| Entry age |
Minimum: 18 years
Maximum: 65 years
|
| Features |
- Chola Swasth Parivar insurance policy comes with two plans which offer flexible options in terms of sum insured
- Offers dual protection of personal accident coverage (individual sum insured) and hospitalization cover floating sum insured)
- Covers pre-hospitalization expenses for up to 30 days and post-hospitalization expenses for up to 60 days
- Covers 141 day care procedures which entail hospitalization for less than 24 less than 24 hours
- No medical check-up will be done for up to 55 years
|
| Coverage |
- Coverage is provided for up to 2 children (3 months to 26 years)
- Hospitalization expenses (standard) which are covered under this policy are listed below:
- 141 day care procedures
- Surgery, oxygen and anaesthesia costs
- ICU charges
- Boarding charges
- Nursing charges
- Doctor's fees
- Plaster casts
- Medicines costs
- Physiotherapy
|
| Sub-limits |
The following are the sub-limits for various ailments under this health insurance policy
| Diseases |
Limits (in Rs) |
| Cataract |
20,000 |
| Tonsillectomy |
20,000 |
| Appendectomy |
30,000 |
| Coronary Angiography |
20,000 |
| Surgery of hernia |
40,000 |
| Urinary surgery |
25,000 |
| Treatment of fracture |
1 lakh |
| Kidney Stone Removal |
30,000 |
|
| Benefits |
The following table shows the benefits under the Pearl and Royale plans. Pearl plan includes Section I only while Royale includes both Section I and II
Section I
| Feature |
Coverage |
| Hospitalisation Expenses |
Rs.3,00,000 (plan 1)
Rs.4,00,000 (plan 2)
Rs.5,00,000 (plan 3)
|
| Co-payment |
10% on expenses (non network hospital) |
| Compulsory Co-payment |
15% on each claim |
| Room Rent |
1% of the Sum Insured |
| Day Care Services |
Covered |
| Pre-Hospitalisation |
Upto 30 days |
| Upto 30 days |
Upto 60 days |
Section II
Personal accident cover for spouse is listed in the table below:
| Condition |
Cover Plan 1 |
Plan 2 |
Plan 3 |
| Death |
3,75,000 |
5,00,000 |
5,00,000 |
| Permanent Disablement
(Partial)
|
1,87,000 |
2,50,000 |
2,50,000 |
| Permanent Disablement |
3,75,000 |
5,00,000 |
5,00,000 |
Personal accident cover for self is listed below:
| Condition |
Cover Plan 1
(Rs)
|
Plan 2
(Rs)
|
Plan 3
(Rs)
|
| Death |
7,50,000 |
10,00,000 |
10,00,000 |
| Permanent Disablement
(Partial)
|
3,75,000 |
5,00,000 |
5,00,000 |
| Permanent Disablement |
7,50,000 |
10,00,000 |
10,00,000 |
Personal accident cover for child is listed below:
| Condition |
Cover Plan 1 (Rs) |
Plan 2
(Rs)
|
Plan 3
(Rs)
|
| Death |
1,50,000 |
2,00,000 |
2,00,000 |
| Permanent Disablement
(Partial)
|
75,000 |
1,00,000 |
1,00,000 |
| Permanent Disablement |
1,50,000 |
2,00,000 |
2,00,000 |
|
| Premium |
The following table shows the premium offered under this policy
| Plans |
Sum Insured |
Royale |
Pearl |
| Plan 1 |
Rs.3,00,000 |
7,919 |
5,100 |
| Plan 2 |
Rs.4,00,000 |
9,337 |
5,890 |
| Plan 3 |
Rs.5,00,000 |
10,548 |
6,960 |
|
| Renewal |
Lifetime renewal |
| Tax benefits |
Available under section 80 D for up to Rs.15,000 |
| Claims |
- Claims can be made across all network hospitals. Insurance provider must be informed 24 hours prior to admission for planned hospitalization and 24 hours after hospitalization for emergency
- Complete claim forms with all required documents have to be submitted under 30 days after discharge for hospitalization at a non-network hospital
- Customers can call Chola helpline at 1800-200-5544
|
| Exclusions |
The following table shows the list of exclusions related to hospitalization and personal accident insurance
| Hospitalization |
Personal Accident |
- Pre-existing conditions are excluded till four years of coverage without break from the commencement date
- Cataract, Fibromyoma Fistula in anus, Hernia, Sinusitis and related disorders are covered after one year of commencement date
- Except accidents, all expenses in the first 30 days of policy commencement are covered
- Knee joint replacement, gallbladder, duodenal ulcers, nodules, breast lumps, ENT disorders, surgery for prolapsed inter vertebral disk and tonsils covered only after two years of commencement of policy
|
- Suicide
- Self-inflicted injury (sane or insane)
- Terrorism
- Sports training
|
|
