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Individual Health Insurance Plans
Aditya Birla Health Insurance
Founded in 2015, Aditya Birla Health Insurance Company Limited (ABHICL) is a joint project between India’s Aditya Birla Group and South Africa’s MMI Holdings. The company is regulated by IRDAI and has a partnership with a plethora of health care providers, such as diagnostic centres, hospitals, doctors, etc.
In addition to chronic care and incentivized wellness, the company’s current portfolio includes some unique solutions for its customers. Being one of India’s major insurance companies, ABHICL also has its feet in corporate lending, housing finance, project finance, asset management, and personal finance management.
| Head Office | Mumbai |
| Vision | “To be a leader and role model in a broad-based and integrated financial services business.” |
| Network Hospitals | 8200+ |
| Policies Sold | 1,86,244+ |
| Solvency Ratio | 1.99 |
| Recent Awards & Achievements | The Fiscal Year 2019-20
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Aditya Birla Health Insurance Plans
1. Activ Health Platinum – Enhanced Plan
Activ Health Platinum – Enhanced plan is a perfect amalgamation of health insurance, wellness benefits, and chronic care. It is one of a kind plan with features including 100% health returns, chronic management programs, and modern treatment methods. In addition, the plan also provides coverage for hospitalization costs arising out of COVID-19 disease.
Key Features:
- Double Sum Insured: You can earn a 50% NCB (No Claim Bonus) for every claim-free year. The maximum amount of the sum insured is 100% under the plan.
- Coverage For Mental Illnesses: Pre- and post-hospitalization expenses for mental diseases are covered under the plan.
- Coverage For Dental Consultations & Investigations: The plan also covers charges arising out of designated dental services on a cashless basis.
Eligibility:
| Premium | Starting At Rs. 7,722 Per Annum |
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2. Activ Health Platinum – Essential Plan
Activ Health Platinum – Essential plan is a comprehensive plan that extends beyond hospitalization coverage. It provides you protection against various chronic illnesses, such as high blood pressure, diabetes, high cholesterol, asthma, etc.
The plan is specifically tailored to candidates having a middle-class income. Various sum insured options are available to the users, thus one can choose a suitable plan based on their budget. In addition to reimbursement and cashback benefits, the plan also provides myriad value-added benefits, such as wellness coaching, health returns, and much more.
Key Features:
- Pre- & Post-Hospitalization Coverage: The plan provides coverage for expenses arising out 30 days of pre-hospitalization and 60 days of post-hospitalization.
- Covers Day Care Treatments: 586 day-care procedures which do not require 24 hours of hospitalization are covered under the policy.
- Expert’s Guidance: The plan provides access to an expert health coach for providing guidance on fitness, nutrition, and mental health.
Eligibility:
| Premium | Starting At Rs. 6,780 Per Annum |
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| Sum Insured | Up To Rs. 10 Lakhs |
3. Activ Assure – Diamond Plan
Activ Assure – Diamond is a cost-effective health insurance plan that provides 360-degree protection to both individuals and family members. In addition to hospitalization coverage, the plan also includes 586 day-care treatments and cashless claims at over 7000 network hospitals. One can either buy an annual policy or a 3-year plan as per their requirements.
Key Features:
- Health Returns: The plan offers up to 30% of the premium as health returns. The policyholder can use this amount for renewing premiums, diagnostic tests, and medicines.
- Annual Health Check-Up: The plan provides annual health check-ups for individuals as well as their family members in every policy year, that too, without any additional cost.
- Reload Sum Insured: For any unrelated and subsequent disease, the plan reloads the sum insured of the policyholder by another 150 percent.
Eligibility:
| Premium | Starting At Rs. 6,371 Per Annum |
| Eligibility | Minimum Age: 91 Days Maximum Age: 65 Years |
| Waiting Period | Initial Waiting Period: 30 Days For Pre-Existing Illness: 36 Months For Specified Procedure OR Illness: 24 Months |
| Sum Insured | Up To Rs. 2 Crores |
4. Activ Care - Plan for Parents
Activ Care – Plan for Parents is a comprehensive health insurance plan that provides 360-degree protection to your parents or people who are above 55 years of age. One can choose from three variants of the plan: Standard, Classic, and Premier. No matter whether your parents are healthy, hospitalized, or recovering, the plan provides much-needed assistance in times of medical exigencies.
Key Features:
- AYUSH Coverage: The plan offers coverage for more than 24 hours of hospitalization due to Yoga, Ayurveda, Unani, Naturopathy, Homoeopathy, and Siddha treatments and procedures.
- Cashless Home Treatment: The plan provides cashless home treatment for various illnesses, such as hepatitis, dengue, chemotherapy, etc.
- Personal Health Coach: In order to make the lifestyle of your parents better than before, the plan also offers nutritional, medical, and wellness sessions.
Eligibility:
| Premium | Starting At 28,373 Per Annum |
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| No Claim Bonus | 10% To 50% |
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5. Activ Secure - Critical Illness Plan
Active Secure – Critical Illness plan provides multi-faceted protection to your future against a critical illness. It is a comprehensive plan meticulously designed to compensate you for lost wages and treatment costs if you are diagnosed with any one of the listed serious illnesses. The plan comes in three variants: Plan 1, Plan 2, and Plan 3.
Key Features:
- 15 Days Survival Period: Under the Activ Secure–Critical Illness plan, you get a short 15-day survival period after the initial diagnosis of any of the designated critical illnesses.
- Maximum Payout: If you’re diagnosed with more than one critical disease, you might get a payout of up to 150 percent of your sum insured.
- Optional Covers: The plan offers optional covers of ‘second e-opinion’ and wellness coach. It can provide an e-opinion on major surgery or a course of therapy for any of the listed critical illnesses. One can also choose a wellness coach and get personalized health advice to help recover faster.
Eligibility:
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6. Activ Secure - Personal Accident Plan
Activ Secure – Personal Accident plan is specifically designed to protect you against accidental death, permanent partial disability, or permanent total disability.
It safeguards your as well as your family’s well-being by providing financial protection against life’s unexpected events. In addition to standard benefits, the plan also offers a variety of supplementary benefits through which you can enhance your coverage.
Key Features:
- Coverage For Accidental Death: In case of accidental death, the plan offers you 100 percent of the sum insured as accidental death cover.
- Emergency Ambulance Cover: In the event of an unfortunate accident, the plan offers you emergency road ambulance coverage.
- No Claim Bonus: For every claim-free year, the plan provides 5% as a bonus cover to the policyholder.
Eligibility:
| Premium | Starting At Rs. 212 Per Annum |
| Eligibility | Minimum Age: 5 Years Maximum Age: 65 Years |
| Emergency Ambulance Cover | Up To Rs. 1000/- |
| Cumulative Bonus | 5% to 50% Of The Sum Insured (Per Annum) |
7. Activ Secure - Hospital Cash Plan
The Activ Secure Hospital Financial plan is meticulously designed to provide daily cash benefits while you are in the hospital. It alleviates any kind of financial stress that you may experience during your hospitalization. The plan covers a variety of expenses such as convalescence, meals, and travel.
Key Features:
- ICU benefit: In case you are admitted to a hospital or ICU due to a road accident, the plan doubles your daily cash allowance.
- Wellness Coach: In order to get more personalized advice on nutrition, health, and fitness, the plan allows you to connect with a top wellness coach.
- Use Your Daily Cash Allowance Without Restrictions: The policyholder can use his/her daily cash allowance for travel expenses, EMIs, household, or even as an income replacement.
Eligibility:
| Eligibility | Minimum Age: 55 Years Maximum Age: 80 Years |
| Daily Cash Allowance Benefit | Between Rs. 500 To Rs. 10,000 For Up To 24 Hours |
| Convalescence Benefit | Pertinent To Hospitalization For More Than 7 Days |
| Tax Benefit | Up to Rs. 25,000 For Senior Citizens: Up To Rs. 50,000 |
8. Activ Secure - Cancer Secure Plan
The treatment costs of cancer are skyrocketing day by day. In order to provide financial protection to cancer patients at every stage of it, Activ Secure – Cancer Secure plan pays lumpsum payouts. It helps the cancer patients to easily tackle the cost of surgeries, radiation, and chemotherapy, which would otherwise break their banks.
Key Features:
- No Claim Bonus: For every claim-free year, you will get a 10% as bonus cover under the plan.
- 7-Days Survival Period: The plan offers a short survival period of just 7 days after you are diagnosed with cancer.
- Extra Payout: If you are diagnosed with major or advanced-stage cancer, you will get an additional payout of up to 100%. This is applicable even if you have had 50% for your early-stage cancer.
Eligibility:
| Premium | Starting At Rs. 428 Per Annum |
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| Sum Insured | Up To Rs. 1 Crore |
Global Health Insurance is specifically designed to provide access to global healthcare solutions so that you can feel safe no matter where you are. The plan covers 16 major illnesses and also provides cashless treatment at the global network of hospitals.
Key Features:
- Total International Health Cover: The plan provides entire foreign health coverage for all in-patient expenditures such as room rent, doctor’s fees, operating room expenses, prescription expenses, and so on.
- International Second E-Opinion: An international second e-opinion is available if the policyholder is diagnosed with any of the 16 major illnesses specified.
- Additional Benefits: Other advantages, such as travel, lodging, and organ donation, are also available to the policyholder.
Eligibility:
| Eligibility | Minimum Age: 91 Days To 5 Years Maximum Age: 65 Years |
| Number Of Illnesses Covered | 16 |
| Renewal Age | No Bar |
The Group Activ Health Insurance is a comprehensive corporate plan whose primary aim is to safeguard the employees’ health and wellbeing. By providing them protection against financial hardships arising out of unexpected medical bills, the plan offers peace of mind to the employees.
Key Features:
- No Medical Underwriting: There is no need for medical underwriting under the plan.
- Customized Coverage: You can customize the plan as per your business needs. Various options in features, waivers, and limits are available under the policy.
- AYUSH Treatment: The plan also provides coverage for Yoga, Homeopathy, Ayurveda, Unani, Naturopathy, and Siddha treatments, which require hospitalization of more than 24 hours.
Eligibility:
| Network Hospitals | 5900+ |
| Health Returns | 30% Of Annual Insurance Premium |
| Recovery Benefit | Rs. 10,000 Once In A Policy Year |
| Reload Of Sum Insured | 10%, 50%, and 100% Of Sum Insured |
Why Should You Buy Health Plans From Aditya Birla?
With so many health insurance companies to choose from, finding the right health insurance plan can be a challenging task. Here are a few reasons why you should choose plans from Aditya Birla Health Insurance:
8200+ Network Hospitals:
To deal with medical exigencies, it is always best to choose a firm that has a large network of hospitals in your area. Aditya Birla Health Insurance has a network of 8200+ hospitals where you can use the cashless service.
Higher Claim Settlement Ratio:
The claim settlement ratio (CSR) is the percentage of total claims that an insurance company settles in a year. It serves as a measure of their reliability. Therefore, before you purchase a health plan, always check how well the company handles its claims.
Options Of Multiple Sum Insured:
The company offers you a variety of sum-insured options. You can purchase insurance as high as Rs. 2 crores and as low as Rs. 2 lakhs. Thus, the company allows you to choose a plan that fits your budget as well as your needs and requirements.
Healthy Solvency Ratio:
When choosing an insurance firm, it’s also vital to consider the solvency ratio. A solvency ratio is a crucial metric used by prospective business lenders to assess an organization’s potential to serve long-term debt obligations. A solvency ratio is a financial health indicator that analyses if a company’s cash flow is sufficient to satisfy its long-term liabilities.
Wellness Coaching:
What makes Aditya Birla Health Insurance plans different from others is that it provides wellness coaching to its clients. On-the-go access to health sector specialists is available to insured members. These medical experts can answer their questions whenever it is convenient for them.
Second E-Opinion:
The company also provides coverage for the second e-opinion in case of designated critical illnesses.
Health Returns:
For people who follow a healthy lifestyle, the company offers reward points. You can receive a refund of up to 30% of your medical insurance premium.
Remarkable Presence:
Aditya Birla Health Insurance has established a Pan-India Presence with a presence in over 2500 cities. For any questions, one can just go to their nearest branch office.
Takes Care Of Your Chronic Illnesses:
For the people suffering from chronic illnesses like asthma, diabetes, and hypertension, Aditya Birla Health Insurance has a Chronic Management Program, which offers Day 1 coverage in case of chronic health conditions. If you develop a chronic condition during the policy term, you will be automatically upgraded to the Chronic Management Program.
How To Calculate Aditya Birla Health Insurance Premium?
To calculate premiums for Aditya Birla Health Insurance plans, you need to consider the following factors:
Gender:
Women typically pay greater medical insurance premiums than males because of two major reasons:
- Women are more likely than men to visit the doctor particularly between the ages of 15 and 44.
- Women are also more likely to be diagnosed with chronic disorders; over 20% of women of reproductive age have excessive menstrual bleeding, and 15% have persistent pelvic pain.
Age:
When comparing men and women of reproductive age, women of childbearing age pay a greater premium. From the age of 60 onwards, however, it is lower for females than for males.
Medical History:
Your premium will be greater if you have a history of illness or if you have a pre-existing illness. However, if you have never been sick and have lived a pretty healthy life, your premium will be lower.
Amount Of Sum Insured:
The amount of coverage you choose has a direct impact on your premiums. It’s crucial to keep in mind that the bigger the sum covered, the more the premium you’ll have to pay.
Type Of Plan:
The amount of money you spend on premiums varies based on the type of health insurance you purchase. Your premium will also rise if you have purchased add-on covers. When compared to individual coverage, a group health insurance policy has a lower premium.
Policy Term:
The length of time your policy has been in effect is also crucial. The premium will be lower if you buy a policy with a longer-term. For insurance with a shorter term, this may not be the case.
BMI (Body Mass Index):
People with a high BMI are more likely to develop ailments such as diabetes and heart disease, necessitating constant medical attention. Therefore, people with a higher BMI are typically charged a higher premium than those with a normal BMI.
Type Of Occupation:
The premium charges are also influenced by the nature of your profession and the level of risk you face at work. If you work in a school, your premium will be lower; but, if you work in an environment with a high risk of injury, such as you are a pilot or you work in a factory, then your premium would be higher.
Area Of Residence:
The cost of your policy premium is also determined by where you stay. There are some areas where premium rates are higher than other areas due to a lack of good food options, the climate, and various health issues.
Lifestyle:
People who smoke, chew tobacco, or snuff are more susceptible to life-threatening diseases such as cancer. As a result, premium rates are higher for such individuals. However, if you do not have any such habit, your premium rates will be relatively lower.
How Can You Buy Aditya Birla Health Plans?
ONLINE METHOD:
- Go to the insurance page of Aditya Birla Health Insurance home page.
- Enter your details, such as your name, date of birth, etc. at the top-right of the page.
- Select the plan as per your need or requirement.
- Now select your policy term, sum insured, etc. to determine your premium.
- Provide your personal details and then make the payment.
OFFLINE METHOD:
- Call or visit the company’s branch.
- The company’s customer representative will guide you in selecting an appropriate plan.
- Provide all necessary details to the company, such as your name, date of birth, etc.
- Select the plan as per your requirement.
- Choose the policy term, sum insured option, and the company will let you know about your premium amount.
- Pay for the premium and it’s all done.
CASHLESS CLAIM:
- Check The List Of Hospitals: Before admitting the insured person, check the list of the network hospitals of Aditya Birla and choose one.
- Show The Cashless Card: Now, show the cashless card and valid ID proofs of the insured person to the network hospital.
- Sending Request: Once your identification is done, the network hospitals will send cashless hospitalization requests to Aditya Birla Health Insurance Private Ltd.
- Reviewing The Form: The company then will review the form and you will be informed about the decision either through mail or SMS.
- Payment: Once the company gives a green signal to your request, it will pay the treatment cost to the network hospital.
REIMBURSEMENT CLAIM:
- Inform The Company: The policyholder should inform Aditya Birla within 15 days after the insured person is discharged from the hospital.
- Submitting The Documents: Following documents must be submitted by the policyholder:
- Claim form
- Original discharge summary
- KYC documents
- Health card
- Consultation papers
- Hospital bills
- Reviewing Of Documents: Aditya Birla will then analyze and review the documents in order to make an appropriate decision.
- Settling The Claim: The company will then reimburse the amount to the registered bank account.
- Visit the official website of the company.
- Click on the ‘Renew’ option at the top right.
- Fill up all necessary details, such as policy number, mobile number, etc.
- Click on the “Abhi Karo” option.
- Pay the premium amount online and the details of your policy renewal will be sent to you either through mail or SMS.
Frequently Asked Questions
Aditya Birla Health Insurance settles claims within 7 working days of receiving required documentation, but not more than 30 days.
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