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Chola MS Top Up Healthline
Objective | A top-up policy that becomes active only with medical expenses above a certain limit. It is meant to be bought as an additional policy to take care of hefty claims. |
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Suited for | This policy is more effective for those who already have a basic health insurance cover and wish to increase the protection further. Those who do not hold any health insurance policy may also go in for this policy if they can pay small medical bills that are not covered by the top-up policy. This policy is available for both individual and family on a floater basis. |
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What does it do? | It is a top up plan that gets activated only when the claim crosses the deductible limit. A deductible is that portion of claim which has to be borne either by an existing policy or by the policyholder himself. In this plan, deductible limit applies afresh each time insured person is hospitalized during the policy term. For instance, an insured accesses hospitalisation services twice during a policy term. For the first time the total medical expenses amounted to Rs 2 lakh and Rs 2.5 lakh during second hospitalisation. If the deductible limit on his policy was Rs 3 lakh, the policyholder will not receive insurance benefit of this policy as the admissible claim expenses were below the deductible limit each time. This policy offers a wide range of deductible starting from as low as Rs 30,000 up to Rs 5 lakh. |
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Pros | Premiums paid under this plan qualify for deduction under Section 80D of Income Tax Act. |
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Cons | There is capping on room rent expenses. |
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Our View | Add-on plans are not intended to duplicate the existing cover, these plans are rather meant to pay for higher claims which are beyond the reach of basic insurance plans. Instead of buying another insurance policy, a top up is recommended if your current insurance cover seems inadequate. The only constraint to this product is that threshold limit applies to every single treatment undertaken as an inpatient in a hospital. In contrast, there are certain policies in the market that cover each hospitalisation after the expenses of previous hospitalisation(s) put together exceed threshold. Such top-up policies have an edge over the policies where deductible applies on each claim. |
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Eligibility | |||||||
Entry Age (years) | |||||||
Minimum | 18, 3 months for children | ||||||
Maximum | 65; 35 for dependent girl child and 25 for dependent male child | ||||||
Maximum Policy Renewal Age (years) | Life long | ||||||
Coverage Type | Individual/ Family floater | ||||||
Policy Term (years) | 1 or 2 or 3 | ||||||
Sum Insured (Rs) | |||||||
Maximum | 15 lakhs over and above deductible | ||||||
Minimum | 50000 over and above deductible | ||||||
Pre Policy Medical Check Up | Mandatory beyond 55 years of age. 50% of medical cost will be reimbursed | ||||||
Grace Period for Policy Renewal | 15 days | ||||||
Policy Termination | Policy may be terminated by giving a 15 days written notice by either parties. In case no claim has been made under the policy, a pre defined percentage of premium will be refunded. Insurance company will retain a part of premium for coverage provided. | ||||||
Customer Service | |||||||
Address | Cholamandalam MS General Insurance Company Limited | ||||||
Mail to | |||||||
Call to | 1800 200 5544 | ||||||
SMS | CHOLA to 56677 | ||||||
Network Hospitals | |||||||
Scope of Cover | |||
Cahless facility | available if treatment availed in a cashless hospital | ||
Reimbursement facility | available if treatment taken in any other non-empanelled hospital | ||
Pre and post hospitalisation | covers pre hospitalisation for 60 days before hospitalisation upto 5% of admissible claim and post hospitalisation for 90 days upto 10% of admissible claim upto maximum of Rs 50000 | ||
Inpatient hospitalisation | covered | ||
Room Rent | covered with sub-limits | ||
Emegency ambulance | covered upto Rs 3000 per hospitalisation | ||
Exclusions and Waiting Period | |||
Pre existing diseases | will be covered after a period of 4 years of continuous renewal. | ||
No claim period | 30 days starting from the inception of the policy | ||
Waiting Period | certain diseases such as cataract, hernia piles etc will be covered after first policy year has elapsed. Other diseases such as hypertension, diabetes, varicose veins etc. will be covered after a waiting period of 2 years. | ||
General Exclusions | Expenses towards out patient treatmentCost of organ transplantDomiciliary treatmentPlastic Surgery, slimming or any other beauty related treatments.All diseases or conditions caused by or related to HIV or AIDS.Naturopathy and non allopathic treatment.Any condition arising due to involvement in any illegal or criminal activity | ||
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