Oriental Happy Family Floater Policy

What is the Plan all About?

Happy family floater is a family floater policy which will enable your family, including spouse, dependant children, parents, parent (in law) and unmarried siblings to be insured under one umbrella policy. A comprehensive health plan which offers a bundle of benefits to assure you a peace of mind for the health concerns of you and your family.

This plan has 3 Policy Variants:

Silver
Gold
Diamond

Key Features

Lifetime Renewability
Sum insured opted upto 20 lacs
Restoration of sum insured
Maternity expenses are covered
Cashless treatment under network list of hospitals
5% discount on buying policy online

Policy Benefits

Hospitalization expenses such as room rent, nursing charges, ICU benefit,medical practitioner,etc. are covered under all the 3 variants of the plan.

Pre and Post Hospitalization expenses are covered upto the limit of 30 days before hospitalization and 60 days after hospitalization.It is covered under all the 3 variants of the plan.
Day care treatment or procedures are covered under all the plan variants in hospital/day care centre but not in the outpatient department of the hospital.
Domiciliary hospitalization or treatment at home is covered due to the unavailability of hospital rooms or considering the condition of the patient, etc.upto Rs 25,000 for silver plan and Rs 50,000 for gold and platinum plan
Daily Hospital cash benefit allowance is given under this plan to combat the non medical expenses during hospitalization. It is covered under gold and diamond plan variant.
Organ donor expenses are covered upto 10% of sum insured under all the 3 plan variants.
Maternity Cover and New born baby cover is available under diamond plan variant.

Value Added Benefits

Medical second opinion is covered for 11 specified critical illnesses.
Treatment for dog bite or other animal as specified.
Attendant Allowance is granted as per the plan variants. This benefit is available with golden and diamond plans.
Optional covers to choose from which are Geographical extensions to SAARC countries, Restoration of sum insured,Personal Accident benefit, Life hardship survival benefit to enhance the policy coverage.
Enhancement f sum insured at the time of renewal on payment of additional premium.
Tax benefit under section 80 D of Income Tax Act,1961.

Sub Limits

Room Rent not exceeding 1 % of the Sum Insured per day for silver and gold plan. For diamond plan variant, the room rent sublimit is Rs.10,000 + 0.5% of the Sum Insured above Rs.10lacs, per day.
ICU expenses not exceeding 2 % of the Sum Insured per day for silver and gold plan.For diamond plan variant, ICU expenses sublimit is Rs.20,000 + 0.5% of the Sum Insured above Rs.10lacs, per day.
Ambulance service charges sublimit for silver plan is Rs.1,000/-per illness OR per policy period 1% of the sum insured subject to maximum Rs 3,000.For gold plan the limit is Rs.2,000/ per illness- OR per policy period Rs 6,000 maximum. For diamond variant, the limits are Rs.3,000/ per illness- OR per policy period Rs 8,000 maximum.
Medical second opinion is maximum paid as Rs 5,000, Rs 10,000 and Rs 15,000 in a policy period for the silver, gold and diamond plan variants.
Co pay is applicable to silver plan as 10% of each and every claim.
Daily Hospital Cash allowance 0.1% of the sum insured upto a maximum of Rs 2,000 per day subject to a maximum of 10 days per illness for the policy period. It is not available for the silver plan variant.

Waiting Period Clause

Initial Waiting Period: Any diseases contracted during first 30 days of the policy start date, except those arising out of accidents.
Specific Waiting Period: The waiting period of specific treatments as mentioned in the policy contract range from 1 year to 2 years of consecutive coverage.
Pre existing Disease Waiting Period: Silver variant of this plan has a waiting period of 48 months years to cover pre existing diseases.
Maternity Waiting Period: The waiting period of 24 months is applicable to avail the maternity benefits under the specified conditions of the policy.

Who can Buy the Plan?

Factor	Minimum	Maximum
Age (as on last birthday)	18 Years	65 Years
Sum Assured	1 Lac	20 Lacs
Cover Type	Family	-
Policy Tenure	1 Year	1 Year
Grace Period	30 Days	-
Free Look Period	15 Days	-
Riders	Geographical Extensions To SAARC Countries, Restoration Of Sum Insured,Personal Accident Benefit, Life Hardship Survival Benefit To Enhance The Policy Coverage.	-