Aditya Birla Health Insurance is one of the country’s most reputable insurance providers. When you purchase an Aditya Birla Health Insurance plan, you gain access to a variety of advantages, including cashless claim settlement at network institutions, daily cash allowance, a range of sum insured options, and tax benefits on premium payments. In addition to individual health insurance and family floater policies, the insurance provider offers various forms of health insurance plans. Each plan type features its own inclusions and exclusions. You can read this article to learn more about what is covered and what is not, and to gain a greater understanding of the claim process.

Plans Made Available by Aditya Birla Health Insurance

Aditya Birla Health Insurance is aware of the various needs of its clients in light of the escalating medical risks and consequently evolving healthcare requirements. Let’s examine the various policy varieties provided by Aditya Birla Health Insurance:

Types of Plans	Plan Features	Hospitalisation Cover
Individual Health Insurance	This plan offers complete medical coverage against health risks. It is one of the most popular plans with unique features such as:1. 10% of sum insured as No Claim Bonus2. 586-day care treatment cover3. 150% reload of sum insured	Up to 1 Crore
Family Floater Health Insurance	This plan lets you enjoy coverage for your entire family under a single plan. Along with protecting your entire family under one plan, it also offers the following benefits:1. No Claim Bonus2. In-patient hospitalisation cover3. Ambulance cover4. Hospital daily cash	Upto 2 Crore

Why Pick Aditya Birla Health Insurance

Aditya Birla Health Insurance plans are renowned for their attractive features. These policies offer a variety of optional coverages to ensure that they meet your specific needs. Their policies are centred on empowering patients during health emergencies. In addition, with a claim settlement rate of 98.08 percent, Aditya Birla medical insurance is one of the most reliable insurers on the market.

Not only does the Aditya Birla Health Insurance Policy cover medical expenses, but it also offers a variety of other benefits. Listed below are several advantages that make Aditya Birla the superior option for a health insurance policy:

• Cashless benefits

In the event that you require medical assistance, you can attend the network hospitals for cashless care. Throughout India, Aditya Birla Health Insurance has numerous network institutions. According to estimates, over 10,000 network hospitals offer nursery, advanced treatment technology, and more.

• Dedicated customer service support:

Aditya Birla Health Insurance Company Limited provides the finest round-the-clock customer service. You can submit questions and complaints, and a prompt response will be provided.

• Increased claim settlement rate:

Claim settlement ratio reflects an insurance company’s capacity to settle policyholders’ claims. The higher the ratio, the greater the ability to resolve claims. The claim settlement ratio of Aditya Birla Health Insurance Company Limited is 98.08 percent, which is an excellent score.

• Effective Health apps

Active Health is a mobile phone application developed by the Aditya Birla Health Insurance Company. This application allows you to monitor your health, count calories, record your medical history, and renew your health insurance policy with ease.

• Tax benefits

Under section 80D of the Income Tax Act, you can deduct up to 75,000 in taxes from the health insurance premiums you, your spouse, your dependent children, and your parents older than age 60 pay.

• Health returns

Health return is a monetary incentive given to policyholders for living a healthful lifestyle. The greatest part is that you can accumulate reward points for a specified time period and redeem them when necessary. To learn more, please visit their website.

• Sum assured

With Aditya Birla Health Insurance, the maximum coverage available is 2 crores. You can select from a variety of sum-assured options based on your needs and budget.

• Free health examinations

Aditya Birla Health Insurance provides their policyholders with complimentary preventative health exams. According to the agreement, you are eligible for the benefits after one to four years of their policy’s duration.

• Home therapy

In the event that you are unable to be admitted to a hospital due to unforeseen circumstances, Aditya Birla Health Insurance policies cover residential care.

Additional Read: Star Health Insurance: Everything You Should Know

Aditya Birla Health Insurance Plans: Features and Benefits

Plans from Aditya Birla Health Insurance are packed with features and infinite benefits.

• Cashless Claims Processing

Cashless treatments are available at 8,200 Aditya Birla network hospitals, where the claim is directly resolved with the hospital.

• Per-day Allowance

The plan includes a 500 daily cash allowance for the first five days of hospitalisation, allowing you to manage emergencies more effectively!

• Multiple Options for Sum Insured

With multiple health insurance sum insured options ranging up to 2 crores, it is simple to find a policy that meets your budget and requirements.

• Health Returns

You are compensated for living a healthy lifestyle with the Aditya Birla mediclaim policy! HealthReturnsTM can save you up to 30 percent on your health insurance premium.

• Day Care Procedure

The Aditya Birla Health Insurance policy provides coverage for 586-day care procedures that do not require 24 hours of hospitalisation.

• Tax Benefits

In addition to providing financial protection against medical emergencies, the plan also provides tax benefits on health insurance premiums. Section 80D of the Income Tax Act of 1961 allows you to deduct the premium you pay for your Aditya Birla Health Insurance policy.

Additional Read: Rashtriya Swasthya Bima Yojana: Eligibility, Coverage, Benefits, How To Enroll

What is covered by Aditya Birla Health Insurance and what is not?

Inclusions

Exclusions

Coverage for expenses incurred in case of hospitalisation for over 24 hours. Expenses incurred on consultation, diagnostics, and post-discharge tests are covered. Aditya Birla Health Insurance sees that you are covered for emergencies. With its road ambulance cover, the plan covers expenses incurred on ambulances due to an emergency. It covers the expenses incurred against 586 treatments annually that may not require hospitalisation for 24 hours. Activ Assure Diamond plan helps you get the necessary medical treatment at home, too. With this benefit, you are covered for medical expenses incurred in getting treatment at home, in case you were unable to be transferred to the hospital or a hospital bed was unavailable. Aditya Birla Health insurance covers the expenses incurred in the vaccination of insured children below the age of 18 years. This benefit is offered with a sum insured of ₹1 crore and above. Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homoeopathy in-patient treatment are covered.

Intentional self-inflicted injury, attempted suicide, and any other act of self-destruction. Diseases or disabilities caused due to any sexual disease or sexually transmitted disease. Any injury, disability, or death that is incurred due to an act of foreign enemies, civil war, war-like operations, etc. Illness or injury caused due to the consumption of any alcohol, intoxicant, substance, drug, or hallucinogen. Any pre-existing injury or disease arising out of a pre-existing illness or any medical complication shall not be covered. Coverage for any hereditary, genetic, or auto-immune disorders. Any healthcare aid that has been taken overseas unless covered under the plan. Dental care or oral care treatment, weight loss or obesity programs, etc. External devices that are required for vision support. Any additional hospital charges or non-medical expenses. Reproductive treatment or pregnancy-related complications.

Calculation of Aditya Birla Health Insurance Premiums

As a result of the skyrocketing cost of medications and medical care, health insurance policies are no longer a luxury; they are now an absolute necessity for every person. With a health insurance policy, you can pursue your future objectives without sacrificing, even in the event of a medical emergency. Using the Aditya Birla Health Insurance premium calculator, you can select an appropriate health insurance policy for you and your family.

• The calculation of premiums for Aditya Birla health insurance is straightforward.
• Choose a policy that meets your needs and fits your budget the best.
• Be certain about the family members you wish to insure.
• Enter the age of each individual
• Include your contact information such as email address and phone number.
• Here are the calculated premium amount, sum insured value, and essential features of the plan after you click submit.

Tax Advantages of the Aditya Birla Health Insurance

In addition to healthcare protection, Aditya Birla Health Insurance provides a number of additional benefits, including tax savings. To mitigate the impact of escalating healthcare costs, the government has enacted numerous exemptions under Section 80D of the Income Tax Act. One of the most lauded advantages is the tax-free health insurance premium.

This table illustrates the utmost tax exemption under Section 80D for health insurance purchased for oneself, one’s spouse, one’s dependent children, and one’s parents.

Condition	Yourself, your partner and your dependent kids	Parents	Total exemption
No one in the family is above 60	₹25,000	₹25,000	₹50,000
Policyholder and his/her family are below 60 but parents are above 60	₹25,000	₹50,000	₹75,000
Both the policyholder and his/her parents are above 60 years	₹50,000	₹50,000	₹1,00,000

Enhance Your Protection Against Medical Emergencies with Aditya Birla Insurance’s Optional Covers

Aditya Birla Insurance provides the most comprehensive health insurance policies with the following exceptional riders/add-ons:

• Surgical Care Add-on

For minor/major surgery, you must be hospitalised for at least 24 hours for medical reasons only. You will receive between 3,000 and 30,000 in benefits. The greatest part is that regardless of the benefit amount you select, the sum assured value of the rider will exceed 50 times that amount.

• Hospital Care Add-on

If you are admitted to the hospital for 24 hours due to any illness or injury, you will be reimbursed for daily expenses beginning on the date of admission. The daily financial allowance ranges from ₹600 to ₹6,000 .

• Waiver of premium

If you are no longer able to pay your premiums due to total disability or critical illness, your health insurance provider will waive all future premium payments.

• Accidental death and disability cover

Under this endorsement, your insurer will cover you if you become totally disabled or perish as a result of an accident. The benefits are payable to either you or your nominee.

• Critical Illness add-on 

Insurance policies do not cover life-threatening conditions such as heart disease, cancer, bone marrow transplant, etc. A critical illness rider will protect you against the costs associated with these illnesses.

Process for Aditya Birla Health Insurance Claims

Aditya Birla Health Insurance makes it simple to submit a claim. The Aditya Birla Health Insurance claim settlement procedure is quick and straightforward, and it does not require a great deal of time. Here is a detailed guide for submitting cashless and reimbursement claims:

1. Cashless Claims

Here’s what you must do:

• Step 1: Visit the network hospital
• Step 2: Show your cashless card for identification
• Step 3: Submit the pre-authorisation request form
• Step 4: Insurer will review your claim 
• Step 5: Claim shall be settled directly with the hospital

2. Reimbursement Claims

Just follow these quick steps:

• Step 1: Get in touch with the insurer 
• Step 2: Submit the claim documents
• Step 3: Claim request is assessed and the reimbursement amount is transferred.

What is the Aditya Birla Health Insurance Claim Payment Ratio?

Consider the provider’s claim settlement ratio (CSR) when selecting a health insurance provider. In the fiscal year 2021-22, Aditya Birla had a claim settlement ratio of 98.08 percent, compared to 94 percent in the fiscal year 2019-20.

A company’s claim settlement ratio reflects its claim-settling capabilities during a specific fiscal year. The calculation is based on the ratio between the total number of claims received in a given year and the total number of claims settled.

The claim settlement ratio assists prospective health insurance policyholders in selecting an appropriate insurance provider. A high CSR reflects the company’s financial strength and its ability to settle claims. Meanwhile, Aditya Birla Health Insurance has the greatest claim settlement ratio on the market.

Required Documents for Submitting an Aditya Birla Health Insurance Claim

Here are some documents you must have on hand when filing a claim with Aditya Birla Health Insurance:

• Claim form
• Aditya Birla Health insurance policy details
• Original medical bills, receipts, prescriptions, etc.
• Doctor’s certificate, for the diagnosis
• Death certificate, in case of death
• Other related documents and invoices.

Aditya Birla Network Hospitals 

A large network of hospitals indicates that, should you require medical care, you would be able to receive high-quality care at a reputable facility. With a robust network of over 8,200 hospitals and healthcare facilities, Aditya Birla will assist you in receiving the appropriate treatment wherever you are in India. As the company continually revises its list of hospitals, it is recommended that you keep reviewing the list, particularly for hospitals in your area.