Group Health Insurance 138 views July 31, 2021

Chola Group Critical Illness Insurance Policy provides financial coverage to the insured in case he/she is diagnosed with a critical illness during the policy term. This policy is available to persons aged between 18 and 65 years. The coverage under this policy is available for primary insured members of the group and his/her spouse and children. Read this page and know more about the coverage of Chola Group Critical Illness Insurance Policy.

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Chola Group Critical Illness Insurance Policy Coverage

The insurer shall pay the insured a lump sum benefit equal to the sum insured in case of diagnosis of any of the covered critical illnesses during the policy term. You have three different coverage options under the Chola Group Critical Illness Insurance Policy. Check the table below to know the illnesses covered under each of these three options.

StandardExtraAdvantage
Cancer of Specified Severity

Myocardial Infarction (First Heart Attack of

specific Severity)

Major Organ /Bone Marrow Transplant

Stroke Resulting In Permanent Symptoms

Open Chest CABG

Kidney Failure Requiring Regular Dialysis

Permanent Paralysis Of Limbs

Multiple Sclerosis With Persisting Symptoms

Motor Neuron Disease With Permanent Symptoms

Open Heart Replacement or Repair of Heart Valves

Third Degree Burns

End Stage Lung Failure

Benign brain tumour

Blindness

Coma of Specified Severity
Cancer of Specified Severity

Myocardial Infarction (First Heart Attack of

specific Severity)

Major Organ /Bone Marrow Transplant

Stroke Resulting In Permanent Symptoms

Open Chest CABG

Kidney Failure Requiring Regular Dialysis

Permanent Paralysis Of Limbs

Multiple Sclerosis With Persisting Symptoms

Motor Neuron Disease With Permanent Symptoms

Open Heart Replacement or Repair of Heart Valves

Third Degree Burns

End Stage Lung Failure

Benign brain tumour

Blindness

Coma of Specified Severity

Surgery to Aorta

Primary (Idiopathic) Pulmonary hypertension

Parkinson’s Disease

Aplastic Anaemia

End Stage Liver Failure

Fulminant Viral Hepatitis

Muscular Dystrophy
Cancer of Specified Severity

Myocardial Infarction (First Heart Attack of

specific Severity)

Major Organ /Bone Marrow Transplant

Stroke Resulting In Permanent Symptoms

Open Chest CABG

Kidney Failure Requiring Regular Dialysis

Permanent Paralysis Of Limbs

Multiple Sclerosis With Persisting Symptoms

Motor Neuron Disease With Permanent Symptoms

Open Heart Replacement or Repair of Heart Valves

Third Degree Burns

End Stage Lung Failure

Benign brain tumour

Blindness

Coma of Specified Severity

Surgery to Aorta

Primary (Idiopathic) Pulmonary hypertension

Parkinson’s Disease

Aplastic Anaemia

End Stage Liver Failure

Fulminant Viral Hepatitis

Muscular Dystrophy

Goodpasture’s syndrome

Apallic syndrome

Systemic lupus erythematosus

Multiple system atrophy

Progressive scleroderma

Pneumonectomy

Pulmonary artery graft

Alzheimer’s disease

Cardiomyopathy

Brain surgery

Progressive supranuclear palsy

Creutzfeldt-jakob disease (CJD)

Major Head Trauma

Encephalitis

Loss of Speech

Bacterial Meningitis

Deafness

Chola Group Critical Illness Insurance Policy Optional Covers

You can enhance your coverage by adding optional covers and paying an additional premium under Chola Group Critical Illness Insurance:

Accidental Death Benefit – In case you sustain any bodily injury due to an accident during the policy period and die within twelve months of its occurrence, the company will pay the sum insured as shown in the policy schedule.

Permanent Total Disability Benefit (PTD) – If the accidental bodily injury results in PTD within twelve months of the accident, the company will pay 100% of the sum insured for the loss of

  1. The sight of both eyes
  2. Two entire hands or two entire feet
  3. One entire hand and one entire foot
  4. The sight of one eye and loss of one entire foot/hand
  5. Hearing of both ears and loss of speech
  6. Hearing of both ears
  7. Loss of speech and loss of one limb or loss of sight of one eye
  8. Comatose state

Permanent Partial Disability Benefit (PPD) – If you suffer from PPD due to an accident, the company will pay a percentage of the sum insured as specified in the policy schedule.

Waiting Period

The insurer shall not be liable to pay if you have any signs and symptoms or are diagnosed with any of the covered critical illnesses within the first 90 days from the date of commencement of the policy. The waiting period doesn’t apply to hospitalization due to an accident.

Claim Procedure

Upon diagnosis/occurrence of any of the above-mentioned critical illnesses, intimate the insurer within 30 days by

  1. Calling the helpline number
  2. Writing an email to customercare@cholams.murugappa.com

You will need to send the intimation in the following format:

  1. Insured Name /Age/Gender
  2. Contact no & email ID
  3. Policy Number / Membership Number
  4. Illness contracted/diagnosis

After that, you need to submit the following claim documents to Chola MS

  1. Duly filled & signed claim form
  2. Detailed attending physician’s report/consultation papers stating the past medical and surgical history
  3. Diagnosis certificate from the specialist
  4. All lab reports supporting the diagnosis of the critical illness
  5. A detailed discharge summary
  6. Operation theatre notes in case of hospitalization
  7. Copy of FIR /MLC in case of road traffic accident injuries resulting in critical illness
  8. Proof of identity and residence

You need to submit the following documents for processing of the claim in respect of the optional covers shown below:

For Accidental Death

  1. Duly filled & signed claim form
  2. Copy of FIR/Police Report, if necessary
  3. Copy of Post Mortem Report/Coroner’s report (If post mortem is conducted)
  4. Copy or Panchanama/Inquest report
  5. Death Certificate
  6. Original Policy Certificate
  7. Original canceled cheque of the claimant/insured to enable payment of claim through NEFT

For Permanent Total and Partial Disablement: 

  1. Duly filled & signed claim form
  2. Report of the attending Doctor confirming the disability
  3. Admit or discharge card
  4. Investigation reports such as X-rays, lab tests, etc
  5. Copy of FIR/Police report, if necessary
  6. Original canceled cheque of the claimant/insured to enable payment of claim through NEFT

Send the above-mentioned documents to the following address:

Cholamandalam MS General Insurance Company Limited Chola MS HELP – Health Claims Department New No.319, Old No.154, Shaw Wallace Building, 2nd Floor, Thambu Chetty Street, Parry’s Corner, Chennai – 600001

Conditions Applicable to Claim Procedure

  1. The insured/claimant should provide the claim documentation within 30 days from the date of diagnosis/occurrence of the critical illness. If the insured fails to submit the documents within the time limit, he/she should satisfy the company with the reason for the delay.
  2. The company is not liable to pay or arrange for claim payment unless the claim is proved valid
  3. The company may require the insured person to be examined by a medical advisor nominated by it in case the same is necessary.
  4. The company shall pay to the insured person or nominee whose name appears on the policy certificate.
  5. The insured/policyholder should acknowledge and agree that the payment of any claim by or on behalf of the insurer shall not constitute any guarantee or assurance regarding the quality or effectiveness of any medical treatment he/she receives.
  6. The insured person should obtain and furnish a copy of all bills, receipts and other documentation to the company upon which a claim is based.

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