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Chola Tax Plus Healthline Policy

What is the Plan all About?

Chola Tax Plus Healthline insurance policy aims to provide medical insurance coverage against hospitalization & non-hospitalization expenses. This policy is available for individuals and families on floater sum insured basis. This health plan covers all your day-to-day medical expenses.

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Key Features

  • Health coverage for individuals and families
  • Flexible sum insured options to choose from
  • No pre-policy medical check-up up to 55 years
  • Get cashless hospitalization across 3500+ network hospitals
  • In-house claims assistance team

Policy Benefits

  • In-patient hospitalization expenses like nursing and boarding expenses, room rent, etc.are covered as mentioned in the policy.
  • Pre & Post hospitalization expenses are covered up to a maximum of 60 days before hospitalization & 90 days post discharge respectively.
  • 141 day care procedures or other listed day care procedures/surgeries, which need the insured to be hospitalized for less than 24 hours are covered.
  • This policy also provides non-hospitalization cover
  • Treatment of illness/injury incurred is covered without hospitalization.
  • Pre & post natal expenses are covered.
  • Expenses incurred in the treatment of pre-existing diseases.
  • Dental treatments.
  • Allopathic and other system of Indian medicine except naturopathy.
  • Contact lenses, spectacles, hearing aids, etc. as prescribed by a medical practitioner.
  • Deductibles under a valid claim.

Value Added Benefits

  • Cumulative bonus where sum insured is increased by 5% on every claim free policy year, subject to a maximum of 50% of the sum insured is available. This benefit is applicable only for the hospitalization cover.
  • Sum Insured can be enhanced at the time of policy renewal.
  • Emergency ambulance charges are covered under this plan.
  • Avail tax benefits u/s 80D as per IT Act, 1961 for premium paid for this plan.

Sub Limits

  • Room rent is covered up to 1% of the sum insured per day.
  • ICU charges are capped up to 2% of the sum insured per day.
  • Pre hospitalization is payable up to 5% of the eligible hospitalization claim amount.
  • Post hospitalization is payable up to 10% of the eligible hospitalization claim amount or Rs 50,000 whichever is less.
  • Ambulance charges are payable up to Rs 3000 per hospitalization.
  • Other Sub-limits for the specified surgeries are:
  • Cataract - 7.5% of SI upto Rs.20,000 per eye
  • Hernia/Hydrocele - 10% of SI upto Rs.30,000
  • Fistula in Anus, Anal Fissure, Piles - 10% of SI Upto Rs.30,000
  • Sinusitis - 10% of SI upto Rs.30,000
  • Tonsilitis or Adenoids - 15% of SI Upto Rs.40, 000
  • Knee & Joint replacement surgery - 50% co-pay applicable

Waiting Period Clause

  • Initial Waiting Period: A waiting period of 30 days from the inception date for all hospitalization claims except in case of accidents.
  • Specific Waiting Period: Specific illnesses such as Hernia, Hydrocele, Benign Prostate Hypertrophy, PilesTonsilitis is covered after continuous coverage for 12 months. Other illnesses such as Hysterectomy, knee replacement surgery Spondylosis, Chronic Kidney Disease is covered after continuous coverage for 24 months.
  • Pre existing Disease Waiting Period: Any pre-existing ailment/injury that was diagnosed /acquired within 48 months from the issuance of the first policy.

Who can Buy the Plan?

Factor Minimum Maximum
Age (as on last birthday) Adult: 18 Years, Children: 3 Months Adult: 65 Years, Children: 35 Years
Sum Assured 1 Lac 5 Lacs
Cover Type Individual/Family Floater -
Policy Tenure 1 Year 1 Year
Grace Period 30 Days -
Free Look Period 15 Days -
Riders Nil -

Exclusions

  • Congenital external anomaly
  • Cost of spectacles, crutches wheel chairs, contact lens & hearing aids
  • Dental treatment/surgery
  • Experimental/Unproven treatment
  • Pregnancy & childbirth related treatment
  • Non-allopathic treatment
  • Expenses towards naturopathy treatment (under non-hospitalization cover)
  • OPD bills without prescription (under non-hospitalization cover), etc.
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