ORIENTAL
Specific Health Plans
Specific Health Insurance Plans

PNB- Oriental Royal Mediclaim-2017

This policy can be taken either for the self alone or along with the family with Sum Insured on floater basis.

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SALIENT FEATURES

i. This policy can be taken either for the self alone or along with the family (as specified in 1.0d above) with Sum Insured on floater basis.

ii. There are 10 Sum Insured slabs ranging from Rs.1 lakhs to 10 lakhs, at an interval of 1 lakh each.

iii. Pre-existing Diseases are covered after three consecutive Policy periods.

iv. Premium is charged based on the age of the proposer Account holder and the Sum Insured opted.

v. No Pre-acceptance medical check-up is required. However, if the Proposal Form reveals adverse Medical History in respect of any proposed individual, such individual may be subject to pre insurance

Medical tests. In such cases, 50% of the cost shall be borne by the Company, if the proposal in respect of that individual is accepted by the Company.

vi. Daily Hospital Cash only in respect of the proposer Account holder: Rs.200 per day of hospitalization is payable, maximum compensation being Rs.1000 during the policy period, subject to hospitalization claim being admissible under the policy.

vii. Organ donor expenses when Insured Person is the Recipient: The policy covers In-patient Hospitalization Medical expenses in respect of the organ donor provided that the organ donation is for the Insured Person and organ donation conforms to the Transplantation of Human Organs Act 1994(amended) and any other extant Act, Central / State Rules / regulations, as applicable, in respect of transplantation of human organs.

viii. Ambulance Charges: The policy covers ambulance charges up to Rs.1000 during the policy period, subject to claim in respect of hospitalization being admissible under the policy.

ix. Funeral Expenses: Lump sum amount of Rs.1000 per insured person is payable in case of death of the insured person, subject to hospitalization claim being admissible under the policy.

x. 116 Day Care Procedures

xi. Term of the Policy is one year and is renewable lifelong.

xii. Cashless facility is available in network hospitals

xiii. Grace Period of 30 days for renewal of policy, subject to conditions

xiv. Free Look Period of 15 days from the date of receipt of the policy documents.

xv. Sub-limits shall apply on following procedures, as below

Product Features

Day Care Treatments

Covered 116 day care treatment

116 Day Care Procedures Covered

Post-Hospitalization

Covered upto 60 days

Medical expenses incurred upto 60 days Post Hospitalization

Pre-Hospitalization

Covered upto 30 days

Medical expenses incurred 30 days prior to Hospitalization

Ambulance Charge

Covered upto Rs.1000 during the policy period,

The policy covers ambulance charges upto Rs.1000 during the policy period, subject to claim in respect of hospitalization being admissible under the policy

Network Hospital Covered

Covered

Cashless facility is available in network hospitals

Eye & Dental Covers

Covered

Cataract Covered as per the sub limits.

Family Floater Option

Covered

Family Covered in this Policy

Existing Illness Waiting Period

Covered after three consecutive Policy periods

Pre-existing Diseases are covered after three consecutive Policy periods

Hospital Room Eligibility

Covered 1 % of the Sum Insured per day

Covered 1 % of the Sum Insured per day

Domiciliary Hospitalization

Available

10% of Sum Insured, Maximum Rs.25000/- during the Policy period.

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