Activ Health (Platinum – Enhanced) in one table
| Insurer | Aditya Birla Health Insurance Company Limited |
|---|---|
| Sum insured | ₹2 lakh to ₹2 crore, in tiers of 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 15 / 20 / 25 / 30 / 40 / 50 / 100 / 150 / 200 lakh |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What Activ Health (Platinum – Enhanced) covers
These are the terms that decide what you are actually paid when you claim. Room rent, co-pay and restoration do more to shape a settlement than the sum insured does, and they are read from Aditya Birla's own policy wording.
| Feature | This plan | What good looks like |
|---|---|---|
| Co-payment | None at ₹4 lakh cover and above. At ₹3 lakh and below, treating in a costlier zone than the one you bought in carries 10%, 15% or 25% | No Co-payment |
| Room Rent Limit | You pick the entitlement when you buy. At ₹4 lakh and above the options are shared room, single private A/C room or any room; at ₹3 lakh and below, 'any room' is not offered | No room rent capping |
| Disease sub-limit | No disease sub-limits on this variant – mental illness, obesity treatment and home treatment are all paid up to the sum insured | No sub-limit |
| No Claim Bonus | 50% of the sum insured added per claim-free year, capped at 100% and at ₹1 crore. You can take it as a renewal discount instead | 50% each year (Minimum upto 100%) |
| Reload of Sum Insured | Up to 100% of the sum insured, but only once in a policy year, never on the first claim, and never for the illness already claimed for | 100% restoration once in a year |
| Pre-Hospitalization | 60 days | At least 60 days |
| Post-Hospitalization | 180 days | At least 120 days |
| Consumables | Non-medical expenses listed in the policy annexure are excluded. The Future Secure add-on buys them back | Consumables covered |
| Chronic Management Program | Consultations and diagnostic tests for diabetes, hypertension, high cholesterol and asthma, cashless from day one where a pre-policy medical exam has confirmed the condition. In-patient treatment for those conditions is covered after 30 days | Chronic conditions covered early |
| HealthReturns | Up to 100% of premium, earned through Active Dayz and a Healthy Heart Score. Spendable on medicines, diagnostics or the next renewal | Wellness reward available |
| Premium Waiver | One policy year's premium waived if a listed illness is diagnosed in an adult aged 18 or over. Optional-cover premium is excluded from the waiver | Included |
| Road Ambulance | At actuals at a network hospital, or up to ₹5,000 per hospitalisation elsewhere | Covered at actuals |
| Entry age | Adults from 18 with no maximum entry age. Children 91 days to 25 years on a floater; an individual policy can start at 5 | No maximum entry age |
Activ Health (Platinum – Enhanced) add-ons you can buy with it
Each of these costs extra and each has its own conditions. Some are genuinely worth it; several exist to patch a gap in the base plan. Ask what each one adds before it goes on your quote.
Activ Health (Platinum – Enhanced) discounts you can ask for
Published discounts on this plan. Most are applied at quote stage rather than offered, so it is worth naming the ones you qualify for. Every figure is a ceiling, not a promise - what you actually get depends on the case.
| Discount | Worth | When it applies |
|---|---|---|
| HealthReturns | Up to 100% of premium | Not a discount at purchase but a reward you accrue. 325 Active Dayz in a year with a green Healthy Heart Score earns the maximum; it is spendable on medicines, diagnostics or the next premium. |
| Family discount | Up to 5% or 10% | 5% for two members on a multi-individual policy, 10% for three or more. |
| Long-term discount | Up to 7.5% or 10% | 7.5% on a 2-year policy and 10% on 3 years, paid as a single premium up front. |
| Preferred Provider Network | Up to 10% | In exchange for agreeing to use the insurer's preferred hospital list. |
| Loyalty discount | Up to 5% | Capped at ₹2,500, on a further retail policy bought from Aditya Birla in the same policy year. |
From the Activ Health prospectus. Discounts apply to the premium and are subject to the insurer's own rules.
Activ Health (Platinum – Enhanced) waiting periods: when each part of the cover starts
Waiting periods run from the day cover began, not from the day you fall ill, and they run in parallel rather than one after another.
| Initial Waiting Period | 30 days |
|---|---|
| Specific Illness | 24 months |
| Pre-Existing Disease | 36 months |
| Critical Illness rider (signs or symptoms) | 90 days, plus a 15-day survival period |
The named illnesses that wait 24 months
These wait 24 months from the start of your first Activ Health policy. An accident is covered from day one. If the same condition is also pre-existing, the longer 36-month clock applies instead. Indicative list – the wording carries the full set.
Activ Health (Platinum – Enhanced) exclusions: what the plan will not pay for
Every policy carries exclusions, and they are the clauses people read for the first time at claim stage. These are the ones worth knowing before you buy.
Where Activ Health (Platinum – Enhanced) falls short
No plan is right for everyone, and a page that only lists strengths is not much use to you. These are the gaps we would raise on a call before recommending it.
Activ Health (Platinum – Enhanced) questions, answered
What does 'day 1 chronic cover' actually mean on this plan?
It refers to the Chronic Management Program, which is outpatient. If a pre-policy medical exam confirms you have diabetes, hypertension, high cholesterol or asthma, the insurer manages that condition – consultations and diagnostic tests, cashless – from day one. Hospitalisation for the same condition is covered after 30 days rather than after the usual 36-month pre-existing wait. It is a genuine benefit, but it is not the same as full day-one in-patient cover.
How does the reload of sum insured work?
Once your cover and accumulated bonus have been used up by earlier claims in the year, it restores up to 100% of the sum insured. Three limits apply: it is available only once a year, it never applies to the first claim of the year, and it cannot be used for the illness or injury already claimed for, including its complications. Unused reload does not carry into the next year.
Is there a room rent limit?
There is a room category entitlement, chosen when you buy. At ₹4 lakh of cover and above you can choose shared room, single private A/C room, or any room. At ₹3 lakh and below the 'any room' option is not offered at all. ICU charges are paid up to the sum insured whichever option you hold.
How much can HealthReturns be worth?
Up to 100% of your premium on this variant. It is earned month by month through Active Dayz – 10,000 steps, 300 calories burned or a 30-minute gym session each counts as one – and scaled by your Healthy Heart Score. Thirteen Active Dayz a month at a green score earns 30% of that month's premium; 325 in a year earns another 50% on top.
What are the waiting periods?
30 days for any illness other than an accident, 24 months for a named list of conditions and procedures, and 36 months for pre-existing disease. The Critical Illness rider has its own 90-day wait plus a 15-day survival period. The pre-existing wait can be shortened with a paid add-on, but only if you take it when you first buy the policy.
Is maternity covered?
Only if you buy the Maternity Expenses add-on. It pays ₹75,000 or ₹1,00,000 for the delivery, with newborn and vaccination costs inside that same limit, and ₹35,000 of stem cell preservation over and above it. Nothing maternity-related is in the base plan.
Read it from the insurer
We summarise. The policy wording is the contract, and it is the only document that settles a dispute. These links go to the insurer's own pages.
Understand the terms before you commit
A plan page tells you what this policy does. These explain why each term matters and what it costs you when it is missing.
Other Aditya Birla plans we have read
Aditya Birla files these separately, and the terms differ between them. If you are choosing within the range, compare the waiting periods and the exclusions rather than the sum insured.