Aditya Birla Health Insurance 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

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

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

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

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