Chola MS Individual Health Line Plan

Product overview

Unique Features of Chola MS Individual Health Line Plan

• This Plan does not required any medical test up to 55 years
• Ayurvedic Therapy Treatments covered under the Advanced Plan.
• This plan also covers Maternity benefits after a waiting period of 5yrs.
• Covers pre-hospitalization expenses for up to 60 days and post-hospitalization expenses for up to 90 days.
• Some Organ Specific are Covered after 1 year like Cataract, benign prostratic hypertropy, etc

Critical features of Chola MS Individual Health Line Plan

• Room rent:
  Limits imposed towards room and ICU rent expenses

1. This Plans has 3 variants Standard,Superior ,Advanced plan
2. Standard Plan- (Sum Insured 1 Lacs- Non AC Single Room upto Rs.1000 per day)(Sum Insured 2/3/4 & Lacs AC Single Room upto Rs.3000 per day)
3. Superior Plan- AC single room up to Rs 3000 per day
4. Advanced Plan-(Sum Insured Rs-4.5 /5.5 Lacs -AC single room up to Rs 3000 per day(Sum Insured - 7.5 & 10 Lacs (Maximum 1% of the Sum Insured)

• Co-Pay:
  Specific % of admissible claim amount to be borne by Insured

1. 20% co payment above age 70 years
2. 30% Co payment for OPD dental Cover and External aids(waiver option available)
3. 20% Co payment for Ayurvedic Therapy Treatments.(waiver option available)

Sub-limits Against Diseases

1. Cataract - 7.5% of SI, max RS 20,000 per eye(Only Applicable Standard and Superior Plan)
2. Hernia or Hydrocele -10% of SI, max RS 30,000(Only Applicable Standard Plan)
3. Fistula in Anus, Anal Fissure, Piles - 10% of SI, max RS 30,000(Only Applicable Standard Plan)
4. Sinusitis -10% of SI, max RS 30,000(Only Applicable Standard Plan)
5. Tonsilitis or Adenoids -15% of SI, max RS 40,000(Only Applicable Standard Plan)

• No Claim Bonus:
  Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal
  5% of basic sum insured up to a maximum of 50 % for each unclaimed year in case opted for(The cumulative bonus is reduced by 5 % of sum insured once a claim is made)
• Pre-Existing Diseases:
  Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer
  This plans has a waiting period of 4 years is case of pre-existing diseases

Eligibility Criteria

• Minimum Age of Entry:- 91 days
• Maximum age of Entry:- 65 years
• Renewal Age:- Life Long Renewal
• Sum Insured:-
  Standard Plan - 1/2/3/4/5 Lakhs
  Superior Plan - 3.5/4.5/5 Lakhs
  Advanced Plan - 4.5/5.5/7.5/10 Lakhs
• Policy Tenure:- 1 year
• Premium Calculated on Basis of:- Age, (i.e. sum Insured Chosen)

Waiting Period

• Covered from Day 1:
  Accidental Injuries.
• Covered after 30 Days:
  All incidences apart from specified surgeries, Permanent exclusion & Pre-existing diseases (if any)
• Covered after 1 Years:
  Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Fistula, Piles, Sinusitis & related disorders, Gallstones.
• Covered after 2 Years:
  Spondylitis, Spondylosis, Knee / Hip joint replacement, Internal congenital diseases, Osteoarthritis of any joint, Calculus diseases of gall bladder and urogenital, Gastric & duodenal ulcers, Internal Tumours, cysts, nodules, polyps including breast lumps (each of any kind unless malignant), Gout & Rheumatism, ENT disorders & Surgery, Surgery of genitourinary system, Surgery for prolapsed inter vertebral disk, Surgery of varicose veins & varicose ulcers, Surgery on tonsils

Exclusions

• Treatment with alternative medicines like acupuncture, acupressure, osteopath, naturopathy, chiropractic, reflexology and aromatherapy.
• Treatment arising from or traceable to pregnancy (whether uterine or extra uterine) and childbirth including caesarean section, and/or any treatment related to prenatal and postnatal care.
• All expenses related to AIDS and related diseases.
• Use/Abuse of intoxicating drugs or alcohol,any hazardous activities.
• War or any act of war, invasion, intentional self-injury or attempted suicide.
• Treatment of obesity,,Cosmetic treatments,mental disorders,external congenital diseases.
• Personal comfort and convenience items or services.

Note: Any claims arising out of or attributable to any of the following is not covered

Tax Benefits

The premium paid for health insurance policy is liable to get a tax rebate under section 80D of the Income Tax Act, 1961.

Claim Process

In case you would like to know about the Claim Process or would like to register a Claim please click the link below.

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