Activ One

For Internal Training Purpose only 1

 Is
99.9%
enough?

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 2
 Presenting a Power of One. A
product
Hence,For All product
99.9% that gives
is NOT enough!

1 0% Coverage
Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Activ One aims to bring…
One S.M.A.R.T solution for all customer’s needs

S Simple product

M Multiple options

A Affordable premiums

R Reliable product & brand

T Transparent solutions

So, why should you choose Activ One…

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 4
Activ One – MAX

For Internal Training Purpose only 5

 Inbuilt Features

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Activ One – Inbuilt Features
Hospitalisation Wider Coverage EMERGENCY
Other Medical Treatments Assistance Services

 Day Care Procedures

 In–Patient Hospitalisation  Domiciliary Hospitalisation  Road Ambulance Cover
 Pre & Post-hospitalisation -  AYUSH Cover
Covers for 90 & 180 days  Mental Illness Hospitalisation
 HIV / AIDS and STD Cover  Obesity Treatment
 Modern Treatment Methods and
Covers up to base Sum Insured Advancement in Technologies Actuals/ up to base Sum Insured

Organ Cashless Home Annual Health  Claim Protect (Non-

Check- up Medical Expense
Donor Treatment Waiver)
Expenses  Super Reload
 Available once in a policy  Super Credit
 Covers the  Medical expenses for year for Insured person(s)
Harvesting cost of treatment at home for aged 18 years and above
organ upto SI illnesses / injuries are covered
On a cashless basis only List of tests vary basis on
sum insured

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 7
 Is this sufficient or you expect MORE from your insurance?
 A great product that’s tailored to exceed your highest expectations. It
provides an impressive coverage of up to 500% of the base sum
insured, with an annual increase of 100% of the sum insured.

 With this product you get an assurance of UNLIMITED reload from

second claim onwards. This means your coverage not only keeps up with
medical inflation but consistently stays ahead of your evolving needs.

 We cover you with 100% coverage on consumables items* like

medication kits, gowns, slippers etc. with ACTIV ONE.

*As per list provided Let’s learn about Activ One in8detail…
Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Exceptional Benefits
Let’s learn top exceptional benefits with Activ One, not available anywhere:

1 Super Reload

2 Super Credit

3 Claim Protect (Non-Medical Expense Waiver)

9
Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Super Reload

What is Super Reload?

The basic Sum Insurance is reloaded as many times as
needed at no extra cost. Covers the same or unrelated
illnesses

What it provides?
- Up to 100% Unlimited Super Reload from 2nd
claim onwards

1 2 3
Applicable for:
In-patient & Domiciliary Hospitalisation,
Home Health Care, AYUSH Treatment,
and Organ Donor Expenses

Assuring 100% coverage all times whenever needed during the policy year.
* Only for floater policies
Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 10
 Super Reload – How it works
In case of a claim, Sum Insured will be utilised in the following sequence:

FIRST - BASE SUM

INSURED SUPER CREDIT

Super
Reload

SUPER RELOAD
CANCER BOOSTER*

* Optional benefit
Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 18
Super Credit

01 What is Super Credit? 02 What it covers?

Super Credit provides customers It ensures an annual increase
with 5 times the Sum Insured on of 100% Sum Insured (SI),
renewals. It helps to tackle the maximum limit of up to 500%. –
increasing costs of medical whether Claim or No Claim
treatment.

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 12
Super Credit – How it works

Activ One •100% of SI per year, up to 500% of Base Sum Insured

•Up to Max of 3 Crores under this benefit
MAX •Provided when Policy is renewed without break

2022 2023 2024 2025 2026 2027

From To Holistic
Assurance Insurance

Basic Sum Basic Sum Basic Sum Basic Sum Basic Sum
Insured Insured Insured Insured Insured
Basic Sum
10 Lacs 10 Lacs 10 Lacs 10 Lacs 10 Lacs
Insured
+ + + + +
10 Lacs
Super Credit Super Credit Super Credit Super Credit Super Credit
10 Lacs 20 Lacs 30 Lacs 40 Lacs 50 Lacs

With Medical inflation in mind we ensure customer MORE Health Insurance, with NO additional cost.

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 13
Claim Protect (Non-Medical Expense Waiver)
Have you heard of instances where Insurance companies give 100% claims that do not cover
Non-Medical CONSUMABLE Expenses
Rest Assured we got you covered 100%

Covers expenses for all You get 100% coverage , even

the Non Consumable for the expenses which many
expenses insurance policies don’t cover

Cost of listed Non-Payable Items are usually 10-20% of the total hospital bill, will be covered making sure he doesn’t have to worry about
these unexpected costs.

Note: Please refer to the NME annexure for the detailed list under this coverage
For Internal Training Purpose only 14
 Let’s see how Mr. Ra One gets 100% Assurance and 100% Benefit

Age - 32 years
Occupation - Businessman
Place - New Delhi
Sum Insured - 10 Lacs
Premium - INR 16,544 (excluding GST)
Policy - 1 year

Let’s see how the plan enhances his cover with just a
nominal additional premium at the time of uncertainty.

1. Super Reload
2. Super Credit
3. Claims Protect

Let’s see each of these in detail.

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 23
 Let’s see how Super Reload benefits Mr. Ra One

Base Sum Insured = 10 Lacs

Heart Attack = INR 12

Heart Attack = INR 5
Accident = INR 8 Lacs Lacs
100% Lacs
Claim 1

Claim 2

Claim 3
Unlimited
Claim Settled from Balance/remaining SI
Again Super Reload
= 2 Lacs
Base Sum Insured
100% Super Reload
Triggered for 10 Lacs
Unlimited Triggered for 10 Lacs
Super Reload
Remaining SI = 2 Lacs Claim of 5 Lacs claim
of Sum
Insured* Paid
Claim of 12 Lacs paid

*All Claims were made in the 1st year

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 16
Let’s see how Super Credit benefits Mr. Ra One
On Renewal his base cover will increase by 100% for each year, up to maximum of 500% of base sum
insured
Complete Coverage
6th Year available from 6th year =
Super Credit – 10 Lacs Base SI (10 Lacs) + Super
Credit (50 Lacs) + Super
5th Year Reload (10 Lacs) = 7
Super Credit – 10 Lacs times Coverage

4th Policy Year

Super Credit – 10 Lacs

2nd Policy Year

Super Credit – 10 Lacs

3rd Policy Year

Super Credit – 10 Lacs
For Internal Training Purpose only 17
Let’s see how Claim Protect benefits Mr. Ra One
Cost of Non Medical Expenses are:

Blood grouping
Blood
and cross Vaccination
reservation
Medication Kit matching of charges
charges
donor samples
INR 10,000 INR 13,000
INR 15,000 INR 12,000

Ra One total Claim was INR 25Lacs during the year.

If 2% of the hospital bill is considered is for Non Medical Expenses he has saved INR 50000

Note: The costs provided in the above table are for illustrative purposes only and may vary.
For Internal Training Purpose only 18 18
 Value Added Benefits

19

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Value Added Benefits
Let’s learn the value added benefits with Activ One:

1 Health Management Program

2 Chronic Care (optional cover)

For Internal Training Purpose only 20

HealthReturns TM

ABHI Purpose
Empowering people to
lead healthier lives

HealthReturns™
Gives you up to 100%
returns on premium

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 21
Steps To Earn HealthReturns™

Download – Activ Start Earning

Health APP Health Returns

Book HA or DHA to
Get Healthy Heart
Score
22
Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
 Why Digital
Health Assessment ?
AI-based tool empowering customers to undergo a
Health Assessment, anywhere-anytime.
Instant results, to begin the Health Returns journey
on the same day.
Smart digital ecosystem for young to mid-age
groups for quick health screening.

Even better, get a DHA done as

soon as Policy gets Active* !

Approved Applied for Approval

Aditya Birla Health Insurance

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Different ways to earn Active Dayz™
One Active Dayz™ can be earned by:

1 Completing a fitness centre or yoga centre activity for a minimum

of 30 minutes at Our panel of Fitness or yoga centre, OR;

Recording 10,000 steps or more in a day for all Insured Persons Aged
2 less than 60 years and 7,500 steps or more for all Insured Persons
Aged 60 years above (tracked through Our mobile application or a
wearable device linked to the Policy number) OR;

3 Burning 300 calories or more in one exercise session per day OR;

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 24
Earning up to 30% HealthReturns™
The insured person will earn HealthReturns™ based on the Healthy Heart Score™, the fitness assessment result and
the number of Active Dayz™ recorded.
HealthReturns™ is accrued on a monthly basis according to the following grid.

Healthy Heart Score™

No of Activ OR Fitness
DayzTM in a Assessment
calendar month Result* Red Amber Green

13 or more Level 5 6.0% 12.0% 30.0%

10 – 12 Level 4 3.6% 7.2% 18.0%
7- 9 Level 3 2.4% 4.8% 12.0%
4–6 Level 2 1.2% 2.4% 6.0%
0–3 Level 1 0% 0% 0%
*In order to achieve a particular level of HealthReturns™ the Insured Person must achieve either the required
number of Active Dayz™ or achieve a level (as shown in table above) under Fitness Assessment.

 The grid above is calculated on the Monthly Premium.

 The Insured Person can earn up 30% of their Monthly Premium as HealthReturnsTM based on the grid above.
25
Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 25
Spending Your HealthReturnsTM

01 Payment of Renewal Premium

04
In-patient Medical Expenses OPTION
and Day Care Treatment or for any retail policy with us

For non-payable claims, in case 05

02
of an In-patient hospitalisation
Non-Medical Expenses
or Day Care Treatment

03 06
Out-patient expenses AYUSH Treatments

26
Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 26
 Chronic Care

27

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Fact Check

Some Facts About Living With Chronic Conditions

Treatment duration
How to manage the condition
Lifetime of customer; a chronic condition
• Stay fit and eat healthy
is not curable, it needs to be managed
• See a specialist regularly
• Get relevant tests done regularly
• Take medicines regularly

Cost of managing the condition Cost of unmanaged Chronic condition

Involves direct cost of treatment
such as doctor fees, cost of tests; Cardiovascular disease, heart attack,
and indirect costs such as making stroke, nerve damage, kidney damage,
lifestyle changes loss of sight, loss of limb, loss of hearing,
Alzheimer's disease… just to name a few

28
Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 28
Chronic Cover – Beyond ABCD
Chronic Cover now with 7 Conditions
Asthma - lung condition that makes it hard to breathe
1
7
Blood Pressure - force of blood moving through your arteries
Angioplasty .
Asthma 1 2

6
Cholesterol - is a fat-like substance in your blood, needed for cell
Blood 3 building
.
Obesity Pressure
Diabetes - health condition, body has trouble regulating the sugar
2 4

5 Chronic Bronchitis - long-term lung condition where the airways in

Chronic Cholesterol 5 lungs are often inflamed
Bronchitis
Diabetes Obesity - a condition characterized by an excessive amount of
3 6 body fat
4
Angioplasty - Coronary Artery Disease with (PTCA) done prior to 1
PTCA : Percutaneous transluminal coronary angioplasty 7 year

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 29
Chronic Care

Diagnosed with chronic condition

• Can be added in future, When chronic condition is diagnosed

• Covered for one or more listed chronic condition(s)
• OPD – Covered on Cashless basis

Note:
• The Policy can be bought as per applicable Premium grid
• Deletion of coverage under Chronic Care for such condition shall not be allowed on subsequent Renewals of the Policy

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 30
 Optional Benefits

31

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
 Optional Covers with Higher Benefits
Optional covers that will optimise the customer’s needs

Personal Accident Cancer Booster

Cover (AD+PTD+PPD) Only applicable for MAX as Optional
Cover

Critical Illness Cover

For more details on *Optional Benefits refer the Policy Wording

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 32
Personal Accident Cover

Accidental Death (AD) Permanent Total Disablement (PTD) Permanent Partial Disablement (PPD)

Sum Insured is paid if Insured: Sum Insured is paid if Insured: Sum Insured is paid if Insured
• Suffers an injury due to an • Suffers an injury due to an accident
• Suffers an injury due to an accident • Injury results in the permanent
accident • Injury results in the PERMANENT PARTIAL disablement
• Injury results in the DEATH total disablement • Within 365 days from the date of the
• Within 365 days from the • Within 365 days from the date of accident,
date of the accident the accident • The total claim amount put together
for all losses will not exceed the total
accidental death sum insured opted

SI Options- 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs, and 50 Lacs

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 33
Critical Illness
List of Critical Illnesses as applicable:
What is • On diagnosis of the listed critical illness,
covered? company shall pay the sum insured. 1 Cancer of Specified Severity
2 Myocardial Infarction (First Heart Attack of specific severity)
3 Open Chest CABG
• Our total, cumulative, maximum liability during 4 Open Heart Replacement Or Repair Of Heart Valves
the lifetime is up to 100% of the sum insured. 5 Kidney Failure Requiring Regular Dialysis
• Once a claim for a listed condition is admissible in 6 Stroke Resulting In Permanent Symptoms
Condition: respect of an insured person, no further renewals
shall be allowed for that insured person under this 7 Major Organ / Bone Marrow Transplant
benefit. 8 Permanent Paralysis Of Limbs
• Initial Waiting Period - 60 Days 9 Multiple Sclerosis With Persisting Symptoms
10 Coma of Specified Severity
• The payment of a benefit under section shall 11 Motor Neuron Disease With Permanent Symptoms
Survival be subject to survival of the insured person for 12 Third Degree Burns
15 days following the first diagnosis of the 13 Deafness
period critical illness/undergoing the surgical
14 Loss of Speech
procedure for the first time.
15 Aplastic Anaemia
16 End Stage Liver Failure
17 End Stage Lung Failure
SI options • 10 Lacs, 15 Lacs, 20 Lacs and 25 Lacs
18 Bacterial Meningitis
19 Fulminant Hepatitis
20 Muscular Dystrophy

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 34
Cancer Booster

Up to 100% of Base policy Sum Insured

Multiple claims during the Policy year pertaining to cancer treatment

under this optional cover is payable up to the Base Sum insured which is
available only once during the policy year.

An additional amount is paid

as Sum Insured for Medical In addition to the foregoing, the conditions stipulated under the In-
Expenses incurred in relation patient Hospitalisation Benefit under the Base Policy shall be applicable.
to a claim related to
Hospitalisation in case of
“Cancer of Specified Severity
Covers Pre and Post Hospitalisation medical expense

Covers Day Care Treatment expenses up to Sum Insured

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 35
Other Optional Covers

Reduction in Specific Disease waiting Room Rent Type Options

period •Option 1 - Single Private Room
•Option 2- Shared Accommodation

Reduction in Pre-Existing Disease Per Claim Deductible

waiting period (1 - 15,000 & 2 - 25,000)

Durable equipment cover Critical Illness cover

[Initial Waiting Period - 60 Days and Survival
Preferred Provider Network Period - 15 Days]
(PPN) Discount Chronic Management Program (OPD)
10% discount applicable

Compassionate Visit Second Medical Opinion for

•up to INR 50,000 for two-way travel fare if
hospitalization exceeds 10 days listed Major Illness

Cancer Booster Annual Screening Package for

i. Covers Pre and Post hospitalisation Cancer Diagnosed Patients
medical expense. INR 10000 / Member /
Policy Year
ii. Covers Day Care Treatment up to Sum
Insured

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 36
 Eligibility Criteria

37

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Eligibility Criteria

Entry Age (Adult)

Minimum age - 18 years | Maximum - No capping

Entry Age (Child)

Individual – Minimum age of entry - 5 years

Dependent Child (floater/Multi individual) - 91 days to 25 years

Policy Type

Individual & Floater basis

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 38
Policy Type

Premium

Premium Zones: Zone 1 ,2 & 3

Premium Type: Age Banded

Relationships covered:

Family Floater Policy:

Self, legally married spouse OR live-in partner (same or opposite sex), dependent Children (Natural/legally
adopted), Parents and Parents-in-law
Individual Policy:
Self, legally married spouse OR live-in partner (same or opposite sex), son, daughter, brother, sister,
grandson, granddaughter, son in-law, daughter in law, brother in-law, sister in-law, nephew, niece, parents
and parents-in-law

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 39
Coverage Option

Sum Insured

5 Lacs, 7 Lacs, 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs, 50 Lacs, 75 Lacs, 1 Crore, 2 Crores

Policy Period option

One, two or three continuous years

 Optional covers under family floater policies, if chosen, will be applicable to all members in the Policy
except in case of Personal Accident Cover (AD, PTD, PPD), Critical Illness Cover, Chronic care(Day 1 In-
patient Hospitalisation),Chronic care restriction, Chronic management Program(OPD)

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 40
Waiting Period

Pre Existing Disease Waiting Period

MAX – 3 Years

Specific Disease Waiting Period

MAX – 2 Years

Initial Waiting Period

MAX – 30 Days

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 41
 FABing - Features, Advantages and Benefits

42

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Activ One FABing Techniques
Features Advantages Benefits

Super Reload • 2nd Claim onwards - • Multiple claims allowed within base • Limitless coverage
Unlimited Refill unlimited times sum insured • Less premium and maximum
(up to Base Sum Insured) • Coverage remains intact coverage

Super Credit • 100% of SI per year, up to • Continuous financial • Ensures long-term insurance
Coverage 500% of base sum insured protection security
increases (up to Max of 3 crore • Claim or no Claim SI • No extra cost for enhanced
irrespective of
claim under this benefit) increases every year sum insurance

Health • Available once in a policy • Health Heart Score generated • Journey of Active dayz™ start
AssessmentTM year at Network Providers on • Pro Activ Health approach
a cashless basis only

HealthReturnsTM • Up to 100% premium • 100% Health = 100% Health • Up to 100% premium back,
returns Insurance effectively lowering health
insurance costs
Claim Protect • Non-payable items will • No Deductions for non payable • No Out of pocket expenses
be covered items • Savings

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 43
Activ One – FABing Techniques
In-patient Features Advantages Benefits
Hospitalisation

Room Rent • No Capping on room rent • 100% coverage

• Can opt for any room • Access to premium / exclusive services

ICU Charges • No Capping • 100% coverage

• Eases financial burden on
customers
Road Ambulance Covers up to • Effortless hospital transport • No extra financial expenses
Cover base Sum • No Capping • No limit on coverage ensures stress
(per Hospitalisation) Insured free relatives

Day Care • Affordable medical advancements • All day care coverages

Treatments for <24-hour treatments • No limit helps to make better choices of
treatment

Modern • Access to a wider range of • Quick treatment

Procedures/ state-of-art treatments
Treatment

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 44
Activ One FABing Techniques
In-patient Features Advantages Benefits
Hospitalisation

HIV / AIDS and • Additional coverage during • Added financial support to take care of
STD Cover difficult times their medical expenses

Mental Illness • Mental Illness treatment on diagnosis • Promotes proactive improvement

Hospitalisation measures

Obesity Treatment Covers up to • Access to a wider range of treatments • Improvement in overall health
base Sum • Reduction of health risks and enhanced
Insured well-being

Pre-Hospitalisation • Easing financial stress during • Complete financial support for treatment
Expenses (90 days) treatment

Post-Hospitalisation • Extended coverage for recovery • Comprehensive post-Hospitalisation

Expenses (180 days) support reimbursement,
• Vital for recovery support

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 45
Activ One FABing Techniques
Features Advantages Benefits

Organ Donor • Hassle free harvesting of the organ • Provides security against unfortunate
Expenses donated to the insured events, for expensive treatments

AYUSH • Covers all the alternate medical • Holistic, minimal side effects, favored
Treatment sciences that the customer may avail treatment choice
Covers up to
base Sum
Domiciliary Insured • Treatment at home option when • Providing medical assistance during
Hospitalisation hospital not feasible or available pandemic or unforeseen events

Home • Cashless treatment for • Empaneled homecare provider offers home

Health Care illnesses/injuries at home treatment for customer convenience

Annual Health • Listed & • Early detection leads to timely • Encourages proactive monitoring for early
Check up Cashless Only treatment and better well-being issue detection and improved health

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 46
Activ One – VYTL

For Internal Training Purpose only 47

Activ One – Variants
Inbuilt covers

• All Non Medical expenses

cover (All 4 lists in
Annexure I) • Day 1 Chronic coverage
• No Capping on room rent • OPD expenses for chronic
conditions on cashless basis
VYTL • Up to 100%
Immediate Coverage and
• Super Credit – Up to 100% of
Health Support
HealthReturnsTM base SI (50% per year)
• Super Reload - Unlimited increases irrespective of claims
Refill from 2nd claim
onwards

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 48
Activ One – Inbuilt Features
Hospitalisation Wider Coverage EMERGENCY
Other Medical Treatments Assistance Services

 In–Patient Hospitalisation  Day Care Procedures  Road Ambulance Cover

 Pre & Post-hospitalisation -  Domiciliary Hospitalisation
Covers for 90 & 180 days  AYUSH Cover
 ICU Charges
 Mental Illness Hospitalisation
 HIV / AIDS and STD Cover
 Obesity Treatment
 Modern Treatment Methods and
Covers up to base Sum Insured Advancement in Technologies Actuals/ up to base Sum Insured

Organ Cashless Home Annual Health  Claim Protect (Non-

Check- up Medical Expense
Donor Treatment Waiver)
Expenses  Super Reload
 Available once in a policy  Super Credit
 Covers the  Medical expenses for year for Insured person(s)  Chronic Care
Harvesting cost of treatment at home for aged 18 years and above  Chronic Management
organ upto SI illnesses / injuries are covered Program (OPD)
On a cashless basis only List of tests vary basis on
sum insured

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 49
 Chronic Management Program

50

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Chronic Care – VYTL

Has chronic condition Under CMP, What is covered

• Under CMP, we also cover expenses:

• IPD Coverage starts from inception
• Covered for one or more listed (i) Medical Practitioner’s consultations;
chronic condition(s) (ii) Diagnostic test for declared Chronic
• OPD – Covered on Cashless basis Condition listed

• Coverage for Age 18 years

• Services can be availed at our
Network Providers and Empaneled
Service Providers

Note:
• The Policy can be bought as per applicable Premium grid and loading (as applicable) for such condition.
• Deletion of coverage under Chronic Care for such condition shall not be allowed on subsequent Renewals of the Policy

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 51 51
 Optional Benefits

52

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
 Optional Covers with Higher Benefits
Optional covers that will optimise the customer’s needs

Personal Accident
Critical Illness Cover
Cover (AD+PTD+PPD)

For more details on *Optional Benefits refer the Policy Wording

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 53
 Activ One - VYTL (Features, Advantages and Benefits)

54

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only
Activ One FABing Techniques
Features Advantages Benefits

Chronic Care • 7 chronic conditions on • No waiting periods • Immediate coverage for chronic
(Day 1 In-patient hospital admission from • Continuous support in the conditions
Hospitalisation) Day 1 chronic journey • Wider coverage of Chronic
condition like Angioplasty
• OPD coverage for medical
consultations and diagnostics tests

Chronic Management • Available on Cashless • Upfront payments, easing • Access medical care without upfront
Program Basis financial stress during crises payments, ensuring peace during
(OPD) (7 Chronic conditions covered) emergencies

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 55
Activ One FABing Techniques
Features Advantages Benefits

Super Reload • 2nd Claim onwards - • Multiple claims allowed within • Limitless coverage
Unlimited Refill unlimited times base sum insured • Less premium and maximum
(up to Base Sum Insured) • Coverage remains intact coverage

Super Credit • 50% of SI per year, up to • Continuous financial • Ensures long-term insurance
Coverage increases 100% of base sum insured protection security
irrespective of
claim
(up to Max of 3 crore under this • Claim or no Claim SI • No extra cost for enhanced
benefit)
increases every year sum insurance

• Available once in a policy • Health Heart Score generated • Journey of Active dayz™ start
Health
year at Network Providers on • Pro Activ Health approach
AssessmentTM
a cashless basis only

HealthReturnsTM • Up to 100% premium • 100% Health = 100% Health • Up to 100% premium back,
returns Insurance effectively lowering health
insurance costs

Claim Protect • Non-payable items will • No Deductions for non payable • No Out of pocket expenses
be covered items • Savings

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 56
Activ One – FABing Techniques
In-patient Features Advantages Benefits
Hospitalisation

Room Rent • No Capping on room rent • 100% coverage

• Can opt for any room • Access to premium / exclusive
services

ICU Charges • No Capping • 100% coverage

• Eases financial burden on
customers

Road Ambulance Covers up to base • Effortless hospital transport • No extra financial expenses
Cover Sum Insured • No Capping • No limit on coverage ensures stress
(per Hospitalisation) free relatives

Day Care • Affordable medical advancements • All day care coverages

Treatments for <24-hour treatments • No limit helps to make better choices
of treatment

Modern • Access to a wider range of • Quick treatment

Procedures/ state-of-art treatments
Treatment

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 57
Activ One FABing Techniques
In-patient Features Advantages Benefits
Hospitalisation

• Additional coverage during • Added financial support to take care of

HIV / AIDS and
difficult times their medical expenses
STD Cover

Mental Illness • Mental Illness treatment on diagnosis • Promotes proactive improvement

Hospitalisation measures

Covers up to
Obesity Treatment base Sum • Access to a wider range of treatments • Improvement in overall health
Insured • Reduction of health risks and enhanced
well-being
Pre-Hospitalisation • Easing financial stress during • Complete financial support for treatment
Expenses (90 days) treatment

Post-Hospitalisation • Extended coverage for recovery • Comprehensive post-Hospitalisation

Expenses (180 days) support reimbursement,
• Vital for recovery support

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 58
Activ One FABing Techniques
Features Advantages Benefits

Organ Donor • Hassle free harvesting of the organ • Provides security against unfortunate
Expenses donated to the insured events, for expensive treatments

AYUSH • Covers all the alternate medical • Holistic, minimal side effects, favored
Treatment sciences that the customer may avail treatment choice
Covers up to
base Sum
Domiciliary Insured • Treatment at home option when • Providing medical assistance during
Hospitalisation hospital not feasible or available pandemic or unforeseen events

Home • Cashless treatment for • Empaneled homecare provider offers home

Health Care illnesses/injuries at home treatment for customer convenience

Annual Health • Listed & • Early detection leads to timely • Encourages proactive monitoring for early
Check up Cashless Only treatment and better well-being issue detection and improved health

Aditya Birla Health Insurance Co. Limited For Internal Training Purpose only 59
Thank You

For Internal Training Purpose only 61