aditya-birla-health

Aditya Birla Activ One

Plain-English breakdown of the plan — every field a shopper actually needs before clicking buy. Compiled from public aditya-birla-health brochures and policy wordings. Always confirm against the official PDF below.

family floaterindividual

Get official policy wording from aditya-birla-health ↗I already have a PDF — decode it →

Trust at a glance

Aditya Birla Health — IRDAI FY 2024-25

Verified

Claim Settlement Ratio: 95.68%
Incurred Claim Ratio: 71.5%
Complaints / 10,000 claims: 16
Network hospitals: 11,500

Source: IRDAI Annual Report FY 2024-25 · UIN 153PolicyPlain earns no commission · numbers shown verbatim

Plan details

Every field, in one place

Sum insured options: ₹2L · ₹5L · ₹10L · ₹25L · ₹50L · ₹1Cr · ₹2Cr · ₹6Cr
Pre-existing disease (PED) waiting: 36 months
Pre-existing covered: Covered after PED waiting period
Co-payment: No copay published
Room rent: No cap
Restoration of sum insured: Unlimited (subject to clauses)
No Claim Bonus (NCB): 100% per claim-free year
Cashless network: 11,500 hospitals (insurer disclosure)
Free-look cancellation window: 30 days
Premium grace days: 30 days
IRDAI UIN: Not confirmed — verify on irdai.gov.in
Last verified: 2026-06 · third party aggregator

Honesty note: HealthReturns benefit and chronic care add-ons described from public marketing; confirm enrolment terms in policy wording.

Indicative premium

Order-of-magnitude only — NOT a quote

Age	Sum insured	Approx annual premium
35	₹10L	~₹15,000/yr
45	₹10L	~₹21,000/yr

Indicative figures vary by city, family member count, medical loading and policy term. Always confirm on the insurer's premium calculator.

Known exclusions

What this plan typically does NOT cover

Cosmetic surgery (non-reconstructive)
Self-inflicted injury, substance abuse
Adventure / hazardous activities
Experimental treatments
Treatment outside India unless rider opted

Known traps

The fine print that decides claim outcomes

HealthReturns wellness discount (up to 100% of premium) is conditional on active step tracking — not guaranteed savings.
Chronic Management Programme covers diabetes / hypertension but requires enrolment and adherence.
Super NCB caps at 100% of base SI cumulatively.
Renewal premium can be re-rated for the entire age band, not just the individual.
Modern treatment percentage caps vary by variant — confirm before opting for advanced procedures.

How to claim

Cashless vs reimbursement — the steps

1Notify insurer. Within 24 hours of emergency admission or 48-72 hours for planned hospitalisation. Use aditya-birla-health's helpline or app — keep the reference number.
2Cashless: Pre-authorisation form filled by hospital, sent to aditya-birla-healthvia the hospital's TPA desk. Approval typically 4-6 hours during business; longer overnight. If your hospital is OUT of network (or PPN-only), you'll be on reimbursement.
3Reimbursement:Pay hospital out-of-pocket, then submit claim form + original bills + discharge summary + investigation reports + KYC. Insurer's IRDAI-mandated turnaround is 30 working days from receipt of complete documents.
4Watch for deductions. Room rent above your eligible category triggers proportionate deduction across the WHOLE bill, not just room rent. Sub-limits on cataract / modern treatment apply even when total SI is far higher.
5If denied: Ask for a written denial citing the exact clause. Internal grievance redressal first, then IRDAI Bima Bharosa or the Insurance Ombudsman.

Got a aditya-birla-health PDF in hand?

PolicyPlain's extractor reads your specific aditya-birla-health wording and surfaces the exact clauses, sub-limits and traps from your policy — not just the catalog defaults.

Upload my aditya-birla-health PDF →← Back to plans library