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About Aditya Birla Health Insurance

Aditya Birla Health Insurance Co. Limited (ABHICL) is a part of the Aditya Birla Group, a conglomerate with interests in various sectors. Aditya Birla Health Insurance was established in 2015 as a result of a partnership between Aditya Birla Capital Limited (ABCL) and Momentum Metropolitan Strategic Investments (Pty) Limited from South Africa (formerly known as MMI Strategic Investments (Pty) Ltd.).

Aditya Birla Health Insurance was established in 2016 to offer health insurance products to cater to the growing demand for quality healthcare coverage in India. They have introduced various health insurance plans, including individual and family policies, critical illness coverage, hospital cash plans, and more.

As of the conclusion of the first half of fiscal year 2022, ABHICL reported a gross written premium (GWP) of Rs. 764 Crore, providing coverage to more than 16.2 million individuals. ABHICL has an extensive nationwide presence, with distribution outlets across over 2800 cities through branches and partner offices. Aditya Birla Health Insurance also enjoys a vast network of 10,500 cashless hospitals.

Collaborations with 11 bancassurance partners and a team of over 51,120 direct selling agents further strengthen their distribution network.

The company aims to provide innovative health insurance solutions that incorporate technological advancements to enhance customer experience. Aditya Birla Health Insurance is focused on creating a seamless digital experience for its customers, possibly including features such as online health policy purchase, claims processing, and customer support.

The company's distribution model has experienced a digital transformation, expanding to 175 branch locations. Additionally, bancassurance services are accessible through a network of 16,000+ branches, along with digital partnerships encompassing over 39 partners. These efforts collectively cover more than 6 million lives, featuring a range of 50+ contextual, tailored products.

Aditya Birla Claim Settlement Ratio

98.12%

Aditya Birla

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. Aditya Birla has a claim settlement ratio of 98.12%, as compared to the industry average of 94.21%.

Aditya Birla Health Insurance Plans Overview

Aditya Birla health insurance offers 2 health insurance plans. The premium of these plans starts from Rs. 7149/yr. The sum insured ranges from Rs. 2 Lakh - 2 Cr. Details of the comprehensive coverage provided by the following 2 Aditya Birla health insurance plans are listed below:

Eligible Age

91 days onwards

Coverage

2 Lakh - 2 Cr

Aditya Birla Platinum – Enhanced Policy

Starting Premium- 8,215/Yr

Eligible Age

91 days onwards

Coverage

2 Lakh - 2 Cr

Top Features From Aditya Birla Health Plans

  • Comprehensive Coverage:Aditya Birla Health Insurance plans often offer extensive coverage,including hospitalization expenses,pre and post-hospitalization costs,daycare procedures, and more.
  • Cashless Hospitalisation:Aditya Birla Health Insurance provides a wide network of 10051+ hospitals,allowing policyholders to avail cashless hospitalization facilities.
  • Chronic Management Program:Policyholders can manage conditions like asthma,diabetes,hypertension,and High Cholesterol etc. with Aditya Birla's program.You can get Day 1 cover on OPD expenses for the above-mentioned chronic diseases.(Hospitalization, however, requires a 90-day waiting period.)
  • Wellness Coaching:Another top feature is that select aditya health insurance plans offer wellness coaching, covering nutrition,fitness,tobacco cessation,and weight management.
  • Lifetime Renewability:Aditya Birla Health policies ensure lifetime renewability, allowing policy renewal without age restrictions.
  • Health Return Benefit:Aditya Birla Health Insurance offers a variety of distinctive health insurance benefits,including HealthReturns™ which rewards you for embracing a healthy lifestyle. You may receive up to 30% of your health insurance premium back.
  • Second E-Opinion:Aditya Birla Health plans provide a unique feature of second e-opinion for critical illnesses. You can consult a panel of medical practitioners for an additional perspective.
  • Reload of Sum Insured:Aditya Birla Health offers the reload benefit in some of the plans.For example - Reload of Sum Insured is available up to 100% of SI in Activ Health Platinum Enhanced product.

Exclusions Across Aditya Birla Health Plans

  1. Pre-existing Conditions: Initial waiting periods or exclusions may apply for pre-existing illnesses. These are usually not covered for a certain duration from the policy inception.
  2. Specific Waiting Periods: Certain treatments or conditions may have specific waiting periods before they are covered. For example, maternity benefits often have waiting periods.
  3. Specific Surgeries: Procedures like joint replacement, cosmetic surgery, and dental surgery are generally excluded from coverage unless necessitated by an accident or illness.
  4. Alternative Treatments: Health insurance plans usually do not cover alternative treatments such as homeopathic and Ayurvedic therapies.
  5. Self-Inflicted Injuries: Injuries or health issues resulting from intentional self-harm or suicide attempts are typically excluded.
  6. War or Nuclear Risks: Injuries or illnesses arising from war, nuclear incidents, or acts of terrorism may be excluded.
  7. Injuries from Hazardous Activities: Injuries sustained during hazardous activities, such as extreme sports or adventure pursuits will not be covered in Aditya Birla Health policies.
  8. Substance Abuse: Health issues resulting from substance abuse, including drug or alcohol abuse, may be excluded.
  9. Congenital Conditions: Birth defects or congenital conditions may be excluded, or there may be waiting periods associated with their coverage.

Aditya Birla Premium Calculator

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Aditya Birla Customer Care

Aditya Birla Claim Process

Aditya Birla supports both cashless claims and reimbursement claims. This section covers the information on how to check Aditya Birla health insurance claim status, fill Aditya Birla health insurance claim form, and the claim settlement process.

Step 1: Hospitalization at Network Hospital:
Find treatment at a hospital from the aditya birla health insurance hospital list of 10051+ hospitals and ensure that the hospital is aware of the cashless claim request.

Step 2: Intimate the Insurance Company:
Inform Aditya Birla Health Insurance within 48 hours, or planned hospitalisation 3 days before your admission. In emergency cases, intimate the insurer within 24 hours of admission.

Step 3: Pre-Authorization Request:
Submit the pre-authorization request form, duly filled and signed, to Aditya Birla company. Include relevant medical documents such as doctor's advice,diagnostic reports,and estimates of treatment costs.

Step 4: Verification by the Insurer
The insurance company will review the pre-authorization request and documents.Carry valid ID proof such as PAN Card, Passport for verification.

Step 5: Claim Process
Post the Pre-Authorization Approval to the hospital, they will process the cashless claim with aditya birla health insurance network hospital.

Step 1: Hospitalisation Information
In case of any emergency, inform Aditya Birla Health Insurance within 48 hours of being admitted and 3 days prior before you are admitted for planned hospitalisation.

Step 2: Make Payment
Once admitted, you can make the payments directly to the hospital unless Aditya Birla Health Insurance has issued a pre-authorization.

Step 3: Fill The Form
Complete the aditya birla health insurance claim form along with submission of all necessary documents, including the medical records, bills, prescriptions, and any other relevant documents.

Step 4: Claim Process
If the claim is approved, Aditya Birla will reimburse the approved amount directly to the policyholder's bank account.

Aditya Birla Health Insurance Renewal Process

Renewal Process of Aditya Birla Health Insurance

To continue enjoying the benefits of your health insurance plan, it is essential to renew your Aditya Birla Insurance policy at regular intervals, depending on your chosen policy term of 1 year, 2 years, or 3 years. Renewing your health insurance policy is crucial to avoid policy lapses and to prevent going through the initial waiting period of 30 days again. Follow these steps for a hassle-free renewal process for Aditya Birla Health Insurance Co. Limited

Read below the process to renew Aditya Birla Health Insurance plan online or offline
Step 1: Visit the official website of Aditya Birla Health Insurance. Click on the ‘Renew’ tab and select ‘Renew Now’
Step 2: Provide information for any two from the following: Policy Number, Date of Birth and Mobile Number. Click ‘Proceed’
Step 3: Pay Health Insurance Premium Online for your Aditya Birla Insurance Policy via any mode of payment of your choice
Step 4: An email will be sent to you confirming the successful payment of premium and policy renewal

If you are not able to renew your policy online then you visit the nearest Aditya Birla Health Insurance branch. You can also contact the company’s customer care executives if you wish to do it via offline mode or reach out to a Turtlemint expert Insurance advisor who can help you with the Aditya Birla Insurance Renewal.

To renew, visit Turtlemint’s home page www.turtlemint.com or download the Turtlemint App here.

FAQs

Assuming all documentation is in order, Aditya Birla Health Insurance typically settles claims within 30 days from the submission date of all "required" documents.

Aditya Birla Company retains the exclusive right to alter, include, or limit any network hospital for cashless services offered under the policy at its discretion. Prior to utilizing the cashless service, the policyholder/insured person should verify the current list of applicable network hospitals on their website.

Regrettably, they are not obligated to process any claims that arise within the grace period.

HealthReturns™ is a rewarding feature applicable to Aditya Birla Activ Health, Activ Assure, and Activ Care Plans. It incentivizes your healthy lifestyle choices by offering monetary rewards that you can accumulate over time and use according to your needs.

By earning 13 Active Dayz™ plus a Green Healthy Heart Score, you can receive up to 30% of your premium back. The principle is straightforward – the healthier your habits, the greater the rewards.
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