Aditya Birla Health Insurance

Aditya Birla Health Insurance Company Limited (ABHICL) is a subsidiary of Aditya Birla Capital Ltd, which is the financial services platform of the Aditya Birla Group. Incorporated in 2015, ABHICL is a joint venture between Aditya Birla Group and MMI Holdings of South Africa. Engaged in the health insurance business since October 2016, the company also has a strong presence across asset management, corporate lending, life insurance, structured finance, general insurance broking, wealth management, equity, private equity, project finance, housing finance, online personal finance management, and even more services. With over 17,000 employees and over 2 lakh agents and channel partners, the company shows a nationwide presence.

Aditya Birla Health Insurance offers a wide variety of health insurance plans that offer you and your family full medical expense coverage in case of any illness, sickness, disease or accident. You can enjoy various health services under Aditya Birla Health Insurance such as cashless treatment, cover for ambulance charges, AYUSH treatments, pre-hospitalisation and post-hospitalisation expenses, intensive care, and wellness programs to help you keep a track of your health. One of the most attractive features offered under Aditya Birla Health Insurance plans is wellness and rewards. These help you keep a track of your health and push you towards a better health in order to achieve targets and hence get further benefits.

Calculating the premium amount for different health insurance plans offered by Aditya Birla Health Insurance is not a cumbersome task. You can calculate them online using the premium calculator available on InsuranceDekho. Health insurance premium calculation helps you to get an estimate of the premium you will be required to pay for the selected plan and hence you are able to plan finances accordingly. Health insurance premiums for Aditya Birla Health Insurance plans depend on the following factors:

• Age: One of the most important factors that affect the premium of a health insurance plan is your age. Youngsters are less prone to health issues as compared to older people. This increases the chances of older people making more claims under their policies and hence they are required to pay higher premiums.
• Policy Term: Different health insurance plans are available with different policy terms and your premium varies accordingly. For instance, if you buy a health insurance policy for a period of 1 year, then your premium will comparatively be lesser than if you buy it for a period of 3 years.
• Sum Insured: High sum insured means greater coverage, and hence higher premiums. So, choose the sum insured as per your requirement after considering the coverage features offered under your health insurance plan. But don’t compromise on it to save premiums. Having enough sum insured saves you in the actual time of need.
• Members Included: Family size impacts your health insurance premiums. Some health insurance plans allow you to add up to 19 relationships. But accordingly, charge premiums too. So, as you increase the number of members under your policy, higher your premium will be.
• Health History: Your, as well as your family’s health history, affect your health insurance premiums. Your premium will be higher in case you have any pre-existing disease. Similarly, you will have to pay higher premiums in case anyone in your family has a history of cancer, heart disease, diabetes, etc.

1. Aditya Birla Activ Assure Diamond Policy: A popular health insurance plan offered by Aditya Birla Health Insurance, Activ Assure Diamond plan is an ideal choice for individuals and families. You can be covered under this plan if you are aged at least 5 years. The plan offers you a wide range of coverage with the sum insured options ranging between Rs. 2 lakh and Rs. 2 crores. The plan offers you many benefits such as health returns, 150% reload of the sum insured, cover for 586 daycare procedures, AYUSH medical treatments, discount on premiums, and domestic and international emergency assistance including an air ambulance. You can also buy add on benefits like Super No Claim Bonus, unlimited recharge, and accidental cover under this plan.

2. Aditya Birla Activ Health Platinum Policy: Activ Health Platinum Policy covers you and your family members who are aged at least 91 days. The policy lets you choose between sum insured options ranging between Rs. 50,000 to Rs. 2 crore as per your requirements. Available for a policy term of 1 year 2 years, and 3 years, this policy offers you several benefits like cover for 60 days pre-hospitalisation and 180 days post hospitalisation expenses, 527 daycare procedures, cumulative bonus, HealthReturns, 100% reload of the sum insured, etc. You can choose from two variants while buying this plan: Essential and Enhanced, where the latter offers you wider coverage.

3. Aditya Birla Activ Secure Policy: Activ Secure policy offers you and your family the much needed financial protection in the event of an accident as well as major critical illnesses. The plan comes with different variants aiming towards fulfilling the varied requirements of different customers. You can buy this policy with the add-on benefits of a second e-opinion and wellness coach at a little extra premium.

4. Aditya Birla Activ Care Policy: Aditya Birla Activ Care Policy is designed to take care of your parents just like you do. Anyone aged between 55 years and 80 years can be covered under this plan for many coverage features including cover for in-patient hospitalisation expenses, daycare treatment, health assessment, No Claim Bonus (NCB), road ambulance cover and restoration of sum insured limit. To enhance the cover under this plan, you can choose from various add-on benefits such as nursing at home cover, lifestyle support equipment, portable medical equipment cover, advanced health check-up cover, room upgrade and PPN discount.

5. Aditya Birla Arogya Sanjeevani Policy: Aditya Birla Arogya Sanjeevani Policy is an affordable health insurance policy that works the best for you and your family. You can choose it for sum insured options between Rs. 1 lakh and Rs. 5 lakh for a wide range of coverage features such as road ambulance cover, 30 days pre-hospitalisation cover, 60 days post-hospitalisation cover, and even dental treatment and plastic surgery if necessitated due to an injury or a disease.

Listed below are some of the features of Aditya Birla Health Insurance that make it a unique health insurance provider:

• Dedicated Customer Support: Aditya Birla Health Insurance has a dedicated team for customer support where you can get your grievances and queries solved in no time.

• A Variety of Health Insurance Plans: Aditya Birla Health Insurance offers you a wide variety of health insurance plans to choose from for yourself and your loved ones.

• Wide Network Of Hospitals: With a wide network of over 6,000 hospitals across India, Aditya Birla Health Insurance becomes a preferred choice for many. You can avail the benefit of cashless and reimbursement treatment at these facilities.

• High Claim Settlement Ratio: With more than 63,000 claims settled, Aditya Birla Health insurance achieved an impressive Claim Settlement Ratio of 70.81% for the financial year 2019-20. This shows that the insurer has a good claim settling ability and hence you can choose it for your health insurance needs.

• Activ Health App: Activ Health App by Aditya Birla Health Insurance puts the power in your hands to create the healthiest version of you. It allows you to keep a track of your fitness activity, store and access all your health history and even allows you to assess and renew your health insurance policy.

The benefits of purchasing Aditya Birla Health Insurance plans are plenty. Apart from protection against healthcare expenses, you can also enjoy tax benefits on the premium paid under these policies under Section 80D of the Income Tax Act, 1961.

See the table below to learn about tax deductions available with Aditya Birla Health Insurance plans under the Income Tax Act:

Claim Settlement Ratio (CSR) refers to the number of claims settled out of the total number of claim requests received by an insurance company. Higher the Claim Settlement Ratio, the better it is. Tabulated below is the Claim Settlement Ratio of Aditya Birla Health Insurance Company.

(Source: IBAI’s General Insurance Claim Insights Handbook For Policyholders - 4th & 5th Edition)

Aditya Birla Health Insurance Claim Process

Aditya Birla Health Insurance offers you a smooth claim settlement process. Read below to know about the process of cashless and reimbursement claims under Aditya Birla Health Insurance plans.

How To Make Aditya Birla Health Insurance Cashless Claim?

You can make a cashless claim with Aditya Birla Health Insurance by following the below-mentioned steps:

Step 1: Approach The Network Hospital
To avail of cashless treatment, visit any network hospital. You can find the list of Aditya Birla Network Hospitals here.

Step 2: Patient Identification
Provide the policy number or show the patient's Aditya Birla Health Insurance ID card for identification purposes at the hospital’s reception. Also show a valid ID proof like voter’s ID, passport, PAN card etc.

Step 3: Cashless Hospitalisation Request Form
one the identification process has been completed, the network hospital will submit the pre-authorization form or the cashless hospitalisation request form to Aditya Birla Health Insurance. You can speed up the process by intimating the insurer by filling up a request form.
Note that in case of emergency hospitalisation, you need to submit the pre authorization form within 48 hours of hospitalisation and in case of planned hospitalisation, you need to submit it 3 days before hospitalisation.

Step 4: Hospitalisation Request Review
Aditya Birla Health Insurance will review your request and notify about the decision to the network hospital. The company will also notify you via SMS or an e-mail within 2 hours if the request is received during business hours.

Step 5: Claim Settlement
Once all the formalities are completed, your claim will be settled at the hospital according to the terms and conditions mentioned in the policy.

How To Make Aditya Birla Health Reimbursement Claim?

You can make a reimbursement claim with Aditya Birla Health Insurance by following the below-mentioned steps:

Step 1: Notify The Insurer
In case of emergency hospitalisation, notify Aditya Birla Health Insurance within 48 hours. Whereas in case of planned hospitalisation, notify 3 days before admission in the hospital.

Step 2: Get Admitted
Get admitted at any network or non-network hospital and get treated.

Step 3: Pay Bills At The Hospital
After getting treated, pay the medical bills directly at the hospital as per its process.

Step 4: Collect And Submit The Claim Documents
Collect relevant documents originally from the hospital and submit them to Aditya Birla Health Insurance within 15 days after discharge from the hospital. Submit the documents to the address: Aditya Birla Health Insurance Co. Limited, 5th floor, Modi Business Centre, Kasarvadavali, Mumbai, Thane West 400615.

Documents Required For Aditya Birla Claim Reimbursement

Following documents need to be submitted during Aditya Birla claim reimbursement:
• Claim form Part A and Part B duly filled by you
• Aditya Birla Health ID card or policy copy
• KYC documents (photo ID and proof of age and address)
• Original discharge card, original hospital bill and final payment receipts
• Diagnostic reports, pharmacy or medical bills along with the prescription
• Letter from medical practitioner specifying duration, complaints, past history and treatment details
• All previous consultation papers related to current illness

Step 5: Claim Processing And Reimbursement
After reviewing your documents, Aditya Birla Health Insurance will approve your claim, or seek more documents or information, or reject it on the basis of policy terms and conditions. You will be communicated about the same on your contact number or registered email ID.

Aditya Birla Health Insurance offers the following benefits with its plans:

• Lifetime Renewability: Aditya Birla Health Insurance plans offer you a lifetime renewability benefit. This means that there is no restriction as to the maximum age at the time of renewal of your existing policy.

• Chronic Management Program: One of the most helpful features that Aditya Birla Health Insurance offers is Chronic Management Program. With this benefit, you can manage your chronic conditions like diabetes, asthma, and blood pressure and live a healthy life. It allows you to book lab tests, book consultation, order medicine, and manage appointments and orders.

• Health Return Benefit: Aditya Birla Health Insurance offers you Health Return benefits that serve as a motivation to stay fit. It offers you monetary rewards on staying fit that can be accumulated over time and redeemed according to your needs. You can use health returns to pay for diagnostic tests or pay for medicines, save it like a fund for the time of emergency, or even use it to pay for your policy premium for the next time.

• Wellness Coaching: Aditya Birla Health Insurance plans offer you the add-on benefit of wellness coach with some of its health insurance plans. On buying this add-on benefit, you can have access to wellness coaching in areas such as nutrition, fitness, tobacco cessation, and weight management.

• Second E-Opinion: Aditya Birla Health Insurance plans offer you the benefit of second e-opinion in case you are diagnosed with a critical illness during the policy period. You can talk to the panel of medical practitioners to get a second opinion on your health condition.

Aditya Birla Health Insurance plans keep you protected against many healthcare expenses. Read the inclusions below:

• Emergency Ambulance Cover: Aditya Birla Health Insurance plans cover you against transportation expenses by providing ambulance services till the hospital.
• Domiciliary Hospitalisation Expenses: Domiciliary expenses are the treatment taken at home on doctor’s advice. Aditya Birla Health Insurance plans cover you against domiciliary hospitalisation expenses.
• Organ Donor Expenses: Aditya Birla Health Insurance plans cover you against the medical and surgical expenses related to organ donation.
• Daycare Treatments: Daycare treatments are those which require less than 24 hours of hospitalisation. For instance, sinusitis, dialysis, eye surgery, etc. Aditya Birla Health Insurance plans cover you against such treatments.
• In-Patient Hospitalisation Expenses: Aditya Birla Health Insurance plans cover you against in-patient hospitalisation expenses when you get admitted to the hospital for at least 24 hours. These expenses include nursing, boarding, room rent among others.

What All Is Not Covered Under Aditya Birla Health Insurance Plans?

Aditya Birla Health Insurance plans do not cover you against some healthcare expenses. Read the exclusions below:

• Some Specific Surgeries: Aditya Birla Health Insurance plans do not cover you against some specific surgeries such as joint replacement, dental surgery, and cosmetic surgery.
• Venereal Or Sexually Transmitted Diseases: Another important exclusion under health insurance plans offered by Aditya Birla Health Insurance is venereal or Sexually Transmitted Disease (STDs).
• Self-Inflicting Injuries: Aditya Birla Health Insurance plans do not cover you against self-inflicting injuries such as the attempt of suicide etc. with and intention of self-harm.
• Injuries Due To War: Under Aditya Birla Health Insurance plans, you are not covered against injuries arising due to war, riot, nuclear threats, or strike.
• Injuries Due To Participation In Hazardous Activities: Aditya Birla Health Insurance plans do not cover you against injuries arising due to participation in any hazardous activity, unlawful act, and adventure sports including paragliding and mountain climbing.

Note that the inclusions and exclusions may differ with different Aditya Birla Health Insurance plans.

Aditya Birla Health Insurance plans come with the following terms:

Note that the terms may vary with different health insurance plans offered by Aditya Birla Health Insurance.

You can buy Aditya Birla Health Insurance plans from InsuranceDekho. Steps for both are given below:

Buy Aditya Birla Health Insurance Plan Online at InsuranceDekho

Step 1: Visit insurancedekho.com. Click on the ‘health’ tab.

Step 2: Fill in your personal details namely gender, name, and mobile number. You will receive a One Time Password (OTP) on that number. Enter that.

Step 3: Select the answer for ‘When do you want to buy the policy’ from the options in the drop-down menu. Click on ‘View Quotes’.

Step 4: Select the family member(s) you wish to add in the health insurance policy and click ‘Continue’.

Step 5: Enter the age of the selected family member(s).

Step 6: Give your Email ID and enter your City. Click on ‘Submit and View Quotes’. Top health insurance plans as per your requirement will be displayed on your screen. Select the most suitable one from them.

Step 7: Select the policy term for the chosen plan. Fill in the required details. Make payment.

You may also mail us at customersupport@insurancedekho.com in case further support is required.

Aditya Birla Health Insurance allows you to easily renew your health insurance plan online after every 1 year, 2 years, or 3 years, depending on the policy term chosen. Your renewal premium will depend on your age, number of members added or removed from the policy, enhancement of sum insured, and coverage features. Read the steps below:

Step 1: Visit the official website of Aditya Birla Health Insurance and navigate to the ‘policy renewal’ page.
Step 2: Fill in the details (policy number, proposer’s date of birth, and proposer’s mobile number)
Step 3: ‘Click on the ‘Proceed’ tab.
Step 4: Verify the policy details and premium amount for policy renewal.
Step 5: Pay online using the available modes of payment.

On successful payment, your policy will be renewed and you can avail benefits under your Aditya Birla Health Insurance policy thereafter.