Good For

Comprehensive Coverage

Good For

Chronic Conditions Coverage

Aditya Birla
Aditya Birla

Activ Health Platinum Enhanced

3.85

Rated by Ditto Insurance

Sum Insured

₹5 L ₹2 Cr

Premiums

Moderate

Entry Age

Adult: 18 years

Child: 91 days - 25 years

Exit Age

Adult: No limit

Child: 26 years

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

Nikhil Nair

Written by Nikhil Nair

Senior Writer

Ishita Jain

Reviewed by Ishita Jain

Editor

IRDAI-Certified Expert
IRDAI Certified

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

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

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?

Yes. Activ Health Platinum Enhanced imposes 4 kinds of 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?

No. Activ Health Platinum Enhanced has no room restrictions - 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.

    Does Activ Health Platinum Enhanced offer a restoration benefit?

    Yes, Activ Health Platinum Enhanced does offer a restoration benefit. You will have 100% of the cover restored, if you are hospitalized one more time in a bid to treat a different complication, in a policy year.