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Aditya Birla Group Activ Health Plan

Today, a majority of people suffer from pre-existing medical conditions, which are usually not covered under most of the regular health insurance plans. To ensure you are adequately covered against all kinds of health conditions, Aditya Birla Health Insurance offers Group Activ Health Plan that covers chronic illnesses like asthma, blood pressure, cholesterol, and diabetes also known as ABCD conditions.

With the help of this policy, you can stay covered against expenses arising out of medical emergencies and hospital treatments for all the insured members.

Key features And benefits

  • Cashless Claim Settlement

    Cashless claim settlement

    The policyholder can avail of cashless claim settlement at any of the network hospitals across India.

  • ABCD disease coverage

    Aditya Birla Group Activ Health Plan covers chronic illnesses like asthma, blood pressure, cholesterol and diabetes also called ABCD conditions.

  • Pre-hospitalisation expenses

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

  • group activ health plan

    Post-hospitalisation expenses

    This policy covers medical costs for illness or injury for 60 days after hospitalisation.

  • 527-day care procedures are covered

    This comprehensive plan covers a total of 527 day-care listed procedures as mentioned in the  group policy wordings.

  • Free health check-up

    The policyholder can avail of free annual health check-up under this policy.

  • Freedom to select the hospital room

    Option to select a shared/single private room during a hospital stay.

  • aditya birla group activ health plan

    Organ donor expenses

    The policy covers organ donor expenses to the extent of the maximum sum insured under this policy.

  • Emergency road ambulance cover

    The plan covers emergency ambulance expenses up to Rs. 2,500 during the policy period.

  • aditya birla group activ health plan

    Tax benefits

    Policyholders can avail of tax exemption under this policy as per section 80D of Income tax act, 1961.

Policy Details

Here are the details of the policy:

Policy Details Group Activ Health - With Co-pay Group Activ Health - Without Co-pay
Policy type Group (For customers of Bajaj Finance Ltd only)  Group (For customers of Bajaj Finance Ltd only)  
Entry age Children – 18 years
Adults – 60 years
Dependent children age 0-25 Years
Children – 18 years
Adults – 60 years
Dependent children age 0-25 Years
Co Pay 10% limited to maximum of Rs.10000 on all claims Not Available
Tenure Annual plan Annual plan
Sum Insured Rs. 2 lakh – Rs. 10 lakh Rs. 2 lakh – Rs. 10 lakh
Starting Premium Including taxes Rs. 5021(Rate are subject to change from 1st Apr 2021) Rs. 5021(Rate are subject to change from 1st Apr 2021)
Number of Members covered 6 members (2 Adults + 4 Children) 6 members (2 Adults + 4 Children)

Plans available

Health insurance helps you stay stress-free during medical emergencies arising due to sickness and accidental injury. Premiums for Group Activ Health with co-pay is Rs. 8,198 and without co-pay is Rs. 8,781.

What is Covered in Aditya Birla Group Activ Health Plan?

Here’s a quick look at the benefits covered under the Aditya Birla Group Activ Health Plan.

Features Description
Chronic diseases Asthma, blood pressure, cholesterol, and diabetes are covered.
Daycare procedures 527 daycare procedures covered. Check the list here.
Pre-and post-hospitalisation Medical expenses incurred from 30 days before hospitalisation and till 60 days after hospitalisation are covered.
Emergency road ambulance cover Get a compensation of Rs. 2,500 for booking an emergency ambulance to carry the patient to the hospital.

How to Purchase the Policy

Here are the steps to purchase the policy:

  • To apply for the Aditya Birla Group Activ Health Plan, click on the 'Get Quote' button and fill in your basic and health details. For further assistance, you may contact the insurance provider.
  • Ensure that the information given in the form is accurate and complete.
  • You may be required to undergo a pre-policy medical examination at any of Aditya Birla Group’s 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

Here are the mandatory documents required 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 tests that the insurer requires you to undergo

How to process a claim?

Here are the steps to process your claim with the insurer:

Cashless claims

With the Aditya Birla Group Activ Health Insurance Plan, you can benefit from cashless treatment at more than 6,000 network hospitals across the country. Here's the procedure to file a claim:

  • First, search for an Aditya Birla capital health insurance network hospital in the city where you want to get cashless treatment
  • Intimate the insurer within 48 hours of emergency hospitalization and 3 days before admission in case of planned hospitalization.
  • 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, which will be 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 per the terms and conditions of the policy after all the formalities are completed.

Reimbursement claims

  • In case of an emergency admission, you need to notify the insurer within 48 hours and pay the charges to the hospital directly unless the insurer has issued a pre-authorisation.
  • For collection and submission of claim documents, you can send the required documents listed below within 15 days of discharge from the hospital:
  1. Original investigation reports
  2. A final hospital discharge summary, FIR or post-mortem report, in case of death
  3. Pharmacy bills along with the prescription
  4. Cancelled cheque or NEFT details for payment
  5. Original bills, receipts, and discharge report
  6. Indoor case papers and duly filled claim form
  7. Original hospital bills, patient's valid photo ID proof, and doctor's report
  8. Original consultation notes, nature of operation performed, and surgeon's bill and receipt
  9. Test reports along with attending doctor's or surgeon's report
  • After reviewing the above documents, the insurer will approve or reject the same 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 you on your registered contact phone number and e-mail address.

Major policy exclusions

Here are some of the exclusions under the aditya birla capital health insurance policy:

  1. Ayurveda/homoeopathy hospitalisation benefit
  2. Daily cash and sum insured reinstatement
  3. Dental treatments and cosmetic surgeries
  4. Fertility, sub-fertility, infertility, sterility, erectile dysfunction, impotence, assisted-conception operation or sterilisation procedure
  5. Human Immunodeficiency Virus (HIV) or variant/mutant viruses and or any syndrome or condition of a similar kind, commonly referred to as AIDS

Waiting periods

Here are the waiting periods under the policy:

◦ Initial waiting period: 30 days
◦ Pre-existing waiting period: 2 years
◦ Special illness restriction: 2 years
◦ Hypertension, diabetes, asthma and cholesterol: 2 years

Note: Refer to the policy brochure to know more about the exclusions.

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 policy document or Certificate of Insurance (COI).

Disclaimer

Conditions apply. This product is offered under the Group Insurance scheme wherein Bajaj Finance Limited is the Master policyholder. The insurance coverage is provided by our partner Insurance Company. Bajaj Finance Limited does not underwrite the risk. IRDAI Corporate Agency Registration Number CA0101. The above-mentioned benefits and premium amount are subject to various factors such as the age of insured, lifestyle habits, health, etc. (if applicable). BFL does not hold any responsibility for the issuance, quality, serviceability, maintenance, and any claims post-sale. This product provides insurance coverage under Aditya Birla Group Activ Health insurance plan, UIN: IRDAI/HLT/ABHI/P-H(G)/V.1/19/2016-17. Please refer insurer's website for Policy Wordings. Purchase of this product is purely voluntary. BFL does not compel any of its customers to mandatorily purchase any third-party products.

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