Aditya Birla Claim Process
  • Explore the CSR process of Aditya Health
  • Know the significance of a good CSR
  • Claim Filing procedure
Aditya Birla Health Insurance
premium

Network hospitals

10500+

premium

Claim settlement ratio

99.41%

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Sum insured

2 CR

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No. of Plans

11

premium

Solvency Ratio

1.9

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Pan India Presence

2300+

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Aditya Birla Health Insurance Claim Process

The claim process in health insurance refers to the procedure that a policyholder must follow to request reimbursement or avail of a cashless claim for medical expenses covered under the health insurance policy. If the policyholder incurs any medical costs, they can file a claim with their insurance provider, to seek compensation. The company has made the entire procedure, from filling the claim to settling it, so simple that even an individual with little knowledge can submit a claim.

Every company has a different procedure for how a policyholder can file a claim, and Aditya Birla Health Insurance is no exception. The company has a claim settlement ratio of 99.41%(for three months), this high figure demonstrates their commitment to their customers and their active dedication to claim resolution.

Health Insurance Companies: Policy and Claim Process

Types of Aditya Birla Health Insurance Claim Process:

The company has designed two methods of filing the claims, according to the convenience of the customer. The methods are:

  • Cashless Claims: The expenses incurred can be settled directly between the insurance provider and the hospital.
  • Reimbursement Claims: The policyholder can pay the expenses upfront and later claim the bill from the insurance provider.

How To Claim Aditya Birla Health Insurance Policy: Cashless Claims

It is a straightforward, three-step process you can complete while at your home. The company offers online platforms such as the official website and mobile application, where customers can submit their claims. Although Let's go through each step, one at a time:

  • Claim Intimation: Here the policyholder has to inform the company about the claim.

    Step 1: Visit the official website of the company 'www.adityabirlacapital.com'.

    Step 2: Select 'Claims', from the main menu options at the top of the page.

    Step 3: In the drop-down menu select the type of claims, you wish to submit. Choose either 'Cashless Claims'.

    Step 4: Click on the 'Cashless Claims'. This will take you to the page where the company will ask whether you have to 'Track Claim' or 'Raise Claim'. For raising the claim click on 'Raise Claim'.

    Step 5: Now, the company will ask the customer to login in the company's account. Enter your registered 'Mobile number' for OTP login or 'Username' and 'Password'. And then hit 'Login'. This will take you to your dashboard. Now enter the details of your expenses, the name of the hospital, and the treatment availed.

  • Document Submission:
    • The policyholder has to now provide all the relevant documents that support the claims. Submit all the required documents along with the claim form.
    • The policyholder can scan and submit the documents online.
  • Claim Settled:
    • The insurance company will cross-check all the claims and the documents provided by the insured.
    • After verification of the documents, the company will transfer the amount directly to the hospital's bank account.

How To Claim Aditya Birla Health Insurance Policy: Reimbursement Claims:

Aditya Birla Health Insurance reimbursement claims are very similar to cashless claims, with the exception that the company may ask for some additional documents such as the original hospital bill, KYC Documents, and proof of payment. Let's go through the process one by one:

  • Claim Initiation: Informing The Company

    Step 1: Visit the official website of the company.

    Step 2: Now, locate the 'Claims' option in the top menu of the webpage. From the drop-down menu select 'Reimbursement Claims'.

    Step 3: This will lead to a page where you have to choose 'Raise a claim' or 'Track Claim'. For filling a claim select 'Raise a claim'.

    Step 4: In the next step, the company will ask the customer to login into the company's user dashboard. Either login by entering the mobile number and receive an OTP or enter the 'User Name' and 'Password'.

  • Submit Essential Documents:
    • Here the customer has to submit essential documents, to substantiate his/her claim.
    • Scan and attach the documents to the website.
  • Settlement Of The Claim:
    • The insurance provider will go through the documents and verify the authenticity of the document.
    • After all the verification the amount will be transferred to the policyholder's bank account.

Sign Up For Aditya Birla Health Insurance User's Account:

For having your dashboard on the company's account the policyholder must have a 'ONE ID' number. If you are not an existing user, here are a few steps you can customers can follow to create a user account.

Step 1: Visit the official website of the company.

Step 2: Click on the 'Login' option on the top right corner of the page.

Step 3: This will take you to the next page, there select the option 'Create One Id with a Product You Own'.

Step 4: Next, under 'Solution you own to create your One Id', select the option 'Health Insurance'.

Step 5: This will take you to the next page where you have to enter 'Member Id', and click 'Register'.

Note: Member ID is the 12-digit number that is sent in the welcoming email, in the Policy Kit, or E-Card.

Aditya Birla Health Insurance Network Hospital List

Aditya Birla Health Insurance Network Hospitals are present in 32 states nationwide. With a wide network of over 10051+ cashless hospitals, Aditya Birla Life Insurance ensures that you are medically secured, irrespective of the city you reside in.

Things to Keep In Mind

For a smooth claim filing process, keep the following points in mind.

For Cashless Claims:

  • Inform the company 72 hours before the case of planned hospitalization.
  • In case of emergency hospitalization, inform the company within 24 hours of hospitalization.

For Reimbursement Claims:

  • Inform the company about the claim within 30 days of discharge from the hospital.
  • The company may request additional documents if the policyholder is receiving the treatment in a non-network hospital.
  • Aditya Birla Health Insurance Company will transfer your compensation within 15 days, after the complete verification of the documents.
  • The insurance provider will ask for KYC documents, prescriptions, payment proof, discharge summaries, and original medical bills.

Conclusion:

Aditya Birla Health Insurance Claim Process is simple and easy to follow. Keep the documents available so that you may not run into any problems later. Original bills submitted will be highly appreciated as this will result in a fast verification. Inform the company first, then submit the document and then wait for the company to verify and settle the claim. The procedure may take longer or shorter, depending on the documents and authenticity of the raised claim.

Explore other Aditya Birla Health Plans

Aditya Birla Health offers a wide range of health insurance plans to fulfill the medical needs of individuals, families, and senior citizens.

Affordable

Activ Assure Diamond is a complete health insurance plan that offers new-age health features at an affordable cost, and covers more than 500 daycare treatments.

Unique Benefits

  • 150% sum insured reload
  • No Room rent capping
  • Mental illness covered

Activ Assure Diamond (Pros)

  • 100% Ambulance Cover
  • Organ Donor Expenses Covered
  • AYUSH Treatment Cover
  • Hospital Allowance
  • Day Care Treatment Covered

Activ Assure Diamond (Cons)

  • 10% Co-Payment
  • Obesity Treatment Unavailable
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Activ Assure Diamond (Other Benefits)

  • Up to 10% Long Term Discount
  • Health Return Points
  • Room Upgrade Available
  • Super No Claim Bonus
  • Unlimited Reload of SI

Activ Assure Diamond (Eligibility Criteria)

  • Entry Age - 5 Years
  • Max Entry Age - Age No Limit
  • SI - 2 L to 2 Cr
  • Waiting Period - 30 Days

Standard

Arogya Sanjeevani Policy

A standard health insurance policy, wherein you can choose coverage of up to Rs.1 lac to Rs.5 lacs.

Unique Benefits

  • Avail 5% cumulative bonus
  • Cataract treatment covered
  • All daycare treatments covered

Arogya Sanjeevani Policy (Pros)

  • AYUSH Treatment
  • Pre & Post Hospitalization Cover
  • Cashless Treatment
  • Day Care Treatments
  • 5% No Claim Bonus

Arogya Sanjeevani Policy (Cons)

  • 5% Co-Payment
  • Obesity Treatment Unavailable
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Arogya Sanjeevani Policy (Other Benefits)

  • High SI
  • Room Rent Cover
  • Cataract Treatment
  • 5% ICU Cover
  • Individual & Family Floater

Arogya Sanjeevani Policy (Eligibility Criteria)

  • Entry Age - 3 Months
  • Max Entry Age - 65 Years
  • SI - 1 L to 5 L
  • Waiting Period - 30 Days

comprehensive Plan

Activ Health Platinum Premier

The plan offers comprehensive coverage with health return benefits, COVID-19 coverage, a chronic management program, and more.

Unique Benefits

  • Dental Cover
  • Health Returns
  • Affordable Premiums

Activ Health Platinum Premier (Pros)

  • Post-Hospitalization Physiotherapy
  • Health Coach Benefit
  • One Premium Waiver
  • Health Assessment
  • Chronic Management Program

Activ Health Platinum Premier (Cons)

  • Illness due to intoxicants
  • Change Of Gender Treatment
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Activ Health Platinum Premier (Other Benefits)

  • Road Ambulance Cover
  • No Claim Bonus
  • Critical Illness Cover
  • Domiciliary Hospitalization
  • Super Reload of SI

Activ Health Platinum Premier (Eligibility Criteria)

  • Entry Age - 91 Days
  • Max Entry Age - 65 Years
  • SI - 10 L to 2 Cr
  • Waiting Period - 30 Days

Super top-up

Activ Assure Diamond + Super Health Topup

A top-up plan offering medical coverage up to Rs. 1 cr. The plan also gives health and wellness discounts.

Unique Benefits

  • 586-day care procedures covered
  • No restriction on room rent
  • Road Ambulance coverage up to 5K

Activ Assure Diamond + Super Health Topup (Pros)

  • COVID-19 Cover
  • Home Treatment Cover
  • DayCare Treatment Covered
  • Affordable Premiums
  • OPD Consultations

Activ Assure Diamond + Super Health Topup (Cons)

  • Illness due to intoxicants
  • Obesity Treatment Unavailable
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Activ Assure Diamond + Super Health Topup (Other Benefits)

  • Air Ambulance
  • Wellness Benefits
  • Long Term Discounts
  • Domiciliary Hospitalization
  • Organ Donor Expenses

Activ Assure Diamond + Super Health Topup (Eligibility Criteria)

  • Entry Age - 91 Days
  • Max Entry Age - 65 Years
  • SI - 3 L to 1 Cr
  • Waiting Period - 30 Days

Cancer Plan

Specially designed plan to protect you against the rising costs of treatment at every stage of cancer – early, major and advanced.

Unique Benefits

  • Short survival period of 7 days
  • Early stages of cancer covered
  • Avail no claim bonus

Activ Secure- Cancer Secure (Pros)

  • Covers 3 Stages
  • 150% of SI
  • 10% of No Claim Bonus
  • High SI
  • Lump Sum Payout

Activ Secure- Cancer Secure (Cons)

  • Illness due to intoxicants
  • Obesity Treatment Unavailable
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Activ Secure- Cancer Secure (Other Benefits)

  • Wellness Coach
  • Second e-Opinion
  • Short Survival Period
  • Upto 1 Cr SI
  • Hospitalization Expense

Activ Secure- Cancer Secure (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 5 L to 1 Cr
  • Waiting Period - 30 Days

Accident Plan

The Plan is designed to protect individuals and families from all the contingencies (death and disabilities) that occur due to accidents.

Unique Benefits

  • Education benefits provided
  • Funeral expenses covered
  • Protection against income loss

Activ Secure Personal Accident (Pros)

  • Total & Partial Disability Cover
  • Accidental Death Cover
  • No Claim Bonus
  • Ambulance Cover
  • Education Benefit

Activ Secure Personal Accident (Cons)

  • Illness due to intoxicants
  • Obesity Treatment Unavailable
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Activ Secure Personal Accident (Other Benefits)

  • Income Cover
  • Loan Protect Cover
  • Orphan Benefit
  • Compassionate Visit
  • Coma Benefit

Activ Secure Personal Accident (Eligibility Criteria)

  • Entry Age - 5 Years
  • Max Entry Age - 65 Years
  • SI - 30 L
  • Waiting Period - 30 Days

Critical Plan

Activ Secure Critical Illness Plan

The plan is designed to provide financial protection against critical illnesses, & offers compensation against the loss of income arising out of critical illnesses.

Unique Benefits

  • Lump Sum payout on detection
  • 150% sum assured
  • Short survival period

Activ Secure Critical Illness Plan (Pros)

  • Cover up to 64 CI
  • 3 Plan Variants
  • High SI
  • Short Survival Period
  • Active Health App

Activ Secure Critical Illness Plan (Cons)

  • Illness due to intoxicants
  • Obesity Treatment Unavailable
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Activ Secure Critical Illness Plan (Other Benefits)

  • Wellness Coach
  • Second Medical Opinion
  • Cancer Cover
  • Kidney Failure Cover
  • Brain Tumor Cover

Activ Secure Critical Illness Plan (Eligibility Criteria)

  • Entry Age - 5 Years
  • Max Entry Age - 65 Years
  • SI - 1 L to 1 Cr
  • Waiting Period - 30 Days

Platinum Plan

Activ Health Platinum Enhanced

A unique Plan with features such as a chronic management program, modern treatments, covid-19, and more.

Unique Benefits

  • High SI
  • Affordable Premiums
  • Wellness Benefits

Activ Health Platinum Enhanced (Pros)

  • Earn 100% Health Return
  • Cover for Dental Consultations
  • Modern Treatment Cover
  • Wellness Coach
  • Mental Illness Cover

Activ Health Platinum Enhanced (Cons)

  • Illness due to intoxicants
  • Change Of Gender Treatment
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Activ Health Platinum Enhanced (Other Benefits)

  • Chronic Management Program
  • Premium Waiver Benefit
  • Reload of SI
  • Road Ambulance Cover
  • Second e-opinion

Activ Health Platinum Enhanced (Eligibility Criteria)

  • Entry Age - Years
  • Max Entry Age - Years
  • SI - 1 L to 1 Cr
  • Waiting Period - 30 Days

comprehensive Plan

Activ Care Classic

It is a comprehensive health insurance plan with 360-degree coverage for senior citizens. It supports your family members at every stage of their health.

Unique Benefits

  • Health Returns Available
  • Comprehensive Health Check-up
  • Up to 50% No Claim Bonus

Aditya Birla Activ Care Classic (Pros)

  • Personal Health Coach
  • AYUSH Treatment Cover
  • 21% Health Returns
  • Cashless Home Treatment
  • Day Care Treatment

Aditya Birla Activ Care Classic (Cons)

  • Illness due to intoxicants
  • Change Of Gender Treatment
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Aditya Birla Activ Care Classic (Other Benefits)

  • Nursing at Home
  • ICU Bed at Home
  • 586 Day Care Treatments
  • Domiciliary Hospitalization
  • ICU Expenses Cover

Aditya Birla Activ Care Classic (Eligibility Criteria)

  • Entry Age - 55 Years
  • Max Entry Age - 80 Years
  • SI - 3 L to 25 L
  • Waiting Period - 30 Days

comprehensive Plan

Aditya Birla Activ Fit

A health insurance plan designed especially for the youth. The plan provides protection and rewards for good health.

Unique Benefits

  • Affordable Premiums
  • Discounts Available
  • Travel Protect

Aditya Birla Activ Fit (Pros)

  • Maternity Cover
  • Binge Refill Feature
  • 10% Good Health Discount
  • Daily Cash Benefit
  • Day Care Treatment

Aditya Birla Activ Fit (Cons)

  • Illness due to intoxicants
  • Change Of Gender Treatment
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Aditya Birla Activ Fit (Other Benefits)

  • Up to 100% NCB
  • Health Check-up
  • Home Treatment
  • OPD Expense Cover
  • Premium Waiver Benefit

Aditya Birla Activ Fit (Eligibility Criteria)

  • Entry Age - 5 Years
  • Max Entry Age - 45 Years
  • SI - 5 L to 1 Cr
  • Waiting Period - 30 Days

Aditya Birla Health Insurance Claim Process: FAQs

1. What is the time frame for Aditya Birla Health Insurance Company to settle the claim?

There is no fixed time frame in which the company settles the claim, however, they pay the compensation within 15 days, after the complete verification of the document.

2. What are the additional documents requested by the company in case of a reimbursement claim?

For Reimbursement claims the company may ask for: KYC documents, medical bills, discharge summary, prescriptions, medical reports, claim form, photo Id.

3. From where I can get the claim form?

The claim form can be obtained from the official website of the company.

4. Can we file our claim offline?

Yes, you can file your claim offline. You can visit the company's nearest branch and submit the claim or call on the toll-free number of the company. The company executive will guide you through the process.

Health Insurance Companies

Aditya Birla Health Insurance Reviews

Read what our customers have to say about Aditya Birla health insurance company and Aditya Birla health mediclaim policy.

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Ritu

Bhopal

February 16, 2024

PolicyX insurance experts helped me enjoy the full potential of my Aditya Birla Health Insurance plan by informing me of all the impressive wellness benefits provided by the insurer.

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Nishtha Holkar

Mysore

February 16, 2024

I was looking for the best critical illness health insurance that can provide adequate coverage for cancer treatments. PolicyX insurance experts pointed me in the right direction with Aditya Bi...

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Nishant Tanwar

Dehradun

February 16, 2024

PolicyX customer service answered all my queries regarding Aditya Birla Activ Health Platinum Enhanced patiently. I am very satisfied with my policy purchase.

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Vivek

Hyderabad

February 14, 2024

When I was confused about opting for a separate senior citizen health plan or including my parents in a family floater health plan PolicyX helped me find the right fit with Aditya Birla Health ...

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Sunjyot Kapoor

Chandigarh

February 2, 2024

PolicyX helped me settle Aditya Birla& 039;s Health plan claim during my hospitalization in a non-network hospital smoothly without any issues.

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Ritika Pandey

Jaipur

February 2, 2024

After careful comparison and amazing suggestions from PolicyX insurance experts, I finalized Aditya Birla Health Insurance for my family’s health care and have been associated with the br...

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Pooja Bansal

Goa

October 4, 2023

Policyx.com s support was instrumental in my decision to purchase Aditya Birla Health Insurance. I couldn t be happier with my choice!

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Pankaj Sharma

Kolkata

October 4, 2023

Aditya Birla Health Insurance s comprehensive coverage is worth every penny. Policyx.com made the buying process easy.

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Daina Mathew

Written By: Daina Mathew

Daina is a content writеr with a profound grasp of Insurancе, Stocks, and Businеss domains. Hеr extensive 3-year еxpеriеncе in thе insurancе industry еquips hеr with a nuancеd undеrstanding of its intricaciеs. Hеr skills еxtеnd to crafting blogs, articlеs, social mеdia copiеs, vidеo scripts, and wеbsitе content. Her ability to simplify complex insurancе concepts into reader-friendly content makes her an еxpеrt in the domain.