Aditya Birla Health Insurance

Aditya Birla Health Insurance

Aditya Birla Health Insurance Co Ltd has designed its plans after ascertaining the diverse medical needs of its customers. Therefore, their health insurance plans are tailor-made to provide you with a myriad of health insurance benefits to protect your own health as well as your family’s health. Their comprehensive range of health plans includes Activ Health Plan, Activ Health Enhanced and Active Health Essential plan that come with attractive benefits to keep you motivated.

Then again, if you want a wider scope of coverage, then you can opt for Activ Assure – Diamond Plan that comes with additional benefits like 150% restoration of sum insured, and also 586-day care procedures among other benefits.

You can further enhance your health insurance coverage with Activ Secure Plans that offers Personal Accident Cover, Hospital Cash Benefit, Critical Illness and Cancer Cover. Moreover, there are Group Health Insurance Plans namely: Group Activ Health and Group Activ Secure offering comprehensive benefits to the insured members at an affordable premium.  You can easily buy a health insurance policy from Aditya Birla General Insurance online from their website.

Aditya Birla Health Insurance at a Glance:

Key Features

Highlights

Network Hospitals

5700+

Incurred Claim Ratio

89.05

Renewability

Lifelong

Additional Rider Benefit Available

Available

Benefits & Features of Aditya Birla Health Insurance Plans

Aditya Birla Health Insurance is already operating in the Indian market, and it currently offers multiple products for individuals, families, and groups. Some of the key features and benefits of Aditya Birla Health Insurance can be listed as follows:

  • Multiple Sum Insured Options: The insurer gives you a choice to choose from multiple sum insured options. You can get insurance cover for as high as 2 Crore rupees. You can select a plan that falls in your budget or meets your needs and requirements.
  • Flexible Plan Options: Aditya Birla health insurance provides different plans. There is one for every customer. The plans are designed for families, individuals, and groups. The insurer provides plans offering specific benefits such as critical illness, personal accident, cancer, etc. Besides this, there are health insurance plans that offer medical coverage to large groups.
  • Wellness Coaching: It is one of the special features that Aditya Birla health insurance offers to its customers. The insured members can have access to experts of health industry on the go. These medical specialists can address their doubts anytime as per their own convenience.
  • Health Returns: Policyholders who follow a healthy lifestyle can get rewards for maintaining a healthy lifestyle. If you want to know more details regarding this provision then you can access the information on the company’s official website.
  • Network Hospitals: The Company has a huge network of medical specialists and hospitals. The list of doctors and hospitals in your city and town is available on their official website.
  • Tax Relief: The cost of premium that you pay for Aditya Birla medical insurance policies earns you tax benefits under the purview of section 80D of the Income Tax Act.

Why Aditya Birla Health Insurance?

Aditya Birla Health Insurance offers a range of personalized health insurance features such as:-

Health Return Benefit

  • People who follow a healthy lifestyle earn reward points
  • You can earn back up to a maximum of 30% of your medical insurance premium

Chronic Management Program

  • This program is specially designed for the management of chronic illness such as diabetes, asthma, hypertension etc.
  • Day 1 cover in case of chronic health conditions
  • In case the insured develops a chronic condition during the policy tenure then you are automatically upgraded to the Chronic Management Program

Hospital Room Options

  • Freedom to use a private room or a shared room during hospitalization
  • In case you get a lower room category, then you are also eligible to avail Health Return benefits

Second E Opinion

  • In case of critical illnesses, Second opinions are also covered
  • And the panel of doctors including international experts and specialists in the field

Aditya Birla Health Insurance Plans

Aditya Birla Health Insurance offers a number of health insurance plans. You can choose one to:

  • Activ Health Essential Plan

    It is a comprehensive health insurance plan that specifically caters to the middle-income applicants. There are multiple sum insured options that you can select as per your budget. Besides the regular cashless and reimbursement benefits, you can also opt for other value-added benefits such as Health Returns, Wellness Coach among others.

    Activ Health Essential Plan Details

    Features

     

    Entry age

    Minimum: 91 days

    Maximum: No age limit

    Policy Term

    1,2,3 Years

    Coverage

    Family Floater coverage up to 9 members

    Sum insured

    Up to Rs.10 lakh

    Cumulative bonus

    10 to 100 % for every claim free year

    Pre-hospitalization expenses

    Up to 30 days before hospitalization

    Post-hospitalization expenses

    Up to 60 days after getting discharged

    Road Ambulance Expenses

    Actual expenses in Network hospitals
    Up to Rs.2,000 per hospitalization in other hospitals

  • Activ Health Enhanced Plan

    It is a comprehensive health insurance plan with a sum-assured limit up to 2 crores. You can opt for a policy term between 1 and 3 years. It is available as an individual as well as family floater plan. Apart from the regular benefits, you can also opt for value-added benefits that Aditya Birla Health Insurance provides.

    Activ Health Enhanced Plan Details

    Features

     

    Entry age

    Minimum: 91 days
    Maximum: No age limit

    Sum Insured

    Minimum: Rs.2 lakhs

    Maximum: Rs.2 crores

    Coverage

    Family Floater coverage up to 9 members

    Co-payment

    Not Applicable

    Cumulative Bonus

    20% to 100 % for every claim free year

    Recovery Benefit

    1% of the SI or a maximum of Rs.10,000

    Organ Donor expenses

    Covered

    Reload of Sum insured

    Automatic restoration for claims for which the sum insured didn’t get exhausted

    Day Care Treatment

    Included for specific procedures

    Domiciliary Hospitalization

     Up to the SI limit

    Pre-hospitalization expenses

    Prior to 60 days of hospitalization

    Post-hospitalization expenses

    Post  180 days of getting discharged from the hospital

    Road Ambulance Cover

    Actual expenses in Network hospitals
    Up to Rs.5,000 per hospitalization in non-network hospitals

  • Activ Secure Personal Accident Plan

    You can buy personal accident cover to ensure financial security against any untoward perils such as accidental death or disabilities. This plan is designed to provide personal accident cover against accidental death, permanent partial and total disabilities. Apart from the regular benefits, there is a range of optional benefits that you can opt to enhance the coverage.

    Activ Secure Personal Accident Plan Details

    Features

     

    Accidental Death Cover

    100% of the SI

    Permanent/Total Disability

    100% of the SI

    Orphan Benefit

    10% of the SI or a maximum of Rs. 15 lakhs

    Education Benefit (Lump sum)

    10% of the SI for a surviving child

    Emergency Ambulance Cover

    Up to Rs.1,000

    Permanent Partial Disabilities

    Up to 100% of the SI based on the nature of the disability

    Modification Benefit

    Up to Rs.1 lakh for modification of vehicle or home

    Funeral Expenses

    1% of the SI or a maximum of Rs.50,000

    Compassionate Visit Cover

    International Travel - up to Rs.25,000
    Domestic Travel - up to Rs.10,000

    Temporary Total Disability Cover(optional benefit)

    up to Rs.50,000 weekly benefit for 100 weeks

    Cumulative Bonus

    5% to 50 % of the SI per year

    Accidental Hospitalization (optional)

    1% of the SI or a maximum of Rs.1 lakh

    EMI Protect Cover (Optional)

    Monthly loan installments for loans as per the policy T & C

    Loan Protect Cover (Optional)

    Covered

  • Activ Secure Critical Illness Plan

    Aditya Birla Activ Secure critical illness policy pays off a lumpsum amount following the first detection of any of the specified critical illness in the plan. There are different variants and a lot of flexible options in this plan. The survival period is also kept low to ensure that insured person get immediate benefits. This policy is designed to ensure adequate financial support to the policyholder in case he/she is diagnoses with a life-threatening disease.

    Activ Secure Critical Illness Plan Details

    Features

     

    Plan 1

    Coverage for up to 14 illnesses

    Plan 2

    Coverage for up to 50 illnesses

    Plan 3

    Coverage for up to 64 illnesses

    Wellness coach (Optional Benefit)

    Guidance on fitness, lifestyle changes, and nutrition

    Medical Second (Optional Benefit)

    Covered

  • Activ Secure Hospital Cash Plan

    You can buy Aditya Birla Activ Secure hospital cash plan if you want to avail daily cash benefit during the term of hospitalization. A basic health insurance policy will only pay off hospitalization expenses, and you must know that there are several hidden expenses that may arise during the hospitalization.

    This hospital cash benefit recompenses a range of expenses including convalescence benefit, food, and travel. There are different options in this plan and you can opt for one to get compensation for daily expenses during hospitalization.

    Activ Secure Hospital Cash Plan Details

    Features

     

    Parental Accommodation Cover

    Cash benefit is provided for one day. It is valid in case there is hospitalization for more than 72 hours of children less than 12 years of age

    Convalescence Benefit

    Applicable to hospitalization more than 7 days

    ICU Cover

    Up to a maximum of 10 days during a policy period

    Daily Cash Benefit

    Provided ( subjected to policy terms and conditions)

    Wellness Coach (optional)

    Guidance on fitness, lifestyle changes, and nutrition

    Deductible

    1 day

  • Activ Secure Cancer Secure

    It is a disease-specific plan provided by Aditya Birla Health Insurance. Unlike a critical illness health insurance policy, it only offers protection against different cancers.
    Coverage is provided for several stages of cancer and a lump sum payment is made upon the first diagnosis of cancer. Apart from cancer cover, there are various other benefits that you can avail with this plan. It includes a medical second opinion and wellness coaching program.

    Activ Secure Cancer Secure Plan Details

    Features

     

    Survival Period

    7 days after the first diagnosis of cancer

    Payout Benefits

    50% of SI for early detection
    100% of SI for major stage detection
    150% of SI for an advanced stage of cancer

    Cumulative Bonus

    10% of the SI or a maximum limit of 100%

    Additional Payout

    Payout  for major stage cancer even after initial payout for early detection of cancer

    Wellness Coaching

    Guidance on fitness, lifestyle changes, and nutrition

  • Activ Assure Diamond

    The coverage is provided to both individual and families. The sum assured option goes up to Rs. 2 crores. You can buy an annual policy or a 3-year plan.

    Activ Assure - Diamond Plan Details

    Features

     

    Sum Insured (Rs.)

    Up to Rs.2 Crore

    Entry Age

    Minimum: 91 days
    Maximum: No Age Limit

    No-Claim-Bonus

    10% of the SI or a maximum of 100% ( for every claim-free year)

    Day Care Treatment

    Includes up to 586 procedures

    Restoration of Sum Insured (Optional Benefit)

    Restoration of SI multiple times after several claims

    Reinstatement of Sum Insured

    up to 150%  or a maximum of Rs.50 lakhs

    Daily Cash Benefit

    Rs.500 on daily basis (maximum 5 days) for SI up to Rs.4 lakhs

    Super NCB (optional)

    50% per claim-free year subject to a maximum of 100%

    Health Check-up Facility

    Once a year based on the sum insured and age of the policyholder

    Organ Donor Expenses

    Covered for both donating and receiving organs

  • Group Activ Health Insurance

    It is an annual group health insurance plan that is provided by Aditya Birla Health Insurance Company. Group health insurance is usually provided by employers to their employees. Also, other groups and associations can opt for group health insurance coverage.

    Group Activ Health Plan Details

    Main features include:

    • Simple and quick underwriting and issuance of the policy
    • Easy documentation process
    • Cashless medical treatment
    • Tailor-made benefits and features
    • Variable options as per the requirements of the applicant

Inclusions of Aditya Birla Health Insurance

Aditya Birla health insurance plans offer a range of benefits. The coverage may vary from insurer to another. However, the list of the common coverage benefits is listed below:

  • 60 days pre-hospitalization cover and 90 days post hospitalization cover
  • Maternity benefits are provided to an adult female insured under some plans
  • Daycare treatments are also reimbursed. Provided they are not in the diagnostic and out-patient department of the hospital
  • Hospital cash benefit
  • Organ donor treatment cover is provided
  • Domiciliary hospitalization expenses are compensated
  • Emergency ambulance cover
  • Cumulative Bonus
  • Restoration of the Sum Insured Amount

For a detailed list of the inclusions of the health insurance from Aditya Birla you can refer to the policy wordings.

Exclusions of Aditya Birla Health Insurance

  • Pre-existing diseases until the completion of the waiting period
  • Additional hospital charges
  • Hospitalization due to hazardous occupation or activities
  • Any kind of auto-immune disorders
  • Mental disorders and neurological ailments
  • Any alternative medicine or complementary medication
  • Hereditary diseases or genetic disorders
  • Rehabilitation expenses
  • Cosmetic and plastic surgeries
  • Dental care and oral care treatment
  • External devices required for eyesight and vision support
  • Any type of experimental treatments
  • HIV and AIDS related complications
  • Routine diagnostic procedures
  • Any kind of non-medical expenses
  • Obesity and weight loss programs
  • Treatment for menopause and puberty disorders
  • Reproductive treatment or maternity-related complications
  • Any kind of laser treatment
  • Treatment for STDs
  • Any kind of sleeping disorders
  • Consumption of alcohol and overdose of drugs or any kind of intoxication
  • Any kind of unlawful act
  • Any medical aid that is taken outside India

For a detailed list of  the exclusions you can refer to the policy wordings.

Documents Required for Aditya Birla Health Insurance Claims

Submit the following documents while filing a health insurance claim:

  • Submit the claim form
  • Provide all the medical bills
  • Death certificate (as per the case)
  • Doctor’s certificate regarding the diagnosis
  • Other relevant documents and bills

Aditya Birla’s customer service page contains all the relevant details that you can check before filing a claim.

Aditya Birla Health Insurance Claim Procedure

You can know all the details regarding claim procedures on Aditya Birla’s health website. In case of a claim, it is important to notify the insurer immediately. You can take a note of their customer service number to know the details regarding the claim. When filing a claim, need to furnish all the above-mentioned documents and proofs.

Once all the documents are submitted, the insurer will verify the claim and settle your claim. You can also know your claim status by logging on to the insurer’s website.

How to Calculate Aditya Birla Health Insurance Premium?

When buying a medical insurance policy, it is important for you to know the factors that affect the cost of the health insurance premium:

  • Sum insured amount
  • Coverage Type
  • Age of the Insured Members
  • Medical history
  • BMI (Body Mass Index)
  • Smoking/Alcohol Habits
  • Area of residence, occupation etc.
  • Any other factors

You can also calculate premium using Aditya birla health insurance premium calculator online.   

How to Compare and Buy Aditya Birla Health Insurance?

Things to consider before buying Aditya Birla Health Insurance plans-

  • Compare the different plans provided by the insurer
  • Choose from the sum insured options
  • Finalize the sum insured amount
  • Always check premium using Aditya Birla health insurance calculator
  • Read the exclusions mentioned in the policy documents
  • Also, check the waiting period clause
  • Consolidate all the documents that you need to file a claim
  • Also read Aditya Birla health insurance reviews as posted by their customers

Documents that you would need to purchase Aditya Birla Health Insurance policy:

  • Identity proof
  • Aadhar card number
  • Address proof
  • Medical certificates (if applicable)

Aditya Birla Health Insurance FAQs

  • Q1. Why should I buy Aditya Birla health insurance

    Ans: Unforeseen circumstances like an injury or an illness do not come with a prior warning. Amid the increasing cost of healthcare expenses, it is important to buy a health insurance policy with an adequate sum insured amount. A medical plan helps to reduce financial stress in case of medical emergency. With a health insurance policy in place, you can focus on your health recovery, instead of worrying about the finances.

  • Q2. What are the factors that affect the cost of the health insurance premium?

    Ans: Health insurance premiums are calculated on the basis of the following parameters. By ascertaining the following risks the insurance company provides you with health insurance quotes. Let’s have a look:

    • Sum insured amount
    • Age of the insured
    • Tobacco or Smoking Habits
    • Medical history
    • Lifestyle factors including your occupation
    • BMI (Body Mass Index)
  • Q3. Should I buy an individual health insurance policy or a family floater plan?

    Ans: A common sum assured is shared by all the insured members in a family floater health insurance plan. Whereas, in an Individual health plan the sum assured is allotted separately to all the insured members.

    1. Individual Sum Insured - Each family member can get an individual amount of sum assured. And the sum assured is the same for every insured member.
    2. Floater Sum Insured - The plan offers a collective amount of sum assured to all the members of the family. And this amount can be used by other insured members, on exhaustion of the individual sum assured.

    Individual plans cost a little more than a family floater plan. But the sum insured amount should not be the only criteria while choosing a health insurance policy.

  • Q4. What is the benefit of cashless hospitalization cover?

    Ans: During hospitalization, the last thing you would want to worry about is making the payment. If you have cashless hospitalization cover, you don’t need to worry about the finances. Aditya Birla health insurance pays off the amount. Moreover, you don’t have to fret about cash or arrange emergency funds. If you buy a medical insurance policy, it’s wise to buy a cashless policy.

  • Q5. What is the portability of health insurance?

    Ans: This means that you can transfer your current health insurance policy from your current health insurer to another insurer. Also, your accumulated health insurance benefits such as the waiting period and No-claim-bonus remain intact. So, if you feel that you do not have sufficient coverage in your existing health insurance policy, then you can switch to Aditya Birla health insurance along with the accumulated benefits.

  • Q6. What are the limitations under Aditya Birla health insurance plans?

    Ans: Your Aditya Birla health insurance claim will be invalidated under the following circumstances- 

    • Surgeries such as cosmetic surgery, joint replacement, and dental surgery
    • Alternative treatments such as Ayurvedic and homeopathic treatment
    • Claims arising during the waiting period
  • Q7. What is a No-claim-bonus/NCB benefit under health insurance policies?

    Ans: No-claim-bonus benefit is provided to the health insurance holder. The insured shall receive a discount for every claim-free year. A No claim bonus is accumulated with each year of renewal.

Written By: PolicyBazaar - Updated: 21 November 2019
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