Aditya Birla Group Health Insurance

A joint venture between the Aditya Birla Group and Momentum Metropolitan Strategic Investments (Pty) Limited, Aditya Birla Health Insurance Company offers a range of retail and corporate health insurance solutions. The group health insurance plans are designed to cater to the health insurance needs of employees.
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Key Statistics of Aditya Birla General Insurance Company
GHI Premiums
₹607 crores
FY 2021
GHI lives insured
4.47 lakh
FY 2020
Health lives insured
51.40 lakh
FY 2020
Health claims Processed
1,75,838
FY 2020
Health claims Settlement Ratio
70.81%
FY 2020
Claims Settled within 3 months
70.56%
FY 2020
*Source - IRDAI and IBAI annual reports  **GMC - Group Medical Cover
***Claims Settlement Ratio (CSR) is the percentage of claims settled by the insurance company against the no. of claims obtained in a financial year. A high claim settlement ratio indicates the good financial health of the insurance group.
GHI Premiums
₹1,009 crores
FY 2021
GHI lives insured
53 lakhs
FY 2020
Health lives insured
1.72 crores
FY 2020
Claims Processed
1,67,673
FY 2020
Claims Settlement Ratio
86.52%
FY 2020
Claims Settled within 3 months
86.42%
FY 2020

What is Group Health Insurance?

A group health insurance plan is one that covers a group of individuals under one policy. The policy is called the Master Policy, and it contains the name of all insured members. Group health plans can be bought by registered groups to cover their members. 
The most common example is the employer-employee group, where employers buy group health plans to safeguard the health and wellbeing of their employees. Group health plans allow affordable coverage to members, and the coverage is available without the individual medical underwriting of each member.
Highlights  of Aditya Birla Group Health Insurance
Pan India presence in over 2,300+ cities
8,700+ network hospitals
More than 10 million lives insured until date
More than 1.97 lakhs claims settled

Aditya Birla group health insurance plans

Here’s a look at the group health insurance plans offered by Aditya Birla Health Insurance Company:
Group Activ Health
Highlights of the policy
Pre-existing diseases
Covered from day one
International treatment and hospitalization
Yes, for critical illnesses
Coverage for non-allopathic AYUSH treatments
Yes
Second medical opinion online for major illnesses
Yes
Optional coverage benefits
Yes
What's covered?
Inpatient treatment
Daycare treatments
Domiciliary hospitalization
Ambulance cover
Pre- and post-hospitalization expenses
OPD expenses
Hospital cash allowance
Inpatient psychiatric treatments
Organ donor cover
Accidental hospitalization
General list of exclusions
War, mutiny, nuclear risks, and the like
Acts of criminal nature
Self-inflicted injuries or suicides
Alcohol and/or drug abuse
Weight management treatments
Unproven or unscientific treatments
Cost of lenses, spectacles, or hearing aids
Inpatient psychiatric treatments
External and congenital defects or disabilities
Group Activ Secure
Highlights of the policy
Day care treatments
Over 586 daycare procedures are covered
Additional benefits
Yes, optional coverage benefits such as coma coverage, second e-opinion, etc., are available to enhance policy convergence.
Cashless treatments
Yes, easy cashless claims are available in a network of more than 5,600 hospitals across India.
Claim-free year bonus
Yes, policyholders can earn a cumulative bonus for each claim-free policy year.
What's covered?
Personal accident cover with a lump sum benefit in the case of accidental death or permanent disability
Inpatient coverage for hospitalization due to an accident
Ambulance cover
Optional cover for critical illnesses and hospital cash benefit, among others
Group Activ Travel
Highlights of the policy
Customized plans
Get customized plan options, depending on the regions you travel to.
International coverage
International coverage is available if you fall ill when traveling on business.
24*7 helpline
The company offers a 24*7 helpline for claims.
Additional benefits
Yes, you can choose from different optional coverage benefits for a customised policy.
What's covered?
Inpatient hospitalization abroad
Ambulance charges
Cost of medicines and drugs
Nursing charges
Lifestyle support because of an accident
Mugging cover
Optional coverage benefits such as emergency cover for pre-existing illnesses, non-medical cover such as loss of passport, personal accident cover, etc.
Please note that Plum has collated and presented this data for informational purposes only and at a particular point in time. Plum does not endorse, rate, or recommend any particular insurer or insurance product offered by an insurer. The final terms, conditions, and premiums may vary depending upon factors including group size, age, location, and applicable taxes.

Here's how Aditya Birla is better with Plum

Here are reasons why Plum and Aditya Birla is the right choice for your group insurance needs:
Go digital with Plum
A seamless digital claim experience for your employees.
Complete group cover for all
Most comprehensive coverage and wellness program at the best price.
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Transparent benefits and pricing structure because we believe in honesty.
Get doctor on call
Access to Plum’s in-house specialized doctor consultation services, free of cost.
Plum Wellness program
Coverage enhancement through health and wellness benefits, only at Plum.
Chat support on Whatsapp
Our WhatsApp-enabled claim process ensures an easy and hassle-free claim experience.
Automated admin solution
Manage your team and employee health benefits program online on a single dashboard. 
Track your claims
Know how your team is utilizing their employee benefits and medical coverage.
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Open
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to access your insurance
Click on use
my insurance button
on the dashboard
Select
Open WhatsApp
and continue to chat

Lodging a Claim Under Aditya Birla Group Health Insurance Plans

In the case of a medical emergency covered under your Aditya Birla Group Health Insurance Plan, you should contact the insurance company immediately and register your claim. The other claim-related steps are:
For cashless hospitalization, locate and get admitted to a networked hospital.
Fill up a pre-authorization claim form and submit it 72 hours before a planned hospitalization. In the case of an emergency, submit the form within 24 hours of hospitalization.
Based on the details furnished in the pre-authorization claim form, cashless claims will be accepted or rejected.
If accepted, you can avail of cashless treatments, and the insurer would foot the medical bills directly.
In the case of admission to a non-networked hospital, you would have to pay the medical bills yourself. After discharge, fill and submit the claim form with all the relevant medical documents. The insurer would then reimburse the claim.
Filled claim form
Identity and age proof
A copy of the health card or policy document
Doctor’s prescription advising hospitalization
KYC documents
Discharge summary issued by the hospital
MLC or police FIR for accidental claims
In case of reimbursement claims, original copies of hospital records, diagnostic reports, and hospital bills has to be submitted along with bank details of the insured member
For cashless hospitalization, locate and get admitted to a networked hospital.
Fill up a pre-authorization claim form and submit it 72 hours before a planned hospitalization. In the case of an emergency, submit the form within 24 hours of hospitalization.
Based on the details furnished in the pre-authorization claim form, cashless claims will be accepted or rejected.
If accepted, you can avail of cashless treatments, and the insurer would foot the medical bills directly.
In the case of admission to a non-networked hospital, you would have to pay the medical bills yourself. After discharge, fill and submit the claim form with all the relevant medical documents. The insurer would then reimburse the claim.
Filled claim form
Identity and age proof
A copy of the health card or policy document
Doctor’s prescription advising hospitalization
KYC documents
Discharge summary issued by the hospital
MLC or police FIR for accidental claims
In case of reimbursement claims, original copies of hospital records, diagnostic reports, and hospital bills has to be submitted along with bank details of the insured member

Here’s why you will love Plum

With Plum, get complete access to your insurance plan on WhatsApp
Check your healthcare benefits
Intimate your claim
Read what’s covered and not covered
Select other health benefits
Download your Digital health ID Card
See daycare treatment list

Frequently asked 
questions

What is the sum insured under Aditya Birla group health insurance plans?

The sum insured depends on the number of employees covered, the size of the organization, the type of group, the risks involved, etc. The sum insured is usually decided mutually between Aditya Birla Health Insurance Company and the group.

Who chooses the optional coverage benefits?

The optional coverage benefits can be chosen by the group head, i.e., the registered policyholder of the group health insurance policy. Each optional coverage would attract an additional premium.

Can my family members be covered?

Aditya Birla Group Health Insurance plans allow coverage to be extended to your family too. So, the group policyholder can choose to extend the coverage to the families of insured members. An insured member’s spouse, dependent children, dependent parents, and dependent parents-in-law can be covered under the plan.

How is the premium calculated?

The premium depends on the sum insured, the type of group, the number of members covered, their age, the coverage selected, etc.

What are HealthReturns?

HealthReturns is a special coverage feature offered under Aditya Birla’s Group Activ Health plan. Under this feature, if the insured members prove themselves healthy and lead a fit lifestyle, they can accumulate a part of their premiums in rewards. This accumulated benefit can be used to pay for excess claims, meet the deductibles on outpatient expenses, or other medical costs the plan does not cover.