Plan: Health Plan B Type: Single

Description > Benefits > How it works > Exclusions

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Description:

In the unfortunate event of you or your family members meeting with an illness or accident resulting in hospitalization, Cholamandalam’s Health Insurance gives you a cash free hospitalization in more than 1400 hospitals across India. Our Health Insurance also reimburses the expenses during Pre-Hospitalization and Post-Hospitalization stages of treatment.

 
 

Benefits:

General
Entry Age Minimum 5 yrs
Entry Age Maximum 55 yrs
Individual Policy Yes
Group Policy Yes
Underwriter Cholamandalam
Plan Name Health Insurance
Mandatory Requirement for Policy Cover Medical Report for Age > 45
Coverage Details
Floater Available No
Cover while in India Yes
Cover while travel abroad No
What does Policy Cover( See Details Below)
Yearly Health Checks No
Doctor Visits No
Specialist Doctor Visits No
Prescription Drugs Only if hospitalized
Hospitalization Yes
Pre- Hospitalization Yes
Post Hospitalization Yes
Day care Expenses Yes as per list issued by Cholamandalam
Domiciliary Hospitalization No
Accident Yes, Hosp. Arising out of Accident
Emergency Care Yes
Pre-existing Diseases No
Hospitalization Abroad No
Network
Network of Doctors to Visit Free to Choose any Doctor
Network of Hospitals to visit Listed Hospital Available in Policy Document
Option to Choose out of Network Doctor  
Choose out of Network Hospital Yes. But No Cashless Admission
Claim Settlement
Who settles Claim TPA defined by Underwriter
Process for Claim in Network Outlined by Policy Document
Process for Claim for out of Network Pay & Claim Re-imbursement
Other Services
Cashless Admission Within Network
Ambulance Call Network Hosp.
Emergency Hot Line  
Toll free numbers within India Available in Policy Doc.
Toll free numbers when abroad No
 
 
 
What the policy Covers?

In the unfortunate event of you or your family members meeting with an illness or accident resulting in hospitalization, our Health Insurance gives you a cash free hospitalization in more than 1400 hospitals across India. Our Health Insurance also reimburses the expenses during Pre- Hospitalization and Post- Hospitalization stages of treatment.

    Pre-Hospitalization: Medical expenses incurred 60 days prior to the hospitalization are reimbursed. This is the longest time period offered by any Health Insurance policy in India.

    Hospitalization: You will be reimbursed hospitalization expenses like room and board, doctors fees, intensive care unit charges, nursing expenses, surgical fees, operating theatre expenses, anesthesia and oxygen and their administration, physical therapy, drugs and medicines consumed on premises, hospital miscellaneous services (laboratory, x-ray, diagnostic test, etc.), dressing, ordinary splints and plaster casts, costs of prosthetic devices if implanted during a surgical procedure, radiotherapy, chemotherapy, organ transplantation including the treatment costs of the donor but excluding the cost of the organ.

    Post-Hospitalization: Once discharged from hospital, the policy shall pay for medical expenses related to the hospitalization, for a period of 90 days after discharge. This is something unmatched by any other Health Insurance policy in India.

    Day Care Procedure: The policy covers over 130 minor surgeries that require less than 24 hours hospitalization under our Day Care Procedure. These surgeries ordinarily fall outside the scope of Health Insurance Policies available in the Indian market.Local Ambulance Service: In the event of an emergency, cover is provided for expenses incurred on ambulance services to the nearest hospital where Emergency Health facilities are available. Cholamandalam Health Insurance policy ensures comprehensive coverage by offering value added features, at a nominal increase in premium, like:

    General Health and Eye Examination: You will be reimbursed the expenses incurred for general health and eye examination.

    Hospital Daily Allowance: In addition to hospital expenses, a daily hospital allowance will be paid during the period of hospital

 

Exclusions:

Diseases, which have been in existence at the time of proposing this insurance.

Illness that commenced during the first 30 days of inception of the first policy.

During the first year of policy, treatment for Cataracts, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal Disease, Fistula in anus, Piles, Sinusitis and related disorders, will not be reimbursed.

Any dental treatment or surgery of a corrective, cosmetic or aesthetic nature, unless it requires hospitalization and is carried out under general anaesthesia and is necessitated by illness or Accidental Bodily injury.

The treatment of obesity (including morbid obesity) and any other weight control programs, services, or supplies.

Diagnostic, X-ray or laboratory examination not incidental to or inconsistent with the diagnosis and treatment of the Illness or Injury for which the Insures was Hospitalized.

Vaccination, inoculation, cosmetic treatments (including any complications arising out of or howsoever attributable to any cosmetic treatments or the placement of an existing breast implant), aesthetic treatments, experimental, investigational or unproven procedures or treatments, devices and pharmacological regimens of any description.

Voluntary medical termination of pregnancy, pregnancy, childbirth and their consequences, including changes in chronic conditions as a result of pregnancy.

Naturopathy treatment.

The Insured's participation in any hazardous activities, including but not limited to scuba diving, motor-racing, parachuting, hang-gliding, rock or mountain climbing, as a member of the armed forces, the paramilitary, the security forces, the fire or ambulance services, lifeboat service, police force and the like, whether part time or full time, voluntary or paid.

Costs incurred in connection with the provision or fitting of hearing aid, eyeglasses or contact lenses.

The use, misuse, or abuse of alcohol, substances or drugs (whether prescribed or not).

HIV, AIDS, all related medical conditions.