Aditya Birla Active Health Enhanced - Platinum

Aditya Birla Active Health Enhanced - Platinum

Aditya Birla Activ Health Platinum Enhanced plan is specially designed to keep you healthy and cover your medical expenses when required. It is more than a regular health insurance plan as it comes with unique features, such as HealthReturns, reload of the sum insured, Chronic Management Program, multiple choices for hospital rooms, etc. These features make the plan one of a kind.

Read More

Why Do You Need Aditya Birla Activ Health Platinum Enhanced Insurance?

You must buy an Aditya Birla Activ Health Platinum Enhanced plan for the following reasons:

• You can avail cashless hospitalization benefit at more than 9000network hospitals across India without paying from your pocket.
• The sum insured options are higher, starting from Rs2 lakh to Rs 2 crore, to serve every requirement of yours.
• HeathReturn, recovery benefit, chronic management program, second e-opinion for major illnesses, expert wellness coach, are some of the unique features that are worth your money.
• The cumulative bonus increases your sum insured by 50% up to a maximum of 100% or Rs 1 crore for each claim-free year
• Long term discount of 7.5% and 10% are available if you opt for a 2-year or 3-year policy tenure respectively
• 10% preferred provider network (PPN) discount is also available
• Tax benefits can be earned on premiums paid towards Aditya Birla Active Enhanced health plan under the IT Act, section 80D.

Salient Features of Aditya Birla Activ Health Platinum Enhanced Plan

The salient features of the Aditya Birla Activ Health Platinum Enhanced plan include:

• It offers both individual and family floater policies.
• It provides a health check-up facility to the insured once a year.
• Earn up to 100% of the premium as health returns. These returns can be used for paying the renewal premiums further.
• You will be covered from day 1 for medicines, diagnostic tests, consultation with physicians in case of lifestyle illnesses, such as diabetes, blood pressure, asthma, hypertension, under the Chronic Management Program.
• The policy offers a premium waiver for 1 year in case you are diagnosed with a listed critical illness.
• The policy ensures 100% restoration of the policy sum insured. However, it is applicable only with an unrelated illness or accident after the first claim is made and the sum insured is not exhausted in the previous year.

Aditya Birla Activ Health Platinum Enhanced Plan Eligibility Criteria

The below table shows the eligibility criteria of the Aditya Birla Activ Health Platinum Enhanced plan:

Coverage under Aditya Birla Activ Health Platinum Enhanced Plan

The coverage provided by the Aditya Birla Activ Health Platinum Enhanced plan includes:

• In-patient Hospitalization– It covers in-patient hospitalisation expenses, including room rent, nursing expenses, doctor’s fees, OT charges, medicine costs, consultation fees and so on.
• Pre-hospitalization Medical Expenses– It covers medical expenses incurred before hospitalization up to 60 days.
• Post-hospitalization Medical Expenses– It covers medical expenses incurred after hospital discharge up to 180 days.
• Day Care Treatment– It is available for treating certain illnesses that don’t require 24 hours hospitalisation, such as dialysis, cataract, chemotherapy, tonsillectomy, etc.
• Domiciliary Hospitalization– It covers the cost of the treatment availed at home in case hospitalisation is not possible.
• Road Ambulance Cover– It covers the cost of road ambulance services up to actual expenses in case of network hospitals and up to Rs 5000 per hospitalization in case of non-network hospitals.
• Organ Donor Expenses– It pays for the expenses incurred by organ donors for harvesting of the organ during a transplant.
• AYUSH Cover– It covers the cost of availing treatment through the AYUSH school of medicines.
• Mental Illness Hospitalization– It pays for the medical expenses incurred on the treatment of mental illnesses.
• Obesity Treatment– It covers the cost of availing medical treatment for obesity.
• Home Treatment– It pays for the expenses incurred on availing necessary treatment at home after discharge from the
• Modern Treatment Methods– It covers the medical expenses incurred on availing treatment through modern treatment methods.
• Emergency Assistance Services (Includes Air Ambulance)– It covers the cost of availing emergency assistance services, including air ambulance, within or outside India.
• OPD Cover– It offers coverage for outpatient consultations up to Rs 1000 in case of a sum insured of Rs 15 lakh or above.
• Second E-opinion for Major Illnesses– In case of major illnesses, such as cancer, kidney failure, heart attack, etc., a second opinion can be taken from qualified specialists and its costs will be covered under this policy.
• Dental Consultations & Investigations – It pays for the cost of dental consultations and investigations in case of a sum insured of Rs 15 lakh or above.
• Recovery Benefit –It provides a recovery benefit of 1% of the sum insured up to Rs 10,000 in case of accidental hospitalization for 10 consecutive days.

Exclusions under Aditya Birla Activ Health Platinum Enhanced

The following treatment expenses are excluded under the Aditya Birla Activ Health Platinum Enhanced plan:

• Venereal diseases
• External congenital anomalies
• Sexually transmitted diseases
• Abuse of intoxicants like drugs or alcohol
• Intentional self-injury
• Maternity expenses
• Injuries due to war and nuclear perils

You can check the full list of exclusions by referring to the policy wordings.

Aditya Birla Activ Health Platinum Enhanced Insurance Claim Process

A claim can arise anytime and you should know how to initiate it in order to ensure a smooth claim process. You can claim your health insurance in two ways - Cashless Claim and Reimbursement Claim. Take a look at the claim procedure below:

Cashless Claim Process

The cashless facility can be availed at the network hospital of Aditya Birla Health Insurance Company Limited only. Whether it is a planned or emergency hospitalization, if you go for a cashless facility then the hospitalization expenses will be borne by the insurance provider. The process is as follows:

• Visit the nearest network hospital of the Aditya Birla Health Insurance Company
• Carry the Aditya Birla health card and show it at the hospital help desk along with an ID proof
• Fill a cashless hospitalization request form and submit the pre-authorization letter to the TPA  The TPA will submit the application to the insurance provider.
• The insurer may accept or reject your request, depending on various grounds.
• Upon its approval, you can receive cashless services at the network hospital.
• The incurred expenses will be paid as per the policy terms and directly settled by the insurer after your discharge from the hospital.

Note: If you plan to be hospitalized for the treatment of an illness, the insurance provider has to be notified 48 hours prior to the hospitalization. In the case of emergency hospitalization, the window to inform the insurer is within 24 hours of getting admitted.

Reimbursement Claim Process

When you go with a reimbursement claim, you don’t require to avail the services from a network hospital only. Instead, you can pick a random hospital according to your choice and get the treatment. However, the incurred expenses have to be paid by you initially and you will have to register a claim with Aditya Birla Health Insurance Company after hospital discharge. To initiate your reimbursement claim, follow the steps given below:

• Inform the insurer and register a claim by calling their 12x7 helpline number. You can also write them to their official email Id to register a claim.
• Collect all the relevant documents, medical bills in original along with the receipts, discharge summary stating about nature of illness or accident, etc. at the time of hospital discharge
• Submit all the required documents along with the filled-in claim form to the insurance company. You can send them via post or upload them online by login into the insurer’s portal using your username/password.
• After receiving the documents and verifying them, the insurer will reimburse up to the admissible amount. You will have to bear the deductibles in your plan as decided at the time of buying the policy.

What Are the Documents Required for Claim Settlement?

In order to raise a claim under the Aditya Birla Activ Health Platinum Enhanced plan, you will need to submit the following documents:

• Duly filled and signed claim form
• Medical certificate from the treating doctor stating about the illness or details of diagnosis
• Proof of medical and pharmacy bills and receipts
• Hospital discharge summary
• Death certificate, in required
• Original diagnostic reports
• KYC documents, if required
• Other related documents asked by Aditya BirlaHealth Insurance Company

How to Buy Aditya Birla Activ Health Platinum Enhanced Insurance Online?

When it comes to buying Aditya Birla Activ Health Platinum Enhanced insurance, you can buy both online or offline. To buy it online, follow the steps given below:

• Visit the official website of Policybazaar Insurance Broker Private Limited
• Click on the icon of ‘Health Insurance’
• Provide your contact details like mobile number, etc.
• Enter the requested personal details, such as age, medical history, etc.
• The Aditya Birla Activ Health Platinum Enhanced plan along with the premium will be shown.
• Check the details of the plan and pay the premiums online
• Get the policy instantly. You can get the printed copy downloaded from your registered email id.

Documents Required for Buying Aditya Birla Activ Health Platinum Enhanced Insurance

The important documents that you may need to be attached along with your application for buying the Aditya Birla Activ Health Platinum Enhanced plan are:

• Proof of Age: Considerable documents include- Birth Certificate, Voter’s ID, PAN Card, Passport, Driving License, School or College Certificate,
• Identity Proof: Adhaar Card, Driving License, Passport, Voter’s ID, PAN Card,
• Address Proof: Utility bills, Passport, Bank Statement, Voter’s ID,
• Income Proof: Six months salary slips, Employer’s Certificate, Form 16, etc.
• Passport-sized photographs
• Medical health check-up test, if required

Aditya Birla Activ Health Platinum Enhanced Renewal Process

In order to get the policy benefits continuously, it is essential to renew your policy before it expires. You can renew it either online or offline. However online renewal is the most preferred, convenient yet recommended process of renewing the Aditya Birla Activ Health Platinum Enhance insurance policy. Here are the easy steps to renew your policy online:

• Visit the official website of Policybazaar Insurance Broker Private Limited
• Go to the ‘Renew Your Policy’ option and click on the ‘HealthRenewal’ option available on the drop-down menu
• Log in by entering your policy number or mobile number
• The details of your Aditya Birla Activ Health Platinum Enhanced policy will be displayed.
• Cross-check the details of the policy
• Click on the Renew option to proceed with the online payment facility
• Pay the renewal premium using debit/credit cards or through net banking.
• A confirmation of the payment w ill be sent to the registered contact number and mail ID. The renewed policy will be sent to you as well.