Is Aditya Birla Health Insurance Good? A Detailed Review

When you’re looking for a health insurance policy, it’s crucial not only to compare plans but also to assess the insurer behind them. The company you choose can significantly impact your claim experience, customer support, and overall satisfaction, especially during medical emergencies. However, as there are so many different health insurers in the market, how do you know which one is right for you? Over the years, Aditya Birla Health Insurance has established itself as a prominent player in the market. With its focus on wellness benefits and preventive care, it has attracted attention among both young professionals and families. This brings us to the key question: Is Aditya Birla Health Insurance good, and does it live up to expectations? Let’s take a closer look.

If you need help choosing the right policy, feel free to chat with us on WhatsApp or book a call at a convenient time—no spam — just honest insurance advice.

Is Aditya Birla Health Insurance Good? Blog Overview

Aditya Birla Health Insurance Company Overview

Aditya Birla Health Insurance is a joint venture between Aditya Birla Capital Limited and MMI Holdings, a South Africa-based financial services group. Although it was launched only in 2015, the company has made impressive strides in innovation and customer engagement. What sets Aditya Birla apart is its focus on preventive healthcare. Unlike traditional insurers that focus solely on hospitalization benefits, this insurer incentivizes staying healthy with unique offerings such as:

• HealthReturns: Rewards for staying fit
• Chronic Care Management: For lifestyle diseases such as diabetes and hypertension
• Wellness Coaching and discounts for fitness engagement.

These initiatives not only help you stay well but also reduce long-term health risks. Let’s now explore how Aditya Birla performs across critical health insurance metrics.

Infog for customer service, policy benefits, policy coverage, premium (rated out of 10)

To determine if an insurer is reliable, we must examine specific performance indicators, including the number of claims they settle, their pricing strategies, and customer ratings of their experience.

Claim Settlement Ratio of Aditya Birla Health Insurance

Claim Settlement Ratio (CSR) measures the percentage of claims an insurer successfully settles in a year. A higher CSR means a higher likelihood that your claim will be paid. It is calculated using the formula:

CSR = (Total number of claims settled in a year/ Total number of claims received)*100

The average CSR from 2021 to 2024 stands at 95%, surpassing the industry average of 90%. This indicates a strong track record of settling claims promptly, which is within the ideal range of 90-100%. Do you want to learn more about what Claim Settlement Ratio values mean? Check out our detailed blog on it.

Incurred Claim Ratio of Aditya Birla Health Insurance

Incurred Claim Ratio shows the proportion of premiums collected that are paid out in claims. It matters because an ICR that’s too high (more than 90%) may suggest unsustainable pricing, while a ratio that's too low (<50%) could mean that not enough claims are being paid out. The formula for calculating ICR is as follows:

ICR = (Total Amount of Claims Settled/ Total Premiums Collected)*100 

With an average ICR of 68% from 2021 to 2024, Aditya Birla Health Insurance maintains a balance between collecting premiums and paying out claims. It’s within the ideal range of 50-80%. If you need a deeper dive into Incurred Claim Ratio values, we’ve explained it thoroughly in our blog post on it. 

Complaint Volume of Aditya Birla Health Insurance

Complaint volume indicates the number of customers who have experienced issues with the insurer, whether related to claim delays, customer support, or policy servicing.  For Aditya Birla Health Insurance, the average complaint volume from 2021 to 2024 is 22, which is around than the industry average of 23. While not alarming, it does suggest that some areas, such as customer service or claim delays, could be improved.

Average Annual Business Volume of Aditya Birla Health Insurance

Business volume shows how well the insurer is doing financially and how much market trust they’ve gained. Aditya Birla Health Insurance has an average annual business volume of ₹2,498 crores, while the industry average is ₹2,990 crores. Although Aditya Birla’s average is slightly below the industry average of ₹2,990 crores, it shows strong growth year over year, especially impressive for a newer entrant in the market.

Key Features of Aditya Birla Health Plans

Aditya Birla Health Insurance offers a comprehensive suite of features designed to promote wellness, manage chronic conditions, and provide extensive access to healthcare.

1) HealthReturns:

You can earn up to a 100% discount on renewal premiums by maintaining a healthy lifestyle, such as regular exercise and health check-ups. This initiative encourages proactive health management and rewards policyholders for their commitment to well-being. Although achieving 100% might be difficult, even a basic active lifestyle can result in 30-50% discounts, which add significant value.

2) Chronic Care Add-ons:

Aditya Birla offers optional add-ons that provide both coverage and reduced waiting periods for specific chronic conditions, including Asthma, Hypertension, Hyperlipidemia, diabetes mellitus, Chronic Obstructive Pulmonary Disease (COPD), Obesity, and even Coronary Artery Disease (if a percutaneous transluminal coronary angioplasty (PTCA) was performed more than a year ago). These benefits enable proactive management of long-term health risks and reduce the financial burden associated with chronic diseases.

3) Wellness Coaching:

Access expert health coaches who provide personalized guidance on weight management, smoking cessation, mental health support, and more. This holistic approach helps you build healthy habits and achieve your health goals.

4) Wide Network:

Benefit from cashless hospitalization across a network of over 12,000 hospitals nationwide. This extensive network ensures you receive quality medical care without the burden of upfront payments. Also, always check for the hospitals that you prefer in your vicinity to see if they are a part of the insurer’s network.

Aditya Birla Health Insurance's plans are tailored to support your health journey, offering financial incentives, chronic condition management, expert coaching, and extensive healthcare access. Let’s look at the popular offerings of Aditya Birla Health Insurance.

Aditya Birla Health Insurance Popular Plans Available

Aditya Birla Health Insurance offers a range of plans designed to meet different needs — whether you’re a young professional, a fitness enthusiast, or a senior citizen.

Here are some of their most popular plans:

Pros and Cons of Aditya Birla Health Insurance

To help you weigh your options better, here’s a quick summary:

1) Advantages of Aditya Birla Health Insurance

• Strong Claim Settlement Ratio (95% average over 3 years)
• Aditya Birla Health Insurance is backed by the strong Aditya Birla Group, which vouches for its solvency, stability, and longevity. 
• The Aditya Birla brand brings credibility and assurance, which can be reassuring when choosing a health insurance provider.
• Innovative Wellness Features (HealthReturns™, fitness rewards)
• Affordable Plans with Chronic Disease Coverage, no significant restrictions on room rent, no disease-wise limits, and no compulsory copayment clauses. 
• Wide Network of Cashless Hospitals (12,000+)

2) Disadvantages of Aditya Birla Health Insurance

• Slightly higher complaint volume
• As a relatively new entrant in the health insurance market (launched in 2016), it lacks the decades-long historical data some older insurers possess. However, performance so far has been promising.

Customer Reviews and Public Sentiment on Aditya Birla Health Insurance

Aditya Birla Health Insurance generally receives positive feedback for its innovative features, affordability, and customer support. However, some customers have reported issues related to claim processing and policy management.

1) Positive Feedback

Policyholders appreciate features like HealthReturns™, fitness programs, and clear explanations of policy benefits with no hidden conditions.

2) Areas of Concern

Some customers have experienced delays in claim settlements, with reports of extended turnaround times and inadequate communication.

A few users have reported difficulties in reaching customer support or receiving prompt resolutions to their issues.

Comparison: Aditya Birla vs Other Health Insurers

Choosing the right health insurance provider involves evaluating several key metrics such as claim settlement efficiency, financial strength, service quality, and accessibility. In this comparison, we analyze how Aditya Birla Health Insurance fares against major competitors, including Care Health Insurance, HDFC ERGO, ICICI Lombard, and Niva Bupa (formerly Max Bupa), based on verified data from 2021 to 2024. Each metric highlights a specific dimension of performance, enabling you to determine which insurer best aligns with your needs.

1) Claim Settlement Ratio

In terms of claim settlement, HDFC ERGO emerges as the leader with an impressive 98% average claim settlement ratio, indicating exceptional reliability in processing and approving claims. Aditya Birla holds a strong position with a 95% ratio, outperforming Care Health Insurance (90%), Niva Bupa (91%), and ICICI Lombard (85%). This suggests that while HDFC ERGO is slightly ahead, Aditya Birla has demonstrated strong consistency in fulfilling claims, making it a dependable choice for policyholders.

2) Incurred Claim Ratio

The Incurred Claim Ratio indicates the percentage of premiums collected that are paid out as claims. Aditya Birla, with a 68% ICR, reflects a healthy balance between profitability and customer benefit, suggesting efficient underwriting and fair claims distribution. In contrast, HDFC ERGO’s (86%) and ICICI Lombard's (83%) higher ICR may imply slightly generous claim approvals but could also impact their long-term sustainability. Care (59%) and Niva Bupa (58%) have lower ICRs, which may suggest stricter claim processing or lower utilization. Among the five, Aditya Birla maintains an optimal balance between coverage and cost-effectiveness.

3) Complaint Volume

Customer satisfaction often correlates with the number of complaints an insurer receives. HDFC ERGO and ICICI Lombard both perform strongly here, with an average of only 7 complaints annually, indicating excellent customer service and resolution standards. Aditya Birla maintains a comparatively low complaint volume of 22, significantly better than Care (36) and Niva Bupa (43). While it doesn’t lead in this category, Aditya Birla still demonstrates consistent customer satisfaction with fewer issues reported than most competitors.

4) Annual Business Volume

When evaluating overall market presence and trust, HDFC ERGO commands the highest annual business volume at ₹5,120 crores, indicating a strong customer base and financial stability. Care, ICICI Lombard, and Niva Bupa follow with ₹4,890 crores, ₹4,814 crores, and ₹4,077 crores, respectively. Although Aditya Birla’s business volume is lower at ₹2,498 crores, it reflects robust growth considering the insurer’s relatively recent entry into the market. This suggests strong potential for expansion, especially given its unique wellness-centric offerings.

5) Network Hospitals

Hospital accessibility is crucial in emergencies. HDFC ERGO again leads with a network of 13,000+ hospitals, ensuring maximum reach for cashless treatment. Aditya Birla is a close second, with over 12,000 hospitals, offering broad geographic coverage and strong access to care. This is more extensive than Care Health’s (11,400+) and Niva Bupa’s (10,000+) networks, making Aditya Birla a strong option for those who prioritize hospital availability. Please note that the network hospitals are subject to constant change; refer to the insurer’s website for the most up-to-date information. 

Overall, HDFC ERGO is best suited for those seeking top-tier reliability, minimal customer issues, and the widest network of hospitals. However, Aditya Birla Health Insurance stands out with a compelling mix of wellness incentives (such as HealthReturns™), strong claim ratios, and broad accessibility, making it particularly attractive for proactive, health-conscious individuals and families. Care Health Insurance offers budget-friendly plans but lags in complaint handling and claim settlements, while Niva Bupa provides decent coverage but currently faces service and claims-related challenges. For those valuing innovation, chronic care support, and reasonable customer satisfaction at a competitive price, Aditya Birla stands out as a well-rounded and future-ready health insurer.

Who Should Consider Aditya Birla Health Insurance? (Ditto’s Take)

Aditya Birla Health Insurance is especially well-suited for fitness-focused individuals and families who can benefit from the insurer’s HealthReturns™ program, which offers financial rewards, up to 100% of the premium in select plans, for maintaining healthy habits. If you're someone who tracks your steps, follows a workout regimen, or enjoys wellness challenges, this insurer turns your lifestyle into tangible savings.

It’s also a wise choice for young families working with moderate budgets who want access to an extensive hospital network (12,000+ partners) without compromising on key benefits. The plans are competitively priced, especially for those under 35, with additional incentives like early bird discounts and cashless preventive care.

Tech-savvy users who prefer managing their policies, claims, fitness tracking, and consultations through a mobile app will appreciate Aditya Birla’s digital-first experience, which includes a robust app interface and integrated wellness services.

Lastly, Aditya Birla stands out for its coverage of chronic conditions and mental health support—ideal for those who want coverage for lifestyle diseases like diabetes or hypertension immediately, as well as access to mental wellness tools such as counseling and coaching.

In summary, if you’re young, health-conscious, digitally inclined, or managing a chronic condition, Aditya Birla offers a unique blend of value, innovation, and wellness-centric coverage.

Conclusion: Is Aditya Birla Health Insurance Good?

Yes, Aditya Birla Health Insurance is a solid option for individuals and families who value preventive care, wellness incentives, and modern healthcare coverage. It performs strongly on most industry benchmarks, especially in claim settlement and innovation. Although it has a few drawbacks, such as occasional customer service concerns and a relatively lesser track record, its growth and benefits far outweigh these issues. Before purchasing, be sure to read the fine print of each policy and assess which one best suits your specific needs.

Why Choose Ditto for Health Insurance?

At Ditto, we’ve assisted over 7,00,000 customers with choosing the right insurance policy. Why customers like Piyush below love us:

✅No-Spam & No Salesmen

✅Rated 4.9/5 on Google Reviews by 12,000+ happy customers

✅Backed by Zerodha

✅100% Free Consultation

You can book a FREE consultation here. Slots are filling up quickly, so be sure to WhatsApp or book a call now.

FAQs