Cholamandalam Chola Swasth Parivar Plan

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Chola Swasth Parivar plan is an all-inclusive family floater insurance plan that provides coverage to families on a floating sum insured basis. It also provides personal accident benefit to all the insured members on an individual basis. It is an economical plan that comes in two variants with flexible sum insured options.

Features of Chola Swasth Parivar Insurance Plan

  • It covers hospitalization expenses for most of the illnesses including 141 daycare procedures where 24 hours of hospitalization is not required
  • The limit for pre-hospitalization expenses is up to 30 days and for post-hospitalization expenses, it is up to 60 days
  • It offers dual protection that includes hospitalization cover on floater sum insured basis and personal accident cover on the individual sum insured basis (under Plan Royale)
  • The minimum entry age criterion is 18 years and the maximum entry age is 65 years
  • No medical screening is required for proposers below 55 years of age
  • Coverage for two children starting from 3 months to 26 years
  • Lifetime policy renewal
  • Tax saving benefits U/S 80D for

Benefits of Chola Swasth Parivar Insurance

Chola Swasth Parivar comes in two variants with flexible sum insured options:

Pearl Plan 
Features / Options Plan 1 Plan 2 Plan 3
Coverage Section I
Hospitalization Cover (per family during a policy term) INR 3 lakhs INR 4 lakhs INR 5 lakhs
Compulsory co-pay clause for every permissible claim 15 percent 
Co-pay (per family per policy year) 10 percent is  applicable to eligible treatment expenses in a Non-Network hospital
Room Rent Charges (per day) 1 percent of the SI
ICU Room Charges (per day) 1.5 percent of the SI
Post-Hospitalization Expense Cover  Up to 60 days Post Discharge
Pre-Hospitalization  Expense Cover Up to 30 days Before Hospitalization
Day Care Services ( in Network Hospital) Covered
The waiting period for specific diseases 2 years

 

Royale  Plan
Features / Options Plan 1 Plan 2 Plan 3
Hospitalization Cover (per family during a policy term) INR 3 lakhs INR 4 lakhs INR 5 lakhs
Compulsory co-pay clause for every permissible claim 15 percent
Co-pay (per family per policy year) 10 percent is  applicable to eligible treatment expenses in a Non-Network hospital
Room Rent Charges (per day) 1 percent of the SI
ICU Room Charges (per day) 1.5 percent of the SI
Post-Hospitalization Expense Cover Up to 60 days Post Discharge
Pre-Hospitalization  Expense Cover Up to 30 days Before Hospitalization
Day Care Services ( in Network Hospital) Covered
The waiting period for specific diseases 1 year
Personal Accident Cover
Personal Accident Cover for Self
Death INR 7.5 lakhs INR 10 lakhs INR 10 lakhs
Permanent Total Disablement INR 7.5 lakhs INR 10 lakhs INR 10 lakhs
Permanent Partial Disablement INR 3.75 lakhs INR 5 lakhs INR 5 lakhs
Personal Accident Cover for Spouse
Death INR 3.75 lakhs INR 5 lakhs INR 5 lakhs
Permanent Total Disability INR 3.75 lakhs INR 5 lakhs INR 5 lakhs
Permanent Partial Disability INR 1,87,000 INR 2.5 lakhs INR 2.5 lakhs
Personal Accident Cover Per Child (Up to a maximum of 2 children)
Death INR 1.5 lakhs INR 2 lakhs INR 2 lakhs
Permanent Total Disability INR 1.5 lakhs INR 2 lakhs INR 2 lakhs
Permanent Partial Disability     INR 75,000 INR 1 lakh INR 1 lakh


Coverage Provided in Chola Swasth Parivar Insurance Plan

This plan recompenses pre-hospitalization expenditures for up to 30 days and post-hospitalization overheads for up to 60 days. Compensation offered is for standard hospitalization expenses like:

  • Nursing charges
  • Room and boarding charges
  • Medical practitioner’s fees
  • Surgery, oxygen and anesthesia charges
  • Dressing, plaster casts, and ordinary splints
  • Cost of the prescribed medicines during hospitalization
  • ICU charges
  • Other hospital services (such as x-ray, lab tests etc.)
  • Physiotherapy
  • 141 daycare procedures ( where hospitalization required is less than 24 hours)

The coverage amount payable per person for the following treatments/ procedure/disease/surgery during the policy term is subjected to the sub-limits as mentioned in the table below:

Disease/Procedure/ Surgery Claim Limits During Each Policy Term
Removal of Kidney Stone INR 30,000
Appendectomy  INR 30,000
Cataract Eye Surgery INR 20,000
Tonsillectomy INR 20,000
Hernia Surgery INR 40,000
Prostate gland surgery INR 25,000
Lithotripsy(daycare) INR 10,000
Hysterectomy (Surgical procedure to remove  the uterus) INR 40,000
D & C - Dilatation and Curettage of Uterus (daycare) INR 5,000
Hydrocele Surgery INR 15,000
Urinary surgery INR 25,000
ENT Surgery INR 35,000
Coronary Angiography INR 20,000
Gastrectomy INR 15,000
Knee surgery / fracture / dislocation INR 1 lakh
Coronary Angioplasty INR 1 lakh


Main Exclusions of Chola Swasth Parivar Insurance Plan

The following expenses are not covered by the insurer. For a detailed list of exclusions you can refer to the policy wording:

Exclusions of Hospitalization Expenses

  • Any pre-existing health condition that was there before buying the policy shall not be covered until completion of 48 months of the policy term
  • Expenses incurred during the initial 30 days of policy commencement, unless it is an accidental case
  • There is a waiting period of one year before covering the expenses incurred on medical procedures related to Hernia, Cataract, Hydrocele, Benign Prostratic Hypertropy, Fistula in anus Hysterectomy, piles, sinusitis, internal congenital disease, and related disorders (only covered under the Royale plan)
  • There is a waiting period of 2 years in the Pearl plan for the following medical procedures: Cataract, Hysterectomy for Fibromyom, Benign Prostratic Hypertropy, Hernia, Fistula in anus hydrocele, Piles, Sinusitis, Internal Congenital Disease, and related disorders. Adding to the list is spondylosis, spondilitis, knee / hip joint replacement, osteoarthritis of any joint, urogenital, duodenal and gastric ulcers, cysts, internal tumours, nodules, ENT disorders, polyps including breast lumps, gout and rheumatism, surgery for prolapsed intervertebral disk, surgery of genitourinary system, tonsil surgeries, and surgery of varicose veins.

Limitations of Personal Accident Plan

  • Terrorist act or Terrorism
  • Suicide, self-inflicted injury, or any other deliberate attempt
  • Involvement in sports or other hazardous activities

Chola Swasth Parivar Insurance Premium Table

This premium rate is applicable to applicants up to 70 years of age. Premium in Rs. (Additional Service Tax of 18% is applicable)

Plans Sum Assured Pearl Plan Royale 
Plan 1 INR 3 lakhs 5,256 8,161
Plan 2 INR 4 lakhs 6,070 9,623
Plan 3 INR 5 lakhs 7,173 10,870


Chola Swasth Parivar Insurance Claims Procedure

Chola MS provides express claims settlement services from their in-house claims desk at all the network hospitals:

  • In the event of planned hospitalization, intimate the insurer before 24 hours of hospitalization
  • In the event of emergency hospitalization, you need to inform the insurance company within 24 hours of the hospitalization.
  • In case of non-network hospitals you need to submit the completed claim form along with all required documents within a month of discharge.
  • For any assistance, you can call the insurer on their 24-hour helpline at their toll-free number.