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Health Insurance 453 views August 2, 2021
Chola Healthline Plan offers financial protection to you and your family against medical expenses during the policy term. The policy covers your family either on an individual or on a family floater basis. The company shall cover all the medically necessary expenses as mentioned in the policy schedule. Continue reading this page and learn about the Chola Healthline Plan coverage.
Table of Contents
You’ll get coverage against the following expenses during the policy period.
If you or any of the insured members are hospitalized due to an illness/injury for more than 24 hours, the insurer shall cover the following expenses:
Note: The coverage for Single AC room is allowed, except for the sum insured of INR 1 or 2 Lakhs. For the sum insured INR 1and Lakh, the maximum room rent covered is INR 1,500 and 3,000 per day, respectively. In case you are admitted to a higher room category, differential room rent would be deducted from the claim amount.
The insurer shall cover daycare procedure/treatment up to sum insured, provided the hospitalization is for less than 24 hours. In case you undergo the daycare procedure in a non-network hospital, the same must be pre-authorized. You need to obtain pre-authorization 72 hours before the date of admission in case of planned admission and within 24 hours in case of emergency admission.
Any medical expenses incurred immediately before the hospitalization up to 60 days shall be covered by the insurer. If you have opted for the Value Healthline variant, the pre-hospitalization expenses shall be covered up to 30 days only.
Any medical expenses incurred after the discharge from the hospital, the insurer shall cover such expenses up to 90 days. If you have opted for the Value Healthline variant, the post-hospitalization expenses shall be covered up to 60 days only.
The insurer shall cover the domiciliary hospitalization expenses for up to 7 days. The insurer pays for domiciliary hospitalization if the medical treatment continues for at least 2 days.
The insurer shall cover non-allopathic treatments, such as Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy, up to sum insured for the treatment of an illness or accidental bodily injury.
Any medical expenses incurred on a legal Organ Donor’s treatment for the harvesting of the organ shall be covered up to the sum insured.
The insurer will pay for ambulance expenses to transfer the insured person to the nearest hospital. Check out the table below to know about the ambulance cover as per your chosen variant.
|Variant||Ambulance Cover Per Hospitalization (In INR)|
The insurer will pay for the expenses of delivery or the lawful medical termination of pregnancy during the policy period, excluding elective termination. This benefit is limited to two deliveries/terminations or either one of each during the lifetime of the insured. Under this cover, you’ll get coverage for pre and post-natal expenses per delivery or termination. This benefit will be payable after three consecutive renewals without a break. The company’s maximum liability under this section is INR 1 Lakh per delivery.
Note: This benefit is available if you opt for the Privilege Healthline variant.
You’ll get coverage for a newborn baby from the day of birth to 90 days, provided the insurer has accepted the claim under maternity expenses. This benefit is available if you opt for the Privilege Healthline variant.
The insurer shall provide you the following benefits other than the above-mentioned coverages during the policy term.
The insurer shall pay a daily allowance of INR 500 per day for the accompanying adult if an insured child aged 18 yrs or less is hospitalized for more than 24 hours. This benefit is payable to you for up to 7 days.
Note: This benefit is available if you opt for the Enrich Healthline variant.
The insurer shall cover the cost of dental treatments, spectacles, contact lens or hearing aids, (excluding batteries) up to INR 10,000 if it is advised by the doctor. This benefit is available to you only once in a block of two policy years, irrespective of the policy tenure and the number of claims made.
You’ll receive an allowance of INR 10,000 if you are hospitalized for 10 continuous days, provided the policy is on an Individual Sum Insured basis. For family floater variants, the insurer will cover up to the limit specified by it in the schedule of benefit.
Note: This benefit is available if you opt for the Privilege Healthline or Enrich Healthline variant.
If you opt for the Enrich and Privilege Healthline Plan variant, you’ll get coverage for critical illnesses and accidental bodily injury during the policy period. The critical illness benefit is available to you up to the age of 65 years. The total number of claims payable under this section should not exceed twice the sum insured and cumulative bonus.
Note: The double sum insured is applicable only for the current policy year and any unused sum insured cannot be carried forward.
The insurer shall pay up to INR 25,000 for the cost incurred for an opinion from a specialist doctor. This benefit is available only if a valid hospitalization claim is accepted by the insurer for a critical illness. You can avail of this benefit only once in a policy period. For family floater variants, the insurer will cover up to the limit specified by it in the schedule of benefit.
If you renew the policy without any break, you’ll be entitled to the following benefits:
Under Freedom, Enrich and Privilege Healthline Plan variants, you will be eligible for a free health checkup after claim-free policy years. Check out the table below to know when you’ll get the free health checkup benefit.
|Variant||Health Checkup Benefit|
|Freedom Healthline||Once after three claim-free years|
|Enrich Healthline||Once after two claim-free years|
|Privilege Healthline||Once after two claim-free years|
Note: In the case of the family floater policy, all the members are eligible for this benefit. If any of the members have made a claim, this benefit isn’t available for any members
If you haven’t made a claim in a policy year and have renewed the policy without a break, you’ll be eligible for a cumulative bonus. Check out the table below to know about the cumulative bonus as per your chosen plan.
|Variant||Cumulative Bonus (as % of Sum Insured)||Maximum Cumulative Bonus (as % of Sum Insured)||Reduction in Cumulative Bonus (as % of Sum Insured)|
A free look period of fifteen days applies to the policy from the date of receipt to review the terms and conditions. If you disagree with the terms and conditions, return the policy stating the reason for it. If you haven’t made any claim during the free look period, the insurer will refund the paid premium after deduction of the medical examination and stamp duty charges. If 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. Whereas, 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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