Overview
Aditya Birla's Activ One MAX plan is a comprehensive health insurance solution with unique features like "HealthReturns™", which rewards healthy habits, and "Reload of Sum Insured" which ensures coverage even after claim exhaustion. It also offers coverage for pre- and post-hospitalization, day-care treatments, and modern procedures. With wellness coaching and chronic care management, the plan is tailored for individuals and families seeking holistic healthcare protection. Coverage options extend up to ₹6 crore for enhanced financial security.
Experts Review
Written by Nikhil Nair
Senior Writer
Aditya Birla's Activ One MAX plan stands out for its focus on wellness and preventive care alongside robust hospitalization benefits. The "HealthReturns™" feature is particularly appealing, offering up to 100% of premiums back as rewards for maintaining a healthy lifestyle—an innovative way to incentivize fitness. At the same time, the Unlimited "Reload of Sum Insured" ensures uninterrupted coverage even after exhausting the base sum insured, which is a significant advantage during multiple claims in a policy year. The Activ One MAX also comes with a renewal bonus of up to 100% every year, which is capped at 500% of the original base sum insured, regardless of a claim.
Additionally, coverage for modern treatments and day-care procedures ensures flexibility in addressing diverse healthcare needs. In addition, it offers coverage for Asthma, Hypertension, Hyperlipidemia, Diabetes mellitus, Chronic Obstructive Pulmonary Disease (COPD), Obesity, and Coronary Artery Disease from Day 1 via the chronic care add-on. The plan also offers inbuilt consumables coverage.
Pros
Offers a wide range of features.
Premiums are relatively well priced.
Insurer has a solid track record with great claim and service metrics.
Cons
Maternity benefits not offered, which is a notable gap.
Doctor consultations are not covered, which could be a drawback for some. Need to opt add-on for doctor consultations.
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
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
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
Customisable
Change Any room to Single Private room or Shared Accommodation.
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’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Customisable
For Asthma, Hypertension, Cholesterol, Diabetes mellitus, Chronic Obstructive Pulmonary Disease (COPD), Obesity or Coronary Artery Disease (PTCA done prior to 1 yr): Pre existing disease waiting period is reduced from 3 years to 0 days.
Customisable
For any illness: Pre existing disease waiting period is modified/reduced from 3 years to 2 years and 1 year.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 90 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.
Add-ons
Chronic Care
Recommended
For Asthma, Hypertension, Cholesterol, Diabetes mellitus, Chronic Obstructive Pulmonary Disease (COPD), Obesity or Coronary Artery Disease (PTCA done prior to 1 yr): Pre existing disease waiting period is reduced from 3 years to 0 days.
Reduction in PED
Recommended
For any illness: Pre existing disease waiting period is modified/reduced from 3 years to 2 years and 1 year.
Chronic Care Management Program (OPD)
Get coverage for defined e-consultation sessions and pathology tests for listed conditions already diagnosed as PEDs.
Critical Illness
Paid out as a lump sum amount for Critical illnesses between Rs. 10 lakhs to Rs. 50 lakhs based on the cover chosen.
Personal Accident Cover
Paid out as a lump sum amount for Accidental Death, Total Permanent Disability, Permanent Partial Disability between Rs. 10 lakhs to Rs. 50 lakhs based on the cover chosen.
Compassionate Visit
Lump sum of Rs. 50,000 for a policy year, covering 1 family member, if hospitalization exceeds 10 days
Room Rent Modifier
Change Any room to Single Private room or Shared Accommodation.
Per Claim Deductible
Choose deductible between ₹15,000 and ₹25,000 and get a discount on premiums.
Tele-OPD Consultation
Each insured member can get unlimited e-consultations from General Physicians.
Cancer Booster
Get additional coverage up to 100% of Sum Insured for medical expenses linked to Cancer of Specified Severity.
Durable Equipment Cover
Covers the cost of durable items like Ventilator, Wheelchair, Prosthetic device, Suction Machine, etc up to 5L or base sum insured; whichever is lower.
Second Medical Opinion
Get second medical opinion for listed 27 major illnesses from doctors & experts from the network facilities.
Annual Screening Package for Cancer diagnosed Patients
Get pay out for medical expenses done on annual screening package for people diagnosed with Cancer, provided the conditions required are met up to defined limits on a reimburesement basis.
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.
Treatment involving Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy, KTP Laser Surgeries, Cyber Knife Treatment, Femto Laser Surgeries, Bioabsorbable Stents, Bioabsorbable Valves, Bioabsorbable Implants. Use of Radio Frequency (RF) probe for ablation.
Stem cell therapy except Hematopoietic stem cells for bone marrow transplant for haematological conditions) or Surgery, or growth hormone therapy or Hormone Replacement Therapy
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.
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 periodCustomisable
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. This policy also further allows to reduce the PED waiting period to 2 years and 1 year for all diseases and to 0 days for certain diseases.
What's missing in the policy
Maternity benefits not offered.
Doctor consultations are not covered. Need to opt add-on for doctor consultations.
Customer Reviews
J
Jahanvi Bidhani
Reload of Sum Insured ensures I'm covered even after a claim, which is a big relief.
C
Chitra Singh
Day 1 coverage for chronic conditions like Diabetes, Asthma is simply amazing!
M
Mamita Yadav
Achieving the HealthReturns™ might require consistent effort, which can be challenging.
H
Hrithik Sharma
The wellness benefits are great, but might not appeal if you're not into tracking activities.
S
Shahbaz Khan
Renewal bonus up to 500% of original SI is incredible for long-term coverage growth!
K
Khushi Pandey
HealthReturns™ offering up to 30% premium back is a great motivator to stay fit!
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Frequently Asked Questions
Does Activ One MAX 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.
Does Activ One MAX have room rent restrictions?
Does Activ One MAX offer a restoration benefit?
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