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Chola MS Top Up Healthline

Objective

A top-up policy that becomes active only with medical expenses above a certain limit. It is meant to be bought as an additional policy to take care of hefty claims.


Suited for

This policy is more effective for those who already have a basic health insurance cover and wish to increase the protection further. Those who do not hold any health insurance policy may also go in for this policy if they can pay small medical bills that are not covered by the top-up policy. This policy is available for both individual and family on a floater basis.


What does it do?

It is a top up plan that gets activated only when the claim crosses the deductible limit. A deductible is that portion of claim which has to be borne either by an existing policy or by the policyholder himself. In this plan, deductible limit applies afresh each time insured person is hospitalized during the policy term. For instance, an insured accesses hospitalisation services twice during a policy term. For the first time the total medical expenses amounted to Rs 2 lakh and Rs 2.5 lakh during second hospitalisation. If the deductible limit on his policy was Rs 3 lakh, the policyholder will not receive insurance benefit of this policy as the admissible claim expenses were below the deductible limit each time. This policy offers a wide range of deductible starting from as low as Rs 30,000 up to Rs 5 lakh.
It covers hospitalisation expenses including doctor's fee, nursing, room charges up to the daily limit stated in the policy document, ICU charges, oxygen, OT charges, anesthesia and other expenses incurred as an inpatient. This plan can be bought as an individual or as a family floater policy.


Pros

Premiums paid under this plan qualify for deduction under Section 80D of Income Tax Act.
Policyholder can escape from hassle of paying premiums annually by selecting a higher policy term of 2 or 3 years.
It provides for lifelong renewals as there is no policy ceasing age.
There is no need to undertake pre-policy medical check up upto 55 years of entry age.


Cons

There is capping on room rent expenses.
Deductible applies afresh on each claim.


Our View

Add-on plans are not intended to duplicate the existing cover, these plans are rather meant to pay for higher claims which are beyond the reach of basic insurance plans. Instead of buying another insurance policy, a top up is recommended if your current insurance cover seems inadequate. The only constraint to this product is that threshold limit applies to every single treatment undertaken as an inpatient in a hospital. In contrast, there are certain policies in the market that cover each hospitalisation after the expenses of previous hospitalisation(s) put together exceed threshold. Such top-up policies have an edge over the policies where deductible applies on each claim.

Eligibility
Entry Age (years) 
Minimum18, 3 months for children
Maximum65; 35 for dependent girl child and 25 for dependent male child
Maximum Policy Renewal Age (years)Life long
Coverage TypeIndividual/ Family floater
Sum Insured (Rs) 
Maximum15 lakhs over and above deductible
Minimum50000 over and above deductible
Policy Term (years)1 or 2 or 3
Pre Policy Medical Check UpMandatory beyond 55 years of age. 50% of medical cost will be reimbursed
Grace Period for Policy Renewal15 days
Policy TerminationPolicy may be terminated by giving a 15 days written notice by either parties. In case no claim has been made under the policy, a pre defined percentage of premium will be refunded. Insurance company will retain a part of premium for coverage provided.
Customer Service 
AddressCholamandalam MS General Insurance Company Limited
Dare House 2nd floor, No 2 N.S.C. Bose Road, Chennai 600 001
Mail to[email protected]
Call to1800 200 5544
SMSCHOLA to 56677
Network HospitalsHttp://www.cholainsurance.com/nwhosp/
Additions to the Plan
Scope of Cover
Cahless facilityavailable if treatment availed in a cashless hospital
Reimbursement facilityavailable if treatment taken in any other non-empanelled hospital
Pre and post hospitalisationcovers pre hospitalisation for 60 days before hospitalisation upto 5% of admissible claim and post hospitalisation for 90 days upto 10% of admissible claim upto maximum of Rs 50000
Inpatient hospitalisationcovered
Room Rentcovered with sub-limits
Emegency ambulancecovered upto Rs 3000 per hospitalisation
Exclusions and Waiting Period
Pre existing diseaseswill be covered after a period of 4 years of continuous renewal.
No claim period30 days starting from the inception of the policy
Waiting Periodcertain diseases such as cataract, hernia piles etc will be covered after first policy year has elapsed. Other diseases such as hypertension, diabetes, varicose veins etc. will be covered after a waiting period of 2 years.
General ExclusionsExpenses towards out patient treatmentCost of organ transplantDomiciliary treatmentPlastic Surgery, slimming or any other beauty related treatments.All diseases or conditions caused by or related to HIV or AIDS.Naturopathy and non allopathic treatment.Any condition arising due to involvement in any illegal or criminal activity
Room Rent limit applicable under different Sum Insured
Plan OptionABCDEFG
Sum Insured (over & above deductible)500002 lakh3 lakh5 lakh6 lakh10 lakh15 lakh
Room charges limit per day5002000400050006000750010000
Annual Premium Option for 1 year policy tenure
PlanSum Insured (over & above deductible)/ DeductibleNo. of Members / Age3 months to 40 years40 years to 65 years65 years to 70 years
Plan A50000 / 300001 Member220033904158
2 Members248039674927
3 Members276045445696
4 Members298350066312
5 Members317453986835
Plan B2 lakhs / 1 lakh1 Member234936594447
2 Members266643045288
3 Members298349496130
4 Members323754646803
5 Members345259037375
Plan C3Lacs / 2Lacs1 Member266342165109
2 Members305850006116
3 Members345457837123
4 Members377064107928
5 Members403969438613
Plan D5 lakhs / 3 lakhs1 Member315650616094
2 Members367460567347
3 Members419370518601
4 Members460878479603
5 Members4961852310456
Plan E6 lakhs / 4 lakhs1 Member316049715909
2 Members367959447115
3 Members419969178322
4 Members461576959288
5 Members4968835610108
Plan F10 lakhs / 5 lakhs1 Member356255366474
2 Members418266497822
3 Members480277639171
4 Members5298865410249
5 Members5720941111166
Plan G15 lakhs / 5 lakhs1 Member402562527265
2 Members476175458811
3 Members5496883810357
4 Members6085987211594
5 Members65861075212646
Premium rates are exclusive of service tax.
Single premium Option for a 2 year policy term
PlanSum Insured/ DeductibleNo. of Members / Age3 months to 40 years40 years to 65 years65 years to 70 years
Plan A50000 / 300001 Member422765077979
2 Members476376139454
3 Members5299871910928
4 Members5728960412108
5 Members60931035713110
Plan B2 lakhs / 1 lakh1 Member451270248533
2 Members5120825910146
3 Members5727949511758
4 Members62141048313049
5 Members66271132314145
Plan C3Lacs / 2Lacs1 Member511480909802
2 Members5872959311732
3 Members66301109513662
4 Members72361229615206
5 Members77521331816519
Plan D5 lakhs / 3 lakhs1 Member6059971011690
2 Members70531161714093
3 Members80471352416495
4 Members88421504918416
5 Members95181634620050
Plan E6 lakhs / 4 lakhs1 Member6066953911335
2 Members70621140313648
3 Members80581326715961
4 Members88551475817812
5 Members95331602619384
Plan F10 lakhs / 5 lakhs1 Member68371062012419
2 Members80251275515003
3 Members92141488917587
4 Members101651659719654
5 Members109731804821411
Plan G15 lakhs / 5 lakhs1 Member77241199413935
2 Members91341447216898
3 Members105451695019862
4 Members116731893222232
5 Members126322061724247
Premium rates are exclusive of service tax.
Single premium Option for a 3 year policy term
PlanSum Insured/ DeductibleNo. of Members / Age3 months to 40 years40 years to 65 years65 years to 70 years
Plan A50000 / 300001 Member6059930211397
2 Members68221087613493
3 Members75851244915590
4 Members81951370817268
5 Members87131477818694
Plan B2 lakhs / 1 lakh1 Member64651003712184
2 Members73301179514477
3 Members81941355216771
4 Members88851495718606
5 Members94731615220166
Plan C3Lacs / 2Lacs1 Member73211155413989
2 Members83991369116734
3 Members94771582719479
4 Members103401753621675
5 Members110731898923541
Plan D5 lakhs / 3 lakhs1 Member86651385816675
2 Members100791657020091
3 Members114921928223507
4 Members126242145226240
5 Members135852329628564
Plan E6 lakhs / 4 lakhs1 Member86761361416169
2 Members100921626519458
3 Members115091891722748
4 Members126422103825380
5 Members136052284027617
Plan F10 lakhs / 5 lakhs1 Member97711515217710
2 Members114621818821385
3 Members131522122425061
4 Members145052365328001
5 Members156542571730500
Plan G15 lakhs / 5 lakhs1 Member110331710619867
2 Members130392063024082
3 Members150452415528296
4 Members166502697431668
5 Members180142937134534
Premium rates are exclusive of service tax.