{"uin":"OICHLIP25046V062425","name":"HAPPY FAMILY FLOATER 2024","url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425","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":"Happy Family Floater Policy 2024 is a family floater health indemnity policy with Silver, Gold, Diamond and Platinum plans and sum insured options from Rs.1 lakh to Rs.50 lacs. It has 30 days initial waiting, 36 months pre-existing disease waiting, 1% room rent limit per day, 2% ICU limit per day and 10% co-payment under the Silver plan.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:02:10.861873+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Silver","Gold","Diamond","Platinum"],"display":"Silver, Gold, Diamond and Platinum","note":null,"quote":"The benefits under this Policy are available under four plans, viz Silver, Gold, Diamond and Platinum as opted by the Insured in the proposal form.","sources":[{"clause":"3.1","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"One policy runs for one year and is renewable lifelong.","display":"One year; renewable lifelong","note":"From the prospectus; the policy wording defines Policy Period by the schedule but does not print the one-year term.","quote":"Term of the Policy is one year and is renewable lifelong.","sources":[{"clause":"2","heading":"FEATURES IN THE POLICY","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13776#c-2"}],"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 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":"5.18","heading":"NOTIFICATION OF CLAIM: Immediate notice of claim with particulars relating to Policy","page":33,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-18"}],"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 filmetcsupported 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 bills, receipts, discharge card, illness and medical history records, cash memos with prescriptions, test reports, consultant and surgeon certificates, MLC/FIR/Post Mortem Report if applicable, disability/death certificate if applicable, organ donation documents, previous policy details and any other information required by TPA/Company","note":null,"quote":"Final claim along with original Bills/ Cash memos/reports, claim form and documents as | listed below should be submitted to the Company / TPA within 15 days of discharge from the Hospital / Nursing Home.\n• Original bills, all receipts and discharge certificate / card from the Hospital.\n• All documents pertaining to the Illness, starting from the date it was first detected, i.e. Doctor’s consultations reports/history\n• Medical history of the patient recorded by the Hospital.\n• Original Cash-memo from the Hospital (s) / chemist (s) supported by proper prescription.\n• Original receipt, pathological and other test reports from a pathologist / radiologist including filmetcsupported by the note from attending Medical Practitioner / Surgeon demanding such tests.\n• Original attending Consultants / Anesthetists/ Specialist certificates regarding diagnosis and bills / receipts etc.\n• Surgeon’s original certificate stating diagnosis and nature of operation performed along with bills / receipts etc.\n• MLC/FIR/Post Mortem Report,( if applicable)\n• Disability certificate, Death certificate ( if applicable)\n• Documents in respect of organ donation claim, shall be in accordance with the extant Act, Central / State Rules / regulations, as applicable, in respect of transplantation of human organs\n• Details of previous policies, if the details are already not with TPA.\n• Any other information required by TPA /Company.","sources":[{"clause":"5.19","heading":"CLAIM DOCUMENTS: Final claim along with original Bills/ Cash memos/reports, claim form","page":33,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-19"}],"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 receipt of the last necessary document. If investigation is warranted, it must complete investigation within 30 days and settle or reject within 45 days from receipt of the last necessary document, with interest for delay.","display":"15 days from last necessary document; 45 days if investigation","note":"Another clause in the same wording says the Company/TPA shall within 30 days offer a settlement or reject after receipt of the last document/clarification.","quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of receipt of last necessary document. ... However, 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. ... On receipt of the last document /clarification, the Company/TPA shall within a period of 30 days offer a settlement of the claim to the insured.","sources":[{"clause":"5.2","heading":"CONDITION PRECEDENT TO ADMISSION OF LIABILITY: The terms and conditions of the","page":29,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-2"},{"clause":"5.19(d)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-19-d"}],"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","Change of Gender Treatments: Code – ExcI07","Cosmetic or Plastic Surgery- Code- ExcI08","Hazardous or Adventure sports- Code- ExcI09","Breach of law – Code –ExcI10","Treatment for, Alcoholic drug or substance abuse or any addictive condition and consequences thereof.– Code- ExcI12","Refractive Error- Code- ExcI15","Unproven Treatments- Code – ExcI16","Sterility and Infertility- Code- ExcI17","Maternity- Code- ExcI18","Treatment taken outside the geographical limits of India."],"display":"PED, specified disease/procedure waiting period, 30 day waiting period, investigation and evaluation, rest cure/rehabilitation/respite care, change of gender, cosmetic or plastic surgery, hazardous/adventure sports, breach of law, alcohol/drug/substance abuse, refractive error, unproven treatments, sterility and infertility, maternity and treatment outside India","note":"Maternity exclusion does not apply for Diamond and Platinum Plan; sterility and infertility exclusion does not apply to Platinum Plan Assisted Reproduction Treatment up to the limits mentioned.","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 ... Change of Gender Treatments: Code – ExcI07 ... Cosmetic or Plastic Surgery- Code- ExcI08 ... Hazardous or Adventure sports- Code- ExcI09 ... Breach of law – Code –ExcI10 ... Treatment for, Alcoholic drug or substance abuse or any addictive condition and consequences thereof.– Code- ExcI12 ... Refractive Error- Code- ExcI15 ... Unproven Treatments- Code – ExcI16 ... Sterility and Infertility- Code- ExcI17 Expenses related to sterility and infertility. ... Maternity- Code- ExcI18 ... Treatment taken outside the geographical limits of India.","sources":[{"clause":"4.1","heading":"Pre-existing Diseases - code -ExcI0 1","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-1"},{"clause":"4.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-2"},{"clause":"4.3","heading":"30 day waiting period- code – ExcI03","page":24,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-3"},{"clause":"4.4","heading":"Investigation & Evaluation – Code – ExcI04","page":24,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-4"},{"clause":"4.5","heading":"Rest Cure, rehabilitation and respite care – Code -ExcI05","page":24,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-5"},{"clause":"4.7","heading":"Change of Gender Treatments: Code – ExcI07 Expenses related to any treatment, including","page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-7"},{"clause":"4.8","heading":"Cosmetic or Plastic Surgery- Code- ExcI08 Expenses for cosmetic or plastic surgery or any","page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-8"},{"clause":"4.9","heading":"Hazardous or Adventure sports- Code- ExcI09 Expenses related to any treatment necessitated","page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-9"},{"clause":"4.10","heading":"Breach of law","page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-10"},{"clause":"4.12","heading":null,"page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-12"},{"clause":"4.15","heading":null,"page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-15"},{"clause":"4.16","heading":"Unproven Treatments- Code","page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-16"},{"clause":"4.17","heading":null,"page":26,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-17"},{"clause":"4.18","heading":"Maternity- Code- ExcI18","page":26,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-18"},{"clause":"4.38","heading":null,"page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-38"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"First contact the Company through its website, toll-free/phone number, e-mail or branch grievance cell. If not satisfied, contact the grievance officer at Customer Service Department, Corporate Office, Block - 4, Plate-A, NBCC Office Complex, Kidwai Nagar East, New Delhi - 110023.","display":"Company website/phone/e-mail or branch grievance cell first; then grievance officer, Customer Service Department, Corporate Office, New Delhi","note":null,"quote":"In case of any grievance the insured person may contact the company through\nWebsite: www.orientalinsurance.org.in Toll free: 1800118485 Or 011- 33208485 E-mail: csd@orientalinsurance.co.in\nInsured person may also approach the grievance cell at any of the company’s branches with the details of grievance. If insured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer at: Customer Service Department, Corporate Office, Block - 4, Plate-A, NBCC Office Complex, Kidwai Nagar East, New Delhi - 110023.","sources":[{"clause":"5.12","heading":"GRIEVANCE REDRESSAL In case of any grievance the insured person may contact the","page":32,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-12"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"Silver: Rs.1, 2,3,4 & 5 lakh; Gold: Rs.6,7,8,9 & 10 lakh; Diamond: Rs.12, 15, 18 and 20 lacs; Platinum: Rs.,25,30, 40 and 50 lacs.","display":"Rs.1, 2,3,4 & 5 lakh; Rs.6,7,8,9 & 10 lakh; Rs.12, 15, 18 and 20 lacs; Rs.,25,30, 40 and 50 lacs","note":"Options differ by plan: Silver, Gold, Diamond and Platinum respectively.","quote":"Sum Insured Available | Rs.1, 2,3,4 & 5 lakh | Rs.6,7,8,9 & 10 lakh | Rs.12, 15, 18 and 20 lacs | Rs.,25,30, 40 and 50 lacs","sources":[{"clause":"3.1","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to covered accident claims; does not apply if the insured person has continuous coverage for more than twelve months.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"4.3","heading":"30 day waiting period- code – ExcI03","page":24,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-3"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"36 months","note":"Waiting period is reduced by prior continuous coverage under portability norms; applies afresh to enhanced sum insured to the extent of increase.","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.","sources":[{"clause":"4.1","heading":"Pre-existing Diseases - code -ExcI0 1","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#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 conditions have 1 year, 2 Years or 3 Years waiting periods; if the disease is pre-existing, the PED exclusion applies.","quote":"The expenses on treatment of following ailments / diseases / surgeries, if contracted and / or manifested after inception of first Policy (subject to continuity being maintained), are not payable during the waiting period specified below. ... Xvii | Hypertension. | 90 days* ... Xviii | Diabetes. | 90 days* ... I | Benign ENT disorders and surgeries i.e. Tonsillectomy, Adenoidectomy, Mastoidectomy, Tympanoplasty etc. | 1 year ... Iii | Surgery of hernia. | 2 years ... Xxii | Joint Replacement due to Degenerative condition. | 3 Years","sources":[{"clause":"4.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#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/surgeries, polycystic ovarian diseases, hernia, hydrocele, non infective arthritis, undescendent 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 surgery, varicose veins/ulcers, joint replacement due to degenerative condition, age related osteoarthritis and osteoporosis","note":null,"quote":"I | Benign ENT disorders and surgeries i.e. Tonsillectomy, Adenoidectomy, Mastoidectomy, Tympanoplasty etc. | 1 year\nIi | Polycystic ovarian diseases. | 1 year\nIii | Surgery of hernia. | 2 years\nIv | Surgery of hydrocele. | 2 years\nV | Non infective Arthritis. | 2 years\nVi Undescendent Testes. | 2 Years\nVii | Cataract. | 2 Years\nViii | Surgery of benign prostatic hypertrophy. | 2 Years\nIx | Hysterectomy for menorrhagia or fibromyoma or myomectomy or prolapse of uterus | 2 Years\nX | Fissure / Fistula in anus. | 2 Years\nXi | Piles. | 2 Years\nXii | Sinusitis and related disorders. | 2 Years\nXiii | Surgery of gallbladder and bile duct excluding malignancy. | 2 Years\nXiv | Surgery ofgenito-urinary system excluding malignancy. | 2 Years\nXv | Pilonidal Sinus. | 2 Years\nXvi | Gout and Rheumatism. | 2 Years\nXvii | Hypertension. | 90 days*\nXviii | Diabetes. | 90 days*\nXix | Calculus diseases. | 2 Years\nXx | Surgery for prolapsed inter vertebral disk unless arising from accident. | 2 Years\nXxi | Surgery of varicose veins and varicose ulcers. | 2 Years\nXxii | Joint Replacement due to Degenerative condition. | 3 Years\nXxiii | Age related osteoarthritis and Osteoporosis. | 3 Years","sources":[{"clause":"4.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":23,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#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":5},"display":"five continuous years","note":"Applies to sums insured of the first policy; for enhanced sums insured, five continuous years runs from the date of enhancement. After moratorium, claims are contestable only for proven fraud and remain subject to 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":"5.10","heading":"MORATORIUM PERIOD After completion of five continuous years under this policy no look","page":32,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-10"}],"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 entire policy with all family members to another insurer by applying at least 30 days before, but not earlier than 60 days from, the renewal date, and gets accrued continuity benefits in waiting periods if continuously covered without lapses.","display":"Allowed, with waiting-period continuity credit","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":"5.8","heading":"PORTABILITY","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-8"}],"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, renewable lifelong","note":"From the prospectus; the wording says renewal shall ordinarily be renewable except on grounds of fraud, misrepresentation and non-disclosure.","quote":"Term of the Policy is one year and is renewable lifelong.","sources":[{"clause":"2","heading":"FEATURES IN THE POLICY","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13776#c-2"}],"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 shall apply on renewals based on individual experience, and renewal shall not be denied because the insured made claims in preceding policy years.","display":"No loading on renewals based on individual experience","note":null,"quote":"Renewal shall not be denied on the ground that the insured had made a claim or claims in the preceding policy years ... No loading shall apply on renewals based on individual experience.","sources":[{"clause":"5.7","heading":"FREE LOOK PERIOD: The free look period shall be applicable on new individual health","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-7"}],"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 claims having been made; no refund is made where any claim has been admitted or lodged or any benefit availed.","display":"Proportionate premium for unexpired period if annual policy and no claim; 7 days’ notice","note":"For policies with term more than 1 year, refund is for the unexpired policy period where risk coverage for such policy years has not commenced.","quote":"Cancellation by insured - Any time during the term, by giving 7 days’ notice in writing. Refund by Insurer : ... a) proportionate premium for unexpired policy period, in case of Annual policies, subject to no claim (s)having been made during the policy period. ... Notwithstanding 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","page":30,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-5"},{"clause":"5.5(a)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-5-a"},{"clause":"5.5(b)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-5-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 treatment for this insurance has to be taken in India only, except where the policy has been extended to SAARC countries.","display":"India only, except SAARC extension","note":"SAARC extension is by written request before travel and is reimbursement-only outside India.","quote":"All medical treatment for the purpose of this insurance will have to be taken in India only (except where the Policy has been extended to SAARC countries) and all claims shall be payable in Indian currency only.","sources":[{"clause":"5.21","heading":"MEDICALRECORDS","page":34,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-21"}],"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":"Applicable on new individual health insurance policies and not on renewals or at porting/migration, except a stated one-time option on renewal into Happy Family Floater Policy - 2021.","quote":"the insured person shall be 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":"5.7","heading":"FREE LOOK PERIOD: The free look period shall be applicable on new individual health","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#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":"The grace-period definition 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":"5.33","heading":"GRACE PERIOD: In the event of delay in renewal of the Policy, a grace period of 30 days is","page":38,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-33"}],"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":"The proposer must be 18 years or more. Children can be covered from 1 day to 18 years, with extensions for financially dependent male students up to 25 years and for female, divorced and widowed daughters as stated; maximum entry age is 65 years for all members, extendable above 65 up to 70 years under Silver or Gold with 20% co-payment.","display":"Proposer 18 years or more; child from 1 day; maximum entry age 65 years, extendable to 70 years under Silver/Gold with 20% co-payment","note":"The policy wording's family definition says dependent children between 91 days and 18 years, while the prospectus eligibility and midterm inclusion clauses allow newborn child from 1 day.","quote":"Any person of 18 years or more can take this Policy covering self and /or anyone or more of the family members as mentioned below: ... Dependent Children (i.e. natural or legally adopted) between the ages of 1 day to 18 years. However male child can be covered up to the age of 25 years if he is a bonafide regular student and financially dependent. ... ENTRY AGE: Maximum Entry Age under the Policy is 65years for all members. However, with a compulsory co-payment of 20% of each and every claim, persons above the age of 65 and up to 70 years of age can also be covered under Silver or Gold Plan, but not under Diamond and Platinum Plan.","sources":[{"clause":"1","heading":null,"page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13776#c-1"},{"clause":"1(ii)","heading":null,"page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13776#c-1-ii"},{"clause":"5.28","heading":"ENTRY AGE","page":37,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-28"}],"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 refer to monthly premium mode in the grace-period definition but do not state which premium payment modes are available for this product.","quote":null,"sources":[],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["GEOGRAPHICAL EXTENSION TO SAARC COUNTRIES","RESTORATION OF SUM INSURED","PERSONAL ACCIDENT COVER: (WORLD – WIDE)","LIFE HARDSHIP SURVIVAL BENEFIT PLAN","WAIVER OF PROPORTIONATE DEDUCTION CLAUSE","WAIVER OF 10 % CO-PAY under silver plan"],"display":"SAARC geographical extension; restoration of sum insured; worldwide personal accident cover; life hardship survival benefit; waiver of proportionate deduction; waiver of 10% co-pay under Silver plan","note":"SAARC extension is stated to have no additional premium; the other listed coverages are under coverage that can be taken on payment of additional premium.","quote":"GEOGRAPHICAL EXTENSION TO SAARC COUNTRIES: The Policy can be extended to cover InsuredPersons visiting other SAARC (South Asian Association for Regional Co-operation) countries - Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan, Sri Lanka. ... Following coverage can be taken on payment of additional premium. ... RESTORATION OF SUM INSURED: ... PERSONAL ACCIDENT COVER: (WORLD – WIDE): ... LIFE HARDSHIP SURVIVAL BENEFIT PLAN: ... WAIVER OF PROPORTIONATE DEDUCTION CLAUSE ... WAIVER OF 10 % CO-PAY under silver plan is available on payment of extra premium.","sources":[{"clause":"3.2.1","heading":"GEOGRAPHICAL EXTENSION TO SAARC COUNTRIES: The Policy can be extended to cover","page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-2-1"},{"clause":"3.2.2","heading":null,"page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-2-2"},{"clause":"3.2.2(ii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-2-2-ii"},{"clause":"3.2.2(iv)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-2-2-iv"},{"clause":"Row 1(viii)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-row-1-viii"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is not available during the grace period. The insurer shall offer coverage during the grace period if the premium is paid in instalments during the policy period.","display":"No coverage during grace period, except coverage offered if premium is paid in instalments during the policy period","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.\n• the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period.","sources":[{"clause":"5.7","heading":"FREE LOOK PERIOD: The free look period shall be applicable on new individual health","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-7"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room, boarding and nursing expenses are limited to 1 % of the Sum Insured per day under Silver, Gold, Diamond and Platinum.","display":"1 % of the Sum Insured per day","note":"Same percentage applies across all four plans.","quote":"Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. | 1 % of the Sum Insured per day | 1 % of the Sum Insured per day | 1% of the Sum Insured per day. | 1% of the Sum Insured per day.","sources":[{"clause":"3.1","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-applicable","value":null,"display":null,"note":"The policy states a room rent limit as a percentage of sum insured per day, not a room category such as shared or single private room.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU expenses are limited to 2% of the Sum Insured per day under Silver, Gold, Diamond and Platinum.","display":"2% of the Sum Insured per day","note":"Same percentage applies across all four plans.","quote":"Intensive Care Unit (ICU) Expenses as provided by the Hospital /Nursing Home.* | 2% of the Sum Insured per day. | 2% of the Sum Insured per day. | 2% of the Sum Insured per day | 2% of the Sum Insured per day","sources":[{"clause":"3.1","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"quote-verified","value":"If the insured is admitted in a room where the room category or room rent is higher than eligibility, the insured bears a ratable proportion of the total and specified associated medical expenses, but this does not apply to medicines/pharmacy/drugs, consumables, medical devices/implants and diagnostics.","display":"Yes, ratable proportion of associated medical expenses if room is above eligibility","note":"An optional waiver of proportionate deduction is available on payment of additional premium.","quote":"If the Insured Person is admitted in the hospital in a room where the room category or the Room Rent incurred is higher than the eligibility as specified in the Policy Schedule/ Certificate of Insurance, then the Policyholder/ Insured Person shall bear a ratable proportion of the total & specified Associated Medical Expenses (including surcharge or taxes thereon) in the proportion of the difference between the Room Rent of the entitled room category/eligible Room Rent to the Room Rent actually incurred. However, this will not be applicable in respect of Medicines/Pharmacy/ Drugs, Consumables, Medical Devices/ implants and Cost of Diagnostics.","sources":[{"clause":"5.31","heading":"PROPORTIONATE CLAUSE - If the Insured Person is admitted in the hospital in a room","page":38,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-31"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"Under the Silver plan the insured has to bear 10% of admissible claim amount in each and every claim. Gold, Diamond and Platinum show NIL compulsory co-payment; persons above 65 and up to 70 years can be covered under Silver or Gold with a compulsory co-payment of 20% of each and every claim.","display":"Silver: 10% of each and every claim; Gold/Diamond/Platinum: NIL; age 65-70 under Silver/Gold: 20%","note":"Waiver of 10% co-pay under Silver plan is available on payment of extra premium.","quote":"Compulsory co-payment | 10% of each & every claim | NIL | NIL | NIL ... Under the SILVER plan the insured has to bear 10% of admissible claim Amount in each and every claim. ... However, with a compulsory co-payment of 20% of each and every claim, persons above the age of 65 and up to 70 years of age can also be covered under Silver or Gold Plan, but not under Diamond and Platinum Plan.","sources":[{"clause":"3.1(b)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-b"},{"clause":"4.40","heading":"Compulsory Co-Payment: Under the SILVER plan the insured has to bear 10% of admissible","page":29,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-40"},{"clause":"5.28","heading":"ENTRY AGE","page":37,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-28"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"not-stated","value":null,"display":null,"note":"The documents mention deductibles only generically for claims falling in two policy periods and do not state a product deductible amount or basis.","quote":null,"sources":[],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Domiciliary Hospitalization: 10% of Sum Insured, Maximum Rs.25000/- during the Policy Period under Silver; Maximum Rs. 50,000/- during the Policy Period under Gold, Diamond and Platinum.","Treatment for Dog bite (or bite of any other rabid animal like monkey, cat etc.): Maximum Rs.5,000 /- actually incurred on immunization injections in any one Policy Period.","Advanced Treatments: specified per-policy-period sub-limits by procedure and sum insured slab.","Maternity expenses: 2.5% of the Sum Insured per delivery or termination under Diamond and Platinum.","Assisted Reproduction Treatment: Rs. 2, 00,000/- under Platinum Plan.","Air Ambulance Cover: maximum up to 5% of the policy sum insured under Platinum Plan."],"display":"Domiciliary, dog/rabid animal bite injections, advanced treatments, maternity, ART and air ambulance have sub-limits","note":"Advanced treatment sub-limits differ by procedure and sum insured slab.","quote":"Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines &Drugs, Diagnostic Material and Dialysis, Chemotherapy, Nursing expenses. | 10% of Sum Insured, Maximum Rs.25000/- during the Policy Period. | Maximum Rs. 50,000/- during the Policy Period. | Maximum Rs. 50,000 during the Policy Period. | Maximum Rs. 50,000 during the Policy Period. ... Treatment for Dog bite (or bite of any other rabid animal like monkey, cat etc.) | Maximum Rs.5,000 /- actually incurred on immunization injections in any one Policy Period. ... Company’s maximum liability per delivery or termination shall be limited to 2.5% of the Sum Insured ... The maximum liability of the Company for such treatment shall be limited to Rs. 2, 00,000/-. ... The policy covers Air Ambulance cost maximum up to 5% of the policy sum insured ... ADVANCED TREATMENTS All the following procedures, will be covered in the policy ... within the sub-limits","sources":[{"clause":"3.1(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-b-2"},{"clause":"3.1.3(iii)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-3-iii"},{"clause":"3.1.4","heading":"ASSISTED REPRODUCTION TREATMENT (ART) Assisted Reproduction Treatment is defined asthe","page":14,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-4"},{"clause":"3.1.8","heading":"AIR AMBULANCE COVER(available for Platinum Plan Only) The policy covers Air Ambulance","page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-8"},{"clause":"3.1.15","heading":null,"page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-15"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days prior to Hospitalization","note":"Expenses must be for the same condition and the inpatient hospitalization claim must be admissible.","quote":"Pre and Post Hospitalization expenses | Medical expenses incurred 30 days prior to Hospitalization and up to 60 days post Hospitalization.","sources":[{"clause":"3.1(b)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-b"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"up to 60 days post Hospitalization","note":"Expenses must be for the same condition and the inpatient hospitalization claim must be admissible.","quote":"Pre and Post Hospitalization expenses | Medical expenses incurred 30 days prior to Hospitalization and up to 60 days post Hospitalization.","sources":[{"clause":"3.1(b)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-b"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Day care procedures/surgeries listed in Appendix I are covered when taken in a hospital/day care centre but not the outpatient department, and any other day care treatment is covered if prior written approval from Company/TPA is obtained.","display":"Listed Appendix I day care procedures and other approved day care treatments","note":null,"quote":"Day care procedures / surgeries (Appendix I) where such treatment is taken by an Insured Person in a Hospital / day care centre(but not the Out-patient department of a Hospital),Or ... Any other day care treatment as mentioned and for which prior approval from Company / TPA is obtained in writing.","sources":[{"clause":"3.1(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-a-2"},{"clause":"3.1(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-b-2"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary hospitalization is covered up to plan limits when treatment normally requiring hospital care is taken at home because the patient cannot be moved to hospital or because hospital room is unavailable. It is not covered if treatment lasts three days or less or for listed diseases such as asthma, bronchitis, diabetes, hypertension and others.","display":"Covered up to domiciliary limits; not if treatment lasts three days or less or for listed diseases","note":"Limits: Silver 10% of Sum Insured up to Rs.25000/- during the policy period; Gold, Diamond and Platinum Maximum Rs. 50,000 during the policy period.","quote":"DOMICILIARY HOSPITALISATION means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home under any of the following circumstances:\nA. the condition of the patient is such that he/she is not in a condition to be moved to a hospital, or B. The patient takes treatment at home on account of non-availability of room in a hospital. ... DOMICILIARY HOSPITALIZATION benefit shall, however, not cover expenses in any of the following cases:\nA. if the treatment lasts for a period of three days or less B. incurred on treatment of any of the following diseases:","sources":[{"clause":"2.12","heading":"DOMICILIARY HOSPITALISATION","page":2,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-2-12"},{"clause":"3.1.1","heading":"DOMICILIARY HOSPITALIZATION benefit shall, however, not cover expenses in any of the","page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-1"}],"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 inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems during each policy year up to the sum insured limit in any AYUSH Hospital.","display":"Covered up to sum insured in any AYUSH Hospital","note":null,"quote":"The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as specified in the policy schedule in any AYUSH Hospital.","sources":[{"clause":"3.1(b)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-b"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Advanced treatments are covered if treated as inpatient care, domiciliary hospitalization or day care treatment in hospital, with per-policy-period sub-limits for listed procedures including Uterine Artery Embolization and HIFU, Balloon Sinuplasty, Deep Brain stimulation, Oral chemotherapy, Immunotherapy, Intra vitreal injections, Robotic surgeries, Stereotactic radio surgeries, Bronchial Thermoplasty, Green/holmium laser prostate treatment, IONM and hematopoietic stem cell therapy.","display":"Covered with procedure-wise sub-limits","note":"The same clause also lists Stereotactic radio surgeries, Bronchial Thermoplasty, Vaporization of the prostrate, IONM and hematopoietic stem cell therapy with separate sub-limits.","quote":"ADVANCED TREATMENTS All the following procedures, will be covered in the policy, if treated as in-patient care or as a part of domiciliary hospitalization or as day care treatment in the hospital, within the sub-limits in the complete policy period which is as defined below:\nName of the Procedure | Sub limits for sum insured slab from Rs.1.0 lac to Rs. 10.0 lacs | Sub limits for sum insured slab from Rs.12.0 lac to Rs. 50.0 lacs\nA. Uterine Artery Embolization and HIFU | Per policy period: Up to INR 50,000.\nB. Balloon Sinuplasty | Per policy period: Up to INR 40,000.\nC. Deep Brain stimulation | Per policy period 10% of SI, subject to maximum INR 50,000. | Per policy period 10% of SI, subject to maximum INR 1,50,000.\nD. Oral chemotherapy | Per policy period 25% of SI, subject to maximum INR 50,000. | Per policy period: Up to INR 1,50,000.\nE. Immunotherapy- Monoclonal Antibody to be given as injection | Per policy period 10% of SI, subject to maximum INR 50,000. | Per policy period 10% of SI, subject to maximum INR 1,50,000.\nF. Intra vitreal injections | Per policy period 10% of SI, subject to maximum INR 50,000. | Per policy period 10% of SI, subject to maximum INR 1,50,000.\nG. Robotic surgeries | Per policy period 10% of SI, subject to maximum INR 1,00,000.* | Per policy period 10% of SI, subject to maximum INR 2,00,000.*","sources":[{"clause":"3.1.15","heading":null,"page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-15"}],"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":null,"quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance service charges are covered by plan per illness and per policy period limits: Silver Rs.1000 per illness and 1% of Sum Insured subject to Rs.3000 per policy period; Gold Rs.2000 and Rs.6000; Diamond Rs.3000 and Rs.8000; Platinum Rs.5000 and Rs.15000. Platinum also has air ambulance cover up to 5% of SI for medical emergency cases only.","display":"Road ambulance: Rs.1000/Rs.3000 Silver, Rs.2000/Rs.6000 Gold, Rs.3000/Rs.8000 Diamond, Rs.5000/Rs.15000 Platinum; air ambulance up to 5% SI in Platinum","note":"Air ambulance is available for Platinum Plan only and can be availed once during the entire policy lifetime.","quote":"Ambulance service charges as herein after defined. | Per Illness - Rs.1000 maximum & Per policy period 1% of Sum Insured, Subject to maximum Rs.3000. | Per Illness - Rs.2000 maximum & Per policy period 1% of Sum Insured, Subject to maximum Rs.6000. | Per Illness - Rs.3000 maximum & Per policy period 1% of Sum Insured, Subject to maximum Rs.8000. | Per Illness - Rs.5000 maximum& Per policy period 1% of Sum Insured, Subject to maximum Rs.15000. ... Air Ambulance Cover ... Not available | Not available | Not available | Maximum upto 5% of the SI for medical emergency cases only.","sources":[{"clause":"3.1(b)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-b"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"quote-verified","value":"Restoration is an optional benefit for Silver and Gold only, on extra premium. If sum insured is reduced or exhausted by a claim, it is restored to the claim amount but not exceeding the opted restoration limit of 50% or 100% of sum insured; aggregate restored amounts during the policy period cannot exceed the opted 50% or 100%.","display":"Optional for Silver and Gold: 50% or 100% of Sum Insured","note":"Not available for Diamond and Platinum. The document does not state that restoration can be used for the same illness; aggregate of all claims payable during a policy period shall not exceed the sum of the Sum Insured and Restored Sum Insured.","quote":"Restoration of Sum Insured(It is an optional benefit on payment of extra premium) (Refer clause 3.2.2 A below) | 2 options- (i) 50% of the Sum Insured (ii) 100% of the Sum Insured | 2 options-(i) 50% of the Sum Insured (ii) 100% of the Sum Insured | Not available | Not available ... If during the Policy Period the Sum Insured gets reduced or exhausted on account of a claim under the Policy, the Sum Insured is automatically restored to the extent of the claim amount but not exceeding the Restoration limit opted (50% / 100% of Sum Insured) at the inception of the Policy.","sources":[{"clause":"3.1(b)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-b"},{"clause":"3.2.2(ii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-2-2-ii"}],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"No cumulative bonus is stated. The old no-claim discount/loading was discontinued; any existing no-claim discount continues until a claim is reported, and claim loadings are discontinued.","display":"No cover increase stated; old no-claim discount/loading discontinued","note":"Claim under PA section will not affect the no-claim discount earned thus far.","quote":"NO CLAIM DISCOUNT /LOADING: This is a one-time benefit for those Insured Persons covered under Happy Family Floater Policy. Happy Family Floater Policy had the provision of No Claim Discount / Loading, which has been discontinued under Happy Family Floater Policy- 2015.However, The discount on account of ‘No Claim’ that would have been earned by the Insured on renewal of the Happy Family Floater Policy, would be allowed when the Policy is renewed for the first time, into Happy Family Floater Policy-2021. However, there will be no change in discount even if there are no claims reported under the subsequent Happy Family Floater Policy-2021 Policy (ies). This discount shall continue till a claim is reported under the Policy and upon reporting of a claim, any discount earned on account of ‘No Claim’ shall be forfeited.","sources":[{"clause":"5.30","heading":"NO CLAIM DISCOUNT /LOADING: This","page":37,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-30"}],"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 items and personal comfort items are not payable, including gloves, mask, oxygen mask and similar items. Consumables are not subject to proportionate deduction, but the policy does not state that all consumables are covered.","display":"Listed non-medical items not payable; consumables exempt from proportionate deduction","note":null,"quote":"List I – List of which coverage is not available in the policy ... 56 | GLOVES ... 60 | MASK ... 62 | OXYGEN MASK ... Items of personal comfort Items of personal comfort and convenience (as listed in respective Appendix-II) including telephone, television, aya, barber, beauty services, baby food, cosmetics, napkins, toiletries, guest services. ... However, this will not be applicable in respect of Medicines/Pharmacy/ Drugs, Consumables, Medical Devices/ implants and Cost of Diagnostics.","sources":[{"clause":null,"heading":"T Other Operations","page":44,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-t-other-operations"},{"clause":"4.33","heading":null,"page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-33"},{"clause":"5.31","heading":"PROPORTIONATE CLAUSE - If the Insured Person is admitted in the hospital in a room","page":38,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-31"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses are covered only in Diamond and Platinum Plan for the insured or spouse after the plan has been continuously in force for minimum 24 months, limited to two deliveries or terminations or either during the lifetime of the insured person, and to 2.5% of the Sum Insured per delivery or termination in any one policy period.","display":"Diamond/Platinum only: 24 months waiting, 2.5% of Sum Insured, two deliveries/terminations lifetime","note":"Not available under Silver and Gold. Not eligible if already having two or more living children. Pre-natal and post-natal expenses are not covered unless admitted in hospital/nursing home and treatment is taken there.","quote":"MATERNITY EXPENSES: The Company shall pay the Medical Expenses incurred as an In-patient for a delivery (including caesarean section) or lawful medical termination of pregnancy during the Policy Period limited to two deliveries or terminations or either during the lifetime of the Insured Person. This benefit is applicable only in Diamond and Platinum Plan, and available only tothe Insured or his spouse, provided that: ... Diamond / Platinum Plan has been continuously in force for a period of minimum 24 months in respect of both the Insured and his/her spouse. ... Company’s maximum liability per delivery or termination shall be limited to 2.5% of the Sum Insured","sources":[{"clause":null,"heading":"A. MATERNITY EXPENSES","page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-a-maternity-expenses"},{"clause":"3.1.3(i)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-3-i"},{"clause":"3.1.3(iii)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-3-iii"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New born baby is covered from day one, and medical expenses incurred for treatment taken in hospital as inpatient are payable, subject to policy terms and conditions and payment of requisite premium.","display":"Covered from day one on payment of requisite premium","note":"Available under all plans in the benefit table.","quote":"NEW BORN BABY means baby born during the Policy Period and is cover from day 1. ... New born Baby shall be covered from day one and Medical expenses incurred for treatment taken in Hospital as in patient shall be payable, subject to terms and conditions of the policy. ... The Policy covers New Born Baby from day 1 only on payment of requisite premium.","sources":[{"clause":"2.32","heading":"NEW BORN BABY","page":6,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-2-32"},{"clause":"3.1.3(v)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-3-v"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"quote-verified","value":"Mental illness cover pays medical expenses including pre and post hospitalization expenses only under conditions including illness covered by the mental illness definition, hospitalization in a Mental Health Establishment and hospitalization advised by a Mental Health Professional. Mental conditions associated with abuse of alcohol and drugs, mental retardation and non-hospitalization psychotherapy/counselling are excluded.","display":"In-patient mental illness treatment covered with conditions","note":null,"quote":"MENTAL ILLNESS COVER The Company shall indemnify the Hospital or the Insured the Medical Expenses (including Pre and Post Hospitalization Expenses) only under certain conditions as:-\ni) Illness covered under definition of mental illness mentioned under definitions clause*.\nii) Hospitalization in Mental Health Establishment as defined under definitions clause*.\niii) Hospitalization as advised by Mental Health Professional as defined under definitions clause*.\niv) Mental Conditions associated with the abuse of alcohol and drugs are excluded.\nv) Mental Retardation and associated complications arising therein are excluded.\nvi) Any kind of Psychological counseling, cognitive/ family/ group/ behavior/ palliative therapy or other kinds of psychotherapy for which Hospitalization is not necessary shall not be covered.","sources":[{"clause":"3.1.14","heading":"MENTAL ILLNESS COVER MENTAL ILLNESS COVER The Company shall indemnify the","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-14"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":"The documents state pre-acceptance medical check-up requirements and reimbursement of 50% cost if accepted, but do not state a preventive health check-up benefit.","quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"OPD is generally excluded, except the OPD benefit for Dental and Ophthalmic cover in Platinum Plan, which reimburses up to Rs. 5,000 in a block of every three years for outpatient consultations, diagnostic tests and prescribed medicines/drugs.","display":"Generally excluded; Platinum dental/ophthalmic OPD up to Rs. 5,000 in a block of every three years","note":"Platinum variant only; Refractive Error Code Excl15 does not apply for this benefit.","quote":"Out Patient Department (OPD) Any expenses incurred on OPD (Except OPD benefit for Dental and Ophthalmic cover in Platinum Plan). ... The policy will reimburse OPD expenses Maximum up to Rs. 5,000 in a block of every three years for Dental and Ophthalmic care with respect of\ni) Out-patient consultations by a medical practitioner.\nii) Diagnostic tests prescribed by a medical practitioner.\niii) Medicines/drugs prescribed by a medical practitioner.","sources":[{"clause":"4.27","heading":"Out Patient Department (OPD) Any expenses incurred on OPD (Except OPD benefit for Dental","page":26,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-4-27"},{"clause":"3.1.10","heading":"OPD BENEFIT FOR DENTAL AND OPHTHALMIC COVER(Available only for platinum","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-3-1-10"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"quote-verified","value":"For Silver Plan, premium is charged on the basis of two zones: Zone I is Gujarat, Mumbai, Greater Mumbai and Delhi NCR, and Zone II is rest of India. For Gold, Diamond and Platinum, premium rates are the same Pan India.","display":"Silver has Zone I/Zone II premiums; other plans Pan India","note":null,"quote":"For Silver Plan, the premium in the policy will be charged on the basis of the 2 Zones, as defined below:\nZones are as defined below: ... Zone I Gujarat, Mumbai, Greater Mumbai, and Delhi NCR\nZone II Rest of India\nInsured Person can choose the Zone at the time of proposal, and can also change it at the time of renewal. For other Plans, I.e. Gold, Diamond and Platinum Plans the premium rates will be same Pan India.","sources":[{"clause":"5.17","heading":"PAYMENT OF PREMIUM","page":33,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-17"},{"clause":null,"heading":"Zone I Gujarat, Mumbai, Greater Mumbai, and Delhi NCR","page":33,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-zone-i-gujarat-mumbai-greater-mumbai-and-delhi-n"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless facility is available in network hospitals, subject to pre-admission authorization by the Company/TPA. The insurer pays the network provider directly to the extent pre-authorization is approved.","display":"Available at network hospitals with pre-authorisation","note":"List of network hospitals is available on the insurer's official website and from the concerned TPA on demand.","quote":"CASHLESS FACILITY Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer to the extent pre-authorization is approved. ... 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.","sources":[{"clause":"2.4","heading":"CASHLESS FACILITY Cashless facility","page":2,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-2-4"},{"clause":"5.20","heading":null,"page":34,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-5-20"}],"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 may be serviced by the Third Party Administrator (TPA) or by the Company, as the case may be.","display":"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":"WE VALUE YOUR HEALTH & YOUR WEALTH. BUILD A PRODUCTIVE NATION","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789#c-we-value-your-health-your-wealth-build-a-product"}],"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, single Sum insured for proposer and family","note":"From the prospectus.","quote":"A floater policy covering the proposer and his / her family under single Sum insured under one Policy.","sources":[{"clause":"2","heading":"FEATURES IN THE POLICY","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13776#c-2"}],"law":[]}],"documents":[{"kind":"wording","label":"POLICY_WORDINGS_148642ec2f.pdf","pages":52,"fetched_at":"2026-10-17 19:53:52+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/POLICY_WORDINGS_148642ec2f_3904b1eb54.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13789"},{"kind":"prospectus","label":"PROSPECTUS_2024_f2d88c06bf.pdf","pages":51,"fetched_at":"2026-10-17 19:53:18+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/PROSPECTUS_2024_f2d88c06bf_e6ccbf1fb8.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425/document/13776"}],"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":"HAPPY FAMILY FLOATER 2024 (UIN OICHLIP25046V062425), IndiaInsurances, https://indiainsurances.com/policy/oriental-insurance/happy-family-floater-2024-oichlip25046v062425"}