Overview
The Aditya Birla Activ Assure Diamond is a comprehensive health insurance policy offering sum insured options from ₹2 lakhs to ₹2 crores. It features a 150% reload of the sum insured for unrelated claims (maximum up to 50L), coverage for daycare procedures (up to SI), and no room rent capping for sums insured above ₹7 lakhs (meanwhile, for 2L–4L SI: 1% of SI; 5L SI: Single private AC room). The plan includes a health coach for chronic conditions, a super no-claim bonus (NCB) (as an add-on) to double the sum insured within two claim-free policy years, and HealthReturns™ rewards of up to 30% of the premium.
Experts Review
Written by Nikhil Nair
Senior Writer
The Aditya Birla Activ Assure Diamond plan is a robust health insurance solution that offers extensive coverage with innovative features. It's 150% reload benefit ensures financial security during multiple claims, while the super NCB option allows policyholders to gain up to double their sum insured within two claim-free years, providing significant long-term financial protection. The inclusion of a health coach for managing chronic conditions like diabetes and hypertension adds value by promoting lifestyle management.
However, the plan has several limitations. Room rent restrictions apply for sums insured below ₹7 lakhs, which may limit comfort during hospitalization. A mandatory 20% co-payment clause applies to claims for individuals aged 61 and above, increasing out-of-pocket expenses. While the claim settlement ratio is competitive, operational efficiency in claims processing may vary regionally. Furthermore, timely renewal is essential to maintain continuous coverage benefits, which can be inconvenient if overlooked.
Pros
Feature set is satisfactory.
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
If you bought this policy after you turned 61, you have to pay 20% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Customisable
Change Single Private Room to Any 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’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.
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 - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Add-ons
NCB Super
Mandatory
Additional bonus of 50% up to a maximum of 100%, with a clawback of 50% if claimed in the previous year.
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.
Room Rent Modifier
Recommended
Change Single Private Room to Any Room.
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).
Unlimited Reload
Recommended
Restores the cover unlimited times up to 100% of the sum insured for different illness.
Accident Booster
Get additional coverage up to 100% of Sum Insured for medical expenses linked to accidental hospitalization.
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.
Parkinson and Alzheimer’s disease, general debility or exhaustion (“rundown condition”).
Venereal disease, all sexually transmitted disease or Illness including but not limited to HPV, Genital Warts, Syphilis, Gonorrhoea, Genital Herpes, Chlamydia, Pubic Lice and Trichomoniasis.
Treatment for 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 or other procedure unless specifically approved by Us in writing in advance.
Expenses related to any admission primarily for diagnostics and evaluation purposes 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.
Doctor consultations are not covered. Need to opt add-on for doctor consultations.
Customer Reviews
A
Ankit Sharma
The 150% reload of sum insured is a very good feature, gives extra protection.
P
Pooja Mehra
Super NCB to double sum insured in 2 claim-free years is amazing! Great long-term benefit.
R
Rajesh Kumar
Health coach for chronic conditions like diabetes is a very helpful and unique feature.
P
Priya Reddy
I was relieved to see that the plan includes coverage for modern treatments like robotic surgeries—it’s reassuring to have that kind of support in today’s time.
G
Geeta R.
Room rent restriction for SI below ₹7 lakhs is a drawback. Should be no capping for all.
N
Nisha Agarwal
No room rent capping for sum insured above ₹7 lakhs is a relief. Can choose a good room.
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Frequently Asked Questions
Does Activ Assured Diamond 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 Assured Diamond have room rent restrictions?
Does Activ Assured Diamond offer a restoration benefit?
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