Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Activ Health Platinum Enhanced is sold by Aditya Birla and Comprehensive is sold by Star Health. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products are reasonably comprehensive. They do the basics quite well, but they won’t have all the bells and whistles (Think extensive coverage for international, dental, maternity and other such matters). So if you are looking for something else entirely, then both these policies may not cut it.
And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?
That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.
Let’s start with Activ Health Platinum Enhanced. The product comes from Aditya Birla’s stable:
The company only began operations in the year 2016 as a subsidiary of Aditya Birla Capital Ltd., which in turn happens to be a joint venture between the famed Aditya Birla Group and MMI Holdings (South Africa).
While the company boasts a claim settlement ratio of 87.54% along with a network of more than 10,051+ hospitals, do remember they’ve only been in the market for a few years now. So they don’t have an extensive track record.
Comprehensive meanwhile comes from Star Health’s stable:
Star Health Insurance is India's first standalone health insurance firm. And with an army of retail advisors pushing their products across the country, they’ve managed to capture a fair share of the Indian market.
The company also boasts a network of over 13,000+ hospitals and a decent claim settlement ratio of 83.07%.
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Compare Insurances |  Aditya Birla Activ Health Platinum Enhanced |  Star Health Comprehensive |
|---|---|---|
| Network hospitals | 10,051+ | 13,000+ |
| Claim settlement ratio (avg. of last 3 years) | 87.54% | 83.07% |
| Co-payment | No | 10% (if purchased after turning 61) |
| Room rent | Any Room | Single Private room |
| Disease sub-limit | No | No |
| Pre existing diseases waiting | 3 years | 3 years |
| Pre/Post hospitalization | 60/180 days | 60/90 days |
| No claim bonus | 50% per year (up to 100%) | 50% per year (up to 100%) |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 100% restoration (once for different illness) | 100% restoration (once for any illness after complete exhaustion of sum insured) |
| Health check-up | Once every year | Once every year |
| Maternity | Available (up to ₹20,000 after 2 years) | |
| Out Patient Department | Up to ₹1,200 (cap of ₹300 on each consultation) | |
| Day care |
Feature Comparison
Co payment
With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. In this case, however, Activ Health Platinum Enhanced doesn’t impose a mandatory co-payment clause whereas Comprehensive imposes a co-payment clause of 10% if you purchase after turning 61.
Room rent
If the policy does impose room rent restrictions then the insurer may only let you stay in a room of a certain specification or impose a cap on the total room rent. If you were to breach either criterion then the insurance company may ask you to pay a portion of all the expenses you incurred while staying in the room. In this case, however, Activ Health Platinum Enhanced lets you stay in Any Room and Comprehensive lets you stay in a single private room. In effect, both policies impose restrictions on the kind of room you can pick.
Sub limits
Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, neither Activ Health Platinum Enhanced imposes disease-wise sub-limits nor does Comprehensive
Waiting periods for pre-existing diseases:
If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. This cooling period is referred to as the Pre-existing-disease waiting period. In this case, Activ Health Platinum Enhanced imposes a 3 year waiting period on pre-existing diseases and Comprehensive will similarly tell you to wait 3 years before making a claim related to your pre-existing diseases
Pre and post Hospitalization expenses
Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Activ Health Platinum Enhanced covers expenses incurred 60 days before hospitalization and expenses incurred 180 days post-hospitalization. Meanwhile, Comprehensive covers expenses incurred 60 days before hospitalization and expenses incurred 90 after hospitalization, although there may be different sub-limits
No claim bonus
Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. And in this case, Activ Health Platinum Enhanced offers a no-claim bonus of 50% and Comprehensive similarly extends a 50% no-claim bonus.
Domiciliary
Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, Activ Health Platinum Enhanced offers domiciliary cover. And Comprehensive also coves domiciliary expenses.
Ayush treatments
Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, Activ Health Platinum Enhanced covers Ayush procedures and Comprehensive also extends coverage for Ayush treatments.
Maternity benefits
If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, however, Activ Health Platinum Enhanced doesn’t offer protection for maternity-related hospitalizations whereas Comprehensive offers maternity cover.
Out Patient Department (OPD)
Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, Activ Health Platinum Enhanced doesn’t offer OPD protection whereas Comprehensive offers OPD cover.
Final Conclusion
After considering all the features on hand and the claim settlement ratio of Aditya Birla, we believe that Activ Health Platinum Enhanced is a better alternative to Comprehensive for most use cases that we’ve evaluated so far.
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