Is worldwide coverage available under this plan?

Category: Health Insurance

What is iPartner by ICICI Lombard? (Simply Explained)

Post author By parastar
Post date February 18, 2023

What is iPartner by ICICI Lombard? (Simply Explained)

So, are you looking to sell insurance to your prospects but are wondering about how to get going? Well, ICICI Lombard has come up with their iPartner program. What is the ICICI iPartner program? This article will attempt to talk about the most important aspects of the iPartner program, such as:

ICICI Lombard iPartner explained
Features and benefits of iPartner
How to become an iPartner with ICICI Lombard
Eligibility criteria
ICICI iPartner Pro Mobile App

ICICI iPartner explained

To understand how the ICICI Lombard iPartner program works, you will first have to understand ‘what is PoSP and its workings?’ PoSP stands for Point of Salesperson. A PoSP has the ability to sell insurance and related products to their clients. He or she essentially acts as an insurance agent.

To become a PoSP, a person has to complete a 15-hour certification program as per IRDA regulation. Once this is done, a PoSP can begin selling insurance on their own. The ICICI Lombard iPartner program is essentially ICICI Lombard’s version of a PoSP program where you can sell ICICI Lombard insurance products to your customer base and get a commission from it.

Features and benefits of iPartner

Brand value of ICICI Lombard: Partnering up with ICICI Lombard through their iPartner program and selling ICICI Lombard insurance policies is ought to be a pleasant experience, as ICICI Lombard has a favorable brand image in the eyes of prospective customers. The sales conversion is likely to be high due to this brand value.
Flexible timings: You are your own master after enrolling in the iPartner program. You can select your own work hours and do not have to adhere to any deadlines. Work as much as or as little as you wish.
Commissions: As a PoSP, you will be eligible to receive a commission on insurance sales and renewals. The commission rate depends on the type of policy sold.

Type of policy sold	Commission rate
Health insurance	15%
Business insurance	10%
Car insurance	15%
Bike insurance	15%

Data taken from: https://www.icicilombard.com/become-posp-insurance-agent

Paperless: As a PoSP, you do not need to collect or deal with any paper work. The entire sales process is online and the customer documents need to be uploaded directly to the ICICI portal. This leads to streamlining of process and ease of management.
Online claims: Your customers can directly initiate online claims, they do not need to come to you to initiate a claims request. This saves a lot of time and effort.

How to become an iPartner with ICICI Lombard

You can enroll in the ICICI Lombard iPartner program by following these simple steps:

Step 1: Download the ICICI Lombard iPartner Mobile App

Step 2: Upload your KYC documents

You will now need to upload the following KYC documents to the App:

Cancelled check (to setup bank payments)
Aadhar Card
PAN Card
Education certificate

Step 3: Document verification
The company will then verify your documents and accept or decline your application.

Step 4: Sell insurance
Once accepted, you can now sell ICICI Lombard insurance products through the iPartner program.

Eligibility criteria

Age	Qualification
18+	SSC

ICICI iPartner Pro Mobile App

The iPartner Pro Mobile App has the following features:

You can generate insurance quotes through the App.
These insurance quotes can be directly sent to your customers.
Your customers can directly buy insurance through the sales link generated through the App.
You can raise a pay-out request through the App.

ICICI Lombard Health Insurance Login Process (Simple Guide)

ICICI Lombard Customer Care- Phone numbers, email ID & social media

ICICI Lombard Claim Status- How to check your claim status

ICICI Lombard Health Insurance Plans

Are you looking for a new ICICI Lombard insurance policy or a policy renewal? Reach out to us and let us assist you.

Oriental Health Insurance

How Oriental Insurance’s Corona Kavach Policy Can Protect You from COVID-19

Post author By parastar
Post date February 17, 2023

How Oriental Insurance’s Corona Kavach Policy Can Protect You from COVID-19

Corona Kavach by Oriental Insurance is a robust health policy that will protect you and your loved ones against the financial burden arising from COVID-19. In this article, let us show you how this health insurance policy is suitable to fulfill the health requirements of you and your family members. In this article we will talk about the following:-

What is covered under the Oriental Corona Kavach policy?
Key features of Oriental Corona Kavach Policy
What are the exclusions under the Oriental Corona Kavach policy?
Oriental Corona Kavach claim settlement procedure
Oriental Corona Kavach policy eligibility
Oriental Corona Kavach frequently asked questions (FAQs)

What is covered under the Oriental Corona Kavach policy?

Below given are the general inclusions that will be covered or paid for under this policy:-

Hospitalization expenses: Oriental’s Corona Kavach plan covers hospitalization expenses of in-patient care arising due to COVID-19. Hospitalization expenses like room, bed charges, nursing, doctor’s fees, etc will also be covered under the policy.
Intensive care: This policy covers all Intensive Care Unit (ICU), and Intensive Cardiac Care Unit (ICCU) expenses.
Homecare treatment expenses: The plan also covers home care treatment of the policyholder suffering from COVID-19 up to the sum insured for 14 days. Diagnostic tests, doctor’s consultation fees, nursing charges, prescribed medicines, etc are covered under the plan. This plan also pays for medical equipment like PPE kits, oxygen cylinders, pulse oximeters, nebulizers, and so on.
AYUSH coverage: Alternative treatments like AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) are covered up to the sum insured limit under the policy.
Pre and Post hospitalization: Oriental’s Corona Kavach policy covers 15 days of pre-hospitalization and 30 days of post-hospitalization expenses.
Ambulance charges: The policy also pays for road ambulance charges for transferring the patient to the hospital up to Rs 2000 per hospitalization.
Daily cash optional benefit: This plan also offers a daily cash benefit as an optional rider which provides extra cushion to the policyholder during a financial crisis. Under this optional rider, the policyholder will receive 0.5% of the sum assured as a daily cash payout during hospitalization.
Co-Morbidity coverage: This plan also covers any pre-existing conditions suffered by the policyholder in conjunction with COVID-19. All medical tests, procedures, treatment, etc of the existing medical ailment triggered by COVID-19 shall be covered up to the sum insured.

Key features of Oriental Corona Kavach Policy

Below given are some important key features of Oriental’s Corona Kavach Policy.

Sum insured limit: Oriental’s Corona Kavach policy provides a wide range of sum insured options starting from Rs 50,000 up to Rs 5 lacs.
Family floater benefit: The company also offers the option to avail of a family floater benefit under which all the members of the family can be protected against COVID-19 under a single policy.
Policy tenure: This plan has a tenure of three and half months (3 ½ months), six and half months (6 ½ months), and nine and half months (9 ½ months).
Waiting period: This policy has a waiting period of 15 days after which it shall cover hospitalization and medical expenses for COVID-19.

What are the exclusions under the Oriental Corona Kavach policy?

Below provided are a few general exclusions under the Corona Kavach policy:-

Experimental/Unproven treatments: Any unproven treatments or experimental procedures that lack medical authentication to prove their effectiveness will not be covered. However, treatments authorized by the government only shall be covered under this policy.
Cosmetic procedures: Any cosmetic procedures or surgeries shall not be covered under the policy.
Dietary supplements: Any dietary supplements purchased without a doctor’s prescription will not be covered under this policy. However, multivitamins and mineral supplements prescribed by the doctor shall be covered.
Treatment outside India: Any treatment availed outside the geographical limit of India will not be covered.
Investigation and evaluation tests: Expenses related to any admission primarily for diagnostics and evaluation purposes will not be liable to be paid by the company. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment shall not be covered under this policy.

What is Oriental’s Corona Kavach claim settlement procedure

There are two ways the policyholder can file for a claim with Oriental Health Insurance I.e the Cashless claim and reimbursement claim.

For cashless claim

Follow these simple steps laid down for availing cashless treatment:

Step 1– The policyholder can avail of cashless treatment when admitted to a network hospital of the company. In case of an emergency inform the insurance company within 24 hours of hospitalization or 72 hours prior to planned hospitalization.
Step 2– You will have to duly fill out the claim form available at the hospital and submit it to the TPA department at the network hospital.
Step 3– The insurance company will verify all the information and after thorough verification, the company will approve your cashless claim request.
Step 4– In case your cashless claim request is not approved by the company due to reasons like unsatisfactory submission of documents, etc, you can avail of the treatment and then apply for reimbursement of the hospital bills from the insurer.

For reimbursement claim

The policyholder will have to avail of a reimbursement claim when admitted to a non-network hospital.

Follow these steps to avail of a reimbursement claim

Step 1:- In case of an emergency inform the insurance company within 24 hours of hospitalization or within 72 hours prior to planned hospitalization.
Step 2:- Submit all the required documents to the company within 15 days of the discharge date to initiate the claim process.
Step 3: The insurance company will then evaluate the claim’s authenticity.
Step 4: Once all the supporting documents relating to the claim are proven authentic, the claim will be accepted and the amount shall be reimbursed to the policyholder.

Documents to be submitted for claim

Submit the following documents within 15 days from the date of discharge to the company to initiate the reimbursement claim process.

Dully signed and filled authorization form
All original medical bills, prescriptions, receipts, reports, etc
Original copy of medical reports like x-ray, scans, etc.
Photo identification proofs
Discharge summary
Death certificate ( if applicable)
FIR ( if application)

Oriental Corona Kavach policy eligibility criteria

Individuals between the age groups of 18 years and 65 years can opt for Oriental’s Corona Kavach plan. However, under the family floater plan dependent children from day 1 up to 18 years of age shall be covered.

What is no claim bonus in health insurance?

Frequently asked questions about Oriental Health Insurance Corona Kavach

The minimum age to enter the policy is from 1 day for children up to 18 years of age.

There is a waiting period of 15 days from the policy purchase date after which the policy will cover all hospitalization expenses for COVID-19.

Yes, alternate treatments like Ayurveda, Yoga, Unani, Siddha, Homeopathy, Naturopathy, etc are covered under the plan.

Yes, you can avail of tax benefits under Section 80 D of The Income Tax Act, 1961, on the premiums paid by you.

No, a pre-policy medical check-up before purchasing this policy is not required.

No, this policy provides coverage for medical treatment availed within the country.

Oriental Health Insurance

Oriental Health Insurance Plans (Top 15 Plans)

Post author By parastar
Post date February 17, 2023

Oriental Health Insurance Plans (Top 15 Plans)

Oriental health insurance offers a variety of plans to safeguard you and your family’s future. Listed below are the various health insurance plans offered by the Oriental Health Insurance company.

Happy Family Floater Policy
Mediclaim Insurance Policy (Individual)
PNB- Oriental Royal Mediclaim
OBC- Oriental Mediclaim Policy
Mediclaim Insurance Policy (Group)
Oriental Happy Cash – Nischint Rahein
Oriental Super Health Top-up
Pravasi Bharatiya Bima Yojana
Health of Privileged Elders
Arogya Sanjeevani Policy-Oriental Insurance
Overseas Mediclaim Policy (E&S)
Jan Arogya Bima Policy
Oriental Dengue Kavach
Oriental Critical Illness Policy
Corona Kavach and Group Corona Kavach

1.) Oriental Happy Family Floater policy

Orientals Happy Family floater policy is a family floater plan that offers coverage to you and your family members under a single sum assured. This plan covers inpatient hospitalization expenses,multiple daycare treatments,pre and post hospotalization charges and much more. You can choose to cover yourself,legally wedded spouse, children and dependent parents under this policy. This plan is available in 3 variants- Silver, Gold and Diamond Plan.

Key Features

Takes care of in-patient hospitalizations expense,multiple daycare treatments, pre and post hospitalizations, ambulance charges and more.
Benefit of cover restoration if you exhaust your coverage because of previous claims.
Organ donor benefit of up to 10% of the sum insured.
Benefit of second medical opinion for 11 major illnesses all round the world between Rs.5,000- Rs. 15,000 depending on the plan selected.
Receive daily cash and Attendant allowance benefit of Rs. 600 – Rs. 1000. (for Gold and Diamond plan)
Compulsory 10% co payment on ever claim only in the Silver plan.

Oriental Happy Family Floater policy
Age Entry	91 days – 65 years
Sum Insured	Rs. 1 lakh – 20 lakh

2.) Mediclaim Insurance Policy (Individual)

This is a health insurance plan that provides comprehensive coverage to the insured that safeguards them from hospital related expenditure incurred due to any sickness,illness or any injury.
You can also cover yourself,your spouse,your children and parents under this policy under family floater basis.

Key Features

Covers reasonable and customary costs in respect of Hospitalization
Covers ICU charges,room rent,boarding & nursing expenses,emergency ambulance costs,etc
Pays towards anesthesia, Blood, Oxygen, Operation Theater costs,medicines & drugs,etc.
Pays 30 days pre and 60 days post hospitalization.
Daily cash allowance up to maximum 6 days of hospitalization
Covers inpatient Ayush Treatment and Organ donor expense.

Mediclaim Insurance Policy (Individual)
Age Entry	18 years- 70 years
Sum Insured	Rs.1lakh- Rs 10 lakh

3.) PNB- Oriental Royal Mediclaim

This policy is designed for any account holders of Punjab and National Bank at a low premium cost o protect the from healthcare related expenses.
This policy can be taken for self along with his family members.

Key Features

Benefit of daily cash benefit during hospitalization only for the primary holder of the policy up to Rs 1,000.
The plan covers In-patient Hospitalization expenses in respect of the organ donor provided that the organ donation is for the Insured Person
Covers 116 daycare procedures,Ambulance charges, Funeral expense in case of death of the insured max up to Rs 1,000.
Covers up to 30 days pre and 60 days post hospitalizations expenses.
Covers doctors, surgeons fees, chemotherapy, radiotherapy, medicines, blood, oxygen, etc.

PNB- Oriental Royal Mediclaim
Age Entry	18years -79 years
Sum Insured	Rs.1lakhs -10 lakhs

4.) OBC- Oriental Mediclaim Policy-2017

Oriental’s Insurance’s OBC Mediclaim policy is made for the account holders of Oriental Bank of Commerce at a affordable premium costs. This particular plans is in 3 variants One account one policy,one person one policy and multiple accounts- one policy.
This policy can be taken either for the self alone or along with the family under single sum insured.

Key Features

The policy covers inpatient hospitalization,domiciliary hospitalization for the necessary illness or injury
Covers 30 days pre and post hospitalization expense along with emergency ambulance costs.
Covers for Operation Theater Charges,Chemotherapy,Radiotherapy,Cost of pacemaker,etc.
Organ donor expenses can be covered in this policy
Daily cash allowance benefit when hospitalized for 24 hours and above

OBC- Oriental Mediclaim Policy
Age Entry	Years 18- 79 years
Sum insured	Rs. 1lakh – Rs10 lakh

6.) Mediclaim Insurance Policy (Group)

Oriental Insurances mediclaim policy can be purchased by any Corporate group, Organization or company provided there are at least 50 members in the group. This plan provides extensive health coverage to the insured members of the groups safeguarding them from medically related expenses. The members can also choose to extend their coverage to their family members including spouse, children, parents.

Key Features

This policy covers the necessary and customary hospital expenditure of the policyholder.
Covers room rent,nursing and boarding,ICU charges
Provides Emergency Ambulance cover up to Rs.2000.
The plan also covers for Mental illness and HIV
Covers advanced and modern technological treatments such as Deep brain stimulation,Oral chemotherapy,Balloon Sinuplasty,etc.
Optional Maternity cover along with New born cover available at low premium.
Cover In-patient Ayush hospitalization and pre and post hospitalization charges.

Mediclaim Insurance Policy (Group)
Age Entry	18 years onward
Sum insured	Rs. 1lakh – Rs10 lakh

7.) Oriental Happy Cash – Nischint Rahein

This is a daily cash benefit plan that pays the insured daily lump sum cash allowance when he/she is hospitalized for a maximum period of 24 hours.

Key features

Receive daily cash benefit towards convalescence,when your hospitalization exceeds more than a period of 30 to 60 days.
Cash benefit toward in-patient Ayush treatment.
25% additional cash benefit on the hospitalization of a insured female member
No medical tests mandatory to avail this policy.
The policyholder will receive daily cash upon multiple hospitalizations in the same year.

Oreintal Happy Cash policy
Age Entry	3months – 60 years
Sum insured	Rs500 – Rs 3000

8.) Oriental Super Health Top-up

This is a Super Top-Up plan which starts covering your medical expenses once you have exhausted the sum insured of your base health insurance policy.

Key Features

Covers inpatient hospitalization expenditures
Covers organ donor expense when the insured is the recipient
Benefit of Maternity and New born baby cover available
Mental illness coverage also available in the policy
The plan also covers Modern day advanced treatments like Robotic surgeries, Stereo-tactic radio surgeries, etc
Policy coverage can be extended after 70 years of age with paying 10% additional premium

Oriental Super Top-Up plan
Age Entry	3 months- 65 years
Sum insured	Rs3 lakh – Rs.30 lakhs

9.) Oriental Pravasi Bharatiya Bima Yojana

This plan is designed for any Indian Emigrants going overseas for work related purpose,as well as Indian Citizens who have applied and obtained an emigration clearance as per the Emigrant Act,1983.
This plan provides accidental death and disability coverage to the insured while working overseas.

Key Features

Lump sum payout of 100% sum insured in case of accidental death of the individual.
Lump sum payout of 100% sum insured when suffering from permanent total disablement due to accident.
This plan also covers the cost of hospitalization under family floater basis in the event of accident related hospitalization.
Maternity coverage available to the insured female under the policy.
The policy covers the repatriation expenses in the event of demise of the insured individual.
Air transportation cost of the attendant and insured covered in case of death or disability.

10.) Oriental Health of Privileged Elders (HOPE)

Oriental’s Health of Privileged plan is exclusively designed for individuals above the age 60 of years,this plan provides coverage towards specific illnesses or conditions in the policy that are prone due to old age.
The plan provides coverage for accidental injury and multiple treatments such as cardiovascular diseases,chronic renal failure, cancer, orthopedic diseases and more.

Key Features

Covers in-patient hospitalization,domiciliary hospitalization,ambulance expense,etc
This plan also covers alternative treatments like Ayush.
Covers 30 days pre and 60 days post hospitalization expenditure
This policy covers only specified illness in the policy and pays a percentage of Sum assured on the covered condition or illness.

Oriental Insurance Health of Privileged Elders (HOPE)
Age Entry	60 years onward
Sum insured	Rs 1 lakh – Rs 5lakh

11.) Arogya Sanjeevani Policy-Oriental Insurance

This is a standard Health Insurance policy that is designed to cover Hospitalization Expenses for In-Patient Care or Day Care Treatment incurred for treatment of an Illness/ Injury sustained.
This plan can be availed on an individual or a family floater basis as well.

Key Features

Covers inpatient hospitalization,multiple daycare treatments, pre and post hospitalization charges, etc.
Cumulative bonus of 5% of Sum Insured,Max up to 50% during claim free years.
Specified modern and advanced treatments up to 50% of sum insured.
Dental treatment and plastic surgery covered, if medically necessitated due to disease and injury.
AYUSH Treatment covered up to sum insured.
Life-long renewals allowed with no exit age.

Arogya Sanjeevani Policy-Oriental Insurance
Age Entry	3months – 65 years
Sum insured	Rs. 1 lakh – Rs 20 lakhs

12.) Overseas Mediclaim Policy (E&S)

This plan is designed for individuals who are traveling abroad for Education or Employment ,it protects them against any travel or health hazard that can happen overseas.

Key Features

Covers medical expenses in case of an accident or illness
Coverage for mental, nervous and emotional disorders is limited to 30 days continuous in-hospital expenses
Coverage against accidental death or Permanent Total Disablement due to accident.
Covers the cost of repatriation in case of death of the insured.

13.) Oriental Jan Arogya Bima Policy

This is a special plan designed for lower income families of the country to provide them with standard health car coverage at a low premium cost.

Key Features

Covers medical expense and inpatient hospitalization
Cover domiciliary treatment expenses
Pays Diagnostic Materials and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs & Cost of organ
Coverage for room rent,ICU charges, nursing and boarding charges.
The policy term is of 1 year

Oriental Jan Arogya Bima Policy
Age Entry	3months – 70 years
Sum insured	Rs. 5,000/

14.) Oriental Dengue Kavach

Oriental’s Dengue kavach policy provides the insured individual lump sum benefit of 100% sum insured on the first positive diagnosis of Dengue fever.
You can also include to cover your family under this policy.

Note:- this is only a benefit based policy,it does not cover the cost hospitalization.

Key Features

Receive lump sum benefit on the first positive diagnosis of dengue
Waiting period of thirty days from the beginning of the policy

Oriental Dengue Kavach policy
Age Entry	18 years-65 years
Sum insured	Rs. 10,000 – Rs. 20,000

15.) Oriental Critical Illness Policy

As the name suggests, this policy is crafted to secure the insured against listed critical illnesses or conditions in the policy. Under this the insured will receive 100% lump sum benefit on his first diagnosis of any of the specified life threatening illnesses or conditions such as cancer of specified severity, first heart attack, open heart surgery, paralysis, stroke and more

This plan comes under 2 variants- plan A and Plan B

Plan A- covers 11 critical illnesses
Plan B- covers 22 critical illnesses

Key Features

100% sum insures on first diagnose of any of the specified illness or conditions
Medical Second Opinion Benefit max of up to Rs. 10,000

Oriental Critical Illness Policy
Age Entry	18 years – 65 years
Sum Insured	Rs 2 lakh- Rs 50 lakh

16.) Oriental Corona Kavach and Group Corona Kavach

Corona Kavach policy offers to safeguard you against hospital expenditure incurred due to the treatment of Covid-19.
This plan can be availed on family floater as well as individual basis.

Key Features

This plan covers inpatient Hospitalizations,home care treatment incurred for treatment for Covid-19 during the policy period.
Covers inpatient Ayush treatment.
Covers 15 days pre and 30 days post hospitalization expenses.
Daily cash benefit for each 24hours of hospitalization for treatment of corona virus.
Covers room rent,ICU,oxygen,ventilator costs, etc.

What is no claim bonus in health insurance?

Are you looking for a new Oriental Health Insurance policy or a policy renewal? Reach out to us and let us assist you.

Health Insurance

Oriental Health Insurance (Plans, Benfits, and more)

Post author By parastar
Post date February 17, 2023

Oriental Health Insurance (Plans, Benefits, and more)

About the company

The Oriental Insurance Company was established in 1947, the year of independence. The company was initially a subsidy of the General Insurance Corporation of India until 2003, when it separated itself from the parent company and was set up as an independent insurance company.
Oriental Insurance Company, headquartered in New Delhi, currently has over 1800 branches and offices across the country and employs over 13,000 people. The company also operates in Nepal, Kuwait, and Dubai.
Oriental Insurance offers a suite of insurance products like the unique Corona Kavach Policy, the overseas Mediclam Policy, the family floater health insurance policy, the Arogya Sanjeevni Policy, motor insurance, and travel insurance plans, among others.
The company had a robust claim settlement ratio of 93.96% in FY 2019–2020.

Highlights of the company

Oriental Health Insurance
Network Hospitals	4000+
Claim settlement Ratio	93.96% FY 2019-2020
Incurred Claim Ratio	108.80%
Renewal	Lifetime
Website	https://orientalinsurance.org.in/
Contact	1800118485/011-33208485

Types of health insurance plans offered by Oriental Health Insurance

Here are the 15 types of plans offered by the Oriental Insurance Company.

Plan Name
Happy Family Floater Policy	This is a family floater plan that covers you and your family under a single policy. You can cover yourself, legally wedded spouse, dependent children and parents.
Mediclaim Insurance Policy (Individual)	This is a health insurance plan which offers extensive coverage to the insured that safeguards them from hospital related expenditure incurred due to any sickness, illness or any injury
Oriental Royal Mediclaim PNB	This plan is only available for account holders of Punjab and National Bank, with the purpose to safeguard them from medically related expense at a affordable premium.
Oriental Mediclaim Policy- OBC	This plan is available for account holders of Oriental Bank of Commerce,to provide them essential healthcare coverage at a low premium cost. This particular plans is in 3 variants One account one policy,one person one policy and multiple accounts- one policy.
Oriental Mediclaim Insurance Policy (Group)	Oriental’s Mediclaim insurance policy is programmed to offer comprehensive coverage against hospitalization expense. This plan can be purchased by any members of corporate group, Organization or company
Oriental Happy Cash-Nischint	This is a cash benefit plan which provides daily cash to the insured during hospitalization.
Oriental Super Health Top-up	This plan is a Super Top-Up plan which will come into action after you have exhausted the coverage of your base health insurance policy. Super Health Top-up comes with wide range of sum insured with flexible sum deductible option.
Pravasi Bharatiya Bima Yojan	This policy is made for Indian emigrants working in abroad. This plan provides accidental death and disability coverage to the insured while working overseas
Health of Privileged Elders	This is a health Insurance plan exclusively for senior citizens,offering them coverage for specified illnesses and conditions. Individuals above the age of 60 can purchase this policy.
Arogya Sanjeevani Policy-Oriental	Arogya Sanjeevani policy provides standard health coverage at a affordable premium. This plan covers in patient hospitalization and multiple listed modern and advanced treatments. This plan is available on individual or Family floater sum insured basis.
Overseas Mediclaim Policy (E&S)	This plan is an ideal plan for individual who travel abroad for education or employment. It covers Covers medical expenses in case of an accident or illness abroad.
Jan Arogya Bima Policy	The aim of this plan is to provide standard health coverage to weaker sections of the society at affordable premium rate. The plan covers basic and necessary hospital expenditure incurred in the treatment of any illness or accident
Oriental Dengue Kavach	This is a benefit based policy,which provides lump sum payout of 100% sum insured when the insured is positively diagnosed with Dengue fever.
Oriental Critical Illness Policy	Under this the insured will receive 100% lump sum benefit on his first diagnosis of any of the specified life threatening illnesses or conditions specified in the policy. This policy comes in 2 variants – Plan A and Plan B
Corona Kavach and Group Corona Kavach	This policy covers all medical and hospital expenditure incurred in the treatment of COVID-19.

Why should you select a health insurance policy from Oriental Health Insurance?

Here are a few reasons why you could choose to buy health insurance plans from Oriental Health Insurance.

Robust settlement ratio: the company has a robust claim settlement ratio of 93.96%, which signifies that the company is very supportive and efficient in settling legitimate claims without depriving the customers of their rights.
Network Hospitals: The company has a solid network of more than 4500 hospitals associated with them, where you can avail hassle-free cashless treatment without worrying to pay the hospital bills from your own pocket.
Affordability: Oriental Insurance Company offers plans that provide you with extensive coverage and many other valuable benefits at a very affordable premium.
Portability Feature: All plans offered by the company come with a portability feature, which means that you can easily switch to another plan with another health insurance company in case you are not satisfied.

Some Key Features of Oriental Health Insurance

Comprehensive Coverage: The plans offered by the company provide comprehensive coverage, protecting you from expenses related to inpatient hospitalization, daycare procedures, pre and post-hospitalization, domiciliary treatments, and much more.
Cumulative Bonus: Many plans offered by the company provide you with the benefit of a cumulative bonus, which increases your coverage up to a certain percentage in the event of no claims.
Reviewability: The plans come with a lifelong renewal option, which means that you can renew the policy without any restrictions or age bar, provided you pay the premium on time.
Cover Restoration: Various health plans by Oriental Health Insurance come with the benefit of cover restoration. This means that the company will provide you with additional coverage at no cost in case you exceed your sum insured by making a claim during the policy year.
Tax Benefit: Get a deduction on the health insurance premium paid by you to the company under Sec. 80 of the Income Tax Act of 1961.
Value Added Benefits: Oriental Insurance plans include numerous value added benefits such as maternity and new-born baby coverage, daily cash benefit, convalescence benefit, personal accident and disability coverage, and so on.

How do I purchase Oriental Health Insurance policies?

Online Method:-

Follow the easy steps provided to buy Oriental Health Insurance Plans online.

Step 1: Visit the company’s official website (www.https://orientalinsurance.org.in/).
Step 2: Click on the “Buy Online” tab and select the health policy you wish to purchase.
Step 3: Fill out all the details accurately, and then click Calculate Premium.
Step 4: Once again, check all the details and make the premium payment.
Step 5: Once the premium is paid, your policy will be generated instantly within 10-15 minutes, and soft copies of the policy document will be sent to the registered email address.

Offline Method

You can also purchase the policy by visiting the nearest branch of the company
You can also contact the customer care executive on their toll-free number: 1800-118485 or 011-33208485.

How to File a Claim with Oriental Health Insurance

A health insurance claim can be filed in two ways: cashless claim settlement and reimbursement claim.

cashless claim settlement

When you are admitted to a company network hospital, you can file for a cashless claim settlement.

Here are a few steps that you can follow to file for cashless claim settlement:

Step 1: Inform the company 72 hours before in the case of a planned hospitalization or within 24 hours in the case of an emergency hospitalization.
Step 2: Completely fill out and submit the pre-authorization form to the hospital, along with the health card and photo ID proofs.
Step 3: The hospital will send your pre-authorization claim form and other documents to the company to initiate the cashless treatment process.
Step 4: The company will further assess your claim with the terms and conditions of the policy and intimate their decision to the hospital.
Step 5: Once the company is satisfied with their investigation and gives the hospital the green light, you can begin receiving cashless treatment.
Step 6: In the event that the company rejects your claim. The reasons for this will be provided to you in writing.

Reimbursement claim settlement with Oriental Health Insurance

When you are admitted to a company non-network hospital, you must file a reimbursement claim.

Follow the steps provided by us to file a reimbursement claim with Oriental Health Insurance.

Step 1: Inform the company 72 hours before a planned hospitalization or within 24 hours in case of an emergency hospitalization.
Step 2: After your discharge, get the reimbursement claim form from the company. You can simply do so by visiting their website and downloading the form there.
Step 3: Completely fill out the claim form and submit it to the company or its third-party administrator with all the required documents to initiate the claim process.
Step 4: Once you have submitted all the necessary documents, the insurance company will verify your request with your policy benefits.
Step 5: Once the company has assessed your claim, The reimbursement amount will be deposited directly into your linked bank account.

Note: The policyholder or his or her relatives need to submit the duly filled claim form along with the necessary documents to the insurance company within 15 days from the date of discharge.

Documents required to file a claim:

A dully filled and signed pre-authorization claim form
Photo identification proof
All original bills, reports, and receipts
All original test reports, scans, diagnoses,x-rays,ECG,MRI,etc
Original chemist and pharmacy bills, receipts, and prescriptions
Original doctors’ certificates, surgeons’ reports, etc.
FIR (if applicable)
Death certificate (if applicable)

Renewal Process for Oriental Health Insurance

You can easily renew your health insurance policy with Oriental Health Insurance online with the following steps provided by us:

Step 1: Go to the official website of the company.
Step 2: Click on the “Renew” tab.
Step 3: Enter your existing policy number and policy details.
Step 4: Click on “Renew Now” and verify your policy premium.
Step 5: Review your premium and any no-claim bonus to be credited, if any, and pay your premium online.
Step 6: Once you have made the payment, you will receive a confirmation email along with the premium receipt at your registered email address.

Offline Renewal Process

You can visit the nearest branch of Oriental Insurance Company to renew your policy, or you can also get in touch with their customer care executive at Toll Free: 1800-118485 or 011-33208485 and state your request.

How to Calculate the Premium for Oriental Health Insurance

You can now easily calculate your Oriental Health Insurance premium online by using the calculator available online and providing certain details.

Choose whether you want to purchase a health plan on an individual or family floater basis.
Select your sum insured.
Number of individuals to be insured
Age, name, mobile number, email address, and other details
Pan-India coverage (if requested).
Medical history (if any)

Your premium will be displayed immediately after you enter these details into the calculator.

What is no claim bonus in health insurance?

Are you looking for a new Oriental Health Insurance policy or a policy renewal? Reach out to us and let us assist you.

Frequently asked questions about Oriental Health Insurance

12 September 1947

IRDA registration no: 556

Yes, Oriental Insurance is regulated by the IRDA.

Mrs. Sunita Tuli Nagpal

Shri R. R. Singh

(As of 2022)

1.52 (As of 2021)

1800118485 / 011-33208485

Health Insurance

How to port a health insurance policy? (Easy Steps)

Post author By parastar
Post date January 21, 2023

How to port a health insurance policy? (Easy Steps)

A health insurance policy is a contract between an insurance company and the insured. Even though it is usually a long term contract, it is not mandatory for the insured person to continue with the health insurance company in perpetuity. The insured can easily replace his old insurance provider with a new one; This process is called insurance porting and this feature was introduced by the IRDA of India.

Let us now address some of the most important questions with respect to porting your health insurance policy:

Why would you want to port your health insurance policy?
What are the benefits of porting your health insurance policy?
What are the steps of porting your insurance policy?
What are the documents required to port an insurance policy?
What are some special points to keep in mind?

Why would you want to port your health insurance policy?

There are a variety of reasons why a person would want to port their health insurance policy. It is possible that he or she may be getting a better premium rate, he or she may be unhappy with the customer support, or he or she may be getting better bang for their buck with another insurance provider. All of the above are valid reasons for a person to port their health insurance policy.

What are the benefits of porting your health insurance policy?

Let us talk about some of the most pertinent benefits in porting a health insurance policy:

Lower premium rates: The IRDA of India has created an environment of high competition among insurance companies in India. Due to this, insurance companies are constantly looking to get more customer by slashing premium rates. A policyholder can leverage this situation and look to port their policy to another insurer.

Better coverage: Similar to the tactic of reducing premium rates, insurance companies also provide additional services, perks and additional coverage to attract customers. You can take advantage of this.

Better service: At times, a customer may be satisfied with the premium rates and the coverage provided by his current insurer but he may be highly dissatisfied by the kind of service provided to him. This is where he may opt to port his policy from his current provider to another company that has a track record for providing better customer service and satisfaction.

Higher claim settlement ratio: The claim settlement ratio is the percentage of claims a health insurance company settles. For instance, if a health insurance company receives 100 claims, and settles only 95 claims, the company’s claim settlement ratio is 95%. A high claim settlement ratio should be of paramount importance while considering buying a health insurance policy.

What are the steps of porting your insurance policy?

Let’s now understand the steps of porting your insurance policy.

Step 1) Intimate your new health insurance provider

Once you have zeroed in on your new health insurance provider, initiate a portability request with them. Ensure that you have placed this portability request 45 days prior to the renewal date of your current policy.

Step 2) Fill-up and submit the portability form

The insurance company will now provide you with a portability form and a proposal form. You will need to fill-up these forms accurately and honestly and furnish them to your new insurance provider.

Step 3) Port to your new insurance provider

The insurance company will now take a maximum of 15 days to decide on your application. If the new insurance company decides to port your account, you will now have an insurance contract between yourself and your new insurer. The old insurance contract will now be terminated.

What are the documents required to port an insurance policy?

The following documents will be required to initiate a porting request:

Policyholder’s identification documents and address proof (Aadhar Card, PAN Card, etc)
Old policy bond
Details pertaining to any previously made claims
proposal form and portability form

What are some special points to keep in mind?

There are 2 important points that you need to keep in mind before porting your health insurance policy, they are:

No claim bonus: It is imperative to keep in mind that your No Clam Bonus (NCB) if any is carried on from your last insurer to your new insurer. You do not want to miss out of any NCB coverage that you may have accumulated in your last insurance policy.

Coverage: Another very important aspect to keep in mind is if there is any divergence in the level of coverage provided by your old insurer and your new insurer. If your new insurance provider provides additional coverage, then that is fine but there should not be less coverage than before. Check the policy brochure and policy bond in detail before taking the leap.

Why is health insurance important?

What is no claim bonus in health insurance?

Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

Frequently asked questions

Yes, you are eligible towards insurance portability as per the IRDA of India.

You must ensure that you inform your new insurance provider 45 days prior to your current insurance policy's renewal date.

Yes, NCB is generally carried forward. But you must verify this with your new insurance provider.

Health Insurance

Park Mediclaim TPA (Role, Features, Customer Care, and More)

Post author By parastar
Post date October 28, 2022

Park Mediclaim TPA (Role, Features, Customer Care, and More)

Park Mediclaim Insurance TPA is an Indian Third Party Administrator (TPA) Company, which acts as a link between insurance companies and policyholders. It is the role of the TPA Company to provide customer support, customer education, and claim management.

Let us now talk about some of the main aspects of Park Mediclaim Insurance TPA, such as:

Role of Park Mediclaim Insurance TPA
How to login and register?
How to submit a claim?
Important Downloads
Empaneled Hospitals
Customer Support

Role of Park Mediclaim Insurance TPA

Customer Enrollment: The company engages in the enrollment and education of potential insurance buyers. Once educated, the company then offers the best possible insurance products to their clientele.

Customer Support: Once enrolled, it is the role of Park Mediclaim Insurance TPA to provide quality customer support to policyholders, both during hospitalizations as well as pre and post hospitalization.

Health Card: It is the job of the TPA company to furnish the policyholder with his/her Insurance Health Card. The policyholder can avail treatment only once they furnish this Health Card to the hospital.

Claims Management: All claim related queries, grievances, and support will be extended by the TPA Company to the policyholder.

How to login and register?

Some of the benefits and features of Park Mediclaim Insurance TPA can be accessed by registering and logging into their official website. How can you do this? Here’s how:

Step 1) Visit the official website of Park Mediclaim TPA

https://www.parkmediclaim.co.in/

Step 2) Navigate to the ‘Login’ section on the top bar

Step 3) Select your ‘Login Type’

Here, you will have to select your login type. There are various types of logins, such as:

Agent Login
Corporate Login
Broker Login
RO Login
Branch Login
Hospital Login
Admin Login
Employee Login

Once selected, enter your Username and Password and click on ‘Login.’

How to submit a claim?

Submitting an insurance claim is one of the most important aspects. Let us now understand how you can submit an insurance claim with Park Mediclaim TPA

How to submit cashless claim?

Step 1) Inform the TPA Company or Insurance Agent

First, you will need to inform your TPA Company or Insurance Agent.

Step 2) Submit your Health Card to the hospital

Your hospital will request your Health Card or your Policy Bond, you will have to submit this during the admission process.

Step 3) Fill-up the forms

Now, you will have to fill-up and submit the Pre-authorization form, attached your ID and address proof, and submit it to the hospital. Post submission, the hospital will verify your details with the TPA company, and upon verification they will accept your cashless request.

Once your cashless request is accepted, all hospital payments will be paid by the insurance company directly to the hospital.

How to submit reimbursement claim?

Step 1) Inform the TPA company or Insurance Agent

First, you will need to inform the TPA company or the Agent.

Step 2) Submit your Health Card to the hospital

Your hospital will request your Health Card or your Policy Bond, you will have to submit this during the admission process.

Step 3) Keep all original documents

After admission, you will have to ensure that you store all hospital related documents like admission summary, discharge summary, bills, reports, receipts, etc. All of these documents will have to be submitted to the TPA company after discharge.

Step 4) Submit all documents after discharge

Upon discharge, fill-up the claim form and attach all of your medical documents. Now, submit these documents to the TPA company. Your claim will now be registered.

Step 5) Follow-up after your claim

You will also have to follow-up on the status of your claim on a timely basis.

Important Downloads

Important insurance related downloads can be accessed through the Park Mediclaim TPA website here. Important downloads include:

Pre-auth Form
Hospital Agreement
Claim Forms
PPN Declaration Letter
TPA Information Sheet
Empaneled Hospitals List

Empaneled Hospitals

If you want to avail cashless treatment, then the policyholder will have to get admitted to an empaneled hospital. Check a list of empaneled or network hospital here. Once on this page, enter your city, state, hospital name, and then press on ‘Submit.’

Customer Support

Type

Contact Details

Phone Number

(+91) 11-43191000-100 / 1800-11-55-33

Email Support

park@parkmediclaim.co.in

info@parkmediclaim.co.in

Paramount TPA (Claim Status, Customer Care, Hospital List, and more)

MD India Health Insurance TPA Pvt Ltd

Safeway TPA

Raksha Health Insurance TPA Pvt Ltd

Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

Health Insurance

Does Health Insurance cover Dental Treatment?

Post author By parastar
Post date October 26, 2022

Does Health Insurance cover Dental Treatment?

With the increasing penetration of health insurance, health insurance companies have begun introducing more comprehensive coverage. However, in the case of dental insurance, most companies do not offer dental coverage as a standalone policy but can be purchased as an additional cover or an optional rider.

In this article we will talk about the following:

What does dental insurance cover?
Importance of dental insurance coverage
Companies offering dental insurance coverage
Inclusions and exclusions under dental coverage

What does Dental Health Insurance cover?

In simple terms, in dental cover, any dental treatment related to illnesses, accidents, or injuries will be covered under the plan. To cover the cost of these treatments it is always advisable to buy a dental cover keeping in mind the cost of medical inflation.

Importance of Dental Insurance

1.) Protect your finances

Nowadays dental treatment is expensive due to inflation, innovation, usage of high-tech set-ups, etc. Hence to avoid having to spend your hard-earned money on these expensive treatments it is always safer to buy a dental cover along with a standard health plan.

2.) Routine dental check-ups

Many health insurance companies provide the policyholder free dental health check-ups to take necessary care of the individual’s oral hygiene.

3.) Free consultations

The policyholders will receive a number of free consultations under the cover depending on the policy scope.

4.) Teeth whitening

Some health insurance companies also provide compensation for teeth whitening treatments or procedures.

5.) Tax benefit

Avail of tax benefits on your health insurance premiums under Section 80D of the Income Tax Act.

Companies offering Dental Insurance coverage

Following are the health insurance companies that offer dental coverage

Sr. No	Company Name	Plan Name
1	Care Health Insurance	Care Plus Plan
2	TATA AIG	TATA AIG Medicare Premier Plan
3	Digit Health Insurance	Digit Care Plus Plan
4	Future Generali Health Insurance	Future Total Health Plan
5	Chola Ms Health Insurance	Chola Ms Privilege Healthline Plan
6	Kotak Mahindra Health Insurance	Health Premier Plan
7	ManipalCigna Health Insurance	ProHealth Insurance
8	Oriental Insurance	Oriental Mediclaim Policy
9	Reliance Health Insurance	Digital Care Management Policy
10	SBI Health Insurance	SBI Arogya Plus Plan
11	Star Health Insurance	Star Comprehensive Plan
12	Aditya Birla Health Insurance	Activ Health Platinum Plan Activ Health Enhanced Plan
13	Raheja Health Insurance	QUBE Health Insurance Plan
14	IFFCO Tokio Health Insurance	Individual Medishiled Plan
15	Edelweiss Health Insurance	HealthPlus Plan

Inclusions and exclusions under dental coverage

Following below are some of the general inclusions and exclusions under dental health cover in India. It is always advisable to thoroughly check the scope and terms of the policy before opting for one.

Inclusions	Exclusions
Dental surgery/Implants	Cosmetic procedures
Oral consultations	Dentures
Root canal treatments	Jaw alignment /correction
Treatment of gum illnesses	Orthodontic treatments
Decayed tooth treatments	Placement of dentures
Filling of cavity	Prosthesis
Accidental damage or injury to tooth/teeth	Implants

Frequently asked questions

It is advisable to always compare various dental plans based on their features, benefits, coverage, and premium. Comparing these factors will assist you in purchasing the right dental plan suitable for your needs

Yes, you can easily purchase a dental cover online in the comfort of your home. However, we advise you to thoroughly read the terms and conditions of the policy and get your doubts cleared before buying the policy.

Yes, root canal treatment is covered under dental health insurance cover.

No, generally dental insurance does not offer coverage for braces, but many health insurance companies have started offering coverage for the same. It is advisable to check the same in the policy wording.

Health insurance companies do not offer dental insurance as a general standalone policy. However, you can buy it as an additional cover or a rider policy bundled up with a general health plan.

Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

Does Health Insurance cover alternative treatments in India?

Health Insurance

Does Health Insurance cover alternative treatments in India?

Post author By parastar
Post date October 26, 2022

Does Health Insurance cover alternative treatments in India?

With the increasing trend in awareness because of its benefits, coverage for holistic treatments like Ayurveda, Ayush, Unani, etc are now widely offered by many health insurance companies. Many lifestyle illnesses and also chronic diseases have been cured with the help of alternative treatments. Because of the increase in demand for alternate treatments, popularly known as AYUSH treatment, many health insurance companies now offer coverage for the same.

In this article let us talk about the following:

What are alternative health treatments in India?
Scope of coverage
Plans that offer Ayush coverage
What benefits of Ayush coverage?
Frequently asked questions

What are alternative treatments in India?

In 2013, The Insurance Regulatory and Development Authority of India (IRDA) issued new guidelines which advised health insurance companies to provide plans that cover alternative treatments. Alternative or AYUSH includes treatment like Ayurveda, homeopathy, naturopathy, Unani, and Siddha, in India.

Scope of Coverage

Although AYUSH cover is available under a health plan, the same is bundled with a comprehensive health plan. Health insurance companies solely do not offer AYUSH coverage.

Companies that offer coverage for alternative treatments

Company Name	Plan Name
Care Health Insurance	Care Plus Plan
TATA AIG Health Insurance	Medicare Policy
HDFC Ergo Health Insurance	My-health Suraksha Plan Optima Secure Plan
Bajaj Allianz Health Insurance	Covers AYUSH in most plans
Kotak Mahindra Health Insurance	Group Smart Cash Plan Group HealthCare Plan
Chola MS Health Insurance	Health Line Plan Individual HealthLine Plan
Future Generali Health Insurance	Health Total Plan
Oriental Insurance Company	Super Top Up Plan
Star Health Insurance	MediClassic Insurance Plan
Bharati AXA Health Insurance	Smart Health Insurance Smart Super Health Assure Plan Health Advantage Plan
IIFCO Tokio Health Insurance	Individual Medishied Plan
ManipalCigna Health Insurance	Pro Health Plan Super Top-Up Pan
New India Assurance	New India Mediclaim Policy
SBI Health Insurance	Arogya Premier Health Arogya Plus Plan
Digit Health Insurance	Digit Health Care Plus
Universal Sampoo	Healthcare Plus Plan
Niva Bupa Health Insurance	Health Companion Plan
Apollo Munich Health Insurance	Easy Health Exclusive Plan
Relaince Health Insurance	Health Infinity Policy

What are the benefits of AYUSH cover?

Now let us discuss the advantages that you will gain from opting for an AYUSH cover.

1.) Covers different treatments

Along with covering allopathy, your plan will also pay for treatments like Ayurveda, homeopathy, Unani, Siddha, and so on, giving more options to the policyholder while deciding the line of treatment.

2.) Affordable treatment

AYUSH treatment is highly affordable compared to allopathy treatment hence it is advisable to buy a plan that provides coverage for the same.

3.) Treatment for cancer

According to proven studies, alternative treatments like Ayurveda, Siddha, etc have proved to be beneficial in the cure of cancer.

4.) Widely available

As opposed to allopathy, AYUSH treatment is easily accessible in remote areas across the country, especially in villages and small towns.

5.) Inpatient hospitalization

Expenses incurred from inpatient hospitalization under AYUSH will also be covered as per the terms and conditions of the policy.

Frequently asked questions

Alternative and holistic treatments like Ayurveda, Yoga, Unani, homeopathy, Siddha, naturopathy, and so on is covered under the AYUSH.

The following are the exclusions under Ayush:

Pre and post-hospitalization expenses.
Beauty or rejuvenation procedure.
Daycare procedures that require less than 24 hours of hospitalization.

The following are the valid reasons to keep in mind while opting for an Ayush cover.

AYUSH treatment is comparatively more affordable than allopathy treatment.
It is ideal for senior citizens and individuals as the chances of side effects are lesser.
Ayush treatment is easily obtainable in rural and urban locations.
Highly effective in curing ailments like high blood pressure, sugar, and also in some cases cancer.

Everyone is eligible for coverage if the health insurance company offers its coverage under the policy’s condition.

The policyholder can avail of both cashless and reimbursement options in case of a claim. In case the policyholder is admitted to a network hospital of the company they can avail of cashless option.

In case the policyholder is admitted to a non-network hospital of the insurer they will have to opt for reimbursement claim settlement.

Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

What is no claim bonus in health insurance?

Health Insurance

Good Health Insurance TPA (Features, Downloads, and More)

Post author By parastar
Post date October 26, 2022

Good Health Insurance TPA (Features, Downloads, and More)

Good Health Insurance TPA is an Indian Third-Party Administrator (TPA), which was incorporated in 2003. Good Health Insurance TPA is headed by Mr. Srikanth Charan Mudigonda, who serves as the company Managing Director. The company has settled over 1.5 Lac claims, which has won it numerous awards including “India’s Most Promising TPA of the year- 2016.”

Let us now look at some of the most important topics concerning Good Health Insurance TPA, including:

Role of the company
How to submit a claim?
How to login and register under their website
Downloads
Network Hospitals
Customer Care

Role of the company

As a TPA company, Good Health Insurance TPA has to fulfil the following important roles:

Acts as a link: The company acts as a link between the insurance company and the policyholder. The TPA company will have to act as a mediator between both parties and will have to act in the best interest of both parties.

Claim Management: All claim related logistics will have to be handled by the TPA company, from customer guidance to submission of documents. Once all of the documents are submitted to the TPA company, the company will then forward the same to the insurance company. Once this is done, the TPA company will correspond with the policyholder on behalf of the insurance company pertaining to the claim.

Customer Support: This is a very important function of any TPA company, they are mandated to provided customer support to policyholders. Most TPA companies also provide a 24×7 Customer Support Helpline that policyholders can avail of.

How to submit a claim?

If you are a Good Health Insurance TPA customer and are wondering about how to submit a claim, then please follow through. You can submit two type of claims, cashless claim, and reimbursement claim. Let us go through with the claim submission steps for both.

How to submit a cashless claim?

Step 1) Inform your insurance agent / TPA Company

The first thing you need to do is to inform your agent or TPA Company about the hospitalization. It is vital the company be informed as soon as possible about the hospitalization.

Step 2) Submit the policy bond or Health Card to the hospital

Now, upon admission, the policyholder’s family must submit the policyholder’s policy bond or Health Card to the hospital. Once submitted, the hospital will enter into correspondence with the TPA Company and verify the policy bond. Once verified, all hospital bills will be directly paid by the insurance company to the hospital, the policyholder will not need to spend out of pocket.

Note: Cashless hospitalizations can only be availed at network hospitals.

How to submit a reimbursement claim?

A reimbursement claim can be applied in the following steps:

Step 1) Inform your insurance agent / TPA Company

Here again, the first thing you need to do is to inform your agent or TPA Company about the hospitalization.

Step 2) Keep all original medical documents

Now, you will need to meticulously keep a record of all medical documents, including admission summary, doctor’s certificates, diagnosis reports, hospital bills, receipts, discharge summary, etc. You will have to submit all of the original copies to the TPA company upon discharge.

Step 3) Submit all documents to the TPA Company

All medical documents must be submitted to the company within 15 days of discharge, it is extremely important that there is no delay here. You will have to submit the following forms along with the medical documents:

Filled-up claim form
Copy of your policy bond or E-Card
ID and address proof

Once submitted, your claim will be registered.

How to login and register under their website

The various benefits and features of Good Health Insurance TPA can be accessed by registering and logging into their official online portal.

How to login?

Step 1) Visit the official website

You can access the official Good Health Insurance TPA Website here.

Step 2) Navigate to the ‘Logins’ section

Now, you will need to navigate to the ‘Logins’ section on the top of the website. Once there, click on the type of login. There are a variety of logins such as:

Corporate Employee Login
Insurer Login
Provider Login
Retail Policies Login
Retail Agent Login

And more.

Downloads

You can also download important documents through the official website of Good Health. How?

Step 1) Visit the official website

Step 2) Navigate to the ‘Downloads’ section on top of the page

Here, you can download the following documents/forms:

Pre-Auth Form
Reimbursement Form
Cashless Form
CKYC Form
PPN Declaration Form

Network Hospitals

It is pivotal that all hospital admissions be done in a network hospital if you wish to avail cashless hospitalization. You can check out a list of all network hospitals navigating to the ‘Network Hospital Search’ button on the far right side of the official home page of Good Health TPA. Once on this page, you will have to enter the following:

Insurance company name
State and City

Click on ‘Submit’ once done. You will now get a list of all network hospitals in your area.

Customer Care

Department	Phone Number / Email ID
Customer Care	1860-425-3232 customer.care@ghpltpa.com
Senior Citizens Helpline	1800-102-9919
Hyderabad Branch	1860-425-3232
Bengaluru Branch	080-41521384 & 25202113
Chennai Branch	044-28150765
Mumbai Branch	1860-425-3232
Delhi Branch
Cochin Branch	1860-425-3232
Madurai Branch	0452–4379765 & 4231115
Visakhapatnam Branch	9515668775
Coimbatore Branch	0422–6450322 & 4362030 & 2306898

Paramount TPA (Claim Status, Customer Care, Hospital List, and more)

MD India Health Insurance TPA Pvt Ltd

Safeway TPA

Raksha Health Insurance TPA Pvt Ltd

Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

Health Insurance

Genins India Insurance TPA (Services, Customer Support and more)

Post author By parastar
Post date October 22, 2022

Genins India Insurance TPA (Services, Customer Support and more)

Genins India Insurance TPA is an Indian Third Party Administrator (TPA) that acts as a bridge between insurance companies and their policyholders. The TPA company was founded in 1996 and currently operates in 250+ Indian Cities, and has over 30+ offices across the nation.

If you are a customer of Genis India Insurance TPA, there are certain important topics that you would wish to know about, we will talk about the following important aspects of the company:

Role of Genins India Insurance TPA
How to file a claim?
How to login?
Health Card
Downloads
Network Hospitals
Customer Care
Mobile App

Role of Genins India Insurance TPA

As a TPA Company, Geninis India has the following roles:

Customer Enrollment: Potential customers are enrolled to their service after their sales team explains the benefits and features of their chosen insurance policy.
Claim Management: Once a customer is enrolled, it is the job of the TPA company to ensure that any claims initiated by the policyholder is managed by the TPA company.
Customer Support: The TPA company should act as a single point of contact for the policyholder as the customer has taken the insurance policy through the TPA company. All queries and grievances should be handled by the TPA company.
Issuance of Health Card: The TPA company handles the issuance of Health E-Cards. The policyholder can present this card to the hospital and avail treatment.

How to file a claim?

You can file a claim either online or offline. Let us talk about both methods below:

Offline claim submission

Step 1) Intimate your insurance agent or Genins TPA

The first thing you should do is immediately inform your agent or TPA company about the hospitalization.

Step 2) Decide on whether the claim will be a cashless claim or not

Now, you will have to take a call whether your claim will be a cashless claim or a reimbursement claim. If your claim is a cashless claim, then the entire claim will be directly handled by the insurance company and the hospital. If it is a reimbursement claim, then you will have to meticulously keep a record of all medical documents and store them safely.

Step 3) Submission of documents

If you opt for a reimbursement claim, you will have to submit all of the requested documents such as medical reports, diagnostic reports, admission summary, discharge summary, doctor’s reports, etc to the TPA company. All originals must be submitted. Keep a Xerox copy of all submitted documents for your personal record. Once all documents are submitted, the insurance company will assess the claim.

Online claim submission

You can also submit your claim online through the official website. Here’s how:

Step 1) Visit the official Genins TPA website

Step 2) Navigate to ‘Online Intimation’ button

Step 3) Enter your details

Here, you will need to enter the following details:

Card Number
Policy Number
Employee Code

Once entered, click on next and progress, your claim will be intimated to the company. Next, you will have to physically submit the documents to the TPA company to finish your claim submission process.

How to login?

In order to login you will need to visit the official Genins India TPA Website and navigate to the ‘Login’ section on the top bar.
Once you click on the ‘Login’ button, you will get a selection of logins, Agent login, Insured login, Corporate login, Hospital login, etc.
You will need to select your preferred login and enter your username policy number and click on ‘login.

Health Card

How can you download your Health E-Card?

Step 1) Visit the official website

Step 2) Navigate to the ‘Print E-Card’ button

Step 3) Download E-Card

Now, enter your policy number and employee number, and press on ‘Download E-Card.’

Downloads

There are a host of important documents and forms that you can download from the Genins India TPA Download Section, they are:

Authorization Request Form
Reimbursement Claim Form
Claim Intimation Form
PPN Declaration Form
KYC Guidelines
Cashless Claim Form
Claim Submission Checklist

Just navigate to the ‘Downloads’ section on the top bar of the home page and click on it. You will now be able to download all of the above forms and documents.

Network Hospitals

Why is it important to check out if your preferred hospital is a network hospital? Well, you can only avail cashless hospitalization through a network hospital. If you get admitted to a non-network hospital, you will have to opt for a reimbursement claim. Therefore, it is extremely important to check if your preferred hospital is an empaneled or network hospital.

Check if your hospital is a network hospital with Genins TPA by following the steps below:

Step 1) Visit the official Genins TPA Website

Step 2) Click on ‘Network Hospitals’

Step 3) Check your hospital

Now, enter the following details:

Insurance company
State
City

Now, click on ‘Search.’ You will now be presented a list of all empaneled hospitals for your selected city/state.

Customer Care

Department

Contact Details

Customer Support

18008902359 / +91-120-4144100

gil@geninsindia.com

Senior Citizens Helpline

+91-120-4144100

seniorcitizens@geninsindia.com

Source: Geninsindia.com

You can also reach out to them using their online form.

Mobile App

You can also access the various services and features of the company through their official mobile app (Android) here. The company, as of today does not have an IOS App for Apple users.

Paramount TPA (Claim Status, Customer Care, Hospital List, and more)

MD India Health Insurance TPA Pvt Ltd

Safeway TPA

Raksha Health Insurance TPA Pvt Ltd

Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.