{"uin":"OICHLIP24034V012324","name":"Oriental Youth Eco Care Policy","url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324","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":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Oriental Youth Eco Care Policy is a health indemnity policy available on Individual, Floater and Floater with Floater basis under Basic and Premium plans, with a one year policy term and sum insured bands from INR. 3.0 lac to INR. 100.0 lacs. It has a 30 day initial illness waiting period, 12 months pre-existing disease waiting period, 45 days pre-hospitalisation cover, 90 days post-hospitalisation cover and lifelong renewal with a 30 day grace period.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:02:21.915584+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":["Basic","Premium"],"display":"Basic and Premium","note":null,"quote":"The benefits under this Policy are available on Individual/Floater/Floater with Floater Basis under two plans, viz Basic & Premium as opted by the Insured in the proposal form.","sources":[{"clause":"1","heading":"PREAMBLE","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-1"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"The policy term is one year.","display":"one year","note":"Stated in the prospectus; the policy wording defines policy period as the period mentioned in the schedule.","quote":"i) The Policy term is one year.","sources":[{"clause":"3","heading":"OTHER FEATURES","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13784#c-3"}],"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 while taking 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":30,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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":["Original bills, all receipts and discharge certificate / card from the Hospital.","All documents pertaining to the Illness, starting from the date it was first detected, i.e. Doctor’s consultations reports/history","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 from a pathologist / radiologist including film etc supported by the note from attending Medical Practitioner / Surgeon demanding such tests.","Original attending Consultants / Anesthetists/ Specialist certificates regarding diagnosis and bills / receipts etc.","Surgeon’s original certificate stating diagnosis and nature of operation performed along with bills / receipts etc.","MLC/FIR/Post Mortem Report,( if applicable)","Disability certificate, Death certificate ( if applicable)","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","Details of previous policies, if the details are already not with TPA.","Any other information required by TPA /Company."],"display":"Original hospital bills and receipts, discharge certificate/card, illness and medical history, prescriptions and cash memos, test reports, consultant and surgeon certificates, MLC/FIR/post mortem report if applicable, disability or death certificate if applicable, organ donation documents if applicable, previous policy details and any other information required.","note":"Documents should 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 film etc supported 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","page":30,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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 the claim within 30 days from receipt of last necessary documents. If investigation is warranted, it shall complete investigation within 30 days and settle within 45 days from receipt of the last necessary document; payment after acceptance is within 7 days.","display":"30 days from last necessary documents; 45 days if investigation; payment within 7 days of acceptance","note":null,"quote":"The Company shall settle the claim within 30 days from the date of the receipt of last necessary documents in accordance with the provisions of Regulation 27 of IRDAI (Health Insurance) Regulations, 2016.Upon acceptance of an offer of settlement by the insured, the payment of the amount due shall be made within 7 days from the date of acceptance of the offer by the Insured. However, where the circumstances 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 the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":"5.23","heading":"PAYMENT OF CLAIM: All medical treatment for the purpose of this insurance will have to","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-5-23"}],"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","Cosmetic or Plastic Surgery- Code- ExcI08","Hazardous or Adventure sports- Code- ExcI09","Treatment for, Alcoholic drug or substance abuse or any addictive condition and consequences thereof.– Code- ExcI12","Sterility and Infertility- Code- ExcI17","Maternity- Code- ExcI18","Out Patient Department (OPD) Any expenses incurred on OPD","Treatment taken outside the geographical limits of India.","Permanently Excluded Diseases"],"display":"PED, specified disease/procedure waiting periods, 30 day waiting period, investigation and evaluation, rest cure, cosmetic/plastic surgery, professional hazardous/adventure sports, substance abuse, sterility and infertility, maternity, OPD, treatment outside India and permanently excluded diseases.","note":"Maternity and sterility/infertility exclusions do not apply for the Premium Plan to the stated limits.","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 ... Cosmetic or Plastic Surgery- Code- ExcI08 Expenses for cosmetic or plastic surgery or any ... Hazardous or Adventure sports- Code- ExcI09 Expenses related to any treatment necessitated ... Treatment for, Alcoholic drug or substance abuse or any addictive condition and consequences thereof.– Code- ExcI12 ... Sterility and Infertility- Code- ExcI17 Expenses related to sterility and infertility. ... Maternity- Code- ExcI18 ... Out Patient Department (OPD) Any expenses incurred on OPD (Excludes ART under ... Treatment taken outside the geographical limits of India. ... Permanently Excluded Diseases In respect of the existing diseases, disclosed by the insured and mentioned in the policy schedule","sources":[{"clause":"4.1","heading":"Pre-existing Diseases - code -ExcI0 1","page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-1"},{"clause":"4.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-2"},{"clause":"4.3","heading":"30 day waiting period- code – ExcI03","page":20,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-3"},{"clause":"4.4","heading":"Investigation & Evaluation – Code – ExcI04","page":20,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-4"},{"clause":"4.5","heading":"Rest Cure, rehabilitation and respite care – Code -ExcI05","page":20,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-5"},{"clause":"4.8","heading":"Cosmetic or Plastic Surgery- Code- ExcI08 Expenses for cosmetic or plastic surgery or any","page":21,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-8"},{"clause":"4.9","heading":"Hazardous or Adventure sports- Code- ExcI09 Expenses related to any treatment necessitated","page":21,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-9"},{"clause":"4.12","heading":null,"page":21,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-12"},{"clause":"4.17","heading":null,"page":21,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-17"},{"clause":"4.18","heading":"Maternity- Code- ExcI18","page":22,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-18"},{"clause":"4.27","heading":"Out Patient Department (OPD) Any expenses incurred on OPD (Excludes ART under","page":22,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-27"},{"clause":"4.38","heading":null,"page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-38"},{"clause":"4.39","heading":null,"page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-39"}],"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":"First contact the company through its website, toll-free numbers, email or a branch grievance cell. If not satisfied, contact the grievance officer at Customer Service Department, Oriental House, A-25/27, Asaf Ali Road, New Delhi-110002.","display":"Company website/toll-free/email/branch grievance cell, then grievance officer at Customer Service Department, Oriental House, New Delhi","note":null,"quote":"In case of any grievance the insured person may contact the company through Website: 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, Oriental House, A-25/27, 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":28,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":null,"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(a)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-3-a"}],"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":12},"display":"12 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 12 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":18,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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 specified disease/procedure waiting periods are 1 year and 2 years. If hypertension or diabetes is pre-existing at inception, the longer of the two waiting periods applies.","quote":"Hypertension. | 90 days* ... Diabetes. | 90 days* ... Benign ENT disorders and surgeries i.e. Tonsillectomy, Adenoidectomy, Mastoidectomy, Tympanoplasty etc. | 1 year ... Surgery of hernia. | 2 years","sources":[{"clause":"4.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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.","Joint Replacement due to Degenerative condition.","Age related osteoarthritis and Osteoporosis."],"display":"Benign ENT disorders and surgeries, polycystic ovarian diseases, hernia, hydrocele, non-infective arthritis, undescended testes, cataract, benign prostatic hypertrophy, hysterectomy/myomectomy/prolapse of uterus, fissure/fistula, piles, sinusitis, gallbladder/bile duct surgery, genito-urinary surgery, pilonidal sinus, gout and rheumatism, hypertension, diabetes, calculus diseases, prolapsed inter vertebral disk, varicose veins/ulcers, degenerative joint replacement and age related osteoarthritis/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 | Joint Replacement due to Degenerative condition. | 2 Years\nXxiii | Age related osteoarthritis and Osteoporosis. | 2 Years","sources":[{"clause":"4.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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 applies from the date of enhancement 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","page":28,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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 and gets accrued continuity benefits in waiting periods as per IRDAI portability guidelines.","display":"Can port to other insurers with accrued continuity benefits in waiting periods","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":28,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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":"quote-verified","value":true,"display":"Yes, ordinarily renewable lifelong","note":null,"quote":"The policy shall ordinarily be renewable lifelong except on grounds of fraud, misrepresentation by the insured person.","sources":[{"clause":"5.8","heading":"RENEWAL OF POLICY: The policy shall ordinarily be renewable lifelong except on grounds of","page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-5-8"}],"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":"No loading applies on renewals based on individual experience.","display":"No loading on renewals based on individual experience","note":null,"quote":"No loading shall apply on renewals based on individual experience.","sources":[{"clause":"5.8","heading":"RENEWAL OF POLICY: The policy shall ordinarily be renewable lifelong except on grounds of","page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-5-8"}],"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 15 days' written notice. The company refunds premium on short-term rates for the unexpired policy period: up to 1 month 1/4th of annual rate charged, up to 3 months 1/2, up to 6 months 3/4th, and exceeding 6 months full annual rate; no refund if a claim has been admitted or lodged or any benefit availed.","display":"15 days' written notice; short-term refund rates, no refund if claim admitted/lodged or 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":27,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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 for the policy must be taken in India only, claims are payable in Indian currency only, and treatment outside India is excluded.","display":"India only","note":null,"quote":"All medical treatment for the purpose of this insurance will have to be taken in India only and all claims shall be payable in Indian currency only. ... Treatment taken outside the geographical limits of India.","sources":[{"clause":"5.23","heading":"PAYMENT OF CLAIM: All medical treatment for the purpose of this insurance will have to","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-5-23"},{"clause":"4.38","heading":null,"page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-38"}],"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":"Applies on new health insurance policies, not on renewals or at porting/migrating.","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 health insurance","page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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. Coverage is not available during the grace period.","sources":[{"clause":"5.8","heading":"RENEWAL OF POLICY: The policy shall ordinarily be renewable lifelong except on grounds of","page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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":"Any person aged between 18 years and 45 years residing in India can take this insurance.","display":"18 years to 45 years","note":null,"quote":"Any person aged between 18 years and 45 years residing in India can take this insurance.","sources":[{"clause":"3","heading":"COVERAGE UNDER THE POLICY","page":9,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3"}],"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 documents state that premium is paid in advance but do not list yearly, half-yearly, quarterly or monthly payment modes.","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":"not-stated","value":null,"display":null,"note":"The documents describe Basic and Premium plans, but do not state add-on covers sold for extra premium.","quote":null,"sources":[],"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: The policy shall ordinarily be renewable lifelong except on grounds of","page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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 by sum insured slab: up to 5 lakhs, Single Room up to 1% of Sum Insured, maximum Rs 5,000 per day; 7-10 lakhs, Single Room maximum Rs. 10,000 per day; above 10 lakhs, actual expenses.","display":"Up to 5 lakhs: Single Room up to 1% of SI, max Rs 5,000/day; 7-10 lakhs: Single Room max Rs. 10,000/day; above 10 lakhs: actual expenses","note":null,"quote":"Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home.\nSum Insured Slabs | Limit per day\nUp to 5 lakhs | Single Room up to 1% of Sum Insured, maximum up to Rs 5,000/- per day\n7- 10 lakhs | Single Room, maximum up to Rs. 10,000/- per day.\nAbove 10 lakhs | Actuals Expenses.","sources":[{"clause":"3.1","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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":"quote-verified","value":"Single Room is allowed for sum insured up to 10 lakhs, with rupee caps. Above 10 lakhs, room expenses are paid at actual expenses.","display":"Single Room up to 10 lakhs; actual expenses above 10 lakhs","note":null,"quote":"Up to 5 lakhs | Single Room up to 1% of Sum Insured, maximum up to Rs 5,000/- per day\n7- 10 lakhs | Single Room, maximum up to Rs. 10,000/- per day.\nAbove 10 lakhs | Actuals Expenses.","sources":[{"clause":"3.1","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-1"}],"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 by sum insured slab: up to 5 lakhs, maximum Rs.10,000 per day; 7-10 lakhs, maximum Rs. 20,000 per day; above 10 lakhs, actual expenses.","display":"Up to 5 lakhs: Rs.10,000/day; 7-10 lakhs: Rs. 20,000/day; above 10 lakhs: actual expenses","note":null,"quote":"Intensive Care Unit (ICU) Expenses as provided by the Hospital /Nursing Home.\nSum Insured Slabs | Limit per day\nUp to 5 lakhs | Maximum up to Rs.10,000/- per day\n7- 10 lakhs | Maximum up to Rs. 20,000/- per day\nAbove 10 lakhs | Actual expenses.","sources":[{"clause":"3.2","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-2"}],"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 the specified associated medical expenses in the proportion of eligible room rent to actual room rent. This does not apply to medicines, pharmacy, drugs, consumables, medical devices or implants and diagnostics.","display":"Yes, ratable proportion for associated medical expenses if room 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 below 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":"5.30","heading":"PROPORTIONATE CLAUSE - If the Insured Person is admitted in the hospital in a room where","page":33,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-5-30"}],"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":"not-stated","value":null,"display":null,"note":"The policy defines co-payment but does not state a product co-payment percentage or when it applies.","quote":null,"sources":[],"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":"quote-verified","value":"A 3 day deductible applies to domiciliary hospitalization and to Daily Hospital Cash Allowance. No general rupee deductible for the base hospitalization indemnity cover is stated.","display":"3 day deductible for domiciliary hospitalization and Daily Hospital Cash Allowance","note":"Daily Hospital Cash Allowance is under the Premium Plan.","quote":"Expenses for Domiciliary Hospitalization i.e. treatment at home , if medical treatment is continuously required for more than three (3) days ... 3 day deductible will be applicable ... When an Insured Person is hospitalized and a claim is admitted under the Policy, then the Insured Person shall be eligible for a Daily Cash Allowance ... and 3 day deductible will be applicable.","sources":[{"clause":"3.12","heading":"DOMICILIARY HOSPITALIZATION","page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-12"},{"clause":"3.12(ii)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-12-ii"},{"clause":"3.20","heading":"DAILY HOSPITAL CASH ALLOWANCE","page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-20"}],"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":["Mental Illness Cover: Up to 10 lakhs, up to 50% of Sum Insured; Above 10 lakhs, As per the limits of Sum Insured","Modern Treatment: Up to 10 lakhs, up to 25% of Sum Insured; Above 10 lakhs, As per the limits of Sum Insured","Cataract Treatment: Up to 10 lakhs, up to Rs 50,000/- per eye including IOL; Above 10 lakhs, up to Rs 1,00,000/- per eye including IOL.","Maternity expenses: Up to 10 lakhs, Up to Rs 50,000; 15 -25 lakhs, Up to Rs 75,000; Above 25 lakhs, Up to Rs 1,00,000"],"display":"Mental illness, modern treatments, cataract and maternity have stated sub-limits.","note":"Maternity expenses are in the Premium Plan.","quote":"MENTAL ILLNESS COVER ... Sum Insured Slabs | Limit per policy period\nUp to 10 lakhs | up to 50% of Sum Insured\nAbove 10 lakhs | As per the limits of Sum Insured ... MODERN TREATMENT ... Sum Insured Slabs | Limit per policy period\nUp to 10 lakhs | up to 25% of Sum Insured\nAbove 10 lakhs | As per the limits of Sum Insured ... CATARACT TREATMENT ... Sum Insured Slabs | Limits\nUp to 10 lakhs | up to Rs 50,000/- per eye including IOL.\nAbove 10 lakhs | up to Rs 1,00,000/- per eye including IOL. ... The maximum liability under maternity expenses shall be as below:-\nSum Insured Slabs | Limit per event( Maternity expenses)\nUp to 10 lakhs | Up to Rs 50,000\n15 -25 lakhs | Up to Rs 75,000\nAbove 25 lakhs | Up to Rs 1,00,000","sources":[{"clause":"3.10","heading":"MENTAL ILLNESS COVER","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-10"},{"clause":"3.11","heading":"MODERN TREATMENT","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-11"},{"clause":"3.11(I)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-11-i"},{"clause":"3.18","heading":"CATARACT TREATMENT","page":15,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-18"},{"clause":"3.22","heading":"MATERNITY EXPENSES","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-22"}],"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":45},"display":"45 days","note":null,"quote":"Pre and Post Hospitalization- Medical expenses incurred 45 days prior to Hospitalization and up to 90 days post Hospitalization.","sources":[{"clause":"3.5","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-5"}],"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":90},"display":"90 days","note":null,"quote":"Pre and Post Hospitalization- Medical expenses incurred 45 days prior to Hospitalization and up to 90 days post Hospitalization.","sources":[{"clause":"3.5","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-5"}],"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":"Relaxation to the 24 hours minimum hospitalisation duration is allowed in the listed day care procedures and surgeries in Appendix I, when taken in a hospital or day care centre and not the outpatient department.","display":"Listed day care procedures / surgeries in Appendix I","note":"Appendix I lists the covered procedures, including cataract, haemodialysis, radiotherapy for Cancer and Cancer Chemotherapy.","quote":"Relaxation to 24 hours minimum duration for Hospitalization is allowed in 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).","sources":[{"clause":"3.4","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-4"}],"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 when treatment at home is continuously required for more than three days, up to 10% of Sum Insured subject to maximum Rs 50000 per individual/family per policy period, if the patient cannot be moved to hospital or takes treatment at home because no hospital room is available.","display":"Covered up to 10% of Sum Insured, maximum Rs 50000 per policy period, if continuously required for more than three (3) days","note":"A 3 day deductible applies and the clause excludes specified diseases such as asthma, diabetes, epilepsy and hypertension.","quote":"Expenses for Domiciliary Hospitalization i.e. treatment at home , if medical treatment is continuously required for more than three (3) days, in which case the cost of medical treatment for the eligible period shall be payable up to 10% of Sum Insured subject to maximum up to Rs 50000/- per Individual/family per policy period subject to: ... The condition of the patient is such that he/she is not in a condition to be moved to a Hospital, Or ... The patient takes treatment at home on account of non-availability of room in a Hospital.","sources":[{"clause":"3.12","heading":"DOMICILIARY HOSPITALIZATION","page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-12"},{"clause":"3.12(i)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-12-i"},{"clause":"3.12(ii)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-12-ii"}],"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":"Inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems is covered up to 25% of Sum Insured in any AYUSH Hospital.","display":"AYUSH inpatient care up to 25% of Sum Insured","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 25% of Sum Insured as specified in the policy schedule in any AYUSH Hospital.","sources":[{"clause":"3.8","heading":"AYUSH TREATMENT","page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-8"}],"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":"The policy covers the listed modern treatments when medically indicated as inpatient or day care treatment. Limits are up to 25% of Sum Insured for sum insured up to 10 lakhs, and as per Sum Insured limits above 10 lakhs.","display":"Covered; up to 25% of Sum Insured for SI up to 10 lakhs, as per Sum Insured above 10 lakhs","note":null,"quote":"The following procedures will be covered (wherever medically indicated) either as in patient or as part of day care treatment in a hospital/Day care centre, specified in the policy schedule, during the policy period:\nA. Uterine Artery Embolization and HIFU (High intensity focused ultrasound) B. Balloon Sinuplasty C. Deep Brain stimulation D. Oral chemotherapy E. Immunotherapy - Monoclonal Antibody to be given as injection F. Intra vitreal injections G. Robotic surgeries H. Stereotactic radio surgeries ... I) Bronchial Thermoplasty J. Vaporization of the prostrate (Green laser treatment or holmium laser treatment) K. IONM - (Intra Operative Neuro Monitoring) L. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions to be covered.\nFollowing limits will be applied-\nSum Insured Slabs | Limit per policy period\nUp to 10 lakhs | up to 25% of Sum Insured\nAbove 10 lakhs | As per the limits of Sum Insured","sources":[{"clause":"3.11","heading":"MODERN TREATMENT","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-11"},{"clause":"3.11(I)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-11-i"}],"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, inpatient hospitalization medical expenses of the organ donor are covered if the donation conforms to the Transplantation of Human Organs Act 1994 and the insured person's hospitalization claim is admissible. The policy does not cover organ acquisition cost, donor screening, donor pre- and post-hospitalisation expenses, or donor complications after harvesting.","display":"Donor inpatient hospitalisation expenses covered when insured person is recipient, within Sum Insured","note":"The company’s overall liability under this clause during the policy period shall not exceed the Sum Insured.","quote":"The Policy covers in-patient Hospitalization Medical expenses in respect of the organ donor provided that the donation conforms to the Transplantation of Human Organs Act 1994(amended) and/or any other extant Act, Central / State Rules / regulations, as applicable, in respect of transplantation of human organs. ... The claim of the Insured Person is admissible under the Hospitalization section of the Policy. 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":"3.16","heading":"ORGAN DONOR EXPENSES- WHEN INSURED PERSON IS THE RECIPIENT","page":14,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-16"},{"clause":"3.16(ii)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-16-ii"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Emergency road ambulance is covered subject to an admissible hospitalisation claim: up to 10 lakhs, Rs 5,000 per occurrence and Rs 10,000 per policy period; 15-25 lakhs, Rs 10,000 and Rs 20,000; above 25 lakhs, Rs 25,000 and Rs 50,000. Air ambulance is covered for specified life-threatening emergencies in India, once during the policy lifetime, with limits of 10% of Sum Insured up to 10 lakhs, 25% for 15-25 lakhs, and actual expenses above 25 lakhs.","display":"Road ambulance up to Rs 5,000/Rs 10,000/Rs 25,000 per occurrence by SI slab; air ambulance up to 10%/25% of SI or actual expenses by SI slab","note":"Air ambulance is available only for listed ailments: cardio-vascular diseases, central nervous system diseases and accidental trauma cases.","quote":"Subject to an admissible hospitalization claim, Emergency Road Ambulance expenses incurred is payable as per below table-\nSum Insured Slabs | Limits\nUp to 10 lakhs | Up to 5,000/- per occurrence maximum up to 10,000/- per policy period.\n15-25 lakhs | Up to 10,000/- per occurrence maximum up to 20,000/- per policy period.\nAbove 25 lakhs | Up to 25,000/- per occurrence maximum up to 50,000/- per policy period. ... Expenses incurred towards transportation by an Air Ambulance for treatment of a disease / illness / injury in case of an emergency that requires admission to a Hospital. ... Up to 10 lakhs | Maximum up to 10% of Sum Insured\n15-25 lakhs | Maximum up to 25% of Sum Insured\nAbove 25 lakhs | Actual expenses Incurred. ... V) The insured person is in India. ... VII) This cover can be availed only once during the entire policy lifetime.","sources":[{"clause":"3.6","heading":"Road Ambulance Expenses","page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-6"},{"clause":"3.7","heading":"Air Ambulance Cover","page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-7"}],"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":"not-stated","value":null,"display":null,"note":"The documents do not state restoration or refill of the sum insured after use.","quote":null,"sources":[],"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":"The Sum Insured, excluding cumulative bonus, increases by 10% for each claim-free policy year if renewed without break, up to a maximum of 100% of the sum insured. If a claim is made, the accrued cumulative bonus may be reduced at the same rate at which it accrued.","display":"10% per claim-free policy year, maximum 100%; may reduce at same rate after claim","note":null,"quote":"Sum insured (excluding Cumulative Bonus) shall be increased by 10% in respect of each claim free policy year, provided the policy is renewed without a break subject to maximum of 100% of the sum insured. If a claim is made in any particular year, the cumulative bonus accrued may be reduced at the same rate at which it has accrued.","sources":[{"clause":"3.15","heading":"CUMULATIVE BONUS","page":14,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-15"}],"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":"Listed non-medical and consumable items are not covered under List I, including GLOVES and MASK. Some items are instead subsumed into room charges, procedure charges or costs of treatment under the appendices.","display":"Listed items such as GLOVES and MASK are not covered","note":null,"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":"Appendix III","heading":null,"page":43,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-appendix-iii"},{"clause":null,"heading":"List II – Items that are to be subsumed into Room Charges","page":45,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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":46,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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 under the Premium Plan for inpatient delivery, including caesarean section, or lawful medical termination of pregnancy, limited to two deliveries or terminations in the insured person's lifetime after 24 months of continuous cover for both insured and spouse. Limits per event are Rs 50,000 up to 10 lakhs SI, Rs 75,000 for 15-25 lakhs, and Rs 1,00,000 above 25 lakhs.","display":"Premium Plan: 24 months waiting; up to Rs 50,000/Rs 75,000/Rs 1,00,000 per event by SI slab","note":"Applies under the Premium Plan; Basic Plan excludes maternity except ectopic pregnancy as stated in the exclusion.","quote":"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 provided that:\ni) Policy has been continuously in force for a period of minimum 24 months in respect of both the Insured and his/her spouse. ... The maximum liability under maternity expenses shall be as below:-\nSum Insured Slabs | Limit per event( Maternity expenses)\nUp to 10 lakhs | Up to Rs 50,000\n15 -25 lakhs | Up to Rs 75,000\nAbove 25 lakhs | Up to Rs 1,00,000","sources":[{"clause":"3.22","heading":"MATERNITY EXPENSES","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-22"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"A newborn child can be included midterm on payment of pro-rata premium from 1 day of birth to maximum 90 days, or at policy renewal. Waiting period exclusions 4.1, 4.2 and 4.3 apply from the date of inclusion.","display":"Newborn child from 1 day of birth to Max 90 days, on pro-rata premium","note":null,"quote":"Midterm inclusion of members is permitted under the Policy, on payment of pro-rata premium only for\n• Newly wed spouse within 90 days of marriage or at the time of renewal of the Policy.\n• Newborn child from 1 day of birth to Max 90 days or at the time of renewal of the Policy. For members subsequently added, Exclusion No. 4.1, 4.2 and 4.3 shall apply from the date of their inclusion in the Policy.","sources":[{"clause":"5.28","heading":"MIDTERM INCLUSION: Midterm inclusion of members is permitted under the Policy, on","page":33,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-5-28"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"quote-verified","value":"Inpatient or daycare treatment for mental illness is covered if the illness is under the policy definition, hospitalization is in a mental health establishment and advised by a mental health professional. Limits are up to 50% of Sum Insured for SI up to 10 lakhs, and as per Sum Insured above 10 lakhs.","display":"Covered as inpatient/daycare; up to 50% of SI for SI up to 10 lakhs, as per SI above 10 lakhs","note":"Mental conditions associated with abuse of alcohol and drugs, mental retardation and psychological counselling or psychotherapy not requiring hospitalization are excluded.","quote":"The Company shall indemnify the Hospital or the Insured the Medical Expenses incurred (including Pre and Post Hospitalization Expenses) for treatment as an inpatient/daycare under certain conditions with following limits as below:-\n1. Illness covered under definition of mental illness mentioned under clause2.52.\n2. Hospitalization in Mental Health Establishment as defined under clause2.53.\n3. Hospitalization as advised by Mental Health Professional as defined under clause2.54. ... Sum Insured Slabs | Limit per policy period\nUp to 10 lakhs | up to 50% of Sum Insured\nAbove 10 lakhs | As per the limits of Sum Insured","sources":[{"clause":"3.10","heading":"MENTAL ILLNESS COVER","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-10"}],"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":"quote-verified","value":"Cost of health check-up is reimbursed once at the expiry of every block of three continuous underwriting years if no claims are reported during the block, available after three claim-free years until expiry of the fourth policy year. Limits are Rs 1,500/2,000/3,000 for individual and Rs 3,000/4,000/6,000 for family, by SI slab.","display":"Once after every THREE continuous underwriting years with no claims; individual up to Rs 1,500/2,000/3,000 and family up to Rs 3,000/4,000/6,000","note":"This provision applies only for continuous insurance without break under Oriental’s Youth Eco Care policy.","quote":"The Insured shall be entitled for reimbursement of cost of Health checkup undertaken once at the expiry of a block of every THREE continuous underwriting years provided there are no claims reported during the block. This benefit is available to the insured person after three claim free years, till the expiry of the fourth year of the policy. ... Upto 10 lakhs | Upto Rs 1,500\n15-25 lakh | Upto Rs 2,000\nAbove 25 lakh | Upto Rs 3,000 ... Upto 10 lakhs | Upto Rs 3,000\n15-25 lakh | Upto Rs 4,000\nAbove 25 lakh | Upto Rs 6,000","sources":[{"clause":"3.19","heading":"COST OF HEALTH CHECKUP","page":15,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-19"},{"clause":null,"heading":"Sum Insured(without Cumulative Bonus) Benefit","page":15,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-sum-insured-without-cumulative-bonus-benefit"}],"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 ART under the Premium Plan. Telemedicine/online consultation for diagnosis and treatment of a covered disease or illness is reimbursable with limits of 2 consultations per policy period up to Rs. 1000 per consultation for SI up to 10 lakhs, and 3 consultations up to Rs. 1500 per consultation for SI above 10 lakhs.","display":"OPD excluded; telemedicine covered within limits; ART excluded from OPD exclusion under Premium Plan","note":"ART is a Premium Plan benefit and inpatient treatment is not mandatory for that benefit.","quote":"Out Patient Department (OPD) Any expenses incurred on OPD (Excludes ART under ... Expenses incurred by insured on telemedicine/Tele-consultation/Online consultation with a registered medical practitioner for Diagnosis & treatment of a disease/illness covered under the Policy. ... Sum Insured Slabs | Limit\nUp to 10 lakhs | Max 2 consultations per policy period, max Rs. 1000 per consultation\nAbove 10 lakhs | Max 3 consultations per policy period, max Rs. 1500 per consultation","sources":[{"clause":"4.27","heading":"Out Patient Department (OPD) Any expenses incurred on OPD (Excludes ART under","page":22,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-4-27"},{"clause":"3.13","heading":"TELEMEDICINE/ONLINE CONSULTATION","page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-3-13"}],"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":"not-stated","value":null,"display":null,"note":"The documents do not state premium zones or city-based co-pay.","quote":null,"sources":[],"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 is available through the Company or TPA when admission is in a network hospital or nursing home and is subject to pre-admission authorisation. The Company or TPA issues a pre-authorisation or guarantee of payment letter after verifying eligibility and information.","display":"Available in network Hospital/Nursing Home, subject to pre admission authorization","note":"The list of network hospitals is available on the insurer's official website and from the concerned TPA on demand.","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. The Company / TPA shall, upon getting the related medical details / relevant information from the Insured Person / Network Hospital / Nursing Home, verify that the person is eligible to claim under the Policy and after satisfying itself will issue a pre- authorization letter / guarantee of payment letter to the Hospital / Nursing Home mentioning the sum guaranteed as payable","sources":[{"clause":"5.21","heading":null,"page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#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 the Company, as the case may be.","display":"Third Party Administrator (TPA) or the Company","note":null,"quote":"has paid premium to the Company as consideration for such insurance to be serviced by Third Party Administrator (hereinafter called the TPA) or the Company as the case maybe.","sources":[{"clause":null,"heading":"ORIENTAL YOUTH ECO CARE POLICY","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-oriental-youth-eco-care-policy"}],"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, Floater Cover and Floater with floater cover available","note":null,"quote":"Floater Cover-: A single Sum Insured will be provided for all family members which covers your entire family (as per definition clause 2.16) under a single plan. i.e. anyone can utilize as much amount up to Sum Insured limits.\nFloater with floater cover-: Policy holder can opt for coverage on floater basis for different group of members of family within same policy for different Sum Insured limits.","sources":[{"clause":"1","heading":"PREAMBLE","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798#c-1"}],"law":[]}],"documents":[{"kind":"wording","label":"Policy Wording.pdf","pages":51,"fetched_at":"2026-10-17 19:54:17+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/Oriental_Youth_Eco_Care_POLICY_7f90dc47b6.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13798"},{"kind":"prospectus","label":"Prospectus.pdf","pages":33,"fetched_at":"2026-10-17 19:53:53+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/Oriental_Youth_Eco_Care_Policy_Prospectus_b49e7a9232.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324/document/13784"}],"versions":[],"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":"Oriental Youth Eco Care Policy (UIN OICHLIP24034V012324), IndiaInsurances, https://indiainsurances.com/policy/oriental-insurance/oriental-youth-eco-care-policy-oichlip24034v012324"}