Health Insurance 124 views May 18, 2021

Chola MS Vector Borne Diseases Insurance Plan safeguards you financially against vector-related diseases such as Malaria, Dengue, etc. So, if you or any of your insured family members are diagnosed with a Vector-borne disease/illness anytime during the policy period, the insurance company shall pay a lump sum benefit equal to 100% of the sum insured. Read this page further and know more about the list of vector-borne diseases covered under the Chola MS Vector-borne Diseases Insurance Plan.

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Chola MS Vector Borne Diseases Insurance Plan Coverage

The following vector-borne diseases shall be covered under this policy –

  1. Malaria
  2. Dengue
  3. Lymphatic Filariasis
  4. Kala – Azar
  5. Japanese Encephalitis
  6. Chikungunya
  7. Zika Virus

Malaria: If you are diagnosed with Malaria and get hospitalized for at least 24 hours, you will get covered by this plan. Further, diagnosis of malaria and its complications should be confirmed by a registered medical practitioner with confirmatory tests indicating the presence of Plasmodium falciparum, vivax malariae in the patient’s blood. The laboratory examination must be countersigned by a pathologist/microbiologist in peripheral blood smear or positive rapid diagnostic test (antigen detection test).

Dengue: If Dengue is confirmed by a registered medical practitioner following the below-mentioned examinations, the insurer shall cover the illness treatment –

  1. Decreasing platelet level < 100,000 cells/mm3
  2. Immunoglobulins/PCR test showing positive results for Dengue

Lymphatic Filariasis: In case you are diagnosed with Lymphatic Filariasis during the policy period, the insurer will cover your treatment expenses. The illness must be confirmed by a registered medical practitioner along with the following signs or symptoms –

  1. Presence of microfilariae in blood smear
  2. Lymphoedema,
  3. Elephantiasis
  4. Scrotal Swelling

The benefit under this illness shall be payable to you only once in a lifetime. Any treatment other than for Lymphatic Filariasis and its complications shall not be covered.

Kala Azar: If you have signs or symptoms of Kala Azar, such as irregular bouts of fever, substantial weight loss, swelling of the spleen and liver and anemia and the same being confirmed by a registered medical practitioner, the insurer will cover the treatment of the disease.

Japanese Encephalitis (JE): If you suffer from a high fever, headache, neck stiffness, disorientation, coma, seizures, spastic paralysis and such other symptoms of JE and the same is confirmed by your medical practitioner as per the positive serological test for JE by immunoglobulin M (IgM) antibody capture ELISA (MAC ELISA) for serum and cerebrospinal fluid (CSF), the insurer shall cover the cost of treatment.

Chikungunya: Chikungunya’s common symptoms are fever with joint pain, muscle pain, headache, nausea, fatigue and rash. And if you are diagnosed with the same by a registered medical practitioner and by Serological tests, such as enzyme-linked immunosorbent assays (ELISA), the insurer shall cover the cost of its treatment.

Zika Virus: Zika virus has symptoms like mild fever, skin rash, conjunctivitis, muscle and joint pain, malaise or headache. If Zika virus diagnosis is confirmed by a registered medical practitioner and by plaque-reduction neutralization testing (PRNT), the insurer will cover the medical expenses related to the illness.

Chola MS Vector Borne Diseases Insurance Plan Restoration Benefit (Optional Cover)

The restoration benefit helps restore your sum insured if any claim against any one of the above-listed conditions arises during the policy term. The sum insured will be restored up to 100% and the policy shall continue until the allowable number of claims is paid or the end of the policy term, whichever is earlier. Under this cover, you’ll be covered against all conditions except the condition for which the claim has been already made. The claimed condition will be covered after a 60-day cooling-off period post the restoration of the sum insured. In case of renewal, the cooling-off period will continue to the next policy year. Under Family Floater cover, other insured members will be continuously covered without any cooling-off period.You can get the restoration benefit by paying an additional premium.

Exclusions from Chola MS Vector Borne Diseases Insurance Plan

The policy does not cover the hospitalization expenses if it arises due to any of the following –

  1. Treatment of any illness other than the above-listed disease
  2. Any vector-borne disease for which you have already been diagnosed with and received treatment within the waiting period.
  3. Hospitalization less than 24 hours
  4. Diagnosis and treatment outside India. However, this exclusion shall not apply in the following countries: Canada, Dubai, Hong Kong, Japan, Malaysia, New Zealand, Singapore, Switzerland, USA, and countries of the European Union.
  5. Treatment on an OPD basis
  6. Hospitalization for diagnostic purposes
  7. Treatment in any hospital or by any other provider blacklisted by the insurer. However, this exclusion shall not apply in the case of emergency hospitalization
  8. Non-allopathy treatment

Waiting Period

The insurer is not liable for any claim for the listed conditions if they are diagnosed within 15 days (waiting period) from the date of the policy commencement. The initial waiting period shall be increased to 60 days if you are suffering from any of the listed conditions other than Lymphatic Filariasis at the time of policy purchase. In case you are suffering from Lymphatic Filariasis at the time of buying a policy, Lymphatic Filariasis will be excluded from the policy and the waiting period would be increased to 60 days for all other illnesses.

Note – The initial waiting period would be waived off if the policy is renewed continuously without a claim.

Free Look Period

The Insurance company will provide you a free look period of 15 days from the date of receipt of this policy to review the terms and conditions and return the same if not acceptable. In such a case the insurer will refund the paid premium after retaining charges towards medical tests, stamp duty charges and pro-rata premium (from policy start date till the date of its cancellation).

General Conditions Applicable to Chola MS Vector-borne Diseases Insurance Plan

  1. Once 100% of the sum insured is paid, the policy shall cease to exist in the case of an individual policy. However, under a family floater cover, the policy will continue for the other insured members.
  2. You can renew the cover for 100% of the sum insured immediately after the policy is terminated due to claims under the policy.
  3. A cooling-off period of 60 days applies in case of a claim for policy renewal
  4. The maximum number of claims allowed per policy year is as follows – Self (1 claim), Self + Spouse (1 claim), Self + Spouse + 1/2 Children or Parents/Parents in law (2 claims)
  5. You should be hospitalized for a minimum period of 24 hours for any of the listed conditions to receive a claim payment
  6. In case you die due to the covered conditions after getting hospitalized, the claim amount shall be payable to the proposer or the nominee

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