Oriental Critical Illness Policy

We welcome You as Our Customer. This document explains how the ORIENTAL CRITICAL ILLNESS POLICY could provide value to your Health Care. In the document the word You, You means the Insured under the Policy. We, Our, Us, Company means the Insurer i.e The Oriental Insurance Co. Ltd.

INTRODUCTION:

ORIENTAL CRITICAL ILLNESS POLICY is a benefit Policy. In the event of the insured person being first diagnosed as suffering from a Critical Illness, symptoms (and/or the treatment) of which were not present in such insured person at any time prior to inception of the Policy, the Company shall pay to the insured person the benefit defined below.

Critical Illness Benefit
The Company shall pay the full sum insured as mentioned in the schedule, provided:

i. The insured person is diagnosed with a critical illness specifically listed and defined in the policy; and

ii. the insured person survives such critical illness by number of days specified in the policy schedule as survival period or more, from the date of diagnosis/ date of undergoing the surgical procedure.

Critical Illness includes the following illness/ surgeries, depending on the plan opted.

1. Cancer of specified severity
2. Myocardial infarction ( first heart attack)
3. Open chest CABG
4. Open heart replacement or repair of heart valves
5. Coma of specified severity
6. Kidney failure requiring regular dialysis
7. Stroke resulting in permanent symptoms
8. Major organs/ bone marrow transplant
9. Permanent paralysis of limbs
10. Motor neuron disease with permanent symptoms
13. Benign brain tumour
14. Blindness
15. Deafness
16. End stage lung failure
17. End stage liver failure
18. Loss of speech
19. Loss of Limbs
20. Major Head trauma
21. Primary (ideopalhic) pulmonary hypertension
22. Third degree burns.

Medical Second Opinion Benefit

a. Medical Second Opinion Benefit up to 1% of Sum insured in a policy period subject to maximum of Rs.10000 for Sum Insured up to Rs. 20 lakhs and Rs.20000 for Sum Insured up to Rs.50 lakhs.

b. Claim under this clause would be admissible subject to the critical illness claim being admissible.

c. This expense is payable only once per illness per insured person during the lifetime of the insured person.

d. The second opinion benefit is valid only if critical illness policy is in force.

SALIENT FEATURES

Eligibility
i. Proposer should be between eighteen (18) years and sixty five (65) years.

ii. Maximum entry age of any family member is sixty five (65) years.

iii. Children between the age of eighteen (18) years and twenty five (25) years pursuing full time studies can be covered, provided bonafide certificate from educational institution is submitted as proof. Unmarried and/or unemployed female children can also be covered as dependents.

iv. Policy can be availed for self and the following family members
a. Spouse
b. Dependent legitimate or legally adopted children, up to twenty five (25) years of age
c. Parents OR Parents in Law ( either of them)
d. Unmarried dependent siblings