Aditya Birla Activ Health Essential
Aditya Birla Capital has a wide number of policies that cater to the dynamic need of its potential policyholders. Having said that, Aditya Birla Activ Health Essential plan is one of its kind health insurance policies one can consider for.
Health insurance being one of the necessities these days, it is equally important that one selects the right cover available. In this regard, anyone looking for extensive health coverage can go for this health insurance from Aditya Birla.
What is Aditya Birla Activ Health Essential?
Aditya Birla Activ Health Essential policy is a health insurance plan not only provides health cover but also rewards the policyholder for maintaining a healthy lifestyle. With the specific objective of improving and building on healthy living, this plan comes with the added benefits of HealthReturns.
Features and Benefits of Aditya Birla Activ Health Essential
The features of Aditya Birla Activ Health Essential online insurance plan are as follows:
- Term: Potential policyholders can choose between a policy term of 1, 2, or 3 years depending on their preference.
- Sum Insured: The minimum sum insured to be availed with Aditya Birla Activ Health Essential is Rs 50,000. On the other hand, the maximum sum insured amount that could be availed from this insurance policy is Rs10 lacs
- Pre/Post Hospitalisation Cover: Aditya Birla Activ Health Essential provides coverage for hospitalization medicals bill for 60 days (2 months) after treatment or discharged, so that the policyholder may recover to the fullest. Similarly, the policy also covers the medical expenses for 30 days worth of pre-hospitalization medical bills and expenditures.
- Lifestyle Bonuses: Aditya Birla Activ Health Essential insurance rewards the policyholder for staying healthy and fit.by maintaining a healthy and optimized lifestyle. The policyholder can be eligible for added benefits like reduced premiums and expanded coverage for the family of the policyholder
- Health Monitoring: Policyholders and the dependents of the family floater of the policy receive the option to avail health check-ups. Each adult (as mentioned in the policy) gets a free health care check-up every year. This check-up is customized as per the stage the policyholder’s life is at
- Home Coverage: If the policyholder is unable to go to a hospital and is in need to be treated at home, then Aditya Birla Activ Health Essential still provides coverage for the expenses for the treatment
- Day Carea Cover: A wide number of hospitalized treatment do not require the patient to stay in the hospital for prolonged periods.in such situations, Aditya Birla Activ Health Essential policy provides the policyholder coverge for 527 daycare procedures.
Benefits of Aditya Birla Active Essential Plan
Aditya Birla Activ Health Essential insurance policy also has added benefits on top of its regular features:
- Aditya Birla Activ Health Essential is liable to tax benefits on the premium paid as per Section 80 D of the Income Tax Act of 1981
- Upon being admitted to a hospital for treatment, the policyholder has the flexibility in choosing the type of hospital room/ bed as per the policy
- The policyholder can earn back up to 30% of the premiums of the policy by simply staying healthy and adopting a healthy, sustainable lifestyle
- Additionally, the policyholder can get a cumulative bonus of 10% of the Sum Assured for each year he or she does not apply for a claim. This can be added up to a total of 100% cumulative bonus of the Sum Assured
- Aditya Birla Activ Health Essential plan offers coverage against 527 different daycare procedures
- Also, Aditya Birla Activ Health Essential health insurance plan provides one day cover for the treatment of major chronic diseases like Diabetes, Hypertension, high cholesterol, and other ailments in association with the Chronic Management program
- The policy offers day 1 cover fro chronic disorders such as diabetes, hypertension, asthama, high cholesterol etc.
Exclusions of Aditya Birla Activ Health Essential Policy
With all the features and benefits that Aditya Birla Activ Health Essential plan offers, certain clauses termed as exclusions of this policy, which are not covered by the policy. This means that the policyholder will not be eligible for a claim in the instance that he or she faces these below-mentioned situations:
- Drug Abuse/ Recreational Medication: This includes the illegal use of medication that has not been prescribed and thus leads to a medical emergency or detreated health condition.
- Cosmetic Surgery: Any surgery or operation that is outside the scop of health issue is not covered by the Aditya Birla Activ Health Essential plan. Cosmetic surgery does not correlate to any health conditions that have much significant effect on one’s health. Similarly, complications resulting from cosmetic surgeries are not covered by the Aditya Birla Activ Health Essential plan
- Treatment Availed Outside the Country: The Aditya Birla Activ Health Essential will not cover any medical treatment done in a foreign country. This health insurance plan is only applicable within the geographical boundary of India.
- Mental Conditions/ Disorders: This includes mental conditions like Parkinson’s, Alzheimer’s, run-down condition, stress, and other general debilities or exhaustion which are excluded.
- Injuries from Extreme Sports: This policy will not cover those who incur a medical emergency from an extreme sport in a professional to semi-natural sense. This includes injuries from sports like, parasailing, water polo, skydiving, bungee jumping, ballooning, and other sports that may involve snow and/ or water. Similarly, racing sports like horseback riding, vehicular racing, flying, underwater exploration/ diving, hang gliding, rock and mountain climbing, etc. are not included in Aditya Birla Activ Health Essential coverage policy.
- War: If the policyholder were to be affected with ailment or injury as a direct or indirect result of actions like war, invasion, retaliation of a foreign country/ enemy, and similar such operations, then Aditya Birla Activ Health Essential policy will not provide coverage.
- Medical Procedures/ Conditions: Certain medical conditions are incurable, like HIV and AIDS. These, along with genetic and hereditary disorders, are not covered. Similarly, the exclusions from this policy also entail medical procedures like circumcision and dental treatment
- Self-harm: If the policyholder were to expose him or herself to harm on purpose or inflict self-injuries or actively disregards adherence to medical advice, then he or she will not receive coverage for the damage sustained as a result of such activities
Eligibility Criteria to Buy Aditya Birla Active Health Essential Plan
To be eligible for Aditya Birla Activ Health Essential insurance policy, the potential policyholder must:
- Have a minimum entry are of 91 days. There is no maximum limit to the age for entry.
- Children, till the age of 25 years can be covered by the policy floater as dependents of the policy.
- The floater allows the policyholder to cover his or her family consisting of the policyholder him/ herself along with three children (till the age of 25) and a spouse, parents who are dependents, and parents-in-law.
Aditya Birla Active Health Essential Plan: Claim Process
When it comes to the claim process, the policyholder can choose between a cashless claim or a reimbursement claim.
Cashless Claim Settlement:
- The policyholder must first get admitted to a hospital network and follow the formalities
- At the time of admiiting, the Aditya Birla Activ Health Essential policy number or a cashless card has to be furnished to avail services, along with appropriate proof of identity.
- The cashless pre-authorization form or the cashless hospitalization request form must be filled out and submitted.
- After submission, the insurer shall have the form reviewed and accordingly approve the form
- After approval, the claim settlement hall is processed. The policyholder and his or her family members can track and check the status of the claim at the official Aditya Birla Capital website
For a reimbursement claim process, the policyholder is required to intimate his insurer within 15 days on his or her discharge from the hospital and is required to submit the following:
- Part A and B of the Claim Form
- Imaging reports from before and after the treatment/operation
- Copy of the insurance policy along with KYC proof and health card
- FIR copy or certificate of Medico-Legal
- Copy of the Certificate of Hospital Registration
- Medical bills
- Discharge proof/ certificate
- Previous diagnosis and medical documents
- Final hospital with detailed break- up of all incorporated expenses
- Attested letter of the practicing medical professional who is in charge of treatment
After submitting the documents mentioned above, the insurer shall check and approve the claim accordingly. Upon approval, the amount shall be reimbursed to the policyholder's bank account via NEFT transaction.
How to Buy Aditya Birla Activ Health Essential Plan?
Those who wish to buy a health insurance plan from Aditya Birla's capital insurance company can easily go for it by visiting there official website.
People can visit the site and compare Aditya Birla Activ Health Essential online with other health insurance policies and find the one which best suits their needs.
Steps to purchase Aditya Birla Activ Health Essential plan online are as follows:
- Visit the Aditya Birla Capital website
- Compare and contrast different health insurance policies that the company has to offer
- Select the desired policy and get a ‘quick quote’ for further details about the selected policy
- Scan and upload the required documents in the form of images and attach it with the application form
- Select the method of premium payment
- Payments for purchase can be made directly online through NEFT transactions and net banking
Alternatively, one can visit the nearest Aditya Birla Capital Insurance Branch and get in touch with one of their agents and directly purchase Aditya Birla Activ Health Essential policy from them.
Documents Required to Buy Aditya Birla Active Essential Plan
The following documents are required to purchase the Aditya Birla Activ Health Essential policy:
- The filled-out police application form
- KYC address proof and ID proof- This can be provided through Aadhaar card, Voter’s ID card, passport, driver’s license, etc.
- Medical check-up report- This report may or may not be required depending on the health of the applying policyholder. According to their health, the managing insurance agent may ask for a medical report of the applicant
Aditya Birla Activ Health Essential Insurance Renewal Process
The Aditya Birla Activ Health Essential insurance plan renewal process is as simple as buying this policy. If someone is reneweing the policy online, then the below-mentioned steps are to be followed:
- Visit the Aditya Birla Capital official website
- Go to the renew tab and select 'quick renew’
- Enter the policy number along with the birth date and mobile number of the proposer
- Fill out the renewal application form
- Attach the necessary documents along with a copy of the original policy
- Pay the renewal premium through net banking, NEFT, or by visiting the nearest Aditya Birla Capital insurance branch
After submitting the necessary forms, the appropriate insurance agent shall review the renewal form for approval. After approval, the policy shall be renewed.
Ans: Different factors that affect the rate of premium for medical health insurance are:
- Coverage amount
- Age of the policyholder
- Smoking habits if any
- Medical history
- Lifestyle choices of the policyholder
Ans: In a cashless claim, the insurance provider is directly responsible for paying and covering the medical bill on behalf of the policyholder. This way, in times of medical emergencies, the policyholder needs not to worry about the proceedings of financial transactions.
Ans: No, if the policyholder gets injured or develops additional medical conditions while in the waiting period of the policy, then the policy will not cover that injury/ medical condition, except it is an accidental injury.
Ans: The Aditya Birla Activ Health Essential offers the policyholder the opportunity to earn back up to 30% of the premiums by simply being healthy. This comes in the form of health retunes, which is an added benefit of the Aditya Birla Activ Health Essential policy.
Ans: The Aditya Birla Activ Health Essential insurance plan can be availed either an individual or a family floater basis. The individual floater provides coverage only to the policyholder, whereas the family floater stretches the coverage to the family members of the policyholder. This generally entails the inclusion of 6 family members (inclusive of the policyholder) and three children till the age of 25 years.
Written By: Paisawiki - Updated: 18 November 2020