Cholamandalam Health Insurance

Chola MS General Insurance Company has been formed as a joint venture between two leading companies – the Murugappa Group and Mitsui Sumitomo Insurance Company Limited. The Murugappa Group is a leading Indian financial services company with its name established in the gold loan segment. Mitsui Sumitomo, on the other hand, is a Japan-based insurance company with multinational operations. Chola MS offers different types of general insurance policies whether it is for individuals or for corporates. Health insurance plans are also offered by the company in different variants so that they can fulfil individual coverage requirements.

Things to know about Chola MS

Here are some facts about Chola MS which make the company a formidable insurance player in the market –

1. The company is spread across India with a network of 87 branches and more than 34,000 agents selling its products
2. Ever since the company was established, it has been growing at a steady pace. In the year 2018, the company crossed the INR 40 million mark and collected a Gross Written Premium of INR 41, 026 million
3. The company has won various awards in the field of insurance. Some of these awards include the Golden Peacock Award for Risk Management, Best CSR Practice Award, etc.
4. The company has more than 89 lakh customers and it has an average claim settlement of 2.2 lakh claims in a year

Key features of Cholamandalam health insurance plans

Besides other general insurance plans, Chola MS also offers a variety of health insurance plans which have the following key features –

1. All health plans offered by the company promise lifelong renewals without any cover ceasing age
2. Indemnity health plans offered by the company cover the cost of hospitalisation in case of any injury or illness
3. Fixed benefit plans are also offered by the company which pay a lump sum benefit irrespective of actual medical costs that you incur
4. The premiums that you pay for Cholamandalam health insurance plans are allowed as a deduction under Section 80D of the Income Tax Act

Why choose Cholamandalam health insurance plans?

Here are some reasons which make Cholamandalam health insurance plans ideal solutions for your health insurance needs –

1. Cholamandalam health insurance offers a good combination of inbuilt as well as optional coverage benefits
2. The premiums of the plans are low and competitive allowing you to enjoy affordable health insurance coverage
3. A range of discounts are offered under Cholamandalam health insurance plans which help in lowering the premium that you pay
4. The company offers a Slice of Health Program which promotes healthy living among its policyholders
5. The company’s claim process is easy and it is tied up with all leading hospitals in the country to offer you cashless claim settlements

Health insurance plans offered by Chola MS

Chola MS offers four types of health insurance policies which are discussed below –

1. Chola Healthline Plan

   Chola Healthline is a comprehensive health insurance plan which covers the actual hospitalisation costs. The plan is, therefore, an indemnity oriented health insurance plan offered by the company. The plan has an extensive scope of coverage which allows coverage for most medical costs. The salient features of the plan are as follows –

   1. The plan is offered in four variants which are Value Healthline, Freedom Healthline, Enrich Healthline and Privilege Healthline. The sum insured and coverage features vary across the different variants
   2. Maternity and newborn baby coverage is available with Privilege Healthline variant
   3. The sum insured is doubled for critical illnesses and accidental claims under Enrich and Privilege plan variants
   4. Free health check-ups are available in all variants except Value Healthline
   5. You get premium discounts for choosing long term coverage and also depending on your location
   6. No co-payment is applicable under any variant of the plan except the Value Healthline variant

   Eligibility conditions of Chola Healthline Plan

   Entry age	Adults – 18 years to 65 years Dependent children – 90 days to 26 years
   Sum insured	INR 2 lakhs to INR 25 lakhs
   Term of the plan	1 year to 3 years
   Pre-entrance health check-ups	Not requireduntill 45 years of age
   Waiting period for pre-existing illnesses	48 months
   No claim bonus	5% increase in the sum insured after every claim-free year subject to a maximum of 25% for Value plan, 50% for Freedom and Privilege Plan. For Enrich Plan, the no claim bonus is a 50% increase in the sum insured subject to a maximum of 100%

2. Chola MS Critical Healthline Plan

   This is a critical illness policy which offers the payment of a fixed amount if the insured suffers from any of the covered critical illnesses. This benefit can then be used by the policyholder for meeting any type of financial requirement. The salient features of Chola MS Critical Healthline Plan are as follows –

   1. There are two plan variants which are Standard and Advanced
   2. Standard Plan covers 10 critical illnesses while the Advanced Plan covers 12 critical illnesses
   3. Ambulance charges of up to INR 1000 are also covered under the Advanced Plan

   Eligibility conditions of Chola MS Critical Healthline Plan

   Entry age	5 years to 65 years
   Sum insured	INR 3 lakhs, INR 5 lakhs and INR 10 lakhs
   Term of the plan	1 year
   Pre-entrance health check-ups	Not required until 55 years of age

3. Chola Super Top-up Healthline Plan

   This is a supplemental health insurance plan which comes with a deductible limit. If the total claims of a policy year exceed the deductible limit that you have selected, the super top-up policy would pay the exceeding claim. For instance, if the deductible limit is INR 2 lakhs and you incur two claims of INR 1 lakh and INR 1.5 lakhs in a policy year, the super top-up plan would become effective in the second claim and pay a claim of up to INR 50,000. Other features of this policy are as follows –

   1. You can buy the policy on an individual sum insured or on a floater sum insured basis
   2. There are two coverage options under the plan – Premier Plan and Supreme Plan
   3. There are a range of sum insured and deductible options available under both plan variants for you to select from
   4. There is no maximum cover ceasing age even for children
   5. There are more than 7760 cashless hospitals across India at which you can avail cashless settlements
   6. If three or more family members are added to the coverage, you get a premium discount ranging from 5% to 10%
   7. You get a premium discount of 6% for a two-year cover and 12% for choosing a three-year coverage
   8. If you buy the policy online from the company’s website, another 10% premium discount would be available
   9. AYUSH treatments are also covered under the plan

   Eligibility conditions of Chola Super Top-up Healthline Plan

   Entry age	3 months to 70 years
   Sum insured	INR 3 lakhs to INR 25 lakhs
   Deductible limit	INR 1 lakh to INR 20 lakhs
   Term of the plan	1 year to 3 years
   Pre-entrance health check-ups	Not required until 55 years of age
   Waiting period for pre-existing illnesses	Premier Plan – 48 months Supreme Plan – 36 months

4. Chola Hospital Cash Healthline Plan

   This is also a fixed benefit health insurance plan which covers hospitalisation. If you are an insured member is hospitalised for 24 hours or more, the plan would pay daily cash allowance for each day of hospitalisation. This allowance is fixed and does not depend on your medical expenses. The plan, therefore, helps you meet the incidental expenses of hospitalisation which are not covered under regular health insurance policies. The features of Hospital Cash policy are as follows –

   1. If you are admitted to the ICU, the cash allowance would double
   2. If hospitalisation exceed a period of 20 continuous days, a lump sum convalescence benefit would also be paid
   3. There are six plan variants to choose from and the daily benefit would depend on the plan option selected
   4. If two members are covered under the plan you get a premium discount of 5%. The discount increases to 10% if 3 or more members are covered

   Eligibility conditions of Chola Hospital Cash Healthline Plan

   Entry age	Adults – 18 years to 65 years Dependent children – 90 days to 26 years. Unmarried daughters can be covered up to 36 years
   Hospital daily cash benefit	INR 1000 to INR 3000
   Term of the plan	1 year to 3 years
   Pre-entrance health check-ups	Not required until 55 years of age
   Waiting period for pre-existing illnesses	48 months

Coverage benefits under Cholamandalam health insurance plans

The health insurance plans offered by Cholamandalam have a range of coverage benefits which provide coverage for different types of medical expenses. The common coverage features which are available under Healthline and Super Top-up Plans are as follows –

1. Hospitalisation expenses

   Under this head, the expenses incurred on hospitalisation of 24 hours or more are covered. These expenses include room rent, doctor’s fee, anaesthetist’s fee, surgeon’s fee, ICU Room rent, cost of blood, oxygen, medicines, etc. are covered. Coverage for hospitalisation expenses is covered up to the sum insured.

2. Pre hospitalisation expenses

   This covers the expenses covered if they are incurred before hospitalisation. Such expenses incurred include doctor’s fees, consultation charges, medicines, diagnostic tests, etc.

3. Post hospitalisation expenses

   Under this cover, expenses incurred after you are discharged from the hospital are covered. These expenses are incurred on monitoring your health and on diagnostic tests incurred on reviewing your recovery are covered.

4. Ambulance costs

   Costs incurred on hiring an ambulance for taking you to the hospital are covered under this head

5. Daycare treatments

   While hospitalisation cover covers the costs incurred when you are hospitalised for 24 hours or more, there are treatments which do not require hospitalisation for 24 hours. This is because of the advancement of medical technology due to which the treatments are done within a few hours. Such treatments are called daycare treatments and Cholamandalam health insurance plans cover specified or all types of daycare treatments.

6. Organ donor treatments

   Expenses incurred on harvesting an organ from a donor so that the organ can be used in your organ transplant surgery are covered under Cholamandalam health insurance plans. This coverage is available until the sum insured that you have selected.

7. Domiciliary treatments

   Treatments which you are forced to take at home are called domiciliary treatments. Such treatments are covered under Cholamandalam health insurance plans if there are no vacant hospital beds or if you are in no condition to be moved to a hospital. Domiciliary treatments can either be covered for a specified amount or up to the sum insured depending on the plan that you select.

8. Health check-ups

   Cholamandalam health insurance plans also offer you the benefit of free health check-ups at specified policy intervals. These health check-ups are allowed up to a specified limit and help you track your health and maintain a healthy lifestyle.

Other coverage benefits

The above-mentioned coverage features are the common coverage benefits which are available under both indemnity health insurance plans offered by Chola MS. Besides these coverage benefits, the following benefits can also be found in different plan variants either as inbuilt benefits or as optional covers–

1. AYUSH treatments

   AYUSH treatments involve treatments taken using Ayurveda, Unani, Siddha or Homeopathy means of medicine. These treatments are also called non-allopathic treatments and they are covered either up to the sum insured or up to a specified limit depending on the plan option that you choose.

2. Maternity expenses

   The costs incurred on pregnancy-related treatments and childbirth is also covered under some plans. Moreover, maternity benefit covers the prenatal and post-natal care which might be required for pregnant mothers. For childbirth, both normal and Caesarean deliveries are covered. There is a limit to the coverage amount available and maternity expenses are covered after a specified waiting period.

3. Newborn baby cover

   Under this cover, the newborn baby is covered from birth to three months. If the baby suffers any medical complications, the costs incurred on the required treatments would be covered.

4. Hospital cash allowance

   This offers fixed cash benefit if you or an insured member is hospitalised and the hospitalisation exceeds 24 hours. The allowance is paid per day of hospitalisation and is payable for a limited number of days in a policy period.

5. Sum insured restoration

   This is a benefit which is found in Cholamandalam health insurance plans. Under this benefit, the sum insured is refilled back to its original amount if the coverage is used up in earlier claims which occurred in the policy year. Thus, the benefit gives you the double sum insured coverage and comes in handy in case of multiple claims in a policy year.

6. Convalescence benefit

   If your hospital stay is for a long period of time, usually 10 days, the plan pays a lump sum benefit for the extended hospitalisation that you face.

Exclusions under Cholamandalam health insurance plans

Though the above-mentioned coverage benefits make Cholamandalam health insurance quite comprehensive in their scope of coverage, there are instances which are not covered by the plan. These instances are called exclusions and here is a list of common exclusions which are found in all health insurance policies offered by the company –

1. Illnesses which you suffer at the time of buying the policy. These illnesses are called pre-existing illnesses and they are excluded for a specific period called the waiting period. During this period, any complications due to the illness would not be covered
2. Illnesses which occur within 30-60 days of buying the policy are not covered
3. Specific illnesses and treatments have a waiting period of two years. During this waiting period, they are not covered
4. Any type of self-inflicted injury, deliberate physical harm and/or attempted suicides are not covered
5. Injuries or illnesses which occur due to substance abuse, addiction, criminal activities, wars, nuclear perils, etc. are not covered
6. Cosmetic treatments and circumcision are not covered
7. Dental treatments are usually excluded unless they are specifically covered by the policy
8. Cost of lenses, spectacles, hearing aids, etc. are excluded from the scope of coverage
9. Mental and congenital diseases and disorders are not covered under Cholamandalam health insurance plans
10. Participation in defence activities, hazardous sports and aviation would not be covered

How to buy Cholamandalam health insurance plans?

 When it comes to buying Cholamandalam health insurance plans, there are two ways using which you can buy the policy. They are as follows –

1. Offline

   Under the offline mode, you can buy a policy from the company’s branch office or from an agent of Chola MS. The company has more than 135 branches in India and you can approach the nearest branch office to buy the policy that you want. Alternatively, you can contact an agent of Chola MS and buy a suitable health insurance plan from him/her. Chola MS has a network of more than 8865 advisors and you can get in touch with an agent to buy Cholamandalam health insurance plan.

2. Online

   Another popular mode of buying a Cholamandalam health insurance plan is the online mode. Chola MS offers the online purchase mode for its health insurance policies. To buy online, you just have to visit the company’s websitehttps://www.cholainsurance.com/ and choose the plan that you want to buy. Provide your coverage details and the premium would be calculated. You can also choose optional coverage benefits to extend the scope of coverage. When you do so, the premium would be recalculated and displayed. Pay the premium online and you would be able to buy the plan from anywhere without having to visit the company’s branch or look for the company’s agent.

Points to remember before buying Cholamandalam health insurance

Before you proceed to buy Cholamandalam health insurance plans, here are some pointers which you should remember –

1. Ensure that you choose a suitable policy which fulfils your coverage requirements. If you want a complete scope of coverage, choose an indemnity oriented plan which covers the medical costs. If, on the other hand, you have an existing policy and want to increase your coverage, you can opt for super top-up plans as the premiums would be low. So, choose the most suitable policy as per your needs.
2. Read the coverage benefits which the policy offers and understand exactly which costs would be covered under the plan. If needed, choose the required add-ons to make the coverage customised to your needs
3. Also read through the exclusions so that you know the exact coverage benefits and the instances where the claims would not be paid
4. If you have a family who is dependent on you, buy a family floater health plan and cover all your family members under a single policy
5. The sum insured of the plan should be commensurate with the increasing medical costs. If the sum insured is low, you would face out-of-pocket expenses when the coverage proves insufficient in covering the medical costs.
6. The premium of the policy should be affordable so that you can easily renew the plan regularly without fail and enjoy lifelong coverage

How to renew Cholamandalam health insurance plans?

Renewal of Cholamandalam health insurance plans is also simple. The online portal of the company offers you an easy and instant renewal of your policy. Just visit the company’s website and choose to renew the plan. Thereafter you would have to enter in your policy details to check your existing plan. If you want you can make changes in your existing policy and then renew. To renew you would have to pay the renewal premium online and your policy would be instantly renewed.

Making a claim under Cholamandalam health insurance

A health insurance policy proves useful when you face an illness or an injury and need to be hospitalised for treatments. In that case, a claim occurs in your health insurance plan. To make a claim in the policy, you should take the following steps –

1. Inform Chola MS of your claim immediately
2. Fill up a pre-authorization form if you want the cashless settlement of your claims. The form is available at the networked hospital at which you are taking treatment and also on the website of the insurance company. The form should be filled and submitted in time. For planned hospitalisation cases, the form should be submitted to Chola MS at least 3-4 days before you are actually hospitalised. For emergency hospitalisations, however, you can get the form from the hospital and submit it within 24 hours of your hospitalisation
3. Once the company receives the pre-authorization form, your claim would be processed and approved
4. Once the claim is approved, the hospital would give you cashless treatments. The medical expenses associated with your treatments would be automatically settled by Chola MS with the networked hospital
5. After you are discharged from the hospital, fill up the claim form and submit it to the insurance company with the relevant documents needed for the claim
6. The company would assess the documents submitted and then complete the claim settlement process
7. If, on the other hand, you take treatments at a non-networked hospital, you should bear your medical costs from your own pockets. After being discharged from the hospital, fill up the claim form and submit the details of the expenses that you have incurred. Based on the documents submitted, the insurance company would reimburse you for the costs that you have incurred

Documents required for claim settlements

To get your claims duly settled, the following documents would have to be submitted to Chola MS –

• The claim form, filled and signed by the policyholder
• Policy bond
• Discharge summary collected from the hospital
• All the original medical bills and hospital bills associated with your treatment
• All the original medical reports and hospital reports associated with your treatment
• Doctor’s prescriptions where the hospitalisation has been advised
• Any other type of document which Chola MS might need based on your claim

Review of Cholamandalam health insurance

Chola MS offers a good range of health insurance plans of all kinds so that all your health insurance needs can be met. These plans offer a range of sum insured levels under different plan variants so that you can choose the coverage that you need. The premiums are low and there are different types of discounts which make the premiums more affordable. So, you can buy Cholamandalam health insurance plans without a doubt and enjoy a good scope of coverage.