Aditya Birla Capital Activ Assure Diamond Plan

Brief Overview

Aditya Birla Group is a billion-dollar Indian multinational company. It is one of the most reliable brands in the country today. Founded in the year 1857, the company has a vast network of companies in different sectors. An important branch of the company is Aditya Birla Capital that takes care of all the various financial services including health insurance. 

Medical treatments and hospitalisation costs are forever on a rise. Aditya Birla Capital offers many health insurance products and plans that act as a backup plan for medical emergencies. One such plan is Aditya Birla Activ Assure Diamond Health Plan. An all-inclusive health insurance indemnity plan, Activ Assure Diamond Health Plan allows you to safeguard yourself and your family against almost all kinds of medical emergencies. 

With no maximum age of entry,  Aditya Birla Activ Assure Diamond Health Plan covers you, your spouse and up to 4 dependent children. Another unique feature of the plan is that in case the sum insured limit is exhausted, there would be an automatic 150% reload of the sum insured. Activ Assure Diamond covers 586-day care procedures, domiciliary treatments and AYUSH treatments as well. 

Best Features of Aditya Birla Activ Assure Diamond Health Plan

1. The plan offers a high sum insured that can go from INR 2 lakhs to INR 2 crores
2. You are eligible for a No Claim Bonus of 10% of the sum insured with every year without claims
3. The policy would cover AYUSH treatments
4. The policy term can be 1 year/ 2 years or 3 years
5. For a subsequent claim that arises due to unrelated illness, you can receive a 150% of sum insured (up to INR 50 lakhs)
6. The policy covers 586 day-care procedures
7. You have the option of doubling the sum insured in 2 years, an additional 50% of SI per year
8. International/Domestic Emergency Assistance Services are also offered
9. Stay fit and avail HealthReturns worth up to 30%
10. When a member’s entry age is above 60 years, there is a mandatory co-payment of 20%
11. You can get an optional 100% of sum insured reload, that too for unlimited times
12. Multiple discounts are offered on the plan

Benefits of Aditya Birla Activ Assure Diamond Health Plan

1. In-patient hospitalisation
   When an insured is hospitalised for over 24 hours, the policy, as per the eligibility, would cover the expenses on room rent, operation theatre, medicines, consumables, doctor’s fee etc
2. Reload of Sum Insured
   In case the sum insured is inadequate, you can get an additional 150% of the sum insured, to a maximum of INR 50 lakhs, for hospitalisation that is unrelated to a previous claim in that policy term.
3. ICU Charges
   If an insured member is admitted to an ICU, 2% of the sum insured will be covered for Sum Insured of INR 2 lakhs, 3 lakhs and 4 lakhs. For Sum Insured of INR 5 lakhs and above, ICU charges will be covered up to the sum insured.
4. Pre and Post-hospitalisation 
   There are many expenses that are incurred before and after the hospitalisation as well. With the Activ Assure Diamond Health Plan, you would be covered for 30 days before and 60 days after the hospitalisation as well for the treatment-related expenses. 
5. Day-care Procedures
   Certain medical procedures do not need a patient to be hospitalised for a period of more than 24 consecutive hours and hence, many health plans do not cover such treatments. But with the Activ Assure Diamond Health Plan, you get covered for 586 such day care procedures.
6. Organ Donation
   As per your plan eligibility, in case of an organ transplant the organ donor harvesting expenses will be covered. 
7. Home Care/ Domiciliary Treatment
   If you couldn’t get admitted to a hospital due to unavailability of room/ bed, you may have to undergo medical treatment at home. The expenses of such treatment will be covered.
8.  Vaccination
   For children till the age of 18 years of age, the policy would cover vaccination expenses as per the given schedule, provided the sum insured opted for over INR 1 crore. 
9. Discounts
   You can avail the following discounts:
   1. Discount= 7.5% for a 2-year policy
   2. Discount= 10% for a 3-year policy
   3. Discount= 5% when 2-3 members are covered under Multi-Individual Policy
   4. Discount= 10% when 4 or more members are covered under Multi-Individual Policy
10. AYUSH Treatments
    Your alternate medicine in-hospitalisation expenses will also be covered as per your plan.
11. No Claim Bonus
    When you do not make a claim in the policy tenure, you are eligible for a bonus which is 10% of the sum insured, up to a maximum of 50%.
12. Daily Allowance
    For each day at the hospital, you will receive an additional per day allowance. This benefit will be for a maximum period of 5 days and will be applied when the sum insured is up to INR 4 lakhs. 
13. Second E-opinion
    When detected with a listed critical illness, an e-opinion through a consortium of specialists will be provided.
14. Health Check-ups
    Depending on the age of the insured member, a free health check-up is customised for each member under the policy.
15. Health Returns
    You can earn up to 30% of your health insurance premium amount in the form of HealthReturns.
16. Optional Covers
    The plan also provides the choice of opting for various optional covers which can further enhance the coverage. For example:
    1. Cancer Hospitalisation Booster
    2. Accidental Hospitalisation Cover
    3. Unlimited Reload of Sum iNsured
    4. Super NCB
    5. Any Room Upgrade

Plan Details of Aditya Birla Activ Assure Diamond Health Plan

• Waiting Period
  The waiting period is applicable as follows:
  • When the policy is purchased, a 30-day waiting period is applicable for treatment related to any sickness
  • Hospitalisation due to accidental injuries are covered from day 1
  • There is a 2 year waiting period for the specific illness and treatments 
• Free Look Period
  If you purchase the policy and are still unsure, you can return the policy to the company within the first 15 days, provided no claim has been made yet. You would have to notify the company along with the reason for return. The premium that you have paid will be refunded after deducting the stamp duty charges and the proportional risk cover.

What is not Covered in Aditya Birla Activ Assure Diamond Health Plan?

The permanent exclusions of Active Assure Diamond are listed below, for an exhaustive list, kindly refer to the policy document. Hospitalisation for the following reasons are not covered:

1. Breach of law/ illegal/ criminal activities
2. Cosmetic/ reshaping/ aesthetic surgeries
3. Mental and psychological disorders
4. War/ uprising/ revolutions
5. Abuse of intoxicants
6. Spectacles, hearing aid and contact lenses 

Renewal Process of Aditya Birla Activ Assure Diamond Health Plan

If you and your family are having a family health insurance cover, you must always ensure that you get a renewal before the insurance lapses. After the expiry date, a 30-day Grace Period is given to you to get your plan renewed. After this period your policy would lapse. It is imperative to remember that a claim made during the grace period will not be accepted by the company. 

The renewal process of Active Assure Diamond Health Plan is very simple. Visit the official website, go to “Renew” and enter the policy details, date of birth and registered mobile number. You will be redirected to a page with your policy summary. You can make the renewal payment via any of the electronic mediums that are available. 

The policy can also be renewed by visiting a branch office and filling in the paperwork. Once you make the payment, your policy will be renewed. 

Aditya Birla Activ Assure Diamond Health Plan - Claim Process

A claim has to be raised when an insured member is hospitalised. If you or any other insured family member needs hospitalisation due to an illness or injury or a planned surgical procedure, you need to inform the company at the earliest. In case of planned hospitalisation, inform the company at least 3 days before admission in the hospital and in case of an emergency, within 48 hours of hospitalisation. 

There are 3 ways to notify the company:

1. The claim can be notified online through the company website
2. You can write an email to the company
3. You can call on 1800 270 7000

• Cashless Claim 
  A cashless health insurance treatment can be sought only at a network hospital. The list of hospitals that fall in the network of Aditya Birla Health Insurance company is available on the company website. At the hospital, you need to submit your Health Card along with the Pre-Authorisation form. Along with this your KYC documents and treatment-related documents would be required. In case the hospitalisation is planned, keep in mind that once the authorisation is received, the treatment has to be done within a period of 15 days.
  If your claim is accepted, the company will settle the bills with the hospital directly. 
• Reimbursement Claim 
  At a non-network hospital, you do not have the advantage of seeking cashless treatment, however, after making the bill payment yourself you have the facility of claiming a reimbursement. Within 15 days of discharge, all the mentioned documents have to be submitted to:
  
  Aditya Birla Health Insurance Co Limited,Claims Department, 5th floor, Modi Business Centre, Kasarvadavali, Mumbai, Thane West-400 615

If your reimbursement claim is approved, the company will transfer the claim amount in your registered bank account through NEFT.

• Required Documents for claim processing
  Given below is an indicative list of documents required when making a claim, more documents may be required depending upon the treatment
  • Valid Photo ID document
  • Claim Form A and B
  • Health Card or Policy Papers
  • KYC documents
  • Doctor’s prescription that advises hospitalisation
  • Doctor’s prescription of all investigations, tests, medicines, consultations etc
  • Treatment-related bills and receipts
  • Discharge Summary
  • Ambulance Charges, if used
  • A Medico-Legal Certificate or FIR in case of an accidental injury
  • Bank Account details, cancelled cheque

Aditya Birla Health Insurance - Network Hospitals

Aditya Birla health insurance has a network of over 7,000 well-renowned hospitals. Spread across the length and breadth of the country, in case of a medical emergency you would never be far from receiving cashless medical treatment. 
At a network hospital, there is very little paperwork required and most of the procedures are carried out by the company associates. Once all the paperwork verification is complete, the final bill is settled by the company.  

Click https://www.adityabirlacapital.com/healthinsurance/#!/hospital-search to locate a network hospital near you.

Review of Aditya Birla Activ Assure Diamond Health Plan

Activ Assure Diamond Health Plan by Aditya Birla Health Insurance helps you cover yourself and your loved ones. Along with wide coverage, the plan offers a variety of benefits. The plan is designed to provide numerous health benefits that take care of you as well as your family members. There are attractive advantages that drive you to stay fit and healthy. If you too are looking for a comprehensive health insurance policy that suits your and your family’s health insurance needs then you have the option to choose from the Activ Assure-Diamond plan. 

Aditya Birla Health Insurance - Customer Care Details