Apollo Munich Optima Restore Plan | Health Insurance

All You Need To Know

Key benefits

- 150% Reload of Sum Insured, for subsequent claims due to unrelated illness, maximum up to 50 lakhs
- Covers 586 day care procedures even if hospitalization is less than 24 hours.
- International /Domestic Emergency Assistance Services (Including Air Ambulance)
- Earn HealthReturnsTM worth up to 30% of your premium for staying fit and healthy

Key Features

In-patient Hospitalization	In case of a hospitalization of more than 24 hours due to a planned treatment or an unforeseen emergency, we will cover expenses like room rent, doctor’s fee, operation theatre expenses, medicines, drugs and other consumables under the policy as per your eligibility.
Pre-hospitalization medical expenses	You may incur expenses for consultations or diagnostic tests before your hospitalization, such costs will be covered up to 30 days before your hospitalization where a claim under In-patient hospitalisation / Domiciliary hospitalization / day care treatment is accepted.
Post-hospitalization medical expenses	You may incur expenses for medicines, diagnostic tests or physiotherapy such costs will be covered up to 60 days after your discharge from the hospital where a claim under In-patient hospitalisation / Domiciliary hospitalization / day care treatment is accepted.
Day care treatment	Due to advancements in medical science, certain medical procedures like a dialysis may not require a 24-hour hospitalization, we will cover you for such 586 procedures as well.
Domiciliary Hospitalization (Home Care)	We will cover your medical expenses in case you need to get treated at home, if your health condition did not allow hospital transfer or due to unavailability of a bed at the hospital
Road Ambulance Cover	In case of an emergency, we will cover costs incurred on transportation to a hospital by a road ambulance as per your eligibility.
Organ Donor Expenses	In case of organ transplants to you, we not only cover you, we also cover the medical expenses of the organ donor for harvesting the organ for your use, as per your eligibility.
Reload of Sum Insured	In case the sum insured with no claim bonus (if any) / super NCB (if opted) is insufficient as a result of previous claims in that policy year, then you get an additional 150% of sum insured, maximum up to 50 lakhs, for hospitalization due to an illness unrelated to previous claims in that policy year.
AYUSH In-patient treatment	We will pay you as per your eligibility, for medical expenses incurred by you towards your in-patient hospitalization under AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) treatment.
Daily Allowance	For each day that you get hospitalized, you get an additional benefit of Rs.500/- per day as daily allowance. This benefit shall be payable for a maximum limit of 5 days per hospitalization and is applicable only for sum insured up to Rs.4 lacs
Vaccination	Vaccination expenses for children up to 18 years of age included in the policy will be covered as per the schedule provided. This benefit is applicable only for sum insured of 1 Crore and above.
No Claim Bonus	With our policy, you get benefits even if you do not claim. We will provide you with a No Claim Bonus which is 10% of Sum Insured for each year that you do not claim. Whenever there is a claim, No Claim Bonus reduces by the same rate at which it increased, which is 10% of Sum Insured. The Maximum limit for No Claim Bonus is 50% of Sum Insured.
Health Check-Up Program	We provide a free health check-up for each and every insured member once in a policy year customized to the life stage you are in. This is available from the first year itself. The tests are based on the Age and Sum Insured.
Second E-opinion on Critical Illness	When it comes to detection of a major illness such a cancer, kidney failure or heart attack, then a second opinion is always helpful. We understand that and provide you with a second e-opinion through a consortium of well qualified specialists.
Domestic / International Emergency Assistance Services (Including Air Ambulance)	We travel on work or sometimes to get away from our busy lives and sometimes we may end up going to places that are remote. In such cases where an adequate medical facility is not available and you need medical help, we will help you reach such a medical facility and then take you back to your home.
HealthReturns^TM	Our policy rewards you for staying fit and healthy and these rewards are accumulated in the form of HealthReturns^TM. . You can start earning HealthReturns by completing the following steps: Complete a health assessment which as a result provides you a healthy heart score. Start exercising to earn Activ Dayz. monthly based on the accumulated Activ Dayz and your Healthy Heart Score.
Health Coach	At times when we are suffering from any of the chronic conditions, a coaching session with a specialist may help. We give you a personalized coaching by a medical expert who will guide you through your health journey when you are suffering from Asthma, Hypertension, Hyperlipidemia or Diabetes mellitus. These coaching session shall be provided on telephonic discussion with You to help you become healthier version of yourself.
Reduction in PED Waiting Period	Choosing this optional cover reduces your applicable waiting period of 48 months for claims related to Pre-existing diseases to, 24 months.
Unlimited Reload of Sum Insured	Through this optional cover, your sum insured can be reinstated unlimited times, whenever you need it the most. If, due to claims made, you ever run out of your health cover, we reinstate the entire sum insured unlimited times in a policy year. This benefit is an extension of Reload of Sum Insured.
Super NCB (Super No Claim Bonus)	With Super NCB (Super No Claim Bonus), your Sum Insured increases by 50% every claim-free year with a maximum accumulation of 100% of Sum Insured. The accumulated Super NCB serves as an extension to your inbuilt NCB. You can opt for Super NCB either when applying for the policy, or at renewal. In case of a claim, Super NCB reduces at the same rate at which it has increased, which is 50% of Sum Insured.
Accidental Hospitalization booster	In case of an unfortunate event of hospitalization due to an accident, this optional cover will provide you with an additional sum insured equal to your sum insured for in-patient hospitalization.
Cancer Hospitalization Booster	In case of an unfortunate event of hospitalization of any of the insured members aged more than 18 years due to cancer, this optional cover will provide them with an additional sum insured equal to your sum insured for in-patient hospitalization.
Any room Upgrade	This optional cover gives you the necessary freedom and helps you to get admitted in a hospital without any restriction on type of room. This optional cover is applicable for sum insured 5 Lakh and above

Click Here to read the policy wording.

Commission on General Insurance

FAQs

Basic Covers

In-patient Hospitalization, Room Type & ICU Charges

Under the Activ Assure Diamond plan, up to what amount room rent is covered?
Rs. 2, 3, 4 Lacs – 1% of Sum Insured
Rs. 5 Lacs Sum Insured – Single Private A/C Room
Rs. 7 Lacs & above Sum Insured – covered up to sum insured.

Under the Activ Assure Diamond plan, up to what amount ICU charges is covered?
Rs. 2, 3, 4 Lacs – 2% of Sum Insured
Rs. 5 Lacs & above Sum Insured – covered up to sum insured.

Under the Activ Assure Diamond plan, if a customer opt for higher room category. Will there be any proportionate deduction for ICU charges, pharmacy, diagnostics & medical devices cost?
No.

Under the Activ Assure Diamond plan, is there any Zone wise classification while calculating the premium?
No.

Under the Activ Assure Diamond plan, will there be any co-payment applicable if a customer avails the treatment in Higher Zone.
No.

Pre & Post Hospitalization Expenses

Under the Activ Assure Diamond plan, pre-hospitalization expenses are covered up to how many days?
Pre-hospitalization medical expenses are covered for 30 days.

Under the Activ Assure Diamond plan, post-hospitalization expenses are covered up to how many days?
Pre-hospitalization medical expenses are covered for 60 days.

Day Care Treatment

How many Day Care procedures are covered in the Activ Assure Diamond plan?
586 Day Care procedures is covered up to sum insured.

Domiciliary Hospitalization (Home Care)

Under the Activ Assure Diamond plan, do we cover the cost for domiciliary hospitalization?
Yes, it is covered upto 10% of Sum Insured.

A customer who is diagnosed with Asthma. Will his expenses be covered under domiciliary hospitalization?
There are 9 exclusions under Domiciliary, below is the list:

Asthma, bronchitis, tonsillitis, and upper respiratory tract infection including laryngitis and pharyngitis, cough and cold, influenza;
Arthritis, gout and rheumatism;
Chronic nephritis and nephritic syndrome;
Diarrhea and all type of dysenteries, including gastroenteritis;
Diabetes mellitus and insipidus;
Epilepsy;
Hpertension;
Psychiatric or psychosomatic disorders of all kinds;
Pyrexia of unknown origin.

Road Ambulance Cover

Under the Activ Assure Diamond plan, up to what amount road ambulance charges are covered?
Sum Insured upto 4Lacs – Rs. 1,500
Sum Insured upto 5Lacs to 10Lacs – Rs. 2,000 Sum Insured upto 15Lacs to 40Lacs – Rs. 2,500 Sum Insured upto 50Lacs to 75Lacs – Rs. 3,000 Sum Insured upto 1Cr to 2Cr – Rs. 5,000

Under the Activ Assure Diamond plan, how many times in a year, a customer can avail the road ambulance facility?
There are no such limits.

Organ Donor Expenses

Do we cover the cost for Organ Donor Expenses, under the Activ Assure Diamond plan?
Yes, Organ Donor expenses is covered up to Sum Insured.

I am covered under our Diamond plan, but my brother is not. Will my medical expenses be covered under Organ donor if I donate organ to my brother?
No, medical expense for donor is covered if the organ is for the use of insured person, who is recipient for the organ.

Reload of Sum Insured

Under the Activ Assure Diamond plan, do we provide Reload benefit?
Yes, Reload benefit is available up to 150% Sum Insured and Max upto 50Lacs.

Under the Activ Assure Diamond plan, will Reload of Sum insured apply for the first claim in case of any illness/injury?
No.

Under the Activ Assure Diamond plan, will Reload of Sum Insured be trigged for Ayush hospitalization too?
No, it applies only for IPD and Day care claims.

Under the Activ Assure Diamond plan, will calculation of No Claim Bonus and Super NCB be on the reloaded Sum Insured or base Sum Insured?
Base Sum Insured.

AYUSH (In-patient hospitalization)

Under the Activ Assure Diamond plan, do we cover the cost for Ayush In-patient hospitalization?
Sum Insured upto 4Lacs – Rs. 15,000
Sum Insured upto 5Lacs to 10Lacs – Rs. 20,000
Sum Insured upto 15Lacs to 40Lacs – Rs. 30,000 Sum Insured upto 50Lacs to 75Lacs – Rs. 40,000 Sum Insured upto 1Cr to 2Cr – Rs. 50,000

Under the Activ Assure Diamond plan, if a customer avail AYUSH treatment then will we cover pre and post hospitalization expenses?
No, we do not cover pre and post hospitalization expenses under AYUSH treatment.

Under the Activ Assure Diamond plan, what does Ayush include?
Ayush Treatment refers to the medical and / or hospitalization treatments given under ‘Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.

Daily Allowance

Under the Activ Assure Diamond plan, do we provide the Daily Allowance benefit?
Yes, it is covered Rs. 2, 3 & 4 Lacs Sum Insured – Rs. 500/ day & Max 5 day per hospitalization.

Vaccination Cover

Under the Activ Assure Diamond plan, do we cover the Vaccination cost?
Yes, it is covered up to Rs. 10,000/- (Applicable for Sum Insured 1Cr and above).

Under the Activ Assure Diamond plan, an insured aged 55 wants to take a vaccination for Pneumonia. Will it be covered under Vaccination Cover?
No. This benefit is available only for Insured Person up to 18 years.

Additional Benefit

No Claim Bonus

Under the Activ Assure Diamond plan, do we provide No Claim Bonus for claim free years?
Yes, we do provide No Claim Bonus of 10% increase per annum, Max up to 50% of Sum Insured.

Under the Activ Assure Diamond plan, in case of a claim year will we reduce the earned Cumulative Bonus?
Yes, earned Cumulative Bonus will be reduce by 10%.

In Diamond plan, will my Cumulative Bonus increase? If I opt for enhancement of Sum insured at the time of renewal?
If the Sum Insured under the Policy has been increased at the time of Renewal, the Cumulative Bonus shall be calculated on the Sum Insured of the last completed Policy Year.

Under the Activ Assure Diamond plan, a customer has purchased a policy for 3yrs. How will his No Claim Bonus (NCB) gets calculated?
NCB gets calculated for every claim free year no matter, whether the policy tenure is for 1yr, 2yrs or 3yrs.

Health Checkup Program

Under the Activ Assure Diamond plan, do we provide the Health Check- up Program?
Yes, it is available once in a policy year.

Under the Activ Assure Diamond plan, who ho can avail of a health check-up?
All Insured Person, there are separate set of tests as per age and SI slabs.

Under the Activ Assure Diamond plan, can a person do health check up outside the network and apply for reimbursement later?
No, the health check-ups will be arranged by us on cashless basis only and at our Network Providers/empanelled service providers (such as Diagnostic centres).

In Activ Assure Diamond plan, can I avail health check-up program if I have made a hospitalization claim in the policy year?
Yes, health check-up program is available irrespective of claim.

Under the Activ Assure Diamond plan, what if client has undergone Pre-Policy Medical Check-up (PPMC), when can the client go for Annual Health Check-up?
No, defined time gap between the two tests.

Under the Activ Assure Diamond plan, a customer who has already undergone the Health Assessment (HA). When can he go for the Annual Health Check-up?
There is no fixed time gap between the two tests, but the customer cannot repeat the tests that were covered in HA (MER, Total Cholesterol, FBS)

Second E-Opinion on Critical Illnesses

Under the Activ Assure Diamond plan, do we provide Second E-opinion on Critical Illnesses?
Yes, it is available for 15 listed Critical Illnesses.

Domestic Emergency Assistance Services (including Air Ambulance)

Under the Activ Assure Diamond plan, do we provide Domestic Emergency Assistance Services (including Air Ambulance) benefit?
Yes, it is available.

International Emergency Assistance Services (including Air Ambulance)

Under the Activ Assure Diamond plan, do we provide International Emergency Assistance Services (including Air Ambulance) benefit?
Yes, it is available.

Under the Activ Assure Diamond plan, what happens when insured is travelling for more than 90 Days, is he/she not eligible to avail worldwide emergency assistance service?
As per Terms & Conditions Trips exceeding 90 days from residential address without prior notification to us are excluded.

Under the Activ Assure Diamond plan, a customer goes for a vacation 150 kms away from his home & while doing any ice sports activity (not on a professional or semi-professional nature) gets into an emergency like an accident & needs emergency assistance. Would he be eligible for it? Also is he eligible to claim for the accident?
Mentioned condition is excluded under the policy hence claim related to same will not be considered.

Do we have any specific list of countries in where we provide medical assistance under worldwide emergency assistance?
Our partner Assist America Provides services globally (worldwide) and do not have any such country where they do not give the services. So, no geographical exclusions. Hence all the countries are covered for providing our medical emergency assistance.

Under the Activ Assure Diamond plan, a Customer who has individual policy was on holiday with one of his friends and there they met with an accident and requests for worldwide emergency assistance. WWEA decided to provide air ambulance will they also assist the friend who is also seriously injured?
No, they will not provide assistance to friend.

A person buys our Policy, and he travels to US for some official tour purpose. There he got severe pain in his stomach he got admitted in hospital there and Dr. suggested some Diagnostic Test. Which resulted some Gall Bladder related problem (not stone) and he had been advised for the surgery. Approximate Cost: 10000USD. But customer does not have too much money, he wants to come back India and then get treated for this. So, in this case can he avail Worldwide Emergency Assistance facility?
It will not be covered in given case.

Under the Activ Assure Diamond plan, NRI customer who is in abroad wants to come in India for treatment. Will we cover his traveling cost in worldwide emergency cover?
No, we will not cover.

Value Added Benefits:

Health Assessment

Under the Activ Assure Diamond plan, do we provide the Health Assessment™?
Yes, once in a year.

Under the Activ Assure Diamond Plan, a customer who has undergone the PPMC will the tests under HA will be repeated?
No, tests in HA will not be repeated.

In Activ Assure Diamond plan, what is Health Assessment?
Health Assessment is a simple health exam that measures the Insured Person on the parameters of MER (including BP, BMI, HWR and smoking status), Fasting Blood Sugar and Total Cholesterol.

Under the Activ Assure Diamond plan, how do we calculate Health Heart Score™?
For calculation of Healthy Heart Score™, tests under Health Assessment™ namely - MER (including BP, BMI, HWR and smoking status), Fasting Blood Sugar, Total Cholesterol will have to be carried out at one go (together) and at least once every Policy Year.

In Activ Assure Diamond family floater plan of 2 adults and 1 child age 22 yrs. How many are eligible for health assessment?
Health Assessment (HA) is only for adult members (above 18 years).

Health Returns

Under the Activ Assure Diamond plan, what is the total percentage of HealthReturns that a customer can earn?
Total percentage of HealthReturns that a customer can earn is Up to 30%.

Under the Activ Assure Diamond plan, can I earn HealthReturns just on the basis on good Health Assessment results without doing Active Dayz™?
No, it is important to do Health Assessment as well as Active Dayz™ to earn HealthReturns™ if a customer is not doing Active Dayz™ the substitute is to take a fitness assessment twice in a year.

How HealthReturns through Active Dayz will get calculate in our multiyear policy of 3 years?
HealthReturns™ through Active Dayz™ and Healthy Heart Score™ gets calculated monthly. Irrespective of whether the premium has been paid for 1 year, 2 years or 3 years.

A customer has paid 3 years’ policy premium together and every year he is earning HealthReturns. Can he redeem his 3 years accumulated HealthReturns against the 4th year renewal premium?
Yes, he can redeem his 3 yrs. accumulated HealthReturns against the 4th year renewal premium.

Can a customer redeem his accumulated HealthReturns against buying the new retail policy through ABHI?
Yes.

Can a customer use his earned HealthReturns for paying the gym membership fees?
No, this is not permitted.

A customer’s policy is issued without Pre policy medical check-up. Next day he moved out of India for his business/Job purpose for 10-12 months and there he is being tracking his Active Dayz™. He gets his Free Health Check done over there at his own cost in the first month and shares the same medical reports with us to avail the benefits of HealthReturns. Will we consider his reports?
No, we would not consider the reports from outside and he will not get the HealthReturns.

If a person does less than 3 Active Dayz and has a Healthy Heart Score of Red, how much HealthReturns will he get?
0%.

What is the ratio while calculating HealthReturns for self, spouse & 2 kids?
1:1:0:0.

A customer undergoing Day Care Treatment wants to use his HealthReturns™ to cover his expenses Rather than using up his SI and cumulative Bonus amount. As per policy T&C, is he allowed to do so?
No.

Health Coach

Under the Activ Assure Diamond plan, who all are eligible for Health Coach Benefit?
All Insured Persons Aged 18 Years or above, suffering from any one or more of the listed chronic conditions namely Asthma, Hypertension, Hyperlipidemia or Diabetes Mellitus is/are eligible for a health coaching session with our expert Health Coach.

Under the Activ Assure Diamond plan, will consultation with Health Coach Impact the sum insured?
No, this benefit is above and beyond SI and will not reduce it.

Under the Activ Assure Diamond plan, how many sessions under health coach facility an insured can avail?
2 sessions during a policy year.

Optional Covers

Unlimited Reload of Sum Insured

Under the Activ Assure Diamond plan, do we provide Unlimited Reload of Sum insured benefit?
Yes, we do provide 100% of Sum Insured (Unlimited Times).

Under the Activ Assure Diamond plan, will Sum Insured + No Claim Bonus and Super NCB be considered while calculating the Unlimited Reload of Sum Insured?
No, Unlimited Reload of Sum Insured calculation will be done on the base SI.

Super NCB

Under the Activ Assure Diamond plan, do we provide Super No Claim Bonus for claim free years?
Yes, we do provide Cumulative Bonus of 50% increase per annum, Max up to 100% of Sum Insured.

Under the Activ Assure Diamond plan, in case of a claim year will we reduce the earned Cumulative Bonus?
Yes, earned Cumulative Bonus will be reduce by 50%.

In Diamond plan, will my Super No Claim Bonus increase, if I opt for enhancement of Sum insured at the time of renewal?
If the Sum Insured under the Policy has been increased at the time of Renewal, the Super NCB shall be calculated on the Sum Insured of the last completed Policy Year.

Under the Activ Assure Diamond plan, a customer has purchased a policy for 3yrs. How Super No Claim Bonus (Super NCB) gets calculated?
Super NCB gets calculated for every claim free year no matter, whether the policy tenure is for 1yr, 2yr or 3yr.

Under the Activ Assure Diamond plan, what will happen to the accumulated Super NCB if the policyholder decides to opt out of the Super NCB benefit on renewal?
The accumulated Super NCB will not get carried forward.

Accidental Hospitalization Booster

Under the Activ Assure Diamond plan, how much amount is given towards Accidental Hospitalization Booster benefit?
100% of Sum Insured.

Is the accidental hospitalization booster option available for all customers irrespective of SI?
No, Only customer who have SI 1 Cr and below can opt for this benefit.

Can an insured who has opted for this benefit, choose to use this booster rather than his SI to pay for Accidental hospitalization?
No, this benefit can be used only when he has used up his Sum Insured completely.

How many times can an insured person use accidental hospitalization booster benefit?
Once during the policy year.

Cancer Hospitalization Booster

Under the Activ Assure Diamond plan, how much amount is given towards Cancer Hospitalization Booster benefit?
100% of Sum Insured.

Under the Activ Assure Diamond plan, can an insured who has opted for cancer hospitalization booster, choose to use this booster rather than his SI to pay for Accidental hospitalization?
No, this benefit can be used only when he has used up his Sum Insured completely.

Under the Activ Assure Diamond plan, how many times can an insured person use cancer hospitalization booster?
Once during the policy year.

In a family floater, is the Cancer Hospitalization booster available to all insured members?
The following members in a family floater can avail of the booster - Above 18 years / Only Self & Spouse not the child.

Any Room Upgrade

Under the Activ Assure Diamond plan, a customer who has bought sum insured below or above 5Lacs are they eligible to opt for optional cover of Any Room upgrade?
No, optional cover of Any Room upgrade is available only with 5Lacs S.I.

Preferred Provider Network (PPN)

How much is the PPN discount?
10% discount.

Plan Summary

What is the sum insured options available under the Activ Assure Diamond plan?
Rs.2 Lac, 3 Lac, 4 Lac, 5 Lac, 7 Lac, 10 Lac, 15 Lac, 20 Lac, 25 Lac, 30 Lac, 40 Lac, 50 Lac, 75 Lac, 100 Lac,
150 Lac, 200 Lacs.

What is the minimum entry age for Activ Assure Diamond plan?
Dependent children age 91 days to 5yrs will be covered only if one adult is covered under family floater policy. In case of individual policy, minimum age at entry is 5 years. Children upto 25 yrs can be covered under the floater as dependents.

What is the maximum entry age for Activ Assure Diamond plan?
No maximum age at entry.

How long is my Policy valid?
Policy is valid for the duration mentioned in your Policy schedule. We offer you an option of buying our health policy for a term of 1 year, 2 years or 3 years. You can renew your policy at the end of the policy term.

A customer who has Activ Assure Diamond plan. In future can he add his newly wedded spouse and kid to his existing policy?
Yes, newly wedded Spouse and newborn baby can be added in the Policy during the term of Policy by paying premium as applicable.

What is the benefit for choosing a policy duration of more than 1 year?
You can avail of a long-term discount of 7.5% and 10% on selecting 2 and 3-years policy, respectively.

What is the maximum entry age for Activ Assure Diamond plan?
The maximum entry age is 65 years.

Under the Activ Assure Diamond plan, is there any Zone wise classification while calculating the premium?
No.

I want to cover my 4 family members under Individual type policy under Activ Assure Diamond plan. Do I get any discounts?
You can avail a 5% discount on covering 2 or 3 family members and a 10% on covering 4 or more family members in an Individual Policy type.

Can I increase my Sum insured in Activ Assure Diamond Plan?
Yes, you can request for enhancement of Sum insured at the time of renewal. However, the enhancement is subject to underwriting decision and applicability of waiting periods such as first 30 days waiting period, two- years waiting period and pre-existing disease waiting period.

If I increase my Sum insured in Activ Assure Diamond Plan, will I have to serve a waiting period?
All waiting periods, as applicable for your plan, shall apply afresh on the Sum insured to the extent of enhancement over the previous policy Sum insured from the effective date of such enhancement.

Till what age can I renew my Activ Assure Diamond plan?
Lifetime renewal.

Is there any mandatory co-payment applicable under the Activ Assure Diamond plan?
Yes, mandatory co-payment of 20% for age at entry 61yrs and above.

Optional covers under family floater policies, if chosen will be it applicable to all members in the policy?
Yes.

How many days initial waiting period is applicable?
30 days (not applicable in case of accident & subsequent renewal).

How many days Pre-existing disease waiting period is applicable?
48 months.

What is the waiting period for Listed Illness/Procedure?
24 months.

What is the waiting period for specific disease/Procedure?
48 months.

What will be the waiting period applicable for Mental illness & bariatric surgery?
30 days.

Tax related questions

Do I get Tax benefit on the amount I paid as premium for this Policy?
Yes, the premium paid for health insurance policies qualifies for deduction under Section 80D of the Income Tax Act. You are entitled to a deduction of up to Rs. 25000 as medical insurance premium paid for yourself, your spouse, and children. In addition to it, if you pay health insurance premium for your parents, you will be entitled to additional deduction of up to Rs. 25,000/- (if parents are not senior citizens) Or up to Rs. 50,000/- (if parents are senior citizens).

Is premium paid through HealthReturns eligible for tax benefit?
No, Premium paid through health returns is not eligible for tax benefit

Other Common Queries

What is a pre-existing condition?
Pre-Existing Disease or PED means any condition, ailment or injury or related condition(s) for which there were signs or symptoms, and / or were diagnosed, and / or for which medical advice / treatment was received within 48 months prior to the first policy issued by the insurer and renewed continuously thereafter.

What is the difference between Individual & Floater cover?
In an individual policy, each person is covered for separate Sum insured as selected at the time of buying the policy. In a Family Floater plan, all insured members are covered under a floater sum insured. The sum insured for a Family Floater is our maximum liability for all claims made by all the insured members (a single Sum Insured which is shared by all members).

What if I do not declare my health condition while buying Activ Assure Diamond Plan?
Your health insurance policy is issued based on the Disclosure to information norm, including the information provided by you in respect of the Insured Persons in the Proposal Form and any other details submitted in relation to the Proposal Form.

What are the factors that affect my Activ Assure Diamond plan premium?
Premium for your Activ Health policy depend on following factors:

Your age
Gender (for individual plan)
Plan type (individual/ floater)
No. of member covered (in individual policy, you get discount for covering 2 or more members under same policy)
Selected term for policy (You get 7.5% and 10% discount respectively for buying 2yrs and 3yrs term policy)
Selected SI
Any pre-existing condition that you may have at the time of first buying this policy or detected at the time of pre policy medical checkup.

How can I contact Aditya Birla Health Insurance Co. Ltd?
You can email us at care.healthinsurance@adityabirlacapital.com or You can call our toll free no. 1800 270 7000 or You can visit our website www.adityabirlacapital.com/healthinsurance or You can visit any of our Branch offices or Corporate office.

Under the Active Assure Diamond plan, what is Migration?
Migration means an insured having a health insurance policy has an option to shift his/her policy to a similar policy with the same Insurer:

An Individual Health Insurance Policy holder shall have option to shift to either:
A) A Similar Individual health insurance policy, or
B) To a Group Health Insurance Policy, provided the members meets the terms related to health insurance coverage of the group policy.
A member of Group Health Insurance policy can migrate to a similar Individual Health Insurance policy. However, the same will be applicable in case:
A)   Exit from Group Policy.
B)   Modification of Group Policy (including the revision in the premium rates).
C)   Withdrawal of Group Policy.

Under the Active Assure Diamond plan, what are the benefits of Migrating?
While doing so insured will get continuity benefit for applicable waiting periods for the number of years the existing policy was continuously renewed previously.

Under the Active Assure Diamond plan, what is the difference between Migration & Portability?
Transferring the policy within ABHI is known as Migration and transferring the policy externally is known Portability.

Under the Active Assure Diamond plan, what is Moratorium period?
After completion of eight continuous years under the policy, no look back would be applied. This period of eight years is called as Moratorium Period.

Under the Active Assure Diamond plan, what is Moratorium period?
After completion of eight continuous years under the policy, no look back would be applied. This period of eight years is called as Moratorium Period.

Under the Active Assure Diamond plan, do we provide maternity benefit?
No.

Under the Active Assure Diamond plan, do we provide Chronic Management Program?
No.

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Aditya Birla Activ Assure

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