| 3- Coverages available under Group Health Insurance Policy |
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| Insurance Companies can make exceptions by charging extra premium for coverage of |
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- Pre Exisiting diseases
- Maternity Cover
- Deletion of condition year 1/ year 2
- Deletion of 30 days waiting period clause
- Day 1 baby coverage under maternity or family sum insured.
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| Health Insurance Covers hospitalization when a patient is in hospital for more than 24 hours due to: |
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- Illness
- Accident
- Surgery requirement
- Symptoms, when diagnosis is been done According to the Document of Cholamandalam MS General Insurance the costs covered are
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- Room, Boarding Expenses in Hospital/Nursing Home
- Nursing Expenses, intensive care unit expenses,
- Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist fees
- Anesthesia
- Blood Oxygen,
- Operation Theater Charges,
- Surgical Appliances, Medicines,
- Drugs,
- Diagnostic Materials,
- X-ray,
- Dialysis,
- Chemotherapy,
- Radiotherapy,
- Pacemaker cost,
- Artificial Limbs,
- Cost of Organs.
- Pre-Hospitalization Expenses
- Post-Hospitalization Expenses
- General Health and Eye Examination (Optional with extra premium)
- Local Ambulance Services (Optional with extra premium)
- Hospital Daily Allowance (Optional with extra premium)
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| Admissible Limits : |
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- Minimum 24 hrs. Hospitalization except Dialysis,
Chemotherapy, Radiotherapy, Eye Surgery, Dental Surgery, Lithotripsy, D&C,
Tonsillectomy (insured discharged on same day)
- Pre-Hospitalization Expense: Laboratory, X-ray or any other
medically necessary diagnostic procedures ordered by a physician (60 days
prior to Hospitalization in case of all type of covers)
- Post-Hospitalization Expenses: The
medically necessary treatment ordered by a physician and readered (within
a time period of the Insured person's discharge from Hospital or Day
Treatment) (90 days after hospitalization in case of all type of covers).
- General
Health and Eye Examination: Radiology, Blood Diabetes, Liver,
Renal/Kidney, Cardiac Lipid, Phospholids, Lung, Abdomen, Cancer,
Optometry, Slit Lamp Examination, Direct Fungus Examination, Indirect
Fungus Examination, Color Vision Testing, Prescription of Glasses if
necessary.
- Local Ambulance Services; Emergency ambulance road transportation by a
licensed ambulance service to the nearest Hospital.
- Hospital Daily Allowance: The Hospital Daily Allowance benefit is
payable per day of Hospitalization in India for a limited period per
person and policy period.
- Day care Surgeries: Microsurgical operations on the middle ear, other
operations on the middle and internal ear, nose and the nasal sinuses, the
eyes, the skin and subcutaneous tissues, the mouth and the face, Traumatological
surgery and orthopedics, the breast, the digestive tract, the female
sexual organs, the male sexual organs, the urinary system.
For Applicants aged 45 and above a medical test is mandator
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