Aditya Birla Health Insurance

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Policies Issued

25,000,000+

Year of Inception

2015

No. of Branches

1,094+

Network Hospitals

10,500+

About Aditya Birla Health Insurance

Aditya Birla Health Insurance Company Limited is a part of Aditya Birla Group. The company was established as a result of the coming together of Aditya Birla Capital Limited, a leading financial services company and MMI Holdings Limited one of the largest insurance companies in South Africa. Aditya Birla Capital Limited holds a 51% stake in the company whereas MMI Holdings Ltd. holds a 49% stake in the company. Both the partnered companies have a legacy of being in the financial services market for more than a century

Along with offering a wide range of health insurance products that provide financial protection, the company also takes a conventional approach and offers various other services to promote the importance of health. The company follows a more customer-centric approach and highlights the importance of the proactive health of all its policyholders. Aditya Birla Health also makes use of smart technology in almost all their health insurance procedures, from buying a policy to raising a claim, giving them an edge over the other insurers

Things to know about Aditya Birla Health Insurance Company Limited Here are some of the important facts about Aditya Birla Health Insurance Company and the Group

Aditya Birla Capital Limited is renowned for risk management, sales management, people practices, and product innovation and investor education
The company has reported a CTI, Consolidated Total Income of INR 5591.96 crore for the 31 March 2021 quarter-end
Aditya Birla is one of the largest general insurance brokers and as well as health insurance companies in India
Aditya Birla Capital Limited is one among top 5 private diversified NBFCs (Non-Banking Financial Companies) in India
Aditya Birla Group is a premium global conglomerate that operates in 35 countries which is being worth USD 11.7 billion (January 2019) Why should you choose Aditya Birla Health Insurance Company Limited?Apart from the strong market presence and continuous recognitions received, there are many other strong reasons to choose Aditya Birla Health insurance Company as your insurer.

Following are the reasons to choose the company

The company has a tie-up with more than 8200 hospitals in India. This allows you to easily locate a networked hospital all across the country for cashless claims
With its presence in over 2500 cities, you would never be far from reaching the company getting help in making a claim
The company has a wide customer base and has already insured more than 8.9 million lives
The company has already settled more than 6.3 lakh claims ever since it started its operations
Aditya Birla offers digitised wellness programmes that offer incentives to the policyholders for following a healthier lifestyle
Aditya Birla offers some of the best health insurance plans which offer a comprehensive scope of coverage at affordable premium rates

Aditya Birla Claim Settlement Ratio

98.12%

Aditya Birla

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. Aditya Birla has a claim settlement ratio of 98.12%, as compared to the industry average of 94.21%.

Aditya Birla Health Insurance Plans

Aditya Birla health insurance offers 12 health insurance plans. The premium of these plans starts from Rs. 212/yr. The sum insured ranges from Rs. 500 - 20 Cr. Details of the comprehensive coverage provided by the following 12 Aditya Birla health insurance plans are listed below:

Aarogya Sanjeevani Plan

Starting Premium- ₹ 5,117/yr

This is a standardized health insurance plan which has been launched as per the directive issued by the IRDA.The plan provides basic health insurance coverage at affordable premium rates.

The features of the plan are as follows

Coverage for cataract treatments is available for up to 25% of the sum insured
Coverage for alternative AYUSH treatments is also allowed by the policy
If you do not make a claim in a policy year, you get a cumulative bonus wherein the sum insured increases by 5% after each claim-free year subject to a maximum increase of 50%

Eligible Age

91 days - 65 years

PED Waiting Period

4 years

Coverage

1 Lakh - 5 Lakh

NCB

5% increase in cover

Activ Assure Diamond Health Insurance

Starting Premium- ₹ 7,149/yr

Aditya Birla Activ Assure Diamond Plan offered by Aditya Birla Health Insurance Company is a comprehensive insurance policy that offers various amazing benefits and features. Along with protecting your finances, it also helps you manage your health proactively with a variety of services like a health coach which gives you personalised coaching by a medical expert. There are many such features, services and additional riders that make this policy a complete package.

USP of Aditya Birla Activ Assure Diamond plan

The policy offers coverage for 586-daycare procedures
The policy offers 150% reload of the sum insured for subsequent claims due to an unrelated illness
No claim bonus of 10% of the sum insured for every claim-free year
The policy provides coverage for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathic (AYUSH) in-patient hospitalisation treatment
Wide range of extensive optional coverages such as Super NCB (no claim bonus), any room upgrade and unlimited reload of the sum insured
International and domestic emergency assistance services including air ambulance
The policy offers you to earn HealthReturns worth up to 30% of your premium by earning Activ dayz and staying healthy. Activ dayz can be earned through a plethora of exercising options such as walking, yoga, running and many more
Booster coverage at an additional amount of premium with an additional sum insured for cancer and accidental hospitalisation
Flexibility to choose the policy term – 1/2/3 years
Family and long-tenure discounts on policies ranging from 5% to 10%

Eligible Age

91 days onwards

PED Waiting Period

4 years

Coverage

2 Lakh - 2 Cr

NCB

10% increase in cover;max upto 50%

Activ Health Platinum Enhanced

Starting Premium- ₹ 7,937/yr

Aditya Birla Activ Health Enhanced plan offered by Aditya Birla Health Insurance Company provides enhanced coverage as the name suggests.There are various unique and advanced features offered by the policy that makes insured to have enhanced and comprehensive health coverage.The policy not just gives you financial security but also helps you live a healthier life. It is one of a kind health insurance product loaded with many unique benefits.

USP of Aditya Birla Activ Health Enhanced plan

The policy covers certain chronic illnesses like hypertension, diabetes, high cholesterol and asthma from day one
Policy rewards you to stay healthy and fit in the form of HealthReturns
The policy offers you the flexibility to choose the hospital room category
Worldwide emergency assistance services to keep you safe when you are travelling
Reload of the sum insured for an unrelated illness in case of insufficient funds due to already made claims
Policy charges premium based on the zone
You can earn up to 30% of your annual policy premium as HealthReturns
Cumulative bonus of 20% on each claim-free year
Unique benefits to promote living healthier life such as chronic management program,HealthReturns and wellness coach
Flexibility to choose the policy term – 1/2/3 years

Eligible Age

91 days onwards

PED Waiting Period

4 years

Coverage

2 Lakh - 2 Cr

NCB

50% increase in cover;max upto 100% for 1cr only

View All Plans

Aditya Birla Top-up Plans

Aditya Birla health insurance provides 1 top-up plan. The premium of these top-up plans start from Rs. 1,338/yr. The sum insured ranges from Rs. 3 Lakh - 95 Lakh. Aditya Birla top-up plans provide enhanced coverage and added protection for your well-being. Explore the details of each Aditya Birla top-up insurance policy below:

Aditya Birla Super Health Plus Top-up Plan A And Plan B Super Top-up

Starting Premium- ₹ 1,338/yr

This is a super top-up insurance plan which helps you in increasing existing health insurance coverage at affordable premiums

The salient features of the policy include the following

Under Plan B, after the policy is continuously renewed for 5 years, the policy can be converted to a nil deductible plan wherein the policy would allow full coverage without any deductible
586-daycare treatments are covered by the policy
Home treatment expenses are covered under Plan B
The plan also allows domestic and international emergency assistance services to its customers
You can earn Health Returns and wellness rewards for maintaining a healthy lifestyle

Eligible Age

91 days - 65 years

PED Waiting Period

3 years

Coverage

3 Lakh - 95 Lakh

NCB

Top Features From Aditya Birla Health Plans

In-patient hospitalisation expenses-Expenses incurred for hospitalisation of more than 24 hours is covered. Expenses included are room rent, nursing and boarding expenses, Intensive care unit charges, operation theatre expenses, medical practitioners fees including fees of specialists and anaesthetics treating the insured person, qualified nurse charges, medicines, drugs and other allowable consumables prescribed by the treating medical practitioner, investigative tests, diagnostic procedures, blood, oxygen, anaesthesia, surgical appliances, chemotherapy, radiotherapy, cost of prosthetic devices like pacemaker implanted during surgical procedures etc.
Pre-hospitalisation medical expenses-Expenses incurred for injury or illness immediately before the hospitalisation is covered. The coverage is offered for a predefined number of days which is usually between 30 days to 60 days
Post-hospitalisation medical expenses-Expenses incurred for injury or illness immediately after the hospitalisation is covered. The coverage is offered for a predefined number of days which is usually between 30 days to 180 days
Daycare treatment-Daycare treatments (medically necessary treatment as advised by a medical practitioner) expenses incurred on any illness or injury during the policy period is covered. However, this is applicable for only treatments that are availed as an in-patient or at daycare centres. These are the medical treatments/surgical procedures that would require less than 24 hours of hospitalisation
Domiciliary hospitalisation-The policy provides coverage for medical expenses incurred on domiciliary hospitalisation during the policy period. However, the coverage is provided only if domiciliary hospitalisation continues for at least three consecutive days
Road ambulance cover-The policy covers the cost incurred up to the specified limit on transportation of the insured person by road ambulance to a hospital for treatment in an emergency situation
Organ donor expenses-The policy covers the medical expenses incurred for an organ donor’s treatment for the harvesting of the organ donated as per the Transplantation of Human Organs Act, 1994
Reload of sum insured-In case the basic sum insured is exhausted during the policy period, the policy provides 100% reload of sum insured option for once in the policy period
Cumulative bonus If there are no claims made during the policy year, then the cumulative bonus benefit will be given at the end of the policy year. The benefit can be accumulated over the years
Health check-up program-The policy provides free comprehensive health check-up facility once in a policy year for insured above 18 years of age.11)Second e-opinion on critical illnesses-In case the insured person is diagnosed with any of the critical illnesses listed in the policy, the insured person can seek second e-opinion from the company’s panel of medical practitioners. 12)Wellness coach-To create more awareness of proactive health among insured persons, the policy offers wellness coaching in areas like weight management, nutrition, tobacco cessation and activity and fitness

Exclusions Across Aditya Birla Health Plans

Pre-existing illness waiting period:All pre-existing illnesses are excluded for an initial 48 months. For example, diabetes, hypertension, coronary artery disease etc are not covered during this waiting period
Initial waiting period clause:Treatment expenses incurred for any disease/illness/injury for the initial 30 days from the date of policy inception are excluded.
Specific treatments/illnesses –waiting period-Expenses incurred for specific illnesses/treatments are excluded for a specified waiting period (one to two years). Benign ENT disorders and surgeries and polycystic ovarian diseases are excluded for the first one year from the date of inception of the policy. Surgery of hernia, hydrocele, non-infective arthritis, Undescended testes, cataract, surgery of benign prostatic hypertrophy and hysterectomy etc. are excluded for initial two years from the date of inception of the policy.
Maternity waiting period-Any treatment arising from or traceable to pregnancy, childbirth including caesarean section will not be covered until 24 months of continuous coverage has elapsed for that particular insured person since the inception of the maternity expenses benefit under the policy
War and nuclear perils:Any treatment for illness/injury directly or indirectly caused by or attributable to war, invasion, warlike operations (whether war be declared or not), the act of foreign enemy, civil war, public defence, uprising, rebellion, insurrection, revolution, military or usurped acts or by nuclear weapons and materials
Breach of law:An insured person committing or attempting to commit a breach of law with criminal intent are not covered
Self-inflicted injuries:Suicide, attempt to suicide and intentional self-injury and willful or deliberate exposure to danger are not covered
Military operations and Adventurous activities:Participation in naval, military or air force operations, circus, diving, aviation, scuba diving, racing in wheels or horseback, hang-gliding, mountain climbing, parasailing, bungee jumping, river rafting, skydiving, ballooning, ice sports etc are not covered
Alcohol and/or drug abuse:Any injury caused due to or arising out of alcohol consumption or being under the influence of intoxicating drugs
Cosmetic treatments:Plastic surgery, cosmetic surgery and aesthetic treatments (other than necessitated due to accidents/illnesses), re-shaping treatments and surgeries and any complications arising out of it are not covered
Dental treatments:Any dental treatment/surgery which is cosmetic, corrective or of aesthetic procedure, crowns, filling of cavity, root canal treatment etc are not covered
Non-allopathic treatments: Expenses incurred for non-allopathic treatment of illness/injury are not covered
Unproven and experimental procedures:Any treatment that has no proper base which is still in the experimental and investigational phase are not covered
Vaccination:Vaccination or inoculation of any kind, unless it is posted animal bite and there is hospitalisation as an in-patient
Congenital illnesses:Any expenses related to the treatment of congenital illness, birth defects or anomalies and genetic disorders are not covered
Mental disorders:Any expenses incurred for treating mental illness, stress, psychiatric or psychological disorders are not covered
Stem cell therapy : Stem cell therapy or surgery, or growth hormone therapy are not covered
Sexually transmitted diseases : All expenses incurred on the treatment of venereal diseases and sexually transmitted diseases like HIV/AIDS, LAV are not covered
Pregnancy and childbirth : Expenses incurred for treatments arising from pregnancy, miscarriage, abortion, childbirth, caesarean section and complications arising out of it are not covered. The policy also excludes treatments for fertility, subfertility, infertility and related complications
Developmental problems : Treatments for developmental problems, learning difficulties, for example, dyslexia, behavioural problems including attention deficit hyperactivity disorder are not covered
Non-medical expenses : Non-medical charges incurred during the treatment and hospitalisation are not covered
Overseas treatment : Treatments availed outside India are not covered

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Aditya Birla Customer Care

Customer Care Number

1800 2707 000

Email ID

care.healthinsurance@adityabirlacapital.com

Aditya Birla Claim Process

Aditya Birla supports both cashless claims and reimbursement claims. This section covers the information on how to check Aditya Birla health insurance claim status, fill Aditya Birla health insurance claim form, and the claim settlement process.

In case of medical treatments or emergencies, if you decide to seek treatment in-network hospitals for cashless settlement of claims, the following process is to be followed

Firstly, approach Aditya Birla Health Insurance Company’s network hospital nearest to you. You can locate the nearest network hospital on their website
You can provide your policy details to show your cashless health card (provided by Aditya Birla Health Insurance Company). You may also have to show valid ID proof such as PAN card, passport, voter’s ID etc for the purpose of identification
Post identification, network hospital will submit a cashless hospitalisation request form to the insurance company for availing pre-authorisation. Please note, in case of emergency hospitalisation, cashless hospitalisation request needs to be submitted within 48 hours from the time of hospitalisation. In case of planned hospitalisation, cashless hospitalisation request form needs to be submitted at least three days before hospitalisation
The insurance company will review and convey the decision to the network hospital via SMS or email within 2 hours. You can also track your claim status online
Upon approval and receipt of all the relevant documents from the hospital, claims will be directly settled with the network hospital

In case you seek treatment at non-network hospitals you can get the claim reimbursed. Following is the process to be followed for reimbursement of health claims

Inform the insurance company immediately when you are admitted to the network or non-network hospital. In case of emergency hospitalisation, cashless hospitalisation request needs to be submitted within 48 hours from the time of hospitalisation. In case of planned hospitalisation, cashless hospitalisation request form needs to be submitted at least three days before hospitalisation
Make payment to the hospital as per the process
Collect all the original documents related to a medical condition, treatment and hospitalisation from the hospital at the time of discharge
Submit all the relevant documents received from the hospital along with duly filled and signed claim form to the insurance company within 15 days of discharge from the hospital
The insurance company will review documents and approve your claim or seek further clarifications accordingly
Once the claim is approved, payment of claims will be made to you within the specified time limit

Aditya Birla Health Insurance Renewal Process

Renewal Process of Aditya Birla Health Insurance
To continue enjoying the benefits of your health insurance plan, it is essential to renew your Aditya Birla Insurance policy at regular intervals, depending on your chosen policy term of 1 year, 2 years, or 3 years.Renewing your health insurance policy is crucial to avoid policy lapses and to prevent going through the initial waiting period of 30 days again. Follow these steps for a hassle-free renewal process for Aditya Birla Health Insurance Co. Limited

Read below the process to renew Aditya Birla Health Insurance plan online or offline
Step 1: Visit the official website of Aditya Birla Health Insurance. Click on the ‘Renew’ tab and select ‘Renew Now’
Step 2: Provide information for any two from the following: Policy Number, Date of Birth and Mobile Number. Click ‘Proceed’
Step 3: Pay Health Insurance Premium Online for your Aditya Birla Insurance Policy via any mode of payment of your choice
Step 4: An email will be sent to you confirming the successful payment of premium and policy renewal

If you are not able to renew your policy online then you visit the nearest Aditya Birla Health Insurance branch. You can also contact the company’s customer care executives if you wish to do it via offline mode or reach out to a Turtlemint expert Insurance advisor who can help you with the Aditya Birla Insurance Renewal.
To renew, visit Turtlemint’s home page www.turtlemint.com or download the Turtlemint App here.

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Description	The maximum premium for self, spouse and dependent children	Maximum premium for parents (dependent/non-dependent)	Total deductions available under Section 80D of IT Act
All members of the family < 60 years of age	INR 25,000	INR 25,000	INR 50,000
Self, spouse and children < 60 years ageEither of the parents > 60 years age	INR 25,000	INR 50,000	INR 75,000
Self > 60 years ageSpouse and children < 60 years of ageParents > 60 years age	INR 50,000	INR 50,000	INR 1,00,000

Aditya Birla Health Insurance

About Aditya Birla Health Insurance

Aditya Birla Claim Settlement Ratio