Health Insurance 127 views August 2, 2021

Chola Classic Health Family Floater Plan provides financial protection against the medical expenses for the entire family. The insurer shall cover all the medically necessary costs as detailed in the policy schedule of this insurance plan. Read this page and learn about the Chola Classic Health Family Floater Plan coverage.

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Chola Classic Health Family Floater Plan Base Cover

The insurer shall cover the following expenses under the policy:

Inpatient Hospitalization Expenses

If you or any of the insured members are admitted to the hospital for more than 24 hours due to an illness or accidental bodily injury, the insurer shall cover the following expenses up to the sum insured as mentioned in the policy schedule:

  1. Room and Boarding charges
  2. Doctors fees
  3. Intensive Care Unit charges
  4. Nursing Expenses
  5. Surgical fees, operating theatre
  6. Cost of anesthesia and oxygen and their administration charges
  7. Physical therapy
  8. Cost of drugs and medicines consumed as per the prescription of the attending doctor
  9. Cost for hospital miscellaneous services like laboratory, x-ray, diagnostic tests, etc.
  10. Cost of dressing, ordinary splints and plaster casts
  11. Costs of prosthetic devices if implanted during a surgical procedure
  12. Radiotherapy
  13. Chemotherapy
  14. Organ transplantation including the treatment of the donor (excluding the cost of the organ)

The room rent coverage may vary based on your chosen sum insured option. Check out the table below to know about it.

Sum Insured (In INR)Room Rent Coverage Limit (In INR)
5,00,000Upto 3,000 per day
4,00,000Upto 2,500 per day
3,00,000Upto 2,000 per day
2,00,000Upto 1,500 per day
1,00,000Upto 1,000 per day

Pre-Hospitalization Expenses

The insurer will pay for the medical expenses incurred immediately before hospitalization up to 60 days, as per the following conditions:

  1. The expenses were incurred after the first 30 days of the waiting period
  2. Such medical expenses are related to the condition for which the hospitalization takes place
  3. The insurer has accepted the in-patient hospitalization claim

Post-Hospitalization Expenses

The insurer will pay for the medical expenses incurred after the discharge from the hospital up to 60 days as per the following conditions:

  1. Such medical expenses are related to the condition for which you were hospitalized
  2. The insurer has accepted the in-patient hospitalization claim

AYUSH Coverage

The insurer shall cover non-allopathic treatments, except naturopathy, up to the sum insured for the treatment of an illness or accidental bodily injury. The insurer shall cover such treatment if it is taken in an AYUSH Hospital.

Day Care Procedure/Treatment

The insurer shall cover daycare procedure/treatment up to sum insured, provided the hospitalization is for less than 24 hours.

Emergency Ambulance

The insurer will pay for ambulance expenses up to INR 1,000 per family to transfer the insured person to the nearest. This cover is subject to the following conditions:

  1. The ambulance service is offered by healthcare or an ambulance provider
  2. The insurer has accepted the in-patient hospitalization claim
  3. The in-patient hospitalization claim plus the ambulance cover shall not exceed the floater sum insured.

Chola Classic Health Family Floater Plan Additional Benefits

Other than the above-mentioned coverages, the insurer shall provide you the following benefits during the policy term.

Hospital Daily Allowance

You’ll receive a daily allowance for hospitalization as per annum in case of multi-year tenure, provided the insurer has accepted the in-patient hospitalization claim. Check out the table below to know your daily allowance as per your chosen sum insured.

Sum Insured (In INR)Daily Allowance (In INR)
5,00,000500 up to 14 days
4,00,000400 up to 10 days
3,00,000300 up to 7 days
2,00,000200 up to 7 days
1,00,000-

External Aids and Appliances

If the insurer has accepted the in-patient hospitalization claim, it shall also cover the expenses of external aids and appliances up to INR 10,000 upon discharge, provided it is advised by the doctor. The cover is for the following external aids and appliances only:

  1. Abdominal belts (used Post-Hernia and related surgeries)
  2. Belts for Prolapsed Intervertebral disc (PIVD)
  3. Artificial Limbs
  4. Crutches
  5. Wheel-chair
  6. Trusses (used Post-Hernia and related surgeries)

Home Nursing Care Allowance

The insurer shall pay home nursing care allowance per day for a limited period towards nursing expenses incurred after hospitalization. This benefit is payable if the attending medical practitioner recommends such care given the patient’s medical condition. The coverage under this section is provided up to the limits as shown in the table below:

Sum Insured (In INR)Daily Allowance (In INR)
5,00,000300 up to 10 days
4,00,000300 up to 10 days
3,00,000200 up to 7 days
2,00,000200 up to 7 days
1,00,000-

Cumulative Bonus

If you haven’t made a claim in a policy year and renewed it without a break, your sum insured will increase by 5%. The maximum cumulative bonus shall not exceed 50% of the policy sum insured.

Upon a claim during a policy year, the cumulative bonus shall reduce by 5% ensuring that the limit of indemnity shall not be less than 100% of the Basic Sum Insured.

In the case of multi-year tenure, any decrease in the cumulative bonus will be determined at the start of a new policy year and the same will be reflected on the policy schedule at the time of renewal.

Chola Classic Health Family Floater Plan Eligibility Criteria

You need to meet the following age criteria to get the benefits of the Chola Classic Health Family Floater Plan:

  1. Minimum entry age – 90 days
  2. Maximum entry age – 65 years

Family members (including the spouse and dependent children) dependent on the primary insured and not having an independent source of income will be covered under the policy.

Waiting Period

The following waiting period applies to the Chola Classic Health Family Floater Plan starting from the date of policy commencement. Check out the pointers below to know about it:

  1. Initial waiting period – 30 days
  2. Waiting period for specific illnesses/treatments – 12 months
  3. Waiting period diseases – 48 months

Exclusions from Chola Classic Health Family Floater Plan

The insurer shall not pay for the following under the policy:

  1. War or any act of war, invasion, acts of foreign enemies, hostilities whether war is declared or not
  2. Intentional self-injury or attempted suicide
  3. Expenses related to the surgical treatment of obesity
  4. Vaccination or inoculation unless it is a part of post-animal bite treatment
  5. Medical treatment expenses traceable to childbirth
  6. Expenses towards miscarriage unless caused by an accident
  7. Lawful medical termination of pregnancy
  8. Any admission primarily for diagnostics and evaluation
  9. Any admission primarily for enforced bed-rest and not for receiving treatment
  10. Change-of-gender treatments
  11. Cosmetic or plastic surgery unless for reconstruction due to accident, burns or cancer
  12. Participation in hazardous or adventure sports
  13. Commit a breach of law with criminal intent
  14. Treatment for, alcoholism, drug or substance abuse or any addictive condition and its consequences
  15. Treatments received in health hydros, nature cure clinics, spas or similar establishments
  16. Dietary supplements and substances that can be purchased without prescription
  17. Treatment for correction of eyesight due to refractive error < 7.5 dioptres
  18. Unproven treatments
  19. Sterility and Infertility treatments
  20. Sexually transmitted disease or illness
  21. Cost of hearing aids, eyeglasses or contact lenses
  22. Naturopathy Treatments

Free Look Period

A free look period of fifteen days starting from the date of receipt of the policy is provided to you to review the terms and conditions. If you disagree with the terms and conditions, you can return the policy stating the reason for it. If you haven’t made any claim during the free look period, you’ll be entitled to a refund of the paid premium less any expenses incurred on medical examination and stamp duty charges. Where the risk has already commenced and you have returned the policy, a deduction towards a proportionate risk premium for the period on the cover will be made. If only a part of the insurance coverage has commenced, such proportionate premium commensurates with the insurance coverage during the free look period.

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