Group Insurance 433 views May 26, 2021

Chola Group Hospital Cash Health Insurance Policy provides a daily benefit in case you are hospitalized during the policy period for more than 24 hours. This policy is available to persons aged between 18- 65 years. Under this policy, you can also cover your spouse, dependent children (aged between 03 months to 26 years), parents or parents-in-law. Keep reading this page below and know about the coverage, exclusions and terms and conditions of the Chola Group Hospital Cash Health Insurance Policy.

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Chola Group Hospital Cash Health Insurance Policy Benefits

The insurer shall pay the following benefits in case you’re hospitalized during the policy term –

Daily Benefit for Normal Hospitalization (Sickness): You’ll receive a daily benefit for each consecutive and completed hospitalization of more than 24 hours or daycare procedure.

Daily Benefit for Normal Hospitalization (Accident): In case you are hospitalized due to an accident, the insurer will pay a daily benefit for each consecutive and completed hospitalization of more than 24 hours or daycare procedure.

Daily Benefit for ICU Hospitalization (Sickness): The insurer will pay a daily benefit in case you are hospitalized for more than 24 hours in an ICU ward for the treatment of an illness.

Daily Benefit for ICU Hospitalisation (Accident): You will get a daily benefit in the event of hospitalization due to an accident for each consecutive and completed period of more than 24 hours in an ICU ward.

Conditions Applicable to the above-mentioned Benefit

  1. Whenever you receive an ICU Benefit under this policy, you won’t get the daily benefit for normal hospitalization
  2. The daily benefit will be payable for every completed 24 hours of hospitalization
  3. If the hospitalization remains less than 24 hours, a Single day benefit will be payable to you in respect of daycare procedures.

List of Day Care Procedures Covered Under Chola Group Hospital Cash Health Insurance Policy

The insurer shall cover the following day care procedures under this policy

  1. Microsurgical operations on the middle ear
  2. Other operations on the middle and internal ear
  3. Operations on the nose and the nasal sinuses
  4. Operations on the eyes
  5. Operations on the skin and subcutaneous tissues
  6. Operations on the mouth and face
  7. Operations to the tongue
  8. Operations on the salivary glands and salivary ducts
  9. Operations on the tonsils and adenoids
  10. Traumatological surgery and orthopedics
  11. Operations on the breast
  12. Operations on the digestive tract
  13. Operations on the female sexual organs
  14. Operations on Bartholin’s glands (cyst)
  15. Operations on the male sexual organs
  16. Operations on the prostate and seminal vesicles
  17. Operations on the scrotum and tunica vaginalis testis
  18. Operations on the testes
  19. Operations on the spermatic cord, epididymis and ductus deferens
  20. Operations on the penis
  21. Operations on the urinary system
  22. Other Operations such as Lithotripsy, Coronary angiography, Haemodialysis, Cancer Chemotherapy and Radiotherapy for Cancer

Chola Group Hospital Cash Health Insurance Policy Optional Covers

By paying an additional premium, you can extend coverage under this policy with the following optional benefits

  1. Convalescence Benefit: If you are hospitalized for at least 10 consecutive days, a lump sum amount is payable towards convalescence once in a policy period. This benefit shall be payable to you in case of an admissible claim under the base cover.
  2. Accompaniment Benefit for Parent Hospitalisation: In case your parents are hospitalized (aged above 60 years), a lump sum amount equal to 5X the Daily Benefit for Normal Hospitalization (Sickness) shall be payable once in a policy period.
  3. Accompaniment Benefit for Children Hospitalisation: if children aged 12 years or less get hospitalized during the policy period, the insurer will pay a lump sum amount equal to 5X the Daily Benefit for Normal Hospitalization (Sickness).
  4. Child Birth Benefit: The insurer will pay a lump sum amount equal to 5X the daily benefit in case of hospitalization due to childbirth. Only the female insured members are covered under this optional cover. A waiting period of 9 months from the date of inception of the policy applies to this benefit, which is payable for the delivery of a maximum of two living children. Ectopic pregnancy and termination of pregnancy shall not be covered under this optional cover.

Exclusions from Chola Group Hospital Cash Health Insurance Policy

The insurer shall not pay the benefits if hospitalization occurs due to the following –

  1. War or any act of war
  2. Breach of law with criminal intent o
  3. Intentional self-injury or attempted suicide
  4. Abuse of alcohol or narcotic drugs
  5. Ionizing radiation or contamination from any nuclear fuel or any nuclear waste
  6. Experimental or unproven treatment.
  7. Participation in any hazardous activities such as scuba diving, motor racing, parachuting, etc.
  8. Treatment of obesity and any other weight control program
  9. Sterility treatment
  10. Circumcisions unless necessitated by illness or injury
  11. Laser treatment for correction of the eyesight due to refractive error
  12. Sex transformation operations
  13. Cosmetic treatments unless necessitated by traumatic injury, burns or cancer
  14. Vaccination or inoculation unless part of post-animal bite treatment.
  15. Sexually transmitted diseases
  16. Medical equipment such as wheelchairs, crutches, artificial limbs, etc.
  17. Any external congenital diseases/defects/anomalies.
  18. Dental treatment or surgery unless necessitated by illness or accidental bodily Injury
  19. Treatment by a Medical Practitioner who shares the same residence with the insured
  20. Any treatment or part of a treatment that is not of a reasonable charge or medically necessary
  21. Hospitalization due to pregnancy, childbirth and its consequences
  22. Treatment/operation to cure impotence or to improve potency
  23. Oral Chemotherapy
  24. Natural Perils such as avalanche, earthquake, volcanic eruptions.
  25. Naturopathy Treatments
  26. Non-Allopathic or Alternative treatment

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