Cholamandalam Insurance Plans

Cholamandalam Health Insurance

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Key highlights of Health Insurance

Cholamandalam MS offers health insurance in India to insureds the option of availing quality treatment at more than 6500+ leading hospitals across the country. They have an incurred claims ratio of 35.00%, and also covered 18.06 lac lives during the same year 2018-19, as per the data provided by IRDAI.

Key features of Cholamandalam Health Insurance

  • Room Rent: Daily Limit from ₹3,000 upto Single Occupancy A/C Room
  • Co-pay: No co-pay if entry age < 55 yrs / 10% co-pay for ages > 55 years
  • Restoration: NIL. However Double SI for Critical Illness/Accidents

Cholamandalam Health Insurance review

Cholamandalam Health Insurance
Chola Health Insurance sum insured
2 lacs − 25 lacs options available
Incurred Claims Ratio *
35.00%
Chola Health Insurance tenure options
1,2,3 years options available
Claims Settlement Ratio **
73.87%
List of network hospitals
6,500+ hospitals
Number of policies issued *
103,232
Maximum family floater coverage
Self, Spouse + 4 dependent children
Number of lives covered *
1,806,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

Why Should One insure themselves through Cholamandalam MS India Health and Mediclaim Insurance plans?

  • As a Murugappa Group Company, trust and reliability are the foremost values the company works to uphold.
  • Transparency – They believe in crystal clear transactions. With Chola MS, what you see is what you get.
  • Technology - Staying ahead of the times with effective use of technology has always been a feather in our cap.
  • 89,00,000 Customers so far since inception serviced through their 136 branches across India.
  • Average of 2,20,000 Claims settled per year.
  • Wide Range Of Health Insurance Products From Individual Plans to Family Floater Schemes with Sum Insureds ranging from ₹2 lacs to ₹25 lacs.
  • Covers Hospitalisation Treatment including coverage for Covid 19 Expenses.
  • Tax benefit: Premium paid by any mode other than cash is eligible for tax relief as provided under Section 80-D of the Income Tax Act.
Cholamandalam MS Health Insurance is today one of the profitably growing insurance players in India with a lot of focus on both retail and group insurance products. Today the Cholamandalam MS health insurance in India premium is one of the most competitive in the market across all their plans apart from being competitive in their benefit structure. They are also one of the players who have built a strong hospital network across India with a current strength of 6,500+ and growing. Most of the customer’s Cholamandalam MS health insurance reviews have been positively influencing the growth of their business year on year. One can also follow the Cholamandalam MS health insurance renewal link on eindiainsurance.
  • Benefits
  • Claim Process
  • Exclusions

Benefits under Cholamandalam MS India Health Insurance plans include:

Basic Coverage of Chola health insurance

  • Hospital admission longer than 24 hrs
  • Related medical expenses incurred upto 30/60 days prior to date of admission
  • Related medical expenses incurred upto 60/90 days from date of discharge
  • 141 listed day-care procedures requiring hospitalization for less than 24 hrs
  • Domiciliary hospitalisation
  • AYUSH coverage
  • Donor expenses for organ transplantation
  • Ambulance expenses
  • Maternity expenses (under Privilege Plan)
  • Newborn baby hospitalisation expenses (under Privilege Plan)

Additional Benefits of Cholamandalam mediclaim insurnace

  • Child hospitalization allowance per hospitalization
  • Outpatient Dental/Specs/Contact Lens/Hearing Aids
  • Extended hospitalisation allowance
  • Double Sum Insured for Accidents and Critical Illnesses
  • Specialist opinion for Critical Illness

Cholo health insurance Renewal Benefits

  • Health checkup
  • Cumulative Bonus

Discount on Chola health insurance

  • Discount on long term policy purchase: 6% on 2-year policy & 12% on 3-year policy
  • Location-based Discount:
    • A discount of 10% on the premium for Insured from Tier 2 locations
      • Tier 1 Locations: Mumbai, Chennai, Bengaluru, Kolkotta, New Delhi, Gurgaon, Hyderabad, Ahmedabad
      • Tier 2 Locations: Rest of India excluding Tier 1 Locations

Claim Process for Cholamandalam health insurance

Assistance Contact Numbers :
Call at: Toll Free 1800 208 5544
Email ID: customercare@Cholams.murugappa.com
Write to: Chola MS HELP – Health Claims Department
Cholamandalam MS General Insurance Company Limited
Shaw Wallace Building, Old No.154, New No.319, 2nd Floor
Thambu Chetty Street, Parrys Corner, Chennai 600 001
Cashless Claims Process (Planned Admission)
Step 1 Get admitted to any one of Cholamandalam MS network hospitals, currently they have 6500+ hospitals across India hospital list at Chola Health Insurance
Call at : Toll Free 1800 208 5544
The insured should approach the hospital 48 hours in advance and provide his/her policy details/e-cards along with govt. issued photo ID card like Driver’s License/Aadhaar to TPA/Insurance desk.
Step 2 The hospital validates the claim and sends the pre-authorization request to Chola MS. Chola MS shall review, confirm and approve the claim as per policy terms and conditions.
Step 3 The hospital and the insured will be intimated in case of any additional information that is required.
Step 4 Settlement of the claim shall be done by Chola MS to the hospital.

Cashless Claims Process (Emergency Hospitalisation / Admission)
Step 1 Get admitted to any one of Oriental Insurance network hospitals, currently they have 6500+ hospitals across India…hospital list at Chola Health Insurance
Call at : Toll Free 1800 208 5544
In case of emergency hospitalization, contact any of our Network Hospitals within 48 hours of hospitalization along with his/her policy details/e-cards along with govt. Issued photo ID card like Driver’s License/Aadhaar.
Step 2 The hospital validates the claim and sends the pre-authorization request to Chola MS. Chola MS shall review, confirm and approve the claim as per policy terms and conditions.
Step 3 The hospital and the insured will be intimated in case of any additional information that is required.
Step 4 Settlement of the claim shall be done by Chola MS to the hospital.

Reimbursement Claims Process
Step 1 In case of hospitalization, notify us within 48 hours of admission at our Network or non-Network Hospital.
Step 2 Pay directly at the hospital after getting admitted.
Step 3 Submit the claim with all the relevant documents and claim form.
Step 4 Chola MS shall review, confirm and approve the claim as per policy terms and conditions.
Step 5 Settlement of claim : Upon approval of claim by us, payment of the reimbursement claim will be made to the policy holder either through EFT or through cheque/DD.

The indicative list of documents required is mentioned below :
  • Cholamandalam MS Claim Form properly filled in and signed by the claimant along with Medical Certificate Form filled, signed and stamped by the treating doctor.
  • Prescription of doctor advising the admission.
  • Discharge card issued by the hospital.
  • Final hospital bill (in original) and payment receipt.
  • Medical investigation reports.
  • Medicine bills with the supporting prescriptions.
  • Invoice / sticker for implants if used in the surgery.
  • Other bills or documents related to the treatment.
  • Medico Legal Certificate (MLC) / FIR in case of road traffic accidents (RTA).
  • Cancelled Cheque of insured bank account to make the claim payment through NEFT.
The list given is indicative in nature. Further additional documents may be called for depending on the nature of the claim.

Exclusions Under the Cholamandalam medical insurance

Some of the permanent exclusions under the Cholamandalam MS Health Insurance Plans are below, kindly review the policy wordings which are available with your policy kit for the entire list of exclusions under your opted plan. The exclusions include:
  • War or any act of war, invasion, acts of foreign enemies, hostilities whether are be declared or not, civil war, revolution, insurrection, mutiny, martial law.
  • Any Insured Person committing or attempting to commit a breach of law with criminal intent or intentional self-injury or attempted suicide whether sane or insane.
  • The use, misuse or abuse of alcohol, Tobacco and related products, banned substances or narcotic drugs (whether prescribed or not).
  • All expenses caused by ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel.
  • Experimental or unproven treatment.
  • The Insured Person’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 Hazardous Activities for the purpose of this exclusion shall mean any sport or activity, which is potentially dangerous to the Insured Person whether he is trained or not. This shall include Persons whilst working in underground mines, explosives, magazines, workers whilst involved in electrical installation with high tension supply, jockeys, circus personnel, engaged in activities like racing on wheels or horseback, big game hunting, mountaineering, winter sports, Skydiving, Parachuting, Scuba Diving, Riding or Driving in Races or Rallies, Mountain Climbing, hunting or equestrian activities, rock climbing, potholing, bungee jumping, skiing, ice hockey, ballooning, hang-gliding, diving or under-water activity river rafting, canoeing involving rapid waters, polo, yachting or boating outside coastal waters and persons whilst engaged in occupation/activities of similar hazard..
  • Treatment of obesity (including morbid obesity) and any other weight control program, general debility, convalescence, run-down conditions, rest cure, treatment of sleep apnea..
  • Sterility, treatment whether to effect or to treat infertility; any fertility, sub-fertility or assisted conception procedure; surrogate or vicarious pregnancy; birth control, contraceptive supplies or services including complications arising due to supplying services.
  • Circumcisions (unless necessitated by illness or injury and forming part of treatment).
  • Cosmetic treatments (including any complications arising out of cosmetic treatments) unless necessitated by traumatic injury, burns or cancer.
  • HIV (Human Immunodeficiency Virus) /AIDS (Acquired Immune Deficiency Syndrome) and/or infection with HIV including but not limited to conditions related to or arising out of HIV/AIDS such as ARC (AIDS related complex)), Sexually transmitted disease or illness.
  • Psychiatric, mental disorders (including mental health treatments).
  • Any external congenital diseases, defects or anomalies. .
  • Any dental treatment or surgery of a corrective, cosmetic or aesthetic nature unless it requires hospitalisation and is carried out under general anesthesia and is necessitated by Illness or Accidental Bodily Injury.
  • Any expenses towards fitting of hearing aids, eyeglasses or contact lenses.
  • Treatment rendered by a Medical Practitioner which is outside his discipline or the discipline for which he is licensed; treatments rendered by a Medical Practitioner who shares the same residence as an Insured.
  • Except to the extent provided in the Schedule of Benefit, expenses towards pregnancy (other than ectopic pregnancy), childbirth and their consequences, including changes in Chronic conditions as a result of pregnancy.

Cholamandalam Health insurance products

Key Features:
Chola Healthline Insurance offers comprehensive medical and health insurance benefits to individuals and families in India.



Key Features:
Cholamandalam Super Top Up health plan insurance is a comprehensive health insurance policy plan which provides health cover for you and your loved ones to meet your higher medical expenses on a floating sum Insured basis or on individual sum Insured basis.
Key Features:
Chola Hospital Cash Healthline insurance covers expenses for fixed daily allowance for each completed 24 hours of hospitalization.



Key Features:
The Policy covers Hospitalisation Expenses for In-Patient Care or Day Care Treatment incurred for treatment of an Illness contracted/ Injury sustained during the Policy Period.

Key Features:
The Proposer should be minimum 18 years on the Commencement date of the policy.

Cholamandalam MS Health Insurance FAQ’s

Cholamandalam MS has an extensive network of 6,500+ network hospitals across India. One must get admitted to a network hospital in order to avail cashless treatment for their illness. One can get the Cholamandalam MS network hospital list online.

There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured, unless the chosen plan has a Sum Insured Refill benefit, which provides additional coverage even after filing a claim.

When an insured is hospitalized and stays in hospital for more than 24 hours solely for receiving treatment it is termed as inpatient treatment. Out-patient treatment is when insured visits a clinic/hospital or a consultation room for diagnosis and treatment based on the advice of medical practitioner. In out-patient hospitalization patient is not admitted under a day care or as an in-patient.

It is strongly advised to have Health Insurance on your own as well because of reasons of continuity. Firstly, if you change your job, you might not necessarily get Health Insurance from your new employer. In any case you will be exposed to health costs in the transition period between jobs. Secondly, the track record that you have built in Health Insurance at your old employer will not transfer to the new company policy. Covering pre-existing diseases will be a problem in most group insurance policies. In the recent years, many employers are mandating employees to share a part of the Health Insurance premium and claim amount (copayments) in order to prevent frivolous and fraudulent claims. Therefore to avoid the above problems, it is advisable to take a private policy in addition to your company provided group Health Insurance Policy.

Till the age of 55 years, Medical checkup is not required for buying Individual Healthline Insurance. Above 55 years a medical checkup is required at the time of first purchase of the policy. Medical checkups are usually not needed for renewal of policies.

Health Insurance covers all diagnostic tests like X-ray, MRI, Blood Tests etc., as long they are associated with the patients stay in the hospital for at least 24 hours. Any diagnostic tests which have been prescribed in Out Patient Department are generally not covered.

When you get a new Health Insurance Policy, there will be a 30 day waiting period starting from the policy start date, during which period any hospitalization charges will not be payable. However, this is not applicable to any emergency hospitalization occurring due to an accident. This 30 day waiting period is not applicable when the policy is renewed. Some specific ailments have a specific waiting period of one or two years. Some of the covers have specific waiting periods.

A pre-existing disease is any condition, ailment or injury or related condition(s), for which the insured person had signs or symptoms, and /or were diagnosed, and / or received medical advice / treatment within 36/48 months prior to 1st health insurance policy issued by Us under which the insured person was covered.

Under cashless hospitalization, the insured person does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by us for treatment that the insured person is eligible to receive under the terms of his/her policy. This is for your convenience. However, it is important to note here that prior approval is required from us before admission into the hospital. In some cases, you may have to pay for all or part of the treatment if it is not fully covered under the terms of the policy. However, in case of emergency hospitalization, you can obtain approval post-admission. Please note that the cashless facility is available only at our Network Hospitals.

Under Individual Healthline Insurance, the age, the amount of cover (Sum Insured) and the plan of benefits that you choose are the factors that decide the premium. Usually, younger people are considered healthier and thus pay lower annual premium. Older, people pay a higher Health Insurance premium as their risk of health problems or illness is higher.

The premium paid on a health insurance policy is eligible for deduction under Section 80D of the Income Tax Act. So save with your policy now!

A waiting period is the length of time you, the insured, will have to wait before the benefits under the health policy can be utilised.

The following KYC documents are required from the insured person/proposer in cases of reimbursement-
  • If claim amount is below 1 lakh- Photo Id proof & address proof
  • If claim amount is above 1 lakh- Photo Id proof, address proof and a recent photograph
The following details are to be provided to the company at the time of intimation of claim :
  • Policy number
  • Name of the policyholder
  • Name of the insured person in whose relation the claim is being lodged
  • Nature of illness / injury
  • Name and address of the attending medical practitioner and hospital
  • Date of admission
  • Any other information as requested by us

In planned hospitalization the treatment is planned well in advance. The intimation of such hospitalization and authorization from us has to be taken minimum 3 days prior to the date of hospitalization. E.g. Cataract, pace maker implantation, total knee replacement etc are examples for which the hospitalisation can be planned.The insured person should at least 3 days prior to admission to the hospital approach the network provider for hospitalization for medical treatment.

In emergency hospitalization the patient is admitted to the hospital in an emergency situation, for e.g. Severe abdominal pain, accident, heart attack etc. In such event, we should be intimated within 48 hours of admission to the hospital.

You should carry the health card provided by the company with this policy, along with a valid photo identification proof (voter id card / driving license / passport / pan card / any other identity proof as approved by the company).

We shall settle claims, including its rejection, within 7 (seven) working days of the receipt of the last ‘necessary’ document but not later than 30 days.

You should submit the post-hospitalization claim documents at your own expense within 15 days of completion of post-hospitalization treatment or period, whichever is earlier. We shall receive pre and post- hospitalization claim documents either along with the inpatient hospitalization papers or separately and process the same based on merit of the claim derived on the basis of documents received.

It refers to payment of the Medical Expenses incurred by the insured while undergoing Specified Day Care Procedures/ Treatment (as mentioned in the Day Care Surgeries list), which require less than 24 hours Hospitalization.

Co-payment is a cost-sharing requirement under a health insurance policy, where the Policy Holder / insured will bear a specified percentage of the admissible costs.

A ‘Free Look Period’ is a period of 15 days from the date of receipt of the policy that a policyholder, in this case you, have to review the entire health insurance plan. If you disagree with any of the terms or conditions mentioned in the policy, you have the option of returning the policy by stating the reasons for the objection. Following this, you are entitled to a refund of the premium paid, provided no claim has been made under this mediclaim insurance policy (subject only to a deduction of the expenses incurred by the company on medical examination and the stamp duty charges). Please note that this facility is not applicable on renewal and portability cases.

Sub limit defines the capping of insurance amount, for specific surgeries and medical procedures, which reduces the premium of the plan. You can also opt for an add on cover by paying extra premium to remove the sub- limits under the policy.

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How to buy online?

You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque

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Network hospitals

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