{"uin":"OICHLIP26035V012526","name":"ORIENTAL SAMPOORNA SWASTHYA SURAKSHA POLICY","url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526","insurer":{"slug":"oriental-insurance","name":"The Oriental Insurance Company Limited","url":"https://indiainsurances.com/insurer/oriental-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Oriental Sampoorna Swasthya Suraksha is a health indemnity policy with Premium, Elite and Royal plans and individual, floater and floater-floater options. Sum insured limits run up to ₹10 lakhs in Premium, ₹50 lakhs in Elite and ₹500 lakhs in Royal, with policy terms of 1, 2 or 3 years.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:02:37.958813+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":["PREMIUM","ELITE","ROYAL"],"display":"PREMIUM, ELITE and ROYAL","note":null,"quote":"The benefits under this Policy are available under three plans, viz PREMIUM, ELITE, and ROYAL as opted by the Insured in the proposal form.","sources":[{"clause":"3.1","heading":null,"page":8,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#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":"Policy terms of 1, 2 and 3 years are available.","display":"1, 2, & 3 yrs","note":null,"quote":"xxxiii | Long Term Policy (Refer to clause 3.1.21) | 1, 2, & 3 yrs | 1, 2, & 3 yrs | 1, 2, & 3 yrs","sources":[{"clause":"3.1(b)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-3-1-b"}],"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 from the hospital or nursing home, 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":"5.20","heading":"NOTIFICATION OF CLAIM: Immediate notice of claim with particulars relating to Policy","page":46,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-20"}],"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 consultation 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 the 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 certificate/card, medical records and other listed claim papers","note":"For reimbursement claims, these documents must be submitted within 15 days of discharge.","quote":"The final claim, along with original bills, cash memos, reports, claim form, and the required documents listed below, must be submitted to the Company or TPA within 15 days of discharge from the hospital or nursing home. This clause is applicable in cases of claim reimbursement.\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 consultation reports/history\n• Medical history of the patient recorded by the Hospital\n• Original Cash-memo from the Hospital (s) /chemist (s) supported by proper prescription\n• Original receipt, pathological and other test reports from a pathologist/radiologist including film, etc. supported by the note from the 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":"5.21","heading":"CLAIM DOCUMENTS: The final claim, along with original bills, cash memos, reports, claim","page":46,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-21"}],"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":"Non-cashless claims are stated to be settled within fifteen days from submission of claim. The policy also states that the Company/TPA shall offer settlement or reject within 30 days from receipt of the last document or clarification, pay within 7 days after acceptance, and settle within 45 days from the last necessary document if investigation is warranted.","display":"15 days from submission; also 30 days from last document, 7 days after acceptance, or 45 days if investigated","note":"The wording contains both a 15-day settlement statement and more detailed 30/7/45-day claim-payment provisions.","quote":"Settlement of claims (other than cashless) shall be settled within fifteen days from submission of claim. ... On receipt of the last document /clarification, the Company/TPA shall within a period of 30days offer a settlement of the claim to the insured If the Company/TPA, for any reasons to be recorded in writing and communicated to the insured, decides to reject a claim under the Policy, it shall do so within a period of 30 days from the receipt of the last document/clarification ... Upon acceptance of an offer of settlement by the insured, the payment of the amount due shall be made within 7 days from the date of acceptance of the offer by the Insured However, where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document In such cases, the Company shall settle the claim within 45 days from the date of receipt of lastnecessarydocument","sources":[{"clause":"5.2","heading":"CONDITION PRECEDENT TO ADMISSION OF LIABILITY: The terms and conditions of the","page":41,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-2"},{"clause":"5.21.4","heading":"On receipt of the last document /clarification, the Company/TPA shall within a period of","page":47,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-21-4"},{"clause":"5.24","heading":"PAYMENT OF CLAIM: All medical treatment for the purpose of this insurance will have to","page":48,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-24"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Expenses related to the treatment of any illness within 30days from the first policy commencement date shall be excluded except claims arising due to an accident","Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded","Expenses related to the treatment of the listed Conditions; surgeries/treatments shall be excluded until the expiry of the specified waiting period","Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded","Expensesrelatedtoanyadmissionprimarilyforenforcedbedrestandnotforreceivingtreatment","Expenses related to the surgical treatment of obesity that does not fulfill all the below conditions","Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite","Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an accident burn(s) or Cancer","Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports","Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent","Treatment for, Alcoholic drug or substance abuse or any addictive condition and consequences thereof","Expenses related to any unproven treatment, services, and supplies","Expenses related to sterility and infertility","Medical treatment expenses traceable to childbirth","Treatment taken outside the geographic limits of India"],"display":"30-day illness waiting, PED waiting, specified disease/procedure waiting and key standard exclusions","note":"Some exclusions have exceptions, such as accidents during the initial waiting period, obesity surgery if listed conditions are met, cosmetic reconstruction after accident/burn/cancer, sterility/infertility limits for Elite/Royal ART, maternity limits for Elite/Royal, and SAARC extension.","quote":"4.3.1 Expenses related to the treatment of any illness within 30days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered ... Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months, 24 months, and 12 (Below 45 years of age) & 24 (<45age) months ... Expenses related to the treatment of the listed Conditions; surgeries/treatments shall be excluded until the expiry of the specified waiting period ... 4.4.1 Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded ... Expensesrelatedtoanyadmissionprimarilyforenforcedbedrestandnotforreceivingtreatment ... Obesity/Weight Control: Code-EscI06 Expenses related to the surgical treatment of obesity that does not fulfill all the below conditions ... 4.7 Change of Gender Treatments: Code – ExcI07 Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite ... 4.8 Cosmetic or Plastic Surgery- Code- ExcI08 Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an accident burn(s) or Cancer ... 4.9 Hazardous or Adventure sports- Code- ExcI09 Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports ... 4.10 Breach of law – Code –ExcI10 Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent ... 4.12 Treatment for, Alcoholic drug or substance abuse or any addictive condition and consequences thereof–Code- ExcI12 ... 4.16 Unproven Treatments- Code – ExcI16 Expenses related to any unproven treatment, services, and supplies ... 4.17 SterilityandInfertility-Code-ExcI17 Expenses related to sterility and infertility ... i. Medical treatment expenses traceable to childbirth ... 4.38 Treatment taken outside the geographic limits of India","sources":[{"clause":null,"heading":"4.3 30-day waiting period-code– ExcI03","page":37,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-4-3-30-day-waiting-period-code-exci03"},{"clause":null,"heading":"STANDARD EXCLUSIONS 4.1 Pre-existing Diseases-code –ExcI01","page":36,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-standard-exclusions-4-1-pre-existing-diseases-co"},{"clause":null,"heading":"4.2 Specified disease/procedure waiting period – code - ExcI02","page":36,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-4-2-specified-disease-procedure-waiting-period-c"},{"clause":null,"heading":"4.4 Investigation & Evaluation – Code – ExcI04","page":38,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-4-4-investigation-evaluation-code-exci04"},{"clause":null,"heading":"4.5 Rest Cure, rehabilitation and respite care– Code -ExcI05","page":38,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-4-5-rest-cure-rehabilitation-and-respite-care-co"},{"clause":null,"heading":"4.18 Maternity-Code- ExcI18","page":39,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-4-18-maternity-code-exci18"},{"clause":null,"heading":"4.38 Treatment taken outside the geographic limits of India","page":41,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-4-38-treatment-taken-outside-the-geographic-limi"}],"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":"For grievances, the insured may contact the company through website, toll-free number, email or any branch grievance cell. If not satisfied, they may contact the Grievance Officer at Customer Service Department, Corporate Office, Block - 4, Plate- A, NBCC Office Complex, Kidwai Nagar East, New Delhi - 110023 before approaching the Ombudsman.","display":"Company channels or branch grievance cell, 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.inToll-free:1800118485Or011- 33208485 E-mail:csd@orientalinsurance.co.in The insured person may also approach the grievance cell at any of the company’s branches with details of their grievance. If the insured person is not satisfied with the resolution provided through the above methods, they 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":"5.14","heading":"GRIEVANCE REDRESSAL In case of any grievance the insured person may contact the","page":45,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-14"}],"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":"Accident claims are excepted if covered.","quote":"4.3.1 Expenses related to the treatment of any illness within 30days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered","sources":[{"clause":null,"heading":"4.3 30-day waiting period-code– ExcI03","page":37,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-4-3-30-day-waiting-period-code-exci03"}],"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":"Premium plan: 36 months; Elite plan: 24 months; Royal plan: 12 months below 45 years of age and 24 months above 45 years of age. Wording prints '<45age' where the context indicates above 45 years.","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, 24 months, and 12 (Below 45 years of age) & 24 (<45age) months of continuous coverage for PREMIUM, ELITE, and ROYAL Plan respectively after the date of inception of the first policy with the insurer","sources":[{"clause":null,"heading":"STANDARD EXCLUSIONS 4.1 Pre-existing Diseases-code –ExcI01","page":36,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-standard-exclusions-4-1-pre-existing-diseases-co"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"days","amount":90},"display":"90 days","note":"Other listed conditions have waiting periods of 1 year, 2 years or 3 years; if the condition is pre-existing, the PED waiting period applies.","quote":"17 | Hypertension | 90 days*\n18 | Diabetes | 90 days* ... 26 | Waiting period for life style conditions namely, Hypertension, Diabetes, Cardiac conditions is not allowed for more than 90 days except if these diseases are pre-existing and disclosed at the time of underwriting. | 90 days","sources":[{"clause":null,"heading":"4.2 Specified disease/procedure waiting period – code - ExcI02","page":36,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-4-2-specified-disease-procedure-waiting-period-c"}],"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 ie 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 of genito-urinary system excluding malignancy","Pilonidal Sinus","Gout and Rheumatism","Hypertension","Diabetes","Calculus diseases","Surgery for prolapsed inter vertebral disk unless arising from accident","Surgery of varicose veins and varicose ulcers","Joint Replacement due to Degenerative condition","Age related osteoarthritis and Osteoporosis","Obesity","Cardiac conditions"],"display":"Listed specified diseases/procedures include ENT surgeries, PCOD, hernia, hydrocele, arthritis, cataract, BPH, hysterectomy, piles/fissure/fistula, sinusitis, gallbladder/bile duct, genito-urinary, calculi, varicose veins, joint replacement, osteoarthritis/osteoporosis, obesity, hypertension, diabetes and cardiac conditions","note":"The table numbering skips 21.","quote":"No. | Ailment / Disease / Surgery | Waiting Period\n1 | Benign ENT disorders and surgeries ie Tonsillectomy, Adenoidectomy, Mastoidectomy, Tympanoplasty, etc | 1 year\n2 | Polycystic ovarian diseases | 1 year\n3 | Surgery of hernia | 2 years\n4 | Surgery of hydrocele | 2 years\n5 | Non-infective Arthritis | 2 years\n6 | Undescendent Testes | 2 Years\n7 | Cataract | 2 Years\n8 | Surgery of benign prostatic hypertrophy | 2 Years\n9 | Hysterectomy for menorrhagia or fibromyoma or myomectomy or prolapse of uterus | 2 Years\n10 | Fissure / Fistula in anus | 2 Years\n11 | Piles | 2 Years\n12 | Sinusitis and related disorders | 2 Years\n13 | Surgery of gallbladder and bile duct excluding malignancy | 2 Years\n14 | Surgery of genito-urinary system excluding malignancy | 2 Years\n15 | Pilonidal Sinus | 2 Years\n16 | Gout and Rheumatism | 2 Years\n17 | Hypertension | 90 days*\n18 | Diabetes | 90 days*\n19 | Calculus diseases | 2 Years\n20 | Surgery for prolapsed inter vertebral disk unless arising from accident | 2 Years\n22 | Surgery of varicose veins and varicose ulcers | 2 Years\n23 | Joint Replacement due to Degenerative condition | 3 Years\n24 | Age related osteoarthritis and Osteoporosis | 3 Years\n25 | Obesity | 2 year\n26 | Waiting period for life style conditions namely, Hypertension, Diabetes, Cardiac conditions is not allowed for more than 90 days except if these diseases are pre-existing and disclosed at the time of underwriting. | 90 days","sources":[{"clause":null,"heading":"4.2 Specified disease/procedure waiting period – code - ExcI02","page":36,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-4-2-specified-disease-procedure-waiting-period-c"}],"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":"months","amount":60},"display":"sixty continuous months","note":"For enhanced sum insured, the moratorium for enhanced limits is calculated separately from the date of enhancement.","quote":"After the completion of sixty continuous months under this policy, no look-back provision shall be applied. This period of sixty continuous months is referred to as the Moratorium Period.","sources":[{"clause":"5.12","heading":"MORATORIUM PERIOD After the completion of sixty continuous months under this policy, no","page":45,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-12"}],"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":"Policyholders, including all members under family cover, have the option to transfer credits from one insurer to another. Credits include Sum Insured, No Claim Bonus, specific waiting periods, PED waiting period and Moratorium period.","display":"Yes, credits can be transferred from one insurer to another insurer","note":null,"quote":"The Policyholders (including all members under family cover), will have the option to transfer the credit gains from one insurer to another insurer. ... By Porting, the policyholder is entitled to transfer the credits gained to the extent of the Sum Insured, No Claim Bonus, specific waiting periods, waiting period for pre-existing disease, Moratorium period etc. from the Existing Insurer to the Acquiring Insurer in the previous policy.","sources":[{"clause":"5.10(I)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-10-i"},{"clause":"5.10(II)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-10-ii"}],"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 policy wording also says renewal shall not be denied because of claims.","quote":"Long term policy. The person can opt for 3 years and renewable lifelong.","sources":[{"clause":"2","heading":"FEATURES IN THE POLICY","page":1,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13806#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.","display":"No loading on renewals based on individual experience","note":null,"quote":"No loading shall apply on renewals based on individual experience","sources":[{"clause":"5.9","heading":"RENEWAL OF POLICY: The policy shall ordinarily be renewable except on grounds of","page":44,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-9"}],"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 policyholder may cancel by giving 7 days’ written notice. For a one-year policy, the Company refunds premium on a pro-rata basis for the unexpired policy period if no claim is made; for policies over 1 year, it refunds premium for uncommenced policy years, and no refund is made if a claim is admitted, lodged or any benefit availed.","display":"Pro-rata refund for unexpired period on 1-year policy if no claim; no refund if a claim is admitted, lodged or benefit availed","note":null,"quote":"The policyholder may cancel this Policy at any time during the term, by giving 7 days’ notice in writing, ... The Company will refund the premium on a pro-rata basis for the unexpired Policy Period if the term of the policy is one year and there is no claim(s) made during the policy period ... The Company will refund the premium for the unexpired policy period, in respect of policies with terms more than 1 year and risk coverage for such policy years has not commenced 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: The policyholder may cancel this Policy at any time during the","page":42,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-5"},{"clause":"5.5(a)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-5-a"},{"clause":"5.5(b)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#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 must be taken in India only, except where the policy has been extended to SAARC countries. SAARC extension covers Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan and Sri Lanka if requested in writing before leaving India, with reimbursement only and no cashless service outside India.","display":"India only, except SAARC extension on request","note":"Cashless services are not available for treatment outside India under the SAARC extension.","quote":"All medical treatment for the purpose of this insurance will have to be taken in India only (except where the Policy has been extended to SAARC countries) and all claims shall be payable in Indian currency only ... The Policy will cover Insured Persons visiting other SAARC (South Asian Association for Regional Cooperation) countries, including Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan, and Sri Lanka. No additional premium will be charged for this extension. However, the Insured Person must request this extension in writing before leaving the country","sources":[{"clause":"5.24","heading":"PAYMENT OF CLAIM: All medical treatment for the purpose of this insurance will have to","page":48,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-24"},{"clause":"5(b)","heading":"Floater or Floater-Floater Option","page":29,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-b-2"}],"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 health insurance policies, not renewals or at the time of porting/migrating.","quote":"the insured person shall be allowed a 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":"5.8","heading":"FREE-LOOK PERIOD: The free look period shall be applicable on new health insurance","page":43,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-8"}],"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":"15 days applies where premium is paid on a monthly installment.","quote":"a grace period of 15days (where premium is paid on a monthly installment) and 30 days (where premium is paid quarterly/half-yearly/annual/biennial/triennial installments) is allowed","sources":[{"clause":"5.36","heading":"GRACE PERIOD FOR PAYMENT of PREMIUM: In the event of a delay in the renewal of","page":50,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-36"}],"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":"There is no minimum or maximum entry age for new policyholders.","display":"No Minimum or Maximum entry age","note":null,"quote":"ENTRY AGE: There is no Minimum or Maximum entry age for new policyholders. The premium will be charged as prescribed in the table only.","sources":[{"clause":"5.31","heading":"ENTRY AGE","page":49,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-31"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Monthly","Quarterly","Half- Yearly","Annually","Biennially","Triennially"],"display":"Monthly, Quarterly, Half-Yearly, Annually, Biennially and Triennially","note":null,"quote":"• 1-Year Policy: The policyholder has the option to pay the premium Monthly, Quarterly, Half- Yearly, or Annually.\n• 2-Year Policy: The policyholder has the option to pay the premium Monthly, Quarterly, Half- Yearly, Annually, or Biennially.\n• 3-Year Policy: The policyholder has the option to pay the premium Monthly, Quarterly, Half- Yearly, Annually, or Triennially.","sources":[{"clause":null,"heading":"Original Sum Insured (SI): ₹5,00,000","page":31,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-original-sum-insured-si-5-00-000-2"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["PERSONAL ACCIDENT COVER","OPTION FOR CO-PAY WITH FIXED AMOUNT","ROOM RENT UPGRADATION CLAUSE","PRE EXISTING DISEASE (PED) WAITING PERIOD BUYBACK OPTION"],"display":"Personal Accident cover, fixed co-pay option, room rent upgradation and PED waiting period buyback","note":"These are optional covers/additional-premium options and are not treated as base-policy benefits for other fields.","quote":"The following coverage can be taken on payment of an additional premium. The amount payable under this section will be in addition to selected health Insurance benefits 3.2.1 PERSONAL ACCIDENT COVER: (WORLDWIDE): ... 3.2.2 OPTION FOR CO-PAY WITH FIXED AMOUNT: This is an optional benefit in this policy given to policyholders. ... 3.2.3 ROOM RENT UPGRADATION CLAUSE: ... By paying an additional premium, policyholders have the option to enhance their room rent and associated charges by either 50% or 100%. ... 3.2.4 PRE EXISTING DISEASE (PED) WAITING PERIOD BUYBACK OPTION: The Pre-Existing Disease (PED) Waiting Period Buyback Option allows policyholders to accelerate coverage","sources":[{"clause":null,"heading":"3.2 OPTIONAL COVERS","page":32,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-3-2-optional-covers"},{"clause":null,"heading":"3.2 OPTIONAL COVERS","page":32,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-3-2-optional-covers-2"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"No coverage is available during the renewal grace period. If the premium is paid in instalments during the policy period, coverage will be available for the grace period also.","display":"No coverage during renewal grace; coverage during instalment grace within the policy period","note":"The wording separately says coverage is not available during the grace period at renewal.","quote":"However, no coverage shall be available during the grace period and any disease/Injury contracted during the break period shall not be covered and shall be treated as a Pre-existing disease in case of renewal only. If the premium is paid in instalments during the policy period, coverage will be available for the grace period also.","sources":[{"clause":"5.36","heading":"GRACE PERIOD FOR PAYMENT of PREMIUM: In the event of a delay in the renewal of","page":50,"url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820#c-5-36"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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-stated","value":null,"display":null,"note":null,"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":null,"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]}],"documents":[{"kind":"wording","label":"OSSSP POLICY WORDING.pdf","pages":64,"fetched_at":"2026-10-17 19:54:45+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/OSSSP_POLICY_WORDING_1df44ca74f.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13820"},{"kind":"prospectus","label":"OSSS PROSPECTUS.pdf","pages":69,"fetched_at":"2026-10-17 19:54:22+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/OSSS_PROSPECTUS_c9223491b2.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/13806"},{"kind":"premium","label":"OSSP PREMIUM CHART.pdf","pages":null,"fetched_at":"2026-10-17 19:51:17+00","source_url":"https://oicl-cms-media.s3.ap-south-1.amazonaws.com/OSSP_PREMIUM_CHART_fcf8fb03ba.pdf","url":"https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526/document/30498"}],"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 SAMPOORNA SWASTHYA SURAKSHA POLICY (UIN OICHLIP26035V012526), IndiaInsurances, https://indiainsurances.com/policy/oriental-insurance/oriental-sampoorna-swasthya-suraksha-policy-oichlip26035v012526"}