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Swasth Parivar Pearl Plan

Cholamandalam MS Health Insurance

3.5/5 22 User Reviews

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.

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Highlights of Chola Swasth Parivar Insurance – Pearl Plan

  • Available in three variants – Plan 1 (SI-Rs.3 lakh), Plan 2 (SI-Rs.4 lakh), Plan 3 (SI-Rs.5 lakh)
  • 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
  • Income Tax Benefit Under Section 80D of the Income Tax Act 1961

Scope of cover

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

3 lakh, 4 lakh, 5 lakh


discount

Family Discount


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.

Pre Hospitalization

Compensates for the Pre-Hospitalisation expenses for consultations, investigations and medicines incurred up to 30 days before Hospitalisation

Post Hospitalization

Compensates for the Post-Hospitalisation expenses for consultations, investigations and drugs incurred up to 60 days after discharge from Hospitalisation.

Good to Have Benefits

PORTABILITY

If you are currently insured with a different insurer and wish to switch to Bajaj Allianz Healthguard Family Floater 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.

Emergency Ambulance

Payable as part of the in-patient expenses up to a maximum of sum insured.

Value Adds

Dental Coverage

Not applicable unless it required due to an accidental injury.

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.

Terms & Conditions

Room Rent / Room Category

1% of the sum insured limit towards the room rent & 2% of the sum insured limit towards the ICU charges.

Co-Payment

You will have to bear 10% of co-payment if you seek the treatment in any hospital outside the network. Similarly, 15% co-pay applies to every eligible claim.

Sub-Limits

Certain surgeries like Cataract, Appendectomy, Tonsillectomy and so on have a capping on the cost that varies between Rs.20,000 to Rs.40,000.

Waiting Period

Cooling Off Period

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

Specific Illnesses

24 months waiting period for few listed conditions like any types of gastric or duodenal ulcers, Benign prostatic hypertrophy, Endometriosis, Fibromyoma, etc.

Pre-Existing Illnesses

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
  • Domiciliary Treatment
  • Pregnancy (other than ectopic pregnancy), childbirth and their consequences, including changes in chronic conditions as a result of pregnancy
  • 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 Swasth Parivar Insurance – Pearl Plan

Chola's Swasth Parivar Insurance – Pearl Plan is offered on a family floater basis. The plan includes 141 day-care procedures along with 30 & 60 days of pre and post hospitalization costs. However, a co-payment for every claim and a strict limit on the room rent & ICU charges along with the exclusion of other benefits like maternity cover and no claim bonus is a dampener.

**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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