Overview
The Aditya Birla Activ Health Platinum Enhanced is a comprehensive health insurance policy designed for individuals and families, offering cover amounts up to ₹2 crores, depending on the mode of purchase. Its standout features include Day-1 coverage for chronic conditions like diabetes and hypertension, a 100% reload of the sum insured for unrelated claims, and the unique Premium Waiver benefit, which waives one year’s premium upon detection of listed illnesses. Additional benefits include HealthReturns™ rewards, worldwide emergency coverage, wellness coaching, and pre-post hospitalization cover (60-180 days respectively).
Experts Review
Written by Nikhil Nair
Senior Writer
The Aditya Birla Activ Health Platinum Enhanced plan is a robust health insurance solution that prioritizes both preventive and curative care. Its Day-1 chronic management coverage is a significant advantage for individuals with pre-existing conditions, ensuring immediate access to treatment. The Premium Waiver feature is particularly noteworthy, as it reduces financial stress by waiving one year’s premium if an adult policyholder is diagnosed with listed illnesses. The 100% reload benefit ensures continuous financial protection during multiple claims in a policy year.
The plan also excels in promoting wellness through HealthReturns™, which rewards healthy behavior with up to 100% of the premium back. Worldwide emergency coverage and wellness coaching further enhance its appeal for individuals seeking global healthcare access and personalized guidance.
However, the plan has certain drawbacks. While comprehensive, premiums are higher due to its extensive features, which may deter budget-conscious buyers. Additionally, the three-year waiting period for pre-existing diseases might be a limitation for those seeking immediate coverage.
Pros
Feature set is satisfactory.
Premiums are relatively well priced.
Insurer has a solid track record with great claim and service metrics.
Offers Premium Waiver, which makes this policy stand out.
Cons
Maternity benefits not offered, which is a notable gap.
Aditya Birla
Key Insights
Founded
2016
Aditya Birla was established 9 years ago, making it a relatively new entrant with a developing track record.
Claims Experience
95% claims settled in 30 Days
Aditya Birla settles 95% of all claims it receives demonstrating strong credibility.
Network Hospitals
12,000+
Aditya Birla has a strong network with over 12,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
22 complaints per 10,000 claims registered
Aditya Birla experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
Features
All
Great
Good
Premium Waiver
STANDOUT
The insurer will waive off the premiums for 1 year in case of detection of listed illnesses for adults aged 18 years & above.
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
When selecting the policy you were probably asked about your choice of room. It could have been a single private room, a shared room or even a general ward. And so long as you stay in a room you picked at the time, it’s all good. But if you picked one room and then opted to stay in a more expensive room, then you’ll have to co-pay a part of the bill.
Customisable
Change Any Room to Shared Room or Single Private Room.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre existing diseases waiting
If you are already dealing with Asthma, Hypertension, Hyperlipidemia, Diabetes, then the insurer will cover you from day 1. However, if you are dealing with other pre-existing diseases including thyroid, kidney stones, etc., then you’ll have to wait 3 years before they start covering these complications.
Add-ons
Future Secure
Recommended
Cover increases in line with inflation, consumables covered, and No Claim Bonus is protected if total claim amount is less than 25% of sum insured.
ABHI Protect
Recommended
Get restoration unlimited number of times for any illness along with a fixed payout of ₹10,000 once in a policy year post the insured member is discharged from the hospital (available once for all insured members in a policy year).
OPD
Get coverage for outpatient consultations, prescribed diagnostics and pharmacy up to defined limits as chosen.
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 1 day, with a maximum payout of ₹500 to 5000 for up to 30 days.
Critical Illness
Paid out as a lump sum amount for Critical illnesses between Rs. 3 lakhs to Rs. 20 lakhs based on the cover chosen.
International
Covers international planned treatments up to defined limits for listed major illnesses on reimbursement/cashless basis.
Personal Accident Cover
Paid out as a lump sum amount for Accidental Death, Total Permanent Disability between Rs. 5 lakhs to Rs. 30 lakhs based on the cover chosen.
Room Rent Modifier
Change Any Room to Shared Room or Single Private Room.
Cancer Booster
Get additional coverage up to 100% of Sum Insured for medical expenses linked to Cancer of Specified Severity.
Tele-OPD Consultation
Each insured member can get unlimited e-consultations from General Physicians.
Vaccine Cover
Get coverage against vaccination for diseases declared as pandemic or epidemic up to specified limits per insured person.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Services for terminally ill individuals addressing non-medical needs are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Cataract
Glaucoma
Refractive Error Correction
Sinusitis
Rhinitis
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
Maternity benefits not offered.
Customer Reviews
U
Usha Khanna
Day-1 chronic management is a lifesaver! No waiting for my existing conditions.
V
Vikram Batra
The Premium Waiver feature is amazing! Such a relief if a serious illness is diagnosed.
W
Wendy D'Silva
100% reload benefit gives me peace of mind about multiple claims.
D
Deepak E. Jain
Reload benefits are good, but always best to understand the exact terms.
B
Bharat C. Kumar
Since it's a 'Platinum Enhanced' plan, I expect the premium to be quite high.
Z
Zafar Ansari
Good comprehensive plan, covers a lot of ground.
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Frequently Asked Questions
Does Activ Health Platinum Enhanced have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
- Chronic Management Program Waiting Period: No waiting period for illnesses and conditions arising out of Asthma, Hypertension, Hyperlipidemia, Diabetes.
Does Activ Health Platinum Enhanced have room rent restrictions?
Does Activ Health Platinum Enhanced offer a restoration benefit?
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