Aditya Birla Activ Assure Diamond Product Page

Aditya Birla Activ Assure Diamond Product Page

Aditya Birla Activ Assure Diamond Plan

A Quick Overview Of The Plan!

Aditya Birla Health Insurance Company offers the Activ Assure Diamond health insurance plan. With this plan at hand, you can just shield yourself and your family in case of a medical contingency while also ensuring a healthy life. This policy comes with some noteworthy features and various sum insured options ranging from Rs 2 lakhs to Rs 2 crores. Activ Assure Diamond Plan from Aditya Birla Health Insurance Company provides you access to the required medical care, making it the ideal choice for securing the health of you and your family.

Are There Any Eligibility Rules?

Minimum Age Of Entry:

  • For a family floater policy, the minimum entry age for dependent children is from 91 days to 5 years if one adult is covered under the same policy. Under the floater, children who are less than 25 years old can be covered as dependents.
  • For individual policies, the minimum entry age is 5 years.

Maximum Age Of Entry: The Aditya Birla Activ Assure Diamond Plan does not have a maximum entry age. Age is calculated as the number of years completed as of the last birthday.

Let's Uncover Its Benefits And Limits!

Aditya Birla Activ Assure Diamond Plan covers inpatient hospitalisation expenses, which include room boarding and nursing charges, medical practitioner fees, the cost of prescribed medicines and drugs, ICU charges, and other related expenses incurred during the hospitalisation.

Besides that, here is a breakdown of all other expenses the plan covers -

  • Pre & Post Hospitalisation Expenses CoverageAditya Birla Activ Assure Diamond Plan covers the cost of all the tests, medication, treatments, etc you may incur before and after you are discharged from the hospital. This means that you need not fret about arranging funds to cover these expenses.

    The insurer will cover these expenses up to the sum insured for 30 days before you are hospitalised and 60 days after you are discharged from the hospital. But, on one condition - the expenses must be related to the medical condition for which you are hospitalised and your claim must be approved as part of your inpatient hospitalisation coverage.

  • Daycare Treatment CoverageDid you know certain surgeries or medical procedures that used to require an extended hospital stay can now be done within 24 hours? All thanks to technological advances in medicine! These are called daycare treatments. With such treatments, you can now enjoy a faster recovery time and can quickly return to your regular activities. And, the best part is that Aditya Birla Activ Assure Diamond Plan covers over 586 daycare procedures up to the sum insured under this policy.

  • Domiciliary Treatment Coverage: Sometimes, an injury/illness that requires immediate medical attention may prevent you from getting hospitalised due to its severity or the unavailability of no hospital beds in the hospital. In such cases, you can get medical treatments/procedures right from the comfort of your home. Aditya Birla Activ Assure Diamond Plan covers domiciliary treatments up to 10% of the sum insured.

  • Organ Donor CoverageAditya Birla Activ Assure Diamond Plan includes coverage for organ donors. Under the policy, it covers the costs related to harvesting the organ from the donor for transplantation, up to the sum insured (when the insured person is the recipient).

  • Modern Treatments CoverageTechnology is transforming healthcare, leading to the emergence of modern treatments. The result is greater access to super-effective treatments, offering hope to people with medical conditions previously considered untreatable. The Aditya Birla Activ Assure Diamond Plan covers the expenses associated with modern treatments up to the sum insured.

  • Non-Medical Expenses:Aditya Birla Activ Assure Diamond Plan offers coverage for non-medical expenses. Consumables such as gloves, nebulization kits, oxygen masks, and other items necessary for treatment are considered non-medical expenses. It covers these expenses up to the sum insured - ensuring all-around financial protection. Remember, this benefit is available as an add-on, so you will need to pay a little extra.

  • Room Rent LimitAs part of your health insurance package, your insurance company will cover the room in which you are hospitalised. Suppose you select a room that falls within your plan's room rent limit, you don't have to worry about an extra bill at the end. However, if you choose a room with higher rent than you're eligible for, you'll face proportionate deductions. This means that you will be liable for a proportionate share of the entire bill, rather than just the difference in the room rent.

    Worry not! With Aditya Birla Activ Assure Diamond, you have the freedom to pick any room - shared room, single room, deluxe room or any room available without any restrictions. No room rent limit is applicable on policies with a sum insured of Rs 7 lakhs and above. This eliminates the need for you to worry about the cost of the room and lets you choose what suits you best.

  • No Claim Bonus: The Aditya Birla Activ Assure Diamond Plan rewards you with a 10% no claim bonus if you do not make any claims during a policy year, which can go up to a maximum of 50%. Any claim made during a policy year will result in a reduction of the bonus by 10% of the basic sum insured.

  • Reload Benefits: Aditya Birla Activ Assure Diamond Plan offers restoration benefits as well. In case you use up your sum insured, it will be reloaded up to 150% of the original sum insured, up to a maximum of 50 lakhs. This feature offers you financial security and ensures that you and your family remain protected against ever-rising medical costs.

    During a policy year, the sum insured can only be restored once. You can, however, reload the sum insured unlimited times during the policy year by opting for Unlimited Reload of the sum insured. So, with unlimited reload, you get the limitless assurance you need. Please note that the reloading of the sum insured applies to subsequent claims within a policy year.

Here Are Some Other Cool Things About The Product

  • No Financially Limits On Coverage For Treatments/Diseases

    If your policy doesn't explicitly state that it won’t cover a certain illness, you can make a claim for it up to the full sum insured. It means this policy does not levy sub-limits based on any treatment/disease. This ensures that you are not bound by financial constraints when it comes to receiving the healthcare you deserve.

  • Health Coach To Take Charge Of Your Health

    You qualify for a health coaching session if you suffer from any of the following chronic conditions: asthma, hypertension, hyperlipidemia or diabetes mellitus. These coaching sessions will empower you with personalised guidance to help you better manage your condition. They will be available for telephonic consultation as a callback service. To qualify for this benefit, you must be at least 18 years old. During a policy year, you may take advantage of a maximum of 2 coaching sessions.

  • Health Returns - An Incentive To Stay In Shape

    An intriguing feature of the Aditya Birla Activ Assure Diamond Plan is the 'Health Returns' which reward members for staying active and healthy. This helps you to take additional steps for a healthier lifestyle, thereby increasing the value you receive from the policy.

  1. To get started, simply download the ActivHealth App and fill out the online health questionnaire. This will not be applicable to people that have undertaken the pre-policy medical test before policy issuance for the first policy year.
  2. Your healthy heart score will be calculated based on these test results. This score is valid for 12 months and will be updated automatically on the basis of your recent test results if another Health TM Assessment is done.
  3. You can earn ‘Active Dayz’ by maintaining a regular physical activity regimen. In case you achieve 13 Activ Dayz every month, this will result in you earning up to 30% of your policy premium as HealthReturns. On the other hand, in case you achieve 4 Activ Dayz per month, this will result in you earning up to 6% of your policy premium as HealthReturns.

These accumulated funds can be put to use as per your needs, like buying medicines, paying for diagnostic tests, paying for next policy premiums, keeping them as an emergency fund, etc. The HealthReturns earned will automatically be adjusted to pay the renewal premium if they are not utilised during the policy year.

1 Active Day = 10k steps daily/Half an hour gym session/300 calories burned

Earn HealthReturnsTM as a % of your premium

Activ Dayz Healthy Heart Score
Green Amber Red
13+ 30% 12% 6%
10-12 18% 7% 4%
7-9 12% 5% 2%
4-6 6% 2% 1%
0-3 0% 0% 0%

Listen! You Might Not Get Covered Right Away….

Some illnesses and diseases may not be covered after you purchase a health insurance policy for a certain period of time. This is called a waiting period. After the waiting period gets over, you can enjoy the full coverage of your health insurance policy and access the benefits of the policy.

Here are the various kinds of waiting periods -

  • Initial Waiting Period: All medical conditions, except for accidents, entail an initial waiting period of 30 days. You won't be able to claim hospitalisation expenses during the first 30 days unless you get hurt due to an accident.
  • Waiting Period For Pre-Existing Diseases: A pre-existing disease is any medical condition or illness that you have had in the 48 months before the issuance of the health insurance policy. For pre-existing diseases, the Aditya Birla Activ Assure Diamond Plan imposes a 48-month waiting period. So, you cannot file a claim for pre-existing disease-related expenses during this period and have to pay for them yourself.
  • Waiting Period For Specific Diseases: Some insurance companies have a list of medical conditions or illnesses which have a waiting period regardless of whether you have had those conditions before. It is decided by the insurer and has nothing to do with your health status. For specific diseases, the Aditya Birla Activ Assure Diamond Plan has a waiting period of 24 months, and for genetic diseases, the waiting period is 48 months. To avoid any hassles in the future, it is important to read the policy documents carefully and understand the waiting periods associated with different illnesses.

OMG! Your Policy May Not Cover This…

Exclusions are situations that your health insurance policy doesn't cover at any cost. These include -

  • Standard Permanent Exclusions: All insurance companies are required to strictly abide by the IRDAI's 'standard permanent exclusions'. Insurance companies are required to disclose these exclusions when you purchase a policy so you know what you're agreeing to. Some of these include -
  1. Investigation and evaluation: Hospitalisation for observation or monitoring only.
  2. Rest cure, rehabilitation, and respite care: Bed rest in a healthcare facility without any active treatment.
  3. Plastic/cosmetic surgery: Surgery or treatment intended to modify the appearance or characteristics of the body.
  4. Profession in hazardous or adventure sports: Medical expenses you incur as a result of participating in activities such as river rafting, mountaineering, scuba diving, horse racing, etc. as a professional.
  5. Obesity/weight control: Obesity and weight control treatments or surgeries.
  6. Unproven treatments: Medical procedures, surgeries, or treatments that have not been proven to work.
  7. Change of gender treatment: Treatment intended to alter a person's body's characteristics to those of the opposite gender.
  8. Breach of law: Treatment expenses associated with treating a person who has attempted or committed a crime against the law.
  9. Expenses related to birth control, sterility infertility: Contraception, sterilisation, artificial insemination, advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc.
  10. Excluded providers:Medical treatment administered by a medical practitioner or hospital that is excluded by the insurer.
  11. Narcotics: Treatment for drug abuse, alcoholism, etc.
  12. Treatments in establishments arranged for domestic purposes: Costs associated with treatment in health spas, nursing homes, or similar facilities arranged entirely or partly for domestic use.
  13. Dietary supplements, substances purchased without prescription: Supplements such as vitamins, minerals, etc. not prescribed by a medical professional.
  14. Refractive error: The cost of correcting refractive errors of up to 7.5 diopters to improve vision.
  • Additional Permanent Exclusions: Insurance companies may list some additional exclusions apart from the standard permanent exclusions. They may choose to permanently exclude certain diseases or severe medical conditions that they believe are risky or too costly to cover. It is however important to remember that insurers are restricted to the list of illnesses specified by the Insurance Regulatory and Development Authority of India (IRDAI) for which permanent exclusions can be applied. This ensures that customers are adequately protected and that they are not denied coverage for illnesses that should be covered.
  • Non-Standard Exclusions (Specific exclusions): These exclusions go beyond the IRDAI's list of standard permanent exclusions. Depending on the policy terms and conditions, these exclusions may vary among insurers. The following are some of the top specific exclusions under the Aditya Birla Activ Assure Diamond Plan:
  1. Participating in naval, military or air force operations, intentionally exposing oneself to danger, or intentionally injuring oneself.
  2. Preventive health examinations and routine examinations.
  3. The practice of circumcision (unless deemed necessary by illness or injury and as part of treatment).
  4. Treatments that could have been performed without hospitalisation on an outpatient basis.
  5. Assistive hearing devices, spectacle lenses, or contact lenses, including optometric treatment and multifocal lenses.
  6. Alopecia, baldness, wigs, toupees, and all related treatments.
  7. Stockings, diabetic test strips, and other medical supplies.
  8. External Congenital Anomalies or diseases or defects.
  9. Any dental procedure or surgery, unless it requires hospitalisation due to an accident, including dentures, implants, artificial teeth, and dental surgery of any kind.
  10. Ablation or other procedures using radio frequency (RF) probes without prior written approval from the US.
  11. Diseases such as Parkinson's and Alzheimer's, general debility, or exhaustion (“rundown condition”).

A Quick Glance At The Benefits And Limitations Of The Plan

Product Benefits Coverage Limits
Pre-Hospitalisation Expenses

30 days up to the sum insured

Post-Hospitalisation Expenses

60 days up to the sum insured

Daycare Treatment Coverage 586 procedures up to the sum insured
Domiciliary Treatment Coverage 10% of the sum insured
Organ Donor Coverage Harvesting expenses up to the sum insured
Non-Medical Expenses Sum insured, if you opt for an add-on
Room Rent Limit No limit for a sum insured of Rs 7 lakhs and above
Modern Treatment Coverage Sum insured
No Claim Bonus 10% increase in sum insured every claim-free policy year, up to a maximum of 50%
Reload Benefit Up to 150% of the sum insured
Pre-existing disease Covered after a 48-month waiting period
Specific Diseases

● Specific illnesses are covered after a 24-month waiting period.

● Genetic illnesses are covered after a 48-month waiting period.

Questions about Car Insurance

Frequently Asked Questions (FAQs)

There are a variety of sum insured options available with the Aditya Active Assure Diamond Plan ranging from Rs 2 lakhs to Rs 2 Crores.

Pre and post-hospitalisation expenses are not covered under the AYUSH treatment benefit.

The policy offers a No Claim Bonus (NCB) of 10% of the sum insured for every claim-free year, up to a maximum of 50%.

There are three policy terms available for this plan including 1, 2, and 3 years.

Pre- and post-hospitalisation expenses such as diagnostic tests, follow-up tests, etc., are covered by the policy. These benefits are available for 30 or 60 days, respectively.