Aditya Birla

Aditya Birla

Activ Health Platinum Essential

Activ health platinum essential is fairly economical and it does an okay job. But once you're hospitalized, they'll make you split the bill, they might not offer the full cover for some treatments and they'll make you wait 4 years before covering complications arising out of pre-existing illnesses.

What's good here?

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Pre & Post hospitalization expenses covered

No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.

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day_care

Day Care treatments covered

If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.

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domiciallary

Full coverage even if you are forced to hospitalize at home

The insurer will bear the costs even if you are hospitalized at home due to a condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.

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health_checkup

Free Health Checkups every year

If you’re planning on getting a full body checkup every year just to make sure you’re in fine working condition, the insurer will cover the costs.

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What's bad here?

special mention
warning
Be aware of

Has disease wise sub-limits

Your insurance cover won’t be fully available in case you are treated for Angioplasty, Knee replacement, Cataract and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.

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co_pay

You will have to pay a portion of the bill

The policy will only cover 80% of the final bill. The rest is on you. They call this a co-payment.

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ped

Long waiting period for pre-existing diseases

If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems only after 4 long years. It could be much shorter you know? Like 2 years perhaps!

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What's okay here?

room_rent

Restrictions on the rooms you can pick and much more

When selecting the policy you were probably asked about your choice of room. It could have been a single private room, a shared room or even a general ward. And so long as you stay in a room you picked at the time, it’s all good. But if you picked one room and then opted to stay in a more expensive room, then you’ll have to co-pay a part of the bill. Read more here

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ncb

Special Bonus for being healthy and not claiming insurance

Your sum insured increases by 10% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 100%. But hey, it's still a bonus.

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What's lacking here?

restoration

No Restoration Benefit

Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.

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ayush

No Cover for Alternative Medicine

Think of getting Ayurvedic, Homeopathic or other alternative treatment to cure an illness. Tough Luck!!! Your insurer won’t cover this expense.

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Frequently Asked Questions

Yes. Activ Health Platinum Essential imposes 5 kinds of waiting periods -
  • 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
  • Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
  • Pre-Existing Disease Waiting Period: There's a 4-year waiting period for any pre-existing disease you may have while buying the policy.
  • Maternity and Newborn Waiting Period: There’s a 4-year waiting period before you can make claims related to pregnancy and childbirth. (Add-on Cover)
  • Chronic Management Program Waiting Period: There’s a 2-year waiting period for a list of chronic diseases post clearing the eligibility criteria.
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