{"uin":"OICHLIP23134V052223","name":"Happy Family Floater 2021","url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223","insurer":{"slug":"oriental-insurance","name":"The Oriental Insurance Company Limited","url":"https://indiainsurances.com/insurer/oriental-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":"Individual","kind":"product","status":"active","approved_on":"2022-04-11","withdrawn_on":null,"summary":"Happy Family Floater Policy 2021 is a health indemnity family floater with Silver, Gold, Diamond and Platinum plans and sum insured options from Rs.1 lakh to Rs.50 lakhs. It has 30 days initial waiting, 48 months pre-existing disease waiting, an eight year moratorium, and the Silver plan has a 10% compulsory co-payment.","analysis":{"state":"machine","analysed_at":"2026-10-19 21:46:36.105833+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Silver","Gold","Diamond","Platinum"],"display":"Silver, Gold, Diamond and Platinum","note":null,"quote":"The benefits under this Policy are available under four plans, viz Silver, Gold, Diamond and Platinum as opted by the Insured in the proposal form.","sources":[{"clause":"3.1","heading":null,"page":7,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"not-stated","value":null,"display":null,"note":"The wording refers to the Policy Period or the schedule, but does not print a fixed policy term.","quote":null,"sources":[],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"Immediate notice of claim must be given to the Company or TPA during hospital treatment, within 48 hours of admission and before discharge, unless waived in writing.","display":"Within 48 hours of admission but before discharge","note":null,"quote":"Immediate notice of claim with particulars relating to Policy Number, ID Card No., Name of Insured Person in respect of whom claim is made, Nature of disease / Injury and Name and Address of the attending Medical Practitioner / Hospital /Nursing Home etc. should be given to the Company/ TPA while taking treatment in the Hospital / Nursing Home by fax, e-mail. Such notice should be given within 48 hours of admission but before discharge from Hospital / Nursing Home, unless waived in writing.","sources":[{"clause":"5.19","heading":"NOTIFICATION OF CLAIM: Immediate notice of claim with particulars relating to Policy","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-19"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Final claim","original Bills/ Cash memos/reports","claim form","Original bills, all receipts and discharge certificate / card from the Hospital","All documents pertaining to the Illness","Medical history of the patient recorded by the Hospital","Original Cash-memo from the Hospital (s) / chemist (s) supported by proper prescription","Original receipt, pathological and other test reports","Original attending Consultants / Anesthetists/ Specialist certificates","Surgeon’s original certificate","MLC/FIR/Post Mortem Report,( if applicable)","Disability certificate, Death certificate ( if applicable)","Documents in respect of organ donation claim","Details of previous policies","Any other information required by TPA /Company"],"display":"Claim form, original bills, receipts, discharge card, medical history, test reports, consultant/surgeon certificates, MLC/FIR/Post Mortem Report if applicable, disability/death certificate if applicable, organ donation documents, previous policy details and any other information required","note":"Final claim documents are to be submitted within 15 days of discharge.","quote":"Final claim along with original Bills/ Cash memos/reports, claim form and documents as listed below should be submitted to the Company / TPA within 15 days of discharge from the Hospital / Nursing Home.\n• Original bills, all receipts and discharge certificate / card from the Hospital.\n• All documents pertaining to the Illness, starting from the date it was first detected, i.e. Doctor’s consultations reports/history\n• Medical history of the patient recorded by the Hospital.\n• Original Cash-memo from the Hospital (s) / chemist (s) supported by proper prescription.\n• Original receipt, pathological and other test reports from a pathologist / radiologist including filmetcsupported by the note from attending Medical Practitioner / Surgeon demanding such tests.\n• Original attending Consultants / Anesthetists/ Specialist certificates regarding diagnosis and bills / receipts etc.\n• Surgeon’s original certificate stating diagnosis and nature of operation performed along with bills / receipts etc.\n• MLC/FIR/Post Mortem Report,( if applicable)\n• Disability certificate, Death certificate ( if applicable)\n• Documents in respect of organ donation claim, shall be in accordance with the extant Act, Central / State Rules / regulations, as applicable, in respect of transplantation of human organs\n• Details of previous policies, if the details are already not with TPA.\n• Any other information required by TPA /Company.","sources":[{"clause":"5.20","heading":"CLAIM DOCUMENTS: Final claim along with original Bills/ Cash memos/reports, claim form","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-20"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The Company shall settle or reject a claim within 30 days from receipt of the last necessary document. If investigation is warranted, it shall complete investigation not later than 30 days from receipt of the last necessary document and settle or reject within 45 days from receipt of the last necessary document.","display":"30 days from last necessary document; 45 days if investigation is warranted","note":"For delayed payment, interest is at a rate 2% above the bank rate.","quote":"The Company shall settle or reject a claim, as the case may be, within 30 days from the date of receipt of last necessary document. ... where the circumstance of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document. In such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":"5.2","heading":"CONDITION PRECEDENT TO ADMISSION OF LIABILITY: The terms and conditions of the","page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Pre-existing Diseases - code -ExcI0 1","Specified disease / procedure waiting period- code- ExcI02","30 day waiting period- code – ExcI03","Investigation & Evaluation – Code – ExcI04","Rest Cure, rehabilitation and respite care – Code -ExcI05","Obesity/Weight Control : Code- EscI06","Change of Gender Treatments: Code – ExcI07","Cosmetic or Plastic Surgery- Code- ExcI08","Hazardous or Adventure sports- Code- ExcI09","Breach of law – Code –ExcI10","Treatment for, Alcoholic drug or substance abuse or any addictive condition and consequences thereof.– Code- ExcI12","Unproven Treatments- Code – ExcI16","Sterility and Infertility- Code- ExcI17","Treatment taken outside the geographical limits of India"],"display":"Main exclusions include PED, specified disease/procedure waiting periods, 30 day waiting period, investigation and evaluation, rest cure, obesity surgery outside conditions, gender change, cosmetic surgery, hazardous sports, breach of law, alcohol/drug abuse, unproven treatment, sterility/infertility and treatment outside India","note":"Excl01 to Excl03 are waiting-period exclusions; the others listed are permanent or standard exclusions.","quote":"Pre-existing Diseases - code -ExcI0 1 ... Specified disease / procedure waiting period- code- ExcI02 ... 30 day waiting period- code – ExcI03 ... Investigation & Evaluation – Code – ExcI04 ... Rest Cure, rehabilitation and respite care – Code -ExcI05 ... Obesity/Weight Control : Code- EscI06 ... Change of Gender Treatments: Code – ExcI07 ... Cosmetic or Plastic Surgery- Code- ExcI08 ... Hazardous or Adventure sports- Code- ExcI09 ... Breach of law – Code –ExcI10 ... Treatment for, Alcoholic drug or substance abuse or any addictive condition and consequences thereof.– Code- ExcI12 ... Unproven Treatments- Code – ExcI16 ... Sterility and Infertility- Code- ExcI17 ... Treatment taken outside the geographical limits of India.","sources":[{"clause":"4.1","heading":"Pre-existing Diseases - code -ExcI0 1","page":21,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-1"},{"clause":"4.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":21,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-2"},{"clause":"4.3","heading":"30 day waiting period- code – ExcI03","page":22,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-3"},{"clause":"4.4","heading":"Investigation & Evaluation – Code – ExcI04","page":22,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-4"},{"clause":"4.5","heading":"Rest Cure, rehabilitation and respite care – Code -ExcI05","page":22,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-5"},{"clause":"4.6","heading":"Obesity/Weight Control","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-6"},{"clause":"4.7","heading":"Change of Gender Treatments: Code – ExcI07 Expenses related to any treatment, including","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-7"},{"clause":"4.8","heading":"Cosmetic or Plastic Surgery- Code- ExcI08 Expenses for cosmetic or plastic surgery or any","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-8"},{"clause":"4.9","heading":"Hazardous or Adventure sports- Code- ExcI09 Expenses related to any treatment necessitated","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-9"},{"clause":"4.10","heading":"Breach of law","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-10"},{"clause":"4.12","heading":null,"page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-12"},{"clause":"4.16","heading":"Unproven Treatments- Code","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-16"},{"clause":"4.17","heading":null,"page":24,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-17"},{"clause":"4.38","heading":null,"page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-38"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"The insured person may first contact the company through website, toll free numbers or e-mail, or approach the grievance cell at any branch. If not satisfied, the insured may contact the grievance officer at the Customer Service Department, 4th Floor, Agarwal House, Asaf Ali Road, New Delhi-110002.","display":"Company website/toll-free/e-mail or branch grievance cell first; then grievance officer at Customer Service Department, New Delhi","note":null,"quote":"In case of any grievance the insured person may contact the company through\nWebsite: www.orientalinsurance.org.in Toll free: 1800118485 Or 011- 33208485 E-mail: csd@orientalinsurance.co.in\nInsured person may also approach the grievance cell at any of the company’s branches with the details of grievance. If insured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer at: Customer Service Department 4th Floor, Agarwal House Asaf Ali Road, New Delhi-110002.","sources":[{"clause":"5.13","heading":"GRIEVANCE REDRESSAL In case of any grievance the insured person may contact the","page":30,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-13"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"Silver: Rs.1, 2,3,4 & 5 lakh; Gold: Rs.6,7,8,9 & 10 lakh; Diamond: Rs.12, 15, 18 and 20 lacs; Platinum: Rs.,25,30, 40 and 50 lacs.","display":"Rs.1, 2,3,4 & 5 lakh; Rs.6,7,8,9 & 10 lakh; Rs.12, 15, 18 and 20 lacs; Rs.,25,30, 40 and 50 lacs","note":"Plan-wise options are Silver, Gold, Diamond and Platinum respectively.","quote":"Sum Insured Available | Rs.1, 2,3,4 & 5 lakh | Rs.6,7,8,9 & 10 lakh | Rs.12, 15, 18 and 20 lacs | Rs.,25,30, 40 and 50 lacs","sources":[{"clause":"3.1","heading":null,"page":7,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to covered accident claims.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"4.3","heading":"30 day waiting period- code – ExcI03","page":22,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-3"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":48},"display":"48 months","note":null,"quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with the insurer.","sources":[{"clause":"4.1","heading":"Pre-existing Diseases - code -ExcI0 1","page":21,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-1"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"days","amount":90},"display":"90 days","note":"Other listed waiting periods are 1 year, 2 years, 4 Years and 5 Years. If hypertension or diabetes are pre-existing at inception, the PED exclusion applies.","quote":"Xvii | Hypertension. | 90 days*\nXviii | Diabetes. | 90 days* ... I | Benign ENT disorders and surgeries i.e. Tonsillectomy, Adenoidectomy, Mastoidectomy, Tympanoplasty etc. | 1 year ... Iii | Surgery of hernia. | 2 years ... Xxiii | Joint Replacement due to Degenerative condition. | 4 Years\nXxiv | Age related osteoarthritis and Osteoporosis. | 5 Years","sources":[{"clause":"4.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":21,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Benign ENT disorders and surgeries i.e. Tonsillectomy, Adenoidectomy, Mastoidectomy, Tympanoplasty etc.","Polycystic ovarian diseases.","Surgery of hernia.","Surgery of hydrocele.","Non infective Arthritis.","Undescendent Testes.","Cataract.","Surgery of benign prostatic hypertrophy.","Hysterectomy for menorrhagia or fibromyoma or myomectomy or prolapse of uterus","Fissure / Fistula in anus.","Piles.","Sinusitis and related disorders.","Surgery of gallbladder and bile duct excluding malignancy.","Surgery ofgenito-urinary system excluding malignancy.","Pilonidal Sinus.","Gout and Rheumatism.","Hypertension.","Diabetes.","Calculus diseases.","Surgery for prolapsed inter vertebral disk unless arising from accident.","Surgery of varicose veins and varicose ulcers.","Congenital internal diseases.","Joint Replacement due to Degenerative condition.","Age related osteoarthritis and Osteoporosis."],"display":"Benign ENT disorders, polycystic ovarian diseases, hernia, hydrocele, arthritis, undescendent testes, cataract, BPH, hysterectomy/myomectomy/prolapse, fistula/fissure, piles, sinusitis, gallbladder/bile duct surgery, genito-urinary surgery, pilonidal sinus, gout/rheumatism, hypertension, diabetes, calculus diseases, prolapsed inter vertebral disk surgery, varicose veins/ulcers, congenital internal diseases, joint replacement due to degenerative condition, age related osteoarthritis and osteoporosis","note":null,"quote":"I | Benign ENT disorders and surgeries i.e. Tonsillectomy, Adenoidectomy, Mastoidectomy, Tympanoplasty etc. | 1 year\nIi | Polycystic ovarian diseases. | 1 year\nIii | Surgery of hernia. | 2 years\nIv | Surgery of hydrocele. | 2 years\nV | Non infective Arthritis. | 2 years\nVi Undescendent Testes. | 2 Years\nVii | Cataract. | 2 Years\nViii | Surgery of benign prostatic hypertrophy. | 2 Years\nIx | Hysterectomy for menorrhagia or fibromyoma or myomectomy or prolapse of uterus | 2 Years\nX | Fissure / Fistula in anus. | 2 Years\nXi | Piles. | 2 Years\nXii | Sinusitis and related disorders. | 2 Years\nXiii | Surgery of gallbladder and bile duct excluding malignancy. | 2 Years\nXiv | Surgery ofgenito-urinary system excluding malignancy. | 2 Years\nXv | Pilonidal Sinus. | 2 Years\nXvi | Gout and Rheumatism. | 2 Years\nXvii | Hypertension. | 90 days*\nXviii | Diabetes. | 90 days*\nXix | Calculus diseases. | 2 Years\nXx | Surgery for prolapsed inter vertebral disk unless arising from accident. | 2 Years\nXxi | Surgery of varicose veins and varicose ulcers. | 2 Years\nXxii | Congenital internal diseases. | 2 Years\nXxiii | Joint Replacement due to Degenerative condition. | 4 Years\nXxiv | Age related osteoarthritis and Osteoporosis. | 5 Years","sources":[{"clause":"4.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":21,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-2"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"years","amount":8},"display":"eight continuous years","note":"For enhanced sums insured, eight continuous years apply from the date of enhancement only on the enhanced limits.","quote":"After completion of eight continuous years under this policy no look back to be applied. This period of eight years is called as moratorium period. ... After the expiry of Moratorium Period no health insurance claim shall be contestable except for proven fraud and permanent exclusions specified in the policy contract.","sources":[{"clause":"5.11","heading":"MORATORIUM PERIOD After completion of eight continuous years under this policy no look","page":30,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-11"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The insured person can port the policy to other insurers by applying at least 45 days before, but not earlier than 60 days from, the renewal date. If continuously covered without lapses, accrued continuity benefits in waiting periods are given as per IRDAI portability guidelines.","display":"Can port to another insurer with waiting-period continuity credit, applying 45 to 60 days before renewal","note":null,"quote":"The Insured Person will have the option to port the Policy to other insurers by applying to such insurer to port the entire policy along with all the members of the family, if any, at least 45 days before, but not earlier than 60 days from the policy renewal date as per IRDAI guidelines related to portability. If such person is presently covered and has been continuously covered without any lapses under any health insurance policy with an Indian General/Health insurer, the proposed insured person will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability.","sources":[{"clause":"5.9","heading":"PORTABILITY","page":29,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-9"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"not-stated","value":null,"display":null,"note":"The renewal clause says the policy is ordinarily renewable, but does not state lifelong renewal or no maximum renewal age.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"Renewal premium is not loaded based on individual claim experience. Claim loadings from previous policies are discontinued when renewed into Happy Family Floater Policy - 2021.","display":"No loading on renewals based on individual experience","note":null,"quote":"No loading shall apply on renewals based on individual experience. ... The insured persons with claim loading(s) on their previous policies will not have any loading on the premium on renewal into Happy Family Floater Policy - 2021, i.e. loadings on account of claims are discontinued.","sources":[{"clause":"5.8","heading":"RENEWAL OF POLICY","page":29,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-8"},{"clause":"5.33","heading":"NO CLAIM DISCOUNT /LOADING: This","page":34,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-33"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"The insured may cancel by giving 15days' written notice. The Company refunds premium on short term rates for the unexpired period, but no refund is made if any claim has been admitted or lodged or any benefit availed.","display":"Refund on short term rates after 15days' written notice; no refund if a claim is admitted, lodged or a benefit availed","note":null,"quote":"The Insured may cancel this Policy by giving 15days' written notice, and in such an event, the Company shall refund premium on short term rates for the unexpired Policy Period as per the rates detailed below.\nPeriod on Risk | Rate of premium to be charged\nUp to 1 Month | 1/4th of the annual rate\nUp to 3 Months | 1/2 of the annual rate\nUp to 6 Months | 3/4th of the annual rate\nExceeding 6 months | Full annual rate\nNotwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by the Insured person under the Policy.","sources":[{"clause":"5.5","heading":"CANCELLATION CLAUSE: The Insured may cancel this Policy by giving 15days' written","page":28,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-5"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"Medical treatment must be taken in India only, except where the policy is extended to SAARC countries. SAARC extension is by written request before leaving India and cashless service is not available outside India.","display":"India only, except optional SAARC extension on reimbursement basis","note":"SAARC extension requires a written request before leaving the country, informing duration, purpose and country of visit.","quote":"All medical treatment for the purpose of this insurance will have to be taken in India only (except where the Policy has been extended to SAARC countries) and all claims shall be payable in Indian currency only. ... The Policy can be extended to cover Insured Persons visiting other SAARC (South Asian Association for Regional Co-operation) countries - Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan, Sri Lanka. No additional premium will be charged for this extension. ... Cashless service will not be available for treatment taken in countries outside India and such claims, shall be considered only on re-imbursement basis.","sources":[{"clause":"5.23","heading":"PAYMENT OF CLAIM: All medical treatment for the purpose of this insurance will have to be","page":33,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-23"},{"clause":"3.2.1","heading":"GEOGRAPHICAL EXTENSION TO SAARC COUNTRIES: The Policy can be extended to cover","page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-2-1"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":15},"display":"15 days","note":"Applicable on new individual health insurance policies, not on renewals or porting/migration, except a one-time option for insureds first renewed into Happy Family Floater Policy - 2021.","quote":"the insured person shall be allowed free look period of 15 days from the date of receipt of the Policy document to review the terms and conditions of the Policy, and to return the same if not acceptable.","sources":[{"clause":"5.7","heading":"FREE LOOK PERIOD: The free look period shall be applicable on new individual health","page":29,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-7"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":null,"quote":"At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.","sources":[{"clause":"5.8","heading":"RENEWAL OF POLICY","page":29,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-8"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"Dependent children can be covered from 91days, and maximum entry age is 65years for all members. Persons above 65 and up to 70 years can be covered under Silver or Gold Plan with 20% compulsory co-payment.","display":"91days to 65years; above 65 up to 70 years under Silver or Gold with 20% co-payment","note":"Child eligibility differs by dependency and marital status as stated in the family definition.","quote":"Dependent Children (i.e. natural or legally adopted) between the ages 91daysto 18 years. ... Maximum Entry Age under the Policy is 65years for all members. However, with a compulsory co-payment of 20% of each and every claim, persons above the age of 65 and up to 70 years of age can also be covered under Silver or Gold Plan, but not under Diamond and Platinum Plan.","sources":[{"clause":"2.13","heading":"FAMILY consists of the Insured and/ or anyone or more of the family members as mentioned","page":2,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-2-13"},{"clause":"5.31","heading":"ENTRY AGE","page":34,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-31"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"not-stated","value":null,"display":null,"note":"The wording does not state whether premiums can be paid yearly, half-yearly, quarterly or monthly.","quote":null,"sources":[],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["Restoration of Sum Insured","Personal Accident Cover","Life Hardship Survival Benefit Plan","Waiver of Proportionate Deduction Clause","Waiver of 10 % co-pay under silver plan"],"display":"Restoration of Sum Insured, Personal Accident Cover, Life Hardship Survival Benefit Plan, Waiver of Proportionate Deduction Clause and Waiver of 10 % co-pay under silver plan","note":"Geographical extension to SAARC countries is also available on request, but the wording says no additional premium is charged for that extension.","quote":"Following coverage can be taken on payment of additional premium. ... RESTORATION OF SUM INSURED ... PERSONAL ACCIDENT COVER: (WORLD – WIDE) ... LIFE HARDSHIP SURVIVAL BENEFIT PLAN ... WAIVER OF PROPORTIONATE DEDUCTION CLAUSE ... WAIVER OF 10 % CO-PAY under silver plan is available on payment of extra premium.","sources":[{"clause":"3.2.2","heading":null,"page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-2-2"},{"clause":"3.2.2(ii)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-2-2-ii"},{"clause":"3.2.2(iv)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-2-2-iv"},{"clause":"Row 1(viii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-row-1-viii"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is not available during the grace period.","display":"No coverage during the grace period","note":null,"quote":"Coverage is not available during the grace period.","sources":[{"clause":"5.8","heading":"RENEWAL OF POLICY","page":29,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-8"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room, boarding and nursing expenses are limited to 1 % of the Sum Insured per day under Silver, Gold, Diamond and Platinum plans.","display":"1 % of the Sum Insured per day","note":"The same table columns are Silver, Gold, Diamond and Platinum.","quote":"Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. | 1 % of the Sum Insured per day | 1 % of the Sum Insured per day | 1% of the Sum Insured per day. | 1% of the Sum Insured per day.","sources":[{"clause":"3.1","heading":null,"page":7,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-applicable","value":null,"display":null,"note":"The room limit is expressed as a percentage of sum insured per day, not as a room category such as shared room or single private room.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU expenses are limited to 2% of the Sum Insured per day under Silver, Gold, Diamond and Platinum plans.","display":"2% of the Sum Insured per day","note":"The same table columns are Silver, Gold, Diamond and Platinum.","quote":"Intensive Care Unit (ICU) Expenses as provided by the Hospital /Nursing Home.* | 2% of the Sum Insured per day. | 2% of the Sum Insured per day. | 2% of the Sum Insured per day | 2% of the Sum Insured per day","sources":[{"clause":"3.1","heading":null,"page":7,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"quote-verified","value":"If the insured is admitted in a room where the room category or room rent is higher than eligibility, the insured bears a ratable proportion of associated medical expenses. This does not apply to medicines/pharmacy/drugs, consumables, medical devices/implants and diagnostics.","display":"Yes, associated medical expenses are reduced proportionately if room rent/category exceeds eligibility","note":null,"quote":"If the Insured Person is admitted in the hospital in a room where the room category or the Room Rent incurred is higher than the eligibility as specified in the Policy Schedule/ Certificate of Insurance, then the Policyholder/ Insured Person shall bear a ratable proportion of the total & specified Associated Medical Expenses (including surcharge or taxes thereon) in the proportion of the difference between the Room Rent of the entitled room category/eligible Room Rent to the Room Rent actually incurred. However, this will not be applicable in respect of Medicines/Pharmacy/ Drugs, Consumables, Medical Devices/ implants and Cost of Diagnostics.","sources":[{"clause":"5.35","heading":"PROPORTIONATE CLAUSE - If the Insured Person is admitted in the hospital in a room","page":35,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-35"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"Silver plan has a compulsory co-payment of 10% of each and every claim; Gold, Diamond and Platinum show NIL in the benefit table. Persons above 65 and up to 70 years covered under Silver or Gold have compulsory co-payment of 20% of each and every claim.","display":"Silver: 10% of each & every claim; Gold/Diamond/Platinum: NIL","note":"The Silver 10% co-pay can be waived on payment of extra premium.","quote":"Compulsory co-payment | 10% of each & every claim | NIL | NIL | NIL ... Under the SILVER plan the insured has to bear 10% of admissible claim Amount in each and every claim. ... with a compulsory co-payment of 20% of each and every claim, persons above the age of 65 and up to 70 years of age can also be covered under Silver or Gold Plan ... WAIVER OF 10 % CO-PAY under silver plan is available on payment of extra premium.","sources":[{"clause":"3.1(b)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-b"},{"clause":"4.40","heading":"Compulsory Co-Payment: Under the SILVER plan the insured has to bear 10% of admissible","page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-40"},{"clause":"5.31","heading":"ENTRY AGE","page":34,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-31"},{"clause":"Row 1(viii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-row-1-viii"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"not-stated","value":null,"display":null,"note":"No product-specific deductible amount or basis is printed in the provided wording.","quote":null,"sources":[],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Uterine Artery Embolization and HIFU: Per policy period: Up to INR 50,000.","Balloon Sinuplasty: Per policy period: Up to INR 40,000.","Deep Brain stimulation: 10% of SI subject to maximum INR 50,000 or INR 1,50,000 depending on sum insured slab","Oral chemotherapy: 25% of SI subject to maximum INR 50,000 or up to INR 1,50,000 depending on sum insured slab","Immunotherapy- Monoclonal Antibody to be given as injection: 10% of SI subject to maximum INR 50,000 or INR 1,50,000 depending on sum insured slab","Robotic surgeries: 10% of SI subject to maximum INR 1,00,000 or INR 2,00,000 depending on sum insured slab","Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions to be covered: 10% of SI subject to maximum INR 50,000 or INR 1,50,000 depending on sum insured slab"],"display":"Advanced treatment procedure caps apply, including INR 40,000 to INR 2,00,000 or percentage-of-SI caps depending on procedure and sum insured slab","note":"The same clause also lists caps for Intra vitreal injections, Stereotactic radio surgeries, Bronchial Thermoplasty, Vaporization of the prostrate, and IONM.","quote":"All the following procedures, will be covered in the policy, if treated as in-patient care or as a part of domiciliary hospitalization or as day care treatment in the hospital, within the sub-limits in the complete policy period which is as defined below:\nName of the Procedure | Sub limits for sum insured slabfrom Rs.1.0 lac to Rs. 10.0 lacs | Sub limits for sum insured slab from Rs.12.0 lac to Rs. 50.0 lacs\nA. Uterine Artery Embolization and HIFU | Per policy period: Up to INR 50,000.\nB. Balloon Sinuplasty | Per policy period: Up to INR 40,000.\nC. Deep Brain stimulation | Per policy period 10% of SI, subject to maximum INR 50,000. | Per policy period 10% of SI, subject to maximum INR 1,50,000.\nD. Oral chemotherapy | Per policy period 25% of SI, subject to maximum INR 50,000. | Per policy period: Up to INR 1,50,000.\nE. Immunotherapy- Monoclonal Antibody to be given as injection | Per policy period 10% of SI, subject to maximum INR 50,000. | Per policy period 10% of SI, subject to maximum INR 1,50,000. ... G. Robotic surgeries | Per policy period 10% of SI, subject to maximum INR 1,00,000.* | Per policy period 10% of SI, subject to maximum INR 2,00,000.* ... L. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions to be covered. | Per policy period 10% of SI, subject to maximum INR 50,000. | Per policy period 10% of SI, subject to maximum INR 1,50,000.","sources":[{"clause":"3.1.16","heading":null,"page":15,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-16"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days prior to Hospitalization","note":null,"quote":"Medical expenses incurred 30 days prior to Hospitalization and up to 60 days post Hospitalization.","sources":[{"clause":"3.1(b)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-b"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days post Hospitalization","note":null,"quote":"Medical expenses incurred 30 days prior to Hospitalization and up to 60 days post Hospitalization.","sources":[{"clause":"3.1(b)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-b"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Day care procedures / surgeries listed in Appendix I are covered where treatment is taken in a Hospital / day care centre, but not the Out-patient department. Any other day care treatment is covered if prior written approval from Company / TPA is obtained.","display":"Appendix I day care procedures/surgeries and other day care treatment with prior written approval","note":null,"quote":"Day care procedures / surgeries (Appendix I) where such treatment is taken by an Insured Person in a Hospital / day care centre(but not the Out-patient department of a Hospital),Or ... Any other day care treatment as mentioned and for which prior approval from Company / TPA is obtained in writing.","sources":[{"clause":"3.1(a)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-a-2"},{"clause":"3.1(b)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-b-2"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary hospitalization is covered, with plan-wise limits. Silver is 10% of Sum Insured, maximum Rs.25000/- during the policy period; Gold, Diamond and Platinum are maximum Rs. 50,000 during the policy period.","display":"Covered up to 10% of Sum Insured max Rs.25000/- in Silver; max Rs. 50,000 in Gold/Diamond/Platinum","note":"The wording excludes domiciliary claims if treatment lasts three days or less and excludes listed diseases such as asthma, bronchitis, chronic nephritis, diarrhoea/dysenteries, epilepsy, hypertension, influenza/cough/cold, pyrexia under 10days, tonsillitis/URTI and arthritis/gout/rheumatism.","quote":"DOMICILIARY HOSPITALISATION BENEFITS(Refer clause 3.1.1 below)\ni. | Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines &Drugs, Diagnostic Material and Dialysis, Chemotherapy, Nursing expenses. | 10% of Sum Insured, Maximum Rs.25000/- during the Policy Period. | Maximum Rs. 50,000/- during the Policy Period. | Maximum Rs. 50,000 during the Policy Period. | Maximum Rs. 50,000 during the Policy Period.","sources":[{"clause":"3.1(b)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-b-2"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"The policy indemnifies inpatient medical expenses for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the sum insured in any AYUSH Hospital.","display":"Covered up to sum insured in any AYUSH Hospital","note":null,"quote":"The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as specified in the policy schedule in any AYUSH Hospital.","sources":[{"clause":"3.1(b)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-b"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Advanced treatments are covered if treated as inpatient care, domiciliary hospitalization or day care in hospital, subject to per-policy-period sub-limits by procedure and sum insured slab.","display":"Covered with sub-limits for listed advanced treatments","note":"Other listed procedures include Uterine Artery Embolization and HIFU, Balloon Sinuplasty, Deep Brain stimulation, Intra vitreal injections, Stereotactic radio surgeries, Bronchial Thermoplasty, Vaporization of the prostrate, and IONM.","quote":"ADVANCED TREATMENTS All the following procedures, will be covered in the policy, if treated as in-patient care or as a part of domiciliary hospitalization or as day care treatment in the hospital, within the sub-limits in the complete policy period which is as defined below: ... D. Oral chemotherapy | Per policy period 25% of SI, subject to maximum INR 50,000. | Per policy period: Up to INR 1,50,000. ... E. Immunotherapy- Monoclonal Antibody to be given as injection | Per policy period 10% of SI, subject to maximum INR 50,000. | Per policy period 10% of SI, subject to maximum INR 1,50,000. ... G. Robotic surgeries | Per policy period 10% of SI, subject to maximum INR 1,00,000.* | Per policy period 10% of SI, subject to maximum INR 2,00,000.* ... L. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions to be covered. | Per policy period 10% of SI, subject to maximum INR 50,000. | Per policy period 10% of SI, subject to maximum INR 1,50,000.","sources":[{"clause":"3.1.16","heading":null,"page":15,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-16"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"When the insured person is the recipient, the policy covers inpatient hospitalization medical expenses of the organ donor up to the sum insured. It does not cover organ acquisition cost, donor screening, donor pre/post-hospitalisation expenses or complications consequent to organ harvesting.","display":"Covered for donor inpatient hospitalization when insured is recipient, up to Sum Insured","note":"The donated organ must be for use of the insured person who has been medically advised to undergo organ transplant, and the insured person's hospitalization claim must be admissible.","quote":"Donor Expenses when Insured Person is Recipient. (Refer clause 3.1.8 below) | Maximum up to full Sum Insured ... The Policy covers in- | patient Hospitalization Medical expenses in respect of the organ donor provided that the\ndonation conforms to | the Transplantation of Human Organs Act 1994(amended) ... The Policy does not cover:\n• Cost directly or indirectly associated with the acquisition of the organ and / or cost of organ.\n• cost towards donor screening\n• Any Pre and Post Hospitalization medical expenses of the donor.\n• Any other medical treatment or complication consequent to organ harvesting, in respect of the donor.","sources":[{"clause":"3.1(b)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-b"},{"clause":"3.1.8","heading":"ORGAN DONOR EXPENSES- WHEN INSURED PERSON IS THE RECIPIENT The Policy","page":14,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-8"},{"clause":"3.1.8(ii)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-8-ii"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance charges are covered per illness and per policy period: Silver Rs.1000 per illness and 1% SI max Rs.3000; Gold Rs.2000 and max Rs.6000; Diamond Rs.3000 and max Rs.8000; Platinum Rs.5000 and max Rs.15000. Platinum also has air ambulance up to 5% of sum insured for medical emergency cases only.","display":"Road ambulance: Rs.1000/Rs.2000/Rs.3000/Rs.5000 per illness by plan, with policy-period caps; Platinum air ambulance up to 5% of SI","note":"Air ambulance is available for Platinum Plan only and subject to the conditions in clause 3.1.9.","quote":"Ambulance service charges as herein after defined. | Per Illness - Rs.1000 maximum & Per policy period 1% of Sum Insured, Subject to maximum Rs.3000. | Per Illness - Rs.2000 maximum & Per policy period 1% of Sum Insured, Subject to maximum Rs.6000. | Per Illness - Rs.3000 maximum & Per policy period 1% of Sum Insured, Subject to maximum Rs.8000. | Per Illness - Rs.5000 maximum& Per policy period 1% of Sum Insured, Subject to maximum Rs.15000. ... Air Ambulance Cover (Refer clause 3.1.9 below) | Not available | Not available | Not available | Maximum upto 5% of the SI for medical emergency cases only.","sources":[{"clause":"3.1(b)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-b"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"quote-verified","value":"Restoration is an optional benefit on payment of extra premium under Silver and Gold only, with 50% or 100% of Sum Insured options. If the sum insured is reduced or exhausted by a claim, it is restored to the extent of the claim amount, not exceeding the opted restoration limit.","display":"Optional in Silver/Gold: 50% or 100% of Sum Insured","note":"Optional covers are not part of the base answer unless chosen; restoration is not available under Diamond and Platinum.","quote":"Restoration of Sum Insured(It is an optional benefit on payment of extra premium) (Refer clause 3.2.2 A below) | 2 options- (i) 50% of the Sum Insured (ii) 100% of the Sum Insured | 2 options-(i) 50% of the Sum Insured (ii) 100% of the Sum Insured | Not available | Not available ... If during the Policy Period the Sum Insured gets reduced or exhausted on account of a claim under the Policy, the Sum Insured is automatically restored to the extent of the claim amount but not exceeding the Restoration limit opted (50% / 100% of Sum Insured) at the inception of the Policy. The benefit is available only under Silver and Gold Plan.","sources":[{"clause":"3.1(b)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-b"},{"clause":"3.2.2(ii)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-2-2-ii"}],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"There is no cover-increasing cumulative bonus stated. The wording describes only a one-time No Claim Discount for persons covered under the earlier Happy Family Floater Policy, with no change in discount for subsequent no-claim years and forfeiture after a claim.","display":"No cover-increasing bonus stated; one-time No Claim Discount for earlier Happy Family Floater renewals","note":"Claim under PA section will not affect the NCD earned thus far.","quote":"This is a one-time benefit for those Insured Persons covered under Happy Family Floater Policy. Happy Family Floater Policy had the provision of No Claim Discount / Loading, which has been discontinued under Happy Family Floater Policy- 2015.However, The discount on account of ‘No Claim’ that would have been earned by the Insured on renewal of the Happy Family Floater Policy, would be allowed when the Policy is renewed for the first time, into Happy Family Floater Policy-2021. However, there will be no change in discount even if there are no claims reported under the subsequent Happy Family Floater Policy-2021 Policy (ies). This discount shall continue till a claim is reported under the Policy and upon reporting of a claim, any discount earned on account of ‘No Claim’ shall be forfeited.","sources":[{"clause":"5.33","heading":"NO CLAIM DISCOUNT /LOADING: This","page":34,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-33"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"The wording lists many non-medical or consumable items as not available, including GLOVES and MASK. Some items are to be subsumed into room charges, procedure charges or costs of treatment.","display":"Listed non-medical items not covered; GLOVES and MASK appear in the non-payable list","note":"The policy also says proportionate deduction will not apply to consumables, but this does not override the non-payable item lists.","quote":"List I – List of which coverage is not available in the policy\nSl | Item ... 56 | GLOVES ... 60 | MASK ... List II – Items that are to be subsumed into Room Charges ... List III – Items that are to be subsumed into Procedure Charges ... List IV – Items that are to be subsumed into costs of treatment","sources":[{"clause":null,"heading":"T Other Operations","page":41,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-t-other-operations"},{"clause":null,"heading":"List II – Items that are to be subsumed into Room Charges","page":42,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-list-ii-items-that-are-to-be-subsumed-into-room"},{"clause":null,"heading":"List III – Items that are to be subsumed into Procedure Charges","page":43,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-list-iii-items-that-are-to-be-subsumed-into-proc"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses are covered only under Diamond and Platinum, after the Diamond / Platinum Plan has been continuously in force for at least 24 months for both insured and spouse. The limit is two deliveries or terminations during the lifetime and 2.5% of Sum Insured per policy period.","display":"Diamond/Platinum only; 24 months waiting; two deliveries/terminations lifetime; 2.5% of Sum Insured","note":"Insured persons already having two or more living children are not eligible for this benefit.","quote":"MATERNITY EXPENSES: The Company shall pay the Medical Expenses incurred as an In-patient for a delivery (including caesarean section) or lawful medical termination of pregnancy during the Policy Period limited to two deliveries or terminations or either during the lifetime of the Insured Person. This benefit is applicable only in Diamond and Platinum Plan, and available only to the Insured or his spouse, provided that:\ni) Diamond / Platinum Plan has been continuously in force for a period of minimum 24 months in respect of both the Insured and his/her spouse. ... Company’s maximum liability per delivery or termination shall be limited to 2.5% of the Sum Insured as stated in the Schedule","sources":[{"clause":null,"heading":"A.MATERNITY EXPENSES","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-a-maternity-expenses"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New born baby cover is available under Diamond and Platinum where the maternity claim is admissible. The newborn is covered from day one up to 90 days for inpatient hospital treatment, with aggregate liability limited to 2.5% of the Sum Insured.","display":"Diamond/Platinum only; from day one up to 90 days; 2.5% of Sum Insured","note":"Coverage beyond 90days is only on payment of requisite premium.","quote":"NEW BORN BABY COVER: New born Baby shall be covered from day one up to the age of 90 days and expenses incurred for treatment taken in Hospital as in patient shall only be payable, provided that:\ni. Claim under Maternity clause is admissible under the Policy\nii. In case the 90 days period for the New Born Baby is spread over two Policy Periods, the aggregate liability of the Company, for all claims in respect of the New Born Baby, shall be limited to 2.5% of the Sum Insured of the Policy under which Maternity claim was admitted.","sources":[{"clause":null,"heading":"B.NEW BORN BABY COVER","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-b-new-born-baby-cover"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"quote-verified","value":"The policy covers medical expenses including pre and post hospitalization expenses for mental illness, subject to hospitalization in a Mental Health Establishment and advice by a Mental Health Professional. Alcohol/drug-associated mental conditions, mental retardation and psychotherapy not needing hospitalization are excluded.","display":"In-patient mental illness covered under stated conditions","note":null,"quote":"MENTAL ILLNESS COVER The Company shall indemnify the Hospital or the Insured the Medical Expenses (including Pre and Post Hospitalization Expenses) only under certain conditions as:-\ni) Illness covered under definition of mental illness mentioned under definitions clause*.\nii) Hospitalization in Mental Health Establishment as defined under definitions clause*.\niii) Hospitalization as advised by Mental Health Professional as defined under definitions clause*.\niv) Mental Conditions associated with the abuse of alcohol and drugs are excluded.\nv) Mental Retardation and associated complications arising therein are excluded.\nvi) Any kind of Psychological counseling, cognitive/ family/ group/ behavior/ palliative therapy or other kinds of psychotherapy for which Hospitalization is not necessary shall not be covered.","sources":[{"clause":"3.1.15","heading":"MENTAL ILLNESS COVER MENTAL ILLNESS COVER The Company shall indemnify the","page":15,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-15"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":"The wording does not state a free preventive health check-up benefit.","quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"OPD expenses are excluded except the Platinum plan OPD benefit for dental and ophthalmic cover. That Platinum benefit reimburses up to Rs. 5,000 in a block of every three years for outpatient consultations, diagnostic tests and medicines/drugs for dental and ophthalmic care.","display":"OPD excluded except Platinum dental and ophthalmic cover up to Rs. 5,000 in a block of every three years","note":null,"quote":"Out Patient Department (OPD) Any expenses incurred on OPD (Except OPD benefit for Dental and Ophthalmic cover in Platinum Plan). ... The policy will reimburse OPD expenses Maximum up to Rs. 5,000 in a block of every three years for Dental and Ophthalmic care with respect of\ni) Out-patient consultations by a medical practitioner.\nii) Diagnostic tests prescribed by a medical practitioner.\niii) Medicines/drugs prescribed by a medical practitioner.","sources":[{"clause":"4.27","heading":"Out Patient Department (OPD) Any expenses incurred on OPD (Except OPD benefit for Dental","page":24,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-4-27"},{"clause":"3.1.11","heading":"OPD BENEFIT FOR DENTAL AND OPHTHALMIC COVER(Available only for platinum","page":15,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-3-1-11"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"quote-verified","value":"For Silver Plan, premium is charged based on two zones: Zone I is Gujarat, Mumbai, Greater Mumbai, and Delhi NCR, and Zone II is Rest of India. For Gold, Diamond and Platinum, premium rates are the same Pan India.","display":"Silver has Zone I and Zone II premium; other plans same Pan India","note":"The wording describes zone-based premium for Silver, not a treatment-city co-pay.","quote":"For Silver Plan, the premium in the policy will be charged on the basis of the 2 Zones, as defined below:\nZones are as defined below: ... Zone I Gujarat, Mumbai, Greater Mumbai, and Delhi NCR ... Zone II Rest of India\nInsured Person can choose the Zone at the time of proposal, and can also change it at the time of renewal. For other Plans, I.e. Gold, Diamond and Platinum Plans the premium rates will be same Pan India.","sources":[{"clause":"5.18","heading":"PAYMENT OF PREMIUM","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-18"},{"clause":null,"heading":"Zone I Gujarat, Mumbai, Greater Mumbai, and Delhi NCR","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-zone-i-gujarat-mumbai-greater-mumbai-and-delhi-n"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless access services are available through the Company or TPA when admission is in a network Hospital/Nursing Home and subject to pre-admission authorization. The list of network hospitals is available on the insurer's official website and from the TPA on demand.","display":"Available in network Hospital/Nursing Home with pre-admission authorization","note":"Denial of cashless access is not to be construed as denial of liability; the insured may seek treatment and submit full claim papers.","quote":"Claim in respect of Cashless Access Services will be through the Company / TPA provided admission is in a network Hospital/ Nursing Home and is subject to pre admission authorization. ... List of network Hospitals is available on our official websitewww.orientalinsurance.org.inand will also be provided by the concerned TPA on demand.","sources":[{"clause":"5.21","heading":null,"page":32,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-21"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims and servicing may be handled by the Third Party Administrator or by the Company, as the case may be.","display":"Company / TPA","note":null,"quote":"such insurance to be serviced by Third Party Administrator (hereinafter called the TPA) or the Company as the case maybe. ... should be given to the Company/ TPA while taking treatment in the Hospital / Nursing Home by fax, e-mail.","sources":[{"clause":null,"heading":"WE VALUE YOUR HEALTH & YOUR WEALTH. BUILD A PRODUCTIVE NATION","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-we-value-your-health-your-wealth-build-a-product"},{"clause":"5.19","heading":"NOTIFICATION OF CLAIM: Immediate notice of claim with particulars relating to Policy","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-5-19"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes","note":null,"quote":"HAPPY FAMILY FLOATER POLICY 2021 ... the liability of the Company, in respect of one or all the Insured Persons stated in the schedule, shall be up to the limit specified in the Policy and/or schedule of the Policy, but not exceeding the Sum Insured as stated in the schedule","sources":[{"clause":null,"heading":"HAPPY FAMILY FLOATER POLICY 2021","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-happy-family-floater-policy-2021"},{"clause":"1","heading":"PREAMBLE","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914#c-1"}],"law":[]}],"documents":[{"kind":"wording","label":"Happy Family Floater 2021 policy wordings","pages":49,"fetched_at":"2026-10-17 19:58:14+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/Happy_Family_Floater_2021_policy_wordings_04ad8fa002.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/13914"},{"kind":"wording","label":"Happy Family Floater Policy 2021 (IRDAI copy)","pages":47,"fetched_at":"2026-10-20 02:31:36+00","source_url":"https://irdai.gov.in/documents/37343/931203/OICHLIP22010V042223.pdf/b8f4f473-3670-8936-c219-d87881338353?version=1.0&t=1669353756992&download=true","url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223/document/28652"}],"versions":[{"uin":"OICHLIP22010V042223","version":null,"approved_on":null},{"uin":"OICHLIP23134V052223","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Oriental Insurance official website","url":"https://www.orientalinsurance.org.in/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claim forms","url":"https://www.orientalinsurance.org.in/claim-form","note":null},{"purpose":"claim","kind":"insurer","name":"Health claim status","url":"https://www.orientalinsurance.org.in/health-claim-status","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal","url":"https://www.orientalinsurance.org.in/grievance-redressal","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Happy Family Floater 2021 (UIN OICHLIP23134V052223), IndiaInsurances, https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2021-oichlip23134v052223"}