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Oriental Happy Family Floater Health Insurance

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Oriental Health Insurance
Happy Family Floater Policy
Claim SettlementDedicated Team
Claim Settlement Ratio93.96%
COVID-19 CoverYes
Network Hospitals4,300+
Policies Sold12,50,812

About Oriental Happy Family Floater Health Insurance

Happy Family Floater Policy offered by Oriental Insurance is an indemnity-based medical insurance policy that comes in three variants namely Silver, Gold, and Diamond Policy. The sum insured options under the Silver variant are up to Rs. 5 Lakh, under the Gold variant are up to Rs. 10 Lakh and the Diamond variant are up to Rs. 20 Lakh. The policy covers people who are aged at least 91 days and up to 65 years. However, if you choose a compulsory co-payment of 20% for every claim, then people aged between 65 years and 70 years can also be covered under the Silver or Gold Plan, but not Diamond Policy. For insured people, the co-payment will apply at the time of health insurance renewals also.

The policy covers the insured for several medical expenses such as organ donor expenses, room rent, nursing, and boarding expenses, ambulance expenses, daily hospital cash allowance, newborn baby cover, medical second opinion, maternity expenses, pre-hospitalisation and post-hospitalisation expenses, etc. It comes with a compulsory co-payment of 10% in the Silver variant. This means that in case of a claim, you will be required to pay 10% of the total expenses whereas the health insurance company will pay the remaining 90%. The policy comes with several add-on benefits which you can choose as per your requirement and budget.

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Key Inclusions and Exclusions of the Plan

What's Included

  • Room rent, nursing, and boarding expenses
  • Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees
  • Anaesthesia, blood, oxygen, operation theatre charges
  • Surgical appliances, diagnostic material, medicines and drugs, and x-ray,
  • Dialysis, radiotherapy, cost of a pacemaker, chemotherapy, artificial limbs and related expenses

What's Not Included

  • Intentional self-Injury, suicide or attempted suicide
  • Treatments required due to venereal disease(s) or insanity
  • War, invasion, acts of foreign enemy, hostilities
  • Treatments taken for the purpose of investigation and evaluation
  • Expenses arising due to hospitalisation due to rest cure, rehabilitation and respite care

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Add-ons to Enhance Benefits

  • Restoration of Sum Insured

    Restoration of sum insured add-on is available in Silver and Gold variants with which you can enhance the sum insured in case it gets exhausted due to claims made in the previous policy year. This add-on is applicable for sum insured options between Rs. 3 Lakh and Rs. 10 Lakh, both slabs inclusive. There are two options for the restoration of the sum insured. In the first case, 50% of the sum insured is restored, and in the second case, 100% of the sum insured is restored.

  • Personal Accident Cover (World-Wide)

    This add-on cover is provided to the insured if at any time during the policy term is he/she sustains bodily injury due to sudden or unforeseen and involuntary events caused due to visible, external, and violent means at any place across the globe. If the injury leads to the death or disability of the insured within 12 months, then the company will be liable to pay the covered amount to the insured or the nominee. If the nominee is not present, then the legal heir will receive the benefit subject to terms and conditions.

  • Life Hardship Survival Benefit

    With this add-on cover, the insured gets a survival benefit if during the policy period he/she gets diagnosed with any of the 11 critical illnesses as specified in the policy document. But note that this benefit will not be offered if the insured was already suffering from the illness before policy purchase.

Oriental Happy Family Floater Policy Expert Review

  • Expert Review

    Those who want to cover their entire family under one sum insured under one policy, Happy Family Floater Policy is the one to go for. Offering wide coverage at an affordable premium, the policy ensures that the insured doesn’t face lack of funds during a medical emergency, especially while undergoing treatment. All in all, Oriental Insurance’s Happy Family Floater Policy makes sure the entire family stays happy and unaffected, even in a critical situation. 

    When shedding light on the eligibility, we find that it covers all individuals between the age range of 91 days up to 65 years. Note that the maximum entry age can be extended to 70 years, subject to conditions. What’s best is that you can secure the health of not only self, spouse, dependent children, but also parents/parents-in-law as well as siblings. Renowned for providing extensive coverage, Happy Family Floater Policy comes in the form of three variants, namely Silver, Gold, and Diamond for a policy period of 1 year. Talking about sum insured options, the range starts from Rs. 2 Lakh and goes up to Rs. 20 Lakh. 

  • Major Attractions

    True to its promises, Happy Family Floater Policy offers supreme coverage so that a family is able to handle its medical expenses without any interruption in between a medical treatment. Covering the significant inpatient hospitalisation expenses, Happy Family Floater Policy also takes care of Ayurvedic, Siddha, Unani and Homeopathic treatment expenses. Besides offering extension of policy covering SAARC countries and optional covers of Restoration of Sum Insured, Personal Accident, Life Hardship Survival benefit, the policy also covers you for -

    • 30 days pre-hospitalisation & 60 days post-hospitalisation expenses
    • Cover for specified/listed daycare procedures
    • Coverage for domiciliary hospitalisation
    • Cover for 11 critical illnesses on Benefit Basis
    • Daily Hospital Cash Allowance Benefit - 0.1% of SI per day (Gold and Diamond Plan)
    • Attendant Allowance - Rs. 500 & Rs. 1000 per day of hospitalisation (Gold & Diamond Plan)
    • Maternity and newborn baby cover (Diamond Plan)
    • Organ Donor Benefit - After a waiting period of 12 months
    • Medical Second Opinion for 11 specified major illnesses - Globally
    • Extension of Maximum Entry Age - Silver & Gold Plan
  • What’s More?

    Needless to say, Oriental Insurance through its Happy Family Floater Policy makes sure that no family has to deal with any kind of inconvenience in terms of finance. To make the insurance experience even better, the policy comes with additional beneficial features that includes -

    • Lifelong renewal of policy
    • Option of TPA & non-TPA services
    • Pre-existing disease coverage after four consecutive policy periods
    • Free look period - 15 days
    • Grace period - 30 days
    • Easy policy portability
    • Tax benefits under Section 80D 
    • Discount of 5.5% on premium if services of TPA are not opted
  • Conclusion

    At last, it can be concluded that Happy Family Floater Policy is a boon for every family that longs for financial security, especially at a time when they can't afford instability in terms of finance. If you too want financial protection of first rate, go for this policy without giving any second thoughts.

    It is advisable to choose the online mode for policy purchase so as to enable quick issuance. Moreover, to add more value to the experience, you can choose the platform of InsuranceDekho to buy the policy and benefit from policy transparency, claim settlement support, policy portability, and other advantages.

Oriental Happy Family Floater Policy Brochure

  • 468.29 KB
  • PDF Document
  • Jul 18, 2019

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.

FAQs on Happy Family Floater Policy Health Insurance Plan

  • What are the sum insured options available under the policy?

    The policy comes in three variants, Silver, Gold and Diamond, with different sum insured options. Under Silver variant, the sum insured ranges from Rs. 2 Lakh to Rs. 5 Lakh; under Gold variant, it ranges from Rs. 6 Lakh to Rs. 10 Lakh and under Diamond variant it is Rs. 12 Lakh, Rs. 15 Lakh, Rs. 18 Lakh and Rs. 20 Lakh. 

  • What is the maximum entry age under this policy?

    The maximum entry age under the policy is 65 years for all members; however, this can be extended to 70 years subject to conditions.

  • What is the entry age for children under the policy?

    Generally, dependent children between the age of 91 days to 18 years are covered under the policy. However, the financially dependent male child can be covered up to 25 years of age. A female child can be covered until she gets married.

  • Is pre-acceptance medical check-up required to obtain this policy?

    A pre-acceptance medical check-up is required for persons aged 60 years and above under Silver and Gold variants. However, under Diamond variant, the persons aged 55 years and above are required to undergo a pre-acceptance medical check-up.

  • What is the term and renewability option available under the policy?

    Term of the Policy is one year and is renewable lifelong.

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