Aditya Birla Activ Assure Diamond Health Plan

In recent times there has been an increase in medical treatment costs, and one needs to be financially independent to handle the sudden medical expenses. To ensure you meet these expenses, Aditya Birla’s Activ Assure Diamond Plan brings to you an all-inclusive benefit-rich plan that covers most of the health needs. This plan offers a comprehensive coverage against a wide range of health features, making it one of the most optimal plans for investment.

Key Features and Benefits

  • Modern treatment methods covered

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

  • Mental illness expenses covered

    This policy covers in-patient hospitalisation due to mental illness.

  • Domiciliary hospitalisation covered

    Any expenses incurred for treatment of an illness/injury at home will be covered under the plan. This coverage is applicable, if the home treatment is taken in case a patient isn’t in condition to be moved to a hospital or due to non-availability of a hospital bed.

  • In-patient hospitalisation expenses

    Aditya Birla Activ Assure Diamond plan covers the in-patient hospitalization charges which includes the consultation fee, nursing fee, room rent and OT charges.

  • Pre-hospitalisation expenses

    This policy covers medical costs incurred due to an illness or injury 30 days immediately before hospitalisation.

  • Post-hospitalisation expenses

    The plan pays for the medical costs incurred due to an illness or injury 60 days immediately after hospitalisation.

  • Super no claim bonus

    You can avail the benefit of No Claims Bonus (NCB) for having a claim-free year with Active Assure Diamond Plan. The NCB offered is 10% of the sum insured in the policy and can be accumulated up to 50%. SuperNCB which is an optional benefit, offers an NCB of a minimum of 50% and a maximum of 100% on the sum insured.

  • 586-day care procedures are covered

    This comprehensive plan covers a total of 586 day-care listed procedures.
    Diamond Policy Wording

  • Second e-opinion for critical illness

    Diagnosis of a critical illness can be a devastating news for a family. To help you seek a second opinion, the plan offers an online facility enabling you to consult expert doctors easily. It offers second e-opinion facility for the top critical illnesses mentioned in the policy wordings.

  • Free health check-up

    For both individual and family floater plan, the insured can avail the benefit of annual free health check-up which are based on the age and the sum insured opted for.

  • • Reduction in pre-existing diseases waiting period

    You will have the option to reduce pre-existing diseases waiting period to 24 months from the inception of the policy. This applies all the insured persons covered under this policy.

  • Emergency road ambulance cover

    The plan covers emergency ambulance expenses during the policy period.

  • Vaccination cover

    Vaccination expenses for the new-born baby till the age of two years will be covered in this policy. Please refer the policy wording for the detailed list of vaccines covered.

  • Accidental hospitalisation booster

    In case of an accident, this optional coverage will provide an additional sum-insured equal to the sum insured for in-patient hospitalization.

  • Cancer hospitalisation booster

    For the insured above 18 years, the company will provide an additional sum-insured equal to the sum-insured for in-patient hospitalization.

  • Room upgrade facility

    This optional cover is available to the policyholders with Rs. 5 lakh sum insured. 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.

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 – No max-age
Family Floater
Dependent Children – 91 days to 5 years
Maximum age– No Maximum age
Renewal Lifetime Renewable
Tenure One, two and three years
Sum Insured Rs. 2 lakh – Rs. 2 crore
Number of members covered 6 members (2Adults+4Children)

Plans Available

Health Insurance helps you to be stress-free while dealing with medical contingencies due to sickness and accidental injuries. The plans are available starting from Rs. 2774(including taxes), with maximum coverage of Rs. 2 crore, to know more about the plans in detail please click here

How to Purchase the Policy

  • To apply for the Aditya Birla Activ Assure Diamond Insurance plan, click on the 'Buy Now' button and fill in your basic and health details.
  • Ensure that the information given in the form is complete and accurate.
  • You may be required to 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.

How to Process the Claim

Life is uncertain and so are medical emergencies and accidents. We are here to guide you in these tough times and complete your claim processing in a few simple steps


Cashless Claims

With the Aditya Birla Activ Assure Diamond Plan, you can avail the benefit of 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 the insurer within 48 hours (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 insurance desk of the hospital.
  • Fill in the pre-authorization request form correctly available at the hospital and submit it to the hospital.
  • For quicker action, fill 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 completed.

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 a pre-authorization has been issued by us.
  • Collection and submission of claim documents- send 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 terms and policy.
  • If the request is approved, the insurer will send the reimbursement amount via NEFT to your registered bank account.
  • If the request is rejected, the same will be communicated to your registered contact phone number and email id.

Documents Required for Reimbursement Claims:

Collect below mentioned relevant document in original from the hospital and submit them to us within 15 days of discharge from the hospital

 
  • Original investigation reports
  • Final hospital discharge summary FIR or post-mortem report if happened
  • 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, act of foreign enemy, 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. Circumstance unless required for the treatment of Illness or accidental bodily injury.
  5. Cosmetic, aesthetic and re-shaping treatments & surgeries.
  6. Psychiatric or psychological disorders, 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: In case the insured members are diagnosed with COVID-19.
    • Listed Illness/Procedure Waiting Period: 24 Months
    • Initial Waiting Period: 30 Days (not applicable in case of accident and subsequent renewal)
    • Specified Disease/Procedure Waiting Period: 48 Months
    • Pre-existing Disease Waiting period: 48 months
 
This is an indicative list. Please refer to policy wordings for 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 your policy 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,General Insurance Company Limited, ACKO General Insurance Limited, Max 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 an independent due diligence on the suitability, viability of any insurance product. Any decision to purchase 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.