Activ One VIP
Overview
Aditya Birla Activ One VIP is a premium variant in the Active One series offered by Aditya Birla Health Insurance Co. Ltd. The plan offers all the benefits offered under the base variant Activ One MAX. Extra benefits included in this variant are global (emergency and planned hospitalisation) and maternity coverage with some limits.
However, these benefits make the plan expensive and you do miss out on cumulative bonus. This plan could be a good choice if you specifically want global and maternity benefits.
Pros and Cons
- No copayment – The plan includes no copay or disease-specific limits. You get full coverage on hospitalisation.
- No room restriction – Includes no room rent restriction. Pick any room you like. Your insurer covers the cost.
- Unlimited restorations – The insurer refills your sum insured unlimited times in case you run out of coverage.
- 100% HealthReturns – Earn HealthReturns for staying healthy and get up to a 100% discount on renewal premiums.
- Global Cover – Includes worldwide coverage (excluding USA and Canada) for emergencies with some limits. Also includes planned global treatment of listed major illnesses.
- Maternity Cover – Maternity expenses are covered for up to Rs. 2 Lakh after a 2 year waiting period.
- No cumulative bonus – Bonus feature is missing in this variant.
- Longer waiting period – 3 years waiting period for pre-existing conditions.
- Expensive – This plan is expensive.
Plan Benefits
Pick any room of your choice
The plan covers inpatient hospitalisation expenses up to the sum insured. It does not impose a room rent restriction. Pick any room you like during hospitalisation. The insurer covers the cost fully.
Pre and post-hospitalisation expenses cover available
The plan covers hospitalisation-related medical expenses for up to 90 days before and 180 days after hospitalisation. These include consultation fees, diagnostic tests, medication and other related expenses.
Road ambulance charges covered
The insurer covers road ambulance charges up to the sum insured.
Includes cover for daycare procedures
Many advanced surgeries or procedures done under anesthesia now require less than 24 hour hospitalisation. These are called day care treatments. Your insurer fully covers the cost of such procedures up to sum insured.
Get cover for alternative treatments
Want to take an alternative treatment like Ayurveda or Homeopathy? Don’t worry. Your insurer fully covers your hospitalisation and related expenses.
Organ donor expenses covered
If you are an organ recipient, your insurer will cover the hospitalisation expenses of the organ donor for harvesting the donated organ.
Covers HIV/ AIDS and STD
The plan covers expenses related to treatment of any complication arising due to AIDS/ HIV and sexually transmitted diseases.
Get cover even if you are forced to be hospitalised at home
Are you forced to be hospitalised at home? Imagine this. No beds are available in the hospital or the patient’s medical condition does not allow him to be moved to a hospital. This is called domiciliary hospitalisation. Your insurance policy covers the cost of hospitalisation if it happens for at least 3 consecutive days under the supervision of a medical practitioner.
Covers mental health and related hospitalisation expenses
You get cover for any treatment related to stress, anxiety, depression or any illness impacting mental health.
Unlimited restorations of sum insured available
Even if you claim a part of your base cover, you don’t have to worry about the coverage for future claims. Your insurer restores your full sum insured for all future claims unlimited times during a policy year. This feature comes in handy if you make multiple claims during a policy year.
Get up to 100% discount on renewal premiums
Stay healthy and earn HealthReturns from your insurer. You can use these HealthReturns to pay for OPD expenses, deductibles, non-payable items or get up to a 100% discount on renewal premiums. HealthReturns earned in a policy year, if not utilised, will automatically get adjusted towards the next renewal premium.
Get coverage for non-medical items
Get coverage for the cost of non-medical items such as masks, gloves, syringes, and others. The cost of such items is 10% to 20% of every health claim. This is an inbuilt benefit and does not require extra premium.
Get free annual health check-ups
Get a health check-up every year to monitor your health. Health check-ups can only be taken on a cashless basis at network centres via pre-booking through the insurer’s app.
Get global coverage
The plan covers global treatment in case of emergencies with some limits, excluding the USA and Canada. It also covers planned treatments abroad for 27 listed major illnesses, again subject to limits.
Covers maternity and related expenses
The plan covers maternity and related expenses up to Rs. 1 Lakh or Rs. 2 Lakh, depending on your base sum insured. The cover is only available under the family floater option after a waiting period of 24 months.
Option to reduce waiting periods to 1 year with an add-on
With this add-on, reduce the waiting period on PEDs or specified diseases to 1 year.
Option to add critical illness cover
With Critical Illness add-on, you get coverage for 20 listed critical illnesses. The insurer pays you a fixed lump sum benefit amount in case you are diagnosed with any of the 20 listed critical illnesses when the policy cover is active. This cover includes an initial waiting period of 60 days and a survival period of 15 days for the benefit to be paid.
Option to add personal accident cover
Personal accident add-on covers you against the risk of accident. The insurer pays you a fixed lump sum benefit in case of death or partial or total disability due to an accident.
Get Cancer Booster cover
With this add-on, get extra cover equal to the base sum insured towards hospitalisation expenses related to cancer of specified severity. This benefit is only available on a reimbursement basis.
Annual screenings for cancer-diagnosed patients available
With this add-on, get an annual screening package of up to Rs 10,000 per year in case you are diagnosed with cancer of specified severity. The amount can be utilised to cover medically prescribed diagnostics for cancer patients. This benefit is only available on a cashless basis.
Get cover for Durable Equipment with an add-on
This add-on covers the expenses incurred towards the cost of buying or renting durable medical equipment as prescribed by the doctor during or after hospitalisation. Durable medical equipment such as wheelchairs, ventilators, and prosthetic devices, among others, are included. The upper limit for this benefit is Rs. 5 Lakh.
Get cover for Compassionate Visit with an add-on
In case the hospitalisation exceeds 10 consecutive days, Compassionate Visit add-on covers the cost of travel expenses of an immediate family member to visit the patient. This includes the cost of a 2-way economy class air ticket, up to a maximum of Rs. 50,000.
Get Second Medical Opinion cover
With this add-on, you get access to a second medical opinion from a medical practitioner in case of a major illness. This benefit can be availed once in a policy year at an eligible network provider.
Policy Conditions
| Sum Insured Range | Rs. 50 Lakh and Rs. 6 Crore |
| Entry Age | 91 Days – 25 Years for dependent children; 18 Years onwards for adults |
| Policy Tenure Options | 1, 2 or 3 Years |
| Coverage Types | Individual and Family Floater |
| Family Coverage |
Self, legally married spouse or live-in partner (same or opposite sex), dependent Children (Natural / legally adopted), parents and parents-in-law; up to 2 adults and 4 children can be included under family floater option |
| Premium Payment Options | Monthly, Quarterly, Half-Yearly and Annual |
Exclusions
Waiting Periods
- Initial Waiting Period: 30 days (except accidents)
- Specific Illness Waiting Period: 24 months
- Waiting Period on Pre-Existing Diseases: 36 months
- Critical Illness Cover Waiting Period (Add-on): 60 days
- Maternity Cover Waiting Period: 24 months
Medical Exclusions
- Change of gender treatment
- Cosmetic surgeries (unless due to accident, cancer, etc.)
- Unproven treatments
- Refractive error correction for less than 7.5 diopters
- OPD expenses and Dental OPD treatment
- Sterility and infertility
Non-Medical Exclusions
- Expenses related to any admission primarily for diagnostics and evaluation purposes
- Expenses related to any admission primarily for enforced bed rest
- Self-injury or attempt to suicide
- Alcoholism, drug or substance abuse
- Treatment necessitated by committing breach of law with criminal intent
- Treatment taken by a medical practitioner outside his discipline
- War, terrorism, nuclear events
- Injuries from hazardous sports
About the Insurer
Aditya Birla Health Insurance Co. Ltd. is a stand-alone health insurance company in India. It is a collaboration between Aditya Birla Capital, an Aditya Birla Group company, and Momentum Group Ltd. of South Africa. The company started operations in 2016. The company offers specialised health insurance products covering individuals, families, and senior citizens.
The insurer grew at a fast pace in the last few years, emerging as a trusted provider in the health insurance space. It had a respectable claim settlement ratio of 95.61% in the financial year 2024. However, the worrisome fact is that it received a relatively high number of claim-related complaints, 22 per 10,000 claims.
Performance Highlights (FY24)
Turnover – Rs. 3,701 Crore
Claim Settlement Ratio – 95.61%
Incurred Claim Ratio – 68%
Volume of Claim Complaints – 22
Network Hospitals – 11,000+
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Frequently Asked Questions
What is the Aditya Birla Activ One VIP plan?
Aditya Birla Active One VIP is a premium variant of Aditya Birla’s Activ One series offering comprehensive coverage – domestic & international, maternity, advanced treatments, and more, with no sub-limits on hospitalisation expenses.
What unique features does Aditya Birla Activ One VIP plan offer?
The plan covers modern procedures (robotic surgeries, stem-cell therapy, oral chemo), domiciliary hospitalisation, road ambulance, organ donor, AYUSH, and mental health hospitalisation.
What is 100% HealthReturns?
Health Returns is a reward for staying healthy as you can earn up to 100% of your premium back by maintaining activity levels – like 10,000 steps/day or burning 300 calories.
Does Aditya Birla Activ One VIP plan have a copay?
No, there’s no copayment under this plan.
Is there any sub-limit on room rent, ICU, procedures, etc.?
The plan does not include any room restrictions. Claims are paid as per actuals up to the sum insured.
What’s the waiting period for pre-existing conditions under Aditya Birla Activ One VIP plan?
Pre-existing diseases are covered after a waiting period of 3 years.
What’s the initial waiting period under Aditya Birla Activ One VIP plan?
A 30-day initial waiting period applies. However, hospitalisation due to accidents is covered.
Is there a specified illness waiting period?
Yes, there is a 24 month wait for listed diseases before coverage begins.
Does Aditya Birla Activ One VIP plan cover maternity expenses?
Yes, the plan covers maternity and related expenses up to Rs. 1 Lakh or Rs. 2 Lakh depending on your base sum insured.
Does the plan provide international coverage?
Yes, Aditya Birla Activ One VIP offers emergency cover abroad (excluding USA/Canada). It also covers planned treatment for listed illnesses abroad subject to limits.
Is there a Super Credit benefit under Aditya Birla Activ One VIP?
No, this variant does not include Super Credit (No-claim bonus) benefit.
Is Super Reload (Restoration) benefit available under Aditya Birla Activ One VIP?
Yes, the plan restores full sum insured repeatedly within the same policy year after claims.
Are pre and post-hospitalisation expenses covered?
Yes, 90 days pre and 180 days post-hospitalisation expenses are covered up to sum insured.
How many daycare procedures are covered under Aditya Birla Activ One VIP?
The plan covers all listed day-care procedures (e.g., dialysis, chemo, minor surgeries)
Is domiciliary hospitalisation covered?
Yes, the plan covers domiciliary hospitalisation if done under the supervision of a medical practitioner for more than 3 consecutive days. Some other conditions apply.
Does the plan offer an annual health check-up?
Yes, a free health check-up is available for adults once a year.
Is AYUSH treatment covered under Aditya Birla Activ One VIP?
Yes, inpatient AYUSH treatments are covered up to the sum insured.
What is Claim Protect (Non-Medical Expense Waiver) and how does it work?
Claim Protect feature covers the cost of all non-medical items used during hospitalisation, ensuring comprehensive coverage.
What is the eligibility (age) criteria?
Adults aged 18 years and above can be covered. Children aged between 91 days and 25 years can be covered as dependents.
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