- About Coverfox
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.
For children : 91 days
Minimum : 18 years
Maximum : 65 years
Maximum Members : 8
Maximum Adults : 6
Maximum Children : 5
3 Lakh - 10 Lakh
Discount on Opting for Co-pay
Above the age of 55 years
For children : NA
Minimum : NA
Maximum : NA
Maximum Members : NA
Maximum Adults : NA
Maximum Children : NA
The plan covers the expenses towards 141 day-care procedures that would otherwise require hospitalization of a minimum of 24 hours.
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.
You are covered for Organ transplantation costs including the treatment costs of the donor but excluding the costs of the organ.
Compensates for the Pre-Hospitalisation expenses for consultations, investigations and medicines incurred up to 60 days before Hospitalisation
Compensates for the Post-Hospitalisation expenses for consultations, investigations and drugs incurred up to 90 days after discharge from Hospitalisation.
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.
You can avail tax benefits for the premium amount paid towards this plan under Section 80D of the Income Tax Act,1961.
You can apply for enhancement of Sum Insured at the time of renewal by submitting a new proposal form to the company.
You can claim for expenses towards Dental OPD treatments after a waiting period of 3 years with 30% Co-payment.
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.
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.
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.
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.
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.
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.
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.
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.
Covered as part of the OPD treatment as mentioned above.
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.
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.
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.
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.
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.
A 30 days cooling off period for all claims except any arising out of accidental injuries.
24 months waiting period for few listed conditions like any types of Cataract, Benign prostatic hypertrophy, Hysterectomy, Endometriosis, Fibromyoma, etc.
You can claim for any pre-existing conditions after 48 months from the policy start date.
The Plan will not cover any liabilities towards the treatments of following conditions-
The detailed list of what the policy does not cover is available in the policy wording.
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.