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Introduction

Before we start comparing these two policies we have to set out some ground rules.

Both products are marketed by different insurance companies. Activ Health Platinum Enhanced is sold by Aditya Birla and Care Classic is sold by Care. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.

Second, we know that both products have massive differences in their core structure. Activ Health Platinum Enhanced is quite comprehensive. It offers considerable protection and it doesn’t impose as many restrictions. However, Care Classic is specifically designed for Reproductive Procedures. So in many ways, you’re comparing apples and oranges here.

And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?

That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.


Let’s start with Activ Health Platinum Enhanced. The product comes from Aditya Birla’s stable:

Aditya Birla started operations in the year 2016 as a subsidiary of Aditya Birla Capital Ltd., which in turn happens to be a joint venture between the famed Aditya Birla Group and MMI Holdings (South Africa).

The company holds a claim settlement ratio of 95% along with a network of more than 11,000+ hospitals, and extremely interesting products for young people with a focus on fitness. And considering their track record has been improving rapidly they are emerging as a top health insurer in the market.


Care Classic meanwhile comes from Care’s stable:

Care Health Insurance (formerly Religare Health Insurance) was founded in 2012. And in that time, they’ve managed to corner a large part of the Indian Insurance market.

What’s more impressive?

Care Health Insurance has a remarkable claim settlement ratio of 90% and a network of more than 16,000+ hospitals.

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Insurance Parameters

Recommended
Not Recommended
Network hospitals
11,000+
16,000+
Claim settlement ratio

(avg. of last 3 years)

95%
90%
Co-payment

No

20%

(if purchased after turning 61)

Room rent

Any Room

Single Private room

Disease sub-limit

No

Yes

Pre existing diseases waiting
-

3 years

Pre/Post hospitalization

60/180 days

60/90 days

No claim bonus

50% per year

(up to 100%)

25% per year

(up to 150%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(once for different illness)

100% restoration

(unlimited no. of times

for any illness)

Health check-up
Once every year
Maternity

Available

(Assisted Reproductive treatments covered after 3 years)

Out Patient Department

Available

Day care

Feature Comparison

coPay

Co payment

With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. In this case, however, Activ Health Platinum Enhanced doesn’t impose a co-payment clause whereas Care Classic requires you to co-pay a part of the bill 20% if you purchase after turning 61

roomRent

Room rent

If the policy does impose room rent restrictions then the insurer may only let you stay in a room of a certain specification or impose a cap on the total room rent. If you were to breach either criterion then the insurance company may ask you to pay a portion of all the expenses you incurred while staying in the room. In this case, however, Activ Health Platinum Enhanced lets you stay in Any Room and Care Classic lets you stay in a single private room. In effect, both policies impose restrictions on the kind of room you can pick.

diseaseSublimit

Sub limits

Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, Activ Health Platinum Enhanced doesn’t impose a disease wise sub-limit whereas Care Classic imposes disease-wise sub-limits on Cataract, Modern treatments.

ped

Waiting periods for pre-existing diseases

If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. In this case, Activ Health Platinum Enhanced imposes a waiting period of null years on pre-existing diseases while Care Classic extends a waiting period of 3 years on existing conditions.

prePost

Pre and post Hospitalization expenses

Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Activ Health Platinum Enhanced covers expenses incurred 60 days before hospitalization and expenses incurred 180 days post-hospitalization. Meanwhile, Care Classic covers expenses incurred 60 days before hospitalization and expenses incurred 90 after hospitalization, although there may be different sub-limits

ncb

No claim bonus

Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. In this case, however, Activ Health Platinum Enhanced offers a no-claim bonus of 50% whereas Care Classic offers a no-claim bonus of 25%. And the no-claim bonus may be capped at different levels too.

domiciliary

Domiciliary

Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, Activ Health Platinum Enhanced offers domiciliary cover. And Care Classic also coves domiciliary expenses.

ayush

Ayush treatments

Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, Activ Health Platinum Enhanced covers Ayush procedures and Care Classic also extends coverage for Ayush treatments.

maternity

Maternity benefits

If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, however, Activ Health Platinum Enhanced doesn’t offer protection for maternity-related hospitalizations whereas Care Classic offers maternity cover.

opd

Out Patient Department (OPD)

Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, Activ Health Platinum Enhanced offers OPD cover whereas Care Classic doesn’t offer OPD protection.

Final Conclusion

If you’re specifically looking to buy a policy for Reproductive Procedures, Care Classic makes a lot of sense. But considering Care has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that Aditya Birla has to offer, if the policy is made available to you.

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