Under the Domestic Appliances Breakdown Cover (items getting damaged by electrical / mechanical breakdown), in case the customer has chosen the Silver or Gold Plan, this policy will cover 1 (one) AC. In case the customer has chosen the Platinum Plan, this policy will cover 2 (two) AC machines. The same applies to all other covered Domestic Appliances as well. For Contents Cover (items getting damaged by Fire, Earthquake etc.) all the items in the house will get covered.

If there are two separate families living in this house (owner & tenant), then two separate policies can be issued - one covering the structure, contents and family of the owner-occupied house, and another covering the contents & family only of the tenant. If the owner of the house desires, he can additionally take a Fire Policy for the building structure of the rented out portion also.

If there are two separate families living in this house (owner & tenant), then two separate policies can be issued - one covering the structure, contents and family of the owner-occupied house, and another covering the contents & family only of the tenant. If the owner of the house desires, he can additionally take a Fire Policy for the building structure of the rented out portion also.

The definition for children under these covers is the Insured Person's dependent children aged between six (6) months and eighteen (18) years and up to twenty three (23) years (if attending an accredited institution of higher learning) who are unmarried and who permanently reside with him.

The coverage applies for any chain-snatching incident which may happen anywhere within India. However, this covers only the jewels owned by the proposer or his / her family, and not any borrowed jewels.

During renewal the policy for the subsequent year will be issued as a fresh policy, and hence upgrade / downgrade/ modifications can be done.

Yes.

This can be handled through any one of the following two options:

• The owner can purchase a policy for the structure of the house and his share of the contents (through the Classic Chola Home Policy)
• The tenant can purchase the Chola Total Home Protect (new product) for the Contents (tenant's own share) and Family Members. In case of a claim on the Contents, the claim amount will be paid on the basis of the ownership of the damaged item

Yes, a door / window / sliding door / ventilator / bay window / glass wall etc., which is in the form of a sheet of glass with frames (metal / wooden) is covered under this.

30 (thirty) years old as on the start of the policy.

Yes, if the immediate (proximate) cause of the damage is the earthquake.

No.

• I have contents across both houses - how is this handled?
• 1 flat is registered in my name alone, and the next in my wife's name alone - how do we handle this?

A single policy can be used to cover this. The policy will be issued in the joint names of both the owners, and both will be considered as proposers.

Valuables shall mean gold or silver or any precious metals or articles made from any precious metals; watches or jewellery or precious stones or models or coins or curios, sculptures.

• Old father owns the house, his only son has put in the contents.

The policy can be purchased in the name of both people as joint proposers.

• Old father owns the house, his two sons who are staying in the same place with their families have together put in the contents.

The policy can be purchased in the name of all three people as joint proposers.

• House is on a long-term lease (e.g. BIT Two rooms in Matunga), where the current resident is not the owner but has been staying there for decades and has been enjoying all the rights of owner (including letting it out and collecting rent)

The policy can be sold to them with the "Rented House" set of covers - covering only contents and people.

• In any of the above scenarios if the owner (head of the family) is old, will we cover him in PA?

The PA Cover and Family Floater Accident Hospitalization Covers will be subject to the age limits as per PA & Health. Accordingly, maximum age for this is 70 years only.

Seven (7) years from date of purchase.

No, since there is no frame.

No, this cover will be applicable only if the original accommodation is damaged by any of the covered perils (Fire and Special Perils and Terrorism).

This policy does not cover the common areas. This policy covers only the area restricted under the specified house. In case the apartment society is looking for coverage for common areas that can be handled only through a separate Fire Policy for the building.

Yes, since this is a First Loss Policy.

Yes, under the Contents Cover (under Furniture).

No. The coverage will be applicable only if the peril occurs in the original insured premises.

There is no restriction of the location of the alternate accommodation, as long as it is in the same city / town municipal limits.

The damage to the own house will be covered under the Fire Cover, and the damage to the neighbouring house will be covered under the Public Liability Cover.

This cover will be effective only for Legal Liability and only if the due legal procedure is followed. i.e. a case should have been filed, negligence should have been proven, and the court verdict should have made the insured person liable for payment.

Yes.

Dining Table will be covered only if the glass sheet is enclosed in a frame.

Yes.

No.

Yes.

Yes, it will be applicable.

No, it will not be covered.

Yes, it will be applicable all over India.

No.

• While buying the policy should I declare which of the 2 TVs is covered under the Domestic Appliances Cover?
• Under the Domestic Appliances Cover, during the policy period can I cover my hall TV for first time damage and then my bedroom TV for 2nd time damage?

While buying the policy there is no necessity to specify which of the 2 TVs are to be covered under the Domestic Appliances Cover.

Out of your 2 TVs if you have made a claim for your hall TV for the first time damage under the Domestic Appliances Cover, only that TV will be covered for the rest of the policy period. You will not be able to get another TV covered under the policy.

This will not be covered, since this is not a covered peril.

No.

Yes, the structure will be covered in this case.

Yes, this cover will be applicable.

The Contents Cover will be applicable for all the items which have been damaged by spreading of fire, excepting the original appliance in which the original short circuit had occurred.

No, Earthing is not mandatory for providing coverage.

Earthing is not mandatory for providing coverage.

Yes.

All liabilities which the WC Court / Competent Authority deems payable by the insured, will be covered.

Chola MS will pay up to the Sum Insured available in the policy. In case the Court awards a higher amount, the difference amount will have to be borne by the insured separately.

The product has been designed for comprehensive coverage benefit for the customer. The benefits mentioned under the Silver / Gold / Platinum Policies are created for the purpose of covering the additional risk factors the customer will face. Hence the mandatory covers are not being sold without Silver / Gold / Platinum Plan Covers.

The number of units of each items being covered will be as per the plan of choice. (Please refer to question 2). During the first claim the details of make, model, serial number etc., will be recorded by Chola MS. During the second or subsequent claims, these details will be checked against the AC being claimed for now to determine if it is the same unit or a different one. The total value is restricted to the period of 1 year of the policy period.

In case of Jewellery Cover, the claim amount will be on the basis of the rate of gold as on the date of loss.

This policy covers only the jewels owned by the proposer or his / her family, and not any borrowed jewels.

No. The coverage will be applicable only if the peril occurs in the original insured premises.

The claim amount will be payable on Market Value basis, less depreciation.

Yes. You will need insurance. Even if you're young, healthy and haven't had to see a doctor in years, you will need coverage against unexpected events like accidents or an unforeseen illness. While your Health Insurance coverage may not pay for things that aren't too costly like routine doctor's visits, the preliminary reason to have coverage is to have protection against the large treatment expenses of serious illness or injury.

No one knows when a medical emergency might strike. It is best to buy Health Insurance, to save money when an emergency strikes.

Life Insurance protects your family (or dependents) from financial loss that may arise in the event of your untimely death / or if something happens to you. The payout is made only post the death of the person insured or at the maturity of the policy Health Insurance protects you against ill health / diseases by covering the expenses you might incur (for treatment, diagnosis etc.) in case you are affected by disease or injury.

Life insurance financially compensates your dependents in your absence Health Insurance provides financial recovery to you in case of a health crisis for you or any of your family members.

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.

In addition to the all-too-familiar hospitalization and day care benefits, Chola MS Individual Healthline offers the following:

• Coverage against some of the common OPD expenses like dental treatments and eye care expenses.
• Coverage in case you choose to undertake Ayurvedic treatments.
• Daily cash components to take care of miscellaneous expenses.
• Coverage for Maternity expenses.

Moreover, Chola MS has been awarded as the best insurer in terms of claim settlement in the Health Insurance category by Ministry of Labour in May 2011.

Any illness that you suffer before buying a Health Insurance Policy is called a pre-existing disease. Individual Healthline covers pre-existing illnesses after four years of continuous renewal.

Yes. Maternity / Pregnancy related expenses are covered in Superior and Advanced Plans of Individual Healthline Policy.

Yes, there is a tax benefit available under Section 80D of the income tax act 1961. Every tax payer can avail an annual deduction of RS15,000 from taxable income for payment of Health Insurance premium for self and dependents. For senior citizens, this deduction is RS20,000. Please note that you will have to show the proof for payment of premium. (Section 80D benefit is different from the RS1,00,000 exemption under Section 80C).

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.

Individual Healthline will be issued for a period of 1 year only.

Coverage amount is the maximum amount payable in the event of a claim. It is also known as "Sum Insured". The Sum Insured is one of the factors which will determine your premium.

Yes, you can cover the entire family under one policy. Your Individual Healthline Insurance Policy is in force across India. We have tied up with over 2600 Network Hospitals in the country for cashless settlement for expenses incurred there.

Apart from Allopathic treatments, Individual Healthline Policy also offers coverage for select Ayurvedic treatments.

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.

In the event of hospitalization, the patient or their family will have a bill to pay the hospital. Under Cashless Hospitalization the patient does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by us. This is for your convenience.

However, prior approval is required from us before the patient is admitted into the hospital. In case of emergency hospitalization, approval can be obtained post-admission. Please note that this facility is available only at the network hospitals.

Yes, you can have more than one Health Insurance Policy. In case of a claim, each company will pay rateable proportion of the claim.

For example, a customer has Health Insurance from Insurer A for a coverage of RS1 Lakh and Health Insurance from Insurer B for a coverage of RS3 Lakhs. In case of a claim of RS1.5 Lakhs the companies will pay in the ratio of 1:3 up to the sum assured.

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.

After a claim is filed and settled, the policy coverage is reduced by the amount that has been paid out on settlement.

For Example: In January you start a policy with a coverage of RS5 Lakhs for the year. In April, you make a claim of RS2 Lakhs. The coverage available to you for the May to December will be the balance of RS3 Lakhs.

Any number of claims is allowed during the policy period. However the Sum Insured is the maximum limit under the policy.

There is no document required for buying Health Insurance. All you need to do is to fill our proposal form. You need to give us your passport size photographs to appear in your health Identification card.

Yes, foreigners living in India can be covered under a Health Insurance Policy. However, the coverage would be restricted to ailments / accident within India and hospitalization happens within India.

• Temporary exclusions for some diseases which are not covered till the completion of first or second year of the policy but are covered in subsequent years.
• Permanent exclusions like AIDS, cosmetic surgery which the policy will not be covered at all.
• Conditions arising from diseases existing before the purchase of the policy are not covered. These "pre-existing" diseases are covered usually after 4 years of the policy being in force.

For complete list of exclusions please read Policy Wordings.

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.

In cashless settlement, the claim amount is settled directly with the network hospital. In cases where this is no cashless settlement, the claim amount is paid to the proposer of the policy.

While filling up the proposal form for insurance you need to provide details of the illnesses you have suffered during your lifetime. At the time of insurance, you should be aware whether you have any disease and whether you are undergoing any treatment. We refer such health issues to their medical panel to differentiate between pre-existing and newly contracted illnesses.

Note: It is important to disclose any disease you might be suffering with before buying the Health Insurance Policy. Insurance is a contract based on good faith and any willful non-disclosure of facts might lead to problems in future.

If you cancel the policy, your cover will cease to exist from the date of cancellation of policy. Additionally, your premium will be refunded to you on short period cancellation rates. You will find details for these in the Policy Wordings booklet.

Individual Healthline offers coverage for home hospitalization. This will be applicable in the following cases:

• When the condition of the patient is such that he cannot be moved to the hospital or;
• When there is no bed available in any of the hospitals and only if it is like the treatment given at the hospital / nursing home which is reimbursable under the policy.

This would be subject to certain restrictions both in terms of the amount which is reimbursable as well as the disease coverage.

The proposed insured(s) has to pay for the cost of Pre-Policy Checkup (PPC) medical examination & investigations to the doctor / diagnostic centre. We will co-ordinate the appointment with our empanelled doctor / diagnostic.

On acceptance of your application and subsequent issuance of the policy, 50% of the expenses incurred up to RS500 per insured person will be reimbursed.

Reimbursement will be paid to the customer on approval of the proposal and issuance of policy.

Individual Healthline Policy allows you to claim for medical expenses incurred 60 days before and 90 days after hospitalization, provided they are related to the ailment / accident for which you were hospitalized. Such expenses are termed as pre and post hospitalization expenses.

Yes you can. If you are a customer under Advanced Plan of Individual Healthline, you can claim for dental expenses except cosmetic surgeries.

Yes, your Health Insurance Policy is valid across the country.

No, you cannot claim expenses for a cataract operation in the first year of the policy. However cataract will be covered after first renewal of the policy.

If you make an expense at a non-network hospital, you can claim the expense from us by sending a claim form with details of expenses and relevant documentary proof.

No, you will not get a discount in the premium you pay, but your Sum Insured will be increased by 5% every year.

The Sum Insured increases progressively by five per cent in respect of each claim free year of insurance, subject to a maximum accumulation of 10 claims-free years or 50% of current Sum Insured.

In the event of a claim, if the insured has earned any cumulative bonus, the cumulative bonus will be reduced by 10 per cent of the Sum Insured at the time of renewal. However, the basic Sum Insured will be maintained at all times.

No, you cannot claim cost of health checkup every year. Health checkup is available once after every two claim free renewals.

No, you will not lose cumulative bonus will not be affected by claiming for Health checkup.

If your hospitalized stay is for over 24 hours you can make a claim. However, for certain treatments, such as dialysis, chemotherapy, cataract surgery, etc., the stay could be less than 24 hours. These can be claimed as day care procedures.

If the insurance limit i.e. the Sum Insured is exhausted in a particular year due to large medical expenses, in a particular year, you cannot claim for any further expenses. However your full Sum Insured will be restored for the next year, if you renew your policy.

The claim amount is paid to the nominee of the insured. If no nominee has been assigned under the policy, the insurance company will insist upon a succession certificate from a court of law for disbursing the claim amount.

In case of planned hospitalization, you need to obtain pre-authorization from us in advance. In case of emergency hospitalization, you need to intimate us at the earliest through the hospital and obtain authorization from us to get cashless facility.

Alternatively, you may do the expenditure at the hospital and get it reimbursed from us.

Yes, we will settle the entire bill to the hospital provided that the entire amount is eligible for claim. If there are any co-payments applicable as per the policy, we will settle the eligible amount only.