Question 1

What is the minimum and maximum entry age for Activ Health Platinum Enhanced?

Accepted Answer

The minimum entry age is 91 days for dependent children and 18 years for adults. There is no maximum entry age, allowing individuals to enter the policy at any age, subject to underwriting norms.

Question 2

Till what age can my child stay covered under Activ Health Platinum Enhanced?

Accepted Answer

Dependent children can remain covered under Activ Health Platinum Enhanced up to 25 years of age, provided they are financially dependent on the proposer and continue to meet the policy’s eligibility conditions.

Question 3

Are unmarried children eligible under Activ Health Platinum Enhanced?

Accepted Answer

Yes, unmarried dependent children are eligible for coverage under Activ Health Platinum Enhanced until the specified age limit, as long as they remain financially dependent and are included under the family floater policy.

Question 4

Can I add a new family member later under Activ Health Platinum Enhanced?

Accepted Answer

Yes, you can add a new family member such as a spouse or newborn child either during policy renewal or mid-term in case of specific life events, subject to underwriting and policy conditions.

Question 5

Can my spouse and children be covered under a single sum insured?

Accepted Answer

Yes, Activ Health Platinum Enhanced allows you to cover yourself, your spouse, and dependent children under a single floater sum insured, making it a cost-effective option for family health coverage.

Question 6

Can I cover my parents under Activ Health Platinum Enhanced?

Accepted Answer

Yes, parents can be covered under Activ Health Platinum Enhanced, either within a family floater or under a separate policy, depending on age, health condition, and underwriting acceptance.

Question 7

Can family members be added mid-term under Activ Health Platinum Enhanced?

Accepted Answer

Family members can generally be added mid-term only in the case of life events like marriage or childbirth; otherwise, additions are permitted at the time of policy renewal.

Question 8

What is the PED waiting period if I port to this plan?

Accepted Answer

If you port from another health insurer, the waiting period already served for pre-existing diseases is carried forward, reducing the remaining waiting period under this plan.

Question 9

Can I port my existing health policy to Activ Health Platinum Enhanced?

Accepted Answer

Yes, you can port your existing health insurance policy to Activ Health Platinum Enhanced while retaining continuity benefits such as waiting period credits, subject to underwriting approval.

Question 10

What is the PED waiting period after porting into Activ Health Platinum Enhanced?

Accepted Answer

After porting into Activ Health Platinum Enhanced, the remaining pre-existing disease waiting period is reduced by the duration already completed with the previous insurer, ensuring continuity without restarting the waiting period.

Question 11

What unique benefits does Activ Health Platinum Enhanced offer?

Accepted Answer

The plan stands out with high sum insured options, no room rent limits, international coverage, chronic care programs, and an integrated wellness and rewards ecosystem.

Question 12

Does Activ Health Platinum Enhanced come with disease-wise sub-limits?

Accepted Answer

No, the policy generally does not impose disease-wise sub-limits, offering broader and more flexible coverage for most medical treatments and procedures.

Question 13

Is co-payment compulsory under Activ Health Platinum Enhanced?

Accepted Answer

Co-payment is not compulsory under this plan, unless specifically selected at the time of purchase or applicable due to age-based conditions mentioned in the policy.

Question 14

Does Activ Health Platinum Enhanced offer a No-Claim Bonus?

Accepted Answer

Yes, the policy offers a cumulative No-Claim Bonus that increases the sum insured for every claim-free year, helping enhance coverage without a proportional rise in premium.

Question 15

Does Activ Health Platinum Enhanced provide any loyalty bonus?

Accepted Answer

Loyalty benefits are offered through wellness rewards and renewal-related advantages, encouraging long-term policy continuation and healthy lifestyle practices.

Question 16

Are preventive health check-ups included in all sum insured options?

Accepted Answer

Yes, preventive health check-ups are included across all sum insured options, usually available after a defined policy duration, to promote early detection and preventive care.

Question 17

Does Aditya Birla Health Insurance offer lifelong renewals?

Accepted Answer

Yes, Activ Health Platinum Enhanced offers lifelong renewability, ensuring you can continue coverage throughout your lifetime by renewing the policy on time.

Question 18

Is there a grace period for renewing the policy after expiry?

Accepted Answer

Yes, a grace period of 30 days is provided after policy expiry, during which you can renew the policy without losing continuity benefits, though coverage may pause temporarily.

Question 19

What are the available sum insured options under Activ Health Platinum Enhanced?

Accepted Answer

The plan offers flexible sum insured options ranging from ₹2 lakh up to ₹2 crore, allowing policyholders to select coverage based on medical needs, family size, and long-term healthcare planning.

Question 20

Does Activ Health Platinum Enhanced offer maternity and newborn benefits?

Accepted Answer

Yes, the policy provides maternity and newborn coverage after a specified waiting period, covering delivery expenses and initial medical care for the newborn as per defined policy limits.

Question 21

Are pregnancy-related complications covered under Activ Health Platinum Enhanced?

Accepted Answer

Pregnancy-related complications are covered once maternity benefits become active, provided the complications fall within the policy definitions and are not listed under standard exclusions.

Question 22

Are daycare procedures covered in Activ Health Platinum Enhanced?

Accepted Answer

Yes, the plan covers a wide range of listed daycare procedures that do not require 24-hour hospitalisation, provided the treatment is medically necessary and performed at a recognised hospital.

Question 23

Are pre- and post-hospitalization expenses covered, and for how many days?

Accepted Answer

The policy covers pre-hospitalization expenses for up to 60 days and post-hospitalization expenses for up to 180 days, as long as they are related to an approved hospitalization claim.

Question 24

Does Activ Health Platinum Enhanced include OPD coverage?

Accepted Answer

Yes, OPD consultations, diagnostic tests, and pharmacy expenses are covered through the policy’s wellness and HealthReturns™ benefits, subject to annual limits and applicable terms and conditions.

Question 25

Are room rent or ICU charges capped under Activ Health Platinum Enhanced?

Accepted Answer

No, Activ Health Platinum Enhanced does not impose room rent or ICU sub-limits, allowing you to choose any room category without facing proportionate deductions during claim settlement.

Question 26

Is chemotherapy covered under Activ Health Platinum Enhanced?

Accepted Answer

Yes, chemotherapy is covered under both inpatient hospitalization and eligible daycare treatments, provided it is medically necessary and carried out as per policy coverage guidelines.

Question 27

Are lifestyle diseases covered from day one or after a waiting period?

Accepted Answer

Chronic lifestyle diseases such as diabetes and hypertension are managed under dedicated health programs, while hospitalization related to these conditions is covered after the applicable waiting period.

Question 28

Does Activ Health Platinum Enhanced include mental health treatments or counselling?

Accepted Answer

Yes, the policy covers hospitalisation for mental health conditions, including psychiatric illnesses, along with related pre- and post-hospitalisation expenses, in line with regulatory guidelines.

Question 29

Does Activ Health Platinum Enhanced cover AYUSH treatments?

Accepted Answer

Yes, AYUSH treatments including Ayurveda, Yoga, Unani, Siddha, and Homeopathy are covered when taken as inpatient or daycare treatment at government-recognised AYUSH hospitals.

Question 30

Are diagnostic tests and pathology covered under Activ Health Platinum Enhanced?

Accepted Answer

Diagnostic tests and pathology expenses are covered when prescribed as part of a covered hospitalization or eligible OPD and wellness benefits, subject to policy limits and conditions.

Question 31

Is ambulance service covered under Activ Health Platinum Enhanced?

Accepted Answer

Yes, ambulance charges are covered under the policy, including emergency road ambulance services, subject to defined limits and provided the service is linked to a valid hospitalisation claim.

Question 32

Is organ donor surgery covered under Activ Health Platinum Enhanced?

Accepted Answer

Yes, expenses related to organ donor surgery, including harvesting costs, are covered when the insured person is the recipient, subject to policy terms and medical necessity.

Question 33

Are congenital conditions covered for children under Activ Health Platinum Enhanced?

Accepted Answer

Congenital external conditions are generally covered from birth, while congenital internal conditions are covered after the specified waiting period, subject to policy definitions and exclusions.

Question 34

Does Activ Health Platinum Enhanced cover vaccinations for adults and children?

Accepted Answer

Vaccinations for adults and children may be covered under wellness or preventive care benefits, subject to defined limits and availability under the HealthReturns™ ecosystem.

Question 35

Does Activ Health Platinum Enhanced provide international coverage?

Accepted Answer

Yes, the policy offers international coverage for emergency medical treatment abroad, subject to defined conditions, treatment eligibility, and policy limits as mentioned in the policy wording.

Question 36

Are occupational hazards or accident-related injuries covered?

Accepted Answer

Yes, injuries arising due to accidents, including occupational hazards, are covered under the policy, provided the occupation is not specifically excluded at the time of policy issuance.

Question 37

Are cosmetic or plastic surgeries covered, and under what conditions?

Accepted Answer

Cosmetic or plastic surgeries are covered only if they are medically necessary due to accidents, burns, or congenital defects, and not when performed purely for aesthetic purposes.

Question 38

Does Activ Health Platinum Enhanced include chronic disease management support?

Accepted Answer

Yes, the policy includes structured chronic disease management programs that offer continuous monitoring, expert guidance, and health support for long-term medical conditions.

Question 39

Are wellness, fitness, or reward-based benefits included?

Accepted Answer

Yes, the plan offers HealthReturns™ and wellness rewards that incentivise healthy behaviour and can be redeemed for OPD expenses, diagnostics, medicines, or future premium payments.

Question 40

Does Activ Health Platinum Enhanced provide any death benefit?

Accepted Answer

No, Activ Health Platinum Enhanced is a health insurance plan and does not provide a separate death benefit, as it is designed purely for covering medical expenses.

Question 41

What are PEDs, and when are they covered under Activ Health Platinum Enhanced?

Accepted Answer

Pre-existing diseases are medical conditions present before purchasing the policy and are covered after completion of the specified waiting period, provided they were disclosed at proposal stage.

Question 42

Is day-1 PED coverage available under Activ Health Platinum Enhanced?

Accepted Answer

Day-one coverage for pre-existing diseases is not a standard feature of this plan and is available only if explicitly offered under specific underwriting-approved options.

Question 43

What is the waiting period for PEDs under Activ Health Platinum Enhanced?

Accepted Answer

The standard waiting period for pre-existing diseases under Activ Health Platinum Enhanced is 36 months from the policy commencement date, after which related claims become admissible.

Question 44

Does Aditya Birla offer top-up or super top-up options with this plan?

Accepted Answer

Yes, Aditya Birla Health Insurance offers top-up and super top-up plans that can be used alongside Activ Health Platinum Enhanced to increase overall coverage at affordable premiums.

Question 45

Does Activ Health Platinum Enhanced offer cashless hospitalisation?

Accepted Answer

Yes, the policy provides cashless hospitalisation across a large network of hospitals in India, subject to pre-authorisation and compliance with policy terms and conditions.

Question 46

How long does Aditya Birla take to approve cashless claims?

Accepted Answer

Cashless claims are usually approved within a few hours, provided all required documents and pre-authorisation requests are submitted correctly by the hospital and meet policy requirements.

Question 47

What documents are required to file a claim under this plan?

Accepted Answer

Documents generally include a completed claim form, discharge summary, hospital bills, prescriptions, diagnostic reports, identity proof, and any other documents requested by the insurer.

Question 48

Is pre-authorisation mandatory for hospitalisation under this plan?

Accepted Answer

Yes, pre-authorisation is mandatory for planned hospitalisations to avail cashless benefits, while emergency hospitalisations must be informed within the stipulated time period.

Question 49

How many claims can I make in one policy year?

Accepted Answer

There is no limit on the number of claims you can make in a policy year, as long as the cumulative claim amount does not exceed the available sum insured.

Question 50

Is the hospital network list available, and can I use non-network hospitals?

Accepted Answer

Yes, the network hospital list is easily accessible, and treatment at non-network hospitals is also allowed through reimbursement claims, subject to policy conditions.

Question 51

What is the claim settlement ratio of Aditya Birla Health Insurance?

Accepted Answer

Aditya Birla Health Insurance maintains a strong overall claim settlement performance at the company level, reflecting efficient claim handling and customer-focused processes.

Aditya Birla Activ Health Platinum Enhanced

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Expert Review: Aditya Birla Activ Health Platinum Enhanced

Final Verdict

What Is Activ Health Platinum Enhanced?

Enhanced

Insurer Rating

8.21

Insurance Rating

8.75

Additional Benefits (Informational Only — Not part of score)

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Aditya Birla Activ Health Platinum Enhanced Inclusions and Exclusions

Pre-Hospitalisation

Claim Settlement Ratio

Room Rent

Cashless Healthcare Providers

Daycare Treatment

Modern Treatment

ICU Charges

Cumulative Bonus

Consumable Cover

Initial Waiting Period

Specific Waiting Period

PED Waiting Period

Annual Health Checkup

Post-Hospitalisation

Outpatient Department Cover (OPD Expense)

Deductible Option

Coverage Options

Maternity Cover

AYUSH Treatment

Co-payment

Disease-wise sublimits

Restoration Benefit

Exclusions

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