Aditya Birla Activ Health Platinum Enhanced 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 Aditya Birla Health Insurance’S Activ Health – Platinum Enhanced
ommulative Bonus
Home Care Treatment Expenses
OPD Treatment
Upto 100% health returns
Features
Sub-limits
No sub-limits
Pre-Hospitalisation : 30 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 : 60 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 : Upto Sum Insured
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 Years
Listed specific illness
Waiting Period- PED : 48 months
No pre-existing ailment related claims are accepted within this period.
Room Rent : a) Shared Room to General/Economy Ward – 10% b) Single Private Room to General/ Economy Ward – 20% c) Single Private Room to Shared Room – 10%
Room rent for in-patient hospitalisation
Co pay : 20% Mandatory
% of the claim that the policyholder needs to pay out-of-pocket
Restore Benefit/ Recharge/ Refill : Not Available
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 : Available, once in a policy year
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
No Claim Bonus : Applicable on Sum Insured: 10% increase, Max up to 100% No reduction on claim
% of the sum insured that rises every claim free year.
Video/telephone consultation : Available
E-consultation with expert doctors empanelled with the insurer for a second opinion.
Domiciliary hospitalization : Available
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 : Network Providers - Covered up to Actual expenses Non- network Providers- Reimbursed up to max of Rs 2,000 per hospitalization
Transportation of the patient to the hospital and back home
Convalescence benefit : Only expenses
A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.
Organ Donor : Not Available
The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.
Bariatric cover : up to max of Rs 2,000 per
Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.
Daycare : Not Available
Covers in-patient hospitalisation expenses where the stay is <24 hours under a specified list of treatments
AYUSH : Not Available
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 : Upto Sum Insured
All advanced treatment with upgrade in technology.
Health Management/ Wellness : Available
Benefits provided for staying fit and managing health
Maternity Benefit : Available
All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.