Chola Classic Health-Family Floater- Eligibility, Features & Exclusions

Published: 21-01-2019 10:37:09 AM

The Cholamandalam General Health Insurance Company Limited offers both individual insurance plans as well as family floater plans. The Chola Classic Health-Family Floater provides coverage for inpatient hospitalization of the insured members of the family. The inpatient hospitalization must be for a minimum of 24 hours to get coverage for the expenses. However, there is a facility of coverage for daycare treatments under this family floater plan. The policy provides comprehensive health coverage for the family members insured under the plan. There are 5 plan variants offered under the plan viz. Plan A, Plan B, Plan C, Plan D, and Plan E.

Eligibility Criteria 

Below mentioned are the eligibility criteria defined under the Chola Classic Health Family Floater Plan:

Parameters	Details
Entry Age for Adults	Min: 18 years Max: 65 years
Entry Age for Children	Min: 3 months Max: 26 years
Policy Tenure	1 year
Sum Assured	Rs. 1 lakh to Rs. 5 lakhs
Policy Renewal Period	Lifetime Renewal

Features of the Chola Classic Health Family Floater Plan

• Pre-hospitalization charges of 60 days prior to hospitalization is provided
• Post-hospitalization charges of 90 days post hospitalization are covered
• Hospital daily allowance covered
• Home nursing care allowance is offered
• Emergency ambulance expenses are covered
• 5% of No Claim Bonus (NCB) is offered for every claim-free years up to 50% of the sum insured. If you make one claim during a year, 5% reduction will be applicable in the NCB from the amount insured
• No co-payments are required to avail this plan
• Coverage for 141 daycare treatments is provided that require hospitalization of less than 24 hours
• For Ayurvedic and homeopathic treatments, 100% of the sum insured can be claimed
• Emergency road ambulance coverage of up to Rs. 1000 is provided
• Organ donor expenses are covered
• Below mentioned are the room rents offered based on the sum insured:

Sum Insured	Room Rent Offered Per Day
Rs. 1 lakh	Rs. 1000
Rs. 2 lakhs	Rs. 1500
Rs. 3 lakhs	Rs. 2000
Rs. 4 lakhs	Rs. 2500
Rs. 5 lakhs	Rs. 3000

Points to Consider Before Availing Family Floater Plans

• Consider purchasing health insurance plans for your family at an early age. By doing so, you need not pay higher insurance premiums which will otherwise be necessary
• Determine your financial health and choose the sum insured according to the number of members covered and their health conditions
• Choose a financial provider that offers higher benefits at lower premium rates
• Make sure to read the fine prints of the policy documents to know the inclusions and exclusions of the plan
• Check the waiting period applicable for claiming under the health insurance plan. The waiting periods vary from one insurance company to the other
• Choose an insurance provider that offers cashless hospitalization facility with network hospitals
• Check your family health history as well as the age of the members you wish to get insured. The age and health of the members to be insured highly determines the premium to be paid for the policy
• Select a plan that also includes pre-hospitalization and post-hospitalization coverage. You can also look for coverage with maternity benefits if you have a potential member for the same
• Almost all insurance providers offer health checkup coverage after a few continuous policy years. In fact, some insurance providers also offer free health checkups after a defined policy year
• Look for the available bonus, discounts, and other benefits offered along with the individual health insurance plan from the insurer

How to File a Claim with Cholamandalam General Insurance Company?

If the person insured under the health insurance policies of Cholamandalam General Insurance Company Limited is hospitalized in any of the network hospitals, he/she would not require to pay any money for availing the treatment upfront up to the sum insured. However, this will be based on the terms and conditions of the chosen plan. The insured would need to approach the Third Party Administrator (TPA) desk of the network hospital and submit original copies of the required documents. The hospital will intimate Cholamandalam Insurance Company for the authorization of the treatment. If the insurance company denies the request, no coverage will be provided, and the insured will have to bear all the charges incurred during treatment. On the other hand, if the insurance company accepts the request, the charges applicable for the treatment based on the sum assured under the plan will be settled directly by the insurance company. You can discharge from the hospital without paying anything for the treatment.

Documents Required for Claim Process

• Duly filled and signed the claim form
• Doctor’s prescription advising for hospitalization
• Document of discharge from the hospital
• Receipt for the bills paid for the treatment
• Bills of the medicines bought for the treatment
• Consultation documents
• Final hospital bill
• All other supporting documents

Exclusions under Chola Classic Health Family Floater Plan

No coverage would be offered for the treatment of diseases/ injuries that are defined under the exclusions of the health insurance policy from Cholamandalam Health Insurance. Below mentioned are the exclusions of the Chola Classic Health Family Floater Plan:

• If you avail any treatment using alternative methods like acupuncture, naturopathy, acupressure, aromatherapy, osteopathy, chiropractic, and reflexology, no coverage will be provided
• No coverage will be offered for the treatment resulting from pregnancy and childbirth or treatment for prenatal and postnatal care
• No coverage is offered for any illness/ injury within the 30 days of the policy inception. However, accidental injuries can avail coverage from the 1^st day of the policy inception.
• All expenses related to AIDS and related diseases are excluded
• Treatment/disease resulting from the intoxication of drugs or alcohol are not covered
• Disease/ injury/ illness incurring due to a suicide attempt, self-induced injury, war or warlike situations are excluded
• Treatment done for curing obesity is not covered as per the policy terms
• Cosmetic treatments, in-vitro fertilization charges, infertility treatment, treatment for mental disorders are not covered under
• Treatments for injuries/ accidents due to breach of law are not covered
• Pre-existing conditions would not be covered for the first four policy years

How Long Does Cholamandalam Insurance Company Take to Settle a Claim?

Cholamandalam Health Insurance Company settles claims in a quick and hassle-free manner within just 15 days from the date of claim request. The only prerequisite for this would be that the documents submitted as well as the reason for claiming the money are original and genuine.

Renewal Process of Chola Classic Health Family Floater

Policyholders can renew their policy for a period of 12/24/36 months with subject to the premium of payment prior to the expiry of the policy. Policyholders are also allowed a grace period of 30 days before the expiry of the policy to get their policy renewed.

Advantages of Chola Classic Health Family floater Plan

1. You can enjoy a 15 days free look period that starts from the date of policy inception. You can opt to return the policy in case you are unsatisfied with the policy terms. However, you are not supposed to make any claims during this period if you intend to return the policy.
2. Along with the lifetime renewability option, you are given a 30 days grace period for renewing claims.
3. You can avail a cumulative bonus of 5% NCB that goes up to 50% of the insured sum.
4. Emergency ambulance services are covered.
5. You can avail tax benefits according to the Income Tax Act of India.
6. You can enjoy AYUSH treatment benefits wherein you can use up to 100% of the sum insured.
7. You get 50% to 60% reimbursement for the costs incurred for pre-insurance health checkups.
8. At the time of renewal of the policy, you can enhance the sum insured by providing the necessary documents.

FAQs

Q1. If I opt for the cashless hospitalization facility from Chola general Insurance Company, will the insurer pay off all my bills?

The Chola General Insurance Company Limited offers cashless hospitalization facility with the network hospitals spread across the country. If you avail this facility, the bills arisen from the treatments listed in the inclusion of the policy terms will be settled depending on the sum assured in your health insurance plan.

Q2. How can I contact Chola Health Insurance Company in case I need assistance regarding my health insurance plan?

You can send a written query to the registered office of Cholamandalam Health Insurance mentioned below:

Cholamandalam Investment and Finance Company Limited (Chola),
Dare House, 1st Floor,
No.2, N.S.C. Bose Road, Parrys,
Chennai – 600001

You can also call the insurance company on the toll-free number 1800-102-4565 between 9 am and 7 pm on the working days or send an SMS to 9500000312 for customer assistance from Cholamandalam General Insurance Company Limited.