Is Aditya Birla Health Insurance Good?

Aditya Birla Health Insurance has been growing quickly, with the insurer reporting 64.58% year-on-year premium growth in December, a sign of strong demand and expanding market presence.

Aditya Birla Health Insurance (ABHI) is a standalone health insurance company, set up as a joint venture between Aditya Birla Capital and South Africa’s Momentum Group. It started operations in October 2016 and ranks third on the list of best health insurance companies in India with a Ditto score of 4.49/5.

But is Aditya Birla Health Insurance good? 

In this article, we walk you through the insurer's plans, focusing on Activ One MAX and Activ Yuva. We will cover its performance metrics, sample premiums, the claim process, and the pros and cons, so you can decide whether it's right for you.

Aditya Birla Health Insurance: Plans & Key Features

Activ One MAX

Sum insured ranges from ₹5 lakh to ₹2 crore, and adults can join from age 18 with no upper age limit.

• No Room Rent Cap, No Co-Payment, No Disease-Wise Limits: You can choose any room, and the insurer pays the eligible bill in full.
• Unlimited Restoration: If you exhaust your cover in a year, it refills, and this can happen repeatedly.
• HealthReturns: You can earn back up to 100% of your premium as rewards for healthy habits, and use them toward future benefits like renewal discounts.
• Claim Protect: Covers listed non-medical items (like gloves and masks) that many plans reject.
• Super Credit: Your cover grows when you renew without claims.
• Waiting Periods: 30 days initially, 2 years for specific illnesses, and 3 years for pre-existing conditions.
• Add-Ons That Help: The Chronic Care add-on reduces the waiting period to 0 days for 7 lifestyle conditions, including diabetes, hypertension, and asthma. Another add-on reduces the general pre-existing wait to 2 or 1 year.
• Discounts: 7.5% off if you pay for 2 years upfront, and 10% off for 3 years.

Gaps: Activ One MAX has no maternity cover, and doctor consultations (OPD) need an add-on. 

At Ditto, we rate this plan 4.4 out of 5, and it ranks third on the list of the best health insurance plans in India.

Activ Yuva

This one is built for young adults aged 18 to 45. You can add children aged 91 days to 25 years on a floater.

• Wide Cover Choices: Sum insured from ₹5 lakh up to unlimited, with policy terms of 1 to 5 years.
• Shorter Waiting Period for Existing Conditions: 2 years, or 1 year with an add-on. 
• Short Hospital Stays Count: Hospitalization as short as 2 hours can qualify.
• Wellness-First: Like Activ One MAX, you can earn up to 100% of your premium back through HealthReturns for good nutrition, exercise, and sleep habits.
• Add-Ons: OPD cover and maternity are available as add-ons.
• No room rent limits or disease-wise sub-limits.

Activ Yuva has an age cap of 45 years for buying, so if you are older, Activ One MAX is the easier fit.

Other Aditya Birla Plans

• Activ Fit: Made for active people under 35, with a renewal discount for staying in the policy before turning 35.
• Activ One Maternity: A combo of a base plan and a maternity rider, sold through aggregators.
• Activ Care Classic: Built for senior citizens, with a 2-year pre-existing waiting period.
• Activ Health Platinum Enhanced: A comprehensive plan with cover up to ₹2 crore.

This data has been sourced from IRDAI annual reports and the insurer’s public disclosures. To compare it with other insurers, refer to Ditto Data Lab. 

Solvency Ratio: This shows whether an insurer has enough money to pay future claims. IRDAI requires at least 1.50. ABHI reported 1.84 for FY 24-25, which is comfortably above the minimum. 

Note: A stands for adult, C stands for child. For this comparison, we’ve taken sample profiles of healthy individuals living in Delhi (pincode: 110010) and covered for a sum insured of ₹15 lakh. For Activ Yuva, we’ve added the annual health check-up add-on to make things on par. These are indicative premiums and may vary based on your exact location, health history, and selected add-ons. 

Ditto’s Key Takeaway:

For a single 25-year-old, the two plans cost almost the same. Activ One MAX is even slightly cheaper at ₹25 lakh. 

So which should you pick? If you are under 45 and want a shorter wait for pre-existing conditions, Activ Yuva is a strong pick. If you want the Chronic Care add-on and multi-year discounts, Activ One MAX works better.

How Does the Aditya Birla Health Insurance Claim Process Work?

ABHI lets you claim through the Activ Health app, the website, or the helpline. 

Cashless Claim (At Network Hospitals)

• Inform ABHI: For planned hospitalization, do this at least 48 hours before admission. For emergencies, do it within 24 hours of admission. You can use the Activ Health app, the website, or call 1800 270 7000.
• Choose a Network Hospital: ABHI has 16,500+ to pick from.
• Show your e-card or policy number at the hospital's insurance desk and submit the pre-authorization form.
• Get Approval and Be Discharged: ABHI pays the hospital directly. You pay only the non-payable items.

Under IRDAI's Cashless Everywhere rule, you can also ask for cashless treatment at hospitals outside the network, subject to prior approval. 

Reimbursement Claim

Sometimes you may use a non-network hospital, or cashless may not work. Then you pay first and claim later.

• Inform ABHI as early as possible.
• Get treated and pay the bill yourself.
• Collect Your Documents: the claim form, photo ID, bank details, original bills and receipts, discharge summary, prescriptions, and diagnostic reports.
• Submit them within the deadline mentioned in your policy (many policies allow around 15 days from discharge, so check your wording).
• Get Reimbursed: ABHI aims to decide within 30 days of receiving the last document.

Conclusion: Is Aditya Birla Health Insurance Good?

It is a good choice for most buyers, particularly if you are young, healthy, or planning for a family. Its claim record is better than the industry average, complaints are low, and the plans are flexible.