Activ Health Platinum

Covers the medical expenses for one or more of the following arising out of an insured person’s hospitalization during the policy period following an Illness or injury that occurs during the policy period – room rent, ICU (Intensive Care Unit), OT (Operation Theatre), nurse charges, medicines, medical practitioner’s fees including fees of specialists and anesthetists, anesthesia, blood, oxygen and blood transfusion charges, surgical appliances and prosthetic devices.

60 days of pre-hospitalization and 180 days of post-hospitalization expenses are covered under the policy.

The policy provides coverage for 527 day care procedures.

Available when :

• the condition of the patient is such that he/she is not in a condition to be removed to a hospital, or
• the patient takes treatment at home on account of non-availability of room in a hospital.

Covers the medical expenses incurred for organ donor’s treatment for harvesting of the organ donated.

This covers the costs incurred on transportation of the insured person by road ambulance to a hospital for treatment in an emergency.

• Network providers – Actual expenses
• Non network providers – Reimbursed up to max of Rs 5000 per hospitalization.

Offers flexibility of choosing the room category and paying premium for the room chosen. In case you opt for a lower room category at the time of your hospitalization, a fixed percentage benefit is applied on payable claims and that portion is credited as health returns post claim settlement..

Annual (comprehensive health checkup in a policy year).

This benefit is available in case a person is diagnosed with any of 11 critical illness’.

Upto 100% of sum insured as per the provision once in an active policy year, reload is provided in case of SI inclusive of bonus is insufficient as a result of previous claims.

If insured is hospitalized for 10 days due to accident lump sum amount is paid (1% of SI, maximum up to 10,000).

Emergency medical evacuation & medical transportation is provided to the insured, if travelling more than 150 kms for a period of < 90 days.

The policy provides for-

• 20% increase of sum insured every claim free year, max up to 100%. These do not reduce even when the customer claims in any subsequent year
• Chronic Management Program: The insured person will be entitled to manage medical expenses for out-patient treatment of diabetes, hypertension, hyperlipidemia and asthma. Coverage for i. medical practitioner’s consultations; ii. diagnostic test & iii. pharmacy expenses.
• Health Returns: An insured person can earn up to 30% of premium as Health Returns. This is earned through a combination of Healthy Heart Score™ and Active Dayz and premium is calculated monthly basis fitness grid and scores are generated. This can be redeemed against renewal premium or other incidentals such as diagnostic tests, medicines etc.
• Health Coach: Two coaching sessions available every policy year for customers above 18 years with asthma, hypertension, hyperlipidemia or diabetes.

This plan offers family discount of 5% (After considering zone & room type). One can avail long term discount of 7.5% and 10% upon selecting a 2 and 3 year policy.

• Maternity expenses : This covers medical expenses for child delivery and pre or post-natal expenses and other incidentals., ectopic pregnancy is not covered in this, new born baby & vaccination expenses & Stem cell preservation covering medical expenses towards harvesting & storage of stem cells of new born baby.
• Hospital cash benefit: This benefit shall be payable for a maximum limit of 30 days in a policy year & 10 days for each claim for each continuous and completed period of 24 hours of hospitalization, during the policy period for treatment of an Illness or Injury.
• OPD Expenses: This covers cost incurred for medical expenses on an out-patient basis upto amount specified in policy schedule.

• At the inception of the policy, you get a period of 15 days from the date of receipt of the policy from the date of receipt of the Policy document to review the terms and conditions of this policy. Health insurance policy contracts with a term of 3 years offered over distance marketing mode shall have a free look period of 30 days from the date of receipt of the policy.
• If customer has any objections to any of the terms and conditions, customer may cancel the policy stating the reasons for cancellation and provided that no claims have been made under the policy.
• If the insured person has not made any claim during the free look period, the insured person shall be entitled to:
  • A refund of the premium paid less any expenses incurred on medical examination of the insured persons and the stamp duty charges or;
  • Where the risk has already commenced and the option of return of the policy is exercised by the policyholder, a deduction towards the proportionate risk premium for period on cover or;
  • Where only a part of the insurance coverage has commenced, such proportionate premium commensurate with the insurance coverage during such period.
• Free look period shall not be available on renewals.

For a detailed list of exclusions, you may refer to the document at the bottom of this page.

Should you wish to cancel your Activ Health Platinum insurance coverage, you can contact Aditya Birla Health Insurance Co. Limited, through the contact details mentioned in the product brochure.