Health Insurance 198 views May 21, 2021

Chola Criticare Plan covers 12 major critical illnesses and surgeries. So, if any time during the policy term you are diagnosed with any of the covered critical Illnesses or surgeries as defined in this policy, you’ll be entitled to a lump sum benefit equaling the sum insured. The critical illnesses/surgeries shall be covered after 90 days of commencement of the policy. Read this page further and know the list of covered critical illnesses/surgeries under the Chola Criticare Plan.

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List of Critical Illness Covered Under Chola Criticare Plan

The insurer shall cover the following illnesses/surgeries during the policy period

  1. Cancer of Specified Severity
  2. Myocardial Infarction (First Heart Attack of specific Severity)
  3. Open Chest CABG
  4. Open Heart Replacement or Repair of Heart Valves
  5. Major Organ /Bone Marrow Transplant
  6. Permanent Paralysis Of Limbs
  7. Multiple Sclerosis With Persisting Symptoms
  8. Motor Neuron Disease with permanent symptoms
  9. Creutzfeldt Jakob Disease
  10. Benign Brain Tumor
  11. Fulminant Hepatitis
  12. Aorta Graft Surgery

The policy benefit shall be payable if you complete the survival period. A survival period of 30 or NIL days shall apply to your policy from the date of diagnosis of the illness. So, you have to survive for a period of 30/NIL days from the date of diagnosis to be eligible for the benefit under the policy. The insurer is not liable for payment of any claim in case you die within the survival period.

Exclusions from Chola Criticare Plan

This policy does not cover any loss resulting due to the following:

  1. Any critical illness which is diagnosed before the inception date of the policy
  2. Any illness other than those specified above
  3. Death within the stipulated survival period
  4. Diagnosis/treatment from Medical Practitioners who are practicing outside their discipline
  5. Unproven/Experimental Treatment
  6. Any pre-existing disease/condition or its complication
  7. Sexually transmitted diseases, including Genital Warts, Syphilis, Gonorrhea, Genital Herpes, Chlamydia, Pubic Lice and Trichomoniasis
  8. Loss sustained or contracted due to influence of alcohol or any other intoxicant
  9. Narcotics used without any prescription or medical advice
  10. Intentionally self-inflicted injury/suicide
  11. Loss due to war, foreign invasion, an act of foreign enemies, hostilities and warlike operations
  12. Loss due to ionizing radiation or contamination by radioactivity from any nuclear fuel/nuclear waste
  13. External congenital diseases, defects or anomalies.
  14. Loss due to participation in a speed contest or racing of any kind
  15. Loss due to participation in any flying activity, except as a bona fide, fare-paying passenger
  16. Loss due to any breach of law or participation in an actual or attempted felony, riot, crime, misdemeanor or civil commotion with criminal intent

Chola Criticare Plan Term & Conditions

  1. This policy is available to group members aged between 18 months and 65 years. It includes non-employer–employee groups such as welfare associations, co-operative societies, etc.
  2. The family of the group members is not eligible for coverage under this policy.
  3. The policy term is one year for all types of groups. However, if the policy is issued to the Credit Linked customer segment, the policy term can be 2, 3, 4 or 5 years based upon the loan period, but not more than 5 years.
  4. You’ll receive benefits under this policy only for the first occurrence of the specified illnesses and, thereafter, the policy terminates immediately and shall not be renewable
  5. Any critical illness diagnosed within the first 90 days from the date of commencement of the policy is excluded.

Moratorium Period

After completion of eight continuous policy years, nothing shall be payable under this policy. The moratorium period shall apply to your policy sum insured and, in case of enhancement of sum insured, the moratorium period shall apply to the enhanced limits only. After the expiry of the moratorium period, no claim under this policy shall be contestable except those which are proven fraud and come under permanent exclusions.

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