Aditya Birla Health Insurance - 2021 Plans, Benefits, Claim & Renewal

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

Health insurance plans offered by Aditya Birla Health Insurance Company

Aditya Birla Health Insurance Company specializes in designing a diverse range of innovative health insurance plans. The company exclusively crafts health insurance plans for various customer segments keeping in mind each unique need of the customer category.

Following are the types of health insurance plans currently offered by Aditya Birla Health Insurance Company –

Let’s take a look at some of the common coverage offered by health insurance plans along with exclusions applicable under these plans offered by Aditya Birla Health Insurance Company Limited.

Individual health insurance plans
Family floater health insurance plans
Overseas health insurance plans
Group health insurance plans
Critical illness plans
Senior citizen health insurance plans, and others

What are the coverages offered under Aditya Birla health insurance plans?

Following are the coverages offered under Aditya Birla health insurance plans

Coverage benefits, as mentioned	Meaning of the benefits offered
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
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.
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

What are the exclusions applicable under Aditya Birla health insurance plans?

Following are the exclusions applicable under Aditya Birla health insurance plans –

Exclusions, as mentioned in the plans	Meaning of the benefits that are excluded
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.

List of health insurance plans offered by Aditya Birla Health Insurance Company Limited

Name of the Plan	Variant	Type	Individual/ Family Floater	Age at Entry	Sum Insured
Aditya Birla Activ Assure Diamond Plan	NA	Indemnity Health Insurance Plan	Family Floater	5 years	2 lakhs to 2 crore
Aditya Birla Activ Health Platinum Plan	Enhanced	Indemnity Health Insurance Plan	Individual or Family Floater	Adult- 18 years Child- 91 days	2 lakhs to 2 crore
Aditya Birla Activ Health Platinum Plan	Essential	Indemnity Health Insurance Plan	Individual or Family Floater	Adult- 18 years Child- 91 days	50,000 to 10 lakhs
Aditya Birla Activ Health Platinum Plan	Premier	Indemnity Health Insurance Plan	Individual or Family Floater	91 days No maximum age of Entry	INR 10 lakhs to INR 2 crores
Aditya Birla Global Health Secure	NA	Indemnity health plan covering international treatment for listed illnesses	Individual basis only	Adult – 18 years to 65 years Children – 91 days	INR 3 crores to INR 6 crores
Aditya Birla Corona Kavach Plan	NA	COVID specific indemnity health plan	Individual or Family Floater	1 day to 65 years	INR 50,000 to INR 5 lakhs
Aditya Birla Super Health Plus Top-up	Plan A and Plan B	Super top-up plan	Individual or Family Floater	91 days to 65 years	INR 3 lakhs to INR 95 lakhs
Aditya Birla Activ Secure Personal Accident Plan	NA	Personal Accident Plan	Family Floater	5 to 65 years Child- 91 days	Up to 12 X Annual Gross Income Or 30 lakhs for a non-earning member or 15 lakhs for parents/children
Aditya Birla Activ Secure Critical Illness Plan	NA	Critical Illness Plan	Family Floater	Plan I and Plan II- 5 years onwards Plan III- 18 years onwards Child- 91 days	Up to 12 X Annual Gross Income Or 30 lakhs for a non-earning member or 10 lakhs for parents or 15 lakhs for children
Aditya Birla Activ Secure Hospital Cash Plan	NA	Hospital Cash Plan	Family Floater	5 to 65 years Child- 91 days	Daily allowance of 500 to 10,000
Aditya Birla Activ Secure Cancer Secure plan	NA	Cancer Care Plan	Family Floater	Adult- 18 years and above	5 lakhs to 1 crore
Aditya Birla Activ Care Plan	Standard	Senior Citizen Indemnity Health Insurance Plan	Family Floater	Adult- 55 to 80 years	3 to 10 lakhs
Aditya Birla Activ Care Plan	Classic	Senior Citizen Indemnity Health Insurance Plan	Family Floater	Adult- 55 to 80 years	3 to 10 lakhs
Aditya Birla Activ Care Plan	Premier	Senior Citizen Indemnity Health Insurance Plan	Family Floater	Adult- 55 to 80 years	5 to 25 lakhs

Description of plans with additional benefits, eligibility & exclusions:

Now that you know the coverage benefits offered and exclusions applicable under health plans, here are the details of each health plan offered by the company –

● Aditya Birla Activ Assure Diamond plan

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%

Eligibility conditions and other terms Aditya Birla Activ Assure Diamond plan

Entry age	Above 5 years with no restriction on maximum age
Renewability	Lifelong renewable
Entry age for dependent children	91 days
Pre-entrance medical check-ups	Required
Relationships covered	Self, spouse and dependent children
Co-payment	20% co-pay applicable for an insured person aged above 61 years
Pre-existing illnesses waiting period	48 months
Sum insured	INR 2 lakhs to INR 2 Cr

● Aditya Birla Activ Health Platinum Enhanced plan

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

Eligibility conditions and other terms Aditya Birla Activ Health Enhanced plan

Entry age	Above 18 years. There is no restriction on the maximum entry age
Renewability	Lifelong renewable
Entry age for dependent children	91 days
Pre-entrance medical check-ups	Required
Relationships covered	Self, spouse, dependent children, dependent parents, dependent parents in law
Deductible	INR 25,000 to INR 5 lakhs
Pre-existing illnesses waiting period	48 months except for chronic diseases that get day 1 coverage
Sum insured	INR 2 lakh to INR 2 Crores

● Aditya Birla Activ Health Platinum Essential plan

As the name implies Aditya Birla Activ Health Essential plan offered by Aditya Birla Health Insurance Company provides coverage for all the essential medical expenses and treatment. Along with giving protection financially policy also rewards you for working towards your well-being and maintaining good health. The policy comes with a range of customisable features, additional benefits and optional coverages.

USP of Aditya Birla Activ Health Essential plan

The policy offers chronic management program along with offering day one coverage for chronic diseases like hypertension, diabetes, high cholesterol and asthma.
You can earn up to 30% of your policy premium back with the help of HealthReturns benefit offered by staying healthy
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
The policy covers 527-daycare procedures
Cumulative bonus of 10% of sum insured for each claim-free year which can be accumulated up to 100% of sum insured
Flexibility to choose the policy term – 1/2/3 years
Unique benefits to promote living healthier life such as chronic management program, HealthReturns and wellness coach

Eligibility conditions and other terms Aditya Birla Activ Health Essential plan

Entry age	Above 18 years. There is no restriction on the maximum entry age
Renewability	Lifelong renewable
Entry age for dependent children	91 days
Pre-entrance medical check-ups	Required
Relationships covered	Self, spouse, dependent children, dependent parents, dependent parents in law
Deductible	INR 25,000 to INR 2 lakhs
Pre-existing illnesses waiting period	48 months
Sum insured	INR 50,000 to INR 10 lakhs

● Aditya Birla Activ Health Platinum Premiere plan

Another variant of the Aditya Birla Health Platinum plan is the Aditya Birla Activ Health Premier plan, which comes with a long list of unique benefits. While supporting you in your wellness journey, the plan encourages you to lead a healthy life. A one of a kind plan, the Premiere plan covers modern treatments as well as the chronic management program. Available on an individual as well as family floater basis, the plan does not limit the entry age. The Activ Health Premier plan also covers expert Homeopathic, medicinal, nutritional and mental consultation.

USP of Aditya Birla Activ Health Premiere plan

Unique benefits to promote living healthier life such as chronic management program, HealthReturns and wellness coach
A high coverage policy that offers sum insured from INR 10 lakhs to 2 crores
Just like the Aditya Birla Activ Health Enhanced plan, in the Premiere option also you can choose a policy term of 1/2/3 years
Daycare procedures that require less than 24 hours of hospitalisation, such as dialysis, are also covered
Transportation of the insured member to a hospital in an emergency would be covered. As per actuals in a network and up to INR 5,000 in a non-network hospital
The plan offers a reload of the sum insured, endless times during a year, in case the SI is inadequate
The plan offers Hospital Cash benefits for 30 days per policy year, 10 days for each claim
Maternity benefits can be taken as an additional cover. This would cover NewBorn Baby expenses and vaccination expenses, until a specified period
Unlike other plans, Aditya Birla Activ Health Premier plan covers in-patient hospitalisation expenses due to mental illnesses
Covers obesity treatment up to sum insured of the plan
You can earn HealthReturns by being mindful of your health
After detection of a listed major illness, a second e-opinion will be provided
Earn cumulative bonus for every claim-free year
The plan also covered various modern treatment methods such as Uterine Artery Embolization and HFU, Oral Chemotherapy, Robotic surgeries, Stem Cell Therapy etc

Eligibility conditions and other terms Aditya Birla Activ Health Premiere plan

Entry age	Above 18 years. There is no restriction on the maximum entry age
Renewability	Lifelong renewable
Entry age for dependent children	91 days
Relationships covered	Self, spouse, dependent children (up to 3 between age 3 months and 25 years)
Co-Payment	As specified in the policy
Pre-existing illnesses waiting period	As specified in the policy
Sum insured	INR 10 lakh to INR 2 Crores

● Aditya Birla Global Health Secure

This is a specialized indemnity oriented plan which covers international treatments taken for 16 specific illnesses. The salient features of the plan are as follows –

Inpatient coverage for specified illnesses is allowed in international hospitals so that you can get the best treatments
Coverage for organ donor expenses and post-hospitalisation expenses is also available
The expenses incurred on travelling to the international country for treatments as well as on accommodation are covered
There are additional benefits of an international second opinion and Visa document guidance as well under the policy

Eligibility conditions for Aditya Birla Global Health Secure

Entry age	Adults – 18 to 65 years Children –5 years
Renewability	Lifelong renewable
Entry age for dependent children	91 days to 5 years under the multi-individual policy
Pre-entrance medical check-ups	Required
Relationships covered	Self, spouse, dependent children, dependent parents, dependent parents in law, siblings, grandparents, grandchildren, children-in-law, brother or sister-in-law, nephew or niece
Pre-existing illnesses waiting period	24-48 months
Sum insured	INR 3 crores to INR 6 crores

● Aditya Birla Aarogya Sanjeevani Plan

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%

Entry age	18 to 65 years
Renewability	Lifelong renewable
Entry age for dependent children	3 months to 25 years
Pre-entrance medical check-ups	Not Required
Relationships covered	Self, spouse, dependent children, dependent parents, dependent parents in law
Co-payment	5% of all claims
Pre-existing illnesses waiting period	48 months
Sum insured	INR 1 lakh to INR 5 lakhs

● Aditya Birla Corona Kavach Policy

This health insurance policy is a COVID specific health plan which covers hospitalisation due to Coronavirus. The salient features of the plan are as follows –

This is a short term plan which can be taken for a period of 3.5 months, 6.5 months or 9.5 months
Home treatment costs are also covered by the policy
There is a very small waiting period of 15 days after which coverage against COVID is offered
You can buy the policy on an individual or family floater basis for comprehensive coverage
No deductibles are applicable and the full claim incurred on COVID treatments is paid by the plan

Entry age	18 to 65 years
Entry age for dependent children	1 day to 25 years
Pre-entrance medical check-ups	Not Required
Relationships covered	Self, spouse, dependent children, dependent parents, dependent parents in law
Deductible	INR 50,000 to INR 5 lakhs
Pre-existing illnesses waiting period	15 days
Sum insured	INR 50,000 to INR 10 lakhs

● Aditya Birla Super Health Plus Top-up Plan

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

Entry age	5 to 65 years
Entry age for dependent children	91 days to 25 years
Pre-entrance medical check-ups	Depends on age and sum insured selected
Relationships covered	Self, spouse, dependent children, dependent parents, dependent parents in law, siblings, grandparents, grandchildren, children-in-law, brother or sister-in-law, nephew or niece
Deductible limit	INR 1 lakh to INR 15 lakhs
Pre-existing illnesses waiting period	36 months or 48 months depending on the plan variant selected
Sum insured	INR 3 lakhs to INR 95 lakhs

● Aditya Birla Activ Secure Personal Accident plan

Aditya Birla Activ Secure Personal Accident plan offered by Aditya Birla Health Insurance Company is a comprehensive plan that provides complete financial protection for you and your family in the event of an accident. Coverage includes accidental death, permanent total and partial disablement.

USP of Aditya Birla Activ Secure Personal Accident plan

Education and orphan benefit is provided for dependent children
The policy offers emergency assistance services
The policy provides coverage for modification of residence and vehicle
Complete protection against EMI and loan instruments. However, loan protect limit chosen should not exceed 15 times of annual gross income of the insured
The policy offers a cumulative bonus of 5% for every claim-free year which can be accumulated up to a maximum of 50% of sum insured.
Coverage includes emergency road ambulance benefit, funeral expenses, repatriation of mortal remains and compassionate visit benefit.
The policy offers optional coverage such as accidental in-patient hospitalisation, broken bones benefit, coma benefits, burn benefits, adventure sports cover and temporary total disability and worldwide emergency assistance
The policy offers the option to choose a wellness coach and recover faster with personalised health advice.

Eligibility conditions and other terms Aditya Birla Activ Secure Personal Accident plan

Entry age	5 years to 65 years
Renewability	Lifelong renewable except for temporary total disablement coverage benefit which cannot be renewed after 70 years of age
Entry age for dependent children	91 days
Pre-entrance medical check-ups	Not required
Relationships covered	Self, spouse, dependent children, dependent parents, dependent parents-in-law
Co-payment	none
Pre-existing illnesses waiting period	48 months
Sum insured	Proposer’s sum insured – Up to 12 times of annual gross income for an earning member of the family Non-earning member – 100% of proposer’s sum insured or INR 30 lakh whichever is lower Parents and parents-in-law – 100% of proposer’s sum insured or INR 15 lakhs whichever is lower Dependent children – 100% of proposer’s sum insured or INR 15 lakhs whichever is lower

● Aditya Birla Activ Secure Critical Illness plan

Developing a critical illness poses a greater risk and is challenging mentally, physically as well as financially. The best way to avail financial protection against such contingencies is by buying the right critical illness insurance plan. Aditya Birla Activ Secure Critical Illness plan offered by Aditya Birla Health Insurance Company is specially crafted to provide comprehensive coverage by including all the major critical illnesses. With 150% of sum insured payouts, the policy covers up to 64 critical illnesses.

USP of Aditya Birla Activ Secure Critical Illness plan

Flexibility to choose from three plan variants available

Plan 1 – covers 20 critical illnesses such as heart attack, cancer and kidney failure
Plan 2 – Along with 20 critical illnesses covered, it covers a total of 50 critical illnesses such as brain surgery, tuberculosis and benign brain tumour etc.
Plan 3 – covers 64 critical illnesses and procedures like pacemaker insertion, angioplasty and hysterectomy in addition to 50 critical illnesses covered in plan 2

The policy comes with low survival period requirement of 15 days following the first diagnosis of critical illness
Payout of maximum 150% of sum insured for more than one critical illness in our most comprehensive plan
The policy provides an option of a wellness coach that helps you reclaim good health
The policy continues even after paying for an early stage of critical cancer
Comprehensive protection against various critical illnesses. 20 to 64 types of critical illnesses are covered depending on the plan chosen by you.
The policy offers an option to avail second e-opinion on diagnosed critical illnesses

Eligibility conditions and other terms Aditya Birla Activ Secure Critical Illness plan

Entry age	Plan 1 and plan 2 – 5 year onwards Plan 3 – 18 years onwards
Renewability	Lifelong renewable
Entry age for dependent children	91 days
Pre-entrance medical check-ups	Required
Relationships covered	Self, spouse, dependent children, parents, parents-in-law
Co-payment	None
Pre-existing illnesses waiting period	48 months
Sum insured	Proposer’s sum insured – Up to 12 times of annual gross income for an earning member of the family Non-earning member – 50% of proposer’s sum insured or INR 30 lakhs whichever is lower Parents and parents-in-law – 50% of proposer’s sum insured or INR 10 lakhs whichever is lower Dependent children – 50% of proposer’s sum insured or INR 15 lakhs whichever is lower

● Aditya Birla Activ Secure Hospital Cash plan

Aditya Birla Hospital cash plan offered by Aditya Birla Health Insurance Company is designed to provide protection from unexpected expenses during hospitalisation. The policy provides daily cash allowance during hospitalisation ranging from INR 500 to INR 10,000 per day to meet indirect expenses which include travel expenses (to and fro to the hospital), loss of income and attendant expenses etc.

USP of Aditya Birla Activ Secure Hospital Cash plan

Daily cash allowance for each day of hospitalisation irrespective of the hospital bill
Double benefit in case of admission in an ICU
The policy offers flexibility to choose the coverage for the maximum number of days in a policy year
The policy provides convalescence benefit in case of hospitalisation for more than 7 days
The policy offers parental accommodation benefit
The policy provides an option of a wellness coach that helps you reclaim good health

Eligibility conditions and other terms Aditya Birla Activ Secure Hospital Cash plan

Entry age	5 years to 65 years
Renewability	Lifelong renewable
Entry age for dependent children	91 days
Pre-entrance medical check-ups	Not required
Relationships covered	Self, spouse, dependent children, dependent parents and dependent parents-in-law
Co-payment	None
Pre-existing illnesses waiting period	48 months

● Aditya Birla Activ Secure Cancer Secure plan

Cancer Secure plan offered by Aditya Birla Health Insurance Company is specifically designed to protect you financially against various types of and all stages of cancer. The policy provides coverage from minor to advanced stages of cancer. Usually, treatment of cancer can be intensive with various types of medical procedures to undergo such as chemotherapy, radiation and surgery which is not only painful but also very expensive. The policy pays out a lump sum benefit upon diagnosis of cancer irrespective of the stage. Basically, the policy helps you stay positive and focus on treatments without worrying about finances.

USP of Aditya Birla Activ Secure Cancer Secure plan

Comprehensive coverage with payout at different stages of cancer –early, major and advanced stage
The policy pays out a percentage of sum assured according to stages of cancer. 50% of the sum insured is paid at an early stage of cancer. Additional payout of 100% of the sum insured on major and 150% of the sum insured on the advanced stage of cancer in spite of having claimed for an early stage.
The policy comes with low survival period requirement of seven days from the date of diagnosis
The policy provides an option to choose a wellness coach and recover faster with personalised health advice.
Cumulative bonus of 10% per claim free year is offered which can be accumulated up to a maximum of 100% of sum insured
Wide range of coverage at an affordable rate of premium
The policy offers an option to avail second e-opinion from insurance company’s panel of doctors.
The policy offers flexibility to choose policy tenure – 1 year/2 years/3 years

Eligibility conditions and other terms Aditya Birla Activ Secure Cancer Secure plan

Entry age	18 years and above. There is no restriction on the maximum entry age
Renewability	Lifelong renewable
Entry age for dependent children	Dependent children below 18 years are not covered
Pre-entrance medical check-ups	Not required
Relationships covered	Self, spouse, dependent children, dependent parents and dependent parents-in-law
Co-payment	No
Pre-existing illnesses waiting period	Not applicable
Sum insured	INR 5 lakhs to INR 1 Cr

● Aditya Birla Active Care Health Insurance Plan

Aditya Birla Active Care plan offered by Aditya Birla Health Insurance Company provides comprehensive coverage for senior citizens. With various plan options, coverage benefits and tailored features, the policy aims to provide enhanced protection in the golden years of your parents.

USP of Aditya Birla Active Care Health Insurance Plan

The policy comes in three plan variants to suit different needs – Standard, Classic and Premier
There are 586-daycare procedures covered in the policy
50% to 100% reload of the sum insured in the policy year depending on the plan chosen
International and domestic emergency assistance services including air ambulance
The policy allows you to earn HealthReturnsTM up to 21% of the premium by earning Active Dayz and staying healthy
Second e-opinion on major illnesses
Health coaching session on better lifestyle management
Health and wellness discounts along with a range of comprehensive optional care benefits like lifestyle support equipment, nursing at home and advance health check-up
Flexibility to choose the policy tenure – 1 year or 2 years
Plan can be availed as individual and family floater plan covering self and spouse

Eligibility conditions and other terms Aditya Birla Activ Care Health Insurance Plan

Entry age	Above 55 years
Renewability	Lifelong renewable
Pre-entrance medical check-ups	Required
Relationships covered	Self, spouse
Co-payment	15% of co-payment applicable
Pre-existing illnesses waiting period	48 months
Sum insured	Standard plan – up to INR. 10 lakhs Classic plan – up to INR. 10 lakhs Premier plan – up to INR. 25 lakhs

How to apply for Aditya Birla Health Insurance Company’s insurance plans?

Various health insurance plans offered by Aditya Birla Health Insurance Company can be purchased through Turtlemint by following below simple steps.

Go to Turtlemint and choose health insurance among the category of insurance plans displayed on home page
Share your profile details for health insurance plans. You need to provide details such as name, age, contacts, location, health details, coverage requirement etc.
Compare the various health insurance plans and then choose the most suitable plan as per your insurance need
Click on ‘’buy now’’ button and proceed to buy
Provide necessary details as per KYC and your coverage requirements.
Make the payment online. That completes the buying process!

As soon as you make the payment, the policy will be issued instantly. You would also receive a digital copy of your policy on your registered email ID. A hard copy of the policy document would be mailed to your registered residential address.

How to make claims for the Aditya Birla Health Insurance Plans?

With 24/7 customer support system, strong digital presence for claim intimation, registering a claim with Aditya Birla Health Insurance Company has become simple, easy and convenient process. Cashless claim facility makes the claim process even more convenient with widespread network hospitals.

Turtlemint can help you with claim settlements, you can contact Turtlemint by calling on 1800-266-0101 or write to claims@turtlemint.com and our claims executive will get in touch with you.

Let’s take a look at the claim process involved in health insurance plans that you would want to buy from Aditya Birla Health Insurance Company.

How to apply for Health insurance claims?

Health insurance claims can be raised in two ways with Aditya Birla Health Insurance Company. Either you can opt for cashless settlement of claims or reimbursement of claims.

How to apply for cashless health insurance claim 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.

How to apply for reimbursement health insurance claim process?

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.

What are the list of documents required for health insurance claims in Aditya Birla Health Insurance Company?

The requirement of documents may vary depending on the nature of the claim. However, here are some of the common documents required for health insurance claims –

Health card/ insurance policy copy
Duly filled and signed claim form
Photo ID proof
Medical treatment report
Discharge card/daycare summary/death summary
Original Diagnostic test reports (ECG/Scan/X-ray, imaging, Lab test reports etc) along with prescription and bills
Medical recovery report
Details of medical expenses, original bills with break-ups, final payment receipts and original deposit receipt
All the consultation papers along with details of ailment and treatment details
Police FIR copy/Medico-legal certificates for accident cases
Pre and post-operative imaging reports in accidental cases
Pharmacy and medical bills along with a prescription
For reimbursement cases, provide bank details along with cheque as a proof

For any other queries, you can contact Turtlemint support team on 1800-266-0101 or you can contact Aditya Birla Health Insurance Company’s customer care at 1800-270-7000 or you can write to them on care.healthinsurance@adityabirlacapital.com

FAQ’s

What does domiciliary hospitalisation mean? What are the exclusions applicable under this coverage?

Domiciliary hospitalisation treatment refers to treatment taken at home which would otherwise have required hospitalisation. This could be due to patients conditions to unable to move to a hospital or due to unavailability of beds in hospitals.

Following are the treatments/illnesses that are excluded under domiciliary hospitalisation cover –

Asthma
Bronchitis
Diarrhoea and all types of dysenteries including gastroenteritis
Chronic Nephritis and Chronic Nephritic syndrome
Pyrexia of unknown origin for less than 10 days
Diabetes mellitus and Insipidus
Epilepsy
Hypertension
Influenza, cough and cold
Tonsillitis, Upper respiratory tract infection including laryngitis and Pharyngitis
Arthritis, Gout and Rheumatism
All psychiatric and psychosomatic disorders

Which are the critical illnesses covered under Aditya Birla Activ Health insurance plans?

Following are the major 11 critical illnesses covered under the Activ Health plan –

Cancer of specified severity
Myocardial infarction (first heart attack of specified severity)
Open chest CABG
Coma of specified severity
Open heart replacement or repair of heart valves
Kidney failure requiring regular dialysis
Stroke resulting in permanent symptoms
Major organ/bone marrow transplant
Permanent paralysis of limbs
Motor neurone disease with permanent symptoms
Multiple sclerosis with persisting symptoms

What are the tax benefits offered by Aditya Birla health insurance plans?

Health insurance plans not only give comprehensive protection but also benefit you by saving a few amounts of tax. You can avail tax deduction on premiums paid towards health insurance plans taken for self, spouse, children and parents. Here are the details –

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 age Either of the parents > 60 years age	INR 25,000	INR 50,000	INR 75,000
Self > 60 years age Spouse and children < 60 years of age Parents > 60 years age	INR 50,000	INR 50,000	INR 1,00,000

What are the wellness programs offered by Aditya Birla Health Insurance Company?

Aditya Birla Health Insurance Company helps you focus on well-being and health management along with protection offered in the way of a diverse range of health insurance plans. Below are the wellness programs offered by the company –

Activ together – you can subscribe to get valuable input on health & fitness, diet & nutrition and lifestyle conditions
Activ age – you can know your active age health-wise by filling in just a simple questionnaire. This would help you improve and maintain your good health
Healthy heart score – you can calculate heart score on their website. Aditya Birla Health Insurance policies reward you for maintaining a good score!
Activ Dayz – you can keep updating about your activities that promote good health and earn rewards.
HealthReturns – It is a monetary reward offered by Aditya Birla Health Insurance Company for staying fit and maintaining good health for each insured person.

What are the health services offered by Aditya Birla Health Insurance Company?

Following are the major health services offered by Aditya Birla Health Insurance Company –

Chronic care management program – This service comes as an in-built feature with Activ Health Platinum cover. In case an insured or his family members are suffering from chronic diseases like diabetes, blood pressure and cholesterol, the program helps them manage well to live a healthy life through experts help. Along with this, there is coverage offered for consultation with medical practitioners, diagnostic tests and medicines.
Wellness coaching –Under this service, insured is given personal coaching to maintain good health. Insured can seek coaching by various options like ask specialist, ask a doctor, ask a dietitian, doctor on call, a counsellor on call and smoke cessation.

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