Aditya Birla Health Insurance

Aditya Birla Health Insurance
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About Aditya Birla Health Insurance

Aditya Birla Health Insurance Co. Limited started its operations in October 2016 as a joint venture between Aditya Birla Capital Limited and MMI Strategic Investments of South Africa. It provides a wide range of health insurance policies that offer extensive coverage to customers and are designed to cover the diverse healthcare needs with attractive benefits. Whether it is for hospitalization expenses, intensive care, or wellness programs, Aditya Birla provides all services under one roof.

Highlights

Branches59
Domestic Presence800 locations
Advisors18,500+
Claims Settled63,000+
Hospital Network6,000+
Bancassurance Partners10

Table Data updated on 21-09-2020

Aditya Birla health insurance

What Are the Types of Aditya Birla Health Insurance Plans?

Aditya Birla Health Insurance offers the following 8 plans grouped under 4 types of policies:

1. Indemnity Policies :

  • Activ Health: Platinum
  • Active Assure: Diamond Plan
  • Activ Care

2. Fixed Benefits:

  • Activ Secure

3. Global Policies:

  • Global Health Secure Plan

4. Group Protect Plan:

  • Group Activ Health plan
  • Group Activ Secure plan
  • Group Activ Travel Plan

1. Activ Health Platinum Plan

The Activ Health Platinum plan is designed to cover all medical expenses arising due to hospitalization. It has two variants – Essential and Enhanced.

Eligibility Criteria & Highlights

Category

Essential

Enhanced

Entry age limit

Minimum 91 days, no maximum entry age

Policy Term

1, 2, or 3 years

Sum Assured

50,000 – 10 Lacs

2 Lacs – 2 crores

Road Ambulance cover

Up to Rs. 2,000 per hospitalization

Up to Rs. 5,000 per hospitalization

Cumulative Bonus

10% increase each claim-free year

20% increase claim-free year

Recovery benefit

Not applicable

1% of the sum assured

Table Data updated on 21-09-2020

Features:

  1. The plan offers a HealthReturns benefit under which up to 30% of the annual policy premium can be earned back. Aditya Birla has designed an Activ Health app that tracks our health and on the basis of that, the HealthReturns are provided which can be used to pay further premiums, or for medical expenses.
  2. The policyholder gets the option to choose the hospital room at the start of the policy. If he gets treated in a room category lower than his opted room, he gets HealthyReturns.
  3. For diseases like hypertension, diabetes, asthma, and high cholesterol, 1 day cover of all medical expenses is provided.
  4. The plan also offers a 100% reload of the entire sum assured after the first claim. Apart from this, the company also provides a wellness coach, Chronic management program, and Worldwide assistance services as add-on benefits.

2. Activ Assure Diamond Plan

The Activ Assure Diamond plan is a health policy that provides a cover for total expenses arising out of hospitalization. It also includes treatments done under Ayurveda, Unani, Siddha, Yoga & Naturopathy and Homeopathy systems.

Eligibility Criteria & Highlights

Entry age

Individual plan: 5 years

Family Floater: 91 days

Policy Term

1, 2 or 3 years

Sum Assured

2 Lacs – 2 Crores

Vaccination cover

Rs. 10,000

Table Data updated on 21-09-2020

Features:

  1. If the existing sum assured is exhausted, then the plan offers a 150% reload of the entire amount.
  2. Even if the hospitalization is for less than 24 hours, 586 listed day care procedures are covered under the plan.
  3. The plan offers the benefit of earning up to 30% of the premium under the HealthyReturns reward option for remaining healthy. The HealthyReturns is measured by the Activ Health App designed by the company.
  4. Apart from domestic hospitalization, the plan also provides extensive worldwide emergency cover including Air ambulance provision.

3. Activ Care Plan

The Activ Care plan is designed for senior citizens to help in covering their overall medical costs arising out of hospitalization. Individuals can avail of this plan for their parents and grandparents to protect them financially in times of sickness. The Plan is available in three variants – Standard, Classic, and Premier.

Eligibility Criteria and Highlights

Category Standard Classic Premier
Age at entry Minimum: 55 years
Maximum: 80 years
Policy term 1 – 2 years
Sum Insured 3 Lacs – 10 Lacs 3 Lacs – 10 Lacs 5 Lacs – 25 Lacs
Room Type Shared Room Shared Room Single Private AC Room
Domiciliary Hospitalization Not Available Covered up to 10% of Sum insured Covered up to Sum insured
Reload of Sum insured 50% of sum insured 100% of sum insured 100% of sum insured

Table Data updated on 21-09-2020

Features:

  1. The plan provides comprehensive health care check-up once a year and 2 coaching sessions by a personal health coach every year to ensure that parents/senior citizens are hale and hearty.
  2. It provides an opportunity to earn up to 21% of the premium under the HealthyReturns program.
  3. The plan allows policyholders to take a second opinion on their major illnesses through certified hospitals and provides health and wellness discounts too.
  4. Under optional care benefits, senior citizens are covered for expenses related to nursing at home, lifestyle support equipment, portable medical equipment, and advance health check-up.

4. Active Secure Personal Accident Plan

The Active Secure Personal accident plan is designed to protect individuals and families from all the contingencies (death and disabilities) that occur from unfortunate accidents.

Eligibility Criteria & Highlights

Age Minimum: 5 years
Maximum: 65 years
Policy Tenure 1, 2, 3 years
Sum assured 12 times the annual gross income

Table Data updated on 21-09-2020

Features:

  1. Apart from 100% total payout from death or disability (permanent or partial) due to accidents, the company also offers the option to select from five base plans that give a wide range of benefits such as:
    1. Education benefit
    2. Emergency road ambulance cover
    3. Funeral expenses
    4. Repatriation of mortal remains
    5. Orphan benefit
    6. Modification benefit (residence/repair)
    7. Compassionate benefit
  2. The plan also provides a cumulative benefit of 5% every year.
  3. As optional covers, the plan also provides additional benefits such as EMI protect, Loan protect, adventure sports cover, and Worldwide emergency assistance services.

5. Activ Secure Critical Illness Plan

The Activ Secure Critical Illness plan is designed to provide financial protection against critical illnesses and the expenses related to it. The plan ensures that its wide range of benefits help individuals get compensated against the loss of income arising out of critical illnesses.

Eligibility Criteria & Highlights

Age Minimum entry age:
Plan 1 & 2: 5 years
Plan 3: 18 years
Maximum entry age - 65 years
Policy Tenure 1, 2, 3 years
Relationships covered Self, spouse, up to 4 children, up to 2 parents and 2 parents-in-laws
Sum assured 1 Lac – 1 Crore
(Up to 12 times of annual gross income)

Table Data updated on 21-09-2020

Features:

  1. The policy offers three plans:
    1. Plan 1: Base Level Protection: Against 20 critical illnesses
    2. Plan 2: Comprehensive Protection: Against 50 critical illnesses
    3. Plan 3: Total all-round protection: Against 64 major critical illnesses
  2. All three plans offer complete protection against all hospitalization expenses occurring since the first diagnosis, including a second health opinion and the services of a wellness coach.
  3. Under the comprehensive plan, the policyholder gets a 150% payout of his sum assured for more than one critical illness diagnosed.

6. Activ Secure Hospital Cash Plan

The Activ Secure Hospital Cash Plan is designed to provide daily cash benefit for covering day-to-day expenses while being hospitalized.

Eligibility Criteria & Highlights

AgeMinimum: 18 years
Maximum: 65 years
Policy Tenure 1, 2, 3 years
Days of benefit 30 days/45 days/60 days
Cash benefit Rs. 500 – Rs. 10,000

Table Data updated on 21-09-2020

Features:

  1. The plan provides cash benefit based on the plan chosen, irrespective of what the hospital bill amount.
  2. If the hospitalization is due to a road traffic accident, and admission to ICU is deemed necessary, then twice the daily cash benefit is paid for a maximum of 10 days in a policy year.
  3. Apart from these benefits, the plan also provides convalescence benefits, parental accommodation benefits and a wellness coach who provides guidance on nutrition, fitness, and lifestyle habits.

7. Activ Secure Cancer Secure Plan

The Active Secure Cancer Secure Plan is designed to provide a total medical cover for expenses arising out of a cancer diagnosis. The plan provides benefits for all the three stages of cancer – early, major, and advanced-stage cancer.

Eligibility Criteria & Highlights

Age Minimum: 18 years
Maximum: 65 years
Policy Tenure 1, 2, 3 years
Sum insured 5 lacs – 1 crore
Cancer care cover Early: 50% sum insured, maximum - 10 Lakhs,
Major: 100% sum insured,
Advanced: 150% of the sum insured

Table Data updated on 21-09-2020

Features:

  1. The plan offers 10% cumulative bonus after every claim-free year.
  2. The plan gives coverage of 150% of the sum insured to ensure that all treatment expenses are met.
  3. Apart from the above benefits, the policyholder also gets the option to avail of a second medical e-opinion on his diagnosis and a wellness coach who provides guidance on nutrition, fitness, and lifestyle habits.

8. Global Health Secure

Global Health Secure is an international health cover that provides protection from major illnesses, and cashless treatment across a global network of hospitals. This plan is designed to provide global healthcare options that keep you safe no matter where you are.

Eligibility Criteria & Highlights

Age Minimum: 91 days
Maximum: 65 years
Policy Tenure 1, 2, 3 years
Condition All members should have a domestic Indian health insurance indemnity policy with a sum insured of more than 10 lacs

Table Data updated on 21-09-2020

Features:

  1. The plan provides total international health cover for all expenses arising out of in-patient care such as doctor’s fee, room rent, medicines, drugs, operation theatre expenses, and other expenses.
  2. The company’s service provider also offers expert VISA guidance for foreign travel related to medical treatment.
  3. If the policyholder is diagnosed with any one of the 16 major critical illnesses, then an international second e-opinion is also provided.
  4. Other benefits like, organ donor, travel, accommodation, and repatriation of mortal remains is also provided.

9. Group Protect Plan

The Group Protect plan is a corporate medical insurance plan that provides health coverage to the employees of a company, group, or institution. The following are the types of plans provides under the group protect plan:

  1. Group Activ Health
  2. Group Activ Secure
  3. GroupActiv Travel

Eligibility Criteria & Highlights

Age Minimum: 18 years
Maximum: 65 years
Policy Tenure 1, 2, 3 years
Cancer Secure Cover 50,000 – 2 crores
Income Protect Monthly Limit (4,000 to 8 Lacs)
Heart Secure Cover 50,000 to 10 lacs
Hospital cash Benefit 500 to 10,000 per day
Major Illnesses Cover 5 lacs – 50 lacs
Credit Protect 5,000 – 10 lacs
Heart Assure Cover 5 lacs – 50 lacs

Table Data updated on 21-09-2020

Features:

Group Activ Health:

  1. This plan provides overall health cover from expenses arising out of hospitalization, with more than 520 day care treatments included.
  2. It also includes OPD charges, a second medical opinion, counselling sessions, reconstructive surgery, palliative care, genetic testing, etc.

Group Activ Secure:

The plan provides the following benefits to the employees:

  1. Personal accident cover with 100% of payout of the sum insured. Along with this, the plan also provides full payout on permanent total disablement, permanent partial disablement, temporary total disablement, and other optional benefits that cover contingencies arising out of unfortunate accidents.
  2. Critical illness cover for over 36 major illnesses. Under this plan, it also provides a second E-opinion, education and marriage fund for children, rehabilitation benefit, Loan protection, and a wellness coach.
  3. Hospital cash cover for expenses related to illness or injury.

Group Activ Travel:

The plan provides international health cover for employees who face health crises during their business trips. Following benefits are provided under this cover:

  1. All medical expenses including in-patient and day care treatment, maternity cover, treatment for mental or nervous disorders, etc are covered.
  2. As optional benefits, the plan also provides an extension cover for complications arising out of maternity treatment, adventure sports injury, professional sports injury, medical evacuation, repatriation of mortal remains, dental expenses, loss of baggage, etc.

Why Should You Buy Aditya Birla Health Insurance?

Aditya Birla Health Insurance provides a wide range of benefits that not only covers your health needs but also your overall wellness. Apart from excellent customer support, it also provides the following programs:

Health Services: Aditya Birla takes care of the overall health of the person which includes an active health management program that takes care of all the lab tests, booking doctor consultations, and appointments. It also provides chronic management, and health assessment programs that ensure hassle-free access to all health facilities.

Reward Programs: As we have seen in the policies above, Aditya Birla ensures that you earn from living a healthy life that is tracked through its Health Dashboard. Your overall health is monitored through a host of parameters like Activ Age questionnaire, Healthy Heart Score, Activ Dayz program, etc. All these programs motivate you to remain active and healthy.

How To Buy an Aditya Birla Health Insurance Policy?

There are two ways of buying Aditya Birla Health Insurance – Online and Offline.

Online:

  1. Go to www.policyx.com and at the bottom of the webpage, click on ‘Buy Now’ under the ‘Instant Buy’ section.
  2. Click the Aditya Birla Plan that you wish to buy and click on the ‘Direct URL’ or ‘Policyx URL’, which will take you to the page with all the details of the plan.
  3. Fill the online form with your personal details after which the premium will be generated.
  4. On the payment page, make the payment and the Aditya Birla Health Insurance policy will be emailed to you.

Offline:

Visit the nearest Aditya Birla Insurance office, speak with a representative and explain your needs to him and select the plan which he suggests. Submit the documents requested by the company and make the payment. The soft copy of the policy document will be sent within 48 hours and the hard copy within 15 days.

How is an Aditya Birla Health Insurance Claim Processed?

Cashless Claim:

  1. Check the network hospitals from the list and inform Aditya Birla Health Insurance company about the admission.
  2. At the network hospital, show the Aditya Birla Health Insurance cashless card and valid ID proof like Passport, PAN Card, Voting card, etc.
  3. After the identification is verified, the network hospital will send the cashless hospitalization request form to Aditya Birla. (For planned hospitalization, the form needs to be submitted 3 days in advance, and for emergency cases, it needs to be submitted within 48 hours)
  4. Aditya Birla will review the form and will approve or reject the claim. After completion of the formalities, the decision will be forwarded to you and the payment will be made to the network hospital.

Reimbursement Claim:

In an emergency case, if you are admitted to a non-network hospital, you will have to pay the hospital directly during the discharge.

  1. After discharge, submit the following documents to Aditya Birla within 15 days of discharge:
    1. Claim form
    2. Health card
    3. KYC documents
    4. Original discharge summary
    5. Hospital bills
    6. The invoice with payment receipt
    7. All consultation papers
  2. After reviewing the documents, Aditya Birla will take the appropriate decision and if approved, the amount will be reimbursed through NEFT to the registered bank account.

How Ro Renew an Aditya Birla Health Insurance Policy?

  1. Go to www.policyx.com and at the bottom of the webpage, click on ‘Renew’.
  2. On the next page, select the category (health) and enter your personal details.
  3. Choose the health plan you want to renew and you will be taken to Aditya Birla’s website for the online payment.
  4. Make a payment of the premium generated and the Aditya Birla Health Insurance renewed policy document will be emailed to you.

FAQs

1. Do Aditya Birla Health Insurance policies provide long-term policy discounts?

Yes. If the policy term chosen is 2 years, then a 7.5% discount is provided, and for a 3-year policy term, a 10% discount is provided.

2. What is the Chronic Management Program provided by Aditya Birla Health Insurance?

Under the Chronic Management Program, Aditya Birla provided all types of assistance to help control diseases that are normally excluded from the mediclaim policies. These include diabetes, hypertension, high cholesterol, and asthma.

3. In Activ Care policy, are there any sub-limits for the room rent?

No, there are no sub-limits for the room rent under the Activ care policy. The insured gets the rooms based upon the plan he has chosen.

4. Is there a no claim bonus under the Global Health Secure plan?

There is no provision of a no-claim bonus as the sum insured is very high (3 crores, 6 crores)

5. How much deduction can an employee claim under the Group Protect Policy?

TAn employee can claim up to Rs. 25,000 as a deduction under section 80D of the Income Tax Act.

6. What are the different geographical scopes available while opting for a Group Activ Travel policy?

Following are the scopes that are available:

  • Worldwide (excluding India)
  • Worldwide (Excluding USA, Canada, India)
  • Europe
  • Asia (excluding India)
  • Domestic plans

Page updated on 21-09-2020