Health Insurance

Aditya Birla Health Insurance Co. Limited

(A subsidiary of Aditya Birla Capital Ltd.)

Health Add-ons - Annexure A - Product Benefit Table_Retail Indemnity

Health Add-ons
Add-On Cover Payout Basis Limit / Options
Cover
No.
1 Future Secure -
a) Non Medical Expense waiver Indemnity a) Waiver of Non-Medical Expense exclusion of Base
Policy, List as per annexure 1.
b) Sum Insured Inflation protection
b) Increase in Base S.I. as per Consumer Price Index.
c) No Claim Bonus protector
c) If total payable claim amount in Policy Year is <25%
Sum Insured, then no claim bonus as applicable in
Base Policy Shall not be reduced.

2 Cancer Hospitalization Booster Indemnity Up to 100% of Base policy Sum Insured

(not available for Base Policy with S.I.
Covers Pre and Post hospitalisation medical expense
above 1Cr)
upto Sum Insured and number of days as per Base
Policy

Product Name: Health Add-ons; Product UIN : ADIHLIA22177V012122.

Covers Day Care Treatment upto Sum Insured

3 Reduction in PED Waiting Period Indemnity Option 1 : 4 Yrs to 2 Yrs

Option 2 : 4 Yrs to 1 Yr
Option 3 : 3 Yrs to 2 Yrs
Option 4 : 3 Yrs to 1 Yr

4 Vaccine cover Indemnity Limit option (Individual Basis)

Option 1 : Rs.500 / Insured Person / Per Policy Year
Option 2 : Rs.750 / Insured Person / Per Policy Year
Option 3 : Rs.1000 / Insured Person / Per Policy Year

5 Tele – OPD consultation Indemnity Doctor Consultation <Applicable / Not Applicable>

List of Specialities: General Medicine

6 Personal Accident Fixed Benefit AD+PTD+PPD,

Sum Insured - Rs. 5 Lacs, 6 Lacs, 7 Lacs, 8 Lacs, 9
Lacs, 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs, 30 Lacs, 40
Lacs, 50 Lacs, 1 Cr, 1.5Cr, 2 Cr, 5 Cr, 10 Cr

Cumulative Bonus: 5% in respect of each claim free

policy year, maximum of 50% of the Personal
Accident Benefit sum insured

Note:
I. General Conditions
1 The Add-on covers mentioned above can only be puchased along with Base Policy (Retail Indemnity Health Insurance policy issued by
Aditya Birla Health Insurance Co. Limited) and cannot be purchased in isolation or as a separate product.
2 There will be option to choose one or multiple Add-on covers on paying additional premium and same Add-on covers are allowed to be
taken with multiple Base Policy, subject to underwriting.
3 The Add-on covers are subject to the Policy terms, conditions, exclusions and applicable endorsements of the Base Policy and also of
Add-on covers.
4 Entry Age and Exit age shall be as per Base Policy unless specifically mentioned for any add-on cover.
5 Cover type and tenure shall be as per Base Policy.
6 The Add-on covers shall be available only if the same is specifically mentioned in the Policy Schedule.
7 The Add-on covers shall not be applicable in case if the same is offered as Optional Cover/Base Cover in Base Policy or if specifically
mentioned under Add-on Covers Policy.
8 For applicability of above listed add-ons with Base Product/Plan, please refer annexure "Applicability of cover".
II. Specific Conditions
1) Future Secure: (Non Medical Expense waiver, Sum Insured Inflation Protector, No Claim Bonus Protector)
1. This Add-on cover can be opted at Inception or at renewal.
2. In case of family floater, if opted it is applicable for all insured persons on floater basis. In case of Individual policy, applicable for
the Insured person on individual basis who has chosen the Add-on cover.
3. In case of Sum Insured Inflation Protector, % of Inflation rate is applied on Base Sum Insured excluding No Claim Bonus.

2) Cancer Hospitalization Booster

1. This Add-on cover can be opted at Inception or at renewal
2. Minimum age at entry: 91 days and Maximum age at entry: 65 Years
3. In case of family floater, if opted it is applicable for all insured persons on floater basis. In case of Individual policy, applicable for
the Insured person on individual basis who has chosen the Add-on cover.
4. Cancer Hospitalisation Booster Add-on cover will not be available with following products/plans as Base Policy
1. Activ Health – Premier plan
2. Activ Assure
5. This Add-on cover is not available for Base Policy with SI above 1Cr.
6. Co-payment, if any applicable for Base Policy shall not apply to Add-on covers.

3) Reduction in PED waiting period

1. This Add-on cover can be opted only at Inception of the policy. Not applicable to opt at the time of renewal/roll over.
2. In case of family floater, if opted it is applicable for all insured persons on floater basis. In case of Individual policy, applicable for
the Insured person on individual basis who has chosen the Add-on cover.

4) Vaccine cover
1. This Add-on cover can be opted at Inception or at renewal.
2. Applicable on Individual basis, irrespective of Individual Policy / Family Floater Policy.

Product Name: Health Add-ons; Product UIN : ADIHLIA22177V012122.

5) Tele – OPD consultation
1. This Add-on cover can be opted at Inception or at renewal.
2. Applicable on Individual basis, irrespective of Individual Policy / Family Floater Policy.

6) Personal Accident
1. This Add-on cover can be opted at Inception or at renewal.
2. Applicable on Individual basis, irrespective of Individual Policy / Family Floater Policy.
3. No waiting period applicable for this add-on.
4. Permanent exclusions are as mentioned in the Policy terms and conditions.
5. Minimum age at entry is 91 days and Maximum age at entry is 65 Years.
6. Sum Insured Limit applicable:
i. For Earning Member(s) - Basic cover Sum insured is up to 12 times gross annual income of Insured.
ii. Non-earning Spouse / Parent/Parent in laws – 100% of Proposer’s Basic cover sum insured/eligibility or 30L whichever is
lower.
iii. Children/Student – 100% of Proposer’s Basic cover sum insured/eligibility or 15L whichever is lower.

III. Entry Age

1) Cancer Hospitalisation Booster
Minimum age at entry: 91 days and Maximum age at entry: 65 Years

2) Personal Accident
For Principal Insured members:
Minimum age at entry: 18 years and Maximum age at entry: 70 years
For dependent children:
Minimum age at entry: 91 days and Maximum age at entry: 25 years

3) The minimum and maximum age at entry shall be as per the base product for the following covers
1. Future Secure cover
2. Reduction in PED waiting period
3. Vaccine cover
4. Tele – OPD consultation

4) Minimum and Maximum age at entry of Base Policy

Activ Health:
For adult Insured members:
Minimum age at entry: 18 years
Maximum age at entry: No limit  (For other than Platinum Premiere plans)
Maximum age at entry: 65 years (in case of Platinum Premiere)
 For dependent children
Minimum age at entry: 91 days and Maximum age at entry: 25 years

Activ Assure:
For adult Insured members:
Minimum age at entry: 18 years and Maximum age at entry: No limit

For dependent children:

Minimum age at entry: 91 days and Maximum age at entry: 25 years

Activ Care:
Minimum age at entry: 55 years and Maximum age at entry: 80 years

Product Name: Health Add-ons; Product UIN : ADIHLIA22177V012122.

Aditya Birla Health Insurance Co. Limited. IRDAI Reg.153. CIN No. U66000MH2015PLC263677.
Product Name: Health Add-ons; Product UIN : ADIHLIA22177V012122.
Address: 9th Floor, Tower 1, One World Centre, Jupiter Mills Compound, 841, Senapati Bapat Marg, Elphinstone Road,
Mumbai 400013. Telephone: 1800 270 7000, Email: care.healthinsurance@adityabirlacapital.com,
Website:adityabirlahealthinsurance.com. For more details on risk factors, terms and conditions please read terms and Contact us:
conditions carefully before concluding a sale. Trademark/Logo Aditya Birla Capital is owned by Aditya Birla Management 1800 270 7000
Corporation Private Limited and being used by Aditya Birla Health Insurance Co. Limited under licensed user
agreement(s).
 Health Insurance
Aditya Birla Health Insurance Co. Limited
(A subsidiary of Aditya Birla Capital Ltd.)

Health Add-ons - Annexure - 1 - List of Items waived off from list of NME

Sr. No. Item

1 BABY FOOD
2 BABY UTILITIES CHARGES
3 BEAUTY SERVICES
4 BELTS/BRACES
5 BUDS
6 COLD PACK/HOT PACK
7 CARRY BAGS
8 EMAIL/ INTERNET CHARGES
9 FOOD CHARGES (OTHER THAN PATIENT's DIET PROVIDED BY HOSPITAL)
10 LEGGINGS
11 LAUNDRY CHARGES

Product Name: Health Add-ons; Product UIN : ADIHLIA22177V012122.

12 MINERAL WATER
13 SANITARY PAD
14 TELEPHONE CHARGES
15 GUEST SERVICES
16 CREPE BANDAGE
17 DIAPER OF ANY TYPE
18 EYELET COLLAR
19 SLINGS
20 BLOOD GROUPING AND CROSS MATCHING OF DONORS SAMPLES
21 SERVICE CHARGES WHERE NURSING CHARGE ALSO CHARGED
22 TELEVISION CHARGES
23 SURCHARGES
24 ATTENDANT CHARGES
25 EXTRA DIET OF PATIENT (OTHER THAN THAT WHICH FORMS PART OF BED CHARGE)
26 BIRTH CERTIFICATE
27 CERTIFICATE CHARGES
28 COURIER CHARGES
29 CONVEYANCE CHARGES
30 MEDICAL CERTIFICATE
31 MEDICAL RECORDS
32 PHOTOCOPIES CHARGES
33 MORTUARY CHARGES
34 WALKING AIDS CHARGES
35 OXYGEN CYLINDER (FOR USAGE OUTSIDE THE HOSPITAL)
36 SPACER
37 SPIROMETRE
38 NEBULIZER KIT
39 STEAM INHALER
40 ARMSLING
41 THERMOMETER
42 CERVICAL COLLAR
 43 SPLINT
44 DIABETIC FOOT WEAR
45 KNEE BRACES (LONG/ SHORT/ HINGED)
46 KNEE IMMOBILIZER/SHOULDER IMMOBILIZER
47 LUMBO SACRAL BELT
48 NIMBUS BED OR WATER OR AIR BED CHARGES
49 AMBULANCE COLLAR
50 AMBULANCE EQUIPMENT
51 ABDOMINAL BINDER
52 PRIVATE NURSES CHARGES- SPECIAL NURSING CHARGES
53 SUGAR FREE TABLETS
54 CREAMS POWDERS LOTIONS (Toiletries are not payable, only prescribed medical pharmaceuticals payable)
55 ECG ELECTRODES
56 GLOVES
57 NEBULISATION KIT
58 ANY KIT WITH NO DETAILS MENTIONED [DELIVERY KIT, ORTHOKIT, RECOVERY KIT, ETC]
59 KIDNEY TRAY
60 MASK

Product Name: Health Add-ons; Product UIN : ADIHLIA22177V012122.

61 OUNCE GLASS
62 OXYGEN MASK
63 PELVIC TRACTION BELT
64 PAN CAN
65 TROLLY COVER
66 UROMETER, URINE JUG
67 AMBULANCE
68 VASOFIX SAFETY
69 SURGICAL PLATE

Aditya Birla Health Insurance Co. Limited. IRDAI Reg.153. CIN No. U66000MH2015PLC263677.
Product Name: Health Add-ons; Product UIN : ADIHLIA22177V012122.
Address: 9th Floor, Tower 1, One World Centre, Jupiter Mills Compound, 841, Senapati Bapat Marg, Elphinstone Road,
Mumbai 400013. Telephone: 1800 270 7000, Email: care.healthinsurance@adityabirlacapital.com,
Website:adityabirlahealthinsurance.com. For more details on risk factors, terms and conditions please read terms and Contact us:
conditions carefully before concluding a sale. Trademark/Logo Aditya Birla Capital is owned by Aditya Birla Management 1800 270 7000
Corporation Private Limited and being used by Aditya Birla Health Insurance Co. Limited under licensed user
agreement(s).
 Health Insurance
Aditya Birla Health Insurance Co. Limited
(A subsidiary of Aditya Birla Capital Ltd.)

Health Add-ons - Applicability of cover

For applicability of listed add-ons with Base Product/Plan, please refer below

Base product: Activ Health

Name of the Add-on Cover Name of the Plan

Platinum Essential Gold Enhanced Platinum Enhanced Platinum Premiere
Future Secure
Cancer Hospitalisation Booster X
Reduction in PED Waiting Period
(Only Options 1 & 2) (Only Options 3 & 4) (Only Options 3 & 4) (Only Options 3 & 4)

Vaccine Cover
Tele-OPD Consultation
Personal Accident X X X X

Base product: Activ Assure

Name of the Add-on Cover Name of the Plan

Diamond Silver
Future Secure
Cancer Hospitalisation Booster X X
Reduction in PED Waiting Period
(only option 2)
Vaccine Cover
Tele-OPD Consultation
Personal Accident

Base product: Activ Care

Name of the Add-on Cover Name of the Plan

Standard Classic Premier
Future Secure
Cancer Hospitalisation Booster
Reduction in PED Waiting Period X X X
Vaccine Cover
Tele-OPD Consultation
Personal Accident

Note: indicates applicable and X indicates not applicable

Aditya Birla Health Insurance Co. Limited. IRDAI Reg.153. CIN No. U66000MH2015PLC263677.
Product Name: Health Add-ons; Product UIN : ADIHLIA22177V012122.
Address: 9th Floor, Tower 1, One World Centre, Jupiter Mills Compound, 841, Senapati Bapat Marg, Elphinstone Road,
Mumbai 400013. Telephone: 1800 270 7000, Email: care.healthinsurance@adityabirlacapital.com,
Website:adityabirlahealthinsurance.com. For more details on risk factors, terms and conditions please read terms and Contact us:
conditions carefully before concluding a sale. Trademark/Logo Aditya Birla Capital is owned by Aditya Birla Management 1800 270 7000
Corporation Private Limited and being used by Aditya Birla Health Insurance Co. Limited under licensed user
agreement(s).