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Individual Health Insurance Plans
Chola Vector Borne Diseases Insurance Policy
Vector borne diseases refer to the diseases such as malaria, dengue, chikungunya, etc., which have been the reason for headaches in our country for many decades. Using mosquito nets, repellent, etc. are a few measures that help to prevent this kind of disease, but it is not the ultimate solution because of the dense population and unhygienic living conditions prevailing in the country. If you get affected by any of the vector borne diseases, it may cost you a hefty amount of money. On top of that, a standard health insurance plan does not offer coverage for these. Therefore, Chola MS General Insurance Company has come up with a dedicated plan, Chola Vector Borne Diseases Insurance Plan (Retail), that has been designed keeping in mind the needs of the people affected by these diseases as it helps to reduce the financial burden. To know more about this plan, have a look at the following mentions.
|Entry age||Minimum – 3 months, Maximum – 65 years|
|Minimum age of the proposer||18 years|
|Policy term||1, 2, and 3 years|
|Policy type||Individual policy, Family floater policy|
|Who can be covered|
Individual policy – Self, spouse, children, parents, parents-in-law
Family floater policy (Maximum up to 6 members):
|Sum insured options||Rs. 10 thousand, Rs. 15 thousand, Rs. 25 lakhs, Rs. 50 thousand, and Rs. 75 thousand|
Initial – 15 days
For special conditions – 60 days
|Renewal||The Policyholder will have an option to renew the cover for 100% of the Sum Insured immediately after a policy is terminated after admission of allowable claims under the policy on payment of applicable premium.|
Benefits and Conditions of Chola Vector Borne Diseases
This plan gives you complete financial protection against vector borne diseases. With this plan, the benefits you can avail of, the following table describes that along with the conditions in brief.
|Lumpsum benefit||The policy will pay a fixed benefit equal to 100% of the Sum Insured as per the terms and conditions of the policy if you are diagnosed with any of the Vector Borne diseases as listed and defined in the policy.|
|Hospitalization expenses||The benefit received can be used to cover the cost of hospitalization expenses arising due to the treatment received. Such expenses may include room rent charges, the cost of pharmacy, etc.|
|Diagnostic tests costs||Since this policy pays for the diagnosis of any of the given diseases, the amount received can also be used to cover the cost of any further diagnostic tests such as x-rays, CT scans, blood tests, etc.|
|Traveling expenses||With the lump sum benefit received under the policy, you can use that money to cover your traveling expenses as well.|
|Doctor’s consultation fees||The benefit provided under the policy can also be used to cover the consultation charges of the doctor.|
|Tax exemption benefit||You can avail of up to Rs. 25000tax exemption benefit under this plan under Section 80D of the Income Tax Act for the premiums paid towards the policy.|
Hospitalization must be necessary as advised by the RMP and the Laboratory examination result, and it must confirm the following:
|Lymphatic Filariasis (Commonly known as elephantiasis)|
It must be confirmed by a registered medical
practitioner and laboratory examination results must contain any two of the following criteria:
|Kala-azar (Also known as Visceral leishmaniosis)||The diagnosis must be confirmed by a registered medical practitioner and by parasite demonstration in bone marrow/spleen/lymph node aspiration or in culture medium as the confirmatory diagnosis or positive serological tests for kala-azar should clearly indicate the presence of this disease.|
To confirm Japanese Encephalitis (JE) infection and to rule out other causes of encephalitis requires laboratory testing by immunoglobulin M (IgM) antibody capture ELISA (MAC ELISA) for serum and
cerebrospinal fluid (CSF).
|Chikungunya||The diagnosis must be documented by a registered medical practitioner and by Serological tests, such as enzyme-linked immunosorbent assays (ELISA), confirming the presence of IgM and IgG anti-chikungunya antibodies.|
A diagnosis of Zika virus infection should be confirmed by a registered medical practitioner
and by plaque-reduction neutralization testing (PRNT). PRNT is performed by CDC or a CDC-designated confirmatory testing laboratory to confirm presumed positive, equivocal, or inconclusive IgM results.
Key Highlights of Chola Vector Borne Diseases Policy
This policy offers an optional benefit, Restoration Cover, that can be availed of by paying a little extra premium. The restoration cover comes with the following advantages and clauses.
- Under this cover, the Insured Person will be covered against all conditions except the condition for which the claim was made. The claimed condition will be covered after 60 day cooling off period (waiting period) post-restoration.
- The cooling off period will continue to the next policy year in case of policy renewal falling within this period.
- Under Family Floater cover, other members will be continuously covered without any cooling off period.
- On the restoration of the Sum Insured to 100% after payment of a claim, the policy will continue until an allowable number of claims as specified below is made under the policy or end of the policy term whichever is earlier.
|Members covered||Number of members covered||Maximum allowance number of claims per policy year|
|Self + Spouse||2||2 claims|
|Self + spouse + 1/2 child or parents or parents-in-laws||3 or 4||6 claims|
|Self + spouse + 3/4 children or/and 1/2 parents or parents-in-laws||5 or 6||6 claims|
Exclusions of Chola Vector Borne Diseases
Knowing a policy is not completed if you do not go through the exclusions of it thoroughly. Therefore, to give you a comprehensive idea of the policy, and to avoid future complications, here are the general exclusions of the Chola Vector Borne Diseases Insurance Policy (Retail).
- Any disease or ailment other than the 7 listed vector borne diseases is not covered under the policy.
- The Insured Person should have been hospitalized for a minimum period of 24 hours for any of the listed conditions to be eligible for claim payment under the policy.
- If you file a claim against a listed disease that is still within the waiting period or cooling off period, the company will not be liable to pay for that claim.
- Any treatment has been taken on an OPD basis and hospitalization primarily for any purpose which in routine could have been carried out on an OPD basis and which is not followed by an active
- Any treatment other than allopathy, which means the treatment of disease by conventional means that is with drugs having effects opposite to the symptoms will be excluded as well.
- Diagnosis and treatment received outside India will be excluded from the policy coverage. This exclusion, however, does not apply in the following countries: Canada, Dubai, Hong Kong, Japan, Malaysia, New Zealand, Singapore, Switzerland, the United States, and the European Union.
Frequently Asked Questions
An initial waiting period of 15 days would be increased to 60 days in the following situations:
- If the Insured Person is suffering from any of the listed conditions other than Lymphatic Filariasis at the time of taking the policy.
- In case of the Insured Person is suffering from Lymphatic Filariasis at the time of taking the policy, Lymphatic Filariasis will be excluded from the policy, and for all other listed conditions, the waiting period would be increased to 60 days.
This plan offers coverage for 7 vector borne diseases, and they are – Malaria, Dengue, Lymphatic Filariasis, Kala Azar, Japanese Encephalitis, Chikungunya, and Zika Virus.
For the claims under this policy, the following conditions are there:
- On payment of 100% of the Sum Insured for any of the conditions listed, the policy will cease to exist under Individual policy. However, under a Family Floater cover, the policy will continue for the other insured members.
- Claim payment against ‘Lymphatic Filariasis’ will be paid only once in the entire lifetime of the Insured.
The maximum allowable number of claims applicable per policy year is as follows:
Number of members covered
Maximum allowance number of claims per policy year
Self + Spouse
Self + spouse + 1/2 child or parents or parents-in-laws
3 or 4
Self + spouse + 3/4 children or/and 1/2 parents or parents-in-laws
5 or 6
In that case, the maximum liability for a claim towards a single hospitalization shall be restricted to the Sum Insured for Rs. 75,000 (for all policies put together).
You can cancel your policy at any time during the policy period. In the event of cancellation, the company will retain the proportionate premium for the time period the insured was covered, while the remaining will be refunded back based on the premium table given in the policy schedule.
You need to make a single premium payment at the time of buying the policy.