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Reviewed by Finzony Finance TeamLast updated:
Activ Health Platinum Essential is a health insurance plan built around hospitalization protection, wellness benefits and chronic care management. It provides Day 1 support for listed chronic conditions including diabetes, high blood pressure, high cholesterol and asthma, while also offering HealthReturns, cumulative bonus, daycare treatment, home care and annual health assessment benefits.
Day 1 Chronic Cover + HealthReturns up to 50% + Cumulative Bonus + 586 Daycare Procedures
The biggest strength of Platinum Essential is its focus on people who already manage chronic health conditions or want long-term support around preventive care. The plan combines regular hospitalization benefits with a Chronic Management Program, expert health guidance and wellness rewards. It also provides useful features such as 586 daycare procedures, 60/180-day pre and post-hospitalization cover and a cumulative bonus for claim-free years.
Aditya Birla Health Insurance
Key Insights
Founded
2015
Aditya Birla Health Insurance was established 11 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
95.8% CSR, calculated as a 3-year average
Aditya Birla Health Insurance settles 95.8% of all claims it receives, demonstrating strong credibility.
Network Hospitals
13,000+
Aditya Birla Health Insurance has a network of 13,000+ hospitals, ensuring wide accessibility and convenience for policyholders.
Provides specialised support for listed chronic conditions including diabetes, high blood pressure, high cholesterol and asthma with coverage from Day 1 as applicable.
Applicable to eligible insured persons and conditions under the policy.
Rewards eligible healthy behaviour and can provide up to 50% of premium under the applicable HealthReturns framework.
Actual reward depends on Healthy Heart Score and Active Dayz performance.
Provides a 10% increase in Sum Insured for each claim-free policy year, accumulating up to 100% of SI or ₹50 lakh.
Subject to the applicable policy conditions.
Provides coverage for 586 listed daycare procedures that require less than 24 hours of hospitalization.
Subject to applicable terms and limits.
Covers eligible medical expenses for up to 60 days before and 180 days after hospitalization.
Claim must be otherwise admissible under the policy.
Provides an additional lump-sum style protection option for listed critical illnesses under the applicable rider terms.
The optional cover can include up to 20 listed critical illnesses depending on the selected option.
Provides a fixed daily cash allowance during eligible hospitalization.
Benefit amount and maximum payable days depend on the selected option.
A 30-day initial waiting period generally applies to illness-related treatment, while pre-existing diseases and specified diseases/procedures are subject to the applicable waiting periods in the policy wording. Chronic Management Program conditions have Day 1 coverage as specified by the plan.
Initial Waiting Period
Illness-related hospitalization is generally subject to an initial waiting period of 30 days. Accidental hospitalization is not subject to this initial waiting period.
Pre-Existing Disease Waiting Period
Treatment related to pre-existing diseases is subject to the waiting period specified in the policy wording.
Specified Disease & Procedure Waiting Period
Specified diseases and procedures are subject to the applicable waiting period under the policy wording.
Listed Chronic Conditions
The Chronic Management Program provides Day 1 coverage for listed chronic conditions including diabetes, high blood pressure, high cholesterol and asthma, subject to eligibility and program terms.
Conditions or treatments that the policy clearly says it will not cover.
The Chronic Management Program provides Day 1 support for listed chronic conditions including diabetes, high blood pressure, high cholesterol and asthma. Other specified illnesses and procedures remain subject to the applicable policy waiting periods and terms.
Insurer
Aditya Birla Health Insurance plans and claim process
Activ Health Platinum Essential is a health insurance plan combining hospitalization protection, wellness benefits and a Chronic Management Program.
The plan is particularly suitable for individuals and families looking for health insurance with dedicated support for chronic conditions such as diabetes, hypertension, high cholesterol and asthma.
The official comparison lists entry from age 5 years for individual policies and 91 days for floater policies, with no maximum entry age stated.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official Aditya Birla Health Insurance website before purchasing.
Contact Details
1800 270 7000
Headquarters: 9th Floor, Tower 1, One World Centre, Jupiter Mills Compound, 841, Senapati Bapat Marg, Elphinstone Road, Mumbai – 400013, Maharashtra, India.
The aforementioned ratios have been averaged over three years (FY24-FY26)
Provides protection for accidental death and permanent total disablement under the applicable personal accident cover.
Subject to rider terms, exclusions and Sum Insured selected.
Allows eligible policyholders to access a premium discount through the Preferred Provider Network arrangement.
Availability and discount are subject to the applicable product terms.
Optional mental wellness support including mental health assessment, stress management, consultations and wellness tracking.
Benefits depend on the selected HLTH Meter option and applicable terms.
The official plan comparison lists Sum Insured from ₹50,000 to ₹1 crore, while current Aditya Birla plan listings also show configurations up to ₹2 crore depending on the applicable product and Sum Insured option.
HealthReturns is a wellness reward that can provide up to 50% of premium based on eligible health and activity performance.
It is a dedicated program designed to support listed chronic conditions including diabetes, high blood pressure, high cholesterol and asthma.
Yes. The Chronic Management Program provides Day 1 coverage for the listed chronic conditions, subject to the applicable eligibility and program terms.
Yes. Activ Health Platinum Essential covers 586 listed daycare procedures that require less than 24 hours of hospitalization.
Eligible pre-hospitalization expenses are covered for up to 60 days and post-hospitalization expenses for up to 180 days, subject to policy terms.
The Cumulative Bonus provides a 10% increase in Sum Insured for every claim-free year, with maximum accumulation of 100% of SI or ₹50 lakh under the applicable terms.
Yes. Eligible Home Care Treatment expenses and Domiciliary Hospitalization are covered subject to the applicable policy conditions.
Yes. Eligible AYUSH in-patient hospitalization expenses are covered according to the applicable policy terms.
Yes. Hospitalization for clinically significant mental illness is covered subject to the applicable policy definitions and terms.
Yes. A second e-opinion is available for listed critical illnesses through international experts under the applicable service terms.
Room eligibility depends on the selected Sum Insured and applicable policy structure. Choosing a higher room category than the eligible category can result in co-payment and associated deductions.
The Platinum Essential structure includes mandatory co-payment, and additional co-payment can apply for certain higher-zone or higher-room-category situations.
No. Unlimited reload is not a standard benefit of the Essential variant. The official comparison lists Reload of Sum Insured as unavailable under Essential.
Organ donor expenses are not included in the standard Essential benefits according to the official Platinum Essential versus Enhanced comparison.
Yes. Optional Critical Illness Cover is available and can provide additional protection for listed critical illnesses subject to the selected option and rider terms.
Permanent exclusions include hearing aids and spectacles, baldness-related treatment, cosmetic and aesthetic treatment, treatment related to intoxicant abuse, certain war-related events and intentional self-injury, subject to the detailed policy wording.