{"uin":"OICHLIP25048V052425","name":"ORIENTAL MEDICLAIM INSURANCE POLICY (INDIVIDUAL) 2024","url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425","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":"This is an individual health indemnity policy with a one-year term for treatment taken in India and sum insured from Rs.1lac to Rs.50lacs. It has a 30-day initial waiting period, 36-month pre-existing disease waiting period, room rent capped at 1% of sum insured per day and ICU capped at 2% of sum insured per day.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:01:49.070171+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"One year.","display":"One year","note":null,"quote":"The Policy term is one year and is available to any proposer between the ages of 18 to 65 years for treatment taken in India.","sources":[{"clause":"1","heading":"SALIENT FEATURES OF THE POLICY","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-1"}],"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 should be given to the Company or TPA while taking treatment, within 48 hours of admission but before discharge, unless waived in writing.","display":"Within 48 hours of admission, but before discharge","note":null,"quote":"Immediate notice of claim with particulars relating to Policy Number, ID Card No., Name of Insured Person in respect of whom claim is made, Nature of disease / Injury and Name and Address of the attending Medical Practitioner / Hospital /Nursing Home etc. should be given to the Company/ TPA while taking treatment in the Hospital / Nursing Home by fax, 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":"6.20","heading":"NOTIFICATION OF CLAIM","page":28,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-20"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Original bills, all receipts and discharge certificate / card from the Hospital.","All documents pertaining to the Illness, starting from the date it was first detected, i.e. Doctor’s consultations reports/history","Medical history of the patient recorded by the Hospital.","Original Cash-memo from the Hospital (s) / chemist (s) supported by proper prescription.","Original receipt, pathological and other test reports from a pathologist / radiologist including film etc supported by the note from attending Medical Practitioner / Surgeon demanding such tests.","Original attending Consultants / Anesthetists/ Specialist certificates regarding diagnosis and bills / receipts etc.","Surgeon’s original certificate stating diagnosis and nature of operation performed along with bills / receipts etc.","MLC/FIR/Post Mortem Report,( if applicable)","Disability certificate, Death certificate ( if applicable)","Documents in respect of organ donation claim, shall be in accordance with the extant Act, Central / State Rules / regulations, as applicable, in respect of transplantation of human organs","Details of previous policies, if the details are already not with TPA.","Any other information required by TPA /Company."],"display":"Original bills, receipts, discharge card, medical history, prescriptions, test reports, certificates, MLC/FIR/Post Mortem Report if applicable, disability/death certificate if applicable, organ donation documents, previous policy details and any other information required","note":"The full list is in the cited clause; claim papers are to be submitted within 15 days of discharge.","quote":"Final claim along with original Bills/ Cash memos/reports, claim form and documents as | listed below should be submitted to the Company / TPA within 15 days of discharge ... • Original bills, all receipts and discharge certificate / card from the Hospital. ... • Any other information required by TPA /Company.","sources":[{"clause":"6.21","heading":"CLAIM DOCUMENTS: Final claim along with original Bills/ Cash memos/reports, claim form and","page":28,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-21"}],"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 not later than 30 days and settle or reject the claim within 45 days from receipt of the last necessary document.","display":"15 days from last necessary document; 45 days if investigation is warranted","note":"Another clause in the same document says the Company/TPA shall within 30 days offer settlement or reject from 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. ... where the circumstance of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document. In such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":"6.2","heading":"CONDITION PRECEDENT TO ADMISSION OF LIABILITY: The terms and conditions of the","page":24,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"The insured may contact Oriental through website, toll-free number, email, or the grievance cell at any branch. If not satisfied, the insured may contact the grievance officer at Customer Service Department, Corporate Office, New Delhi before approaching the Insurance Ombudsman.","display":"Company website/toll-free/email or branch grievance cell first; then grievance officer at Customer Service Department, Corporate Office","note":null,"quote":"In case of any grievance the insured person may contact the company through Website: www.orientalinsurance.org.in Toll free: 1800118485 Or 011- 33208485 E-mail: csd@orientalinsurance.co.in\nInsured person may also approach the grievance cell at any of the company’s branches with the details of grievance.If insured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer atCustomer Service Department, Corporate Office, Block - 4, Plate-A, NBCC Office Complex, Kidwai Nagar East, New Delhi - 110023.","sources":[{"clause":"6.13","heading":"GRIEVANCE REDRESSAL In case of any grievance the insured person may contact the company","page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-13"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":null,"quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"5.3(a)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-5-3-a"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"36 months","note":null,"quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with the insurer.","sources":[{"clause":"5.1","heading":"Pre-existing Diseases - code -ExcI0 1","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-5-1"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"days","amount":90},"display":"90 days","note":"Other listed specified disease/procedure waiting periods are 1 year, 2 Years and 3 Years.","quote":"Xvii | Hypertension. | 90 days\nXviii | Diabetes. | 90 days","sources":[{"clause":"5.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-5-2"}],"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":"The listed conditions include ENT surgeries, PCOD, hernia, hydrocele, non-infective arthritis, undescended testes, cataract, BPH surgery, hysterectomy/myomectomy/prolapse, fissure/fistula, piles, sinusitis, gallbladder/bile duct surgery, genito-urinary surgery, pilonidal sinus, gout/rheumatism, hypertension, diabetes, calculus diseases, prolapsed intervertebral disk surgery, varicose veins/ulcers, joint replacement and age-related osteoarthritis/osteoporosis.","note":null,"quote":"I | Benign ENT disorders and surgeries i.e. Tonsillectomy, Adenoidectomy, Mastoidectomy, Tympanoplasty etc. | 1 year ... Xxiii | Age related osteoarthritis and Osteoporosis. | 3 Years","sources":[{"clause":"5.2","heading":"Specified disease / procedure waiting period- code- ExcI02","page":17,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-5-2"}],"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":"For enhanced sum insured, five continuous years applies from the date of enhancement only on the enhanced limits.","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":"6.11","heading":null,"page":27,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-11"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The insured can port the policy to other insurers by applying at least 30 days before, but not earlier than 60 days from, the renewal date; accrued continuity benefits in waiting periods are available as per IRDAI guidelines.","display":"Yes, 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":"6.9","heading":"PORTABILITY","page":26,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-9"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Yes, lifelong renewals allowed","note":null,"quote":"Pre-existing diseases covered after three consecutive renewals. Lifelong renewals allowed.","sources":[{"clause":"1","heading":"SALIENT FEATURES OF THE POLICY","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-1"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"No loading applies on renewals based on individual experience.","display":"No loading on renewals based on individual experience","note":null,"quote":"No loading shall apply on renewals based on individual experience.","sources":[{"clause":"6.8","heading":"RENEWAL OF POLICY","page":26,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-8"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"You may cancel any time during the term by giving 7 days’ written notice. For annual policies, the 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, lodged, or any benefit availed.","display":"Proportionate premium for unexpired period, if no claim","note":null,"quote":"Cancellation by insured - Any time during the term, by giving 7 days’ notice in writing. Refund by Insurer : ... Proportionate premium for unexpired policy period, in case of Annual policies, subject to no claim (s) having been made during the policy period. ... 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":"6.5","heading":"CANCELLATION CLAUSE","page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-5"},{"clause":"6.5(a)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-5-a"},{"clause":"6.5(b)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-5-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 under this insurance must be taken in India only.","display":"India only","note":null,"quote":"All medical treatment for the purpose of this insurance will have to be taken in India only and all claims shall be payable in Indian currency only.","sources":[{"clause":"6.24","heading":"PAYMENT OF CLAIM: All medical treatment for the purpose of this insurance will have to be","page":30,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-24"}],"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":"Applies on new individual health insurance policies and not on renewals or at the time of porting/migrating.","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":"6.7","heading":"FREE LOOK PERIOD","page":26,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-7"}],"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 for renewal","note":"The same document also says a grace period of 15 days is allowed for delay in renewal, and the instalment clause gives 15 days for Half Yearly instalment premium.","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. ... In the event of delay in renewal of the Policy, a grace period of 15 days is allowed.","sources":[{"clause":"6.8","heading":"RENEWAL OF POLICY","page":26,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-8"},{"clause":"6.37","heading":"GRACE PERIOD: In the event of delay in renewal of the Policy, a grace period of 15 days is","page":36,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-37"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Yearly","Half Yearly"],"display":"Yearly and Half Yearly","note":null,"quote":"(Yearly) ... If the insured person has opted for payment of Premium on an Half Yearly installment basis the following Conditions shall apply","sources":[{"clause":null,"heading":"Office Premium per Insured (INR)(Excluding GST)","page":38,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-office-premium-per-insured-inr-excluding-gst"},{"clause":"6.19","heading":"PREMIUM PAYMENT IN INSTALLMENTS: If the insured person has opted for payment of","page":28,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-19"}],"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":["Personal Accident"],"display":"Personal Accident","note":"Voluntary co-payment of 10% or 20% is an optional cost-sharing choice with premium discount, not an extra-premium cover.","quote":"Personal Accident available on optional basis for SI from Rs.2lacs to Rs.10lacs. ... PERSONAL ACCIDENT ( as defined under Clause 4.1.6) Optional Cover (available on payment of additional premium)","sources":[{"clause":"1","heading":"SALIENT FEATURES OF THE POLICY","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-1"},{"clause":"4.1.4","heading":"PERSONAL ACCIDENT ( as defined under Clause 4.1.6) Optional Cover (available on payment of","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-4"}],"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 renewal grace period. If premium is paid in instalments during the policy period, the insurer shall offer coverage during the grace period.","display":"No cover during renewal grace; cover during instalment grace if instalment premium is paid","note":null,"quote":"Coverage is not available during the grace period. ... the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period","sources":[{"clause":"6.8","heading":"RENEWAL OF POLICY","page":26,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-8"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room, boarding and nursing expenses are covered up to 1% of the sum insured per day.","display":"1% of the Sum Insured per day","note":null,"quote":"Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. | Not exceeding 1 % of the Sum Insured per day","sources":[{"clause":"4.1","heading":"COVERAGE The policy covers reasonable and customary charges in respect of","page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"quote-verified","value":"The policy states a room rent percentage limit rather than naming a room category.","display":"No named room category; room rent limit applies","note":null,"quote":"Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. | Not exceeding 1 % of the Sum Insured per day","sources":[{"clause":"4.1","heading":"COVERAGE The policy covers reasonable and customary charges in respect of","page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU expenses are covered up to 2% of the sum insured per day.","display":"2% of the Sum Insured per day","note":null,"quote":"Intensive Care Unit (ICU) Expenses as provided by the Hospital /Nursing Home.* | Not exceeding 2% of the Sum Insured per day.","sources":[{"clause":"4.1","heading":"COVERAGE The policy covers reasonable and customary charges in respect of","page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1"}],"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 category or with room rent higher than eligible, the insured bears a ratable proportion of specified associated medical expenses in the proportion of eligible room rent to actual room rent. This does not apply to medicines/pharmacy/drugs, consumables, medical devices/implants and diagnostics.","display":"Yes, for associated medical expenses if room rent/category exceeds eligibility","note":null,"quote":"If the Insured Person is admitted in the hospital in a room where the room category or the Room Rent incurred is higher than the eligibility as specified in the Policy Schedule/ Certificate of Insurance, then the Policyholder/ Insured Person shall bear a ratable proportion of the total & specified Associated Medical Expenses (including surcharge or taxes thereon) in the proportion of the difference between the Room Rent of the entitled room category/eligible Room Rent to the Room Rent actually incurred. However, this will not be applicable in respect of Medicines/Pharmacy/ Drugs, Consumables, Medical Devices/ implants and Cost of Diagnostics.","sources":[{"clause":"6.32","heading":"PROPORTIONATE CLAUSE - If the Insured Person is admitted in the hospital in a room where","page":33,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-32"}],"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":"There is no stated mandatory co-payment in the base cover. If the insured opts for voluntary co-payment, the insured bears 10% or 20% of each and every admissible claim and gets the corresponding premium discount.","display":"None unless opted; voluntary co-payment 10% or 20% of each admissible claim","note":"Voluntary co-payment is available only for insured persons having Sum Insured of Rs.2 lakhs and above, and must be uniform across all eligible insured persons under a policy.","quote":"If the insured opts for a Co-payment of 10% or 20%, he is eligible for a corresponding premium discount of 10% and 20% respectively. ... Co-payment is applicable on each and every claim, which means the insured shall bear 10% / 20% (as opted by him) of each and every admissible claim.","sources":[{"clause":"4.1.3(i)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-3-i"},{"clause":"4.1.3(ii)","heading":"Co-payment is applicable on each and every claim, which","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-3-ii"}],"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":null,"quote":null,"sources":[],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Uterine Artery Embolization and HIFU","Balloon Sinuplasty","Deep Brain stimulation","Oral chemotherapy","Immunotherapy- Monoclonal Antibody to be given as injection","Intra vitreal injections","Robotic surgeries","Stereotactic radio surgeries","Bronchial Thermoplasty","Vaporization of the prostrate (Green laser treatment or holmium laser treatment)","IONM - (Intra Operative Neuro Monitoring)","Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions"],"display":"Advanced treatments have procedure-wise sub-limits, including uterine artery embolization/HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, immunotherapy, intravitreal injections, robotic surgeries, stereotactic radiosurgery, bronchial thermoplasty, prostate vaporization, IONM and hematopoietic stem cell therapy.","note":"The sub-limits differ by procedure and sum insured slab from Rs.1.0 lac to Rs.10.0 lacs versus Rs.12.0 lac to Rs.50.0 lacs.","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:","sources":[{"clause":"4.1.7","heading":null,"page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-7"}],"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","note":null,"quote":"Medical expenses incurred 30 days prior to Hospitalization and up to 60 days post Hospitalization.","sources":[{"clause":"4.1(b)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-b"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days","note":null,"quote":"Medical expenses incurred 30 days prior to Hospitalization and up to 60 days post Hospitalization.","sources":[{"clause":"4.1(b)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-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 in Appendix I are covered where treatment is taken in a hospital or day care centre, not OPD. Any other day care treatment as defined is covered if prior written approval from the Company or TPA is obtained.","display":"Appendix I day care procedures and other day care treatment with prior approval","note":null,"quote":"Day care procedures / surgeries (Appendix I) where such treatment is taken by an Insured Person in a Hospital / day care centre(but not the Out-patient department of a Hospital),Or ... Any other day care treatment as mentioned in clause 3.10 and for which prior approval from Company / TPA is obtained in writing.","sources":[{"clause":"4.1(a)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-a-2"},{"clause":"4.1(b)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-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 hospitalisation is covered up to 20% of the sum insured, subject to maximum Rs.50,000 per insured person during the entire policy period. It does not cover treatment lasting three days or less and the listed excluded diseases.","display":"20% of Sum Insured, maximum Rs.50,000 per insured person","note":"The benefit excludes treatment lasting three days or less and specified diseases such as asthma, bronchitis, diabetes, hypertension and arthritis.","quote":"DOMICILIARY HOSPITALISATION BENEFITS ... Surgeon, Medical Practitioner, Consultants, Specialists Fees, Blood, Oxygen, Surgical Appliances, Medicines &Drugs, Diagnostic Material and Dialysis, Chemotherapy, Nursing expenses. | 20% of the Sum Insured subject to maximum Rs.50,000 per Insured Person, during the entire policy period.","sources":[{"clause":"4.1(b)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-b-2"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"In-patient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems is covered during each policy year up to the sum insured in an 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":"4.1(b)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-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 in-patient care, part of domiciliary hospitalisation, or day care treatment in hospital, subject to procedure-wise sub-limits for the complete policy period.","display":"Covered with procedure-wise sub-limits","note":"Listed procedures include Oral chemotherapy, Immunotherapy, Robotic surgeries and Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions.","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:","sources":[{"clause":"4.1.7","heading":null,"page":16,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-7"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"The policy covers in-patient hospitalisation medical expenses of an organ donor if the donation complies with transplant law, the organ is for the insured person, and the insured person's claim is admissible. It excludes organ acquisition/cost, donor screening, donor pre/post-hospitalisation expenses and donor complications after harvesting.","display":"Covered for donor in-patient hospitalisation expenses, excluding organ cost, donor screening and donor pre/post-hospitalisation","note":null,"quote":"The policy covers in-patient hospitalization Medical expenses in respect of organ donor provided that the donation conforms to the Transplantation of Human Organs Act 1994(amended) and other applicable laws and rules and I) The organ donated is for the use of the insured person who has been medically advised to undergo organ transplant II) The claim of the insured person is admissible under the hospitalization section of the policy.\nThe policy does not cover:\na) Cost directly or indirectly associated with the acquisition of the organ and/or cost of organ.\nb) cost towards donor screening\nc) Any pre and post hospitalization medical expenses of the donor.","sources":[{"clause":"4.1.2","heading":"DONOR EXPENSES","page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-2"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Registered ambulance service charges are covered up to Rs.2,000 or 1% of sum insured, whichever is less, per hospitalisation, with aggregate expenses not exceeding Rs.4,000 under the policy. Air ambulance is available for sum insured Rs.25.0 lakhs and above, up to 5% of the sum insured, for specified medical emergency conditions.","display":"Road ambulance Rs.2,000 or 1% of SI per hospitalisation, max Rs.4,000 aggregate; air ambulance up to 5% of SI for SI Rs.25.0 lakhs and above","note":null,"quote":"Ambulance service charges as herein after defined. | Rs.2,000 OR 1% of the sum insured whichever is less per hospitalization subject to aggregate expenses not exceeding Rs. 4,000 under the policy. ... Air Ambulance Cover | Maximum upto 5% of the SI for medical emergency cases only. The benefit will be available for sum insured Rs. 25.0 lakhs and above.","sources":[{"clause":"4.1(b)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-b"},{"clause":"4.1.5","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-5"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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 excluded except ectopic pregnancy, and miscarriage is excluded unless due to an accident.","display":"Excluded, except ectopic pregnancy; miscarriage excluded unless due to accident","note":null,"quote":"Maternity- Code- ExcI18\ni) Medical treatment expenses traceable to childbirth (including complicated deliveries and cesarean sections incurred during hospitalization) except ectopic pregnancy.\nii) Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.","sources":[{"clause":"5.18","heading":"Maternity- Code- ExcI18","page":20,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-5-18"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"A new born baby means a baby born during the policy period and covered from day 1. A newborn child can be included midterm from day 1 of birth or at renewal, with waiting period exclusions applying from the date of inclusion.","display":"Covered from day 1; newborn child can be included from day 1 of birth","note":null,"quote":"NEW BORN BABY means baby born during the Policy Period and is covered from day 1. ... Newborn child from day 1 of birth or at the time of renewal of the Policy. For members subsequently added, Exclusion No. 5.1, 5.2 and 5.3 shall apply from the date of their inclusion in the Policy","sources":[{"clause":"3.32","heading":"NEW BORN BABY","page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-3-32"},{"clause":"6.31","heading":"MIDTERM INCLUSION: Midterm inclusion of members is permitted under the Policy, on","page":33,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-31"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"quote-verified","value":"The policy indemnifies medical expenses, including pre and post hospitalisation expenses, for mental illness subject to specified conditions, including hospitalisation in a Mental Health Establishment as advised by a Mental Health Professional. Mental conditions associated with alcohol and drug abuse, mental retardation and non-hospitalisation psychotherapy/counselling are excluded.","display":"Covered for hospitalisation in Mental Health Establishment as advised by Mental Health Professional","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:-\n1. Illness covered under definition of mental illness mentioned under clause 3.52.\n2. Hospitalization in Mental Health Establishment as defined under clause 3.53.\n3. Hospitalization as advised by Mental Health Professional as defined under clause 3.54.","sources":[{"clause":"4.1.5(xi)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-5-xi"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"The insured is entitled to reimbursement of health check-up cost once at the expiry of a block of every three continuous underwriting years, if no claims are reported during the block. The reimbursable cost is limited to 1% of average sum insured or Rs.5000 per insured person, whichever is less.","display":"Once after every THREE continuous claim-free underwriting years, up to 1% of average SI or Rs.5000 per insured person","note":null,"quote":"The Insured shall be entitled for reimbursement of cost of Health checkup undertaken once at the expiry of a block of every THREE continuous underwriting years provided there are no claims reported during the block. The cost so reimbursable shall not exceed the amount equal to 1% of the average sum Insured (SI for PA section is not to be considered), or Rs.5000/- per insured person, whichever is less, during the block of THREE claim free underwriting years.","sources":[{"clause":"6.34","heading":"COST OF HEALTH CHECK UP: The Insured shall be entitled for reimbursement of cost of","page":34,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-34"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"OPD expenses are generally excluded. For insured persons with sum insured of Rs.25.0 lakhs and above, OPD dental and ophthalmic cover reimburses up to Rs.5,000 in a block of every three years; telemedicine is reimbursable up to Rs.2,000 per person per policy period.","display":"OPD excluded, except dental/ophthalmic OPD up to Rs.5,000 every three years for SI Rs.25.0 lakhs and above; telemedicine up to Rs.2,000 per policy period","note":null,"quote":"OPD benefit for Dental and Ophthalmic cover | Maximum Rs. 5,000/- on reimbursement basis in a block of every three years. The benefit will be available for sum insured Rs. 25.0 lakhs and above. ... “The limit of amount payable for telemedicine is maximum Rs. 2,000/- per person, for a policy period. ... Out Patient Department (OPD) Any expenses incurred on OPD.","sources":[{"clause":"4.1.5","heading":null,"page":12,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-5"},{"clause":"4.1.5(xi)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-4-1-5-xi"},{"clause":"5.27","heading":null,"page":20,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-5-27"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless access services are available through the Company or TPA if admission is in a network hospital/nursing home and subject to pre-admission authorisation. Network hospital list is available on Oriental's website and from the concerned TPA on demand.","display":"Yes, in network hospitals with pre-authorisation","note":"Cashless pre-authorisation TAT is immediately but not later than One hour from receipt of request; final bill authorisation within three hours of receipt of discharge authorisation.","quote":"Claim in respect of Cashless Access Services will be through the Company / TPA provided admission is in a network Hospital/ Nursing Home and is subject to pre admission authorization. ... List of network Hospitals is available on our official website- www.orientalinsurance.org.in and will also be provided by the concerned TPA on demand.","sources":[{"clause":"6.22","heading":null,"page":29,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-22"}],"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 handled by the Company or TPA.","display":"Company / TPA","note":"The premium section states a discount if TPA services are not opted for.","quote":"Claim in respect of Cashless Access Services will be through the Company / TPA provided admission is in a network Hospital/ Nursing Home and is subject to pre admission authorization.","sources":[{"clause":"6.22","heading":null,"page":29,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-22"}],"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":false,"display":"No; multiple insureds under one policy each have their own SI","note":null,"quote":"The sum insured of each of the insured person in a policy may vary. ... These Office Premium rates are applicable for insureds taking cover on individual basis. For calculation of Office Premium for multiple insureds taking cover under single policy, each with their own SI, Family Discount of 10% shall be applicable","sources":[{"clause":"6.29","heading":"SUM INSURED","page":32,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-6-29"},{"clause":null,"heading":"Office Premium per Insured (INR)(Including GST)","page":40,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762#c-office-premium-per-insured-inr-including-gst-2"}],"law":[]}],"documents":[{"kind":"prospectus","label":"2_Oriental_Mediclaim_Insurance_Policy_Individual_PROSPECTUS_1facec9fd4.pdf","pages":41,"fetched_at":"2026-10-17 19:53:04+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/2_Oriental_Mediclaim_Insurance_Policy_Individual_PROSPECTUS_1facec9fd4_6c81bb1d40.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425/document/13762"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Oriental Insurance official website","url":"https://www.orientalinsurance.org.in/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claim forms","url":"https://www.orientalinsurance.org.in/claim-form","note":null},{"purpose":"claim","kind":"insurer","name":"Health claim status","url":"https://www.orientalinsurance.org.in/health-claim-status","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal","url":"https://www.orientalinsurance.org.in/grievance-redressal","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"ORIENTAL MEDICLAIM INSURANCE POLICY (INDIVIDUAL) 2024 (UIN OICHLIP25048V052425), IndiaInsurances, https://indiainsurances.com/policy/oriental-insurance/oriental-mediclaim-insurance-policy-individual-2024-oichlip25048v052425"}