Activ One VIP+ Health Insurance Plan

Activ One VIP+ Health Insurance Plan

Overview

Aditya Birla Capital Limited (ABCL) is the holding company for all the financial service businesses of the Aditya Birla Group. With a strong presence across the life insurance, asset management, private equity, corporate lending, structured finance, general insurance broking, wealth management, equity, currency and commodity broking, online personal finance management, housing finance, pension fund management and health insurance business, ABCL is committed to serve the end-to-end financial services needs of its retail and corporate customers. Aditya Birla Capital Limited is a part of the Aditya Birla Group, a USD 40 billion Indian multinational in the league of Fortune 500. Anchored by an extraordinary force of over 120,000 employees, belonging to 42 nationalities, the Aditya Birla Group operates in 36 countries across the globe. About 50 per cent of its revenues flow from its overseas operations.

Highlights For

Activ One

VIP+

Reduction in Pre-Existing Disease waiting period

Critical Illness cover (Initial Waiting Period - 60 Days and Survival Period - 15 Days)

Personal Accident Cover AD+PTD+PPD

Cancer Booster i. Covers Pre and Post hospitalisation medical expense. ii. Covers Day Care Treatment up to Sum Insured

Durable equipment cover i. Ventilator ii. Wheelchair iii. Prosthetic device iv. Suction Machine v. Commode Chairs vi. Infusion pump vii. Continuous Passive motion devices in case of Knee Replacement viii. Oxygen concentrator

Compassionate Visit

Second Medical Opinion for listed Major Illness

product highlights for Activ One VIP+

Features

Sub-limits

Pre-Hospitalisation : 90 days

The amount of expenses incurred during this period prior to hospitalisation such as diagnostic tests, doctor fees, medicines, etc. for investigiation purpose are also payable by the insurer

Post Hospitalisation : 180 days

The amount of expenses incurred during this period after discharge from hospitalisation for the purpose of recovery such as follow-up tests, doctor fees, medicines, etc. are also payable by the insurer

Pre existing Disease cover : 36 months

Coverage for all Pre-Existing Diseases covered after a certain specified waiting period with continuous renewal.

Waiting Period- Initial : 30 days

No claims are accepted within this period except due to accidents/ injury.

Waiting Period- Specific : 24 Months

Listed specific illness

Waiting Period- PED : 36 Months

No pre-existing ailment related claims are accepted within this period.

Room Rent : Actuals up to Base Sum Insured

Room rent for in-patient hospitalisation

ICU Charges : Actuals up to Base Sum Insured

Charges for ICU hospitalisation

Co pay : Not available

% of the claim that the policyholder needs to pay out-of-pocket

Restore Benefit/ Recharge/ Refill : 2nd claim onwards - unlimited times (up to Base Sum Insured)

If the sum insured is exhausted due to hospitalisation expenses of one or more members, there is an automatic restoration of the sum insured for related or unrelated ailments.

Health Check up : Listed & Cashless

Free annual health check-up for all insured members according to the list of tests specfied in the policy document.

No Claim Bonus : Not available

% of the sum insured that rises every claim free year.

Video/telephone consultation : yes,provides telephone consultation

E-consultation with expert doctors empanelled with the insurer for a second opinion.

Domiciliary hospitalization : Actuals up to Base Sum Insured

Home care treatment where there are no beds in the hospital or paitient is not in a condition to be moved to the hospital, This treatment is provided under the supervision of a registered medical practitioner.

Ambulance : Actuals up to Base Sum Insured

Transportation of the patient to the hospital and back home

Convalescence benefit : Not available

A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.

Organ Donor : Actuals up to Base Sum Insured

The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.

Bariatric cover : Not available

Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.

Daycare : Actuals up to Base Sum Insured

Covers in-patient hospitalisation expenses where the stay is <24 hours under a specified list of treatments

AYUSH : Actuals up to Base Sum Insured

Alternative treatment coverage such as ayurvedic, unani, sidha and homeopathy which leads to hospitalisation.

Congenital Coverage : Not available

Covers medical expenses related to diagnosis and treatment of heriditary and internal congenital ailments/ conditions/ traits that exist from birth.

Modern Treatments : Actuals up to Base Sum Insured

All advanced treatment with upgrade in technology.

Health Management/ Wellness : Not available

Benefits provided for staying fit and managing health

Maternity Benefit : For BSI INR 50 Lacs and 75 Lacs - Domestic Maternity up to INR 1 Lac For BSI INR 1 Cr and Above - WW Maternity up to of INR 2 Lacs

All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.

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