Aditya Birla Health Insurance

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Aditya Birla Health Insurance Overview

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.

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:-

1. 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

2. 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

3. 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

4. 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

1. 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

 

2. 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

 

3. 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

 

4. 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

 

5. 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

 

6. 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

 

7. 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

 

8. 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 policy?

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?

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?

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?

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?

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?

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?

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.

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