Health Insurance

Health Insurance plans

Aditya Birla Activ Care (Premier)

Name: Aditya Birla Activ Care (Premier)
Brand: Aditya Birla Health Insurance Company Limited

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Introduction Verdict Pro’s & Cons Specific Exclusions About Insurer Detailed Ratings

Introduction to Aditya Birla Activ Care (Premier)

Aditya Birla Activ Care (Premier) is a health insurance policy offered by Aditya Birla Health Insurance Company Limited. A health insurance plan promises to pay for hospitalization expenses as well as expenses incurred before and after a hospitalization. It ensures that you receive the required medical care without having to worry about the costs associated with it. Aditya Birla’s Activ Care (Premier) Plan is specifically designed to cater to the healthcare needs of senior citizens by taking into consideration the unique health challenges that they may face as they age.

Verdict: Aditya Birla Activ Care (Premier)

This plan is specifically designed for senior citizens, offering comprehensive coverage and support for various stages of their health and well-being. Apart from hospitalization and related expenses, it also covers OPD expenses such as medical consultations, diagnostics tests, etc. On the flip side, it doesn't allow you to make premium payments on a monthly basis and is relatively more expensive than other products in the market. Additionally, as per our research, the insurer has received a higher number of claim settlement as well as policy purchase complaints. This implies that the insurer has a poor track record in terms of both purchase and claims service experience.

Pros & Cons: Aditya Birla Activ Care (Premier)

Covers outpatient department costs, such as medications, consultations, etc.
Cashless facility available for Health Check-Up
Multiple options available for getting premium discounts
Our study observed their responses on Twitter to be relatively quicker than other insurers

Expensive than other products in the market
Limitations on the type of hospital room you choose
Monthly premium payment mode not available
Received higher number of complaints during policy purchase compared to other insurers
Received higher number of complaints on claim settlement compared to other insurers

Specific Exclusions: Aditya Birla Activ Care (Premier)

01 Injury or disease due to war, invasion, act of foreign enemy, and warlike operations

02 Injury or illness due to self injury or participation or involvement in naval, military or air force operation

03 Injury or illness caused by intoxicant abuse, smoking cessation programs, and nicotine addiction treatment, unless prescribed by a medical practitioner

04 Circumcision unless necessary for treating a disease or injury

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About Aditya Birla Health Insurance Company Limited

Aditya Birla Health Insurance Company Limited (ABHICL), a part of Aditya Birla Capital Ltd. (ABCL), is a joint venture between Aditya Birla Group and MMI Holdings of South Africa. ABHICL. The current product portfolio of the company includes unique offerings such as Chronic Care and Incentivized Wellness. It was founded in 2015 and is headquartered in Mumbai, Maharashtra. Mr. Mayank Bathwal is the company's CEO and MD.

Founded in

2015

JV Partners

Aditya Birla Group and MMI Holdings

Turnover (GWP)

653.93 Crores

Number of Policies

6,47,028

Number of Claims

2,81,796

Detailed Product Specs: Aditya Birla Activ Care (Premier)

Claims Experience advisor

Customer Service advisor

Product Benefits (10L Sum Insured) advisor

Limits and Exclusions advisor

% of claims settled in less than 30 days

Reflects on the speed of settling valid claims

98.61%

% of Complaints received on overall claims

% customers unhappy with claims experience

0.24%

Claims Incurred Ratio

72.71%

Claim Settlement Ratio (No. of claims)

What % of the claims received were paid?

90.24%

No. of Cashless Hospitals

10,500+

Notes

1- The health insurance data was last updated in September 2023. All data has been sourced from product brochures, policy wordings, prospectus, public disclosures (Q1, FY 2023-2024), insurer websites, and the IRDAI website.

2- The Claims Settlement Ratio data is taken from NL-37, insurer public disclosures (Q1, FY 2023-2024). It is calculated by dividing the number of claims settled by the sum of claims outstanding at the beginning of the year and claims reported during the year.

3- The data related to claim complaints and policy purchase complaints is taken from NL-45, insurer public disclosures (Q1, FY 2023-2024).

4- The Solvency Ratio data is taken from NL-26, insurer public disclosures (Q1, FY 2023-2024).

5- The data related to claims settled within 30 days is taken from NL-39, insurer public disclosures (Q1, FY 2023-2024).

6- The Claims Incurred Ratio data is taken from NL-4 and NL-5, insurer public disclosures (Q1, FY 2023-2024). It is calculated by dividing the Net Claims Incurred by the Net Earned Premium.

7- For now, we have considered the most comprehensive plans from leading insurance companies. We will keep updating the product pages with new plans in the coming days.

8- We have rated only those plans that can be serviced by individual advisors. This is because of our strong belief that health insurance customers need professional assistance from individual advisors before and after purchase. We do not recommend and hence do not rate direct-to-customer health insurance plans or plans where there aren't enough advisors available to service.

9- Affordability assessment of plans:

・The affordability of comprehensive plans is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1 opting for a cover of ₹10 Lakhs. And, the premiums are as of 30th September 2023.

・The affordability of Care Freedom Plan is assessed using premiums for a 30-year-old male residing in Zone 1 opting for a cover of ₹5 Lakhs. And, the premiums are as of 30th September 2023.

10- The product benefits section is based on a sum insured of ₹10 Lakhs and only highlights the top benefits and features of health insurance plans.

11- Only those hidden and special conditions that apply to the benefits and features we have considered are included on the product pages.

12- The product pages only include the most significant specific exclusions under each plan.

13- The product pages do not include any generic terms, conditions, or exclusions (those that are the same and apply to all health insurance plans).

14- If the policy wording, brochure, or prospectus states that a benefit/feature is available with a specific plan but it is not available online when generating the premium quote, we have not considered that benefit/feature to be available with the plan.

15- The response time on Twitter (Beta) was calculated using a sample set of tweets from February 2023 to August 2023 (analyzed in September 2023).

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