Cholamandalam Health Insurance Policies
About Cholamandalam Company
Cholamandalam MS General Insurance Company Limited, better known as Chola MS, is a joint venture between Murugappa Group and Mitsui Sumitomo Insurance Group of Japan. The Company has 105 branches across the country and has been honored with titles like 'Innovation Leader Award 2012', 'Health Insurance Claims Team for the year 2013' and 'Financial Innovations Award' among others.
Chola MS deals in automobile, travel, home and personal accident insurance besides health insurance. In the field of health insurance, Chola MS is known for providing a wide variety of convenient and comprehensive health packages that can be chosen as per need. The option of buying an online health insurance plan makes it all the more simple.
Why Choose Chola MS Health Insurance Plans?
Chola MS works on the core philosophies of trust, transparency, and technology and offers the following benefits in its plans:
- Cashless treatment at network hospitals.
- Cover for hospitalization as well as pre and post hospitalization charges.
- Health check-ups after a block of claim-free years.
- Lifetime renewability.
- 24x7 claim assistance and early claim settlement.
- Tax benefits under section 80-D of Income Tax Act.
I. Chola Healthline
This policy is a comprehensive health insurance policy which provides medical cover for an individual and his family on individual as well as floater sum insured basis.
The policy is available as three options:
- Value Healthline
- Freedom Healthline
- Enrich Healthline
Eligibility
- Age between 18 years to 65 years.
- Medical screening required. Expenses reimbursed up to 50% in Value and Freedom plans and 100% in Enrich plan on approval.
Key Features
- Policy is available on individual as well as family floater basis.
- Policy term can be 1,2 or 3 years.
- Lifetime renewability option is available if premiums are paid regularly without a break.
- Different options are available for sum insured in different plans.
- Value - Rs. 2 lakhs
- Freedom - Rs. 3,5 or 7 lakhs.
- Enrich - Rs. 3,5,7.5 or 10 lakhs.
- Discount of 6% on a 2-year term and 12% for a 3-year term.
- Co-payment of 10% only in the Value Healthline plan.
Benefits
- Hospitalization Expenses - The policy covers expenses for hospitalization more than 24 hours.
- Pre-hospitalization Charges - For a period of
- 30 days (Value Plan),
- 60 days (Freedom & Enrich Plans) before hospitalization.
- Post-hospitalization Charges- For a period of
- 60 days (Value Plan),
- 90 days (Freedom & Enrich Plans) after hospitalization.
- Emergency Ambulance Charges - Up to an amount of
- Rs. 1000 (Value Plan).
- Rs. 2000 (Freedom & Enrich Plans).
- Cumulative Bonus - On the sum insured for every claim free year, of
- 5% per year, up to a maximum of 25% (Value Plan).
- 5% per year, up to a maximum of 50% (Freedom Plan).
- 50% per year, up to a maximum of 100% (Enrich Plan).
- Domiciliary Treatment Expenses - For a maximum of 7 days per policy year.
- AYUSH Expenses - On treatment under Ayurveda, Unani,Siddha, and Homeopathy
- Organ Donor Expenses - In the case of an organ transplant.
- Additional Benefits of Enrich Healthline
- Child hospitalization allowance per hospitalization - Up to Rs. 500 per day for 7 days.
- Extended hospitalization allowance - Up to Rs. 10000.
- Double sum insured - For critical illnesses.
If in case the policy has been taken on a family floater basis, the above mentioned shall represent the maximum liability of the Company for any and all claims made by the insured during the policy period.
Exclusions Under the Policy
The main exclusions under the policy are:
- A waiting period of 30 days for all medical conditions except in the case of an accident.
- Pre-existing diseases shall be covered after 4 continuous policy years.
- A waiting period of 2 years for the following diseases:
- Congenital internal disease
- Varicose veins
- Arthritis of any kind
- Treatment of diseases of ear/tonsils/adenoids/paranasal sinuses/nasal septum
- Stones in the urinary and biliary system
- Gastric and duodenal ulcers
- Benign hypertrophy of prostate
- Fissures and fistula
- Cataract
- All types of hernias
- Joint replacement surgery, except if due to an accident.
II. Chola Swasth Parivar
This plan takes care of all kinds of medical needs of a family by providing cover for hospitalization expenses for the family on floater basis and personal accident cover on individual sum insured basis.
Key Features
- Dual protection of hospitalization cover as well as personal accident cover.
- Option of choosing from two plans.
- No medical check-up required till 55 years of age.
- Lifetime renewability.
- Tax Exemption under section 80-D of Income Tax Act.
Eligibility
- Age between 18 years to 65 years.
Benefits
Benefits under the policy depend on the plan availed.
| PEARL PLAN (only section 1 is applicable) | |||
| Features | Plan 1 | Plan 2 | Plan 3 |
| Hospitalization expenses (per family per year) | 300000 | 400000 | 500000 |
| Compulsory co-payment on every claim | 15% | ||
| Room rent | 1% of sum insured | ||
| ICU rent | 1.5% of sum insured | ||
| Post-Hospitalization | Up to 60 days after discharge | ||
| Pre-hospitalization | Up to 30 days before hospitalization | ||
| Day care procedures | Covered | ||
| ROYALE PLAN (Both section-1 and section-2 are applicable) | |||
| Features | Plan 1 | Plan 2 | Plan 3 |
| Coverage section-1 | |||
| Hospitalization expenses (per family per year) | 300000 | 400000 | 500000 |
| Compulsory co-payment | 15% on every claim | ||
| Room rent | 1% of the sum insured | ||
| ICU rent | 1.5% of the sum insured | ||
| Post-hospitalization | Up to 60 days after discharge | ||
| Pre-hospitalization | Up to 30 days before hospitalization | ||
| Day care procedures | Covered | ||
| Coverage section-2 | |||
| Personal Accident - Self | |||
| Death | 750000 | 1000000 | 1000000 |
| Permanent total disablement | 750000 | 1000000 | 1000000 |
| Permanent partial disablement | 375000 | 500000 | 500000 |
| Personal Accident - Spouse | |||
| Death | 375000 | 500000 | 500000 |
| Permanent total disablement | 375000 | 500000 | 500000 |
| Permanent partial disablement | 187000 | 250000 | 250000 |
| Personal Accident - Per Child (Maximum 2 Children) | |||
| Death | 150000 | 200000 | 200000 |
| Permanent total disablement | 150000 | 200000 | 200000 |
| Permanent partial disablement | 75000 | 100000 | 100000 |
Exclusions
Mainly, the following are not covered under the policy:
- Pre-existing conditions till 4 years of continuous policy period.
- Expenses on any medical condition in the first 30 days of the policy. This does not apply to accidents.
- Congenital internal disease, treatment of diseases of ear/tonsils/adenoids/paranasal sinuses/nasal septum, Benign hypertrophy of prostate, fissures, and fistula, cataract, all types of hernias, hysterectomy, hydrocele-for 1 year of policy (Royale plan)
- Congenital Internal disease, hysterectomy, hydrocele, spondylitis, spondylosis, varicose veins, arthritis of any kind, treatment of diseases of ear/tonsils/adenoids/paranasal sinuses/nasal septum, stones in the urinary and biliary system, gastric and duodenal ulcers, Benign Hypertrophy of Prostate, fissures and fistula, cataract, all types of hernia, joint replacement surgery- for 2 years of policy (Pearl plan).
- Intentional self-injury or harm.
- Terrorist act.
- Participation in any professional sport.
III. Tax Plus Healthline
This is a unique health insurance plan which covers both hospitalization and non-hospitalization (OPD) expenses. It is available on individual as well as family floater basis.
Key Features
- It has fixed premium options.
- No medical check-up required up to 55 years of age.
- Lifetime renewability.
- 5% claim free bonus per year, up to a maximum of 50%.
Eligibility
- Age between 18 years to 65 years.
- Self, spouse, parents and dependent children may be covered under the policy.
Benefits
Section-1
- Room Rent- Up to 1% of the sum insured.
- ICU Rent - Up to 2% of the sum insured.
- Pre-hospitalization Expenses - Up to a period of 60 days before hospitalization.
- Post-hospitalization Expenses - Up to a period of 90 days after discharge.
- Ambulance Charges - In the case of an emergency, up to Rs. 3000.
- Sub-limits - There are sub-limits in case of the following conditions:
- Cataract - 7.5% of section-1 SI, up to Rs. 20000 (per eye).
- Hernia or hydrocele - 10% of section-1 SI, up to Rs.30000.
- Fistula, fissures, piles - 10% of section-1 SI, up to Rs.30000.
- Sinusitis - 10% of section-1 SI, up to Rs.30000.
- Tonsillitis/adenoids - 15% of SI, up to Rs. 40000.
Section-2
The following are covered up to plan limits:
- Treatment of illness/injury without hospitalization.
- Pre and post-natal expenses.
- All pre-existing diseases.
- Ayush expenses for treatment under Ayurveda, Siddha and Homeopathy.
- Cost of spectacles, contact lenses or hearing aids.
- All dental treatment.
Exclusions
The main exclusions under the policy are:
- Pre-existing conditions till 4 continuous policy years.
- Treatment of any condition/illness in the first 30 days of the policy. It is not applicable in the case of accidents.
- Congenital internal disease, treatment of diseases of tonsils/adenoids, benign hypertrophy of prostate, fissures, and fistula, cataract, all types of hernias, hydrocele - till 1 year of the policy.
- Hysterectomy, hydrocele, spondylitis, spondylosis, varicose veins, arthritis of any kind, treatment of diseases of ear/tonsils/adenoids/paranasal sinuses/nasal septum, stones in the urinary and biliary system, gastric and duodenal ulcers, benign hypertrophy of prostate, fissures and fistula, cataract, all types of hernia, joint replacement surgery - till 2 years of policy.
IV. Family Healthline Insurance
It is a family floater plan that provides cover for allopathic as well as non-allopathic treatments.
Key Features
- Expenses on non-allopathic and allopathic treatments are covered.
- Maternity, dental and eye treatment cover available.
- Lifetime renewability.
- Floater sum assured up to Rs. 15 lakhs.
- Direct claim settlement without TPA involvement.
Benefits
- The policy is available as three plans and the benefits vary as per chosen plan.
| Benefits | Standard | Superior | Advanced |
| Floater sum insured (in lakhs) | 2/3/4/5 | 4/6/8/10 | 6/8/10/12/15 |
| Claim free bonus up to 50% of SI | 5% of SI every claim free year | ||
| Daily cash for shared accommodation (1-day deductible) | Rs. 250/day for maximum 7 days | Rs. 500/day for maximum 7 days | Rs. 500/day for maximum 14 days |
| Minor accompaniment daily cash (1-day deductible) | Rs. 250/day for maximum 7 days | Rs. 250/day for maximum 14 days | |
| Health check-up & eye examination | 0.5% of SI after 2 claim free years | 0.75% of SI after 2 claim free years | 1% of SI after 2 claim free years |
| Ambulance | Rs. 1000 | Rs. 2000 | Rs. 3000 |
| Domiciliary treatment | 15% of SI,max Rs. 70000 | Up to 25% of SI, max Rs. 1 lakh | |
| Maternity benefits (waiting period - 5 years) | Rs. 15000 for normal & Rs. 25000 for cesarean section | Rs. 25000 for normal & Rs. 40000 for cesarean section | |
| AYUSH treatment | Up to 7.5% of SI for specific treatments only, 20% co-payment | ||
| Dental treatment (waiting period -3 years) | Up to 1% of SI, max Rs. 5000 with 30% co-payment | ||
| Cost of spectacles, hearing aids, contact lenses | 1% of SI, max Rs. 5000 once in a 2-year block, 30% co-payment | ||
| Sub-limits | Cataract - 7.5% of SI, max Rs.20000 per eye Hernia/hydrocele - 10% of SI, max Rs. 30000 Fistula/fissures/piles - 10% of SI, max Rs. 30000 Sinusitis - 10% of SI, max Rs. 30000 Tonsillitis/adenoids - 15% of SI, max Rs. 40000 | Cataract- 7.5% of SI, max Rs.20000 p | No sub-limits |
Exclusions
- Pre-existing conditions till 4 continuous policy years.
- Treatment of any condition/illness in the first 30 days of the policy. It is not applicable in the case of accidents.
- Treatment of diseases of sinusitis, benign hypertrophy of prostate, fissures, and fistula, cataract, all types of hernias, hydrocele - till 1 year of the policy.
- Hysterectomy, hydrocele, spondylitis, spondylosis, varicose veins, arthritis of any kind, congenital internal disease, treatment of diseases of ENT, stones in the urinary and biliary system, gastric and duodenal ulcers, benign hypertrophy of prostate, fissures and fistula, cataract, all types of hernia, joint replacement surgery - till 2 years of policy.
V. Individual Healthline
This insurance policy provides a cover not only for the expenses incurred on hospitalization charges but also the incidental expenses.
Key Features
- Sum insured up to Rs. 10 lakhs.
- Cashless hospitalization at network hospitals.
- No medical required up to 55 years of age.
- Lifetime renewability
Eligibility
- Age between 18 years to 65 years.
- Dependent child between 3 months to 35 years (female) or 25 years (male).
Benefits
The benefits vary as per the plan chosen:
| Benefits | Standard | Superior | Advanced |
| Floater sum insured (in lakhs) | 1/2/3/4/5 | 3.5/4.5/5.5 | 4.5/5.5/7.5/10 |
| Claim free bonus up to 50% of SI | 5% of SI every claim free year | ||
| Daily cash for shared accommodation (1-day deductible) | Rs. 250/day for maximum 7 days | Rs. 500/day for maximum 7 days | Rs. 500/day for maximum 14 days |
| Minor accompaniment daily cash (1-day deductible) | Rs. 250/day for maximum 7 days | Rs. 250/day for maximum 14 days | |
| Health check-up & eye examination | 0.5% of SI after 2 claim free years | 0.75% of SI after 2 claim free years | 1% of SI after 2 claim free years |
| Ambulance | Rs. 1000 | Rs. 2000 | Rs. 3000 |
| Domiciliary treatment | 15% of SI, max Rs. 70000 | Up to 25% of SI, max Rs. 1 lakh | |
| Maternity benefits (waiting period - 5 years) | Rs. 15000 for normal & Rs. 25000 for cesarean section | Rs. 25000 for normal & Rs. 40000 for cesarean section | |
| AYUSH treatment | Up to 7.5% of SI for specific treatments only, 20% co-payment | ||
| Dental treatment (waiting period -3 years) | Up to 1% of SI, max Rs. 5000 with 30% co-payment | ||
| Cost of spectacles, hearing aids, contact lenses | 1% of SI, max Rs. 5000 once in a 2-year block, 30% co-payment | ||
| Sub-limits | Cataract - 7.5% of SI, max Rs.20000 per eye Hernia/hydrocele - 10% of SI, max Rs. 30000 Fistula/fissures/piles - 10% of SI, max Rs. 30000 Sinusitis - 10% of SI, max Rs. 30000 Tonsillitis/adenoids - 15% of SI, max Rs. 40000 | Cataract - 7.5% of SI, m | No sub-limits |
Exclusions
- Pre-existing conditions till 4 continuous policy years.
- Treatment of any condition/illness in the first 30 days of the policy. It is not applicable in the case of accidents.
- Treatment of diseases of sinusitis, benign hypertrophy of prostate, fissures, and fistula, cataract, all types of hernias, hydrocele - till 1 year of the policy.
- Hysterectomy, hydrocele, spondylitis, spondylosis, varicose veins, arthritis of any kind, congenital Internal disease, treatment of diseases of ENT, stones in the urinary and biliary system, gastric and duodenal ulcers, benign hypertrophy of prostate, fissures and fistula, cataract, all types of hernia, joint replacement surgery - till 2 years of policy.
VI. Chola Topup Healthline
This is a top-up plan that can be taken over and above an insurance policy to provide cover for higher medical expenses.
Key Features
- Option to choose from 7 plans.
- Available on individual and floater basis.
- Policy term of 1/2/3 years can be chosen.
- No medical required till 55 years of age.
Eligibility
- Age between 18 years to 65 years.
- Dependent child between 3 months to 35 years (female) or 25 years (male).
Benefits
The following benefits are available as per the plan chosen:
| Plan option | Plan A | Plan B | Plan C | Plan D | Plan E | Plan F | Plan G |
| Hospitalization sum insured (over deductible) | 50000 | 2 lakhs | 3 lakhs | 5 lakhs | 6 lakhs | 10 lakhs | 15 lakhs |
| Deductible | 30000 | 1 lakh | 2 lakhs | 3 lakhs | 4 lakhs | 5 lakhs | 5 lakhs |
| Total hospitalization expenses | 80000 | 3 lakhs | 5 lakhs | 8 lakhs | 10 lakhs | 15 lakhs | 20 lakhs |
| Room rent | 500 | 2000 | 4000 | 5000 | 6000 | 7500 | 10000 |
| Pre-hospitalization expenses | Up to 60 days before hospitalization. Up to 5% of admissible claim hospitalization payable. | ||||||
| Post-hospitalization expenses | Up to 90 days after hospitalization. Up to 10% of admissible claim hospitalization payable or Rs. 50000, whichever is less. | ||||||
| Ambulance | Up to Rs. 3000 | ||||||
Exclusions
- Pre-existing conditions till 4 continuous policy years.
- Treatment of any condition/illness in the first 30 days of the policy. It is not applicable in the case of accidents.
- Treatment of diseases of sinusitis, benign hypertrophy of prostate, fissures, and fistula, cataract, all types of hernias, hydrocele - till 1 year of the policy.
- Hysterectomy, hydrocele, spondylitis, spondylosis, varicose veins, arthritis of any kind, congenital Internal disease, treatment of diseases of ENT, stones in the urinary and biliary system, gastric and duodenal ulcers, benign hypertrophy of prostate, fissures and fistula, cataract, all types of hernia, joint replacement surgery - till 2 years of policy.
VII. Critical Healthline Insurance
This insurance policy has been specifically designed to provide financial support in case of diagnosis of 12 listed critical illnesses.
Key Features
- Lump sum payment on diagnosis of any of the listed critical illnesses.
- No medical required up to 55 years of age.
- Lifetime renewability option.
- Option to choose from 2 plans.
Eligibility
- Age between 18 years to 65 years.
- Dependent child between 5 years to 25 years of age may be covered.
Benefits
- Sum insured option of 3/5/10 lakhs.
- Ambulance charges in the case of emergency - Rs. 1000 in the Advanced plan.
- Lump sum amount on the diagnosis of any of the listed critical illnesses as per the plan chosen, after the specified survival period.
There are two options available: Standard and Advanced.
The critical illnesses covered under both plans are:
| Standard plan & Advanced plan | |
| Critical illness covered | Survival period |
| Cancer of specified severity | 30 days |
| First heart attack of specified severity | 30 days |
| Open heart surgery (CABG) | 30 days |
| Stroke resulting in permanent symptoms | 90 days |
| Kidney failure requiring dialysis | 30 days |
| Multiple sclerosis with persisting symptoms | 180 days |
| Permanent paralysis of limbs | 180 days |
| Major organ/bone transplant | 30 days |
| Aortic surgery | 30 days |
| Primary pulmonary hypertension | 30 days |
The following are additionally covered in the Advanced plan:
| Only in Advanced plan | |
| Critical illness covered | Survival period |
| Parkinson's disease | 180 days |
| Motor neuron disease | 90 days |
Exclusions
The main exclusions under the policy are:
- Any critical illness diagnosed in the first 90 days of the policy.
- Any critical illness arising due to a pre-existing condition.
- Intentional self-harm.
- The death of insured before survival period.
VIII. Hospital Cash Healthline
This policy provides a fixed daily allowance for every completed 24 hours of hospitalization to cover the related miscellaneous expenses.
Key Features
- Daily cash as well as convalescence benefit.
- Option to choose from 3 plans.
- No medical required till 55 years of age.
- 10% family discount on premium.
- Lifetime renewability.
Eligibility
- Age between 18 years to 65 years.
- Dependent child between 3 months to 36 years can be covered.
Benefits
The benefits vary as per the plan chosen:
| Benefits | Plan A | Plan B | Plan C |
| Hospitalization daily cash (per day), maximum 20 days | 1000 | 2000 | 3000 |
| ICU benefit (per day) | 2000 | 4000 | 6000 |
| Convalescence benefit | 10000 | 15000 | 20000 |
Exclusions
- Pre-existing conditions till 4 continuous policy years.
- Treatment of any condition/illness in the first 30 days of the policy. It is not applicable in the case of accidents.
- Treatment of diseases of sinusitis, benign hypertrophy of prostate, fissures, and fistula, cataract, all types of hernias, hydrocele - till 1 year of the policy.
- Hysterectomy, hydrocele, spondylitis, spondylosis, varicose veins, arthritis of any kind, congenital Internal disease, treatment of diseases of ENT, stones in the urinary and biliary system, gastric and duodenal ulcers, benign hypertrophy of prostate, fissures and fistula, cataract, all types of hernia, joint replacement surgery - till 2 years of policy.
IX. Chola Accident Protection
Besides health insurance plans, Chola MS also offers accident protection plan which provides financial security in the case of an accident.
Key Features
- Daily cash benefits for hospitalization.
- Compensation for loss of income due to disability.
- Coverage on a worldwide basis.
Eligibility
- Age between 18 years to 69 years of age.
- Dependent children up to 25 years of age can be covered.
Benefits
- Hospital Daily Cash - For hospitalization due to an accident.
- Disability Compensation - A weekly compensation for loss of income due to disability.
- Fracture Compensation - A fixed compensation is given for fracture of bones due to an accident.
- Private Tuition Fee - In case the insured cannot attend school/college due to disability.
- Family Transportation - To the location of the insured in case of death/total permanent disability.
- Transport of Mortal Remains - In the event of death, from the accident site to the hospital/home/crematorium.
- Death Compensation - In the case of death of the insured, the nominee is paid the sum insured.
- Permanent Total Disability - In the case of permanent total disability (as defined in the policy document), compensation of 100% of sum insured is given.
- Permanent Partial Disability - In the case of permanent partial disability (as defined in the policy document), compensation is paid as a specified percentage of the sum insured, as per the disability.
Exclusions
The main exclusions under the policy are:
- War or related perils.
- Participation in military operations.
- Intentional self-harm or injury.
- Loss sustained under the influence of alcohol or other intoxicating substance.
Reference:
This information is extracted from the company�s official website to provide information to the general public. The information is likely to change based on the concerned insurance company�s discretion. Alterations, deletions and/or additions to the existing policy products, coverage, and their premiums may be enhanced or reduced. These figures are only guidelines. We recommend the individual to visit the official website of the insurance company for more details and updated matters.Cite this Article ⇣⇡
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APA
Dr. Shivani Shourie. (2020, June 22). Cholamandalam (Chola MS) Health Insurance Policies - Key Features, Eligibility and Claim Benefits. Medindia. Retrieved on Nov 17, 2024 from https://www.medindia.net/health/conditions/cholamandalam-company-health-insurance.htm.
MLA
Dr. Shivani Shourie. "Cholamandalam (Chola MS) Health Insurance Policies - Key Features, Eligibility and Claim Benefits". Medindia. Nov 17, 2024. <https://www.medindia.net/health/conditions/cholamandalam-company-health-insurance.htm>.
Chicago
Dr. Shivani Shourie. "Cholamandalam (Chola MS) Health Insurance Policies - Key Features, Eligibility and Claim Benefits". Medindia. https://www.medindia.net/health/conditions/cholamandalam-company-health-insurance.htm. (accessed Nov 17, 2024).
Harvard
Dr. Shivani Shourie. 2020. Cholamandalam (Chola MS) Health Insurance Policies - Key Features, Eligibility and Claim Benefits. Medindia, viewed Nov 17, 2024, https://www.medindia.net/health/conditions/cholamandalam-company-health-insurance.htm.