Chola Classic Health – Individual: Eligibility, Features & Benefits

Updated: 31-08-2023 07:16:48 AM

The Chola Classic Health – Individual Plan is an insurance policy that covers inpatient hospitalization of a minimum of 24 hours. The plan offers comprehensive coverage for both the policyholder as well as his/her family members. The policy covers the financial support for high medical expenses. There are 9 plan variants offered under this plan viz. Plan A, Plan B, Plan C, Plan D, Plan E, Plan F, Plan G, Plan H, and Plan I. You can choose the variants depending on the coverage offered by the plan as well as the benefit of the plan. Cholamandalam General Insurance Company Limited offers facilities like cashless claim procedure, additional coverage options, health checkup facilities, etc.

Eligibility Criteria

Mentioned below table is the eligibility criteria for the 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. 50,000 to Rs. 10 lakhs
Policy Renewal Period	Lifetime Renewal
Maximum Permitted Members	5 members including 2 adults and 3 children

Features of Chola Classic Health Individual Plan

• Pre-hospitalization charges of 60 days prior to hospitalization is provided
• Post-hospitalization charges of 90 days post hospitalization are covered
• Room rent for single room offered for sum insured of Rs. 1.5 lakhs to Rs. 10 lakhs
• Room rent for shared accommodation offered for sum insured of Rs. 50,000 to Rs. 1 lakh
• For sum insured of Rs. 50,000 to Rs. 1 lakh, a 15%-20% co-payment is applicable and for sum insured of Rs. 1.5 lakhs to Rs. 10 lakh 15% co-payment will be applicable. The percentage of co-payment depends on the plan variant chosen
• Ayurvedic treatment is covered
• Organ-specific treatments are covered after 1 policy year
• 5% No Claim Bonus (NCB) for every claim free year that can be extended up to 50% on the sum insured. 5% reduction will be applied to the sum insured in case you have made a claim.
• Emergency ambulance expenses are covered
• Coverage for 141 daycare treatments that require hospitalization of less than 24 hours

Points to Consider Before Buying Individual Health Insurance Plan

• Check the waiting period of the plan
• Determine your financial health and choose the plan coverage accordingly
• Check the health records of yours as well as your family in case you are buying individual plans for each one of them
• Check for the availability of cashless hospitalization facility of the insurance provider
• Check for maternity cover in case you want a cover for your spouse’s maternity expenses
• Check for the availability of pre-hospitalization and post-hospitalization coverage offered by the insurance provider
• Look for the available bonus, discounts, and other benefits offered along with the individual health insurance plan from the insurer
• Check for sub-limits and co-payment (if any)
• Look for the health checkup facilities. Almost all insurance providers offer coverage or free health checkup facility after pre-determined continuous policy years.
• Consider insurance providers that have a quick and hassle-free application as well as claim procedure

How to Make Claims with Cholamandalam General Insurance Company Limited?

You can quickly claim for the health insurance from Chola Health Insurance Company by following the steps mentioned below:

1. If you are hospitalized in the network hospitals of Cholamandalam Insurance Company Limited, you do not need to pay any money upfront for your treatments listed under the inclusions of the policy up to the sum insured. You got to approach the Third Party Administrator (TPA) desk of the network hospital of Cholamandalam Insurance Company and submit the necessary documents.
2. The hospital will contact Cholamandalam General Insurance Company to validate the authorization for the treatment. If the company denies the request, no coverage will be offered, and you will have to bear all the charges incurred during the treatment.
3. If the insurance company accepts the request, the bills arising from the treatment will be settled by the insurer based on the sum assured under the health plan.
4. If you are admitted to non-network hospitals of Cholamandalam Insurance Company, you can settle the bills by yourself and save the receipts of the payments. Once the documents like the receipts of the bills settled are submitted to the insurance provider, the company verifies the documents and reimburses the charges incurred up to the sum insured. However, you will have to intimate the insurance company as soon as possible to avoid the rejection of your claims.

Suggested Read: Chola MS Tax Plus Healthline

Documents Required for Claim Process

If you are admitted to non-network hospitals, you will need to pay off your bills from your own pockets. However, you can claim for reimbursement if your treatment is covered as per the policy terms and conditions. Below mentioned are the documents that will be required for claiming for reimbursement from Cholamandalam Health Insurance Company:

1. Duly filled and signed the claim form
2. Doctor’s prescription advising for hospitalization
3. Document of discharge from the hospital
4. Receipt for the bills paid for the treatment
5. Bills of the medicines bought for the treatment
6. Consultation documents
7. Final hospital bill
8. All other supporting documents

Exclusions under the Plan

1. Treatments of injuries due to war or warlike situation.
2. Treatment mode other than allopathy like acupuncture, acupressure, naturopathy, etc.
3. Pregnancy and other related treatments.
4. Expenses related AIDS and such diseases.
5. Obesity treatment.
6. Cosmetic treatment.
7. No pre-existing conditions are covered until the completion of four continuous policy years.
8. 30 days waiting period from the date of commencement of the family health insurance policy applies to all the claims made except for accidental claims.
9. Treatments for illness/ injury/ disease due to abuse of drug or alcohol intoxication is not covered.
10. Treatment for mental disorders and congenital diseases are not covered.
11. Vaccination charges are not covered.
12. Self-induced injuries are not covered.

What is the Time Taken Settle a Claim in Cholamandalam Insurance Company?

Cholamandalam MS Health Insurance is renowned for settling claims in a quick and hassle-free manner. The company settles claims in just 15 days from the date of claim request. The only prerequisite is that the documents submitted as well as the reason for claiming the money are genuine and original.

Renewal Process of Chola Classic Health Individual Plan

Under this plan, policyholders can renew the 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 allowed grace period of 30 days before the expiry of the policy to get their policy renewed.

Advantages of Chola Classic Health Individual Plan

1. Road ambulance offered Rs.1000 to Rs. 2000 based on the plan.
2. Organ donor expenses are covered.
3. Ayurvedic and homeopathic treatment is covered.
4. Daily hospital allowance provided based on the plan chosen.
5. General eye checkup and health checkup offered as per the plan chosen.
6. Accidental injuries are covered right from the inception of the policy.
7. Few defined surgeries will be covered after 1 policy year.
8. Coverage for AYUSH treatment is offered.
9. At the time of policy renewal, you can enhance the sum insured under the policy.
10. You can avail tax benefits as per the Income Tax Act of India for the premium paid in the plan.

Also Read: Chola Classic Health-Family Floater- Eligibility, Features & Exclusions

FAQs

Q1. What is Cashless Hospitalization?

The Chola Health Insurance Company offers the cashless hospitalization facility. You need not pay anything while availing the defined treatment in the network hospitals of Cholamandalam General Insurance Company Limited. On completion of the procedures with the TPA of the hospital, the hospital authorities will communicate to the insurance company, and if the request is verified and accepted, the insurer will settle all the bills.

Q2. Do I have to undergo medical check-up while purchasing a health insurance policy from Cholamandalam Health Insurance Company?

If you fall under the age of 55 years, you do not have to take any medical tests for purchasing the health insurance policies from Cholamandalam. However, in case you are above 55 years, you will have to take medical tests for applying for health insurance plans from Chola Health Insurance Company.

Q3. Can I purchase more than one health insurance policies?

Yes. You can purchase more than one health insurance plans from Cholamandalam Insurance Company Limited. With every claim made, the assured sum of that particular plan will be provided to the insured individual. The insured sum and benefits of each plan vary. You can claim your money from different insurance plans as per the requirement. However, you will need to provide the necessary and original documents for the same.