Health Insurance 103 views August 4, 2021

Chola Super Topup Insurance Plan provides additional protection to you and your family against medical expenses. You can buy the policy on an individual or family floater basis. Chola Super Topup Insurance Plan coverage is based on the variant (Premier or Supreme) chosen by you. Read this post to know more about the Chola Super Topup Insurance Plan coverage.

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Chola Super Topup Insurance Plan Base Cover

The insurer shall cover the following expenses if you buy the Chola Super Topup Insurance Plan.

In-patient Hospitalization Expenses

If you or any of the insured members are admitted to the hospital for more than 24 hours for the treatment of an illness or accidental bodily injury, the insurer shall cover the following expenses:

  1. Room and boarding charges as provided by the hospital or nursing home
  2. Nursing expenses
  3. Fees of Surgeon, Anaesthetist, Medical Practitioner, Consultants & Specialist
  4. Hospital miscellaneous services like laboratory, x-ray, and diagnostic tests
  5. Cost of Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, and Medicines & Drugs, Diagnostic Materials, Cost of Pacemaker, prosthetic and other devices implanted internally during a surgical procedure.
  6. Organ donor expenses to harvest the organ, excluding pre and post-hospitalization expenses of the donor.

Pre-Hospitalization Expenses (Available Under SUPREME Plan)

The insurer shall cover the medical expenses incurred immediately before hospitalization up to 60 days as per the following conditions:

  1. If the expenses are incurred after an initial waiting period of 30
  2. Pre-hospitalization 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 (Available Under SUPREME Plan)

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

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

Emergency Ambulance

The insurer shall cover the ambulance expenses to transfer the insured person to the nearest. This benefit 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. Ambulance expenses shall be reimbursed on submission of original bills
  4. Cashless facility is not available for Ambulance Expenses/Services
  5. Payment under this benefit will reduce the sum insured.

Day Care Procedure/Treatment

The insurer shall cover 141 day care procedures/treatment up to the sum insured, provided the hospitalization is for less than 24 hours. However, you’ll get the cover if the claim amount exceeds the deductible as mentioned in the policy schedule.

Domiciliary Hospitalization

The insurer shall reimburse the expenses for medical treatment taken at home as per the advice of the attending medical practitioner. This benefit is payable as per the following conditions:

  1. The treatment continues for at least 3 days,
  2. Pre and Post-hospitalization expenses shall be covered under this benefit
  3. No payment shall be made towards the following ailments: Asthma, Bronchitis, Tonsillitis, Upper Respiratory Tract infection including Laryngitis and Pharyngitis, Cough and Cold, Influenza, Arthritis, Gout and Rheumatism, Chronic Nephritis and Nephritic Syndrome, Diarrhoea and all types of Dysenteries including Gastroenteritis, Diabetes Mellitus and Insipidus, Epilepsy, Hypertension, Pyrexia of Unknown Origin.
  4. A cashless facility is not available under this benefit
  5. A claim under this benefit will reduce the sum insured

AYUSH Coverage

The insurer shall cover non-allopathic treatments up to the sum insured. However, you’ll get the cover if the claim amount exceeds the deductible as mentioned in the policy schedule. You can avail of this benefit for the treatment of an illness or accidental bodily injury in an AYUSH Hospital.

Chola Super Topup Insurance Plan Sum Insured & Deductible Option

You can choose your Chola Super Topup Insurance Plan Sum Insured from the following options:

Sum Insured (In INR)Deductible (In INR)
3 Lakh1, 2 or 3 Lakh
5 Lakh2, 3, 4, 5 or 10 Lakh
7.5 Lakh3, 4, 5 or 7.5 Lakh
10 Lakh5, 7.5 or 10 Lakh
15 Lakh5 or 10 Lakh
20 Lakh5, 10 or 15 Lakh
25 Lakh10, 15 or 20 Lakh

Waiting Period

Chola Super Topup Insurance Plan has the following waiting period starting from the date of the commencement of risk. 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 for pre-existing diseases – 48 months

Exclusions from Chola Super Topup Insurance Plan

The insurer shall not pay for the claims arising out of the following:

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

You’ll get a free look period of fifteen days from the date of receipt of the policy to review the terms and conditions. In case 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, the insurer will refund 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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