Under the policy of universal health insurance scheme for oriental insurance company an individual as well as group insurance is available. All insured members will be covered under one group policy. Under the name of the earning head the policy will be issued for individual policy and under group policy the name of the association/institution/group will be issued.
The universal health insurance scheme of oriental insurance company will cover for hospitalisation expenses incurred for boarding, surgeon, anaesthetist, consultant fee, nursing expenses, blood, oxygen, operation theatre, pathology reports, artificial limb, cost of pacemaker, cost of organ and similar charges. The total claim for any one is up to Rs. 15,000/-.
Personal accident of the insured only for the earning member of the family who has sustained bodily injuries due to direct and solely form accident resulting in a visible, violent and outward means will be compensated.
The policy will not pay for the following reasons
1. The cost of contact lenses, spectacles and hearing aid. 2. Dental surgery or treatment unless hospitalisation is required. 3. War and war like perils 4. Self inflicted injury 5. Accidents caused due to intoxication of liquor and drugs 6. Naturopathy treatment 7. Person committing breach of law or criminal acts
Procedures followed during time of claim
In the event of any claim the full particulars will be submitted to the TPA named as scheduled in the policy.
All the document s related to the claims must be filed within 7days from discharged date from hospital with the TPA.