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Get Lowest Rates for Health Insurance

Mediclaim Plans starting @ Rs 250* / month

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Chola Individual 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 Individual Healthline insurance is a complete health insurance product that not only allows coverage for hospitalization costs but also for other related expenses connected with it. The plan also provides coverage for maternity expenses and other charges like Spectacles, Contact lens, and Hearing Aids. It also covers costs for general health/eye check-up once in every two continuous claim free years.

Highlights Chola Individual Healthline Insurance Plan

  • Available in three variants – Standard, Superior & Advanced
  • 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
  • Income Tax Benefit Under Section 80D of the Income Tax Act 1961

Scope of cover

Indivdual Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18 years

Maximum : 65 years

Number of Members Covered

Maximum Members : 8

Maximum Adults : 6

Maximum Children : 5

Sum Insured

3 Lakh - 10 Lakh


discount

Discount on Opting for Co-pay

Policy Periods Available

Annual


Pre-Policy Medical Check-up

Above the age of 55 years

Family Floater 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

Important Features

DAY-CARE TREATMENTS
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Day Care Treatments

Includes surgical processes conducted using local or general anaesthesia which requires less than 24 hours of hospitalization because of technological advancement in healthcare. Each company has a specific list of processes which are covered under this category.

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

NO-CLAIM BENEFITS
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NO-CLAIM BENEFITS

Includes no claim benefits. If no claim is made during the policy period, you insurance company can offer you a cumulative bonus. While some companies provide increase in the sum assured annually up to certain limits. Some insurers provide discount on the renewal of premium.

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
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Organ Donor Cover

Includes coverage for in-patient hospitalization expenses, offered to an organ donor for his/her treatment on harvesting an organ for the insured.

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

PRE- HOSPITALIZATION
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Pre Hospitalization

Medical expenses incurred immediately before the insured individual is hospitalized are covered under this benefit. Usually, expenses up to 30 to 90 days before hospitalization are covered under the policy only after the in-patient hospitalization claim is accepted by the insurance company.

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

POST- HOSPITALIZATION
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Post Hospitalization

Medical expenses incurred immediately after the hospitalization are covered under this benefit.The coverage under this benefit would be available only for approved in-patient hospitalization claim is accepted by the insurance company. Usually, expenses up to 30 to 180 days post discharge are covered under the policy.

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
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PORTABILITY

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

TAX BENEFITS
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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
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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
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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.

You can claim for expenses towards Dental OPD treatments after a waiting period of 3 years with 30% Co-payment.

DAILY CASH FOR ACCOMPANYING ADULT IN CASE OF MINOR INSURED
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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 1 day deductible for a maximum of 7 and 14 days respectively.

DAILY HOSPITAL CASH
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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
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Emergency Ambulance

Includes coverage for expenses on ambulance for hospitalization of the insured.

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
Definition
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Home Hospitalization/ Domiciliary Hospitalization

Includes coverage for expenses borne when active treatment is provided to the insured (especially older patients) by health care professionals in the patient's home.

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
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Non- Allopathic Treatment Expense Cover

Includes coverage for expenses on treatment which do not use allopathic methods like Aurveda, Homeopathy, etc. The terms and conditions are different for different policies. This benefit is also refered to as Ayush benefit or Alternative treatment by some the insurers.

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
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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
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Eye-cover

Includes coverage for expenses on out-patient treatment of eyes. In some cases cost of spectacle is also covered under this benefit.

In Advanced Plan, if you renew the policy for three consecutive years, you are entitled to 70 % of the actual cost of either of One pair of spectacles or contact lenses OR a hearing aid (excluding batteries). From the fourth year, this benefit can be availed once in a block of two continuous renewals.

MATERNITY COVER
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Maternity cover

Includes coverage for delivery or related expenses of the insured. At times coverage for the new-born child is also provided under this benefit. https://www.coverfox.com/health-insurance/maternity-health-insurance/

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
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Dental Coverage

Includes coverage for out-patient dental treatment expenses.

Covered as part of the OPD treatment as mentioned above.

FREE LOOK PERIOD
Definition
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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
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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
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Room Rent / Room Category

Hospitals have a fixed tariff or rate chart for all rooms. Mediclaim depends on the amount of room rent limit specified in the policy document. The amount varies depending on the type of room category chosen.

In Standard and Superior Plans, you can opt for an AC Single Room up to Rs.3,000 per day. In Advanced Plan, you are entitled to an AC Single Room up to Rs.3,000 per day for Sum Insured Rs.4.5 Lakhs & Rs.5.5 Lakhs. For Sum Insured of Rs.7.5 lakhs and Rs.10 Lakhs, the limit is up to 1% of Sum Insured.

CO-PAYMENT
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Co-Payment

The fixed amount the policyholder has to pay for covered services when they get the service. When both insured and insurer pay part of the medical expenses, it is called as cost sharing. This is applicable based on the policy you choose.

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
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Sub-Limits

Includes the limits up to which specific conditions are covered under your policy. These limits are applicable for packaged treatments or some specific ailments listed in the policy.

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
Definition
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Cooling Off Period

The period begins right after commencement of the policy within which you cannot claim for any illness except claims related to accident. This period is not applicable for subsequent renewals.

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

Specific Diseases
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Specific Illness

The ailments of specific severity listed in the policy document are included under this category.

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

Pre-existing
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Pre-Existing Illnesses

The ailments that the insured was already diagnosed with before taking the policy.

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 Individual Healthline Insurance Plan

With a full range of benefits on offer such as OPD Cover towards Dental Treatments, Maternity, and External Aids, this plan is one to consider. The plan provides these benefits in three variants that you can choose as per your requirement of coverage and budget. And if you decide to overlook the co-payment clause and limits on room rent, you can surely explore it further to buy.

**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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