a3becd 

  • Do I need to co-pay when I make a claim under the Happy Family Floater Plan?

    A 10% co-payment clause is applicable when you opt for the Silver variant of the Happy Family Floater Plan. No such payment is applicable in the Gold and Platinum variant.

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