Swasth Parivar Pearl Plan

    Cholamandalam MS Health Insurance

    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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