Aditya Birla Super Top Up Health Plan

Aditya Birla Super Top Up plan is the perfect plan if you are looking for additional health coverage for your family. The plan allows you to opt for all the additional benefits required for your family, which otherwise isn’t available in many health covers offered in the market.

The super top-up plan comes with the benefit of a cashless claim facility available in 6000+ network hospitals. It gives you the freedom to customise your current plan, thus opting for greater coverage. It offers affordable premium rates and thus saves you from the burden of ever-changing medical inflations.

 

Key Features and Benefits


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

  • Cashless and reimbursement claim

    The plan offers cashless claim in 6000+ network hospitals and the claim is settled instantly. In case of emergency, you can take the treatment in any hospital and get the medical expenses reimbursed after you are discharged, and submit the necessary bills.

  • High-claim settlement ratio

    This plan offers a high claim settlement ratio of about 93.68% with affordable premium rates.

  • Room rent capping

    This policy covers the room rent for single AC and non-Ac rooms including other charges like professional fees, OT charges, investigation charges, lab reports as per the room rent restriction mentioned in the policy document.

  • Day-care procedures

    The super top-up plan covers a total of 527 day-care listed procedures for the treatment that require less than 24 hours of hospitalisation and are conducted in a hospital or a day-care.

  • Domiciliary hospitalisation covered

    In case of hospital bed unavailability, the plan covers expenses incurred for home care treatment. Insured patients who cannot travel to the hospital, will also be covered under this policy.

  • Pre-hospitalisation expenses

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

  • Post-hospitalisation expenses

    The plan covers medical costs incurred due to any illness or injury for 60 days after hospitalisation.

  • Organ donor expenses

    Medical expenses of an organ donor for organ procurement will be covered under the policy.

Policy Details

Aditya Birla Super Top Up Insurance Plan
Policy Type Family Floater (For all customers of Bajaj Finance Ltd)
Entry Age Adult: 18 Years To 50 Years
Child: 30 Days To 21 years
Renewal Lifetime Renewable
Tenure Annual
Sum Insured Rs. 5 Lakh – Rs. 50 lakh
Number of members covered 6 members (2 adults + 4 children)

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. 5,200 with and offer a maximum coverage of Rs. 50 lakh.

How to Purchase the Policy

  • To apply for the product, click on ‘Apply Now’ and fill in the necessary details in the application form.
  • Make the fee payment online using your preferred mode of payment
  • Fill in your name and mobile number
  • If required opt for a call back from our representatives or complete the process by clicking ‘Buy now’.

List of Documents Required for Purchasing 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 Raise the Claims

For medical emergencies and accidents, one can raise the claims following a few simple steps given below.


Cashless Claims

Documents needed to process cashless claim:

With Aditya Birla Super Top-Up Health Insurance, you can avail the benefit of cashless treatment at 6,000+ network hospitals across 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 (emergency hospitalisation) and 3 days before admission in case of planned hospitalisation.
  • While visiting the hospital, carry the patient’s Aditya Birla Health 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.
  • Aditya Birla Capital Health Insurance 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 them.
  • 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 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.

You will reuire the following relevant documents in original form. Collect it from 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 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. Ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction.
  2. Circumcision unless required for the treatment of Illness or accidental bodily injury.
  3. Cost of spectacles, contact lenses, hearing aids, crutches, artificial limbs, dentures, artificial teeth except for intrinsic fixtures used for orthopaedic treatments such as plates and K-wires.
  4. Human Immunodeficiency Virus or Variant/mutant viruses and or any syndrome or condition of a similar kind commonly referred to as AIDS.
  5. Plastic surgery unless necessary for the treatment of cancer, burns or accidental bodily injury.
  6. Treatment for any mental illness or psychiatric illness, Parkinson's disease.
  7. Vaccination or inoculation unless forming a part of post-bite treatment or if medically necessary and forming a part of the treatment recommended by the treating doctor.
  8. Waiting Period:
  9. • Initial Waiting Period: 30 Days
    • Pre-Existing waiting period: 3 years
    • Specific illness Restriction: 2 years
  10. Refer to the policy brochure to know further exclusions in detail.

Policy Deductibles

Sum Insured Deductibles
Rs. 5 lakh – Rs. 10 lakh Rs. 50000
Rs. 10 lakh – Rs. 20 lakh Rs. 1 lakh and Rs. 2 lakh
Rs. 25 lakh – Rs. 50 lakh Rs. 1 lakh and Rs. 2 lakh

Claim/Assistance Contact Details

BFL Helpline Number: 08698010101

Aditya Birla Health Insurance: 1800-270-7000

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

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.