Chola MS Health Insurance

Overview of Cholamandalam MS Health Insurance:

Chola MS General Insurance Co. Ltd. was formed a decade ago on its core philosophies of Trust, Transparency and Technology.

Headquartered in Chennai, it has grown to be a general insurer of choice by ensuring customer-satisfaction through innovation and operational effectiveness. The company has an extensive branch-network of about 90 centres all over India. It reaches its customers primarily through its 7,000-strong agent network, duly supported by alternate distribution channels viz. bancassurance partners, tie-ups with auto majors and other strategic partnerships.

has a number of product lines catering to retail customers including Auto, Travel, Home and Personal Insurance, to name a few, alongwith business protection solutions for commercial clients.

Chola MS, being one of the leading health insurance providers in India, offers a number of health insurance plans. The health insurance plans offered by Cholamandalam MS come with a lot of attractive features and benefits, and provide comprehensive health insurance coverage at affordable rates.

Key features of Cholamandalam MS Health Plans:

Listed below are main features of health insurance plans from Chola MS:

• A select number of Chola MS Health plans provide double coverage for accidents and critical illnesses.
• They also provide for domiciliary hospitalization and you can with these plans.
• Enjoy cashless hospitalization at over 4300 hospitals across the country.
• Select health plans provide cover for 20 major critical illnesses.
• Get paid for the cost involved in room rent on selected health plans.
• Lifetime renewal facility is available.
• Get tax benefit under section 80 (D) of the Indian Income Tax Act, 1961.
• 24x7 claim assistance service.
• These plans also provide cover for over 140 Day-care procedures.
• Pre and post hospitalization expenses are covered by most of the health plans offered by Chola MS.
• Enjoy easy claim settlement procedure.

Why choose Health Insurance Plans from Chola MS:

There are number of reasons why you choose Chola MS Health Plans. These plans offer a host of attractive benefits which include:

• You can enjoy cashes hospitalization in 4300 hospitals plus hospitals in India.
• Chola MS Health would pay for your pre and post hospitalization expenses up to up to 30 days prior to hospitalization and up to 60 days after discharge.
• Select Chola MS Health plans also include ambulance service within its cover and they will pay for your ambulance charges.
• You may enjoy special benefits when you renew your health insurance policy, provided you have made no claim on your health insurance cover in the previous year. You can also enjoy free medical check-up for not making no claims.
• Under section 80D of the Income Tax Act, 1961, you may get tax benefits on the premiums paid for your health insurance policy.
• You can opt for voluntary deductibles and reduce your premium amount mentioned in the policy. Co-pay facility is available in select health insurance plans.
• Nearly 20 critical illnesses are covered under this policy.
• You can easily purchase these plans online without facing the trouble of manually contacting your health insurance provider.

Types of Health Insurance Policies Provided by Chola MS:

1. Chola MS Healthline Insurance
2. Chola Swasth Parivar Health Insurance Plan
3. Chola Tax Plus Healthline
4. Chola MS FamilyHealthline Insurance
5. Chola MS Individual Healthline Insurance Policy
6. Chola MS Top Up Healthline Insurance Policy
7. Chola MS Critical Healthline Insurance Plan
8. Chola MS Hospital Cash
9. Chola MS Individual Health
10. Chola MS Family Health Insurance

Key details of each of the plans are elucidated and tabulated below:

Chola MS Healthline Insurance

This policy comes with three sub-plans viz.

• Value Healthline
• Freedom Healthline
• Enrich Healthline

They are similar in terms of features but differ in terms of coverage amounts/sub-limits.

Entry Age	18 yrs. to 65 yrs.
Policy Period	1, 2 or 3 yrs.
Renewability	Lifetime
Medical Screening	Required; Costs reimbursed up to 50% (Value or Freedom Plans) and 100% (Enrich Plan) on qualification
Basis	Individual or Floater (Family includes self, spouse, dependent children/parents/parents-in-law/siblings)
Sum Assured	- Value Healthline: Rs.2 lakhs - Freedom Healthline: Rs.3, 5 or 7.5 lakhs - Enrich Healthline: Rs.3, 5, 7.5 or 10 lakhs No-claim Bonus: Enhancement of chosen sum assured on renewal for every claim-free year awarded in the following way - Value Healthline: 5% (max. 25%) - Freedom Healthline: 5% (max. 50%) - Enrich Healthline: 50% (max.100%)
Premium	- Value Healthline: Rs.1,957 to Rs.24,919 - Freedom Healthline: Rs.3,801 to Rs.72,916 - Enrich Healthline: Rs.5,265 to Rs.90,212 Premiums depend on the chosen sum assured, age of insured members, policy tenure, basis of chosen plan and number of members covered. (Floater plans - premium based on age of the oldest member)
Discounts	6% for a 2 yr. tenure; 12% for a 3 yr. tenure
Co-payment	10% - Only on the Value Healthline Plan for members over 55 yrs.
Coverage	The following expenses are met within the chosen sum assured: - Inpatient hospitalisation expenses: Room charges: For coverage option of Rs.2 lakhs: Max.Rs.3,000; other coverage options: Actuals of single A/C room - 141 day care procedures - Pre/Post-hospitalisation expenses: Up to 30/60 days respectively (Value Plan) and Up to 60/90 days respectively (Freedom or Enrich Plans) - Domiciliary Hospitalisation expenses: Up to 7 days - AYUSH treatment - Organ donor hospitalisation expenses - Ambulance costs: Rs.1,000 (Value Plan) and Rs.2,000 (Freedom or Enrich Plans) - Health-check costs: On completion of 3 / 2 claim-free year (Freedom/Enrich plans respectively) - Pre-existing diseases: After a 4-yr. waiting period
Add-on Covers	Available on the Enrich Healthline Plan: - Cash Allowance: Rs.500 per day (max.7 days) per hospitalisation ( of a child) - Convalescence Benefit: Rs.10,000 for hospitalisation beyond 10 days - Critical Illness/Accident Cover: 2 times the chosen sum assured

Chola Swasth Parivar Health Insurance Plan

This policy features two sub-plans viz.

• Pearl
• Royale

Basis	Family floater
Sum Assured	Rs.3, 4 or 5 lakhs
Premiums	Rs.5,005 to Rs.10,351
Co-payment	15% compulsory; 10% voluntary (at non-network hospitals)
Coverage	- Inpatient hospitalisation expenses: Room charges: 1% of chosen sum assured ICU: 1.5% of chosen sum assured (per day) - Costs of treating medical professionals, consumables etc. required for treatment - 141 day care procedures - Pre/Post-hospitalisation expenses: Up to 30/60 days respectively - Day care treatment: At network hospitals only - Pre-existing diseases: After a waiting period of 4 yrs.
Add-on Covers	Personal Accident Cover: Death and Total Permanent Disablement: Rs.7.5 to 10 lakhs (self) and Rs.3.75 to Rs.5 lakhs (spouse); Rs.1.5 to Rs.2 lakhs (per child) Partial Permanent Disablement: Rs.3.75 to Rs.5 lakhs (self) and Rs.1.87 to Rs.2.5 lakhs (spouse); Rs.75,000 to Rs.1 lakh (per child)

Chola Tax Plus Healthline

Entry Age	18 yrs. to 65 yrs.; 3 months for children
Medical Screening	Required for entrants above 55 yrs.
Sum Assured	Rs.1 to 5 lakhs in increments of Rs.1 lakh No-claim Bonus: 5% enhancement in chosen sum assured for every claim-free year, max.50%
Coverage	- Inpatient hospitalisation expenses: Room charges: 1% of the chosen sum assured (per day) ICU charges: 2% of the chosen sum assured (per day) - Pre-hospitalisation expenses: Up to 60 days (max. 5% of actuals) - Post-hospitalisation expenses: Up to 90 days (max.Rs.50,000) - Ambulance costs: Rs.3,000 per hospital stay - Cataract: 7.5% of chosen sum assured (max. 20,000) per eye - Hernia: 10% of chosen sum assured (max. 30,000) - Fistula/Piles: 10% of chosen sum assured (max.30,000) - Sinusitis: 10% of chosen sum assured (max.30,000) - Tonsillitis / Adenoids: 15% of chosen sum assured (max.40,000) - Knee/Joint Replacement Procedures: 50% co-payment - Outpatient cover - Pre/Post-Natal Expenses - Pre-existing diseases: After a 4-yr. waiting period - Dental - Treatment under branches of Indian medicine (not naturopathy) - Prescribed glasses, contact lenses, hearing-aids, prosthetics etc.

Chola MS Family Healthline Insurance

This policy comprises the following plans:

• Standard
• Superior
• Advanced

Basic features are common to all plans but the amount and depth of coverage varies along with the premiums payable.

Entry Age	18 yrs. to 65 yrs. 3 months for children
Medical Screening	Required for entrants above 55 yrs.
Basis	Family Floater (Family includes self, spouse, dependent children)
Sum Assured	- Standard: Rs.2 to 5 lakhs in increments of Rs.1 lakh - Superior: Rs.4 to 10 lakhs in increments of Rs.2 lakhs - Advanced: Rs.6 to 12 lakhs in increments of Rs.2 lakhs; Rs.15 lakhs No-claim Bonus: 5% enhancement of chosen sum assured for every claim-free year
Premium	- Standard: Rs.5,845 to Rs.1,42,297 - Superior: Rs.10,516 to Rs.2,47,593 - Advance: Rs.18,707 to Rs.3,50,661 Depends on age of insured (based on oldest member), chosen sum assured, chosen plan and family size i.e. up to two adults and 3 kids
Co-Payment / Discounts	10% discount on premiums, if 10% co-payment is opted for
Coverage	- Inpatient hospitalisation expenses: Room charges (per day): Up to Rs.3,000 (Standard), Up to Rs.3,000 for Rs.4 lakh cover or 1% of the chosen sum assured for Rs.6, 8 or 10 lakhs cover (Superior) or 1% of the sum assured (Advanced) - Daily Cash Allowance: Rs.250 (Standard) and Rs.500 (Superior and Advanced); per day, up to 7 days, deductible of 1 day - Accompanying a child: Rs.250 (Superior and Advanced); per day, up to 7/14 days respectively, deductible of 1 day - Health-check costs including eye-checks: 0.5% or 0.75% or 1% of the chosen sum assured (Standard or Superior or Advanced respectively), once after 2 claim-free years - Ambulance costs: Rs.1,000 or Rs.2,000 or Rs.3,000 (Superior and Advanced, respectively), once a policy year, per insured member - Domiciliary hospitalisation: 15% or 25% of the chosen sum assured, max. Rs.75,000 or Rs.1 lakh (Superior and Advanced, respectively) - Maternity Expenses: After a 5-yr. waiting period, Rs.15,000 or Rs.25,000 (Superior and Advanced, respectively) - 141 day care procedures - Specific Ayurvedic treatment: Up to 7.5% of the chosen sum assured, 20% co-payment - Dental: After a 3-yr. waiting period, 1% of the chosen sum assured, max. Rs.5,000, 30% co-payment - External Aids: 1% of the chosen sum assured, max. Rs.5,000, every 2nd year, 30% co-payment - Cataract (per eye): 7.5% of the chosen sum assured, max.Rs.20,000 - Hernia: 10% of the chosen sum assured, max. Rs.30,000 - Fistula/Piles: 10% of the chosen sum assured, max. Rs.30,000 - Sinusitis: 10% of the chosen sum assured, max. Rs.30,000 - Tonsillitis: 15% of the chosen sum assured, max. Rs40,000 (Cataract to Tonsillitis: covered under the Standard Plan within limits mentioned above; Cataract only covered under the Superior Plan;Cataract to Tonsillitis: covered under the Advanced Plan on basis of actuals)
Benefits	Chola MS Wellness Service: Rs.350 or Rs.500 per person (SMS reminders)

Chola MS Individual Healthline Insurance Policy

Suited for protection of an individual, it provides three coverage options under plans titled Standard, Superior and Advanced. The sub-limits applicable to the various expenses depend on the plan chosen by the proposer and the coverage option therein.

Entry Age	18 yrs. to 65 yrs.; 3 months for children
Renewability	Required above the age of 55 yrs.
Medical Screening	Required above the age of 55 yrs.
Sum Assured	- Standard: Rs.1 to 5 lakhs in increments of Rs.1 lakh - Superior: Rs.3.5 to 5.5 lakhs in increments of Rs.1 lakh - Advanced: Rs. 4.5, 5.5, 7.5 or 10 lakhs No-claim Bonus: 5% increase in sum assured, every claim-free year
Premiums	- Standard: Rs.2,619 to Rs.31,688 - Superior: Rs.3,136 to Rs.32,304 - Advanced: Rs.5,320 to Rs.56,181
Discounts	10% discount for 10% voluntary co-payment
Coverage	- Inpatient hospitalisation expenses: Room charges: Up to Rs.1,000 or Rs.3,000 per day depending on chosen coverage (Standard); Up to Rs.3,000 per day (Superior); Up to Rs.3,000 or 1% of chosen sum assured depending on chosen coverage - Pre/post-hospitalisation expenses: Up to 60 / 90 days - Ambulance costs: Rs.1,000 or Rs.2,000 or Rs.3,000 (Standard, Superior, Advanced, respectively) - 141 day care procedures - Daily Cash Allowance (hospitalisation): Rs.250, max. 7 days (Standard); Rs.500, max. 7 days (Superior); Rs.500, max.14 days (Advanced) per day, deductible: 1 day - Health-check costs: 0.5% or 0.75% or 1% of chosen sum assured (Standard, Superior, Advanced respectively), every 2nd claim-free yr. - Cash Allowance for accompanying a hospitalised minor (Superior/Advanced): Rs.250 per day, max.14 days; deductible: 1 day - Domiciliary hospitalisation: 15% (max. Rs.70,000) or 25 (max. Rs.1 lakh) of the chosen sum assured (Superior/Advanced respectively) - Maternity Expenses: Up to Rs.25,000 or Rs.40,000 (Superior/Advanced respectively) - Ayurvedic Treatment: Up to 7.5% of chosen sum assured; 20% co-payment (Advanced) - OPD Dental: 1% of chosen sum assured, max. Rs.5,000; 30% co-payment (Advanced) - External Aids: 1% of chosen sum assured, max. Rs.5,000; 30% co-payment; (Advanced) Cataract (per eye): 7.5% of the chosen sum assured, max.Rs.20,000 - Hernia: 10% of the chosen sum assured, max. Rs.30,000 - Fistula/Piles: 10% of the chosen sum assured, max. Rs.30,000 - Sinusitis: 10% of the chosen sum assured, max. Rs.30,000 - Tonsillitis: 15% of the chosen sum assured, max. Rs40,000 (Cataract to Tonsillitis: covered under the Standard Plan within limits mentioned above; Cataract only covered under the Superior Plan; Cataract to Tonsillitis: covered under the Advanced Plan on basis of actuals)
Benefits	Chola MS Wellness Service: Rs.350 or Rs.500 per person (SMS reminders)

Chola MS Top-Up Healthline Insurance Policy

This is a health insurance policy which enhances the cover of a basic health plan. Taken in-addition to an existing policy, this makes coverage more comprehensive.

There are 7 coverage options viz. Plan A, B, C, D, E, F and G. Each plan features a deductible which is the amount the proposer bears on admissible claims. Sub-limits on the various expenses covered under this policy also vary according to the chosen plan.

Entry Age	18 yrs. to 65 yrs.; 3 months for children
Policy Period	1, 2 or 3 yrs.
Renewability	Lifetime
Medical Screening	Required above the age of 55 yrs.
Basis	Individual or Floater
Sum Assured	Plan A: Rs.50,000; applicable deductible:Rs.30,000 Plan B: Rs.2 lakhs; applicable deductible:Rs1 lakh Plan C: Rs.3 lakhs; applicable deductible: Rs.2 lakhs Plan D: Rs.5 lakhs; applicable deductible Rs.3 lakhs Plan E: Rs.6 lakhs; applicable deductible: Rs.4 lakhs Plan F: Rs.10 lakhs; applicable deductible: Rs.5 lakhs Plan G: Rs.15 lakhs; applicable deductible: Rs.5 lakhs
Premiums	- 1 yr. policy: Rs.2,472 to Rs.14,029 - 2 yr. policy: Rs.4,749 to Rs.27,244 - 3 yr. policy: Rs.6,808 to Rs.38,802 Premiums are based on the oldest insured member and depend on chosen sum assured, number of insured members, age and policy tenure.
Coverage	- Inpatient hospitalisation expenses: Including charges for treating medical professionals, consumables, equipment, supplies, OT etc. Up to Rs.80,000 (A); Rs.3 lakhs (B); Rs.5 lakhs (C),Rs.8 lakhs (D), Rs.10 lakhs (E), Rs.15 lakhs (F), Rs.20 lakhs (G) Room charges: Rs.500 (A), Rs.2,000 (B), Rs.4,000 (C), Rs.5,000 (D), Rs.6,000 (E), Rs.7,500 (F), Rs.10,000 (G) - Pre-hospitalisation expenses: Up to 60 days, max.5% of actuals - Post-hospitalisation expenses: Up to 90 days, max.10% of actuals (up to Rs.50,000) - Ambulance costs: Up to Rs.3,000 per hospitalisation - Pre-existing diseases: After a 4-yr. waiting period

Chola MS Critical Healthline Insurance Plan

This plan can be taken in addition to a basic health plan to make coverage more comprehensive. Basic plans do not cover critical illnesses whereas this plan specifically targets these events.

There are two options based on the number of critical illnesses covered i.e. 1. Standard Plan: Covers 10 illnesses 2. Advanced Plan: Covers 12 illnesses

Entry Age	18 yrs. to 65 yrs.; 5 yrs. for children
Renewability	Lifetime
Medical Screening	Required above the age of 55 yrs.
Basis	Individual
Sum Assured	Rs.3, 5 or 10 lakhs
Premium	Standard: Men - Rs.825 to Rs.65,370 Women - Rs.776 to Rs.60,665 Advanced: Men - Rs.928 to Rs.67,018 Women - Rs.839 to Rs.61,247 Premium depends on chosen sum assured, age and gender of the insured
Coverage	Lump sum payment on diagnosis of specified critical illnesses, subject to a survival period varying of 30 to 180 days. Standard Plan: Cancer, Stroke, First Heart Attack, CABG, Renal Failure, MS, Major Organ/bone marrow transplant, Permanent Paralysis, Aorta Surgery, Primary Pulmonary Hypertension Advanced Plan: Cancer, Stroke, First Heart Attack, CABG, Renal Failure, MS, Major Organ/bone marrow transplant, Permanent Paralysis, Aorta Surgery, Primary Pulmonary Hypertension, Parkinson’s Disease, Motor Neuron Disease + Ambulance costs: Rs.1,000 once in a policy year.

Chola MS Hospital Cash

This policy offers holders a way to meet expenses during hospitalisation. The three medical insurance plans mentioned below offer varying levels of cover. Customers can avail of this policy, based on their affordability, given the range of premiums charged under Plan A, Plan B or Plan C.

Hospitalisation expenses in this case includes ICU charges and extended stay and payout is given as a lump sum once claims are successfully processed.

Entry Age	18 yrs. to 65 yrs.; 3 months for children
Renewability	Lifetime
Medical Screening	Required above the age of 55 yrs.
Premium	- Plan A: Rs.762 to Rs.6,817 - Plan B: Rs.1,317 to Rs.13,355 - Plan C: Rs.1,872 to Rs.19,893
Discounts	5% for every additional member covered, max.10%
Coverage	- Hospitalisation Cash Benefits:: Rs.1,000 (A), Rs.2,000 (B), Rs.3,000 (C); per day - ICU charges: Rs.2,000 (A), Rs.4,000 (B), Rs.6,000 (C); per day - Convalescence Benefit: Lump sum payment; Rs.10,000 (A), Rs.15,000 (B), Rs.20,000 (C); per day - Pre-existing diseases: After a 4-yr. waiting period

Chola MS Individual Health

This plan gives the client a chance to enhance their cover by paying additional premium.

Entry Age	18 yrs to 65 yrs.
Policy Period	1 year
Renewability	Lifetime
Medical Screening	Required above 45 yrs.
Sum Assured	Rs.1, 1.5, 2, 3, 4, 5, 7.5 or Rs.10 lakhs No-claim Bonus: 5% enhancement of sum assured for every claim-free year; max. 50%
Premium	Basic: Rs.1,643 to Rs.24,555 Basic + Extra: Rs.1,811 to Rs.29,200 Premiums depend on chosen coverage and age of insured member
Discount	Family discount: On total premium for additional members covered
Coverage	- Inpatient hospitalisation expenses: Room, services of medical professionals, consumables, equipment, supplies etc. - Pre/Post-hospitalisation expenses: Up to 60/90 days respectively - Pre-existing diseases: After a 4-yr. waiting period - Ambulance costs: Depending on chosen sum assured - 141 day care procedures
Coverage	- Inpatient hospitalisation expenses: Room, services of medical professionals, consumables, equipment, supplies etc. - Pre/Post-hospitalisation expenses: Up to 60/90 days respectively - Pre-existing diseases: After a 4-yr. waiting period - Ambulance costs: Depending on chosen sum assured - 141 day care procedures
Add-on Covers	Extra Health Cover for extra premium (sub-limits apply)
Benefits	Chola MS Wellness Health Alerts Service

Chola MS Family Health Insurance

This is similar to the Individual Policy but offered on a floater basis to cover not just the proposer but his/her entire family as well.

Entry Age	Up to 65 yrs.
Renewability	Lifetime
Medical Screening	Not required
Basis	Floater
Sum Assured	Rs.2 to 5 lakhs
Premium	Rs.5,223 to Rs.18,173
Coverage	- Inpatient hospitalisation expenses: Room, services of medical professionals, consumables, equipment, supplies etc. - Pre/Post-hospitalisation expenses: Up to 60/90 days respectively - Pre-existing diseases: After a 4-yr. waiting period - Daily Cash Allowance - Domiciliary nursing - Ambulance costs: Depending on chosen sum assured - 141 day care procedures - External Aids
Benefits	Chola MS Wellness Health Alerts Service

All health assurance and mediclaim policies must be read in conjunction with their individuals terms and conditions. It should also be remembered that every plan lists out certain exclusions i.e. events or circumstances that can lead to disqualification of claims made.

*GST and other charges are to be factored in wherever applicable.

How to File a Claim with Chola MS Health?

Claim settlement is subject to the claim intimation made by the insured member to Chola MS and approval of the claim as per policy terms and conditions. Policyholders can make 2 types of health insurance claims with Chola MS Health:

• l Cashless Claim: Visit a network hospital of Chola MS Health and display your health card at the TPA helpdesk along with a photo identity card, and investigation reports. The hospital will submit a pre-authorisation request form to Chola MS Health. Upon approval, the hospital will provide cashless treatment to the insured member and the insurer will settle the medical bills directly with the hospital.
• Reimbursement Claim: Pay the hospital bills upfront out of your own pocket. At the time of discharge, collect all the original medical documents and submit it to the insurer along with a duly-filled reimbursement claim form. The claim will be approved or rejected as per the policy terms and conditions.

Incurred Claims Ratio of Chola MS Health Insurance for the Year 2017-18

Net Earned Premium (in Crore)	Net Claims Paid (in Crore)	Incurred Claims Ratio (in %)
Rs.339.16 crore	Rs.135.53 crore	39.96%

Chola MS Health Insurance FAQs:

Examples of Network Hospitals in Major Cities:

CITY	NAME OF HOSPITAL
DELHI	GOPAL NURSING HOME & EYE HOSPITAL
MUMBAI	DNA MULTISPECIALTY HOSPITAL
KOLKATA	DAFODIL NURSING HOME PVT.LTD.
BANGALORE	CHAYA HOSPITAL
CHENNAI	ATHIPATHI HOSPITAL & RESEARCH CENTRE

*Disclaimer - This is not an exhaustive list but an indicative representation of hospitals that form a part of the company's wider network.