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Chola Family Healthline Insurance Plan

Chola MS General Insurance Company Limited (IRDA Reg. No. 123) is a strong partnership between Murugappa Group and Mitsui Sumitomo Insurance Group of Japan. Chola MS offers an extensive array of products that include Engineering, Health, Accident, Marine, Motor, Liability, Travel, Property as well as rural insurance for individuals and corporates.

Chola MS's Family Healthline is a comprehensive family coverage suited for young and growing families. Extensive and versatile, this medical insurance plan allows cover for a series of health demands covering Ayurvedic treatments, Maternity, Dental and Eye care beyond standard covers provided by a regular mediclaim policy. It includes you, your spouse and children with a Floater Sum Insured that allows any family member to claim up to its limit.

Highlights Chola Family Healthline Insurance Plan

  • Available in three variants – Standard, Superior & Advanced up to a sum insured of Rs.15 Lakhs
  • Pays for Pre and post hospitalization expenses for 30 and 60 days respectively.
  • Covers 141 daycare treatments that would otherwise require a minimum of 24 hrs hospitalization
  • No medical pre-policy medical checkup up to 55 years
  • Offers lifetime renewability option for continued coverage
  • Cashless hospitalization at over 2,600 hospitals
  • Direct claims settlement through Chola MS Help without involving any third party administrator
  • Income Tax Benefit Under Section 80D of the Income Tax Act 1961

Scope of cover

Indivdual Plan

Entry Age

For children : NA

Adults :

Minimum : NA

Maximum : NA

Number of Members Covered

Maximum Members : NA

Maximum Adults : NA

Maximum Children : NA

Sum Insured

NA


discount

NA

Policy Periods Available

NA


Pre-Policy Medical Check-up

NA

Family Floater Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18 years

Maximum : 65 years

Number of Members Covered

Maximum Members : 4

Maximum Adults : 2

Maximum Children : 2

Sum Insured

2 Lakhs - 15 Lakhs


discount

On Opting for Co-Pay of 10%

Policy Periods Available

Annual


Pre-Policy Medical Check-up

Above the age of 55 years

Important Features

DAY-CARE TREATMENTS

The plan covers the expenses towards 141 day-care procedures that would otherwise require hospitalization of a minimum of 24 hours.

    NO-CLAIM BENEFITS

    For every claim free year, you will get an increase of 5% in your sum insured up to a maximum of 50%. However, with every claim, the reduction in sum insured will also be at 5% up to your original sum insured.

      ORGAN DONOR COVER

      You are covered for Organ transplantation costs including the treatment costs of the donor but excluding the costs of the organ.

        PRE- HOSPITALIZATION

        Compensates for the Pre-Hospitalisation expenses for consultations, investigations and medicines incurred up to 60 days before Hospitalisation

          POST- HOSPITALIZATION

          Compensates for the Post-Hospitalisation expenses for consultations, investigations and drugs incurred up to 90 days after discharge from Hospitalisation.

            Good to Have Benefits

            PORTABILITY

            If you are currently insured with a different insurer and wish to switch to Chola Family Healthline Insurance Plan, you can do the same without losing your accrued benefits after the waiting periods.

              TAX BENEFITS

              You can avail tax benefits for the premium amount paid towards this plan under Section 80D of the Income Tax Act,1961.

                SUM ASSURED ENHANCEMENT

                You can apply for enhancement of Sum Insured at the time of renewal by submitting a new proposal form to the company.

                  OPD EXPENSE COVER

                  In Advanced Plan, you can claim for expenses towards Dental OPD treatments after a waiting period of 3 years with 30% Co-payment up to a maximum of 1% of Sum Insured or Rs.5,000, whichever is less.

                    DAILY CASH FOR ACCOMPANYING ADULT IN CASE OF MINOR INSURED

                    This benefit entitles you to claim up to Rs. 250 per day in Superior and Advanced with a one day deductible for a maximum of 7 and 14 days respectively.

                      DAILY HOSPITAL CASH

                      If you choose shared accommodation, you are entitled to Daily Cash Allowance with one-day deductible up to Rs. 250 per day for a maximum of 7 days in Standard Plan, Rs. 500 per day for a maximum of 7 days in Superior Plan and Rs. 500 per day for a maximum of 14 days in the Advanced Plan.

                        EMERGENCY AMBULANCE

                        You are entitled to the expenses towards the Emergency Ambulance up to Rs. 1,000 in Standard Plan, Rs.2,000 in Superior Plan and Rs.3,000 in Advanced Plan.

                          HOME HOSPITALIZATION/DOMICILIARY HOSPITALIZATION

                          In Superior and Advanced Plans, you can claim up to Rs. 15% of the SI (Max. Rs.70,000) and 25% of the SI (Max. Rs.1 Lakh) respectively.

                            NON-ALLOPATHIC TREATMENT COVER

                            In Advanced Plan, you can claim for any Ayurvedic treatment up to a maximum of 7.5% of sum insured with 20% co-pay. For details on this benefit, please refer the policy schedule.

                              Value Adds

                              DISCOUNTS

                              You have the option to avail 10% Co-Payment on all claims under the policy. By opting this co-payment, you get a discount on the premium.

                                EYE-COVER

                                In Advanced Plan, if you renew the policy for three consecutive years, you are entitled to compensation of the costs towards these aids up to 1% of sum insured to a maximum of Rs.5,000. From the fourth renewal, this benefit can be availed once in a block of two continuous renewals.

                                  MATERNITY COVER

                                  In Superior and Advanced Plan, you can claim this benefit up to a maximum of Rs.15,000 for Normal Delivery & Rs.25,000 for a Caesarean AND Rs.25,000 for Normal Delivery & Rs.40,000 for a Caesarean respectively after a waiting period of five years.

                                    DENTAL COVER

                                    Covered as part of the OPD treatment as mentioned above.

                                      FREE LOOK PERIOD

                                      For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within 15 days from the date of receipt of the policy document.

                                        GENERAL HEALTH CHECK-UP & EYE EXAMINATION

                                        Once in every two continuous renewals, you can claim this benefit up to 0.5% of Sum Insured, 0.75% of Sum Insured & 1% of Sum Insured in Standard, Superior, and Advanced Plan respectively.

                                          Terms & Conditions

                                          ROOM RENT/ ROOM CATEGORY

                                          In Standard Plan, you can opt for an AC Single Room up to Rs.3,000 per day. In Superior Plan, the limits are up to Rs.3,000 or 1% of sum insured depending on the sum insured you have opted. And in Advanced Plan, the limit is up to 1% of Sum Insured.

                                            CO-PAYMENT

                                            20% Co-payment on Ayurvedic Treatments. 30% Co-payment on OPD Dental Treatments. 20% Co-payment for claims related to any member who is above 70 years. 30% Co-payment on claims related to External Aids like Spectacles, etc.

                                              SUB-LIMITS ON SURGERY

                                              Certain surgeries like Cataract, Hernia, Tonsillectomy and so on have a capping on the cost that varies between Rs.20,000 to Rs.40,000. The details are mentioned in the policy schedule.

                                                Waiting Period

                                                Cooling off period

                                                A 30 days cooling off period for all claims except any arising out of accidental injuries.

                                                  Specific Diseases

                                                  24 months waiting period for few listed conditions like any types of Cataract, Benign prostatic hypertrophy, Hysterectomy, Endometriosis, Fibromyoma, etc.

                                                    Pre-existing

                                                    You can claim for any pre-existing conditions after 48 months from the policy start date.

                                                      Permanent Exclusions

                                                      The Plan will not cover any liabilities towards the treatments of following conditions -

                                                      • Attempted suicide
                                                      • Use of alcohol or drug
                                                      • AIDS
                                                      • Congenital diseases
                                                      • Cosmetic, aesthetic or related treatment
                                                      • The treatment of obesity (including morbid obesity) and any other weight control programs, services, or supplies
                                                      • Infertility and in vitro fertilization.
                                                      • Hospitalization out of war, riot, strike and nuclear weapons

                                                      The detailed list of what the policy does not cover is available in the policy wording.

                                                      Review of Chola Family Healthline Insurance Plan

                                                      Chola MS's Family Healthline is quite a deep insurance cover. It provides almost all the medical benefits including Maternity, Hospitalization Expenses, Dental Cover, Cost of Spectacles and Hearing Aids and so on. However, the strict co-payment clauses clubbed with rigid room rent limits restraints the plan.

                                                      **Reviews and ratings are based only on Benefits and Conditions. Things like Claim Settlement Ratio, Hospital Network have not been covered under product ratings. These are covered under Company ratings.

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