Feature-by-feature comparison of ICICI Lombard Elevate and Aditya Birla Active One MAX, including coverage benefits, waiting periods, restoration benefits, claim settlement ratio, and insurer performance metrics.
Health insurance decisions in India often come down to two or three shortlisted plans — and right now, ICICI Lombard Elevate and Aditya Birla Activ One MAX are two of the most searched premium health plans in the country. Both are marketed as comprehensive, future-ready policies, but they are built around very different philosophies. ICICI Lombard Elevate is a modular, add-on-driven plan that lets you build a highly customised policy. Aditya Birla Activ One MAX is a feature-rich, wellness-linked plan with strong built-in restoration and bonus mechanics.
This comparison is meant for first-time health insurance buyers, families evaluating a floater policy, working professionals comparing employer-independent cover, self-employed individuals who need robust standalone protection, and anyone actively choosing between these two specific plans before buying. We’ll go feature by feature, explain what each clause actually means in plain English, and tell you which plan suits which kind of buyer — without marketing language.
Note on data: All comparative data in this article is based on official brochures, policy wordings, insurer disclosures, and the product infographic used for this comparison, at a base sum insured of ₹10 lakh, without optional add-ons/riders unless specified. Insurer performance metrics pertain to FY24-25 disclosures. Always verify current numbers against the latest insurer brochure and IRDAI website before purchase, since insurers revise wordings and ratios periodically.
Quick Comparison Table
| Parameter | ICICI Lombard Elevate | Aditya Birla Activ One MAX |
|---|---|---|
| Insurer | ICICI Lombard General Insurance | Aditya Birla Health Insurance |
| Plan type | Modular, add-on based, individual/family floater | Comprehensive, wellness-linked, individual/family floater |
| Starting Sum Insured | ₹5 lakh (available from ₹5 lakh up to an unlimited amount) PolicyX | ₹5 lakh (Zone 2/3), ₹7 lakh (Zone 1 cities, base Activ One family) |
| Maximum Sum Insured | Unlimited, via the Infinite Care benefit ICICI Lombard | Up to ₹3 crore (with Super Credit/bonus build-up) |
| Family Floater | Yes | Yes |
| Entry Age | 91 days (child) to no upper limit typically | 91 days (child) to no upper limit typically |
| Renewability | Lifelong | Lifelong |
| Network Hospitals | 10,600+ | 12,900+ (per infographic); Aditya Birla independently claims a network of over 16,500 hospitals Aditya Birla Capital in some disclosures |
| Claim Settlement Ratio (FY25) | 85.82% | 95.88% |
| Incurred Claim Ratio (FY25) | 71% | 72% |
| Complaint Ratio (per 10,000 claims) | 13.98 | 16 |
| Overall Winner | Better for customisation & unlimited cover seekers | Better for claim reliability, bonus growth & network reach |
ICICI Lombard Elevate is positioned as a build-your-own health insurance plan. It is a customizable flagship plan with sum insured options from ₹5 lakh up to an unlimited amount, combining a basic hospitalization cover with 33 optional add-ons that let a buyer tailor the plan closely to their needs. PolicyX
Who should buy it: People who don’t want a one-size-fits-all policy — they want to pick precisely which benefits (room upgrade, consumables cover, maternity, global cover, faster PED coverage) they pay for, and skip the rest.
Major highlights:
- Unlimited sum insured option with the Infinite Care benefit for an infinite claim amount — an unusual, industry-first structure. ICICI Lombard
- Unlimited restoration of sum insured through the Reset benefit, and a 100% cumulative bonus for an infinite period via the Power Booster benefit — but note, these enhanced versions are typically add-ons, not the base plan (the infographic shows the base plan offers restoration only once per year and no built-in bonus). ICICI Lombard
- Pre-existing disease cover, including diabetes, hypertension, asthma and obesity, after just 30 days via the Jumpstart benefit (again, an add-on/waiting-period-reduction feature, not automatic in the base plan). ICICI Lombard
- Organ donor cover extending up to the full sum insured for the transplant recipient’s expenses, plus the donor’s inpatient costs (donor’s pre/post hospitalization and certain complications are excluded). Oneassure
- Maternity coverage including surrogacy treatment, covering up to ₹5 lakh for surrogate mother and oocyte donor expenses — sold as an add-on. Ditto Insurance
- Wellness ecosystem: reward points for healthy habits, video/tele consultations, pharmacy and diagnostic services, and second opinions. Aditya Birla Capital
- Long-term pay discount: a 7.5% discount on the 2nd year premium and additional discounts for multi-year advance payment. Ditto Insurance
Strengths:
- Extreme flexibility — pay only for what you need.
- Sum insured can genuinely scale to “unlimited,” attractive for high-net-worth buyers.
- Wide range of niche covers (surrogacy, organ donor, global treatment as add-ons).
Weaknesses:
- The base plan is comparatively lean: restoration is once a year, no claim bonus is not built in, maternity and OPD are not available without add-ons.
- ICICI Lombard’s 3-year average claim settlement ratio (FY 2022-25) is 84.5%, and FY25 stands at 85.82% — lower than Aditya Birla’s. Ditto Insurance
- Room rent is capped to a Single Private AC Room in the base plan (not “any room”), which can mean partial deductions if a policyholder chooses a higher category room.
- Real value depends heavily on choosing the right (and paying for) add-ons — a buyer who doesn’t customise gets a fairly basic policy.
2. Aditya Birla Activ One MAX Overview
Activ One MAX is Aditya Birla Health Insurance’s premium, wellness-integrated plan. It is a comprehensive health plan that prioritises both health and financial well-being, with unique features like HealthReturns™, sum insured refill, super credit, and non-medical expenses waiver. OneAssure
Target audience: Families and individuals who want a strong “just works” base policy with generous automatic benefits (unlimited restoration, high bonus growth, no room-rent restriction) without needing to buy several add-ons to get there.
Major strengths:
- Unlimited automatic restoration built into the base plan — if the sum insured is exhausted, it restores again in the same policy year for the same or a different illness, without requiring an add-on.
- No Claim Bonus of 100% per year, up to a maximum of 500%, built into the base product — a much stronger accumulation curve than ICICI Elevate’s base plan.
- Any room type allowed, with no room-category restriction, reducing the risk of proportionate deduction disputes.
- Annual health check-up included in the base plan.
- Chronic Care add-on can reduce the pre-existing disease waiting period from 3 years to 0 days for select conditions. Aditya Birla Capital
- A strong hospital network of over 16,500 hospitals in some disclosures (12,900+ per this comparison’s data), giving wide cashless access, including Tier-2 cities. Aditya Birla Capital
- A claim settlement track record around 96%, among the stronger figures in the category. Aditya Birla Capital
Weaknesses:
- No OPD benefit and no built-in maternity cover in the base plan (similar gap to ICICI Elevate).
- Higher premiums and optional add-ons can increase costs significantly for buyers who want the full wellness/global-cover experience. Beshak
- Aditya Birla Health Insurance is a relatively newer entrant (about a decade old), so its long-term claims track record is shorter than some legacy insurers. Aditya Birla Capital
- Slightly higher complaint ratio (16 per 10,000 claims) than ICICI Lombard (13.98) per the FY25 data used here.
3. Feature-by-Feature Comparison
| Feature | ICICI Lombard Elevate | Aditya Birla Activ One MAX | Winner |
|---|---|---|---|
| Special Feature | Modular plan; add-ons for room upgrade, consumables, indefinite bonus | Unlimited automatic restorations | Depends on buyer — see below |
| Room Rent | Single Private AC Room | Any room type | Activ One MAX |
| ICU | No specific sub-limit mentioned; covered per policy terms | No specific sub-limit; covered per policy terms | Tie |
| Copayment | None | None | Tie |
| Disease-wise limits | None | None | Tie |
| Consumables | Available as add-on | Check plan wording/add-on | ICICI Elevate (explicit add-on visibility) |
| Pre-Hospitalisation | 90 days | 90 days | Tie |
| Post-Hospitalisation | 180 days | 180 days | Tie |
| Day Care | Covered up to sum insured | Covered up to sum insured | Tie |
| Modern Treatments | Covered up to sum insured | Covered up to sum insured | Tie |
| AYUSH | Covered up to sum insured | Covered up to sum insured | Tie |
| Organ Donor | Covered up to sum insured (with exclusions on donor’s pre/post-hosp) | Covered as per plan wording | ICICI Elevate |
| Domiciliary Hospitalisation | Covered | Covered | Tie |
| Home Care | Available via add-ons/telehealth features | Available under health management program | Tie |
| Mental Illness | Covered per IRDAI mandate | Covered per IRDAI mandate | Tie |
| Bariatric Surgery | Covered subject to conditions | Covered subject to conditions | Tie |
| Restoration Benefit | Once per year (base); unlimited via add-on | Unlimited, built-in | Activ One MAX |
| No Claim Bonus | Not available in base plan | 100% per year, max 500%, built-in | Activ One MAX |
| Maternity | Not available (add-on possible) | Not available | Tie (both weak here) |
| Newborn Cover | Typically via maternity add-on | Typically via maternity add-on | Tie |
| Vaccination | Limited/add-on dependent | Limited/add-on dependent | Tie |
| Health Check-up | Not available in base plan | Once every year, built-in | Activ One MAX |
| OPD | Not available | Not available | Tie |
| Wellness Benefits | Reward points, healthy habit incentives | HealthReturns™, step-based rewards | Both strong, different mechanics |
| Teleconsultation | Available | Available | Tie |
| Second Opinion | Available | Available | Tie |
| Air Ambulance | Domestic air ambulance available | Available per plan wording | Tie |
| Road Ambulance | Covered | Covered | Tie |
| Global Coverage | Available as add-on (not in base) | Available for specified treatments (higher variants) | Depends on variant |
| Unlimited Claims | Via Infinite Care add-on | Via Super Credit accumulation | Both, different structures |
| Unlimited Restore | Via Reset add-on | Built into base plan | Activ One MAX |
| Waiting Period Modification | Via Jumpstart add-on (30 days for select conditions) | Via Chronic Care add-on (0 days for select conditions) | Both offer, Activ One MAX’s stated reduction is stronger |
| Claim Settlement Ratio | 85.82% (FY25) | 95.88% (FY25) | Activ One MAX |
| Network Hospitals | 10,600+ | 12,900+ | Activ One MAX |
| Sum Insured Ceiling | Unlimited (via add-on) | Up to ₹3 crore | ICICI Elevate (theoretically higher ceiling) |
Key takeaway: In its base, no-add-on form, Activ One MAX wins on almost every automatic benefit — restoration, bonus, room rent, and health check-up. ICICI Elevate’s real strength only shows up once you start adding riders, at which point it can outpace Activ One MAX on customisation and theoretical sum insured ceiling.
4. Understanding Every Difference
Room Rent Limit
What it means: This defines which hospital room category your policy pays for in full. If you choose a costlier room than your entitlement, most insurers apply a “proportionate deduction” — cutting your entire claim, not just the room charge, in the same proportion as the room rent excess.
Example: If your entitlement is a single AC room costing ₹5,000/day but you occupy a ₹10,000/day room, and your policy has proportionate deduction, your entire hospital bill claim could be cut by roughly 50%, not just the room charge.
Which plan is stronger: Activ One MAX, since “any room type” removes this risk entirely.
Who should choose it: Anyone who anticipates wanting a higher category room (e.g., in metro hospitals) without worrying about deduction clauses.
Restoration Benefit
What it means: If your sum insured is exhausted during the policy year, restoration “refills” it so you’re not left uninsured for the rest of the year.
Example: You have a ₹10 lakh sum insured. A major surgery costs ₹8 lakh. Later that year, a family member is hospitalized for ₹5 lakh. With unlimited restoration, the second claim is still payable. With “once per year” restoration, you get one refill only — if you’ve already used it, further claims beyond the original sum insured may not be paid.
Which plan is stronger: Activ One MAX (unlimited, automatic) vs ICICI Elevate (once per year in base plan).
Who should choose it: Families with several members on one floater policy, or anyone worried about multiple large claims in a single year, should lean toward Activ One MAX or add the Reset benefit to Elevate.
No Claim Bonus (NCB)
What it means: A reward for not claiming in a policy year — your sum insured increases at renewal without extra premium.
Example: On a ₹10 lakh base with Activ One MAX’s 100%/year bonus, after two claim-free years your effective cover could reach ₹20 lakh (capped eventually at 500%, i.e., ₹50 lakh on a ₹10 lakh base). ICICI Elevate’s base plan does not build this in automatically — bonus growth needs the Power Booster add-on.
Which plan is stronger: Activ One MAX for buyers who don’t want to actively manage add-ons.
5. Restoration Benefit Comparison
| Aspect | ICICI Lombard Elevate | Aditya Birla Activ One MAX |
|---|---|---|
| Base plan restoration | Once per year | Unlimited (multiple times per year) |
| Same illness restoration | Typically restricted in “once per year” structures unless enhanced | Allowed as part of unlimited restoration |
| Different illness restoration | Allowed once | Allowed, unlimited |
| Enhanced version | Available as “Reset” add-on for unlimited restoration | Already built-in |
Real-life scenario: A family of four on a ₹10 lakh floater has the father hospitalised for a cardiac procedure (₹6 lakh) in April, and in September the mother needs an unrelated surgery (₹7 lakh). Under Activ One MAX’s unlimited restoration, both claims can potentially be honoured (subject to policy terms and one claim per restored amount typically not being usable for the same person/same illness in the same instance). Under ICICI Elevate’s base plan with only one restoration per year, the family gets covered for the first claim and the restored amount for the second, but there’s no buffer left if a third major claim arises the same year — unless the Reset add-on was purchased.
6. No Claim Bonus Comparison
| Aspect | ICICI Lombard Elevate (Base) | Aditya Birla Activ One MAX |
|---|---|---|
| Bonus per claim-free year | Not available (add-on required for equivalent) | 100% |
| Maximum bonus cap | N/A in base; check Power Booster add-on terms | 500% |
| Effect of a claim | N/A | Bonus typically reduces (insurer-specific formula) rather than resetting to zero, per most such structures |
| Long-term value | Depends entirely on which add-on is purchased | Strong built-in compounding value even without add-ons |
For a buyer who stays largely claim-free, Activ One MAX’s built-in bonus means your effective cover can grow substantially over 5 years without extra premium — a meaningful long-term value driver, especially as medical inflation rises.
7. Waiting Period Comparison
| Waiting Period Type | ICICI Lombard Elevate | Aditya Birla Activ One MAX |
|---|---|---|
| Initial Waiting Period | 30 days | 30 days |
| PED (Pre-Existing Disease) Waiting | 36 months | 36 months |
| Specific Disease/Procedure Waiting | 24 months | 24 months |
| Maternity Waiting | N/A (add-on dependent) | N/A (not in base) |
| Accident Waiting | None (accidents typically covered from day 1) | None (accidents typically covered from day 1) |
| Add-on waiting reduction | Jumpstart add-on — reduces PED wait for select conditions to as low as 30 days | Chronic Care add-on — can reduce PED wait to 0 days for select conditions |
Why waiting periods matter: These are periods during which specific claims won’t be paid even though your policy is active. A 36-month PED wait means if you’re diagnosed with diabetes before buying the policy, related complications aren’t covered for 3 years unless you buy a waiting-period-reduction add-on. For buyers with known pre-existing conditions, this single clause can matter more than any other feature — Activ One MAX’s Chronic Care add-on claiming a reduction to 0 days is a strong differentiator if applicable to your condition and available at underwriting.
8. Claims Experience
Both insurers offer cashless and reimbursement claim routes with app-based tracking.
- Cashless process: Both plans support cashless treatment at network hospitals; pre-authorisation is required for planned hospitalisation, and emergency cashless requests are typically processed within a few hours.
- Reimbursement: Both require original bills, discharge summary, and claim forms submitted within the insurer’s specified timeline (commonly 15–30 days post-discharge).
- Digital claims: Both insurers offer app-based claim initiation and tracking (ICICI Lombard’s app ecosystem and Aditya Birla’s ABCD/Activ Health app).
- Turnaround: Aditya Birla’s stronger FY25 claim settlement ratio (95.88% vs 85.82%) suggests a higher proportion of claims are being resolved, though settlement ratio alone doesn’t capture speed — check “claims settled within 30 days” data (NL-39 disclosure) for turnaround specifics before purchase.
- Customer support: Both insurers offer 24×7 helplines; actual service quality is best verified through recent customer reviews closer to your purchase date, as this can shift year to year.
9. Network Hospitals
| Aspect | ICICI Lombard Elevate | Aditya Birla Activ One MAX |
|---|---|---|
| Network size (this comparison’s data) | 10,600+ | 12,900+ |
| Alternative disclosed figure | — | 16,500+ Aditya Birla Capital per some disclosures |
| Major hospital chains | Broad coverage of major corporate chains (verify specific hospital near you) | Broad coverage of major corporate chains, plus stated push into Tier-2 cities |
| Tier-2 city presence | Reasonable, verify locally | Generally cited as stronger reach in Tier-2/3 markets |
Practical tip: Network numbers change frequently as insurers add or drop hospitals. Before buying, always search the insurer’s live network hospital locator for your specific city/pin code rather than relying only on the aggregate count.
10. Insurer Performance
| Metric (FY25) | ICICI Lombard | Aditya Birla Health Insurance |
|---|---|---|
| Claim Settlement Ratio | 85.82% | 95.88% |
| Incurred Claim Ratio | 71% | 72% |
| Complaint Ratio (per 10,000 claims) | 13.98 | 16 |
| Network Hospitals | 10,600+ | 12,900+ |
| 3-year average CSR (FY22-25, per third-party ratings) | ~84.5% | ~96% |
What these numbers mean:
- Claim Settlement Ratio (CSR) measures the proportion of claims an insurer settles versus receives. A higher number generally signals a lower chance your claim gets rejected — Activ One MAX’s insurer scores notably higher here.
- Incurred Claim Ratio (ICR) measures claims paid against premiums collected. A ratio too low can suggest an insurer profits heavily on that book (possible pricing/benefit mismatch); too high (over 100%) can signal financial strain. Both insurers sit in a healthy 70-72% band.
- Complaint Ratio reflects customer grievances per claims volume — lower is better. ICICI Lombard is marginally better here.
Always cross-check current figures on the IRDAI website since these ratios are updated annually and can shift.
11. Premium Comparison (Indicative Only)
Exact premiums are not published as flat rate cards by either insurer for public comparison — they depend on your age, city zone, sum insured, medical history, and underwriting decision, and both insurers offer online quote tools for exact pricing. The ranges below are broad, illustrative market ranges for a ₹10 lakh individual base plan and should not be treated as insurer-quoted figures:
| Age | Illustrative Individual Premium Range (₹10L SI, per year) |
|---|---|
| 25 | ₹6,000 – ₹9,000 |
| 30 | ₹7,000 – ₹10,500 |
| 35 | ₹8,500 – ₹12,500 |
| 40 | ₹10,500 – ₹15,500 |
| 45 | ₹13,500 – ₹19,500 |
| 50 | ₹18,000 – ₹26,000 |
| Family Floater (2 adults + 1-2 kids) | ₹18,000 – ₹35,000 (varies widely with age band) |
Why premiums differ between these two plans: Activ One MAX’s stronger built-in benefits (unlimited restoration, high NCB, no room-rent cap) typically make its base premium somewhat higher than ICICI Elevate’s leaner base plan — but Elevate’s price can climb quickly once multiple add-ons are stacked on. Always get a live, personalised quote from each insurer’s website before deciding — these figures are directional only, not a quote.
12. Hidden Differences Most Buyers Miss
- Room rent wording: “Single Private AC Room” (Elevate base) vs “Any room type” (Activ One MAX) is not cosmetic — it can materially change what you actually receive at claim time due to proportionate deduction clauses.
- Sub-limits: Neither plan shows disease-wise sub-limits in the base comparison, but always check the full policy wording for any cataract, joint-replacement or similar procedure-specific caps that sometimes exist even when “no disease-wise limit” is advertised broadly.
- Consumables: Items like gloves, syringes, and PPE kits are often excluded by default across the industry unless a consumables add-on is active — verify this explicitly for both plans before assuming full coverage.
- Restoration conditions: “Unlimited” restoration often still has fine print — e.g., it may not apply to the same person for the same illness within the same claim instance. Read the exact restoration clause, not just the headline.
- Bonus conditions: No-claim bonus can typically reduce (not always disappear) if a claim is made — the exact reduction formula differs by insurer and matters for long-term compounding.
- PED clauses: A 36-month PED wait is standard, but “add-on reduction to 0 days” (Activ One MAX’s Chronic Care) is usually restricted to a defined list of conditions (like diabetes, hypertension) — not all pre-existing diseases qualify.
- Permanent exclusions: Both insurers will carry a standard exclusion list (cosmetic treatment, self-inflicted injury, certain experimental treatments) — this doesn’t differ meaningfully between the two and should be read in full.
- Hospital definition: Both insurers use the IRDAI-standard definition of “hospital” (minimum bed count, qualified staff, etc.) for claims eligibility — a day-care centre or small nursing home that doesn’t meet this definition may not qualify for cashless/reimbursement.
- Waiting period reduction options: Both are add-on-gated, not automatic — don’t assume you’ll get the reduced wait without explicitly selecting and paying for the rider (and passing underwriting for it).
- Add-ons materially change the comparison: This entire comparison is base-plan-to-base-plan. If you plan to buy 3-4 add-ons on Elevate, re-run this comparison including their extra premium, since a heavily customised Elevate can end up costing more than Activ One MAX’s already-loaded base plan.
13. Pros and Cons
ICICI Lombard Elevate
Pros
- Deep customisation via 33+ add-ons
- Path to unlimited sum insured (Infinite Care add-on)
- Strong niche covers: organ donor, surrogacy/maternity add-ons
- Multi-year prepay discounts
Cons
- Lean base plan — best features are paywalled behind add-ons
- Lower claim settlement ratio (85.82% FY25) than Activ One MAX
- Room rent restricted to single private AC room in base plan
- No built-in bonus or unlimited restoration
Aditya Birla Activ One MAX
Pros
- Unlimited restoration built into base plan
- Strong 100%/year, up to 500% no-claim bonus, built-in
- No room-rent restriction
- Higher claim settlement ratio (95.88% FY25) and larger network
- Free annual health check-up included
Cons
- No OPD or maternity in base plan (shared weakness with Elevate)
- Slightly higher complaint ratio (16 vs 13.98)
- Add-ons/global cover can push premiums up notably
- Newer insurer with a shorter long-term track record than some legacy players
14. Who Should Buy ICICI Lombard Elevate?
- Buyers who want to actively customise their policy and are comfortable evaluating 30+ add-ons.
- High-net-worth individuals who want a genuine path to an unlimited sum insured.
- Couples planning surrogacy/assisted reproduction who value the dedicated surrogate/oocyte donor cover.
- Buyers who prioritise organ-donor cover specifics.
- People comfortable paying multi-year premiums for the prepay discount.
15. Who Should Buy Aditya Birla Activ One MAX?
- Buyers who want strong benefits without needing to shop for add-ons — unlimited restoration and high bonus growth from day one.
- Families who want freedom of room choice without deduction risk.
- Buyers who value a demonstrably higher claim settlement ratio and a larger network.
- People managing chronic lifestyle conditions who may benefit from the Chronic Care add-on’s faster PED coverage.
- Buyers who want an included annual health check-up.
16. Expert Recommendation
| Buyer Profile | Suggested Direction |
|---|---|
| Young professional (25-30) | Activ One MAX for built-in bonus growth over a long horizon |
| Married couple, no kids | Either; if maternity is a near-term plan, budget for the relevant add-on on both |
| Family with children | Activ One MAX for unlimited restoration across multiple family members on one floater |
| Senior citizens | Compare age-specific senior variants of both insurers separately — this comparison is for the standard adult plan |
| Parents (as proposer for elderly parents) | Verify entry-age and loading terms directly with each insurer; premiums rise sharply post-60 |
| Diabetic buyer | Activ One MAX’s Chronic Care add-on, if the condition qualifies for the 0-day wait |
| People with other PEDs | Check condition-specific eligibility on both insurers’ Jumpstart/Chronic Care riders before assuming coverage |
| Frequent travellers | ICICI Elevate if global treatment add-on suits your travel pattern; verify Activ One MAX’s global cover variant too |
| Corporate employee (has group cover) | Either, as a top-up/independent policy; Elevate’s add-on flexibility can complement group gaps |
| Business owner / self-employed | Activ One MAX for reliability given no employer backup cover |
| High-income family | ICICI Elevate for the unlimited sum insured ceiling |
| Budget-conscious buyer | Compare live quotes for both at ₹5-10 lakh base — Activ One MAX’s stronger base benefits may offer better value per rupee without needing add-ons |
17. Comparison Scorecard (out of 10)
| Parameter | ICICI Lombard Elevate | Aditya Birla Activ One MAX |
|---|---|---|
| Coverage (base plan) | 6.5 | 8 |
| Value for Money | 7 | 8 |
| Claim Experience | 7 | 8.5 |
| Hospital Network | 7.5 | 8.5 |
| Add-ons/Customisation | 9 | 7 |
| Restoration | 6 (base); 9 (with add-on) | 9 |
| Bonus | 5 (base); 8 (with add-on) | 8.5 |
| Overall Rating | 7 | 8.3 |
(Scores reflect base plan strength unless otherwise noted; ICICI Elevate’s scores rise significantly once relevant add-ons are purchased.)
18. Frequently Asked Questions
1. Which plan has a higher claim settlement ratio?
Aditya Birla, at 95.88% (FY25), versus ICICI Lombard at 85.82%.
2. Does ICICI Lombard Elevate offer unlimited sum insured?
Yes, via the Infinite Care add-on/option, not automatically in every base variant.
3. Does Activ One MAX offer unlimited restoration by default?
Yes, unlimited restoration is built into the base plan.
4. Is there a no-claim bonus in ICICI Elevate’s base plan?
No — bonus accumulation requires the Power Booster add-on.
5. What is Activ One MAX’s maximum no-claim bonus?
100% per year, capped at 500% of the base sum insured.
6. Which plan has a bigger hospital network?
Activ One MAX, at roughly 12,900+ (or higher per some disclosures) versus ICICI Elevate’s 10,600+.
7. Do both plans cover pre-existing diseases?
Yes, after the standard 36-month waiting period, with optional add-ons to reduce this for select conditions.
8. Is maternity covered in either base plan?
No — both require a maternity add-on/rider.
9. Which plan has a room rent cap?
ICICI Elevate’s base plan caps at a single private AC room; Activ One MAX allows any room type.
10. Is OPD covered in either plan?
No, OPD is not part of either base plan per the data reviewed.
11. Which plan is better for a self-employed person?
Activ One MAX, given its stronger built-in claim reliability and network, unless heavy customisation is specifically needed.
12. Can I increase my sum insured later?
Both plans allow sum insured enhancement at renewal, subject to underwriting; Activ One MAX also grows it automatically via bonus accumulation.
13. Which plan is cheaper?
This depends on your age, city, and add-ons chosen — always compare live quotes; ICICI Elevate’s bare base plan can be cheaper, but a well-loaded Elevate policy may cost more than Activ One MAX.
14. Does either plan cover AYUSH treatment?
Yes, both cover AYUSH (Ayurveda, Yoga, Unani, Siddha, Homeopathy) up to the sum insured.
15. What is the initial waiting period for both?
30 days for both plans.
16. Which plan has better wellness benefits?
Both have strong wellness ecosystems — ICICI Elevate via reward points and app services, Aditya Birla via HealthReturns™ and step-based rewards — the better fit depends on which app/ecosystem you prefer using.
17. Does either plan offer global/international coverage?
Both offer it in select variants or as add-ons — verify current availability and country/treatment restrictions directly with each insurer.
18. Is organ donor expense covered?
Yes for ICICI Elevate, with clear inclusions/exclusions noted; verify Activ One MAX’s specific donor clause in its current policy wording.
19. Which insurer has fewer complaints?
ICICI Lombard, at 13.98 complaints per 10,000 claims versus Aditya Birla’s 16.
20. Which plan should a first-time buyer pick?
If you want a strong “just works” base policy without managing multiple add-ons, Activ One MAX is generally simpler. If you want to build a highly specific policy and are comfortable evaluating riders, ICICI Elevate offers more room to customise.
21. Do both insurers settle claims cashless?
Yes, both support cashless treatment at their respective network hospitals, subject to pre-authorisation.
Final Verdict
When ICICI Lombard Elevate wins: if you value maximum customisation, want a genuine path to an unlimited sum insured, need specific niche covers like surrogacy or detailed organ-donor benefits, and are willing to actively select and pay for add-ons to get a genuinely strong policy.
When Aditya Birla Activ One MAX wins: if you want strong protection out-of-the-box — unlimited restoration, high automatic bonus growth, no room-rent restriction, a larger hospital network, and a higher claim settlement ratio — without needing to manage a long add-on checklist.
Who should avoid each plan: Buyers uninterested in comparing/paying for add-ons should be cautious about relying on ICICI Elevate’s bare base plan alone, since its most attractive features are gated behind riders. Buyers on a tight budget who don’t need the wellness ecosystem or global cover should compare Activ One MAX’s base premium carefully against simpler competing plans, since loaded variants can get expensive.
Overall recommendation: For most first-time buyers and families prioritising claim reliability and strong automatic benefits, Aditya Birla Activ One MAX’s base plan is the more dependable out-of-the-box choice. For buyers who know exactly what specialised coverage they want and are comfortable customising, ICICI Lombard Elevate offers unmatched flexibility and ceiling. Either way, get a live, personalised quote from both insurers, read the full policy wording (not just the brochure), and match the plan to your specific health profile before purchasing.
