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Highlights Highlights of Aditya Birla Health Insurance Company

Claim settlement ratio 94%

NCB* 50%, up to 100% of SI*

PED Waiting# 48 months

Network Hospital 6500+

Top Health Insurance Plans by Aditya Birla

Activ Fit

Activ Assure Diamond

Activ Health - Platinum (enhanced + essential)

Compare Top Health Plans (Dummy) from Care Health Insurance Company

Comparison between Care Plus, Care Classic (Insta), Care Supreme and Care Advantage

	Care Plus	Care Classic (Insta)	Care Supreme	Care Advantage
Features
Cashless Treatment
Emergency Air Ambulance
Annual Health Check-up
Second Opinion
Automatic Recharge
Premium Waiver
Lifetime renewability
Day Care Treatment

Cashless Treatment

Features
Emergency Air Ambulance
Annual Health Check-up
Second Opinion
Automatic Recharge
Premium Waiver
Lifetime renewability
Day Care Treatment

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Awards and accolades won by Insurance Company {Variable}

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Awards and accolades won by [variable]

In its journey to become one of the largest insurance providers, Bajaj Allianz has won numerous awards. Some of the most recent ones include the following –

The company received the award for Best Insurer in India 2020 bestowed by the IDC Financial Insights Innovation Awards

Best Customer Experience and Best Brand Experience 2020 by CX Asia Excellence Awards

The company was recognised as one of India's best workplaces in BFSI and India’s best workplace for women in 2024.

Future Generali won the E4M Health & Wellness awards in 2024.

It won the ET Best Brand Awards in 2020 based on multiple parameters like innovation and uniqueness.

The company won the Asia-Pacific Stevie Award for “innovation in surpassing customers' expectations” in the health insurance sector.

The company has won the fastest-growing General Insurance Company in India award in 2022 by the World Economic Magazine.

The company has won the IFTA 2022, Excellence in Insurtech Award.

Bajaj Allianz won the Gold Award in the Outlook Money Awards 2020

In the third edition of the India Insurance Summit & Awards, Bajaj Allianz was recognized as the General Insurance Company of the Year 2020

The IDC Financial Insights Asia Pacific also listed the company among the companies ranked as the Best Insurer in the Asia Pacific region.

Key Highlights of Aditya Birla Health Insurance Company

The health insurance plans of the company are inclusive in their scope of coverage. Some of the common coverage benefits that are available under most Bajaj Allianz health insurance plans are as follows:

Features	Meaning
Lives Covered	1.3 million lives covered till date
Cashless hospitals	8000+ cashless hospitals
Selling Agents	17,100+ selling agents
Claims settled	1.97 lacs claims settled
Presence	2300+ 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

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

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

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

HIV, AIDS or STDs are not covered.

Cosmetic or medically unnecessary treatments are excluded.
Unproven medical treatments are not covered.

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

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

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

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 –

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

Entry age	Adults – 18 years onwardsChildren – 91 days onwards in a floater policy or 5 years onwards for individual cover. Children are covered up to 25 years on a floater basis
Sum insured	Rs.2 lakhs to Rs.2 crores
Policy term	1 year to 3 years
Pre-existing waiting period	48 months

How to buy Aditya Birla Health Insurance Plan?

You can now buy and renew motor insurance online in just a few simple steps, saving time and costs. You can visit the website of the insurance company or an aggregator website to buy a motor insurance policy.

Choose the health plan that best fits your needs

Visit Paybima’s official website by clicking the link above to find the most suitable plan for you under ‘health insurance’.

Detailed information must be filled out

Paybima will ask you to complete a form containing the requested medical and personal information to calculate your premium based on your eligibility and coverage requirements. You must supply the following information: name of dependents, sum assured, age, gender, pin code of your location, and contact information. The policy can also be purchased with a personalised consultation from Paybima.

Comparison of plans

Paybima will display all the plans that suit your coverage and eligibility requirements after receiving all the details. You will also be able to see Bajaj Allianz’s health insurance plans. The coverage of the plans and their premiums can be easily compared, so you can find the policy that is right for you.

Fill out the online form

You would have to fill out a proposal form by providing your details correctly after you have finalized your policy. Please provide accurate details when you fill out the proposal form to avoid any issues at the time of claiming.

You’ll need to pay the premium

Purchasing health insurance policies end with the payment of the premium. As long as you don’t make any adverse declarations about your lifestyle habits or medical history in the proposal form, the insurance company will issue you the policy instantly.

A medical screening might be needed

Certain factors, such as your age, lifestyle, medical history, and coverage, may require you to undergo pre-entrance health screening. In cases of high health risk, pre-entrance health screening is required for safety measures. Medical screenings can be obtained at any of the insurer’s network hospitals after which the policy would be issued.

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 [email protected] 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?

A claim for Bajaj Allianz health insurance can be made through Paybima in a very simple and easy manner. Following is a description of the process:

Locating network hospital

In addition to reimbursement, Bajaj Allianz General Insurance also offers cashless claim facilities. If you wish to avail of the cashless claim facility, you must first locate the nearest network hospital via the insurance company’s website. On the insurance company’s website, you can find a list of the hospitals with which it has a relationship.

Admission

The claim form is available on the insurer’s website/TPA,

Pre-authorization Claim form

To receive a cashless settlement of a health claim, you must submit a pre-authorization claim form. The insurance company’s website provides the form for downloading, or you can avail of it from the hospital. The pre-hospitalization form should be submitted at least three to four days before a planned hospitalization. If you are hospitalized in an emergency you can submit the form within 24 hours.

Cashless approval

Insurers approve cashless facilities based on pre-authorized claim forms. The networked hospital will begin treatment once the insurer approves the claim. The insurance company will handle and pay all the bills related to the treatment.

Reimbursement Claim Facility

If you do not get approval for a cashless claim or you are admitted to a non-networked hospital, then your claim will be settled on a reimbursement basis. The insurance company must be notified in such cases before admission. Following hospital discharge, you will be required to settle all the bills, for which you can receive reimbursement by filling out the claim form and enclosing all the original receipts, bills and medical records. Upon assessing your claim and validating your documents, the company will reimburse you.

Customers of Paybima can benefit from quick and easy claim settlements. For help with your claim settlement, you can contact Paybima at 1800 267 67 67 or email at [email protected].
To get a successful settlement of a claim, certain documents are required. Included in these documents are:

The claim form, filled and signed
Your bank account details, like a cancelled cheque, for reimbursement claims
Aadhaar Card, PAN Card, Birth Certificate, etc. are all acceptable forms of ID proof of the insured
In the case of cashless claims, a pre-authorization form is required
To claim reimbursement, original medical documents, receipts, consultation notes, prescriptions, and hospital reports must be provided.