Aditya Birla Health Insurance

Network Hospitals:
Claim Settlement
Ratio: 94%
PED Coverage
Covered aGer 2 Years
Save Tax Under
Section 80D

About Aditya Birla Health Insurance

Aditya Birla Health Insurance Company Limited (ABHICL) functions as a subsidiary of Aditya Birla Capital Ltd, the financial services platform of the Aditya Birla Group. ABHICL, established in 2015, operates as a joint venture between the Aditya Birla Group and MMI Holdings from South Africa. Since October 2016, ABHICL has been actively involved in the health insurance sector, while also maintaining a strong presence in various other domains such as 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 more.

With a nationwide reach, the company boasts a workforce of over 17,000 employees and collaborates with over 200,000 agents and channel partners. Aditya Birla Health Insurance provides an extensive range of health insurance plans designed to provide comprehensive coverage for medical expenses related to illness, sickness, disease, or accidents for both you and your family.

With Aditya Birla Health Insurance, you can benefit from a wide array of healthcare services, including cashless treatment, coverage for ambulance charges, AYUSH treatments, pre-hospitalization and post-hospitalization expenses, intensive care, and wellness programs aimed at assisting you in monitoring your health. Notably, Aditya Birla Health Insurance plans offer appealing features like wellness and rewards, which enable you to monitor your health progress, work towards improving your well-being, meet specific targets, and receive additional benefits as a result.

Aditya Birla Health Insurance Plans Summary

Aditya Birla Activ Assure Diamond Plan: Aditya Birla Health Insurance offers the popular Activ Assure Diamond Plan, which is an excellent choice for individuals and families. This plan is available for individuals aged 5 years and above and provides a wide range of coverage options, with sums insured ranging from Rs. 2 lakh to Rs. 2 crore. The plan offers numerous benefits, including health returns, a 150% reload of the sum insured, coverage for 586 daycare procedures, AYUSH medical treatments, premium discounts, and both domestic and international emergency assistance, including air ambulance services. Additionally, you have the option to purchase add-on benefits such as Super No Claim Bonus, unlimited recharge, and accidental cover.

Aditya Birla Activ Health Platinum Plan: The Activ Health Platinum Plan by Aditya Birla covers you and your family members aged 91 days and above. This policy allows you to choose from a range of sum insured options, starting from Rs. 50,000 up to Rs. 2 crore, based on your specific requirements. Available for policy terms of 1 year, 2 years, and 3 years, this plan offers several benefits, including coverage for pre-hospitalization expenses up to 60 days and post-hospitalization expenses up to 180 days, coverage for 527 daycare procedures, cumulative bonus, HealthReturns, a 100% reload of the sum insured, and more. The plan provides two variants to choose from: Essential and Enhanced, with the latter offering wider coverage.

Aditya Birla Activ Secure Plan: The Activ Secure Plan provides essential financial protection for you and your family in the event of accidents or major critical illnesses. This plan offers different variants to meet the varied requirements of different customers. You can also opt for add-on benefits such as a second e-opinion and a wellness coach at a slightly higher premium.

Aditya Birla Activ Care Plan: The Activ Care Plan by Aditya Birla is specifically designed to take care of your parents, providing coverage just as you would. Individuals between the ages of 55 and 80 can be covered under this plan, which offers coverage for in-patient hospitalization expenses, daycare treatment, health assessments, No Claim Bonus (NCB), road ambulance coverage, and restoration of the sum insured limit. To enhance the coverage, you can choose from various add-on benefits, such as nursing at home cover, lifestyle support equipment, portable medical equipment cover, advanced health check-ups, room upgrades, and discounts under the Preferred Provider Network (PPN).

Aditya Birla Arogya Sanjeevani Plan: The Aditya Birla Arogya Sanjeevani Plan is an affordable health insurance policy suitable for you and your family. You can select a sum insured option between Rs. 1 lakh and Rs. 5 lakh, providing coverage for a wide range of features, including road ambulance cover, 30 days of pre-hospitalization cover, 60 days of post-hospitalization cover, as well as dental treatment and plastic surgery necessitated by injury or disease.

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Why Choose Aditya Birla Health Insurance?

  • Dedicated Customer Support: Aditya Birla Health Insurance is equipped with a dedicated customer support team that promptly addresses your grievances and queries, ensuring timely resolution.
  • A Variety of Health Insurance Plans: Aditya Birla Health Insurance offers an extensive range of health insurance plans, providing you with a wide selection to cater to your own needs and those of your loved ones.
  • Wide Network of Hospitals: Aditya Birla Health Insurance boasts a vast network of over 6,000 hospitals throughout India, making it a preferred choice for many. You can enjoy the convenience of cashless and reimbursement treatments at these healthcare facilities.
  • High Claim Settlement Ratio: Aditya Birla Health Insurance has achieved an impressive Claim Settlement Ratio of 70.81% for the financial year 2019-20, settling over 63,000 claims. This demonstrates the insurer's strong ability to settle claims, making it a reliable choice for your health insurance requirements.
  • Activ Health App: The Activ Health App, developed by Aditya Birla Health Insurance, empowers you to become the healthiest version of yourself. This app allows you to track your fitness activities, securely store and access your health history, and even assess and renew your health insurance policy conveniently.

Key Features of Aditya Birla Health Insurance

  • Lifetime Renewability: Aditya Birla Health Insurance provides you with the valuable benefit of lifetime renewability. This means that there are no restrictions on renewing your existing policy based on your age.
  • Chronic Management Program: Aditya Birla Health Insurance offers a beneficial feature known as the Chronic Management Program. This program enables you to effectively manage chronic conditions such as diabetes, asthma, and high blood pressure, allowing you to lead a healthy life. Through this program, you can conveniently book lab tests, consultations, order medications, and manage appointments and orders.
  • Health Return Benefit: Aditya Birla Health Insurance presents the Health Return benefits to motivate you to maintain good health. These benefits provide monetary rewards for staying fit, which can be accumulated over time and redeemed according to your needs. You have the flexibility to utilize the health returns for diagnostic tests, medication expenses, emergency funds, or even to pay for your policy premium in the future.
  • Wellness Coaching: With select health insurance plans, Aditya Birla Health Insurance offers an additional benefit of wellness coaching. By opting for this add-on feature, you gain access to personalized guidance and coaching in areas such as nutrition, fitness, tobacco cessation, and weight management.
  • Second E-Opinion: Aditya Birla Health Insurance plans include the valuable provision of a second e-opinion. If you are diagnosed with a critical illness during the policy period, you have the opportunity to consult a panel of medical practitioners to obtain a second opinion regarding your health condition.

Aditya Birla Health Claim Settlement Ratio

The Claim Settlement Ratio of a health insurance company represents the percentage of claims successfully settled by the company compared to the total number of claims received during a financial year. It serves as an important indicator of an insurance company's efficiency in handling customer claims.

As a prudent health insurance buyer, it is essential to consider the Claim Settlement Ratio of an insurer before purchasing a plan. Here are the Claim Settlement Ratios for Aditya Birla Health Insurance in the last two financial years:

Financial Year | Claim Settlement Ratio

FY 2018-2019 | 93.68%
FY 2019-2020 | 70.81%

These figures demonstrate the insurer's commitment to efficiently settling claims and providing timely support to policyholders when they need it most. Aditya Birla Health Insurance stands out as a reliable and trustworthy option for individuals seeking comprehensive health coverage.

Dedicated Whatsapp Claim Assistance

Aditya Birla Health Claim Process

Aditya Birla Health Insurance ensures a seamless claim settlement process for its policyholders. Below, you will find the step-by-step procedure for both cashless and reimbursement claims under Aditya Birla Health Insurance plans.

Cashless Claim Process

1: Approach the Network Hospital

To avail cashless treatment, visit any network hospital. You can find the list of Aditya Birla Network Hospitals on their website or contact customer support.

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

Step 3: Cashless Hospitalization Request Form
Once the identification process is completed, the network hospital will submit the cashless hospitalization request form or pre-authorization form to Aditya Birla Health Insurance. You can expedite the process by intimating the insurer by filling up a request form. Note that in case of emergency hospitalization, the pre-authorization form must be submitted within 48 hours, and in case of planned hospitalization, it should be submitted 3 days before admission.

Step 4: Hospitalization Request Review
Aditya Birla Health Insurance will review your request and notify the network hospital about the decision. The company will also inform you via SMS or email 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.

Reimbursement Claim Process

When a policyholder receives medical treatment at a non-network hospital, they will need to settle the bills themselves and later request reimbursement from TATA AIG Health Insurance, subject to the policy's terms and the sum insured. Here are the steps to file a reimbursement claim with TATA AIG Health Insurance:

Step 1: Notify the Insurer
In case of emergency hospitalization, notify Aditya Birla Health Insurance within 48 hours. For planned hospitalization, notify the insurer at least 3 days before admission.

Step 2: Get Admitted
Get admitted to any network or non-network hospital and receive the necessary treatment.

3: Pay Bills at the Hospital
After receiving treatment, pay the medical bills directly at the hospital as per their process.

3: Pay Bills at the Hospital
After receiving treatment, pay the medical bills directly at the hospital as per their process.

Step 4: Collect and Submit Claim Documents
Collect all relevant documents, including the original discharge card, hospital bill, final payment receipts, diagnostic reports, pharmacy or medical bills, prescription, a letter from the medical practitioner specifying duration, complaints, past history, and treatment details, as well as all previous consultation papers related to the current illness. Submit these documents to Aditya Birla Health Insurance within 15 days after discharge from the hospital.

5: Claim Processing and Reimbursement
Upon reviewing your documents, Aditya Birla Health Insurance will either approve your claim, request additional documents or information, or reject the claim based on policy terms and conditions. You will be notified of the decision through your registered contact number or email ID.

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Aditya Birla Health Insurance

Network Hospitals:
Claim Settlement
Ratio: 97%
PED Coverage
Covered after 2 Year
Save Tax Under
Section 80D
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