Chola MS Flexi Health Supreme (Plus)

Chola MS Flexi Health Supreme (Plus) is a health insurance policy offered by Cholamandalam MS General Insurance Company Limited. 

Not only does it cover hospitalisation and related expenses, but it also takes care of the cost of consumables like masks, gloves, etc. This plan offers excellent value for money when compared to other products available in the market.

However, it's important to note that there isn't an option to pay the premium on a monthly basis. Our research has shown that while there have been fewer complaints about policy purchases, there have been a higher number of complaints regarding claim settlements with this insurer. This indicates that the insurer excels in providing a smooth purchasing experience, but falls short when it comes to delivering satisfactory claims service.

What are the benefits offered by the Chola MS Flexi Health Supreme (Plus) Plan?

• Inpatient hospitalisation coverage: Just like any other health insurance plan, the Chola MS Flexi Health Supreme (Plus) Plan covers the costs of inpatient hospitalisation. This includes expenses like room and board fees, nursing charges, medical practitioner fees, prescription drugs, ICU expenses, and any other relevant expenses that you may incur during your stay in the hospital exceeding 24 hours.
• Pre-hospitalization coverage: Pre-hospitalisation charges refer to medical expenses incurred before being admitted to the hospital, which include consultation fees, lab tests, checkups, and medical reports. It's important to note that these expenses will only be covered by the insurer if they are directly related to the medical condition that eventually leads to hospitalisation. Also, note that the claim needs to be approved as a part of the coverage for inpatient hospitalisation. The good news is that with the Chola MS Flexi Health Supreme (Plus) Plan, you'll have coverage for pre-hospitalisation expenses up to 60 days before your hospitalisation, up to the sum insured.
• Post-hospitalisation coverage: Once you leave the hospital, you may face additional medical expenses known as post-hospitalisation costs. These include visits to your doctor, follow-up appointments, rehabilitation programs, and physical therapy, among others. To get these expenses covered, they must be related to your initial hospital stay and your claim must be approved under inpatient hospitalisation coverage. The Chola MS Flexi Health Supreme (Plus) Plan offers coverage for post-hospitalisation expenses up to the sum insured for a period of 90 days after being discharged from the hospital.
• Daycare treatment coverage: Daycare treatment which are medical procedures or surgeries, previously required a lengthy hospital stay, can now be done in just 24 hours thanks to medical advancements. Chola MS Flexi Health Supreme (Plus) Plan covers expenses for all the daycare procedures without any limit up to the sum insured. However, the insurer requires pre-authorisation if you opt to receive a daycare treatment at a non-network hospital.
• Domiciliary treatment coverage: Domiciliary treatments are medical treatments that are provided at home instead of a hospital, usually when you are too sick to be transported to the hospital or when there are no available hospital beds nearby. With the Chola MS Flexi Health Supreme (Plus) Plan, you can get coverage for domiciliary treatment expenses up to the sum insured. However, it's important to note that 14 diseases are excluded from this coverage.
• Organ donor coverage: With the Chola MS Flexi Health Supreme (Plus) Plan,the organ donor expenses are covered. This means that if you ever require an organ transplant surgery as the recipient, all the costs associated with harvesting the organ from the donor will be taken care of up to the sum insured.
• Modern treatment coverage: As medical technology keeps on advancing,  treatments that were once thought to be impossible are now becoming a reality. Cutting-edge treatments, such as stem cell therapy and radio surgeries, aim to cure illnesses that were previously considered incurable. The Chola MS Flexi Health Supreme (Plus) Plan is specifically designed to keep up with these advancements by providing coverage for expenses related to modern treatments up to the sum insured without any limit.
• Non-medical expenses coverage: Non-medical expenses include costs related to important items such as gloves, nebulisation kits, oxygen masks, and other consumables necessary for your treatment. With the Chola MS Flexi Health Supreme (Plus) Plan you are covered for these non-medical expenses up to the sum insured without any limit.
• No Claim Bonus: The Chola MS Flexi Health Supreme (Plus) Plan comes with an enticing perk called the No Claim Bonus. This is a reward that you receive if you manage to go through a policy year without making any claims. The bonus you’ll receive will be equivalent to 50% of the sum insured, with a maximum limit of up to 100% of the sum insured. However, it's worth noting that if you file a claim during the policy year, the accumulated bonus will decrease at the same rate it was earned.
• Super No Claim Bonus:  The Super No Claim works just like the regular No Claim Bonus, but it’s an accelerated version. It's worth mentioning that the Chola MS Flexi Health Supreme (Plus) Plan doesn't offer the Super No Claim Bonus.
• Restoration Benefit: The Chola MS Flexi Health Supreme (Plus) Plan offers the restoration benefit feature. It's designed to replenish the sum insured if it gets used up during a policy year. This benefit covers both related and unrelated illnesses and comes into play when both the sum insured and No Claim Bonus are partially utilised. You have the opportunity to make use of this benefit once during a policy year for subsequent claims.

Please remember that the limitations and conditions mentioned in the benefits above apply to a sum insured of Rs. 10 lakhs

Chola MS Flexi Health Supreme (Plus)  Plan: Financial Limits

• Room rent limit: The room rent limit is the highest amount that your insurance provider will pay for the hospital room you stay in while you're in the hospital. If you pick a room that costs less than or equal to this limit, you won't have to pay any extra charges. But if you decide to go for a room that has a higher rent than what you're eligible for, a proportional deduction will be applied. This means you'll have to pay a proportionate share of the total bill, rather than just the difference. With the Chola MS Flexi Health Supreme (Plus) Plan, you have the freedom to choose any type of room without any limitations.
• ICU rent limit: The Chola MS Flexi Health Supreme (Plus) Plan has got you covered when it comes to expenses during an ICU stay. This means that it fully covers the cost of your ICU stay, up to the sum insured, without any restrictions or limitations.
• Co-payment: Co-payment refers to a certain percentage of the approved claim amount that you are required to pay from your own pocket before your insurer covers the rest. But here's the good news - with the Chola MS Flexi Health Supreme (Plus) Plan, there's no co-payment limit.
• Deductible: A deductible is a specific amount that you have to pay out of your own pocket before your policy kicks in to cover your medical expenses. With the Chola MS Flexi Health Supreme (Plus) Plan there's no deductible limit to worry about. 
• Limits on surgeries/treatments:  It refers to the maximum amount that your health insurance policy will pay for certain medical procedures or treatments. Some health insurance policies may place a cap on the amount that they will cover for certain procedures, while others may not. In the case of the Chola MS Flexi Health Supreme (Plus) Plan, there are no limitations on coverage for important surgeries and treatments such as cataract treatment and joint replacement surgery and they are covered up to the sum insured.

Please note that the above financial limits are taken for a 30-year-old individual, opting for a sum insured of Rs. 10 Lakhs.

Chola MS Flexi Health Supreme(Plus) Plan : Waiting Periods & Exclusions

👉Waiting period

A waiting period refers to a predetermined duration during which specific illnesses and medical conditions are not immediately covered following the purchase of a health insurance policy. You can only claim for these conditions once the waiting period has expired. The length of the waiting period can vary depending on the specific policy you select. Here are a few types of waiting periods -

• Initial waiting period: With the Chola MS Flexi Health Supreme (Plus) Plan, there's a 30-day initial waiting period for all medical conditions, except accidents. This means that during this time, you won't be able to claim hospitalisation expenses unless it's due to an accident. However, once the waiting period is over, you can claim for all covered medical conditions without any restrictions.
• Waiting period for pre-existing diseases: If you happened to have any medical condition or illness in the 36 months before securing your health insurance policy, it would be classified as a pre-existing disease. With the Chola MS Flexi Health Supreme (Plus) Plan, there's a waiting period of 36 months before the policy starts covering pre-existing conditions. This means that during this waiting period, you won't be able to make any claims for expenses associated with your pre-existing disease.
• Waiting period for specific diseases: The Chola MS Flexi Health Supreme (Plus) Plan has waiting periods for certain medical conditions, in addition to any pre-existing diseases you may have. These waiting periods are set by the insurer and are not dependent on your current health status. For this plan, there is a waiting period of 24 months for specific diseases.

👉Exclusions

Health insurance policies do not cover certain situations or medical conditions called exclusions. These can be as follows -

• Standard permanent exclusions: Insurance companies in India are required by the Insurance Regulatory and Development Authority of India (IRDAI) to follow a set of ‘standard permanent exclusions’. These include -

1. Investigation and evaluation: Hospitalisation for monitoring or observation purposes alone.
2. Rest cure, rehabilitation, and respite care: Admission to a facility for rest or respite where no active medical treatment is given.
3. Obesity/weight control: Any surgical or medical procedures intended for weight control or obesity.
4. Change of gender treatment: Medical treatment aimed at altering the body's characteristics to that of the opposite gender is excluded.
5. Plastic/cosmetic surgery: Surgical or medical procedures intended for modifying appearance or body characteristics.
6. Profession in hazardous or adventure sports: Any medical expenses incurred while participating as a professional in adventure activities such as mountaineering, river rafting, scuba diving, horse racing, etc.
7. Breach of law: Any expenses related to the treatment of a person who has committed or attempted to commit a criminal act.
8. Excluded providers: Treatment from medical practitioners or hospitals excluded by the insurance company.
9. Narcotics: Treatment for addictive conditions like alcohol addiction, drug usage, etc.
10. Treatments in establishments arranged for domestic purposes: Treatment expenses incurred in health spas, nursing homes, or similar establishments arranged entirely or partially for domestic reasons.
11. Dietary supplements, substances purchased without prescription: Expenses linked to vitamins, minerals, and other dietary supplements not prescribed by a medical practitioner.
12. Refractive error: Expenses associated with correcting refractive errors up to 7.5 diopters for improved eyesight.
13. Unproven treatments: Any surgeries, medical procedures, or treatments that are not proven to be effective.
14. Expenses related to birth control, sterility, infertility: Contraception, sterilisation, artificial insemination, advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc.
15. Maternity expenses: Costs related to pre/post-natal care, childbirth, and other hospitalisation expenses.

• Additional permanent exclusions: In addition to the permanent exclusions set by the IRDAI, insurance companies have the power to enforce "specific exclusions". If a certain illness is considered high-risk, insurers can choose to permanently exclude it from coverage. However, insurers are limited to the diseases listed in the pre-approved list of illnesses established by the IRDAI for implementing permanent exclusions.
• Non-standard exclusions (Specific exclusions): The Chola MS Flexi Health Supreme (Plus) Plan comes with its own set of exclusions, in addition to the standard ones specified by the IRDAI. It's important to note that these exclusions may differ among insurance providers and are based on the plan's terms and conditions. Here are a few specific exclusions you should be aware of -

1. Injuries or diseases caused by war, invasion, acts of foreign enemies, warlike operations, etc.
2. Treatment for injuries or illnesses resulting from intentional self-inflicted harm or attempted suicide.
3. Injuries or illnesses directly or indirectly caused by nuclear emissions.
4. Costs associated with travel and transportation, including ambulance charges.
5. Circumcision, unless it is necessary for treating a specific disease or injury.
6. Costs related to vaccination and inoculation, excluding post-animal bite treatment.
7. External equipment such as wheelchairs, crutches, artificial limbs, etc.
8. Expenses for treatment of external birth defects.
9. Dental treatment or aesthetic surgeries, except when necessary for treating a disease or injury.
10. Hearing aids, eyeglasses or contact lenses.
11. Yoga and Naturopathy treatments.
12. Treatment related to any sexual problems.

What to expect in terms of claims experience if you buy from Cholamandalam MS General Insurance Company Limited?

• Speed of claims: Cholamandalam MS General Insurance Company has shown a high level of efficiency in claim settlement, processing 96.52% of claims within 30 days. This indicates that you can expect a seamless claim settlement process.
• Claim-related complaints: Based on our research, Cholamandalam MS General Insurance Company has a higher frequency of complaints related to claims compared to other insurance providers, accounting for 0.14%. This implies that their claim settlement process may not be as efficient.
• Claims incurred ratio: It represents an insurer's financial performance. It is the total claims paid out in proportion to the total premiums received in a given fiscal year. Cholamandalam MS General Insurance Company boasts a claim incurred ratio of 66.67%.
• Claim settlement ratio: Cholamandalam MS General Insurance Company has a claim settlement ratio of 76.63%. It represents the ratio of total claims received to the total claims settled by the insurer in a fiscal year.
• Network hospitals: Cholamandalam MS General Insurance Company offers access to a vast network of over 12,000+ hospitals. This extensive network enables customers to receive cashless treatment at a diverse range of healthcare facilities without any financial constraints.

How is the customer service of Cholamandalam MS General Insurance Company?

• Policy purchase-related complaints: Based on our research, Cholamandalam MS General Insurance Company has received no complaints regarding their post-sales service, and stands out shining at 0.00%.
• Response on Toll-Free: During our research, we found that Cholamandalam MS General Insurance Company’s response rate on their toll-free number is average compared to other insurance providers.
• Response on Twitter: Cholamandalam MS General Insurance Company’s response rate on Twitter is slow.

About Cholamandalam MS General Insurance Company

Cholamandalam MS General Insurance Company Limited is a partnership between the Murugappa Group and Mitsui Sumitomo Insurance Company Limited, Japan. They provide a variety of insurance options, including motor insurance, health, property, accident, liability, marine, travel, crop insurance, etc. These plans cater to both individuals and corporations. Established in 2001, the company is based in Chennai, Tamil Nadu. V. Suryanarayanan serves as the CEO and MD of the company.