Cholamandalam Health Insurance
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CHOLAMANDALAM HEALTH INSURANCE

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Cholamandalam Health Insurance

Overview
In 2001, Cholamandalam MS General Insurance Company Ltd (Chola MS) is formed out of a joint venture between Indian conglomerate, the Murugappa Group headquartered in Chennai and the Mitsui Sumitomo Insurance Group, a Japanese insurance company. Chola MS offers a range of insurance products across four wheelers, commercial vehicles, health, home and property, travel, personal accident and rural insurance to individuals as well as corporate clients. The company serves the nation with its 109 branches and 9000 agents across the country. IndusInd Bank and Oriental Bank of Commerce acts as their sales channel for some of its products too. The company follows the philosophy of T3 – Trust, Transparency and Technology for customer delight.

Chola MS Health Insurance at a Glance
  • Cashless claim at 3750 garages and 6500+ hospitals across India
  • Annual health check-up for insured members irrespective of their claims history
  • 78107 Policies were issued in FY 15-16
  • Covers 20 critical illnesses on selected health plans
  • 99.56% of grievances resolved in FY 15-16
  • 44.56% claim settlement ratio
  • Offers dual protection of hospitalization cover and personal accident coverage on individual basis
  • Committed to act courteously, fairly and reasonably in all dealings with the customers

Awards & Recognitions
  • In 2012, Yahoo Finance listed Chola MS as the top Insurer for its user friendliness and economical premium
  • In 2013, Chola MS bagged the “Claims Awards Asia”
  • In 2011, Ministry of Labour and Employment awarded “Rashtriya Swasthya BimaYojana” award for outstanding performance in terms of in-time claim settlement
  • Fintelekt awarded Chola MS, the “Innovation Leader Award” of 2012
  • Received “Financial Insights Innovation Award” for innovation in mobile enablement – Claims Survey Process held at Asian Insurance Congress, Singapore

Documents needed to apply for Chola MS Health Insurance
  • Age proof - (Any One)
    Driving License, Passport, Voter ID Card, Birth Certificate, etc
  • Identity proof – (Any One)
    Driving License, Passport, Voter ID card, PAN Card, Aadhar Card, or any document which proves citizenship
  • Income proof
  • Address proof – (Any One)
    Driving License, Passport and Utility Bill should clearly mention the permanent address
  • Income proof – (Any One)
    Salary Slip, Form 16, ITR
  • Recent passport size photograph

Why Cholamandalam Health Insurance?
Here are some reasons why Chola MS Health is the right insurance provider for you:

Features Description
Sum Insured You can choose a sum insured ranging from Rs2 Lacs to Rs10 Lacs.
Cashless hospitalisation Chola MS Health has over 5000 network hospitals across India where one can avail cashless facility.
Claim process 24/7 claim assistance offers fast, seamless claim process across wide network of hospitals that makes the claim management quick and convenient. The Claim Settlement Ratio of Chola MS Health Insurance for FY2015-16 is 44.56%
No-Claim Bonus (NCB)  Earn up to 100% NCB in the form of a 50-150% increase in sum insured.
Discounts Offers 10% discount for individual plans taken and 11% - 18% discount for plans taken on family floater basis, minimum two and maximum four additional members.
Lifelong renewability  All plans offered by Chola MS Health have a lifelong renewability option
Maternity benefit With Chola MS Healthline’s Privilege Plan maternity expenses uptoRs 1 Lacs per delivery is covered (upto 2 deliveries after 3 consecutive renewals). New born baby hospitalization expenses are also covered.
Health Checkup Insured members of Chola MS Health can avail annual health check-up regardless of their claim history
AYUSH treatments AYUSH treatment upto an amount of sum insured is covered
Riders Apart from 20 specified critical illness coverage, one time additional lumpsum is paid that excludes pre-existing critical conditions.

Types of Chola MS Health Insurance Plans
Chola MS Health offers insurance coverage with comprehensive health cover, critical illness cover ,personal accident cover and mediclaim across various plans.

1. Chola MS Healthline Insurance Plan: This policy from Chola MS comes with four sub-plans – Value, Freedom, Enrich and Privilege and gives comprehensive cover to individual as well as dependants that include parents, parents-in-law and siblings too.

2.Chola Swasth Parivar Health Insurance Plan: An extremely economic policy from Chola MS, which provides insurance cover hospitalization expenses for families on a floating sum insured basis and Personal Accident cover for your family members on individual Sum Insured basis.

3.CholaTax Plus Healthline Plan: With wide range of sum insured option, this plan from Chola MS is meant for providing medical insurance coverage for both hospitalisation and non-hospitalisation, including OPD expenses.

4. Chola MS Family Healthline Insurance Plan: This Chola MS plan covers both allopathy and ayurvedic treatments and is a floater plan where one can include family members. It comes with many add-ons.

5. Chola MS Individual Healthline Plan: This policy from Chola MS covers other incidental expenses associated with hospitalization. It also covers maternity related expenses and eye check-up once in every two continuous claim free years.

6. Chola Topup Healthline Plan: This Topup plan provides coverage for higher medical expenses and available for a sum insured upto Rs 15 Lacs. The tenure of which is upto 3 years with additional insurance available at half the premium.

7. Chola MS Critical Healthline Insurance Plan:This plan from Chola MS provides coverage for upto 12 major illnesses, and pays out lumpsum payment if diagnosed. Claims can be obtained without any proof of expenses incurred.

8. Chola Hospital Cash Healthline Plan: This plan from Chola MS pays daily cash upto Rs 3000 for hospitalisation and provides double benefit for ICU confinement. Simple paperwork makes it less of a hassle.

9. Chola Classic Health – Individual Plan: This plan is available for sum insured upto Rs 10 Lacs and requires no medical check-up till 45 years of age. Also offers family discount on premiums paid.

Chola MS Health Insurance Plans in detail
1)Chola MS Healthline Insurance Plan
Features Description
Entry age 18 – 65 years
Type of Plan Individual / Family Floater
Sum Insured 2 - 25 Lacs
Coverage for Spouse, dependent children, parents, parents-in-law and siblings too.
Policy term 1,2,3years

Inclusions, Benefits and Features
  • In-Patient Hospitalisation-Medical expenses for hospitalisation for a minimum period of 24 hours will be covered with upto sum assured subject to sub-limits; it does not cover outpatient treatment and treatment outside India.
  • Pre-Hospitalisation - Any medical expenses that have been incurred 30 days prior to the hospitalisation for the same illness will also be covered. This also has ambulance cover.
  • Post-Hospitalisation–Similarly, medical expenses incurred30 days after being released from the hospital and for the same illness will also be covered. Expenses such as doctor consultations, Diagnostic tests, medications etc are covered under this.
  • Domiciliary Treatment–Treatment of illness done at home for a period exceeding 3 consecutive days in case of emergency, which would normally need hospitalisation will also be covered in the policy. Its 10% of the sum insured
  • Organ Donor–Covers treatment expenses for organ donor; provided the liability towards expenses incurred on the donor and the insured recipient doesn’t exceed the aggregate of the sum insured and cumulative bonus buffer, if any, of the insured person receiving the organ.
  • Health Checkup–As a preventive measure, this policy provides Annual Health Check-up for policyholder and all members covered by under the policy, including children. The frequency being once in 4 years.
  • Reinstate the policy–This policy enables reinstate the entire Sum Insured amount if you ever run out of your health cover due to claims made. This additional amount can be used by you or by any other insured member for treatment of any ailment.
  • Emergency surface Ambulance charges– Rs 1000 – 5000 per event is paid for ambulance services availed in case of emergency.
  • AYUSH treatment –an amount upto sum insured is paid for treatment at any approved centre for Ayurveda, Yoga, Unani, Siddha and Homoeopathy treatments.
  • Maternity expenses – Only for the Privilege plan, maternity expenses are borne upto 2 deliveries, after 3 consecutive renewals, which is upto Rs 1 Lacs per delivery. New born baby’s hospitalisation expenses are also covered.
  • Specialist Opinion – Under Privilege plan Rs 25000 is offered as a specialist opinion fees for critical illnesses consultation

2)Chola Swasth Parivar Health Insurance Plan
Features Description
Entry age 18 – 65 years; for children minimum entry age is 3 months upto 26 years
Type of Plan Individual / Family Floater
Sum Insured 3 – 5 Lacs
Coverage for Spouse, dependent children, with the limit on number of adults being at 2 and children being at 2.
Policy term 1, 2 or 3year

Inclusions, Benefits and Features
  • In-Patient Hospitalisation
  • Pre-Hospitalisation
  • Post-Hospitalisation
  • Domiciliary Treatment
  • Day care
  • Organ Donor Expenses
  • Daily cash allowance
  • Co-Payment
  • ICU expenses
  • Doctor’s fees and nursing expenses
  • Surgery, anaesthesia and oxygen charges
  • Cost of medicines
  • Physiotherapy expenses
  • Miscellaneous hospital services (path labs, X-Rays etc)
  • Cataract surgery
  • Kidney stone removal expenses
  • ENT
  • Coronary Angiography and Angioplasty
  • Treatment of fracture/dislocation/knee surgery
  • Urinary surgery

3)Chola Tax Plus Healthline Plan
Features Description
Entry age 18 - 65 yrs.; 3 months for children
Type of Plan Individual / Family Floater
Sum Insured 1 to 5 Lacs
Coverage for Self, spouse, dependent children and parents

Inclusions, Benefits and Features
  • Hospitalisation expenses
  • ICU rent
  • Pre-Hospitalisation
  • Post-Hospitalisation
  • Non-Hospitalisation cover
  • Daily allowance
  • Cataract treatments
  • Knee and joint replacement surgery
  • Ambulance expenses
  • Medical examination reimbursements
  • Allopathic treatments and any other Indian medicine other than naturopathy

4) Chola MS Family Healthline Insurance Plan
Features Description
Entry age 18 - 65 yrs; 3 months for children
Type of Plan Individual / Family Floater
Sum Insured Standard : Rs 2- 5 Lacs
Superior : Rs 4 – 10 Lacs
Advanced : Rs 6 – 12 Lacs
Renewability Lifelong renewability
Coverage for Self, spouse and children

Inclusions, Benefits and Features
  • Hospitalisation expenses
  • Pre-Hospitalisation
  • Post-Hospitalisation
  • General health check-up and eye examination
  • Emergency ambulance expenses
  • Daily allowances
  • Home nursing charges
  • Maternity expenses
  • Ayurvedic treatments
  • OPD Dental
  • External aids – specs/contact lens/hearing aid
  • Chola MS Wellness services
  • Organ donor expenses
  • ICU expenses
  • Miscellaneous hospital services – path lab/X-ray/dressings/plaster casts etc

5)Chola MS Individual Healthline Plan
Features Description
Entry age 18 - 65 yrs; 3 months for children
Type of Plan Individual / Family Floater
Sum Insured Standard : Rs1 - 5 Lacs
Superior : Rs 3.5 – 5 Lacs
Advanced : Rs 4.5 – 10 Lacs
Renewability Lifelong renewability
Coverage for Self, spouse and children

Inclusions, Benefits and Features
  • Hospitalisation expenses
  • Pre-Hospitalisation
  • Post-Hospitalisation
  • General health check-up and eye examination
  • Emergency ambulance expenses
  • Daily allowances
  • Home nursing charges
  • Maternity expenses
  • Ayurvedic treatments
  • OPD Dental
  • External aids – specs/contact lens/hearing aid
  • Chola MS Wellness services
  • Organ donor expenses
  • ICU expenses
  • Miscellaneous hospital services – path lab/X-ray/dressings/plaster casts etc

6)Chola Topup Healthline Plan
Features Description
Entry age 18 - 65 yrs; 3 months for children
Type of Plan Individual / Family Floater
Sum Insured Rs 50000 to Rs 15 Lacs depending on the Plan
Renewability Lifelong renewability
Coverage for Self, spouse and children
Policy period 1, 2 or 3 years

Inclusions, Benefits and Features
  • Hospitalisation expenses
  • Pre-Hospitalisation
  • Post-Hospitalisation
  • General health check-up and eye examination
  • Emergency ambulance expenses
  • Daily allowances
  • ICU expenses
  • Medicines and anaesthesia
  • OT charges
  • Surgical appliances and prosthetics
  • Organ donor expenses

7) Chola MS Critical Healthline Insurance Plan
Features Description
Entry age 18 - 65 yrs; 5 years for children
Type of Plan Individual / Family Floater
Sum Insured Rs3, 5 or 10 Lacs
Renewability Lifelong renewability
Coverage for Self, spouse, parents, parents-in-law, dependent child

Inclusions, Benefits and Features
  • 10 to 12 critical illnesses covered
  • Emergency ambulance service for Advanced Plan
  • Major organ transplant
  • Paralysis of limbs
  • Parkinson’s disease
  • Kidney failure/ dialysis
  • Aorta surgery
  • Pulmonary hypertension

8) Chola Hospital Cash Healthline Plan
Features Description
Entry age 18 - 65 yrs; 3 months for children
Type of Plan Individual / Family Floater
Renewability Lifelong renewability
Coverage for Self, spouse and children
Policy period 1, 2 or 3 years

Inclusions, Benefits and Features
  • Hospitalisation expenses
  • ICU charges
  • Convalescence benefit
  • No medical checkups
  • Family discounts
  • Double confinement benefit
  • General health check-up and eye examination
  • Emergency ambulance expenses
  • Daily allowances
  • OT charges

9) Chola Classic Health – Individual Plan
Features Description
Entry age 18 - 65 yrs
Type of Plan Individual
Sum Insured Rs1 Lac to Rs 10 Lacs
Renewability Lifelong renewability
Coverage for Self
Policy period 1 year

Inclusions, Benefits and Features
  • Hospitalisation expenses
  • Pre-hospitalization
  • Post-hospitalization
  • Doctor fees and nursing fees
  • General health check-up and eye examination
  • Daily allowances
  • ICU expenses
  • Medicines and anaesthesia
  • OT charges
  • Surgical appliances and prosthetics
  • Organ Donor expenses
  • Day care expenses
  • Emergency Ambulance

Chola MS Health Exclusions:
  • There is an initial waiting period of 30 days for all illnesses except an accidental injury
  • Treatment of any pre-existing condition or diseases
  • Injury or illness caused due to war, invasion, nuclear weapon, contamination by radioactive materials
  • Sex change, circumcision
  • HIV/AIDS and related diseases
  • All skin conditions, internal tumours, breast lumps
  • Expenses arising out of medical conditions like Cataracts, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Fistula in anus, Piles, internal congenital disease, Sinusitis and related disorders

Chola MS Health Login:
  • For Individuals: Log into the Chola MS General Insurance website with your name, email ID, and mobile number
  • For Corporate Employees: Register with your Member ID and Employee ID.
  • For Corporate Administrators: Register using their Policy Number and Group ID.
  • For Sales Partner: Register using Agent Code and Date of Birth.
  • Brokers or Corporate Agencies: Register with Broker or Agency Code and Date of Joining.
  • Using Social media: You can also sign in with your Facebook, Gmail or mobile connect log-in.

Chola MS Health Insurance Renewal:
  • Log into the Chola MS Health Insurance website with your registered email or member ID and password, provided on the right side of the webpage (http://www.cholainsurance.com/individual/health-insurance.aspx)
  • Enter the exact policy number and expiry date as mentioned in the policy schedule.
  • Enter your age on the renewal calculator to get the renewal premium.
  • You can choose a different policy, altering the sum insured, add or remove dependants, alter rider policy, and edit policy term.
  • The policy schedule contains a unique policy number which changes every year on renewal.
  • Renewal payment can be made 60 days prior to the policy expiry date.
  • There is a 30day grace period within which to renew your policy without losing benefits
  • ou can also opt to renew your policy through an Interactive Voice Response (IVR) and use the direct payment link. Contact 1800-200-5544 (for domestic customers) or 9144-3098-5300 (for overseas customers) for more details.
  • Email can be send for further details to  customercare@ cholams.murugappa.com, SMS CHOLA HEALTH to 56677 can also provide requisite details

Chola MS Health Insurance Claim Settlement:
Cashless Claim Reimbursement Claim
Visit a network hospital of the insurer to avail cashless treatment. If the cashless claim is denied, the insured member can get treated and file for a reimbursement claim after discharge.
Display your health card at the network hospital’s help desk. Submit the claim form along with the medical documents within 15 days of your discharge from the hospital.
Intimate the Claim helpdesk number of Chola MS within 24 hours of unplanned hospitalisation and 48 hours prior to your planned hospitalisation. Claims can be registered at the insurer's customer service centre or any of the branch offices through an application, call, email or in person.
The hospital will verify your identity details and submit a duly-filled and signed pre-authorisation request form to the insurer. To register a claim provide your contact details, name of the insured member, policy number, date and time of the problem, nature of the problem, and location of the problem.
After verification of the pre-authorisation request, the insurer will send an approval letter to the network hospital. Upon successful verification and approval, the claim amount will be sent to the proposer in the form of a cheque within 30 days of receipt of the documents.
The hospital will proceed with the cashless treatment for the insured member. Chola MS will settle the bill directly with the hospital. The insured has to pay those bills that are not covered under the policy. For any claim-related queries, call 1800-200-5544 (for domestic customers) or 9144-3098-5300 (for overseas customers) or email at customercare@cholams.murugappa.com

Chola MS Health Insurance FAQs:
1) How Chola MS Health Insurance policyholders can get in touch with the insurer for any policy-related queries?
You can get in touch with the insurer by filling out a simple online form or calling the customer support centre on the numbers1800-200-5544 (for domestic customers) or 9144-3098-5300 (for overseas customers). You can also mail the insurer with your queries to this email ID customercare@ cholams.murugappa.com. A Call back request can also be placed online.

2) How can I add a family member to my existing policy?
You can download Change Request form from the Chola MS Health Insurance website, fill it, and submit it at the nearest branch office along with additional premium. Mid-term policy addition is allowed only for a new born baby or newly-wed spouse.

3) How can I increase the sum insured of my Chola MSHealth Insurance?
You can download the Change Request form from the Chola MS Health Insurance website, fill it, and submit it at the nearest branch office along with the revised premium. Sum insured can be increased or decreased only at the time of renewal and not during the policy tenure. In the case of health insurance portability, sum insured cannot be enhanced if there’s a claim in the previous policy.

4) What is Re-instatement in the Chola MS Health Plan?
If you exhaust your entire sum insured and cumulative bonus (if any) and still require further hospitalisation for any related or unrelated illness, Chola MS Health will refill the full Sum Insured at no extra cost.

5) What is multiplier benefit?
Under this benefit, during the first claim-free year, the sum insured will increase by 50% and the second claim-free year, the sum insured will be increased by 100%.

6) How can I claim OPD expenses from Chola MS Health?
You may submit all original medical bills and prescriptions to the insurer for reimbursement of OPD expenses. But make sure OPD expenses is covered in your plan.

7) Can I choose multiple sum insured for my family members?
Yes, within the chosen variant, multiple sum insured can be selected for your dependents.