Health Insurance 139 views May 25, 2021

Chola Credit Linked Premium Critical Illness Insurance Policy is available to persons aged between 18-65 years who have borrowed any type of loan from banks/financial Institutions or aggregators. Under this policy, you’ll get coverage against 22 critical illnesses during the policy period. Read this page further to know the list of critical illnesses covered under this policy plus learn about the terms & conditions and exclusions of the Chola Credit Linked Premium Critical Illness Insurance Policy.

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Chola Credit Linked Premium Critical Illness Insurance Policy Cover

The insurer shall cover the following critical illnesses during the policy term –

Cancer of Specified Severity: The diagnosis of cancer must be supported by histological evidence of malignancy. The following shall be excluded from this policy –

  1. All tumors histologically described as carcinoma in situ, benign, pre-malignant, borderline malignant, low malignant potential, neoplasm of unknown behavior, or non-invasive, Cervical dysplasia CIN-1, CIN – 2 and CIN-3.
  2. Any non-melanoma skin carcinoma unless there is evidence of lymph nodes or beyond
  3. Invasive malignant melanoma beyond the epidermis
  4. All tumors of the prostate unless histologically classified as having a Gleason score > 6 or having progressed to at least clinical TNM classification T2N0M0
  5. All Thyroid cancers histologically classified as T1N0M0 (TNM Classification) or below
  6. Chronic lymphocytic leukemia < RAI stage 3
  7. Non-invasive papillary cancer of the bladder which is histologically described as TaN0M0 or of a lesser classification
  8. All Gastro-Intestinal Stromal Tumors histologically classified as T1N0M0 (TNM Classification) or below and with mitotic count <= 5/50 HPFs
  9. All tumors in the presence of HIV infection.

Myocardial Infarction (First Heart Attack of specific Severity): Heart attack or myocardial infarction should be evidenced by the following criteria:

  1. Clinical symptoms of acute myocardial such as chest pain
  2. Electrocardiogram changes
  3. Elevation of infarction-specific enzymes, Troponins or other specific biochemical markers.

The following shall be excluded under this critical illness

  1. Other acute Coronary Syndromes
  2. Any type of angina pectoris
  3. Rise in cardiac biomarkers or Troponin T or I in absence of overt ischemic heart disease or during an intra-arterial cardiac procedure.

 Major Organ/Bone Marrow Transplant: Under this cover, the insurer will cover the medical expenses for the following transplants:

  1. Heart, lung, liver, kidney, pancreas due to irreversible end-stage failure of the relevant organ
  2. Human bone marrow using hematopoietic stem cells if a transplant is confirmed by a specialist medical practitioner.

The following are excluded from this cover:

  1. Other stem-cell transplants
  2. Transplants where only islets of Langerhans are transplanted

Stroke Resulting In Permanent Symptoms: Any cerebrovascular incident producing permanent neurological sequelae such as infarction of brain tissue, thrombosis in an intracranial vessel, hemorrhage and embolization from an extracranial source shall be covered if it is confirmed by a specialist medical practitioner and evidenced by CT Scan or MRI of the brain. Under this cover, the following shall be excluded –

  1. Transient ischemic attacks (TIA)
  2. Traumatic injury of the brain
  3. A vascular disease affecting only the eye or optic nerve or vestibular functions.

Open Chest CABG: Heart surgery should be done via a sternotomy or minimally invasive keyhole coronary artery bypass procedure and the same must be performed by a cardiologist. Because angioplasty and any other intra-arterial procedures aren’t covered under this policy.

Kidney Failure Requiring Regular Dialysis: End-stage renal disease causing chronic irreversible failure of both kidneys must be confirmed by a specialist medical practitioner.

Permanent Paralysis of Limbs: Total and irreversible loss of use of two or more limbs due to the injury or disease of the brain or spinal cord will get covered if it is confirmed by a specialist medical practitioner.

Multiple Sclerosis with Persisting Symptoms: The illness must be confirmed and evidenced by all of the following:

  1. MRI findings unequivocally confirming the diagnosis of multiple sclerosis
  2. Clinical impairment of motor or sensory function must have continued for at least 6 months.

Other causes of neurological damage such as SLE and HIV are excluded.

Motor Neuron Disease with Permanent Symptoms: The insurer shall pay the benefit for this illness if there is significant and permanent functional neurological impairment with objective evidence of motor dysfunction for a continuous period of 3 months.

Open Heart Replacement or Repair of Heart Valves: Open-heart valve surgery to replace or repair one or more heart valves should be caused due to abnormalities or disease-affected cardiac valve(s) and it must be supported by echocardiography and the surgery should be performed by a specialist medical practitioner. Catheter-based techniques such as balloon valvotomy/valvuloplasty are excluded.

Third Degree Burns: The third-degree burns must have scarred at least 20% of the body surface area.

End-Stage Lung Failure: The diseases must be evidenced by all of the following:

  1. FEV1 test results < 1 liter
  2. Need of continuous permanent supplementary oxygen therapy for hypoxemia
  3. Arterial blood gas analysis with a partial oxygen pressure of 55mmHg or less (PaO2 < 55mmHg
  4. Dyspnea at rest

Benign Brain Tumor: The presence of the tumor must be confirmed by a CT scan or MRI. Cysts, Granulomas, malformations in the arteries or veins of the brain, hematomas are excluded under this policy.

Blindness: The diagnosis of blindness must be confirmed and not correctable by aids or surgical procedure and it must be evidenced by:

  1. Corrected visual acuity of 3/60 or less
  2. Field of vision < 10 degrees

Coma of Specified Severity: The diagnosis must be supported by evidence of all the following:

  1. No response to external stimuli for at least 96 hours
  2. Life support measures to sustain life
  3. The permanent neurological deficit for a minimum of 30 days after the onset of the coma.

Note: Coma due to abuse of alcohol or drug abuse is excluded.

Surgery of Aorta: The surgery for a disease of Thoracic and Abdominal Aorta but not its branches excluding traumatic injury of the aorta and congenital narrowing of the aorta.

Primary (Idiopathic) Pulmonary Hypertension: The illness must be confirmed by a cardiologist or specialist in respiratory medicine with evidence of right ventricular enlargement and the pulmonary artery pressure above 30 mm of Hg on Cardiac Cauterization.

Parkinson’s Disease: The disease must be supported by the following conditions:

  1. Controlled with medication
  2. Signs of progressive impairment
  3. Inability to perform daily activities

Aplastic Anemia: Severe irreversible aplastic anemia must be confirmed with the following evidence –

  1. Permanent bone marrow failure due to bone marrow cellularity < 25%
  2. Absolute neutrophil count < 500/mm
  3. Platelets count < 20,000/mm
  4. Reticulocyte count < 20,000/mm

Temporary or reversible Aplastic Anemia is excluded under this policy.

End-Stage Liver Failure: Permanent and irreversible failure of liver function due to

  1. Permanent jaundice
  2. Ascites
  3. Hepatic encephalopathy.

Liver failure due to drug or alcohol abuse is excluded.

Fulminant Viral Hepatitis: The diagnosis must be supported by the following evidence:

  1. Rapid decreasing of liver size
  2. Necrosis involving entire lobules
  3. Rapid deterioration of liver function test
  4. Deepening jaundice
  5. Hepatic encephalopathy

Muscular Dystrophy: The disease must be confirmed by a neurologist with appropriate laboratory, biochemical, histological, and electromyographic evidence. You must have at least three signs or symptoms of Muscular Dystrophy out of six, such as – Washing, Dressing, Transferring, Mobility, Toileting, Feeding

Waiting Period

No benefits shall be paid for any critical illness for which you have signs and symptoms or are diagnosed within the first 60 days from the date of commencement of the policy. However, this waiting period shall not apply to an accidental injury.

Exclusions from Chola Credit Linked Premium Critical Illness Insurance Policy

No claim shall be admissible in respect of any critical illnesses if they arise due to the following –

  1. Any sexually transmitted diseases or any condition associated with Human T-Cell Lymphotropic Virus Type III (III LB III), Lymphadenopathy Associated Virus (LAV), Mutants Derivative, Variations Deficiency Syndrome or any Syndrome or condition of a similar kind such as AIDS.
  2. War, invasion, the act of a foreign enemy, hostilities, civil war, insurrection, terrorism or terrorist acts or similar activities
  3. Participation in naval or military operations
  4. Participation in any hazardous activities such as scuba diving, motor racing, parachuting, hang gliding, rock/mountain climbing
  5. Any natural peril such as storm, tempest, avalanche, earthquake, volcanic eruptions, hurricane, etc.
  6. Radioactive contamination
  7. Consequential losses of any kind
  8. Intentional self Injury
  9. Abuse of intoxicating drugs and alcohol
  10. Occupational disease
  11. Treatment traceable to pregnancy

Free Look Period

There is a free look period of 15 days that starts from the date of receipt of this policy where you can review the terms and conditions of the policy and return the same if not acceptable. On such cancellation refund of paid premium would be made after retaining charges towards stamp duty charges and pro-rata premium from the risk start date till the date of cancellation.

Terms & Conditions of Chola Credit Linked Premium Critical Illness Insurance Policy

  1. On the first diagnosis of any of the above-mentioned critical illnesses during the policy term, the company will pay a lump sum benefit equal to 100% of the sum insured
  2. The insurer will pay a lump sum benefit equal to 50% of the sum insured upon the diagnosis of a second critical illness during the policy term
  3. Nothing shall be payable if the same critical illness is diagnosed for which you had made a claim before
  4. The total benefit payable under this policy shall not exceed 150% of the sum insured
  5. The policy shall terminate upon the payment of 150% of the sum insured
  6. Payment for a second critical illness shall be admissible only after a waiting period of 365 days, which starts from the date of diagnosis of the first critical illness.

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