{"uin":"OICHLIP25035V032425","name":"UNIVERSAL HEALTH INSURANCE POLICY- INDIVIDUAL","url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425","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":"Revision","kind":"product","status":"active","approved_on":"2020-09-30","withdrawn_on":null,"summary":"Universal Health Insurance Policy (Individual) is an indemnity and benefit health policy with Section I sum insured of Rs. 30,000 on a floater basis, plus personal accident and disability benefits for the earning head of family. It has a 30 day initial illness waiting period, a 36 month pre-existing disease waiting period, room rent up to 0.5% of sum insured per day and ICU up to 1% of sum insured per day.","analysis":{"state":"machine","analysed_at":"2026-10-19 21:46:02.365042+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":"not-stated","value":null,"display":null,"note":"No named plan variants inside the product are stated.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"not-stated","value":null,"display":null,"note":"The policy wording points to the policy schedule for the period of insurance.","quote":null,"sources":[],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"Immediate notice of claim should be given to the Company or TPA while taking treatment, within 48 hours of admission but 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, Email. Such notice should be given within 48 hours of admission but before discharge from Hospital / Nursing Home, unless waived in writing.","sources":[{"clause":null,"heading":"7. Conditions Applicable to Section I and II","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-7-conditions-applicable-to-section-i-and-ii"}],"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 / Anaesthetists / 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)","Details of previous policies, if the details are already not with TPA.","Any other information required by Company/TPA.","In case of death of earning member of the family due to accident a post mortem report must be submitted along with other documents of proof of death."],"display":"Original bills, receipts, discharge card, medical records, prescriptions, test reports, consultant and surgeon certificates, MLC/FIR/Post Mortem Report if applicable, disability/death certificate if applicable, previous policy details and any other information required by Company/TPA","note":"Final claim documents are to be submitted within 15 days of discharge.","quote":"Final claim along with original Bills/Cash memos/reports, claim form and documents as listed below should be submitted to the Company / TPA within 15 days of discharge from the Hospital / Nursing Home. ... a) Original bills, all receipts and discharge certificate / card from the hospital. ... b) All documents pertaining to the illness, starting from the date it was first detected, i.e Doctor’s consultations reports / history ... c) Medical history of the patient recorded by the Hospital. ... d) Original Cash-memo from the hospital (s) / chemist (s) supported by proper prescription. ... e) 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. ... f) Original attending Consultants / Anaesthetists / Specialist certificates regarding diagnosis and bills / receipts etc. g. Surgeon’s original certificate stating diagnosis and nature of operation performed along with bills / receipts etc. h. MLC/FIR/Post Mortem Report,( if applicable) ... g) Disability certificate, Death certificate ( if applicable) ... h) Details of previous policies, if the details are already not with TPA. ... i) Any other information required by Company/TPA. ... j) In case of death of earning member of the family due to accident a post mortem report must be submitted along with other documents of proof of death.","sources":[{"clause":null,"heading":"7. Conditions Applicable to Section I and II","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-7-conditions-applicable-to-section-i-and-ii"},{"clause":"14(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-a-5"},{"clause":"14(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-5"},{"clause":"14(c)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-c-3"},{"clause":"14(d)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-d-3"},{"clause":"14(e)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-e-2"},{"clause":"14(f)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-f-2"},{"clause":"14(g)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-g-2"},{"clause":"14(h)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-h"},{"clause":"14(i)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-i"},{"clause":"14(j)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-j"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The Company shall settle or reject a claim within 15 days from the date of submission of claim. If investigation is warranted, it shall complete the investigation not later than 30 days from receipt of last necessary document and settle or reject within 45 days from receipt of last necessary document; delay carries interest at 2% above bank rate.","display":"15 days from submission of claim; investigated claims within 45 days from receipt of last necessary document","note":null,"quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of submission of claim. ... where the circumstance of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document. In such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document. ... In case of delay beyond stipulated 45 days, the Company shall be liable to pay interest to the policyholder at a rate 2% above bank rate from the date of receipt of last necessary document to the date of payment of claim.","sources":[{"clause":"14(b)(i)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-i"},{"clause":"14(b)(iii)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-iii"},{"clause":"14(b)(iv)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-iv"}],"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":["Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months","Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of the specified waiting period","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","Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded.","Expenses related to any admission primarily for enforced bed rest and not for receiving treatment.","Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite.","Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an accident, burns(s) or Cancer","Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports","Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.","Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer","Any expenses incurred on OPD treatment.","Treatment taken outside the geographical limits of India.","The cost of Spectacles, contact lenses and hearing aids.","Any dental treatment or surgery which is a corrective, cosmetic or aesthetic procedure including wear and tear unless arising from disease or injury and which require hospitalization for treatment."],"display":"PED 36 months, specified waiting periods, 30 day illness waiting period, diagnostics-only admission, rest cure, change of gender, cosmetic/plastic surgery, professional hazardous sports, breach of law, excluded providers, OPD, treatment outside India, spectacles/contact lenses/hearing aids, cosmetic dental treatment","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 36 months ... Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of the specified waiting period ... 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 ... Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded. ... Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. ... Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite. ... Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an accident, burns(s) or Cancer ... Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports ... Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent. ... Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer ... Any expenses incurred on OPD treatment. 6.16 Treatment taken outside the geographical limits of India. ... The cost of Spectacles, contact lenses and hearing aids. ... Any dental treatment or surgery which is a corrective, cosmetic or aesthetic procedure including wear and tear unless arising from disease or injury and which require hospitalization for treatment.","sources":[{"clause":null,"heading":"4.1.1 Pre-existing Diseases - code –ExcI 01","page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-4-1-1-pre-existing-diseases-code-exci-01"},{"clause":null,"heading":"4.1.2 Specified disease / procedure waiting period- code- ExcI 02","page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-4-1-2-specified-disease-procedure-waiting-period"},{"clause":null,"heading":"4.1.3 30day waiting period- code – ExcI 03","page":9,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-4-1-3-30day-waiting-period-code-exci-03"},{"clause":null,"heading":"6.1 Investigation & Evaluation – Code – ExcI 04","page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-6-1-investigation-evaluation-code-exci-04"},{"clause":null,"heading":"6.2 Rest Cure, rehabilitation and respite care – Code –ExcI 05","page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-6-2-rest-cure-rehabilitation-and-respite-care-co"},{"clause":null,"heading":"6.4 Change of Gender Treatments : Code – ExcI 07","page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-6-4-change-of-gender-treatments-code-exci-07"},{"clause":null,"heading":"6.5 Cosmetic or Plastic Surgery- Code- ExcI 08","page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-6-5-cosmetic-or-plastic-surgery-code-exci-08"},{"clause":null,"heading":"6.6 Hazardous or Adventure sports- Code- ExcI 09","page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-6-6-hazardous-or-adventure-sports-code-exci-09"},{"clause":null,"heading":"6.7 Breach of law – Code –ExcI 010","page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-6-7-breach-of-law-code-exci-010"},{"clause":null,"heading":"6.8 Excluded Providers- Code – ExcI 011","page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-6-8-excluded-providers-code-exci-011"},{"clause":"14(b)","heading":"Chemical attack or weapons","page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-4"},{"clause":"10","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-10"},{"clause":"11","heading":"Any dental treatment or surgery which","page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-11"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"The insured may first contact the company through its website, toll free numbers or e-mail, or approach the grievance cell at any company branch. If not satisfied, the insured may contact the grievance officer at the Customer Service Department, NBCC Corporate Office, Ground floor, East kidwai nagar New Delhi-110023.","display":"Company website/toll free/e-mail or branch grievance cell, then grievance officer at Customer Service Department, NBCC Corporate Office, 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 ... Insured 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:\nCustomer Service Department: Ground Floor, NBCC, Corporate Office, Ground floor, East kidwai nagar New Delhi-110023.","sources":[{"clause":"16","heading":"GRIEVANCE REDRESSAL","page":15,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-16"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"Rs.30,000/- per person or family as mentioned in the schedule.","display":"Rs.30,000/- per person or family","note":null,"quote":"Company's Liability in respect of all claims including Maternity Benefit admitted during the period of Insurance shall not exceed the Sum Insured of Rs.30,000/- per person or family as mentioned in the schedule","sources":[{"clause":null,"heading":"1 Section – I HOSPITALISATION EXPENSES","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-1-section-i-hospitalisation-expenses"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to accident claims, if covered.","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":null,"heading":"4.1.3 30day waiting period- code – ExcI 03","page":9,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-4-1-3-30day-waiting-period-code-exci-03"}],"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":36},"display":"36 months","note":"For enhanced sum insured, the exclusion applies afresh to the increased amount; portability credit can reduce the waiting period.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with the insurer or its reinstatement.","sources":[{"clause":null,"heading":"4.1.1 Pre-existing Diseases - code –ExcI 01","page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-4-1-1-pre-existing-diseases-code-exci-01"}],"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 conditions have waiting periods of 1 year, 2 Years or 3 Years. Accident claims are excluded from this waiting period.","quote":"Hypertension. | 90 days* ... Diabetes. | 90 days*","sources":[{"clause":null,"heading":"4.1.2 Specified disease / procedure waiting period- code- ExcI 02","page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-4-1-2-specified-disease-procedure-waiting-period"}],"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","Fissure / Fistula in anus.","Piles.","Sinusitis and related disorders.","Surgery of gallbladder and bile duct excluding malignancy.","Surgery of genito-urinary system excluding malignancy.","Pilonidal Sinus.","Gout and Rheumatism.","Hypertension.","Diabetes.","Calculus diseases.","Surgery for prolapsed inter vertebral disk unless arising from accident.","Surgery of varicose veins and varicose ulcers.","Congenital internal diseases.","Joint Replacement due to Degenerative condition.","Age related osteoarthritis and Osteoporosis."],"display":"Benign ENT disorders and surgeries, polycystic ovarian diseases, hernia, hydrocele, non infective arthritis, undescendent testes, cataract, benign prostatic hypertrophy, hysterectomy/myomectomy, fissure/fistula, piles, sinusitis, gallbladder and bile duct surgery, genito-urinary surgery, pilonidal sinus, gout and rheumatism, hypertension, diabetes, calculus diseases, prolapsed inter vertebral disk surgery, varicose veins/ulcers, congenital internal diseases, degenerative joint replacement, age related osteoarthritis and osteoporosis","note":null,"quote":"i | Benign ENT disorders and surgeries i.e. Tonsillectomy, Adenoidectomy, Mastoidectomy, Tympanoplasty etc. | 1 year\nii | Polycystic ovarian diseases. | 1 year\niii | Surgery of hernia. | 2 years\niv | Surgery of hydrocele. | 2 years\nv | Non infective Arthritis. | 2 years\nvi | Undescendent Testes. | 2 Years\nvii | Cataract. | 2 Years\nviii | Surgery of benign prostatic hypertrophy. | 2 Years\nix | Hysterectomy for menorrhagia or fibromyoma or myomectomy | 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 of genito-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 xxi | Surgery for prolapsed inter vertebral disk unless arising from accident. Surgery of varicose veins and varicose ulcers. | 2 Years 2 Years\nxxii | Congenital internal diseases. | 2 Years\nxxiii | Joint Replacement due to Degenerative condition. | 3 Years\nXxiv | Age related osteoarthritis and Osteoporosis. | 3 Years","sources":[{"clause":null,"heading":"4.1.2 Specified disease / procedure waiting period- code- ExcI 02","page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-4-1-2-specified-disease-procedure-waiting-period"}],"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":5},"display":"five continuous years","note":"For enhanced sums insured, five continuous years applies from the date of enhancement only on the enhanced limits; claims remain subject to policy limits, sub-limits, co-payments and deductibles.","quote":"After completion of five continuous years under this policy no look back to be applied. This period of five years is called as moratorium period.","sources":[{"clause":"27","heading":"MORATORIUM PERIOD","page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-27"}],"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 30 days before, but not earlier than 60 days from, the policy renewal date. Continuous cover without lapses gives accrued continuity benefits in waiting periods as per IRDAI portability guidelines.","display":"Allowed; apply at least 30 days before, but not earlier than 60 days from, renewal date","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 30 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":"26","heading":"Portability","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-26"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"not-stated","value":null,"display":null,"note":"The wording states ordinary renewability but does not state lifelong renewal without a maximum age.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"not-stated","value":null,"display":null,"note":"The wording says renewal shall not be denied on the ground of claims, but does not state whether premium is loaded because of a claim.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on 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 any time during the term by giving 7 days’ written notice. For annual policies, refund is proportionate premium for the unexpired policy period, subject to no claim having been made; for policies with term more than 1 year, refund is premium for the unexpired policy period where risk coverage has not commenced, and no refunds are made if a claim has been admitted, lodged or any benefit availed.","display":"7 days’ notice; proportionate premium for unexpired period, subject to no claim","note":null,"quote":"Cancellation by insured - Any time during the term, by giving 7 days’ notice in writing. Refund by Insurer: ... proportionate premium for unexpired policy period, in case of Annual policies, subject to no claim (s)having been made during the policy period. ... refund premium for the unexpired policy period, in respect of policies with term more than 1 year and risk coverage for such policy years has not commenced.\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":"20","heading":"CANCELLATION CLAUSE","page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-20"},{"clause":"20(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-20-a"},{"clause":"20(b)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-20-b"}],"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 surgical treatments must be taken in India and admissible claims are payable in Indian currency; treatment outside India is excluded.","display":"India only","note":null,"quote":"All medical surgical treatments under this policy shall have to be taken in India and admissible claims thereof shall be payable in Indian currency. ... Treatment taken outside the geographical limits of India.","sources":[{"clause":"14(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-6"},{"clause":"14(b)","heading":"Chemical attack or weapons","page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-4"}],"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":30},"display":"30 days","note":"Refund is subject to deductions stated in the free-look clause if no claim has been made.","quote":"The insured person is allowed free look period of 30 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":"21","heading":"FREE LOOK PERIOD","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-21"}],"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":"A definition clause also states fifteen days where premium payment mode is monthly and thirty days in all other cases.","quote":"In the event of delay in renewal of the policy, a grace period of 30 days is allowed.","sources":[{"clause":"22","heading":"GRACE PERIOD","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-22"}],"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":"New Born Baby is covered from 1 day to 3 months. Insurance is available to persons between 5 to 70 years; children between 3 months to 5 years can be covered if one or both parents are covered concurrently.","display":"New Born Baby: 1 day to 3 months; persons: 5 to 70 years; children 3 months to 5 years with parent cover","note":"From the prospectus.","quote":"Age limit: New Born Baby- 1 day to 3 months. This insurance is available to persons between the age of 5 to 70 years. Children between the age of 3 months to 5 years can be covered provided one or both parents are covered concurrently.","sources":[{"clause":"3","heading":"Age limit","page":2,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13775#c-3"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["monthly","Qtrly","Half yearly","Annual"],"display":"Monthly, Qtrly, Half yearly, Annual","note":"Stated in the CIS grace period row.","quote":"15 days (For monthly inst.) 30 days (For other than monthly payments- Qtrly/Half yearly /Annual).","sources":[{"clause":"2(c)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13720#c-2-c-2"}],"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":null,"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":"No coverage is available during the grace period. However, coverage during the grace period is offered if the premium is paid in installments during the policy period.","display":"No coverage during grace period, except where premium is paid in instalments during the policy period","note":null,"quote":"However, no coverage shall be available during the grace period and any disease/injury contracted during the break period shall not be covered and shall be treated as Pre-existing disease. Provided the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period.","sources":[{"clause":"22","heading":"GRACE PERIOD","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-22"}],"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 and boarding expenses are covered up to 0.5% of Sum Insured per day.","display":"Up to 0.5% of Sum Insured per day","note":null,"quote":"Room, Boarding Expenses as provided by the Hospital /nursing home. • If admitted in IC Unit | • Up to 0.5% of Sum Insured per day • Up to 1% of Sum Insured per day","sources":[{"clause":null,"heading":"1 Section – I HOSPITALISATION EXPENSES","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-1-section-i-hospitalisation-expenses"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-applicable","value":null,"display":null,"note":"The policy gives room rent as a percentage of sum insured, not as a room category.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"If admitted in IC Unit, the limit is up to 1% of Sum Insured per day.","display":"Up to 1% of Sum Insured per day","note":null,"quote":"Room, Boarding Expenses as provided by the Hospital /nursing home. • If admitted in IC Unit | • Up to 0.5% of Sum Insured per day • Up to 1% of Sum Insured per day","sources":[{"clause":null,"heading":"1 Section – I HOSPITALISATION EXPENSES","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-1-section-i-hospitalisation-expenses"}],"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 admitted in a room where room category or room rent is higher than the eligibility, the insured bears a ratable proportion of specified associated medical expenses in the proportion of eligible room rent to room rent actually incurred. This does not apply to Medicines/Pharmacy/Drugs, Consumables, Medical Devices/implants and Cost of Diagnostics.","display":"Yes, ratable proportion of specified associated medical expenses","note":null,"quote":"If the Insured Person is admitted in the hospital in a room where the room category or the Room Rent incurred is higher than the eligibility as specified in the Policy Schedule/ Certificate of Insurance, then the Policyholder/ Insured Person shall bear a ratable proportion of the total & specified Associated Medical Expenses (including surcharge or taxes thereon) in the proportion of the difference between the Room Rent of the entitled room category/eligible Room Rent to the Room Rent actually incurred. However, this will not be applicable in respect of Medicines/Pharmacy/ Drugs, Consumables, Medical Devices/ implants and Cost of Diagnostics.","sources":[{"clause":null,"heading":"11.A. MULTIPLE POLICIES","page":14,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-11-a-multiple-policies"}],"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 mentions co-payments only in the moratorium clause as possible policy terms, but no co-payment percentage or trigger is stated for this product.","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":"Not Applicable","display":"Not Applicable","note":null,"quote":"7 | Deductible | Not Applicable","sources":[{"clause":"Row 7","heading":"Deductible","page":2,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13720#c-row-7"}],"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":["Total expenses incurred for any one illness is limited to Rs.15000/- (other than Maternity Benefit)","Maternity Benefit is restricted to Rs.2,500/- for normal delivery and Rs.5,000/- for caesarean/extra uterine delivery"],"display":"Any one illness: Rs.15000/-; maternity: Rs.2,500/- normal delivery and Rs.5,000/- caesarean/extra uterine delivery","note":null,"quote":"Total expenses incurred for any one illness is limited to Rs.15000/- (other than Maternity Benefit) ... The Policy is extended to include one Maternity Benefit with liability under the Section being restricted to Rs.2,500/- for normal delivery and Rs.5,000/- for caesarean/extra uterine delivery.","sources":[{"clause":null,"heading":"1 Section – I HOSPITALISATION EXPENSES","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-1-section-i-hospitalisation-expenses"}],"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":0},"display":"Not applicable","note":"The CIS says pre-hospitalisation is not applicable.","quote":"Pre- hospitalization:- Not applicable","sources":[{"clause":"Row 5","heading":"What am I covered for:","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13720#c-row-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":0},"display":"Not applicable","note":"The CIS says post-hospitalisation is not applicable.","quote":"Post-hospitalization:- Not applicable","sources":[{"clause":"Row 5","heading":"What am I covered for:","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13720#c-row-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":"Day care treatment is defined as treatment or surgical procedure undertaken in a hospital/day care centre in less than 24 hrs because of technological advancement, which would otherwise require hospitalisation of more than 24 hours. The policy has an Appendix I list of day care procedures/surgeries.","display":"Listed day care procedures/surgeries in Appendix I","note":"Procedures usually done in out-patient department are not payable even if converted to day care or taken as in-patient for more than 24 hours.","quote":"DAY CARE TREATMENT: refers to medical treatment, and/or surgical procedure which is:\na) undertaken under General or Local Anaesthesia in a hospital/day care centre in less than 24 hrs because of technological advancement, and\nb) which would have otherwise required a hospitalization of more than 24 hours. ... Appendix I Day care procedures / surgeries","sources":[{"clause":"3.7","heading":"CONDITION PRECEDENT","page":2,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-3-7"},{"clause":"Appendix I","heading":"Day care procedures / surgeries","page":20,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-appendix-i"}],"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":"not-stated","value":null,"display":null,"note":"Domiciliary hospitalisation is defined, but the benefit section does not state that domiciliary treatment is covered.","quote":null,"sources":[],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"The Company indemnifies medical expenses for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems during each Policy Year up to the sum insured specified in the policy schedule in any AYUSH Hospital.","display":"Covered up to sum insured in any AYUSH Hospital","note":null,"quote":"The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as specified in the policy schedule in any AYUSH Hospital.","sources":[{"clause":"14(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-6"}],"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":"not-stated","value":null,"display":null,"note":"The documents do not state cover or caps for modern treatments such as robotic surgery, immunotherapy, oral chemotherapy or stem cell therapy.","quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":"The benefits table mentions cost of organs but does not state cover for the donor's hospital expenses.","quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Ambulance service charges are payable for shifting the insured person from residence to hospital for admission in emergency ward/ICU or from one hospital/nursing home to another by registered ambulance only, if hospitalisation expenses are admissible. No rupee limit is stated.","display":"Registered ambulance payable if hospitalisation expenses are admissible; no rupee limit stated","note":null,"quote":"AMBULANCE SERVICES:means ambulance service charges reasonably and necessarily incurred in shifting the insured person from residence to hospital for admission in emergency ward / ICU or from one Hospital / Nursing Home to another HospitaL / Nursing Home, by registered ambulance only. The ambulance service charges are payable only if the hospitalisation expenses are admissible under the policy.","sources":[{"clause":"3.2","heading":null,"page":2,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-3-2"}],"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":"No restoration or refill of sum insured is stated.","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":"not-stated","value":null,"display":null,"note":"No cumulative bonus or no-claim bonus is stated.","quote":null,"sources":[],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"The policy has a list of items for which coverage is not available, including GLOVES, MASK, OXYGEN MASK and other non-medical items. It also has lists of items to be subsumed into room charges, procedure charges and costs of treatment.","display":"Listed non-medical items such as GLOVES, MASK and OXYGEN MASK are not covered; some items are subsumed into room/procedure/treatment costs","note":null,"quote":"List I- Items for which coverage is not available in the policy ... 56 | GLOVES ... 60 | MASK ... 62 | OXYGEN MASK ... List II- Items that are to be subsumed into Room Charges ... List III - Items that are to be subsumed into Procedure Charges ... List IV- Items that are to be subsumed into costs of treatment","sources":[{"clause":null,"heading":"List I- Items for which coverage is not available in the policy","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-list-i-items-for-which-coverage-is-not-available"},{"clause":null,"heading":"List II- Items that are to be subsumed into Room Charges","page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-list-ii-items-that-are-to-be-subsumed-into-room-2"},{"clause":null,"heading":"List III - Items that are to be subsumed into Procedure Charges","page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-list-iii-items-that-are-to-be-subsumed-into-proc"},{"clause":null,"heading":"List IV- Items that are to be subsumed into costs of treatment","page":26,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-list-iv-items-that-are-to-be-subsumed-into-costs"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"The maternity benefit covers medical expenses incurred in respect of the new born child up to 3 months, within the maternity benefit and overall sum insured of Rs.30,000/-.","display":"New born child expenses up to 3 months under maternity benefit","note":null,"quote":"The above amount would also cover the medical expenses incurred in respect of new born child upto 3 months. However, this Maternity Benefit is within the overall limit of Sum Insured of Rs.30,000/-.","sources":[{"clause":null,"heading":"1 Section – I HOSPITALISATION EXPENSES","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-1-section-i-hospitalisation-expenses"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":"The wording defines mental illness and mental health establishment, but does not state a benefit for in-patient treatment of mental illness.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":"No preventive health check-up benefit is stated.","quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"Any expenses incurred on OPD treatment are excluded.","display":"OPD treatment excluded","note":null,"quote":"6.15 Any expenses incurred on OPD treatment.","sources":[{"clause":"14(b)","heading":"Chemical attack or weapons","page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-4"}],"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":"No city or zone-based premium or treatment-city co-pay is stated.","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 services are available through the Company/TPA when admission is in a networked hospital or nursing home and subject to pre-admission authorization. Network hospital list is available on the insurer’s website and from the concerned TPA.","display":"Available in network Hospital / Nursing Home through Company/TPA, subject to pre admission authorization","note":null,"quote":"Claim in respect of Cashless Access Services will be through the Company/ TPA provided admission is in a networked Hospital / Nursing Home and is subject to pre admission authorization. ... List of network hospitals is available on our official website- www.orientalinsurance.org.in and will also be provided by the concerned TPA.","sources":[{"clause":"14(b)(iv)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-iv"}],"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 cashless services are handled by the Company/TPA; the policy says the Company will pay through TPA to the Hospital/Nursing Home or insured person.","display":"Company / TPA","note":null,"quote":"the Company will pay through TPA to the Hospital / Nursing Home or Insured Person the amount of such expenses ... Claim in respect of Cashless Access Services will be through the Company/ TPA","sources":[{"clause":null,"heading":"UNIVERSAL HEALTH INSURANCE POLICY (INDIVIDUAL) UIN: OICHLIP25035V032425","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-universal-health-insurance-policy-individual-uin"},{"clause":"14(b)(iv)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788#c-14-b-iv"}],"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, family floater basis","note":"From the prospectus.","quote":"The benefit of the family will operate on floater basis i.e. the total reimbursement of Rs.30,000/- can be availed of individually or collectively by members of the family.","sources":[{"clause":"1","heading":"Scope of Cover: This policy has three covers as under","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13775#c-1"}],"law":[]}],"documents":[{"kind":"wording","label":"Policy Wording.pdf","pages":29,"fetched_at":"2026-10-17 19:54:00+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/Policy_Wording_3d25645dd6.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13788"},{"kind":"wording","label":"Universal Health Insurance Policy (Individual) (IRDAI copy)","pages":28,"fetched_at":"2026-10-20 02:31:31+00","source_url":"https://irdai.gov.in/documents/37343/931203/OICHLIP21529V022021_2020-2021.pdf/1ef67e0d-1099-3bd6-e816-d1ccca253a27?version=1.1&t=1668590068769&download=true","url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/28642"},{"kind":"prospectus","label":"Prospectus.pdf","pages":13,"fetched_at":"2026-10-17 19:53:31+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/Prospectus_3fef7fca9c.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13775"},{"kind":"cis","label":"Customer Information Sheet.pdf","pages":10,"fetched_at":"2026-10-17 19:51:45+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/Customer_Information_Sheet_26b75bb006.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425/document/13720"}],"versions":[{"uin":"OICHLIP21529V022021","version":null,"approved_on":null},{"uin":"OICHLIP25035V032425","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Oriental Insurance official website","url":"https://www.orientalinsurance.org.in/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claim forms","url":"https://www.orientalinsurance.org.in/claim-form","note":null},{"purpose":"claim","kind":"insurer","name":"Health claim status","url":"https://www.orientalinsurance.org.in/health-claim-status","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal","url":"https://www.orientalinsurance.org.in/grievance-redressal","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"UNIVERSAL HEALTH INSURANCE POLICY- INDIVIDUAL (UIN OICHLIP25035V032425), IndiaInsurances, https://indiainsurances.com/policy/oriental-insurance/universal-health-insurance-policy-individual-oichlip25035v032425"}