{"uin":"CHOHLIP27041V012627","name":"Family Arogya Raksha","url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627","insurer":{"slug":"cholamandalam-ms-general-insurance","name":"Cholamandalam MS General Insurance Company Limited","url":"https://indiainsurances.com/insurer/cholamandalam-ms-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Family Arogya Raksha is a health indemnity policy with AROGYA PLAN and AROGYA PLUS PLAN on a floater sum insured basis. It offers sum insured options of Rs. 3/4/5/7.5/10 Lakhs or Rs. 3/5/7.5/10 Lakhs, with a 30-day initial waiting period, 24-month pre-existing disease waiting period and 12-month specified disease waiting period.","analysis":{"state":"machine","analysed_at":"2026-10-19 19:02:24.747381+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["AROGYA PLAN","AROGYA PLUS PLAN"],"display":"AROGYA PLAN; AROGYA PLUS PLAN","note":null,"quote":"COVERAGE/ PLANS | AROGYA PLAN | AROGYA PLUS PLAN","sources":[{"clause":"Section 3","heading":"SCHEDULE OF BENEFITS","page":9,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-section-3"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"One year.","display":"One year","note":null,"quote":". POLICY TENURE : One year","sources":[{"clause":"2","heading":"TYPE OF SUM INSURED (SI) OPTIONS","page":1,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4586#c-2"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For cashless network hospitalisation, pre-authorisation is required 72 hours before planned admission and within 48 hours of emergency admission. For reimbursement in a non-network hospital, claim intimation is required within 48 hours for planned hospitalisation and within 24 hours of emergency hospitalisation.","display":"Cashless: 72 hours before planned admission; within 48 hours of emergency admission. Reimbursement: within 48 hours for planned hospitalisation; within 24 hours of emergency hospitalisation.","note":null,"quote":"Cashless - Admission in Network Hospital | Planned Hospitalization: pre-authorization has to be obtained 72 hours prior to the date of planned admission | Emergency Hospitalization: within 48 hours of an emergency admission ... Reimbursement - Admission in Non - Network Hospital (E mail: customercare@cholams.murugappa,com) or phone (@ Toll free no. 1800-208-9100) | Planned Hospitalization - Claim intimation has to be given to us on email or at the Toll free Number within 48 hours for planned hospitalization | Emergency Hospitalization: Claim intimation has to be given to us on email or at the Toll free Number within 24 hours of an emergency hospitalization","sources":[{"clause":"25(I)(b)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-25-i-b"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["duly filled & signed claim form","KYC of the Insured or KYC of the nominee / legal heir in case of death claim","Account details with proof for NEFT","Proof of identity and residence of the beneficiary for claims exceeding Rs 1 Lakh","Original Discharge summary in the hospital letter head","Original Main bill from the hospital with cost wise break up","Original payment receipt","Original investigation reports","All pharmacy bills should be accompanied with relevant prescriptions","Implant stickers or invoice where ever applicable","In case of Road traffic accident (RTA), copy of FIR and/or Medico legal Certificate (MLC)"],"display":"Claim form, KYC, NEFT proof, proof of identity and residence for claims exceeding Rs 1 Lakh, discharge summary, main bill, payment receipt, investigation reports, pharmacy bills with prescriptions, implant stickers or invoice where applicable, FIR/MLC for road traffic accident.","note":null,"quote":"Following documents are to be submitted for processing of the claim along with the duly filled & signed claim form by the insured / nominee in addition to the documents listed in the table below: - KYC of the Insured or KYC of the nominee / legal heir in case of death claim under the policy. - Account details with proof for NEFT of the Insured and of nominee / legal heir in case of death claim under the policy i.e. cancelled cheque, passbook copy has to be submitted with the below listed claim documents. - Proof of identity and residence of the beneficiary for claims exceeding Rs 1 Lakh ... Original Discharge summary in the hospital letter head with the seal and sign of the doctor with complete details of diagnosis, treatment given, treatment advised etc. - Original Main bill from the hospital with cost wise break up - Original payment receipt (Receipt should have Serial No) - Original investigation reports (such as X Ray, Lab Reports, Scan reports etc.) These are required for supporting the ailment, hence all reports taken prior / at the time or after the hospitalization are required. - All pharmacy bills should be accompanied with relevant prescriptions. Bills should contain date and patient name. If pharmacy is charged in the Main Hospital bill, then proper itemized break up of those medicines should be obtained from the hospital. - Implant stickers or invoice where ever applicable - In case of Road traffic accident (RTA), copy of FIR and/or Medico legal Certificate (MLC) would be required.","sources":[{"clause":"25(I)(b)(ii)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-25-i-b-ii"},{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":24,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-24"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"conflicting","value":"The policy wording says the company shall settle or reject a claim within 15 days from receipt of the last necessary document, or within 45 days from the last necessary document where investigation is warranted.","display":"15 days from last necessary document; 45 days where investigation is warranted","note":"CIS says: 'Turn Around Time (TAT) for claims settlement: 30 days from the date of receipt of last necessary document'.","quote":"i) The Company shall settle or reject a claim, as the case may be, within 15 days from the date of receipt of last necessary document. ... iii) However, where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document- ln such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":"3(i)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-3-i"},{"clause":"3(iii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-3-iii"},{"clause":"Excl12","heading":null,"page":2,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4555#c-excl12"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Pre-Existing Diseases – Code – Excl01","Specified disease/procedure waiting period – Code – Excl02","30-day waiting period – Code – Excl03","Investigation & Evaluation – Code – Excl04","Rest Cure, rehabilitation and respite care – code – Excl05","Obesity/Weight Control: Code – Excl06","Change-of-Gender treatments","Cosmetic or plastic Surgery","Hazardous or Adventure sports","Breach of law","Excluded Providers","Treatment for Alcoholism, drug or substance or tobacco abuse or any addictive condition and consequences thereof","Unproven Treatments","Sterility and Infertility","War or any act of war"],"display":"PED waiting period, specified disease/procedure waiting period, 30-day waiting period, investigation and evaluation, rest cure, obesity/weight control, change-of-gender treatments, cosmetic or plastic surgery, hazardous or adventure sports, breach of law, excluded providers, alcoholism/drug/substance/tobacco abuse, unproven treatments, sterility and infertility, war.","note":null,"quote":"i) Pre-Existing Diseases – Code – Excl01: ... ii. Specified disease/procedure waiting period – Code – Excl02: ... iii. 30-day waiting period – Code – Excl03 ... Investigation & Evaluation – Code – Excl04 ... Rest Cure, rehabilitation and respite care – code – Excl05 ... Obesity/Weight Control: Code – Excl06 ... Change-of-Gender treatments: Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex. Code – Excl07 ... Cosmetic or plastic Surgery: Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. ... Hazardous or Adventure sports: Expenses related to any treatment, necessitated due to participation as a professional in hazardous or adventure sports ... Breach of law: Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent. ... Excluded Providers: Code-Excl11: Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer ... Treatment for Alcoholism, drug or substance or tobacco abuse or any addictive condition and consequences thereof.Excl12 ... Unproven Treatments: Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. ... Sterility and Infertility: Code – Excl17: Expenses related to Birth Control, Sterility and infertility. ... War or any act of war, invasion, acts of foreign enemies, hostilities whether war be declared or not, civil war, revolution, insurrection, mutiny, martial law.","sources":[{"clause":"Section 5","heading":"WAITING PERIODS","page":15,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-section-5"},{"clause":"1","heading":"Investigation & Evaluation – Code – Excl04","page":16,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-1-3"},{"clause":"2","heading":"Rest Cure, rehabilitation and respite care – code – Excl05","page":16,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-2-3"},{"clause":"3","heading":"Obesity/Weight Control","page":16,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-3-3"},{"clause":"4","heading":"Change-of-Gender treatments","page":16,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-4-3"},{"clause":"5","heading":"Cosmetic or plastic Surgery","page":16,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-5-3"},{"clause":"6","heading":"Hazardous or Adventure sports","page":16,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-6-3"},{"clause":"7","heading":"Breach of law","page":16,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-7-3"},{"clause":"8","heading":"Excluded Providers","page":16,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-8-3"},{"clause":"9","heading":null,"page":16,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-9-3"},{"clause":"13","heading":"Unproven Treatments","page":17,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-13-2"},{"clause":"14","heading":"Sterility and Infertility","page":17,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-14-2"},{"clause":"16","heading":null,"page":17,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-16-2"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"First write to customercare@cholams.murugappa.com to register the complaint. If dissatisfied or there is no response, escalate to the Nodal Officer and then to the Chief Grievance Officer before approaching the Insurance Ombudsman.","display":"Write to customercare@cholams.murugappa.com, then Nodal Officer, then Chief Grievance Officer.","note":null,"quote":"• Please write to customercare@cholams.murugappa.com to register your complaint. ... • In case you are dissatisfied with the response or have not received a response, you may escalate the same to our Nodal Officer – Nodalescalation@cholams.murugappa.com (Quoting the previous Service request number) • In case you are still unhappy with the response or have not received a response within 7 working days, you may escalate the same to our Chief Grievance Officer - GRO@cholams.murugappa.com (Quoting the previous Service request number)","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":26,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-26"},{"clause":null,"heading":"Escalation Matrix","page":26,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-escalation-matrix"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"AROGYA PLAN: Rs. 3/4/5/7.5/10 Lakhs. AROGYA PLUS PLAN: Rs. 3/5/7.5/10 Lakhs.","display":"AROGYA PLAN: Rs. 3/4/5/7.5/10 Lakhs; AROGYA PLUS PLAN: Rs. 3/5/7.5/10 Lakhs","note":null,"quote":"Sum Insured (SI) in Rs. | Rs. 3/4/5/7.5/10 Lakhs | Rs. 3/5/7.5/10 Lakhs","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":null,"quote":"iii. 30-day waiting period – Code – Excl03 a) Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"Section 5","heading":"WAITING PERIODS","page":15,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-section-5"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"Applies afresh to enhanced sum insured to the extent of increase; portability credit can reduce the waiting period.","quote":"a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months, of continuous coverage after the date of inception of the first policy with insurer.","sources":[{"clause":"Section 5","heading":"WAITING PERIODS","page":15,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-section-5"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":12},"display":"12 months","note":"If a specified disease/procedure is also pre-existing, the longer waiting period applies.","quote":"a) Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of first 12 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident.","sources":[{"clause":"Section 5","heading":"WAITING PERIODS","page":15,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-section-5"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Cataracts","Benign Prostatic Hypertrophy","Hysterectomy for Menorrhagia or Fibromyoma","Hernia","Hydrocele","Fistula in anus","Piles","internal congenital disease","Sinusitis and related disorders"],"display":"Cataracts, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Fistula in anus, Piles, internal congenital disease, Sinusitis and related disorders","note":null,"quote":"f) List of specific diseases/procedures are: Cataracts, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Fistula in anus, Piles, internal congenital disease, Sinusitis and related disorders as below","sources":[{"clause":"Section 5","heading":"WAITING PERIODS","page":15,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-section-5"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"For enhanced sum insured, sixty continuous months runs from the enhancement date on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non- disclosure, misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called as Moratorium period.","sources":[{"clause":"12","heading":"Moratorium Period","page":20,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-12-3"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The insured person can port the policy to other insurers by applying at least 45 days before, but not earlier than 60 days from, the renewal date, with accrued continuity benefits including specific waiting periods, PED waiting period and moratorium period.","display":"Can port to other insurers; apply at least 45 days before but not earlier than 60 days from renewal date.","note":null,"quote":"The insured person will have the option to port the policy to other insurers by applying to such insurer to port the entire policy along with all the members of the family, if any, at least 45 days before, but not earlier than 60 days from the policy renewal date. ... the proposed insured person will get the accrued continuity benefits to the extent of Sum Insured, cumulative bonus if any, Specific waiting periods, waiting period for pre-existing disease in the previous policy, moratorium period, provided the policy was renewed continuously without a break.","sources":[{"clause":"9","heading":"Portability","page":20,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-9-4"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Renewable except on grounds of established fraud or non-disclosure or misrepresentation","note":"Dependent children have maximum renewal age 26 years and may migrate to a separate health insurance policy after completion of 26 years.","quote":"The health insurance policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation by the insured, provided the policy is not withdrawn and also subject to Moratorium clause of the policy.","sources":[{"clause":"10","heading":"Renewal of Policy","page":20,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-10-4"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"No loading applies on renewals based on individual claims experience.","display":"No loading shall apply on renewals based on individual claims experience","note":null,"quote":"v) No loading shall apply on renewals based on individual claims experience","sources":[{"clause":"10","heading":"Renewal of Policy","page":20,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-10-4"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"The policyholder may cancel by giving 7 days written notice. For policies up to one year, the company refunds proportionate premium for the unexpired policy period if no claim has been made; no refund is made where any claim has been admitted, lodged or any benefit availed.","display":"7 days written notice; proportionate premium for unexpired period if term up to one year and no claim; no refund if a claim is admitted, lodged or benefit availed.","note":"For policies with term more than 1 year, refund is for unexpired policy years where risk coverage has not commenced.","quote":"i) The policyholder may cancel this policy at any time during the term, by giving 7 days written notice in writing and in such an event, the Company shall ... a) refund proportionate premium for the unexpired policy period, if the term of policy upto one year and there is no claim(s) made during the policy period ... Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by the insured person under the policy.","sources":[{"clause":"7(i)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-7-i"},{"clause":"7(a)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-7-a"},{"clause":"7(b)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-7-b"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"The policy pays within India and in Indian Rupees only for medical services or procedures rendered in or undertaken within India.","display":"India only; payment within India and in Indian Rupees","note":null,"quote":"The Insurer’s liability to make any payment towards illness or accidental injury shall be to make payment within India and in Indian Rupees only for medical services or procedures rendered in or undertaken within India.","sources":[{"clause":"23","heading":"Territorial Limits","page":22,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-23-3"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Not applicable on renewals or at the time of porting/migrating the policy.","quote":"Every policyholder of new individual health insurance policies, except for those policies with tenure of less than a year, shall be provided a free look period of 30 days beginning from the date of receipt of policy document, whether received electronically or otherwise, to review the terms and conditions of such policy and to return the same if not acceptable.","sources":[{"clause":"14","heading":"Free Look Period","page":21,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-14-3"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":null,"quote":"At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy. Coverage is not available during the grace period.","sources":[{"clause":"10","heading":"Renewal of Policy","page":20,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-10-4"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"Self, spouse and parents can enter from 18 years to 70 Years. Dependent children can enter from 90 Days to 26 Years.","display":"Self, spouse, parents: 18 years to 70 Years; dependent children: 90 Days to 26 Years","note":null,"quote":"Self, Spouse, Parents | Minimum – 18 years Maximum – 70 Years | - The Proposer should be minimum 18 years on the Commencement date of the policy. Dependent Children (upto 3) | Minimum – 90 Days Maximum – 26 Years","sources":[{"clause":"Section 2","heading":"PERSONS WHO CAN BE INSURED","page":9,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-section-2"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Single Premium Payment prior to commencement of cover"],"display":"Single Premium Payment prior to commencement of cover","note":null,"quote":"Premium Payment: Single Premium Payment prior to commencement of cover.","sources":[{"clause":"18","heading":"Premium Payment","page":21,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-18-3"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is not available during the grace period.","display":"Coverage is not available during the grace period","note":null,"quote":"Coverage is not available during the grace period.","sources":[{"clause":"10","heading":"Renewal of Policy","page":20,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-10-4"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"For Arogya Plan SI Rs. 3 & 4 Lakhs, room limit is up to 1% of SI per day; for SI Rs. 5, 7.5 & 10 Lakhs, Single Standard A/c room. For Arogya Plus Plan SI Rs. 3 Lakhs, room limit is up to 1% of SI per day; for SI Rs. 5, 7.5 & 10 Lakhs, Single Standard A/c room.","display":"SI Rs. 3 & 4 Lakhs: up to 1% of SI per day; SI Rs. 5, 7.5 & 10 Lakhs: Single Standard A/c room. Arogya Plus has 1% only for SI Rs. 3 Lakhs.","note":null,"quote":"Room Limit | For SI Rs. 3 & 4 Lakhs - Upto 1% of SI per day For SI Rs. 5, 7.5 & 10 Lakhs - Single Standard A/c room | For SI Rs. 3 Lakhs - Upto 1% of SI per day For SI Rs. 5, 7.5 & 10 Lakhs - Single Standard A/c room","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"quote-verified","value":"Single Standard A/c room is allowed for higher sum insured options: Arogya Plan SI Rs. 5, 7.5 & 10 Lakhs and Arogya Plus Plan SI Rs. 5, 7.5 & 10 Lakhs.","display":"Single Standard A/c room for SI Rs. 5, 7.5 & 10 Lakhs","note":"Lower sum insured options have a rupee-linked per-day room limit instead of only a room category.","quote":"For SI Rs. 5, 7.5 & 10 Lakhs - Single Standard A/c room | For SI Rs. 3 Lakhs - Upto 1% of SI per day For SI Rs. 5, 7.5 & 10 Lakhs - Single Standard A/c room","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU limit is actuals under both AROGYA PLAN and AROGYA PLUS PLAN.","display":"Actuals","note":null,"quote":"ICU Limit | Actuals | Actuals","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"Co-payment is not applicable.","display":"Not Applicable","note":"Stated in the Customer Information Sheet.","quote":"ii. Co-Payment | Not Applicable","sources":[{"clause":"Excl12","heading":null,"page":2,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4555#c-excl12"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"quote-verified","value":"Deductible is not applicable.","display":"Not Applicable","note":"Stated in the Customer Information Sheet.","quote":"iii. Deductible | Not Applicable","sources":[{"clause":"Excl12","heading":null,"page":2,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4555#c-excl12"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"Upto 30 days","note":"Medical expenses must be related to the primary diagnosis and the inpatient hospitalisation or day care claim must be admissible.","quote":"Pre-Hospitalisation Expenses | Upto 30 days | Upto 30 days","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"Upto 60 days","note":"Medical expenses must be related to the primary diagnosis and the inpatient hospitalisation or day care claim must be admissible.","quote":"Post-Hospitalisation Expenses | Upto 60 days | Upto 60 days","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Day care procedures are covered up to the sum insured for any disease, illness or injury requiring less than 24 hours of hospitalisation because of technological advancement. Network hospital procedures are covered, and non-network procedures must be pre-authorized.","display":"Covered up to SI for any disease/illness/injury requiring less than 24 hours because of technological advancement.","note":"Treatment normally taken on an out-patient basis is not included.","quote":"Day Care Procedures: This Policy will indemnify the Medical Expenses incurred as a Day Care Procedure/Treatment for any disease/illness/injury that requires less than 24 hours of Hospitalization because of technological advancement, upto the Sum Insured stated in the policy schedule, during the policy period if it is performed in a network hospital. In case the procedure is performed in a non-network hospital, the same must be pre-authorized by us.","sources":[{"clause":"4","heading":"Day Care Procedures","page":12,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-4-2"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary hospitalisation is covered up to 20% of SI for treatment at home that would otherwise have required hospitalisation, when the insured cannot be transferred to a hospital on medical advice or a hospital bed is unavailable, and the condition continues for at least 3 days.","display":"Upto 20% of SI; at-home treatment when hospitalisation is otherwise required and transfer is not possible or bed unavailable.","note":"Cashless facility is not available for domiciliary claims; listed ailments such as asthma, arthritis, diabetes and hypertension are excluded under this benefit.","quote":"Domiciliary Hospitalization | Upto 20% of SI | Upto 20% of SI ... Domiciliary Hospitalisation: This policy will reimburse the Reasonable and Customary Medical Expenses incurred by an Insured Person for medical treatment taken at his/her home which would otherwise have required Hospitalization upto the limit mentioned in the Schedule of Benefits, provided: ... a) On the advice of the attending Medical Practitioner, the Insured Person could not be transferred to a Hospital or ... b) A Hospital bed was unavailable, and provided that: ... I) The condition for which the medical treatment is required, continues for at least 3 days, in which case the Policy pays reasonable cost of necessary medical treatment for the entire period","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"},{"clause":"6","heading":"Domiciliary Hospitalisation","page":12,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-6-2"},{"clause":"6(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-6-a"},{"clause":"6(b)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-6-b"},{"clause":"6(I)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-6-i"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"AYUSH treatment is covered up to the sum insured when it requires more than 24 hours of hospitalisation or is a day care procedure for illness or injury, and is undergone in an AYUSH Hospital or AYUSH Day care centre.","display":"Covered up to SI in AYUSH Hospital/AYUSH Day care centre","note":null,"quote":"h) AYUSH Treatment: This policy will reimburse the medical expenses incurred towards AYUSH treatment, that require more than 24 hours of Hospitalisation and Day care procedure for illness / injury up to the Sum insured stated in the Policy Schedule. The treatment should have been undergone in AYUSH Hospital/ AYUSH Day care centre as defined in the policy.","sources":[{"clause":"1","heading":"In Patient Hospitalization (IP)","page":11,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-1-2"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Modern treatments are covered up to the sum insured as inpatient or day care treatment, including listed procedures such as oral chemotherapy, immunotherapy, robotic surgeries and stem cell therapy.","display":"Covered up to SI as inpatient or day care treatment","note":null,"quote":"i) Modern Treatment: The following procedures will be covered (wherever medically indicated) either as an Inpatient or as part of Day Care Treatment in a hospital up to the Sum Insured specified in the Policy Schedule, during the policy period. The prevalent treatment / procedures mentioned below are only illustrative and not exhaustive. Any other treatment using advanced technology shall also be considered under Modern Treatment, for the purpose of this cover. ... d) Oral chemotherapy e) Immunotherapy –Monoclonal Antibody to be given as injection ... g) Robotic surgeries ... l) Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered","sources":[{"clause":"1","heading":"In Patient Hospitalization (IP)","page":11,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-1-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"Organ donor inpatient hospitalisation expenses for organ transplantation from donor to the insured recipient are covered up to the sum insured. Donor pre- and post-hospitalisation expenses are not payable.","display":"Covered up to SI; donor pre and post hospitalisation expenses not payable","note":null,"quote":"Organ Donor Expenses | Covered upto SI | Covered upto SI ... g) Organ Donor Expenses: This policy will indemnify the medical expenses incurred towards inpatient hospitalization for Organ transplantation from Donor to recipient insured person. (Pre and Post hospitalization expenses related to the donor’s hospitalization shall not be payable).","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"},{"clause":"1","heading":"In Patient Hospitalization (IP)","page":11,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-1-2"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Emergency road ambulance expenses are covered up to Rs.2500/- per hospitalisation for transfer following an emergency to the nearest hospital with adequate facilities, subject to an accepted inpatient hospitalisation or day care claim.","display":"Emergency road ambulance up to Rs.2500/- per hospitalisation","note":null,"quote":"Emergency Road Ambulance Expenses | Upto Rs.2500/- per hospitalisation | Upto Rs.2500/- per hospitalisation ... Emergency Road Ambulance Expenses: This policy will reimburse the expenses incurred towards engaging an ambulance to transfer the insured person following an emergency to the nearest Hospital with adequate facilities, upto the limit mentioned in the Schedule of Benefits","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"},{"clause":"5","heading":"Emergency Road Ambulance Expenses","page":12,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-5-2"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"The policyholder can choose Cumulative Bonus or No Claim Discount. Cumulative Bonus increases the sum insured by 2.5% of the expiring sum insured for each claim-free renewed policy year, up to 25%, and is reduced by 2.5% after a claim; NCD gives 1% discount on renewal premium subject to no claim.","display":"CB: 2.5% each claim-free year up to 25%; reduced by 2.5% after a claim. NCD: 1% renewal premium discount subject to no claim.","note":null,"quote":"Policyholder shall have an option to choose between Cumulative Bonus (CB) or No Claim Discount (NCD) under the policy. 1. Cumulative Bonus (CB): If the insured has not made a claim in a policy year and has renewed the policy with us without a break, we will increase the Sum Insured under each subsequent policy by 2.5% of the expiring Sum Insured. The maximum cumulative bonus shall at no time exceed 25% of the policy Sum Insured. ... In the event of a claim during a policy year, the cumulative bonus in any subsequently renewed policies shall be reduced at the same percentage at which it has accrued, which is 2.5% of the Sum Insured. ... 2. No Claim Discount (NCD): The Policy shall provide a discount of 1% on the renewal premium, subject to no claim under the expiring policy and the policy has been renewed with us without a break / Premium paid within the Grace Period","sources":[{"clause":"10","heading":"RENEWAL BENEFITS","page":14,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-10-2"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"Non-medical expenses incurred during hospitalisation are not covered; the annexure list of non-medical items includes gloves and mask.","display":"Non-medical expenses not covered; List I includes GLOVES and MASK","note":null,"quote":"Non-medical Expenses incurred during Hospitalisation. The list of such Non-medical Expenses is placed at Annexure1 under List 1. ... 56 | GLOVES ... 60 | MASK","sources":[{"clause":"28","heading":null,"page":18,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-28-2"},{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":31,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-31"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity cover is available up to Rs.20,000/- per delivery or termination, with a 9 months waiting period from the date of commencement of the policy, limited to two deliveries or terminations or either one of each during the insured's lifetime.","display":"Up to Rs.20,000/- per delivery/termination; 9 months waiting period","note":"Pre and post-hospitalization expenses are not covered under maternity cover.","quote":"Maternity Cover (with New Born Baby Cover) | Upto Rs.20,000/- per Delivery/Termination | Upto Rs.20,000/- per Delivery/Termination ... Maternity: This policy will indemnify the reasonable and customary charges incurred towards delivery (normal or caesarean section) or the lawful medical termination of pregnancy (without threat to mother or child’s life) during the policy period excluding elective termination, limited to two deliveries or termination or either one of each during the lifetime of the Insured. ... a waiting period of 9 months from the date of commencement of this policy, is applicable for any claim to be payable under Maternity Cover","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"},{"clause":"7","heading":"Maternity","page":13,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-7-2"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New born baby cover is included with maternity cover; the maternity cover includes medically necessary treatment of the new born baby within the policy period, within the maternity limit.","display":"Included with Maternity Cover; medically necessary treatment of the new born baby within the policy period","note":null,"quote":"Maternity Cover (with New Born Baby Cover) | Upto Rs.20,000/- per Delivery/Termination | Upto Rs.20,000/- per Delivery/Termination ... This will include ectopic pregnancy, pre-natal and post-natal expenses during hospitalization per delivery or termination and medically necessary treatment of the new born baby within the policy period provided that; 1. the maximum limit per delivery or termination shall be upto the amount mentioned in the Schedule of Benefits","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"},{"clause":"7","heading":"Maternity","page":13,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-7-2"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"Health check-up expenses are reimbursed after two continuous claim free years on renewal, up to Rs.2,000/- per family once in every two continuous claim free years.","display":"Upto Rs.2,000/- per family once in every two continuous claim free years","note":"Payment under this benefit is over and above the sum insured.","quote":"Health Check up | Upto Rs.2,000/- per family once in every two continuous claim free years | Upto Rs.2,000/- per family once in every two continuous claim free years ... Health Check up cover: This policy will reimburse the expenses incurred towards cost of Health Checkup after two continuous claim free years on renewal, up to the actuals or the maximum limit as mentioned in the Schedule of Benefits.","sources":[{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":10,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-10"},{"clause":"9","heading":"Health Check up cover","page":14,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-9-2"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"Out-patient treatment is not included in the day care cover, and outpatient prescribed or non-prescribed medical supplies and non-prescription drugs and treatments are excluded.","display":"Out-patient treatment not included; outpatient supplies and non-prescription drugs excluded","note":null,"quote":"Treatment normally taken on an out-patient basis is not included in the scope of cover. ... Outpatient prescribed or non-prescribed medical supplies including elastic stockings, bandages, gauze, syringes, diabetic test strips, and similar products; non-prescription drugs and treatments","sources":[{"clause":"4","heading":"Day Care Procedures","page":12,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-4-2"},{"clause":"17","heading":null,"page":17,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-17-2"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless facility is available in network hospitals and identified GIC common empanelment hospitals through anywhere cashless facility, subject to pre-authorisation.","display":"Cashless in network hospitals and identified GIC common empanelment hospitals, with pre-authorisation","note":null,"quote":"Cashless facility means a facility extended by the Insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the Insurer to the extent pre-authorization approved. ... Procedure for Cashless claims: Obtain our pre-authorisation for any medical treatment in any of our network hospitals as well as identified list of hospitals by GIC for common empanelment through anywhere cashless facility.","sources":[{"clause":"10","heading":"Cashless facility","page":3,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-10"},{"clause":"25(I)(b)(i)","heading":"Procedure for Cashless claims","page":23,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-25-i-b-i"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims are handled by the in-house claims team of Chola MS General Insurance Company; there is no TPA tie-up envisaged for this product.","display":"In-house Claims team; no TPA tie-up envisaged","note":null,"quote":"Claims Team means the Claims administration team within Chola MS General Insurance Company. ... There is no TPA tie –up envisaged for this product. Any arrangement in future will be disclosed in the Policy to the Policyholders.","sources":[{"clause":"11","heading":"Claims Team","page":3,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-11"},{"clause":null,"heading":"FAMILY AROGYA RAKSHA","page":24,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-family-arogya-raksha-24"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Single Sum insured floats among the family members covered under the policy","note":null,"quote":"Floater Sum Insured Basis | Self, Spouse, dependent Children and/or Parents | - Single Sum insured floats among the family members covered under the policy.","sources":[{"clause":"Section 2","heading":"PERSONS WHO CAN BE INSURED","page":9,"url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570#c-section-2"}],"law":[]}],"documents":[{"kind":"wording","label":"Family Arogya Raksha CHOHLIP27041V012627-Policy Wording.pdf","pages":33,"fetched_at":"2026-10-17 19:32:25+00","source_url":"https://www.cholainsurance.com/documents/20121/o/Family%20Arogya%20Raksha%20CHOHLIP27041V012627-Policy%20Wording.pdf/1ad99ce0-dc2a-33da-f066-bf854bc9e297","url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4570"},{"kind":"prospectus","label":"Family Arogya Raksha CHOHLIP27041V012627-Prospectus.pdf","pages":20,"fetched_at":"2026-10-17 19:32:50+00","source_url":"https://www.cholainsurance.com/documents/20121/o/Family%20Arogya%20Raksha%20CHOHLIP27041V012627-Prospectus.pdf/1339aa97-324d-9630-d0be-6eb788149834","url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4586"},{"kind":"cis","label":"Family Arogya Raksha CHOHLIP27041V012627-CIS.pdf","pages":5,"fetched_at":"2026-10-17 19:31:55+00","source_url":"https://www.cholainsurance.com/documents/20121/o/Family%20Arogya%20Raksha%20CHOHLIP27041V012627-CIS.pdf/b3c473ba-957f-4aca-a472-5cd9650fe22a","url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/4555"},{"kind":"premium","label":"Family Arogya Raksha CHOHLIP27041V012627-Rate Chart.pdf","pages":null,"fetched_at":"2026-10-17 19:31:33+00","source_url":"https://www.cholainsurance.com/documents/20121/o/Family%20Arogya%20Raksha%20CHOHLIP27041V012627-Rate%20Chart.pdf/f2e25d94-57c5-dbf9-5b58-83d51e35558b","url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/19533"},{"kind":"proposal","label":"Family Arogya Raksha CHOHLIP27041V012627-Proposal form.pdf","pages":null,"fetched_at":"2026-10-17 19:31:40+00","source_url":"https://www.cholainsurance.com/documents/20121/o/Family%20Arogya%20Raksha%20CHOHLIP27041V012627-Proposal%20form.pdf/220a9f68-d750-151e-8c59-7535fcdd589a","url":"https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627/document/19534"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Cholamandalam MS General Insurance official website","url":"https://www.cholainsurance.com","note":"Website as listed by IRDAI. Not checked: the site returned HTTP 502 to our crawler on 2026-10-19."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Family Arogya Raksha (UIN CHOHLIP27041V012627), IndiaInsurances, https://indiainsurances.com/policy/cholamandalam-ms-general-insurance/family-arogya-raksha-chohlip27041v012627"}