Aditya Birla Group Active Health Plan

Today, a majority of people suffer from pre-existing medical conditions. Many health insurance policies available in the market exclude these existing illnesses before offering a health cover. Considering this fact, Aditya Birla Health Insurance has come up with a flexible Group Activ Health Plan that covers expenses arising out of medical emergency and hospital treatment for all the insured members.

The policy covers critical illnesses like asthma, blood pressure, cholesterol, and diabetes which are collectively known as ABCD conditions.

Key Features and Benefits

The key features covered under this group health cover are as follows:

• 

  Cashless claim settlement

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

• 

  ABCD disease coverage

  Aditya Birla Group Activ Health Plan includes 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.

• 

  Post-hospitalisation expenses

  The Group Activ Plan 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 enjoy 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.

• 

  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.

• 

  Tax benefits

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

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. 5,021 with and offer a maximum coverage of Rs. 10 lakh.

• To apply for the Aditya Birla Group Activ Health Insurance Plan, click on the 'Get Quote' button and fill in your basic and health details. For futher 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 the Aditya Birla Group network diagnostic centres.
• Policy schedule, policy wordings, cashless cards and health guide will be sent to your mailing address.

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.

To raise the claim follow the below given guidelines.

With the Aditya Birla Group Activ Health Insurance Plan, you can avail the benefit of cashless treatment from 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 in case 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 insurance desk of the hospital.
• Fill in the pre-authorisation 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 Claims:
Documents needed to process 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-authorisation has been issued by the insurer.
• For collection and submission of claim documents, you 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.
• 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 to be produced for reimbursement claim.
• A final hospital discharge summary FIR or post-mortem report in case of death to be given.
• 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, patient’s valid photo ID proof, and 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.

1. Ayurveda/Homeopathy hospitalisation benefit.
2. Daily Cash and SI re-instatement.
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.
6. Waiting Periods
◦ Initial Waiting Period: 30 Days
◦ Pre-Existing waiting period: 2 Years
◦ Special illness Restriction: 2 Years
◦ Hypertension, Diabetes, Asthma & Cholesterol waiting period: 2 Years
7. Refer to the policy brochure to know detailed exclusions.

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.