Chola MS Family Healthline Insurance – Eligibility, Features & Claim Process

Updated: 08-09-2023 06:39:08 AM

The Family Healthline Insurance by Chola MS can be your ideal family health insurance plan. This family floater plan offers comprehensive benefits for the policyholder as well as his/her family members. The plan allows any insured family member to claim for the entire sum insured in the policy. Chola MS Healthline offers a lifelong coverage with quick claim settlement procedure along with the Chola MS Family Health Plan. The plan is provided in three variants based on the sum insured, that are:

Plan Variants	Sum Insured
Standard Family Health Line	Rs. 2 lakhs to Rs. 5 lakhs
Superior Family Health Line	Rs. 4 lakhs to Rs. 10 lakhs
Advanced Family Health Line	Rs. 6 lakhs to Rs. 15 lakhs

Eligibility 

Particulars	Details
Entry Age	Min: 18 years Max: 65 years
Entry Age for Children in Family Floater Plan	Min: 3 months Max: 26 years
Policy Tenure	1 year/ 2 years/ 3 years
Sum Assured	Rs. 2 lakh to Rs. 15 lakh
Policy Renewal Period	Lifetime Renewal
Maximum Permitted Members	5 members including 2 adults and 3 children

Features of Family Health Plan

Following are the unique set of features offered by Chola MS Family Healthline Insurance :

• Coverage for 141 daycare treatments that requires hospitalization of less than 24 hours
• 5% No Claim Bonus (NCB) for every claim free year that can be extended up to 50% on the sum insured
• 5% reduction to the sum insured in case you make a claim
• The expenses for organ donation are covered under the Chola MS Family Healthline Insurance
• Free look period of 15 days is provided to policyholder to ascertain whether they want to stay or cancel the policy
• 30 days of Grace Period is available for times when one foregoes the premium payment date

Points to Consider Before Purchasing this plan

• Choose the sum insured for the entire family floater plan wisely taking into consideration number of members to be included in the plan
• Check for the coverage offered by the insurer like the pre-hospitalization expenses, post-hospitalization expenses, ambulance charges, etc.
• Check for co-payment requirement of the family floater plan from your insurer along with its terms and conditions
• Check for the bonuses, discounts, and other facilities offered by the insurer. You can always compare the health insurance plan offered by different insurers online

How to Make Claims with Chola MS?

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

• If you are hospitalized in any of the network hospitals of Chola MS Insurance Company Limited, you do not have to pay any money to avail treatment up to the sum insured under the plan. You have to approach the Third Party Administrator (TPA) desk of the network hospital of Chola MS and submit the Chola MS health card, photo identity proof, and other essential reports.
• The hospital will contact Chola MS Insurance Company to validate the authorization for the treatment. If Chola MS Insurance Company denies the request, no coverage will be offered, and you will have to bear all the charges incurred during the treatment.
• 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.
• If you are admitted to non-network hospitals of Chola MS, 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 need to intimate the insurance company as soon as possible to avoid the rejection of your claims.

Cases where you can’t claim this plan

This Family Healthline Insurance has listed a few permanent exclusions from the policy coverage, they are:

• No pre-existing conditions are covered until the completion of four continuous policy years.
• 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
• Hospitalization induced due to war or warlike situations
• Any illness related to pregnancy
• Cosmetic treatments
• Vaccinations are excluded from the policy coverage of this family health plan.
• Treatment for illness/ injury/ disease due to abuse of drug or alcohol intoxication.
• Treatment for mental disorders and congenital diseases.
• AIDS is not covered as per the terms and conditions of the Chola MS Family Healthline Insurance.
• Alternative treatment modes like naturopathy, chiropractic, osteopathy, reflexology, aromatherapy, acupressure, and acupuncture are not covered under this policy.

How Long Does it Take to Settle a Claim?

Chola MS is known to settle claims in a quick and hassle-free manner. The company has set its record by settling claims in just 15 days from the date of claim request. The only prerequisite for this is that the documents submitted as well as the reason for claiming the money is genuine and original.

Documents Required for Claim Settlement

As mentioned above, if you are paying off your bills from your own pockets, you can claim for reimbursement if your treatment is covered under the insurance terms. Below mentioned are the documents required for claiming for reimbursement:

• Duly filled and signed claim form
• Doctor’s prescription advising for hospitalization
• Discharge papers from the hospital
• Receipt for the bills paid towards the treatment including medicines
• Consultation documents
• Final hospital bill
• Other supporting documents (if any)

Benefits of Chola MS Family Healthline Insurance

• You can avail a free health check-up after completion of two continuous claim-free policy years.
• Cash allowance is offered to the accompanying individual of the insured minor who is hospitalized.
• Treatments that do not require hospitalization are covered under this health insurance plan.
• In the advanced variant of this plan, dental treatments and Ayurvedic treatments are covered that can go up to 7.5% of the sum insured.
• In the superior and advanced variants of the plan, domiciliary and maternity expenses are covered.
• If you chose shared accommodation, daily cash allowance would be provided.
• Under the advanced variant of this plan, the costs incurred for spectacles, contact lenses, prosthetic, hearing aids, etc. are covered. However, you will need to provide the necessary documents for the same like doctor’s prescription.
• Tax deductions of up to Rs. 15,000 are provided for the policyholder, spouse, and dependent children.
• Tax deductions of up to Rs. 20,000 are provided for dependent parents above 60 years as per the policy terms.
• Below are the insured sum provided for some specific treatments/surgeries:

Treatment/ Surgery	Sum Insured
Cataract Surgery	7.5% of the sum insured (up to Rs. 20,000)
Hernia	10% of the sum insured (up to Rs. 30,000)
Fistula in Anus, Piles, Fissures, and such	10% of the sum insured (up to Rs. 30,000)
Sinusitis	10% of the sum insured (up to Rs. 30,000)
Tonsillitis	15% of the sum insured (up to Rs. 40,000)

Also Check: Chola Hospital Cash Healthline (Revision)

Customer Care Services

You can send a written query to the registered office of Chola MS 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 Chola MS.

FAQs

Q1. What is Cashless Hospitalization?

As per the cashless hospitalization facility, you need not pay anything while availing the treatment in the network hospitals of Cholamandalam MS health insurance plans. On completion of the procedures with the TPA of the hospital, the hospital authorities will communicate to the insurer, and if the request is verified and accepted, the insurer will settle all the bills.

Features
Claim Type (In-House or TPA)	In-House
Pre-Hospitalization	Yes, 60 days
Network Hospital Count	5000+
Post-Hospitalization	Yes, 90 days
Room Eligibility	Available (Varies as per the SI)
No Claim Bonus	5% of SI very claim free year
Emergency Ambulance Charges	Yes, Rs.1000 – Rs.3000
Worldwide Coverage	No
Maternity Cover	Yes, for Superior & Advanced Option
Hospitalization at Home	Yes, for Superior & Advanced Option
Day Care Treatment	Yes
Non-Allopathic Treatment Coverage	NO (Specific treatments for Advanced Option)
Health Check-up	No (till the age of 55 years)

Note: SI = Sum Insured