Chola MS Health Insurance

Cholamandalam MS General Insurance is an up and coming general insurer operating in the Indian market. The diverse range of health insurance products offered by the company provides protection against health risks faced by policyholders.

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Cholamandalam MS General Insurance Company Ltd (Chola MS) is a joint venture between the Murugappa Group, an Indian conglomerate, and the Mitsui Sumitomo Insurance Group (MSIG), a Japanese assurance company. Headquartered in Chennai, offering products like Motor Insurance, Health Insurance, Travel Insurance, Personal Accident & Home Insurance.

Chola MS General Insurance Highlights

Features

Specifications

Network Hospitals

8000+

Waiting Period for Pre-existing Disease

4 years

Incurred Claims Ratio

72.54%

Number of Policies Issued

91553

Grievances Solved

99.55%%

Renewability

Lifetime

Chola MS General Insurance Co. Ltd. was formed a decade ago on its core philosophies of Trust, Transparency and Technology.

Headquartered in Chennai, it has grown to be a general insurer of choice by ensuring customer-satisfaction through innovation and operational effectiveness. The company has an extensive branch-network of about 90 centres all over India. It reaches its customers primarily through its 7,000-strong agent network, duly supported by alternate distribution channels viz. bancassurance partners, tie-ups with auto majors and other strategic partnerships.

has a number of product lines catering to retail customers including Auto, Travel, Home and Personal Insurance, to name a few, alongwith business protection solutions for commercial clients.

Chola MS, being one of the leading health insurance providers in India, offers a number of health insurance plans. The health insurance plans offered by Cholamandalam MS come with a lot of attractive features and benefits, and provide comprehensive health insurance coverage at affordable rates.

Key Features of Cholamandalam MS Health Plans

Listed below are main features of health insurance plans from Chola MS:

  1. A select number of Chola MS Health plans provide double coverage for accidents and critical illnesses.
  2. They also provide for domiciliary hospitalization and you can with these plans.
  3. Enjoy cashless hospitalization at over 4300 hospitals across the country.
  4. Select health plans provide cover for 20 major critical illnesses.
  5. Get paid for the cost involved in room rent on selected health plans.
  6. Lifetime renewal facility is available.
  7. Get tax benefit under section 80 (D) of the Indian Income Tax Act, 1961.
  8. 24x7 claim assistance service.
  9. These plans also provide cover for over 140 Day-care procedures.
  10. Pre & post hospitalization expenses are covered by most of the health plans offered by Chola MS.
  11. Enjoy easy claim settlement procedure.

Types of Health Insurance Policies Provided by Chola MS

  • Chola MS Healthline Insurance
  • Chola Swasth Parivar Health Insurance Plan
  • Chola Tax Plus Healthline
  • Chola MS FamilyHealthline Insurance
  • Chola MS Individual Healthline Insurance Policy
  • Chola MS Top Up Healthline Insurance Policy
  • Chola MS Critical Healthline Insurance Plan
  • Chola MS Hospital Cash
  • Chola MS Individual Health
  • Chola MS Family Health Insurance

Key details of each of the plans are elucidated and tabulated below:

Chola MS Healthline Insurance

This policy comes with three sub-plans viz.

  1. Value Healthline
  2. Freedom Healthline
  3. Enrich Healthline

They are similar in terms of features but differ in terms of coverage amounts/sub-limits.

Entry Age

18 yrs. to 65 yrs.

Policy Period

1, 2 or 3 yrs.

Renewability

Lifetime

Medical Screening

Required; Costs reimbursed up to 50% (Value or Freedom Plans) and 100% (Enrich Plan) on qualification

Basis

Individual or Floater (Family includes self, spouse, dependent children/parents/parents-in-law/siblings)

Sum Assured

  1. Value Healthline: Rs.2 lakhs - Freedom Healthline: Rs.3, 5 or 7.5 lakhs - Enrich Healthline: Rs.3, 5, 7.5 or 10 lakhs  
  2. No-claim Bonus: Enhancement of chosen sum assured on renewal for every claim-free year awarded in the following way -  
  3. Value Healthline: 5% (max. 25%) - Freedom Healthline: 5% (max. 50%) - Enrich Healthline: 50% (max.100%) 

Premium

  1. Value Healthline: Rs.1,957 to Rs.24,919 - Freedom Healthline: Rs.3,801 to Rs.72,916 - Enrich Healthline: Rs.5,265 to Rs.90,212  
  2. Premiums depend on the chosen sum assured, age of insured members, policy tenure, basis of chosen plan and number of members covered. (Floater plans - premium based on age of the oldest member) 

Discounts

6% for a 2 yr. tenure; 12% for a 3 yr. tenure

Co-payment

10% - Only on the Value Healthline Plan for members over 55 yrs.

Coverage

  1. Inpatient hospitalisation expenses: Room charges: For coverage option of Rs.2 lakhs: Max.Rs.3,000; other coverage options: Actuals of single A/C room - 141 day care procedures Pre/Post-hospitalisation expenses: Up to 30/60 days respectively (Value Plan) and Up to 60/90 days respectively (Freedom or Enrich Plans)  
  2. Domiciliary Hospitalisation expenses: Up to 7 days  
  3. AYUSH treatment - Organ donor hospitalisation expenses - Ambulance costs: Rs.1,000 (Value Plan) and Rs.2,000 (Freedom or Enrich Plans)  
  4. Health-check costs: On completion of 3 / 2 claim-free year (Freedom/Enrich plans respectively) - Pre-existing diseases: After a 4-yr. waiting period 

Add-on Covers

Enrich Healthline Plan:

Chola Swasth Parivar Health Insurance Plan

This policy features two sub-plans viz.

  1. Pearl
  2. Royale

Basis

Family floater

Sum Assured

Rs.3, 4 or 5 lakhs

Premiums

Rs.5,005 to Rs.10,351

Co-payment

15% compulsory; 10% voluntary (at non-network hospitals)

Coverage

  1. Inpatient hospitalisation expenses: Room charges: 1% of chosen sum assured ICU: 1.5% of chosen sum assured (per day) - Costs of treating medical professionals, consumables etc. required for treatment - 141 day care procedures  
  2. Pre/Post-hospitalisation expenses: Up to 30/60 days respectively - Day care treatment: At network hospitals only - Pre-existing diseases: After a waiting period of 4 yrs. 

Add-on Covers

  1. Personal Accident Cover: Death and Total Permanent Disablement: Rs.7.5 to 10 lakhs (self) and Rs.3.75 to Rs.5 lakhs (spouse); Rs.1.5 to Rs.2 lakhs (per child)  
  2. Partial Permanent Disablement: Rs.3.75 to Rs.5 lakhs (self) and Rs.1.87 to Rs.2.5 lakhs (spouse); Rs.75,000 to Rs.1 lakh (per child) 

Chola Tax Plus Healthline

Entry Age

18 yrs. to 65 yrs.; 3 months for children

Medical Screening

Required for entrants above 55 yrs.

Sum Assured

Rs.1 to 5 lakhs in increments of Rs.1 lakh No-claim Bonus: 5% enhancement in chosen sum assured for every claim-free year, max.50%

Coverage

  1. Inpatient hospitalisation expenses: Room charges: 1% of the chosen sum assured (per day) ICU charges: 2% of the chosen sum assured (per day)  
  2. Pre-hospitalisation expenses: Up to 60 days (max. 5% of actuals) - Post-hospitalisation expenses: Up to 90 days (max.Rs.50,000) - Ambulance costs: Rs.3,000 per hospital stay - Cataract: 7.5% of chosen sum assured (max. 20,000) per eye - Hernia: 10% of chosen sum assured (max. 30,000) - Fistula/Piles: 10% of chosen sum assured (max.30,000) - Sinusitis: 10% of chosen sum assured (max.30,000) - Tonsillitis / Adenoids: 15% of chosen sum assured (max.40,000) - Knee/Joint Replacement Procedures: 50% co-payment  
  3. Outpatient cover - Pre/Post-Natal Expenses - Pre-existing diseases: After a 4-yr. waiting period - Dental - Treatment under branches of Indian medicine (not naturopathy) - Prescribed glasses, contact lenses, hearing-aids, prosthetics etc. 

Chola MS Family Healthline Insurance

This policy comprises the following plans:

  1. Standard
  2. Superior
  3. Advanced

Basic features are common to all plans but the amount and depth of coverage varies along with the premiums payable.

Entry Age

18 yrs. to 65 yrs. 3 months for children

Medical Screening

Required for entrants above 55 yrs.

Basis

Family Floater (Family includes self, spouse, dependent children)

Sum Assured

  1. Standard: Rs.2 to 5 lakhs in increments of Rs.1 lakh - Superior: Rs.4 to 10 lakhs in increments of Rs.2 lakhs -  
  2. Advanced: Rs.6 to 12 lakhs in increments of Rs.2 lakhs; Rs.15 lakhs No-claim Bonus: 5% enhancement of chosen sum assured for every claim-free year 

Premium

  1. Standard: Rs.5,845 to Rs.1,42,297 - Superior: Rs.10,516 to Rs.2,47,593 - Advance: Rs.18,707 to Rs.3,50,661 Depends on age of insured (based on oldest member),  
  2. chosen sum assured, chosen plan and family size i.e. up to two adults and 3 kids 

Co-Payment / Discounts

10% discount on premiums, if 10% co-payment is opted for

Coverage

  1. Inpatient hospitalisation expenses: Room charges (per day): Up to Rs.3,000 (Standard), Up to Rs.3,000 for Rs.4 lakh cover or 1% of the chosen sum assured for Rs.6, 8 or 10 lakhs cover (Superior) or 1% of the sum assured (Advanced)  
  2. Daily Cash Allowance: Rs.250 (Standard) and Rs.500 (Superior and Advanced); per day, up to 7 days, deductible of 1 day - Accompanying a child: Rs.250 (Superior and Advanced); per day, up to 7/14 days respectively, deductible of 1 day - Health-check costs including eye-checks: 0.5% or 0.75% or 1% of the chosen sum assured (Standard or Superior or Advanced respectively), once after 2 claim-free years  
  3. Ambulance costs: Rs.1,000 or Rs.2,000 or Rs.3,000 (Superior and Advanced, respectively), once a policy year, per insured member - Domiciliary hospitalisation: 15% or 25% of the chosen sum assured, max. Rs.75,000 or Rs.1 lakh (Superior and Advanced, respectively) 
  4. Maternity Expenses: After a 5-yr. waiting period, Rs.15,000 or Rs.25,000 (Superior and Advanced, respectively) - 141 day care procedures - Specific Ayurvedic treatment: Up to 7.5% of the chosen sum assured, 20% co-payment - Dental: After a 3-yr. waiting period, 1% of the chosen sum assured, max. Rs.5,000, 30% co-payment - External Aids: 1% of the chosen sum assured, max. Rs.5,000, every 2nd year, 30% co-payment - Cataract (per eye): 7.5% of the chosen sum assured, max.Rs.20,000 - Hernia: 10% of the chosen sum assured, max. Rs.30,000 - Fistula/Piles: 10% of the chosen sum assured, max. Rs.30,000 - Sinusitis: 10% of the chosen sum assured, max. Rs.30,000 - Tonsillitis: 15% of the chosen sum assured, max. Rs40,000 (Cataract to Tonsillitis:  
  5. covered under the Standard Plan within limits mentioned above; Cataract only covered under the Superior Plan; Cataract to Tonsillitis: covered under the Advanced Plan on basis of actuals) 

Benefits

Chola MS Wellness Service: Rs.350 or Rs.500 per person (SMS reminders)

Chola MS Individual Healthline Insurance Policy

Suited for protection of an individual, it provides three coverage options under plans titled Standard, Superior and Advanced. The sub-limits applicable to the various expenses depend on the plan chosen by the proposer and the coverage option therein.

Entry Age

18 yrs. to 65 yrs.; 3 months for children

Renewability

Required above the age of 55 yrs.

Medical Screening

Required above the age of 55 yrs.

Sum Assured

  1. Standard: Rs.1 to 5 lakhs in increments of Rs.1 lakh - Superior: Rs.3.5 to 5.5 lakhs in increments of Rs.1 lakh - Advanced: Rs. 4.5, 5.5, 7.5 or 10 lakhs  
  2. No-claim Bonus: 5% increase in sum assured, every claim-free year 

Premiums

Standard: Rs.2,619 to Rs.31,688 - Superior: Rs.3,136 to Rs.32,304 - Advanced: Rs.5,320 to Rs.56,181

Discounts

10% discount for 10% voluntary co-payment

Coverage

  1. Inpatient hospitalisation expenses: Room charges: Up to Rs.1,000 or Rs.3,000 per day depending on chosen coverage (Standard); Up to Rs.3,000 per day (Superior); Up to Rs.3,000 or 1% of chosen sum assured depending on chosen coverage - Pre/post-hospitalisation expenses: Up to 60 / 90 days -  
  2. Ambulance costs: Rs.1,000 or Rs.2,000 or Rs.3,000 (Standard, Superior, Advanced, respectively) - 141 day care procedures - Daily Cash Allowance (hospitalisation): Rs.250, max. 7 days (Standard); Rs.500, max. 7 days (Superior); Rs.500, max.14 days (Advanced) per day, deductible: 1 day - Health-check costs: 0.5% or 0.75% or 1% of chosen sum assured (Standard, Superior, Advanced respectively), every 2nd claim-free yr.  
  3. Cash Allowance for accompanying a hospitalised minor (Superior/Advanced): Rs.250 per day, max.14 days; deductible: 1 day - Domiciliary hospitalisation: 15% (max. Rs.70,000) or 25 (max. Rs.1 lakh) of the chosen sum assured (Superior/Advanced respectively) - Maternity Expenses: Up to Rs.25,000 or Rs.40,000 (Superior/Advanced respectively) -  
  4. Ayurvedic Treatment: Up to 7.5% of chosen sum assured; 20% co-payment (Advanced) - OPD Dental: 1% of chosen sum assured, max. Rs.5,000; 30% co-payment (Advanced) - External Aids: 1% of chosen sum assured, max. Rs.5,000; 30% co-payment; (Advanced) Cataract (per eye): 7.5% of the chosen sum assured, max.Rs.20,000 - Hernia: 10% of the chosen sum assured, max. Rs.30,000 - Fistula/Piles: 10% of the chosen sum assured, max. Rs.30,000 - Sinusitis: 10% of the chosen sum assured, max. Rs.30,000  
  5. Tonsillitis: 15% of the chosen sum assured, max. Rs40,000 (Cataract to Tonsillitis: covered under the Standard Plan within limits mentioned above; Cataract only covered under the Superior Plan; Cataract to Tonsillitis: covered under the Advanced Plan on basis of actuals) 

Benefits

Chola MS Wellness Service: Rs.350 or Rs.500 per person (SMS reminders)

Chola MS Top-Up Healthline Insurance Policy

This is a health insurance policy which enhances the cover of a basic health plan. Taken in-addition to an existing policy, this makes coverage more comprehensive.

There are 7 coverage options viz. Plan A, B, C, D, E, F and G. Each plan features a deductible which is the amount the proposer bears on admissible claims. Sub-limits on the various expenses covered under this policy also vary according to the chosen plan.

Entry Age

18 yrs. to 65 yrs.; 3 months for children

Policy Period

1, 2 or 3 yrs.

Renewability

Lifetime

Medical Screening

Required above the age of 55 yrs.

Basis

Individual or Floater

Sum Assured

  1. Plan A: Rs.50,000; applicable deductible:Rs.30,000  
  2. Plan B: Rs.2 lakhs; applicable deductible:Rs1 lakh  
  3. Plan C: Rs.3 lakhs; applicable deductible: Rs.2 lakhs  
  4. Plan D: Rs.5 lakhs; applicable deductible Rs.3 lakhs  
  5. Plan E: Rs.6 lakhs; applicable deductible: Rs.4 lakhs  
  6. Plan F: Rs.10 lakhs; applicable deductible: Rs.5 lakhs  
  7. Plan G: Rs.15 lakhs; applicable deductible: Rs.5 lakhs 

Premiums

  1. 1 yr. policy: Rs.2,472 to Rs.14,029  
  2. 2 yr. policy: Rs.4,749 to Rs.27,244  
  3. 3 yr. policy: Rs.6,808 to Rs.38,802 Premiums are based on the oldest insured member and depend on chosen sum assured, number of insured members, age and policy tenure. 

Coverage

  1. Inpatient hospitalisation expenses: Including charges for treating medical professionals, consumables, equipment, supplies, OT etc.  
  2. Up to Rs.80,000 (A); Rs.3 lakhs (B); Rs.5 lakhs (C),Rs.8 lakhs (D), Rs.10 lakhs (E), Rs.15 lakhs (F), Rs.20 lakhs (G) Room charges: Rs.500 (A), Rs.2,000 (B), Rs.4,000 (C), Rs.5,000 (D), Rs.6,000 (E), Rs.7,500 (F), Rs.10,000 (G)  
  3.  Pre-hospitalisation expenses: Up to 60 days, max.5% of actuals - Post-hospitalisation expenses: Up to 90 days, max.10% of actuals (up to Rs.50,000)  
  4. Ambulance costs: Up to Rs.3,000 per hospitalisation - Pre-existing diseases: After a 4-yr. waiting period 

Chola MS Critical Healthline Insurance Plan

This plan can be taken in addition to a basic health plan to make coverage more comprehensive. Basic plans do not cover critical illnesses whereas this plan specifically targets these events.

There are two options based on the number of critical illnesses covered i.e. 1. Standard Plan: Covers 10 illnesses 2. Advanced Plan: Covers 12 illnesses

Entry Age

18 yrs. to 65 yrs.; 5 yrs. for children

Renewability

Lifetime

Medical Screening

Required above the age of 55 yrs.

Basis

Individual

Sum Assured

Rs.3, 5 or 10 lakhs

Chola MS Hospital Cash

This policy offers holders a way to meet expenses during hospitalisation. The three medical insurance plans mentioned below offer varying levels of cover. Customers can avail of this policy, based on their affordability, given the range of premiums charged under Plan A, Plan B or Plan C.

Hospitalisation expenses in this case includes ICU charges and extended stay and payout is given as a lump sum once claims are successfully processed.

Entry Age

18 yrs. to 65 yrs.; 3 months for children

Renewability

Lifetime

Medical Screening

Required above the age of 55 yrs.

Premium

  1. Plan A: Rs.762 to Rs.6,817  
  2. Plan B: Rs.1,317 to Rs.13,355  
  3. Plan C: Rs.1,872 to Rs.19,893 

Discounts

5% for every additional member covered, max.10%

Coverage

  1. Hospitalisation Cash Benefits:: Rs.1,000 (A), Rs.2,000 (B), Rs.3,000 (C); per day  
  2. ICU charges: Rs.2,000 (A), Rs.4,000 (B), Rs.6,000 (C); per day  
  3. Convalescence Benefit: Lump sum payment; Rs.10,000 (A), Rs.15,000 (B), Rs.20,000 (C); per day  
  4. Pre-existing diseases: After a 4-yr. waiting period 

Chola MS Individual Health

This plan gives the client a chance to enhance their cover by paying additional premium.

Entry Age

18 yrs to 65 yrs.

Policy Period

1 year

Renewability

Lifetime

Medical Screening

Required above 45 yrs.

Sum Assured

  1. Rs.1, 1.5, 2, 3, 4, 5, 7.5 or Rs.10 lakhs No-claim Bonus:  
  2. 5% enhancement of sum assured for every claim-free year; max. 50% 

Premium

Basic: Rs.1,643 to Rs.24,555 Basic + Extra: Rs.1,811 to Rs.29,200 Premiums depend on chosen coverage and age of insured member

Discount

Family discount: On total premium for additional members covered

Coverage

  1. Inpatient hospitalisation expenses: Room, services of medical professionals, consumables, equipment, supplies etc.  
  2. Pre/Post-hospitalisation expenses: Up to 60/90 days respectively - Pre-existing diseases: After a 4-yr. waiting period - Ambulance costs: Depending on chosen sum assured - 141 day care procedures 

Coverage

  1. Inpatient hospitalisation expenses: Room, services of medical professionals, consumables, equipment, supplies etc.  
  1. Pre/Post-hospitalisation expenses: Up to 60/90 days respectively - Pre-existing diseases: After a 4-yr. waiting period  
  1. Ambulance costs: Depending on chosen sum assured - 141 day care procedures 

Add-on Covers

Extra Health Cover for extra premium (sub-limits apply)

Benefits

Chola MS Wellness Health Alerts Service

Chola MS Family Health Insurance

This is similar to the Individual Policy but offered on a floater basis to cover not just the proposer but his/her entire family as well.

Entry Age

Up to 65 yrs.

Renewability

Lifetime

Medical Screening

Not required

Basis

Floater

Sum Assured

Rs.2 to 5 lakhs

Premium

Rs.5,223 to Rs.18,173

Coverage

  1. Inpatient hospitalisation expenses: Room, services of medical professionals, consumables, equipment, supplies etc.  
  2. Pre/Post-hospitalisation expenses: Up to 60/90 days respectively  
  3. Pre-existing diseases: After a 4-yr.  
  4. waiting period, Daily Cash Allowance, Domiciliary nursing Ambulance costs: Depending on chosen sum assured - 141 day care procedures - External Aids 

Benefits

Chola MS Wellness Health Alerts Service

All health assurance and mediclaim policies must be read in conjunction with their individuals terms and conditions. It should also be remembered that every plan lists out certain exclusions i.e. events or circumstances that can lead to disqualification of claims made.

*GST and other charges are to be factored in wherever applicable.

How to File a Claim with Chola MS Health?

Claim settlement is subject to the claim intimation made by the insured member to Chola MS and approval of the claim as per policy terms and conditions. Policyholders can make 2 types of health insurance claims with Chola MS Health:

  1. Cashless Claim: Visit a network hospital of Chola MS Health and display your health card at the TPA helpdesk along with a photo identity card, and investigation reports. The hospital will submit a pre-authorisation request form to Chola MS Health. Upon approval, the hospital will provide cashless treatment to the insured member and the insurer will settle the medical bills directly with the hospital.
  2. Reimbursement Claim: Pay the hospital bills upfront out of your own pocket. At the time of discharge, collect all the original medical documents and submit it to the insurer along with a duly-filled reimbursement claim form. The claim will be approved or rejected as per the policy terms and conditions.

GST rate of 18% applicable for all financial services effective July 1, 2017.

Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

FAQs on Chola MS Health Insurance

  • What is a benefit policy?

    The benefit policy allows the insurance company to pay the insured an amount in lump sum, leaving the decision of spending the money on medical treatment or not to the insured.

  • Is the Chola MS Critical Healthline policy the same as the Mediclaim policy?

    No, the Critical Illness policy covers certain specific illnesses and is taken as an add-on to a Mediclaim policy. It is an optional policy that is offered to policy takers in case they are diagnosed with one of the critical illnesses that is listed with the Chola MS Health Insurance.

  • How can the Chola MS Critical Healthline policy be differentiated from the Mediclaim policy?

    The Mediclaim policy provides compensation for the medical expenses incurred by the insured whereas the Chola MS Critical Healthline policy provides the insured with the entire amount as lump-sum when the insured is has a diagnosis of a critical illness.

    Under the Mediclaim policy, the insured has to pay upfront and confirm treatment before the insurance company pays the insured for the medical attention while under the Critical Illness policy, the insured has to produce confirmation of diagnosis of a critical ailment and the insurance company will pay the insured in lump sum.

  • Are there any discounts that can be availed on the Chola MS Family Healthline policy?

    10% discounts on premiums can be availed on the Chola MS Family Healthline policy in the case that 10% co-payment is opted for.

  • Is it possible to get a Chola MS Critical Healthline policy if one already has another critical illness policy?

    Yes, it is possible to get another Chola MS Critical Healthline policy even if the insured already has an existing critical illness policy.

    In case of an existing Chola MS Critical Healthline policy, the insured needs to declare the existent policy at the time of purchasing the new one.

    Furthermore, the insured can claim both of the policies when a critical illness occurs.

  • What is the age of renewability for the Chola MS Individual Healthline policy?

    The age of renewability of the Chola MS Individual Healthline policy is the age of 55 years.

  • Does the Chola MS Critical Healthline policy cover pay for alternative medication?

    Once the insured is diagnosed with critical illness, the Chola MS Critical Healthline policy pays the insured a lump sum amount. The insured can use this amount at his/her discretion which includes alternative medicines.

  • What is the age limit to be eligible for the Chola MS Individual Healthline policy?

    Persons between the ages of 18 years and 65 years are eligible for the Chola MS Individual Healthline policy.

    Children from the age of 3 months and onwards are eligible for the Chola MS Individual Healthline policy.

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