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Aditya Birla Health Insurance’s Activ Health – Platinum Enhanced Plan
Activ Health – Platinum Enhanced Plan is more than just health Insurance, it is a stepping stone towards a healthier life. With unique benefits such as HealthReturnsTM, Relaod of Sum Insured, Choice of Hospital Room and Chronic Management Program.
Features & Benefits
In Patient Hospitalization
- Expenses covered like room rent, doctor’s fee, operation theatre expenses, medicines, drugs and other consumables under the policy as per eligibility including COVID-19
Reload of Sum Insured
- In case the Sum Insured with cumulative bonus (if any) is insufficient as a result of previous claims in that policy year, then you get an additional Sum Insured for
HealthReturnsTM
- Earn upto 100% Health Returns™ for staying fit and healthy and use it towards your health expenses*.Refer to policy document for more details
Chronic Management Program
- Activ Health’s Chronic program has been specially designed for people with conditions like Diabetes, Asthma, High Cholesterol and High Blood Pressure
Wellness Coach
- We constantly keep reminders for our work and schedules, but what about our diet, fitness and nutrition. Qualified wellness coach that will guide you through
Cumulative Bonus
- 50% increase of Sum Insured every policy year, Max upto 100% . Accumulated bonus will not be reduced even when claim is made in any subsequent year upto a limit of 1 Crore Sum Insured
Modern Treatment Methods
- Cover Modern Treatment Methods and Advancement in Technologies like robotic surgeries, oral chemotherapy, etc.* Refer to policy document for more details
Mental Illness Hospitalisation
- An excellent, first of its kind benefit is now available for you. The medical expenses incurred by you up to Sum Insured towards in-patient hospitalization specifically
Obesity Treatment
- Covers medical expenses for Bariatic Surgery which is medically necessary, on the written advice of Medical Practitioner. * Refer to policy document for more details
Mental Illness Hospitalisation
In Patient Hospitalization
Reload of Sum Insured
Wellness Coach
Eligibility & Documentation
Aditya Birla Health Insurance’s Activ Health – Platinum Enhanced Plan Eligibility & Coverage
The Activ Health – Platinum Enhanced Plan is more than just health Insurance, it is a stepping stone towards a healthier life. In availing this plan you can get unique benefits such HealthReturnsTM, Reload of Sum Insured, Choice of Hospital Room and the Chronic Management Program.
Aditya Birla Health Insurance’s Activ Health – Platinum Enhanced Plan – Policy Wordings
Disclaimer:
* Refer to your policy documents.
Aditya Birla Health Insurance Co. Limited. IRDAI Reg.153. CIN No. U66000MH2015PLC263677.
Product Name: Activ Health, Product UIN: ADIHLIP21376V022021,
Address: 9th Floor, Tower 1, One World Centre, Jupiter Mills Compound, 841, Senapati Bapat Marg, Elphinstone Road, Mumbai 400013.
Email: care.healthinsurance@adityabirlacapital.com, Website: adityabirlahealthinsurance.com, Telephone: 1800 270 7000,
Fax: +91 22 6225 7700. For more details on risk factors, terms and conditions please read terms and conditions carefully before concluding a sale. Trademark/Logo Aditya Birla Capital is owned by Aditya Birla Management Corporation Private Limited and Trademark/logo HealthReturnsTM, Healthy Heart Score and Active Dayz are owned by Momentum Metropolitan Life Limited (Formerly known as MMI Group Limited). These trademark/Logos are being used by Aditya Birla Health Insurance Co. Limited under licensed user agreement(s). Tax benefits are subject to changes in tax law, please refer to your tax advisor. Section 41. (1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take or renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or tables of the insurer:
Provided that acceptance by an insurance agent of commission in connection with a policy of life insurance taken out by himself on his own life shall not be deemed to be acceptance of a rebate of premium within the meaning of this sub section if at the time of such acceptance the insurance agent satisfies the prescribed conditions establishing that he is a bona fide insurance agent employed by the insurer.
(2) Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees” AXIS Bank (IRDAI Reg. No: CA0069) is a Corporate Agent of Aditya Birla Health Insurance Co. Limited.
Aditya Birla Health Insurance’s Activ Health – Platinum Enhanced Plan Important Documents
The Activ Health – Platinum Enhanced Plan is more than just health Insurance, it is a stepping stone towards a healthier life. In availing this plan you can get unique benefits such HealthReturnsTM, Reload of Sum Insured, Choice of Hospital Room and the Chronic Management Program.
Activ Health - Platinum Enhanced Plan Leaflet
During a medical emergency we offer a choice of both cashless and reimbursement payment options.
Go cashless if it’s a Network Hospital
Reimburse covered expenses if it’s a Non – Network Hospital
All Original Hospital bills & receipts
Discharge Summary
Investigation reports
Pharmacy bills
Photo Id and Age proof
Any other relevant documents
Always keep one set of photo copied claim documents with you
SMS CLAIMS to 5616181
Frequently Asked Questions
No. You can only be covered under an individual policy if you are suffering from chronic conditions such as Asthma, Diabetes, Hypertension and/or Hyperlipidaemia.
The Insured Person shall be managed under the Chronic Management Program as applicable for the particular combination.
If a customer is diagnosed with 2 chronic conditions, he will have to accept the counter offer for both chronic conditions. If he does not accept, we will not accept the proposal.
Children who develop chronic condition during the term of the Policy will not be eligible for the CMP program – they will only be eligible once they are above 18 years within the same family floater plan.
This is applicable in case of reimbursement; we will reimburse only till the prescribed limit. Customer will need to pay the rest. In cashless, this will not apply as we have a direct tie-up with the network hospitals and the limit has been agreed upon.
Asthma Rs. 10,050/-, High Blood Pressure Rs. 6,900/-, High cholesterol Rs. 6,650/-, Hypertension 6,900/- and Diabetes type 1 Rs. 15,150/-, Diabetes type 2 Rs. 11,050/-
No, we cannot offer.
No, it would not be covered.
Yes, each Insured Person above 18 years of Age on the Start date may avail a comprehensive health check-up in a Policy Year as defined in Policy wording.
Health Assessment is a simple health exam that measures the Insured Person on the parameters of MER (including BP, BMI, HWR and smoking status), Fasting Blood Sugar and Total Cholesterol.
For calculation of Healthy Heart Score™, tests under Health Assessment™ namely - MER (including BP, BMI, HWR and smoking status), Fasting Blood Sugar, Total Cholesterol will have to be carried out at one go (together) and at least once every Policy Year.
No. Is it important to do Health Assessment as well as Activ Dayz to earn HealthReturns If a customer is not doing Active Dayz, the substitute is to take a fitness assessment. However, it is recommended that your participate in Active Dayz.
Fitness Assessment is for people who are not able or willing to visit the gym or track their steps through wearable devices or people who do yoga. A Fitness Assessment will help us assess the fitness levels of the customer. The customer can call and book a fitness assessment (process similar to Health Assessment). We have developed a network of physiotherapists and physical trainers who will do the fitness assessment. This will involve flexibility stretches, push ups, fat measurement etc. A report will generate basis which health returns will be applicable.
For Medicine expenses the customer can claim monthly or at least once every quarter, for pathological tests at least once half yearly and for Doctor’s fees at least once half yearly.
HealthReturns through Active Dayz and Healthy Heart Score gets calculated on a monthly basis. Irrespective of whether the premium has been paid for 1 yr., 2 yrs. or 3 yrs.
We provide for a 100% Reload of the Sum Insured specified in the Policy Schedule, in case, the available Sum Insured inclusive of earned Cumulative Bonus (if any) is insufficient as a result of previous claims in that Policy Year.
The Reload of Sum Insured is available only for future claims and not in relation to any Illness/ Injury (including its complications) for which a claim has been admitted for the Insured Person during that Policy Year
During a Policy Year, the aggregate claim amount payable, subject to admissibility of the claim, shall not exceed the sum of:
- The Sum Insured
- Cumulative Bonus (if earned)
- Reloaded Sum insured (if applicable)
Benefits for optional covers, chronic management program are over and above this.
Additionally, if you have funds under HealthReturns, you may choose to reimburse this against the medical expenses
No, any earned Cumulative Bonus will not be reduced for claims made in the future, unless utilised. If utilized, we will reduce only to the utilized value.
No. Premium paid through HealthReturns is not eligible for tax benefit.
For example, if customer pays Rs 100 premium and customer has Rs 20 as health returns, he will get a tax receipt for Rs 80.
Premium for your Activ Health policy depends on the following factors:
- Your age
- Gender (for individual plan)
- Plan type (individual/ floater)
- No. of members covered (in the individual policy, you get a discount for covering 2 or more members under same policy)
- Selected term for policy (You get 7.5% and 10% discount respectively for buying term policies for 2yrs and 3yrs)
- Selected SI
- Selected room category
- Any pre-existing condition that you may have at the time of first buying this policy or detected at the time of pre-policy medical check up.
No, medical expenses for donors are covered if the organ is for the use of insured person, i.e. the recipient for the organ.
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