Chola MS (Cholamandalam MS) General Insurance Company is a joint venture between Murugappa Group and Mitsui Sumitomo Insurance Group. Being one of the prominent assurance companies, Chola MS provides a range of insurance schemes.
The health insurance scheme, with different options of sum assured, covers all expenses that include hospitalization and domiciliary. This scheme offers a lump sum amount, to cover financial burdens that can occur during a medical emergency, for critical illnesses or accidents.
Having tie ups with 4300+ hospitals, insurance policyholders can avail of cashless and domiciliary treatment to cover pre and post-hospitalization expenses. Cholamandalam MS Health Insurance has a team of Third Party Administrators (TPA), licensed by IRDA, at every tie-up hospital. This team helps the policyholder through the claims and reimbursement process in a hassle-free manner.
The performance of an organization in the market is marked with the Incurred Claim Ratio (ICR). This parameter helps prospective policyholders understand the working and performance of the insurance scheme, thereby helping them choose a suitable plan for investment.
Claims for health insurance are of two kinds - cashless treatment and expense reimbursement after treatment. Cashless claims can be made at the tie-up hospitals. The TPA desk at the hospital will guide the policyholder through the process.
The insurance company takes care of all treatment and hospitalization of the policyholder, . Chola MS provides cashless treatment, depending on the cover opted by the policyholder. The life insured can avail this facility at any empanelled hospital, anywhere in the country.
Depending on the policy, Chola MS will first scrutinize the request for claims and then approve or reject the same. The following process should be followed for reimbursement claims:
In some instances, the insurance company may reject the policyholder's claims for reimbursement in case of cashless hospital and treatment. Reimbursements can still be claimed by following the mentioned process:
Sometimes insurance companies may not accept settlement claims, in case the policyholder is availing treatment or admitted in a hospital that is not tied up with Chola MS's TPA. In such a scenario, the person concerned can file for a reimbursement claim for the expenses incurred while at the hospital. Here's is the process to file a claim:
The following documents, along with duly filled claims form and doctor's certificate, have to be submitted in case of reimbursement of the expenses incurred at the hospital. The claim processing team will get in touch with the policyholder in case more documents are required.
Follow the above mentioned process in order to file a claim with Chola MS Health Insurance. Claim requests are processed only after the receipt and verification of all documents, which can take up to two weeks.
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