Aditya Birla Group Health Insurance
A joint venture between the Aditya Birla Group and Momentum Metropolitan Strategic Investments (Pty) Limited, Aditya Birla Health Insurance Company offers a range of retail and corporate health insurance solutions.
The group health insurance plans are designed to cater to the health insurance needs of employees.
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Key statistics of Aditya Birla general insurance company*
GHI Premiums
GHI lives insured
Health lives insured
Health claims Processed
Health claims settlement ratio***
Health claims Settled within 3 months
What is group health insurance?
A group health insurance plan is one that covers a group of individuals under one policy. The policy is called the Master Policy, and it contains the name of all insured members. Group health plans can be bought by registered groups to cover their members.
The most common example is the employer-employee group, where employers buy group health plans to safeguard the health and wellbeing of their employees. Group health plans allow affordable coverage to members, and the coverage is available without the individual medical underwriting of each member.
Highlights of Aditya Birla group health insurance
Pan India presence in over 2,300+ cities
8,700+ network hospitals
More than 10 million lives insured until date
More than 1.97 lakhs claims settled
Aditya Birla group health insurance plans
Here’s a look at the group health insurance plans offered by Aditya Birla Health Insurance Company:
Group Activ Health: Highlights of the policy
Feature
Type of Cover
Pre-existing diseases
Covered from day one
International treatment and hospitalization
Yes, for critical illnesses
Room Rent
Coverage for non-allopathic AYUSH treatments
ICU Charges
Second medical opinion online for major illnesses
Optional coverage benefits
Included
What’s covered?
Inpatient treatment
Daycare treatments
Domiciliary hospitalization
Ambulance cover
Pre- and post-hospitalization expenses
OPD expenses
Hospital cash allowance
Inpatient psychiatric treatments
Organ donor cover
Accidental hospitalization
ICU Charges
Second medical opinion online for major illnesses
Group Activ Secure: Highlights of the policy
Feature
Nature of Exclusion
Day care treatments
Over 586 daycare procedures are covered
Additional benefits
Yes, optional coverage benefits such as coma coverage, second e-opinion, etc., are available to enhance policy convergence.
Cashless treatments
Yes, easy cashless claims are available in a network of more than 5,600 hospitals across India.
Claim-free year bonus
Yes, policyholders can earn a cumulative bonus for each claim-free policy year.
What's covered?
Personal accident cover with a lump sum benefit in the case of accidental death or permanent disability
Inpatient coverage for hospitalization due to an accident
Ambulance cover
Optional cover for critical illnesses and hospital cash benefit, among others
Group Activ Travel: Highlights of the policy
Feature
Nature of Exclusion
Customized plans
Get customized plan options, depending on the regions you travel to.
International coverage
International coverage is available if you fall ill when traveling on business.
24*7 helpline
The company offers a 24*7 helpline for claims.
Additional benefits
Yes, you can choose from different optional coverage benefits for a customised policy.
What's covered?
Inpatient hospitalization abroad
Ambulance charges
Cost of medicines and drugs
Nursing charges
Lifestyle support because of an accident
Mugging cover
Optional coverage benefits such as emergency cover for pre-existing illnesses, non-medical cover such as loss of passport, personal accident cover, etc.
Please note that Plum has collated and presented this data for informational purposes only and at a particular point in time. Plum does not endorse, rate, or recommend any particular insurer or insurance product offered by an insurer. The final terms, conditions, and premiums may vary depending upon factors including group size, age, location, and applicable taxes.
Here's how Aditya Birla is better with Plum
Go digital with Plum
A seamless digital claim experience for your employees.
Complete group cover for all
Most comprehensive coverage and wellness program at the best price.
Get quotes instantly
Transparent benefits and pricing structure because we believe in honesty.
Get doctors on call
Access to Plum’s in-house specialized doctor consultation services, free of cost.
Plum Wellness program
Coverage enhancement through health and wellness benefits, only at Plum.
Chat support on Whatsapp
Our WhatsApp-enabled claim process ensures an easy and hassle-free claim experience.
Automated admin solution
Manage your team and employee health benefits program online on a single dashboard.
Track your claims
Know how your team is utilizing their employee benefits and medical coverage.
Lodging a claim under Aditya Birla group health insurance plans
In the case of a medical emergency covered under your Aditya Birla Group Health Insurance Plan, you should contact the insurance company immediately and register your claim. The other claim-related steps are:
For cashless hospitalization, locate and get admitted to a networked hospital.
Fill up a pre-authorization claim form and submit it 72 hours before a planned hospitalization. In the case of an emergency, submit the form within 24 hours of hospitalization.
Based on the details furnished in the pre-authorization claim form, cashless claims will be accepted or rejected.
If accepted, you can avail of cashless treatments, and the insurer would foot the medical bills directly.
In the case of admission to a non-networked hospital, you would have to pay the medical bills yourself. After discharge, fill and submit the claim form with all the relevant medical documents. The insurer would then reimburse the claim.
Filled claim form
Identity and age proof
A copy of the health card or policy document
KYC documents
Discharge summary issued by the hospital
MLC or police FIR for accidental claims
In case of reimbursement claims, original copies of hospital records, diagnostic reports, and hospital bills has to be submitted along with bank details of the insured member
Conclusion
With the rising costs of healthcare services and lifestyle diseases, health insurance has become a necessity. When it comes to group medical insurance, financial protection needs to be ensured by an organization for its real assets.
A properly designed policy helps an employee to achieve a sense of belongingness. With Care Group Health Insurance, an employee gets a comprehensive health insurance cover and the flexibility to design the policy as per the specific requirements of the insured.
FAQs
Can I add or remove members after the initial setup?
Super top-up is additional coverage of 20 lakhs added to your existing policy. You can avail the additional cover for yourself, and/or for your entire family (self+spouse+2 kids), and/or your parents.
This policy, however, comes with waiting periods on certain critical illnesses and applicable deductibles.
How are premiums calculated for additions?
Yes, you can add new employees, add new dependents (at the time of marriage or childbirth), and remove employees who exit the company. Additions and deletions can be done using the Plum dashboard.
Do I get refunded for deletions?
Deductible refers to the amount paid by the policyholder (via out-of-pocket or other medical insurance policy) before the super top-up kicks in. Read all about how a deductible works here.
How do I pay for additions and deletions?
No, the policy doesn’t cover same-sex or unmarried couples.
Can an employee convert the group plan to an individual plan if they leave the company?
No, the policy doesn’t cover same-sex or unmarried couples.