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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.

Cholamandalam Health Insurance Policies

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.
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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.
Chola Healthline Benefits Organ Donor Expenses
  • 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.

Chola Swasth Parivar Medcial Needs of a Family

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.
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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.
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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.
Tax Plus Healthline 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 pNo 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, mNo 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.

Chola Accident Protection

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.

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