Cholamandalam MS Arogya Sanjeevani Policy

Cholamandalam MS Arogya Sanjeevani Policy

Arogya Sanjeevani Health Insurance policy offered by Cholamandalam MS General Insurance Company is a standard health insurance policy proposed by IRDAI. This is one of the well-designed health insurance plans that financially assist one in case of a medical emergency. It is available for both family floater and individual basis. Any individual who falls in the age group of 18 years to 65 years can buy this policy for self and family. Under family floater, one can add his/her spouse, self, dependent children, parents-in-law, and parents.

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Cholamandalam MS Arogya Sanjeevani Policy Eligibility Criteria

In Cholamandalam MS Arogya Sanjeevani Policy, one can add his/her family members on either floater basis or individual sum insured basis. Some of the details related to this policy are mentioned below:

Key Features of Cholamandalam MS Arogya Sanjeevani Policy

Cholamandalam Arogya Sanjeevani policy offers the following features and benefits to the insured:

Cover Entire Family: The family floater option of this policy covers the entire family including the parents-in-law.

No Need for Health Check-Up: Before 50 years of age, there is no need to undergo any kind of pre-policy health check-up.

No Sub-Limits: There is no limit on AYUSH treatment.

Provides Family Discount: The policy provides a discount of 5% for three to five members of the policy, whereas for six to seven members a discount of 7% is given. If more than seven family members are included, a 10% discount is given.

Cashless Facility: The policy provides cashless facilities in more than 8200 hospitals.

Tax-Benefits- Tax benefits under the Section 80D are provided on the premium paid

Inclusions of Cholamandalam MS Arogya Sanjeevani Policy

The inclusions of Chola MS Arogya Sanjeevani policy are as follows:

Hospitalization Cover- The doctor fees, treatment charges, medicines costs are covered under hospitalization cover.

Hospital Room Rent- The policy covers boarding charges, room rent, and nursing charges. The limit for these under this policy is a maximum of Rs.5000 or 2% of the sum insured.

Covers the Expenses of Cataract Surgery - The limit for the same is 25% of the sum insured or Rs.40, 000, whichever is lower.

Covers ICU/ICCU Expense - The coverage limit is 5% of the sum insured or Rs.10, 000 per day.

Covers AYUSH Expense – Provides coverage without sub-limits of in-patient hospitalization.

Provides Facility of Co-Payment – 5% for each admissible claim.

Exclusions of Cholamandalam MS Arogya Sanjeevani Policy

Cholamandalam MS Arogya Sanjeevani policy does not cover the following expenses:

• Any medical condition for which the treatment has been received within 48 months from the policy inception date
• Plastic or cosmetic surgeries
• Change in gender treatments
• Hospitalization required for evaluation and medical investigation purpose
• Any illness contracted in the initial 30 days from the policy commencement
• Rest cure, rehabilitation, and respite care related to the expenses of hospitalization
• Treatments of obesity
• Medical expenses related to hazardous activities and adventure sports

How to file Health Insurance Claim for Cholamandalam Arogya Sanjeevani Policy?

In case of emergency hospitalization, one needs to intimate the insurance company within 48 hours of hospitalization. While for planned hospitalization one needs to inform the insurance company at least before 72 hours of hospitalization. The process of claim reimbursement and cashless hospitalization is mentioned below:

Reimbursement Claims:

In case the insured pays the expenses of his/her hospitalization by him/herself, he/ should file a reimbursement claim with Cholamandalam MS within the time range specified in the insurance policy. The company reimburses the claim according to the policy terms.

Cashless Claims:

• Those who have availed the treatment in a network hospital of Chola MS can file a cashless claim
• Initially, he/she has to fill the Cholamandalam MS cashless claim form, which is available at the TPA desk at the network hospital
• This claim form is then shared with the Insurance Company/TPA to get the authorization. As soon as it is verified, a pre-authorization letter is sent to the network hospital by the TPA.
• One now has to sign and cross-check his/her hospital discharge papers
• Now he/she has to submit all the required documents such as ID proof, medical bills, diagnostic reports, NEFT details as needed.
• If his/her cashless claim is denied due to some reason, then he/she can file for reimbursement of his/her hospital expenses.

To know more about Cholamandalam Arogya Sanjeevani policy one can write to us at care@policybazaar.com or speak to us at 1800-708-8787.

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