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Cholamandalam Swasth Parivar Insurance Plan

Cholamandalam Swasth Parivar Insurance Plan - Chola Swasth Parivar Insurance is a comprehensive insurance 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. The premium for this policy is extremely economical.

  • Two plans with flexible sum insured options
  • Covers hospitalization expenses including 141 day care procedures which require less than 24 hours of hospitalization
  • Covers pre-hospitalization expenses for up to 30 days and post-hospitalization expenses for up to 60 days
  • Dual protection - hospitalization cover on floater basis and personal accident coverage on individual basis (under Plan Royale)
  • Tax exemption under Section 80(D) for up to Rs25,000
  • Minimum entry age is 18 years and maximum entry age is 65 years
  • No medical checkup upto 55 years
  • Cover for up to 2 children: minimum entry age is 3 months and up to 26 years
  • Lifetime renewal

UIN no. IRDA/NL-HLT/CHSGI/P-H/V.I/156/13-14

Benefits - Cholamandalam Swasth Parivar Insurance Plan

Chola Swasth Parivar comes in two plans with flexible sum insured options:

Plan Name Pearl (only Section I is applicable)
Features / Options
Plan 1 Plan 2 Plan 3
Coverage Section I
Hospitalisation Expenses (per Family per policy year)
Rs3,00,000 Rs4,00,000 Rs5,00,000
Compulsory Co-payment - applicable on each and every eligible claim 15% applicable on each and every eligible claim Co-payment (per family per policy year) 10% applicable on eligible expenses for treatment in a Non-Network hospital Room Rent - Normal Hospitalisation(per day) 1% of the Sum Insured Room Rent - ICU Hospitalisation(per day) 1.5% of the Sum Insured Post-Hospitalisation Upto 60 days after Discharge Pre-Hospitalisation Upto 30 days prior to Hospitalisation
Day Care Services
(Only in Network Hospital)
Covered Covered Covered
Two years waiting period for specific diseases Applicable
Plan Name Royale (both Section I and Section II is applicable)
Features / Options Plan 1 Plan 2 Plan 3
Coverage Section I
Hospitalisation Expenses (per Family per policy year) Rs3,00,000 Rs4,00,000 Rs5,00,000
Compulsory Co-payment - applicable on each and every eligible claim 15% applicable on each and every eligible claim
Co-payment (per family per policy year) 10% applicable on eligible expenses for treatment in a Non-Network hospital
Room Rent - Normal Hospitalisation(per day) 1% of the Sum Insured
Room Rent - ICU Hospitalisation(per day) 1.5% of the Sum Insured
Post-Hospitalisation Upto 60 days after discharge
Pre-Hospitalisation Upto 30 days prior to Hospitalisation
Day Care Services Covered Covered Covered
(Only in Network Hospital)
One year waiting period for specific diseases Applicable
Coverage Section II
Personal Accident - Self
Death Rs7,50,000 Rs10,00,000 Rs10,00,000
Permanent Total Disablement Rs7,50,000 Rs10,00,000 Rs10,00,000
Permanent Partial Disablement Rs3,75,000 Rs5,00,000 Rs5,00,000
Personal Accident - Spouse
Death Rs3,75,000 Rs5,00,000 Rs5,00,000
Permanent Total Disablement Rs3,75,000 Rs5,00,000 Rs5,00,000
Permanent Partial Disablement Rs1,87,000 Rs2,50,000 Rs2,50,000
Personal Accident - Per Child (maximum two children)
Death Rs1,50,000 Rs2,00,000 Rs2,00,000
Permanent Total Disablement Rs1,50,000 Rs2,00,000 Rs2,00,000
Permanent Partial Disablement Rs75,000 Rs1,00,000 Rs1,00,000

Coverage - Cholamandalam Swasth Parivar Insurance Plan

Chola Swasth Parivar covers pre-hospitalization expenses for up to 30 days and post-hospitalization expenses for up to 60 days. The policy covers standard hospitalization expenses such as:

  • Room and boarding charges
  • Doctor's fees
  • Nursing charges
  • Surgery, anaesthesia and oxygen charges
  • Dressing, ordinary splints and plaster casts
  • ICU charges
  • Cost of medicines during hospitalisation
  • Physiotherapy
  • Miscellaneous hospital services (such as lab, x-ray, etc)
  • 141 day care procedures not requiring hospitalization for more than 24 hours

The claim amount payable per person towards the treatment of under mentioned disease/surgery/procedure during the policy period is subject to the following sublimits:

Disease/Surgery/Procedure Limits for claim in every policy year
Cataract - surgery of eye for lens disorder Rs20,000
Appendectomy - surgical removal of appendix Rs30,000
Tonsillectomy - surgical removal of tonsils Rs20,000
Kidney Stone Removal Rs30,000
Lithotripsy - laser treatment of kidney stone Rs10,000 day care
D & C - Dilatation and Curettage of uterus Rs5,000 day care
Hysterectomy - surgical removal of uterus Rs40,000
Surgery of hernia Rs40,000
Surgery of hydrocele Rs15,000
Surgery of prostate gland Rs25,000
ENT - surgery of ear, nose and throat Rs35,000
Urinary surgery Rs25,000
Gastrectomy - removal of any part of stomach Rs15,000
Coronary Angiography Rs20,000
Coronary Angioplasty Rs1 lakh
Treatment of fracture / dislocation / knee surgery Rs1 lakh

Claim Prorcess - Cholamandalam Swasth Parivar Insurance Plan

With Chola MS, you get express claims processing from our in-house claims desk at all of our network hospitals.

  • In case of planned hospitalization, please inform us 24 hours prior to admission.
  • In case of emergency hospitalization, information must be given within 24 hours after hospitalization.
  • In case of hospitalization in a non-network hospital, please submit completed claims form along with all relevant documents within 30 days of discharge.
  • For assistance, call the 24-hr helpline at 1800-200-5544.

Exclusions - Cholamandalam Swasth Parivar Insurance Plan

Main Exclusions (For complete list of exclusions, please read policy wordings available on our website)

Hospitalization

  • Benefits will not be available for pre-existing conditions until 48 months of continuous coverage from first policy start date
  • Expenses during first 30 days of commencement of policy except in the case of accidents
  • 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)
  • 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)

Personal Accident

  • Intentional self-inflicted injury, suicide or any attempt there at while sane or insane
  • Terrorism or terrorist act
  • While participating or training for any sport as a professional

Premium Table - Cholamandalam Swasth Parivar Insurance Plan

Premium

Premium in Rs(inclusive of service tax @ 18%)

Plans [Age band] Sum Insured Pearl  [Upto 70 years] Royale  [Upto 70 years]
Plan 1 Rs.3,00,000 5,256 8,161
Plan 2 Rs.4,00,000 6,070 9,623
Plan 3 Rs.5,00,000 7,173 10,870
  • Under Royale Plan Personal Accident cover is also available.
  • Tax benefits are subject to changes in applicable laws from time to time.
  • The Company from time to time and subject to IRDA approval, will revise the premium rates / terms and conditions based on experience.

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