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Aditya Birla Group Activ Corporate Health Insurance

Aditya Birla Group Activ Corporate Health Insurance is a comprehensive insurance program that safeguards the health and happiness of the employees in an organization. 

After having this policy, the owner of a company can give his/her employees the financial security they deserve by providing them with a fully customizable plan that guards them against unforeseen medical costs. Keep reading to know about the plan in detail!

Key Highlights Of Aditya Birla Group Activ Corporate Health Insurance

One should purchase this plan as it consists of the following features and benefits:

  • No Medical Underwriting: The plan has a simple documentation process with no medical underwriting for hassle-free policy issuance.
  • Day 1 Cover: The plan covers an organization’s employees from day 1, even with their pre-existing diseases. The plan offers coverage for chronic diseases, including high blood pressure, asthma, and so on.
  • Worldwide Critical Illness Cover: The plan also offers coverage for life-threatening diseases including cancer, cardiovascular disorders, etc. that require hospitalization and daycare therapy outside of India.
  • Second E-Opinion (Optional): The plan also gives an optional feature of a second opinion from the company’s team of highly qualified medical professionals, including international experts. One can get a professional opinion before deciding whether to proceed with major surgery or treatment for a covered serious illness.
  • Health Returns: Under the plan, the employees and employers can get health returns of up to 30% of the annual insurance premium, which they can use to pay for medications, lab work, unexpected expenses, and the following year’s premium.
  • Customized Covers: The plan can be modified specifically for a business and is fully adjustable in terms of features, restrictions, and waivers.
  • Fitness Assessment: The plan also covers a physical fitness exam that tests every insured employee’s strength, BMI, flexibility, cardiovascular endurance, and so on.
  • Health Assessment: This feature of the plan allows a company to assess the health parameters of its employees, such as cholesterol, blood glucose, blood pressure, etc.
  • Health Check-Up Program: The plan offers free health check-ups so that the company can easily track its employees’ fitness and motivate them to lead healthy lifestyle.

Coverage Details Of Aditya Birla Group Activ Corporate Health Insurance

The following aspects are covered under the plan:

CoverageStatus
AYUSH TreatmentCovered
In-Patient HospitalizationCovered
Domiciliary HospitalizationCovered
Road AmbulanceCovered
Accidental HospitalizationCovered
Pre-Hospitalization ExpensesCovered
Hospital Cash BenefitCovered
OPD ExpensesCovered
Psychiatric In-Patient CareCovered
Organ Donor ExpensesCovered
HIV CoverCovered
Infertility TreatmentCovered
Sports Activity CoverCovered (When an insured person is injured during the policy period while participating in a professional sport that is conducted in accordance with the rules, codes of conduct, and recommendations for safe practices established by a governing body or authority, and when such an injury necessitates the insured person to be hospitalized as an ICU patient, the plan will cover the Reasonable and Customary Charges incurred towards the hospitalization of the insured person.)
Wellmother CoverCovered (The company will pay the room rent and other boarding costs for the insured person’s mother to be with the insured person in the same hospital if the insured person is under the age of three and is hospitalized in an ICU, Neo-Natal ICU, or Cardiac Care Unit.)

Key Exclusions Of Aditya Birla Group Activ Corporate Health Insurance

The following expenses are not covered by the policy:

  • Treatment occurring due to war, invasion, and so on
  • Breach of law
  • Intentional self-injury
  • Alcohol or drug abuse
  • Weight management program
  • Refractive error
  • Cosmetic surgeries
  • Unproven or experimental treatments
  • Psychiatric or psychological disorders

For more details on exclusions under the plan, please refer to the policy brochure.

How To Purchase Aditya Birla Group Activ Corporate Health Insurance?

Since the plan cannot specifically be purchased online, Probus Insurance is the only place to do so. The company has gained certification and IRDAI approval and has been in operation for many years with the intention of continually offering its consumers superior insurance solutions.

To purchase the Aditya Birla Group Activ Corporate Health Insurance plan directly from Probus Insurance, go to the business’s website. Select the “We Are Here” chatbot that is now visible on the right side of the page. After providing your name, email, phone number, department, etc., you can ‘live chat’ with any of the company’s customer care agents. Throughout the process of purchasing the plan, he or she will help you.

Alternatively, you can contact the company’s customer care division by utilizing any of the following channels:

  • Call: 7304332968
  • WhatsApp: 7304332968
  • Mail: care@probusinsurance.com

Claim Process Aditya Birla Group Activ Corporate Health Insurance

Under the scheme, there are two different methods of claim settlement available. Below is a discussion of them:

CASHLESS CLAIM:

  1. Finding a cashless network hospital is the first step in the cashless claim process. A cashless claim settlement service is provided by the firm at more than 10051 network hospitals. The company’s website offers a hospital network finder online.
  1. The second step is to visit the hospital and present your Aditya Birla Health Insurance Policy Cashless Card or your policy number for verification. You must also present legitimate ID proof, such as a passport, PAN card, or any similar document.
  1. Request a pre-authorization request form by going to the insurance department of the chosen hospital. Fill it out, give it to the hospital, and the insurance provider will receive it. For scheduled hospitalization, the form must be submitted at least three days before admission; however, for emergency hospitalization, the form must be submitted no later than 48 hours after admission.
  1. Once all required paperwork has been filed and the claim has been examined by the company, the business will handle the claim with the hospital in accordance with the terms and conditions of the policy.

REIMBURSEMENT CLAIM:

  1. Firstly, let the business know that you will be hospitalized. Within 48 hours of being admitted to the hospital for an emergency, notify the company. Additionally, give the business three days’ notice if you plan to go to the hospital.
  1. After being admitted to the hospital, pay all invoices immediately to the facility and maintain track of them.
  1. Within 15 days of discharge, send these records and any required paperwork to the insurance company’s local branch office.
  1. The firm will send the spent money to the insured’s registered bank account after receiving and verifying all of the supporting documentation and approving the claim process.

Renewal Process Of Aditya Birla Group Activ Corporate Health Insurance

Follow the procedures listed below to renew the plan:

  1. Go to the company’s official website.
  1. On the right side of the website, select the “Renew” tab.
  1. Next, input your policy number (in the case of a group policy renewal, use the COI number) and click “Submit”.
  1. Continue with the online payment, and once the renewal procedure has been successfully finished, a confirmation message will be sent to the registered mobile phone you provided.

Frequently Asked Questions

The critical illnesses covered under the benefit are as follows:

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

Yes. The feature comes with the following conditions:

  • Hospitalization of the insured person should occur in India.
  • The hospitalization is for medically necessary treatment and is in accordance with a medical practitioner’s written recommendation.
  • Within seven days of the accident, the insured person is admitted to the hospital.

No. The plan does not provide coverage for the treatment of complete apnoea. For detailed information about the exclusion list of the Aditya Birla Group Activ Corporate Health Insurance plan, refer to the policy’s brochure.

You should keep the following details ready while requesting a pre-authorization form:

  • The insured’s health card along with KYC documents.
  • Name and address of insured person/employee/member in respect of whom the request is being made
  • The policy number
  • Name of the policyholder/employer
  • Nature of the illness/injury and the treatment/surgery required
  • Proposed date of admission
  • Name and address of the attending medical practitioner
  • Hospital where treatment/surgery is proposed to be taken

Some of the key documents that one should require for claim settlement of the policy are as follows:

  • Identity proof
  • Age proof
  • Address proof
  • Passport-sized photograph
  • Duly filled and signed proposal form
  • Medical reports
  • Hospital bills and discharge summary
  • FIR (in case of accidental injury)

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