Aditya Birla Health Insurance Company

Aditya Birla Health Insurance Company Limited was incorporated in 2015 as a joint venture between the Aditya Birla Group and MMI Holdings of South Africa with 51% and 49% stake, respectively. The company is a subsidiary of Aditya Birla Capital Limited. They offer a plethora of comprehensive and affordable health insurance coverage.

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Highlights Highlights of Aditya Birla Health Insurance Company

Claim settlement ratio 96%
NCB* 50%, up to 100% of SI*
PED Waiting# 48 months
Network Hospital 11,000+
Top Health Insurance Plans by Aditya Birla
# Activ Fit
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Activ Assure Diamond
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Activ Health - Platinum (enhanced + essential)
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Compare Top Health Plans from Aditya Birla Health Insurance Company

The Aditya Birla health insurance plans are designed to cover the insured against a wide array of medical and health emergencies. Below are some Aditya Birla health insurance plans sold by the company:
Active Fit
Active Assure Diamond
Active Health – Platinum (enhanced + essential)
Features
Cashless Treatment
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Emergency Air Ambulance
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Free Health Check-up
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Second Opinion
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Unlimited Restore
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Premium Waiver
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Lifetime renewability
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Features
Cashless Treatment
Emergency Air Ambulance
Free Health Check-up
Second Opinion
Unlimited Restore
Premium Waiver
Lifetime renewability
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Awards and accolades won by Aditya Birla Health Insurance company

In its journey to become one of the largest insurance providers, Aditya Birla Health Insurance Company has won numerous awards. Some of the most recent ones include the following –

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Aditya Birla Health Insurance won the Best Health Insurance Co of the Year 2022, at the InsureNext Summit and Awards by Banking Frontier.

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Aditya Birla Health Insurance won Best Product Innovation - BFSI at Dun & Bradstreet's BFSI and Fintech Awards 2023won Best Product Innovation - BFSI at Dun & Bradstreet's BFSI and Fintech Awards 2023

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Aditya Birla Wellness won Silver for innovation in BFSI at SKOCH Awards 2022

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ABHI’s initiative of “Claim Intimation & Registration and track via WhatsApp” won the Excellence in Claims Service (Insurance) – at the ETBFSI Excellence Awards 2022

Key Highlights of Aditya Birla Health Insurance Company

Some key highlights of Aditya Birla Health Insurance company are as follows:

Features

Meaning

Lives Covered
2.3 million lives covered till date

Cashless hospitals
11000+ cashless hospitals

Selling Agents
17,100+ selling agents

Claims settled
1.97 lacs claims settled

Presence
5000+ cities across India

Features of Aditya Birla health insurance plans

The health insurance policies offered by Aditya Birla offer the following standard coverage benefits –

Features

Meaning

In-patient-hospitalization cover
A 24-hour or more hospitalization is called inpatient hospitalization. In such cases, the costs of hospitalization and the associated treatments are covered by the policy

Pre-hospitalization cover
The medical costs that you incur before you are admitted to the hospital are covered under this benefit. You get covered for a specific number of days

Post-hospitalization cover
The medical costs that you incur after you are discharged from the hospital are called post hospitalization costs. Such costs are covered for a specific number of days after discharge

Day-care cover
In some treatments you do not need 24-hour hospitalization. Such treatments are called daycare treatments and they are covered under the scope of the policy

Ambulance cover
If you need ambulance services for getting admitted to the hospital, the cost of the ambulance would be covered up to specified limits

Organ donor cover
This benefit covers the costs incurred on the donor’s hospitalization and the cost of harvesting the organ if you need an organ transplant surgery

Domiciliary cover
Hospitalization at your own home because of non-availability of hospital beds or if you cannot be transferred to the hospital is called domiciliary hospitalization. Such hospitalization is covered under the plan

Free health check-ups
Aditya Birla health insurance plans allow free health check-ups regularly to ensure that you can monitor your health

No-claim bonus
If you don’t make claims in your plan, you get awarded with a no claim bonus. This can be allowed as an increase in the sum insured or as a premium discount

Exclusions in Aditya Birla health insurance plans

Aditya Birla health insurance plans have exceptions wherein claims are not paid. These exceptional instances are called exclusions. The specific list of exclusions depends on the plan that you buy. However, some of the most common exclusions in Aditya Birla health insurance plans are as follows –

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Pre-existing conditions have a specific waiting period. These illnesses are covered after the waiting period is over.

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There is a waiting period of 30 days from the start of the policy. During this period illnesses would not be covered.

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Specific treatments have a waiting period of 2 years. Such treatments are not covered during the waiting period.

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HIV, AIDS or STDs are not covered.

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Cosmetic or medically unnecessary treatments are excluded.

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Unproven medical treatments are not covered.

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Criminal acts, illegal acts, hazardous acts, etc. are not covered

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Claims due to war, civil commotion, nuclear perils, etc. are excluded.

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The cost of hearing aids, dental treatments, spectacles, lenses, etc. is excluded.

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The cost of vitamins, minerals and health supplements are not covered under the plan.

Health insurance plans offered by Aditya Birla

Aditya Birla offers different types of health insurance policies. The most popular plan, also available at Paybima, is as follows –

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Activ Assure Diamond

The salient features of the plan are as follows –

 

Sum insured reload: You might use up the sum insured if you suffer a claim in the policy year. In the case of a second or any other subsequent claim, if the sum insured is not available, the plan offers the reload benefit. Under this benefit, the sum insured is refilled up to 150% so that the claim can be met.

Hospital daily cash benefit: If you are hospitalized for 24 hours or more, besides covering the hospitalization expenses, the plan also pays a daily allowance. The allowance depends on the sum insured that you choose and is paid for up to 5 days.

Vaccination cover: You get covered for the costs of vaccinations, up to Rs.10,000 if you choose a sum insured of Rs.1 crore and above.

Second opinion: The plan covers 15 critical illnesses. If you are diagnosed with any of the covered illnesses, you can avail of a free online second opinion from the company’s panel of specialists.

Air ambulance cover: If you suffer a medical emergency and need an air ambulance for transportation, the plan would cover the cost of hiring the same.

Health Returns: The plan offers the unique feature of Health Returns wherein, if you practice healthy living and stay fit, you earn Health Return points. You can accumulate these points and use them to claim a premium discount on renewal.

International coverage: In a medical emergency, Activ Assure Diamond allows international coverage too which also includes coverage for air ambulance services.

Range of optional coverage benefits: Activ Assure Diamond offers different types of optional coverage benefits. These benefits allow you to customize your policy as per your needs and avail of enhanced coverage.

Eligibility conditions

Minimum age
18 years for adults and 91 days – 5 years for children

Maximum age
45 years for adults and 25 years for dependent children

Sum insured
INR 3 lakh – INR 2 Crore

Policy term
1 year – 3 years

Number of family members covered
Self, spouse, dependent children, and dependent parents

Renewability
Lifetime renewability

Waiting period (Initial waiting period)
30 days

Waiting period (PED)
48 months

Waiting period (Specific disease)
24 months

How to buy Aditya Birla Health Insurance Plan?

Go to the official portal of Aditya Birla Health Insurance. Fill in the “Get Health Insurance”
form on the homepage and apply for the same. Answer a few questions about the policy seeker and
submit.

Or visit the Paybima portal and select  Health Insurance from the options available.

1

Visit the Paybima homepage and click on the ‘Health Insurance’ tab in the dropdown menu.

2

Fill in your required details and request a callback.

3

A Paybima representative will help you buy the most suitable plan.

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You may also reach us at 1800 267 67 67 from 10 AM to 7 PM, or

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You can visit a Paybima branch near you.

The process of renewing Aditya Birla Health Insurance Policy

Paybima’s website makes it possible to purchase and renew health insurance policies. The coverage you currently have will continue as long as you renew your policy on time with Bajaj Allianz.
If you provide your policy number and other information, you can renew your health insurance policy online. During renewal, you can review your plan details and make any necessary changes. The premium amount might change if you make changes in the coverage. Paybima can be contacted via email at Paybima.care@mahindra.com or via telephone at 1800 267 67 67 for more information about renewing your Bajaj Allianz health insurance plan.

What is the Process for Filing a Claim for Aditya Birla Health Insurance Plan?

Claiming an Aditya Birla health insurance policy is as easy as buying one. You can not only buy Aditya Birla health insurance policy online but also claim your health plan with the help of Paybima. Paybima offers a very smooth and hassle-free claim settlement process to its customers. The process is discussed as follows:

1
Network hospital

The very first thing that you need to do is to locate a network hospital of the insurance company. Every insurance company has tied up with health providers in which you can avail cashless treatment. You can locate the network hospital on the website of the company or by contacting Paybima. Aditya Birla Health Insurance has tied up with leading hospitals which will help you to locate one very easily

2
Admission of the insured

After locating a network hospital, you can get yourself admitted to the hospital by showing your health card and ID proof.

3
Submit pre-authorization claim form

For the approval of your cashless claim, you are required to fill, sign and submit a pre-authorisation claim form to the insurance company to initiate the claim process. You can download the pre-authorisation claim from the website of the insurance company or can take it from the insurance desk of the hospital. The pre-authorisation claim form is to be filled with correct details so that there would be no issues at the time of settlement of the claim. Submit a pre-authorisation claim form at least 3 to 4 days before your plan admission to the hospital. You can submit a pre-authorisation claim form within 24 hours in case of emergency hospitalization

4
Get approval from the company for a cashless claim

The insurance company will verify your details and approve your cashless settlement of claim if all your documents and details are correct. The insurer can reject the cashless settlement of the claim in which case you can file for reimbursement.

5
Get the treatment

Once approval has been received by the hospital, the hospital will proceed with the treatment and all the bills will be directly settled by the insurance company.

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Reimbursement claims

If your cashless claim has been rejected or if you get hospitalized in a non-network hospital then your claim would be settled on a reimbursement basis. In such cases, you will have to inform the insurance company about the claim before your planned hospitalization. In case of emergency, you can inform after admission but before discharge from the hospital. All the hospital bills are to be settled by you which on discharge are to be submitted to the insurance company along with the claim form. The company would access your claim and reimburse the costs incurred.

You can contact Paybima for easy claim settlement of Aditya Birla health insurance policy. You can either dial 1800 267 67 67 or mail us at paybima.care@paybima.com and we would gladly help you with your claim settlement.

They are certain documents that are required to be submitted to the insurance company along with the claim form for the successful settlement of your claim. The documents include the following:

  • ID proof of the insured individual
  • Bank details of the insured to make the payment of reimbursement claim
  • Health card
  • Pre-authorisation claim form
  • Doctor’s prescription in which the doctor has advised hospitalisation to the insured
  • Original medical bills and prescriptions
  • Original Hospital bills and reports
  • Consultation notes

Guaranteed Claim Support

When you buy or renew a health insurance plan from us, we guide at every step till your claim is settled.

1800 267 67 67 from 10 AM to 7 PM
care@paybima.com

Start your claim process with us to get our support

Learn all about [Health Insurance/Term Life/Car/Bike] Claims

Review of Aditya Birla Health Insurance Company

Aditya Birla Health insurance plans are quite comprehensive in their scope of coverage and are quite competitively priced. Other highlights are as follows:

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Aditya Birla Health Insurance has been investing effort and time to analyze and understand individual health choices through innovative products and a wider choice of customer-relevant insurance products.

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Aditya Birla health plans also provide access to experts coaches on fitness, nutrition as well as dental consultation. The company also offers homoeopathy teleconsultation and mental wellness counselling.

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You can get premium discounts on Aditya Birla health plans to make them affordable.

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Its plans can be brought online with a minimum of hassles.

Health Insurance Products
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Individual
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Family
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Senior Citizens
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Sahi Advice,
Sahi Insurance

If you have any questions on how to choose the best insurance plan, you can connect with our IRDAI certified insurance advisors.

1800 267 67 67 from 10 AM to 7 PM
care@paybima.com
Advice that comes with Experience.

Paybima is the digital platform of Mahindra Insurance Brokers Ltd

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