Chola Super Topup Insurance- Eligibility, Features & Exclusions

Published: 22-01-2019 08:49:27 AM

Cholamandalam General Insurance Company Limited offers a wide range of insurance plans for the varying insurance requirements of customers. The Chola Super Topup Insurance is a comprehensive insurance policy to cover higher medical expenses.  The plan offers additional benefits in an affordable price range. The reimbursement will be up to the sum insured after subtracting the deductibles. Deductibles are the sum up to which the insurer is not responsible for paying at the time of claim. The deductible does not affect the sum insured, but it is applicable on the aggregate permissible claims made in one policy year.

Types of Chola Super Topup Insurance Plan

There are two variants offered under the Chola Super Topup Insurance Plan, they are:

1. Premiere Plan
2. Supreme Plan

Eligibility Criteria

Parameters	Details
Entry Age	Min: 18 years Max: 70 years
Entry Age for Children in Family Floater Plan	Min: 3 months Max: 26 years
Policy Tenure	2 years/ 3 years
Sum Assured	Rs. 3 lakhs to Rs. 25 lakhs
Policy Renewal Period	12 months/ 24 months/ 36 months

Features of Chola Super Topup Insurance

Following are the features of the Chola Super Topup Insurance Plan:

1. Inpatient hospitalization and nursing expenses during the hospitalization are covered.
2. Miscellaneous expenses incurred due to the hospitalization are covered.
3. Coverage for organ donor is provided
4. Pre-hospitalization charges of 60 days prior to hospitalization and post-hospitalization charges of 90 days post hospitalization is covered.
5. Emergency ambulance services are covered.
6. A total of 141 daycare treatments that requires hospitalization of less than 24 hours.
7. Domiciliary hospitalization expenses are covered provided the reason for the same is justified as per the terms of the policy.
8. Expenses incurred due to Ayush treatment is covered provided the treatment is done in any recognized hospitals.
9. The super topup plan has to be taken over the existing health insurance plan to enhance the sum insured. Only if the expenses go above the deductible, will be the super topup coverage offered.
10. The sum insured or the deductible can be enhanced at the time of policy renewal.
11. You can port from one health plan to another with similar coverage without losing your policy benefits.
12. There are 30 days waiting period during which you cannot make any claims except for accidental claims.
13. A 1-year waiting period is applicable for specific diseases that are listed in the policy documents.
14. A waiting period of 3 years will be applicable for pre-existing conditions under the Supreme variant of the plan.
15. A waiting period of 4 years will be applicable for pre-existing conditions under the Premiere variant of the plan.
16. A 15 days free look period will be offered with the Chola Super Topup Plan during which you can choose to return the plan in case you are unsatisfied with the same. However, you should not make any claim during this period in order to return the policy.
17. In case the insurer finds any fraud or miscellaneous activity in the plan, the policy will be canceled by giving a 15-days’ notice prior to the cancellation.

Points to Consider Before Purchasing Health Plan

1. You have to check the claim settlement ratio of the financial provider offering health insurance plans.
2. Choose the sum insured under the health plan that would be sufficient for your financial requirements in case of medical emergencies.
3. Check for the coverage offered by the insurer like the pre-hospitalization expenses, post-hospitalization expenses, ambulance charges, etc.
4. Check for the co-payment requirement of the family floater plan from your insurer. You need to know about the conditions at which you would need to make a co-payment as well as the amount you need to contribute.
5. Check for the bonuses, discounts, and other facilities offered by the insurer. You go to compare the health insurance plan offered by different insurers online to choose the right insurer as well as the health plan.

How to File a Claim with Chola Super Topup Insurance Plan?

If you are insured under the health insurance policies of Cholamandalam General Insurance Company Limited is hospitalized in any of the network hospitals, you need not pay any money for availing the treatment up to the sum insured. However, this will be based on the terms and conditions of the Chola Health Insurance Policies. You will have to approach the Third Party Administrator (TPA) desk of the network hospital and submit the necessary documents. The hospital will intimate Chola Health Insurance 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. If the insurance company accepts the request, the charges applicable for the treatment based on the sum assured under the plan.

Documents Required 

1. Duly filled and signed 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. Final hospital bill
7. Consultation documents
8. All other supporting documents

Exclusions under Chola Super Topup Insurance Plan

1. The claim amount that falls under the deductible shall not be covered.
2. Expenses arisen due to the treatment of certain diseases defined in the policy documents like varicose veins, congenital diseases, cataract, etc. are not covered.
3. Pre-hospitalization and post hospitalization expenses of the organ donor are not covered.
4. Pre-hospitalization and post hospitalization expenses are not covered for the Premiere variant of the plan.
5. Treatment of injuries due to suicide attempt is not covered.
6. Cosmetic, aesthetic, and such treatments are not covered.
7. Treatment related to pregnancy and childbirth is not covered.
8. Self-induced injuries are not covered.
9. Experimental treatments shall not be covered.
10. Non-medical expenses are excluded from the policy coverage.

What is the Time Required for Cholamandalam Insurance to Settle Claims?

Cholamandalam General Insurance Company Limited is known to settle claims in a quick and hassle-free manner. Within just 15 days from the date of claim request, the company settles the requested claims provided the documents submitted are original, and the reason provided for claiming the money is genuine and justified.

Renewal Process of Chola Super Topup Insurance

Under this plan, policyholders can renew the plan till lifetime. For this, a grace period is allowed of 30 days from the date of expiry of previous policy.

Advantages of Chola Super Topup Insurance Policy

Below mentioned are a few advantages of availing the Super Topup Insurance Plan from Cholamandalam:

1. For every claim free policy years, you can enjoy a 5% No Claim Bonus in the sum insured which can go up to 50%.
2. If you are hospitalized for a continuous period of more than 10 days, you can avail the extended hospitalization allowance based on the sum insured.
3. A domestic road ambulance coverage is provided.
4. No co-payment required.
5. After 2 continuous claim free years, one health check-up will be covered.
6. If an insured child of 18 years or less is hospitalized for more than 24 hours, allowances will be provided to the accompanying individual.
7. After completion of 2 policy years, congenital diseases, varicose ulcers, varicose veins, and many such diseases are covered.
8. The premium paid is qualified to avail tax benefits as per the Indian Income Tax Act.
9. You can avail cashless hospitalization facility as well as get reimbursement for the expenses of hospitalization under the Chola Healthline Plans.

FAQs

 Q1. Can I take multiple Healthline Plans from Cholamandalam Health Insurance Company?

Yes. With Cholamandalam Health Insurance, you can avail more than one health insurance plan. Depending on the coverage offered by each plan, you will be covered for the treatments defined in the terms and conditions of the Healthline policy from Chola Insurance Company.

Q2. Can I downgrade/ upgrade my plan at the time of policy renewal?

The policy renewal is considered to be a fresh insurance plan and due to this reason you can easily downgrade/ upgrade/ modify your plan during renewal as per your requirement.

Q3. Do I have to undergo medical check-up while purchasing a health insurance policy from Chola General 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 General Insurance Company Limited.