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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.
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GOLD PLAN (Limit of Reimbursement) Not exceeding 1 % of the Sum Insured per day. Not exceeding 2% of the Sum Insured per day.
a.
b.
No of days of stay under a and b above should not exceed total number of days of admission in the hospital.
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12-Jun-13 6:40:57 PM
As per the limits of the sum insured. As per the limits of the sum insured.
As per the limits of the sum insured. As per the limits of the sum insured.
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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. Ambulance services charges as defined hereinafter under
e.
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. NIL.
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. 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. 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.
as
NIL
B.
DOMICILIARY HOSPITALISATION (AS DEFINED HEREINAFTER) Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines & Drugs, Diagnostic Material and Dialysis, Chemotherapy, Nursing expenses. Treatment for Dog bite (or bite of any other rabid animal like monkey, cat etc.) 10% of Sum Insured, Maximum Rs.25000/- during policy period. Rs.50000/period. during policy
a.
b.
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 BASIC PLAN 10% compulsory co-pay Sum Insured choice Rs.1.5 lakhs Inbuilt 10% compulsory co-pay Sum Insured choice Rs.1.5 lakhs Attendence allowance- If a child between 3m to 10yrs is admitted. Add On Add On Personal Accident cover for self and dependants. NIL Personal Accident cover for self and dependants. Life Hardship (Survival Benefit), diseases like cancer(IV) stage, End Plan- GOLD Without Co-pay Sum Insured choice Rs.6-10 lakhs Cash allowance admittedy for the days
http://www.orientalinsurance.org.in/happy-family-floater-policy.jsp
12-Jun-13 6:40:57 PM
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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.
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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. Calculate and Buy Online Health Insurance and You Top
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http://www.orientalinsurance.org.in/happy-family-floater-policy.jsp
12-Jun-13 6:40:57 PM