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Oriental Health Insurance Claim Settlement

160 reviews Rate This
Claim SettlementDedicated Team
Claim Settlement Ratio93.96%
COVID-19 CoverYes
Network Hospitals4,300+
Policies Sold12,50,812

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Claim Settlement of Oriental Health Insurance

The popularity of an insurance company is driven by its claim settlement process. Oriental Insurance Company makes sure easy, smooth and hassle-free claim settlement experience. Oriental strives to provide claim settlement service through a renowned Third Party Administrator (TPA). As a policyholder, you’re able to get your claims settled either with reimbursement facility or cashless option. To register a claim, you need to follow the below instructions to make it smoother and more comfortable.

  • Claim Process for Cashless Treatment

    If you receive treatment at a network hospital, then cashless claims can be availed. Below are steps to file a cashless claim:

    • Find a network hospital in the city where you want to get treatment
    • Intimate Oriental Insurance Company as soon as possible in emergency and before admission in case of planned hospitalisation
    • Carry your cashless card and one photo ID proof while visiting the hospital
    • Collect the pre-authorization form from the hospital, fill it and submit
    • The hospital checks your identity and sends the pre-authorization form to the TPA of Oriental Insurance Company
    • The TPA checks the coverage, approves or disapproves the claim
    • If the claim is approved, the medical expenses will be borne by the insurer
  • Reimbursement Treatment

    Reimbursement claim can be filed in both network and non-network hospitals. The steps in the reimbursement process are as follows:

    • Get admitted to any network or non-network hospital
    • Intimate Oriental Insurance Company about the hospitalisation as soon as possible
    • Get the reimbursement claim form from the insurer or download it from their website
    • Provide the required details while filling the form
    • When getting discharged, pay the hospital bills
    • Collect all original bills, documents, and reports
    • Sign all documents and send to the TPA service provider along with the claim form
    • When the documents are received, the TPA service provider investigates the documents  
    • When they find everything correct, the insurer settles the claim as per terms and conditions of the policy
    • The payment will be made in the name of the insured
  • Documents Needed

    Listed below are documents required to file a reimbursement claim:

    • Duly filled claim form
    • Medical recovery report
    • Original investigation reports
    • Final hospital discharge summary
    • Pharmacy bills along with the prescription
    • Original bills, receipts, and discharge report
    • Indoor case papers and duly-filled claim form
    • Original Test Reports (x-rays/sonography/ECG, etc.)
    • A valid photo ID proof
    • Treating doctor's report, and original consultation notes
    • Nature of operation performed and surgeon's bill and receipt
    • Copy of claim intimation given to the Company together with xerox of policy & premium receipt


  • Incurred Claim Ratio (ICR) of Oriental Health Insurance

    The Incurred Claims Ratio or ICR is the most trusted approach to determine whether or not you should buy health insurance policies from an insurance company. It is a way to know the pace of the claim procedure and the productivity of the insurer in terms of revenue. The ICR of Oriental Insurance Company for FY 2018-19 is 113.86%.

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*Tax benefits are subject to changes in Income Tax Act.

Oriental Health Insurance User Reviews

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  • InsuranceDekho has proven to be a trustworthy partner in safeguarding my health. The Oriental Health Insurance...

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    By Jigaysa Mistry
    On: Oct 30, 2023
  • Opting for a family health insurance plan with InsuranceDeko was a thoughtful decision. The Oriental Health In...

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    By Varun kamboj
    On: Oct 12, 2023
  • InsuranceDekho is a platform that provides secured payment methods. I recently bought the Oriental Health Insu...

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    By Sabreen Kaur
    On: Sep 07, 2023
  • At InsuranceDekho, it was very easy to buy health insurance plans. I was able to compare different plans and c...

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    By Yogita Sethi
    On: Aug 22, 2023
  • It is very easy to buy health insurance plans at InsuranceDekho. All that is required is to fill a quote, comp...

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    By Derek Christine
    On: Aug 10, 2023
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Oriental Health Insurance Contact Details

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Claim Process at Oriental Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation as soon as it occurs and for planned hospitalisation intimate as soon as it occurs prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation as soon as it occurs and for planned hospitalisation intimate as soon as it occurs prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

Insurance Products by Oriental General Insurance

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Oriental Health Insurance Claim Settlement FAQs

  • How many claims can I make with Oriental Health Insurance policies?

    There is no restriction on the number of claims you can make in a policy year. However, it should not go beyond the sum insured amount specified in the policy document. 

  • For how long do I need to stay in the hospital to avail the claim?

    You need to stay for at least 24 hours in the hospital to be eligible for a claim. Only for a few daycare procedures and treatments as mentioned in the policy document, you can claim for the hospitalisation less than 24 hours.

  • How soon I need to inform about the hospitalisation to Oriental Health Insurance Firm?

    You should intimate Oriental Insurance Company as soon as you get hospitalised, either it is an emergency or a planned admission.

  • What documents do I need to produce to settle the claim successfully?

    Here are the listed documents that you need to produce before the insurer for claim settlement:

    • Duly filled claim form
    • Diagnosis and test reports
    • Doctor’s reports and consultation notes
    • Medical recovery report
    • Pharmacy bills with the prescription
    • Nature of operation performed 
    • Surgeon's bills and receipts
    • Final hospital discharge summary
    • A valid photo ID proof

    If any other document is needed, the insurer can ask you to bring them.

  • Where should I contact to seek claim related assistance?

    To seek details about the claim settlement procedure of the Oriental Insurance Company, you can connect with our team at 7551-196-989.

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