Chola MS Swasth Parivar Plan

Product Overview

Chola MS Swasth Parivar Plan is an hospitalization policy, which covers inpatient treatment for a minimum period of 24hrs, along with other benefits like day care treatments, Ayurvedic treatment, etc.

Unique Features of Cholamandalam MS Swasth Parivar Plan

• Covers pre-hospitalization expenses for up to 30 days and post-hospitalization expenses for up to 60 days
• Covers 141 day care procedures which require less than 24 hours of hospitalization
• Some Organ Specific are Covered after 1 year like Cataract, benign prostratic hypertropy, etc (Royale Plan)
• Personal Accident Cover - Applicable only for Royale Plan - Subject to limit specified in the Policy wordings.

Critical features of Cholamandalam MS Swasth Parivar Plan

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

1. Room rent limit 1% of the Sum Insured.
2. ICU Limit 1.5% of the Sum Insured.

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

1. 15% co-payment for each and every claims
2. 10% co-payment in a Non-Network hospital

• 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
  This plan does not offer a claim bonus benefits
• 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:- Children-90 days
• Maximum age of Entry:- 65 years
• Renewal Age:- Life Long Renewal
• Sum Insured:-
  Pearl Plan- (Plan1- Rs 3 Lakhs, Plan2- Rs 4 Lakhs ,Plan 3- Rs 5 Lakhs)
  Royale Plan- (Plan1- Rs 3 Lakhs, Plan2- Rs 4 Lakhs ,Plan 3- Rs 5 Lakhs)
• Policy Tenure:- 1 & 2 years
• Premium Calculated on Basis of:- Age, (i.e. sum Insured Chosen)

Add-ons

• Personal Accident Cover in Royale Plan:
  If at any time during the policy period if the insured sustains any bodily injury, percentage of the sum insured as stated will be covered.
  a) Death
  b) Permanent Total Disablement
  c) Permanent Partial Disablement
• Special Conditions (applicable to Section II a, b and c):

1. If the accident impairs a number of physical functions, the degree of disablement given in the Table of Benefits will be added together, but liability in any case shall not exceed 100% of the Sum Insured.
2. In the event of an accident to the Aircraft in which you are traveling as a fare paying passenger and your body cannot be located within 365 days from the date of such accident then we shall pay 100% of the Sum Insured for Death Cover towards loss of life.
3. In the event of Permanent Total Disablement or Permanent Partial Disablement, you will be under obligation:
   a) To have yourself examined by doctors appointed by us/ and we will pay the costs involved thereof.
   b) To authorize doctors providing treatments or giving expert opinion and any other authority to supply us any information that may be required.

If the obligations are not met with due to whatsoever reason, we may be relieved of our liability to pay.
The policy will remain live till 100% of the Sum Insured under any one of the benefit under Coverage Section II a or b is exhausted during the policy period

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 Year (Royale Plan):
  Cataract, benign prostratic hypertropy, hysterectomy for menorrhagia or fibromyoma, hernia, hydrocele, fistula in anus, piles, internal congenital disease, sinusitis and related disorders covered after a waiting period of one year of policy inception (applicable for Royale plan)
• Covered after 2 Years (Pearl Plan):
  Cataract, benign prostratic hypertropy, hysterectomy for menorrhagia or fibromyoma, hernia, hydrocele, fistula in anus, piles, internal congenital disease, sinusitis and related disorders, spondilitis, spondilosis, knee / hip joint replacement, osteoarthritis of any joint, calculus diseases of gall bladder and urogenital, gastric and duodenal ulcers, internal tumours, cysts, nodules, polyps including breast lumps, gout and rheumatism, ENT disorders and surgery, surgery of genito urinary system, surgery for prolapsed inter vertebral disk, surgery of varicose veins and ulcers, surgery on tonsils covered after a waiting period of two years of policy inception (applicable for Pearl plan)

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.

Know More