A guide to Cholamandalam MS Health Insurance

Chola MS General Insurance Co. Ltd. (IRDA Reg. No 123) headquartered in Chennai, is a leading insurance company in India.

Cholamandalam was established about 10 years ago, in 2005, their values truth, transparency, and technology forming the foundation of the multi-faceted company. Chola MS has a number of products such as different kinds of insurance, business protection solutions etc.

Cholamandalam health insurance is very popular amongst their customer base due to their high level of customer satisfaction through optimized operational processes and innovative vision. Cholaandalam Health Insurance has over 90 centers PAN-India and an agent network that is 7000 strong. Cholamandalam Health Insurance offers a spectrum of health insurance policies, the details of which are mentioned below

Features

of members- The plan covers maximum 5 members of your family with up to 3 children and 2 adults.
Lifelong Renewal – The plans offered are lifelong renewable hence it saves you from the financial burden and stress caused by a medical emergency and keeps you well prepared to handle any situation.
Room Rent – If your sum insured is Rs.3/4/5 lakh then an AC room would be charged up to 3000 per day.
Pre & Post hospitalization cover– The plan covers medical expenses for 60 days prior to hospitalization and 90 days post hospitalization only for related medical expenses.
Health Check-ups – All insured would get free health checkup for 2 claim-free years.
Pre-existing diseases– Pre-existing diseases are covered after 4 years of waiting period.
Co-payment– The plan has no co-payment policy.

Benefits of buying Health Insurance from Cholamandalam MS Health Insurance

Cashless treatment: Provides a network of hospitals, where you can avail cashless treatment facilities.
Cumulative Bonus: If no claims are made on the health cover in a particular year, you will be entitled for special benefits through an increment in the sum insured when you renew the policy the following year.
Tax benefits: When you pay the premium for your health insurance policy, you are liable to get a tax rebate under section 80D of the Income Tax Act for a maximum value of Rs.15,000 for normal and Rs.20,000 for senior citizens.

Products offered by Cholamandalam MS Health Insurance

Value Healthline

Individual Coverage

This is most basic of all the health insurance plans offered by Cholamandalam MS. Here is a brief on benefits offered under this plan:

This is a basic health plan which offers coverage of Rs.2 lakh for individuals up to age 65 years.
Pre and post hospitalization expense cover, coverage for day care procedures, coverage for domiciliary treatments, etc. are benefits provided in this plan.
No-claim bonus equal to 5 % of sum insured up to a maximum of up to 25 % is provided after every claim free year.
There are two variables (freedom health line and enrich health line) of this plan.

Family Floater Coverage

In case you want to cover your entire family on a shared basis with Value Health line, here details of the benefits offered:

This is a family floater plan which offers coverage of Rs.2 lakh to the entire family.
Proposer, Proposer’s spouse up to age 65 years and 4 dependent children between age 3 months and 26 years can be covered under the policy.
Pre and post hospitalization expense cover, coverage for day care procedures, no claim bonus, etc. are benefits provided in this plan.

Note:

Co-payment/ co-pay (percentage of sum insured to be paid by individual out of pocket before any claim) of 10% is applicable for individuals above age 55 years.
Sub-limits (limits on room-rent coverage, ICU charges, etc.) are applicable in this plan.

Freedom Healthline

Individual Coverage

This is an advanced variant of Value Healthline which offers wider coverage. Following are briefly the benefits offered under this plan:

This is a health plan which offers coverage in the range of Rs.3 lakh and Rs.7, 50,000 for individuals up to age 65 years.
Pre and post hospitalization expense cover, coverage for day care procedures, etc. are benefits provided in this plan. Compared to basic plan this plan offers pre-hospitalization cover for a longer period.
No-claim bonus equal to 5 % of sum insured up to a maximum of up to 50 % is provided after every claim free year.

Family Floater Coverage

In case you find this plan suitable to cover expenses for your entire family on a shared basis, here are details of family floater coverage:

This is a family floater plan which offers coverage to the entire family in the range of Rs.3 lakh and Rs.7,50, 000.Proposer, Proposer’s spouse up to age 65 years and 4 dependent children between age 3 months and 26 years can be covered under this policy.
Pre and post hospitalization expense cover, coverage for day care procedures, no claim bonus, etc. are benefits provided in this plan. Compared to basic plan this plan offers pre-hospitalization cover for a longer period.
No-claim bonus equal to 5 % of sum insured up to a maximum of 50 % is provided after every claim free year.
Additionally, this plan does not have any sub-limits or co-payment option.

Enrich Healthline

Individual Coverage

This is a health insurance plan with daily cash benefit. Following are some of the details offered under this plan.

This is a health plan which offers coverage in the range of Rs.3 lakh and Rs.10 lakh for individuals between age 18 years and age 65 years.
Basic coverage like pre and posts hospitalization expense cover, coverage for day care procedures, etc. is provided in this plan. However, compared to other variables this plan offers additional benefits like child hospitalization allowance and extended hospitalization allowances (payment of lump sum amount in case of more than 10 days of hospitalization).
No-claim bonus equal to 50 % of sum insured up to a maximum of up to 100 % is provided after every claim free year.
This policy offers additional coverage in case of diagnosis of critical illness or accident (the sum insured is doubled in both the cases).

Family Floater Coverage

In case you want to cover your entire family on a shared basis with Enrich Healthline plan, here details of coverage offered:

This is a family floater plan which offers coverage to the entire family in the range of Rs.3 lakh and Rs.10 lakh.
Proposer, Proposer’s spouse between age 18 year and age 65 years and 4 dependent children between age 3 months and 26 years can be covered under the policy.
Pre and post hospitalization expense cover, coverage for day care procedures, no claim bonus, etc. are benefits provided in this plan.
Compared to other variables this plan offers additional benefits like child hospitalization allowance and extended hospitalization allowances (payment of lump sum amount in case of more than 10 days of hospitalization) are provided in this plan.
No-claim bonus equal to 50 % of sum insured up to a maximum of 100 % is provided after every claim free year.
This policy offers additional coverage in case of diagnosis of critical illness or accident (the sum insured is doubled in both the cases).

Standard Healthline

Individual Coverage

This is basic health insurance plan with sub-limits offered by Cholamandalam, here are details of coverage offered:

This is a health plan which offers coverage in the range of Rs.3 lakh and Rs.5 lakh for individuals between age 18 years and age 65 years.
Basic coverage like pre and post hospitalization expenses, daily cash for shared accommodation, etc. are the benefits provided in this plan.

Note:

Sub-limits are applicable in this plan.

Family Floater Coverage

In case you wish to cover your entire family on a shared basis with Standard Healthline, here are the details of the coverage offered:

This is a family floater plan which offers comprehensive health coverage in the range of Rs.2 lakh and Rs.5 lakh to entire family.
Proposer and spouse between age 18 years and 65 years and dependent children between age 3 months and 26 years can be covered under this policy.
Pre and post hospitalization expense cover, no claim bonus, daily cash benefit, wellness alerts (message alerts reminding of health checkup, medication, etc.), etc. are benefits provided in this plan.

Note:

Sub-limits are applicable in this plan.

If you are convinced that the Standard Healthline plan is suitable as per your requirement, then know more about the details of coverage offered, contact.

Superior Healthline

Individual Coverage

This is health insurance plan with coverage for maternity expenses. Given below are the details of coverage offered by this plan for an individual basis:

This is a health plan which offers coverage in the range of Rs.3,50,000 and Rs.5,50,000 for individuals between age 18 years and age 65 years.
Coverage for pre and post hospitalization expenses, daily cash for shared accommodation, etc. are the benefits provided in this plan.
In addition to this basic cover this plan also provides coverage for domiciliary hospitalization, maternity expenses, etc.

Note:

Sub-limits are applicable in this plan.

Family Floater Coverage

The Health Superior plan is also available for family floater coverage. Details of coverage offered under this plan are as follows:

This is a family floater plan which offers comprehensive health coverage in the range of Rs.4 lakh and Rs.10 lakh to the entire family.
Proposer and spouse between age 18 years and 65 years and dependent children between age 3 months and 26 years can be covered under this policy.
Pre and post hospitalization expense cover, no claim bonus, wellness alerts (message alerts reminding of health checkup, medication, etc.), etc. are benefits provided in this plan. Apart from this basic cover this plan also provides daily cash expense, cash allowance for minor child, domiciliary hospitalization expense, maternity coverage, etc.

Note:

Sub-limits are applicable in this plan.

In case you want to buy a plan with maternity benefit from Cholamandalam MS know more about Superior Healthline.

Advanced Healthline

Individual Coverage

In case you want a health insurance plan which would also cover OPD expenses. Here is a brief of coverage offered under Advanced Healthline which might be suitable as per your needs.

This is a health plan which offers coverage in the range of Rs.3,50,000 and Rs.5,50,000 for individuals between age 18 years and age 65 years.
Coverage for pre and post hospitalization expenses, daily cash for shared accommodation, coverage for domiciliary hospitalization, maternity expenses, etc. are the benefits provided in this plan.
In addition to this basic cover this plan also provides coverage for OPD expenses, Ayurveda treatments, etc.

Note:

Sub-limits are applicable in this plan.

Family Floater Coverage

In case you want to Advanced Healthline for your entire family with a single sum insured on a shared basis. Here are the details of family floater coverage:

This is a family floater plan which offers comprehensive health coverage in the range of Rs.4 lakh and Rs.10 lakh to the entire family.
Proposer and spouse between age 18 years and 65 years and dependent children between age 3 months and 26 years can be covered under this policy.
Pre and post hospitalization expense cover, no claim bonus, wellness alerts, daily cash expense, cash allowance for minor child, etc. are benefits provided in this plan.
In addition to the superior Family Healthline, this plan covers dental treatment is also covered in this plan.

Chola Tax Plus Healthline

Individual Coverage

This health insurance plan is specifically for individual buying health insurance for tax benefits. The individual coverage option offers:

Coverage for individuals between age 18 years and 65 years.
The coverage is offered in two sections:
Section I– Provides coverage for hospitalization expenses in the range of Rs.1 lakh and Rs.5 lakh.
Pre and post hospitalization expenses, day care procedures, etc. are basic benefits provided in this section.
Section II– Provides coverage for out-patient medical expenses (OPD).
The coverage offered under this section is dependent on the section I cover and age of insured member.
No claim will enhance sum insured under section I by 5 % up to a maximum of 50 %.

Note:

This plan offers option to opt for higher Sum insured and OPD expense cover.

Family Floater Coverage In case you want to buy family floater plan for tax benefits, following are the details of coverage offered:

This is a family floater plan which offers coverage to the entire family.
Proposer and proposer’s spouse between age 18 years and 65 years and a maximum of 3 dependent children between age 2 months and 26 years can be covered under this policy.
The coverage is offered in two sections:
Section I – Provides coverage for hospitalization expenses in the range of Rs.1 lakh and Rs.5 lakh.
Pre and post hospitalization expenses, day care procedures, etc. are basic benefits provided in this section.
Section II – Provides coverage for out-patient medical expenses (OPD).
The coverage offered under this section is dependent on the section I cover and age of insured member.
No-claim will enhance sum insured under section I by 5 % up to a maximum of 50 %.

Note:

This plan offers option to opt for higher Sum insured and OPD expense cover.
No-claim bonus is not applicable for Section II.

If you want to Tax benefit plan on individual or family floater basis, please contact for more details on this plan.

Chola Top-up Healthline

Individual Coverage

This is health insurance top-up plan offered by Cholamandalam MS. The details of coverage offered are as follows:

This is a top-up plan (these plans have an agreed upon deductible amount to be paid at the time of claim) for individuals between age 18 years and 65 years.
Coverage offered is in the range of Rs.50,000 and Rs.15 lakh with deductible in range of Rs.30,000 and Rs.5 lakh. There are seven variables of this plan which offers different sum insured and deductible values.
Basic covers like pre and post hospitalization expenses, Ambulance charges, etc. are provided in this plan.

Family Floater Coverage In case you are looking for Top-up plan to cover your entire family on shared basis, refer below to know about the coverage offered:

This is a family floater top-up plan which offers coverage to the entire family in the range of Rs.50,000 and Rs.15 lakh with the deductible in the range of Rs.30,000 and Rs.5 lakh.
Adults between age 18 years and 65 years and dependent children between age 3 months and 26 years are covered in this plan.
There are seven variables of this plan which offers different sum insured and deductible.
Basic covers like pre and post hospitalization expenses, ambulance charges, etc. are provided in this plan.

Note:

Sub-limits are applicable for both individual and family floater coverage.

Chola Hospital Cash Healthline

This is a benefit plan which ensures that additional expenses during hospitalization period are covered. Here are the details of benefits offered:

This is a special plan which offers daily cash during hospitalization for maximum of 20 days, double of daily cash in case of admission in ICU and lump sum amount after 20 days of hospitalization per policy year.
Individuals between age 18 years and 65 years and dependent children between age 3 months and 36 years can be covered in this policy.
This plan offers 5% increase in daily cash up to a maximum of 50 % after claim free year.
The plan has three variables plan A , plan B and plan C which offers different daily cash allowance.

Chola MS Standard Critical Healthline

This is a benefit plan which offers coverage upon diagnosis of Critical illness. Here are benefits offered under this plan:

This is a special plan which offers coverage in case of critical illness in the range of Rs.3 lakh and Rs.10 lakh for individuals between age 5 years and 65 years.
The plan offers lump sum amount after diagnosis of insured person with any of the 10 listed critical illnesses.

Chola MS Advance Critical Healthline

This plan is a variable of Standard Critical Care Healthline which offers coverage in case of critical illness in the range of Rs.3 lakh and Rs.10 lakh for individuals between age 5 years and 65 years.
The plan offers lump sum amount after diagnosis of insured person with any of the 12 listed critical illnesses and also covers ambulance charges in such cases.

Chola Accident Protection Plan

Individual Coverage

This is a personal accident disability plan offered by Cholamandalam MS.

This is a special plan which provides accidental cover in the range of Rs.5 lakh and Rs.1 crore for individuals between age 18 years and 69 years.
Accidental death, permanent total disability, permanent partial disability, etc. can be covered under this policy.

Family Floater Coverage

This is a special family floater plan which provides coverage in case of accidents for the entire family in the range of Rs.5 lakh and Rs.1 crore.
Adults between age 18 years and 69 years and dependent children up to 25 years of age can be covered under this policy.
Accidental death, permanent total disability, permanent partial disability, etc. can be covered under this policy.

Note:

The coverage offered is based on the annual income of the proposer.

If you want to buy personal accident disability plan by Cholamandalam MS on an individual or family floater basis, know more about the terms and conditions under this plan, contact

Chola Swasth Pariwar- Pearl plan

Family Floater Coverage

This is a family floater plan which offers basic coverage in case of hospitalization.

This is basic family floater plan which covers health cost of the entire family in the range of Rs.3 lakh and Rs.5 lakh.
Proposer and spouse between age 18 years and 65 years and a maximum of 2 dependent children in the age of 3 months and 26 years can be covered in this policy.
Pre and post hospitalization expense cover, coverage for day care procedures, etc. are benefits provided in this plan.
There are three variables of this plan which offers different sum insured or coverage.

Note:

This plan has co-pay of 15% (percentage of claim amount to be paid by the proposer) and additional 10 % co-pay for treatments in non-networked hospital (except cases of accident).

Chola Swasth Pariwar- Royal plan

Family Floater Coverage

This is family floater plan which covers health cost of the entire family in the range of Rs.3 lakh and Rs.5 lakh.
Proposer and spouse between age 18 years and 65 years and a maximum of 2 dependent children in the age of 3 months and 26 years can be covered in this policy.
Pre and post hospitalization expense cover, coverage for day care procedures, etc. are benefits provided in this plan.
The plan offers coverage under two sections
Section I – Covers basic hospitalization expenses.
Section II – Provides accidental coverage.
There are three variables of this plan which offers different sum insured or coverage.

Note:

This plan has 15% co-pay which is applicable for any claim and additional 10 % co-pay for treatments in non-networked hospital (except cases of accident).

Claims process at Cholamandalam MS Health Insurance

There are two ways to make claim under a Health Insurance Policy: on cashless basis and on reimbursement basis. In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of the insurance company servicing your policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form. In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for the claim on reimbursement are obtained after hospitalization.

Chola MS Health Insurance has a well-defined claim processing system.

Cashless Service: seeking Pre-Authorization

Complete the pre-authorization form available at the hospital’s insurance/TPA Desk.
Send the completed form via email or fax.
Approved letter will be sent by the claim management team. Remember that the claim management team could send an inquiry to the hospital or you before authorization.
In case the authorization is rejected, initiate the treatment and file for reimbursement claim.

Reimbursement Claim: Claim Submission

Complete the necessary form and submit along with required documents, as per the policy terms and conditions.
Necessary documents include discharge summary, prescriptions, bills etc.
Approved letter will be sent by the claim management team. Remember that you will be answerable to any queries raised by the claim management team before the letter is issued.
In case the claim is rejected, the reasons will be communicated by the team.

In case of any emergencies, you need to inform Chola MS within 24 hours of the admission. In case of planned emergencies, the notification has to reach the company 48 hours prior to the hospitalization. The claim intimation can be done via Chola MS’s toll free number 1800-200-5544. The same could also be emailed to customercare@cholams.murugappa.com

Review of Cholamandalam MS Health Insurance

Chola MS Health Insurance offers wide-ranging health coverage that takes care of your overheads associated with hospitalization and domiciliary to facilitate the enhanced financial health in the course of an unexpected medical exigency. With 105 branches and over 9000 agents across the country, the company claims of user-friendliness and unswerving customer service. With diverse coverage plans suiting every individual, Chola MS undeniably has potential to be ranked as one of the best insurance companies of India.