Aditya Birla Capital Activ Health Platinum Plan

Brief Overview

In life, if there is one thing that is constant, it is ‘change’. Everyone goes through ups and downs in life, and though we may not be able to avoid them, we can surely keep ourselves prepared for any untoward incidents. Aditya Birla Capital - Health Insurance understands that when a medical emergency arises, you want the best policy to cover yourself and your loved ones. The company offers an array of health insurance products and plans that help you in the financial needs that you may have in case you or a family member is hospitalised.

With the Aditya Birla Activ Health Platinum Plan, you can protect yourself and your loved ones. The plan not only provides wide coverage but also rewards you for being fit and healthy. The plan has two variants - Activ Health Platinum - Essential and Activ Health Platinum - Enhanced and together they offer a sum insured starting from INR 50,000 up to INR 2 crore. 

Along with numerous day-care procedures, domiciliary treatments, hospital cash allowance and the guidance of a wellness coach, Activ Health Platinum is a very popular health insurance plan by Aditya Birla Capital that helps you in reaching your goal of a tension-free life.  

Best Features of Aditya Birla Activ Health Platinum Plan

1. Activ Health Platinum Plan is an indemnity health insurance plan
2. Activ Health Platinum Plan has Family floater health insurance options which cover upto 9 members under this plan with 6 adults and 3 children and can cover self, spouse, children, dependent parents as well as dependent parents-in-law
3. It offers coverage from day 1 for patients with pre-existing disease coverage for illnesses such as diabetes, high cholesterol, asthma and hypertension
4. There are 2 variants of this plan - Enhanced and Essential
5. There is a Deductible Option in the Essential variant of Activ Health Platinum Plan
6. The plan offers a reload of the sum insured
7. The policy tenure can be 1 year/ 2 years/ 3 years
8. Health insurance covers hospitalisation due to COVID-19 as well
9. Sum Insured ranges from INR 50,000 to INR 10 lakhs(essential), INR 2 lakhs to INR 2 crore (enhanced)
10. You can earn a cumulative bonus of up to 10%, that would not be reduced even if a claim is made
11. Once a policy Health Check-up Programme
12. Various value-added programmes are offered to the insured members
13. There is the availability of a wellness coach

Benefits of Aditya Birla Activ Health Platinum Plan

1. In-patient Hospitalisation
   Depending on the variant selected, you have the choice to select a shared or single room.
2. Pre and Post-hospitalisation 
   Expenses on diagnosis, investigations, consultations, physiotherapy are not limited to the period of hospitalisation. Therefore, the expenses that you incur before and after your hospitalisation that are related to the treatment are also covered for a specific number of days.
3. Sum Insured Options
   The company gives multiple choices to choose the sum insured that start from INR 50,000 and go as high as 2 crores. Pick an amount that would be suitable to your needs as well as your budget.
4. Day-care Treatment
   Under the Activ Health Platinum plan, you can also cover the treatments that do not require over 24 hours of hospitalisation. 527 day-care procedures are covered in the plan.
5. Reload of Sum Insured
   The plan offers a reload of the sum insured in case of insufficient funds provided it is for an unrelated illness due to which a claim has been made already, during the same policy year.
6. Wellness Coaching
   The plan provides you with a wellness coach which allows you access to expert health coaches who will guide you through a healthy journey.
7. Health Returns
   When you follow a healthy lifestyle and stay fit, it would get you rewards in the form of HealthReturns. You can get up to 30% of your policy premium back as HealthReturns. 
8. Network Hospital
   With Aditya Birla Health insurance you can avail cashless treatment in over 7,000 network hospitals all over the country. You can get the best of medical treatment in leading hospitals.
9. Hospital Cash Benefit
   When admitted in a hospital, there will be a daily allowance that you will receive for a specified number of days in a policy year.
10. Domiciliary Treatment
    Sometimes for a treatment that otherwise required hospitalisation, you have to take home treatment. Expenses made on such a treatment, under the prescription of a doctor would also be compensated for by the health insurance.
11. Second E-opinion
    If an insured is detected with a specified critical illness, an e-opinion will be arranged through a consortium of qualified specialists. 
12. Ambulance Charges
    If during a medical emergency, ambulance service is used for transporting an insured to the hospital, ambulance costs will be covered as per the plan selected. Note that the ambulance should be from a network hospital. 
13. Health Check-ups
    Once a year, the insured members will undergo a health check-up as per their age and medical condition. 
14. Tax Benefits
    Under Activ health Platinum health insurance, the health insurance premium that you pay is tax exempted and can be claimed under Section 80D of the Income Tax Act, 1961.

Plan Details of Aditya Birla Activ Health Platinum Plan

• Waiting Period
  • Except for accident-related injuries, no other hospitalisation expenses are covered within 30 days of policy purchase
  • Expenses on listed surgeries/ conditions/ treatments are not covered till 24 months of policy purchase
  • Chronic Management Programme Waiting Period
    • If  within 3 months from the policy start date, you undergo a Health Assessment which indicates that you suffer from a chronic condition, a 24 month waiting period will be applicable from the same date 
• Free Look Period
  After purchasing Aditya Birla Activ Health Platinum Plan if you feel that you are not happy with the terms and conditions of the policy. The return would be accepted:
  • If the return is requested within 15 days of the policy purchase
  • A claim has not been made in these 15 days
  • A written notice is sent to the company with the reason of return
    The premium that you have paid will be refunded after deducting the stamp duty charges and proportionate risk amount.

What is not Covered in Aditya Birla Activ Health Platinum Plan?

Some of the most common exclusions are listed below, if you want an exhaustive list, it is advised that you refer to the policy document. 

If you are hospitalised due to the following reasons, the treatment will not be covered: 

1. Self-inflicted injuries or suicide attempt
2. Cosmetic/ reshaping/ aesthetic surgeries
3. Mental and psychological disorders
4. Illegal or criminal activities
5. Participation in war or uprising or revolutions
6. Abuse of intoxicants such as alcohol or drugs
7. Spectacles, hearing aid and contact lenses

Renewal Process of Aditya Birla Activ Health Platinum Plan

When you buy a health insurance plan, your goal is to keep your family covered against all kinds of medical emergencies. But after purchasing the health insurance plan, it is equally important that you get them renewed on time in order and enjoy continuous coverage. 
The renewal process of Aditya Birla Activ Health Platinum Plan is simple and quick. You can visit the company website, select the policy, enter the required details and pay the premium. In case you wish to renew the policy offline, you would have to visit a branch office. Fill the Renewal Form and make the payment via your credit/debit card or a cheque. 

Aditya Birla Activ Health Platinum Plan - Claim Process

In case you or any other insured family member needs hospitalisation because of an accidental injury or an illness or a planned surgery, a claim has to be raised. You need to inform the company as soon as possible. Inform the company at least 3 days before admission in case of planned hospitalisation, and the hospitalisation was done in an emergency, you can inform the company within 48 hours of hospitalisation. 

To notify the company, you can either register your claim online through the company website, or you can write an email to them or call on 1800 270 7000.

• Cashless Claim 
  The list of network hospitals is available on the company website, make sure you go through it before selecting the hospital as the list is updated regularly. When you reach the hospital, you have to submit your Health Card. If by chance you do not have your Health Card, take along your policy papers or get in touch with the company. Along with this, you need to submit the Pre-Authorisation form, KYC documents and treatment-related documents as well. If your cashless health insurance claim is accepted, the company will settle the bill with the hospital directly.  
  If the hospitalisation is planned, remember that once you receive the authorisation, the treatment must be taken within a period of 15 days.
• Reimbursement Claim 
  When you seek treatment in a non-network hospital, cashless treatment would not be available. You have to make the payment upfront. However, thereafter, you can make a claim for reimbursement of your expenses, provided you followed all guidelines carefully. After your discharge, fill in the Claim Form and submit all the required documents. Send the documents to:
  
  Aditya Birla Health Insurance Co Limited,Claims Department, 5th floor, Modi Business Centre, Kasarvadavali, Mumbai, Thane West-400 615

Once all the documents are verified, you claim would be approved. If any paperwork or formality is due, you would be notified by the company. When the claim is approved, the claim amount will be transferred into the registered bank account through NEFT.

• Required Documents
  The required documents are: Bear in mind that more documents may be required depending upon the treatment that has been sought by the insured member. 
  • Valid Photo ID document
  • Claim Form A and B
  • KYC documents
  • Health Card or Policy Papers
  • 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
  • Death certificate(in case of death)
  • Bank Account details, cancelled cheque

Aditya Birla Capital- Health Insurance Network Hospitals

Aditya Birla Capital has a strong network of around 7,000 hospitals all through the length and breadth of the country. When you go to a network hospital, you have the advantage of claiming cashless treatment. You can opt for a cashless claim for all the covered expenses, up to the Sum Insured that you have selected, that are incurred due to your treatment. The final bill is settled by the company. You pay only for the uncovered expenses and your share of co-payment.

Review of Aditya Birla Activ Health Platinum Plan 

The Aditya Birla Activ Health Platinum insurance plan that is provided by Aditya Birla Health Insurance Company offers an essential and enhanced coverage for the medical expenses and treatment that you might have to incur for yourself or your loved ones. As explained earlier, the plan not only covers your in-patient expenditure, it also motivates you to stay fitter and healthier through its HealthReturn rewards. The policy is quite flexible and lets you customise a lot of benefits as per your insurance needs while giving you the option of multiple additional benefits. 

Aditya Birla Health Insurance - Customer Care Details