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Aditya Birla Activ Assure Diamond Health Plan

With increasing medical treatment costs, there is a need for a smart health insurance plan to handle these unforeseen expenses. This is where Aditya Birla's Activ Assure Diamond Plan comes to aid. This all-inclusive benefit-rich plan offers optimal health coverage to secure the health of you and your family.

This plan offers comprehensive coverage with a variety of features, making it one of the most optimal plans to be invested in. This plan offers a high sum assured with an easy buying process.

Key features and benefits

  • Hospitalisation benefits:

  • Coverage against modern treatment expenses

    The plan includes new-age treatments such as robotic surgeries, oral chemotherapy, and balloon sinuplasty procedures.

  • Mental illness expenses covered

    This policy covers In-patient Hospitalisation due to mental illness.

  • Hospitalisation Expenses Covered

    This plan covers illnesses and medical procedures such as COVID-19 and bariatric surgery along with hospitalisation expenses.

  • 586-day care procedures covered

    This comprehensive plan covers 586 listed day-care procedures even if hospitalisation is less than 24-hours (the same is attached below). Diamond Policy Wording

  • 150% Reload of Sum Insured

    Even if the sum insured gets exhausted, the policyholder can get a reload of their sum insured amount by another 150%.*
    *Applicable in case of subsequent claims due to unrelated illnesses.

  • No room rent capping

    This cover is available to the policyholders with a sum insured of Rs. 7 Lakhs and above. They have the freedom to get admitted to the hospital without any restriction on room type.

  • AYUSH treatment

    Policyholders who believe in AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) treatment can also benefit from buying the plan as it covers the in-patient treatment charges for the same.

  • Wellness benefits:

  • Free annual health check-up

    The insured can benefit from an annual free health check-up from day one of the policy for individual and family floater plans.

  • HealthReturns™

    The insured can earn up to 30% of their premium as HealthReturns™.

  • Health coach

    This policy offers access to a health coach for nutritional and wellness counselling.

  • Comprehensive coverages:

  • Cumulative bonus

    If the policyholder opts for the Activ Assure Diamond plan and does not claim it for a fiscal year, they can avail cumulative bonus in the subsequent year.

    The cumulative bonus is 10% of the sum assured for the policy and can be accumulated up to 50%, which is an optional benefit. The cumulative bonus is 50% of the sum insured, max up to 100% of the sum insured.

  • Accidental Hospitalisation Booster

    In case of an accidental hospitalisation, this optional coverage will provide an additional 100% of the sum insured.

  • Cancer hospitalisation booster

    For insured individuals above 18 years, the company will provide an additional 100% sum insured in case of cancer hospitalisation.

Policy Details

Aditya Birla Activ Assure Diamond Health Plan
Insurer name Aditya Birla Health Insurance Co. Limited
Policy type Individual (Self Only)/Family Floater
Entry age Individual plan:
Minimum entry age – 5 years
Maximum entry age – Not applicable
Family floater plan:
Dependent children – 91 days to 5 years
Maximum age– Not applicable
Renewal Lifetime Renewable
Policy term One, two and three years
Sum insured Rs. 2 lakh – Rs. 50 lakh
Premium starting from (Rs.) Rs. 4,059
Number of members covered 6 members (2 adults + 4 children)

How to purchase the policy?

  • To apply for the Aditya Birla Activ, Assure Diamond Insurance plan, click on the 'Apply Now' button and fill in your basic and health details. Our representative will contact you to provide further assistance.
  • Ensure that the information given in the form is complete and accurate.
  • You may undergo a pre-policy medical examination at our network diagnostic centres.
  • Policy schedule, policy wordings, cashless cards, and health guide will be sent to your mailing address.

List of documents required to buy the policy

The following mandatory documents will be needed to purchase the policy:

  • Photograph of the applicant
  • Age proof, such as birth certificate, Voter's ID, PAN card, passport, etc.
  • Identity proof, such as passport, Aadhaar card, PAN card, Voter's ID, etc.
  • Income proof, such as Form 16, salary slips, employment certificate, etc.
  • Address proof, such as telephone bill, electricity bill, passport, bank statement, Voter's ID, etc.
  • Medical test that the insurer requires you to undergo

How to process the claim?

Life is uncertain, and so are medical emergencies and accidents. You can complete your claim processing in a few simple steps.


Cashless claims

With the Aditya Birla Activ Assure Diamond Plan, you can benefit from cashless treatment at more than 6,000+ network hospitals anywhere in the country. The procedure to file a claim is as follows:

 
  • First, search for an Aditya Birla network hospital in the city where you want to get cashless treatment.
  • Intimate Aditya Birla within 48 hours of emergency hospitalisation and 3 days before admission in case of planned hospitalisation.
  • While visiting the hospital, carry the patient’s insurance cashless card or the policy details.
  • Show the health insurance cashless card and valid ID proof at the hospital's insurance desk.
  • Fill in the pre-authorization request form correctly available at the hospital and submit it to the hospital.
  • For quicker action, fill in the request form on the official website and intimate the insurer. Wait for the decision as your request will be reviewed.
  • The insurer may take up to 2 hours after receiving the request and will inform about the decision via an e-mail and an SMS.
  • You can also check the status online. The claim will be processed as per the terms and conditions of the policy after all the formalities are complete.

Reimbursement claim:

  • In case of an emergency admission, you need to notify the insurer within 48 hours and pay the charges to the hospital directly unless they have issued a pre-authorisation.
  • Collection and submission of claim documents: Send the insurer the list of the documents mentioned below within 15 days of discharge from the hospital.
  • After reviewing the documents, the insurer will approve or reject the same as per the policy terms.
  • The insurer will send the reimbursement amount via NEFT to your registered bank account if the request is approved.
  • If the request is rejected, the same will be communicated to your registered contact phone number and e-mail address.

Documents required for reimbursing claims

Collect below mentioned relevant documents in original from the hospital and submit them to the insurer within 15 days of discharge from the hospital.

 
  • All original investigation reports
  • Final hospital discharge summary, FIR or post-mortem report, if any.
  • Pharmacy bills along with the prescription
  • Cancelled cheque or NEFT details for payment.
  • Original bills, receipts, and discharge report.
  • Indoor case papers and duly filled claim form.
  • Original hospital bills and a valid photo ID proof
  • Treating doctor's report
  • Original consultation notes, nature of operation performed, and surgeon's bill and receipt
  • Test reports along with attending doctor's or surgeon's report.

Major policy exclusions

  1. Treatment directly or indirectly arising from or consequent upon war or any act of war, invasion, an act of a foreign enemy, or war-like operations.
  2. Breach of law with criminal intent, intentional self-injury or attempted suicide while sane or insane.
  3. Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol
  4. Circumcision, unless required for the treatment of illness or accidental bodily injury.
  5. Cosmetic, aesthetic, and re-shaping treatments and surgeries.
  6. Psychiatric or psychological disorders and mental disorders.
  7. Hearing aids, spectacles or contact lenses, including optometric therapy.
  8. Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances.
  9. Waiting Period:
    • 15 Days Initial Waiting Period:
    • Initial waiting period: 15 days – 30 days
    • Listed illness/procedure waiting period: 24 months
    • Specified disease/ procedure waiting period: 48 months
    • Pre-existing disease waiting period: 48 months

Given above is an indicative list. Please refer to policy wordings for a detailed list of exclusions and waiting periods.

Claim/ assistance contact details

BFL helpline number: 08698010101

Aditya Birla Health Insurance Co. Limited: 1-800-270-7000 / 1-800-22-7000 

E-mail: –  wecare@bajajfinserv.in

Mailing address:Ground Floor, Bajaj Finserv Corporate Office, Off Pune-Ahmednagar Road, Viman Nagar, Pune – 411014.


*For claim related issues please refer to your document or certificate of insurance (COI).

Disclaimer

Bajaj Finance Limited ('BFL') is a registered corporate agent of third party insurance products of Bajaj Allianz Life Insurance Company Limited, HDFC Life Insurance Company Limited, Future Generali Life Insurance Company Limited, Bajaj Allianz General Insurance Company Limited, SBI General Insurance Co. Ltd, ACKO General Insurance Co. Ltd, Niva Bupa Health Insurance Company Limited, Aditya Birla Health Insurance Company Limited and Manipal Cigna Health Insurance Company Limited under the IRDAI composite registration number CA0101.

Please note that BFL does not underwrite the risk or act as an insurer. Your purchase of an insurance product is purely on a voluntary basis after your exercise of independent due diligence on the suitability and viability of any insurance product. Any decision to purchase an insurance product is solely at your own risk and responsibility, and BFL shall not be liable for any loss or damage that any person may suffer, whether directly or indirectly. This product provides insurance coverage under Aditya Birla Activ Assure Diamond Health Plan with UIN: ADIHLIP21250V032021. For more details on risk factors, terms and conditions, please carefully read the product sales brochure of the insurance company before concluding a sale. Tax benefits applicable, if any, will be as per the prevailing tax laws. BFL does NOT provide tax/investment advisory services. Please consult your advisors before proceeding to purchase an insurance product.

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