Question 1

Is co-payment compulsory or optional under Activ One Max Plus?

Accepted Answer

Co-payment is generally optional and may apply only in specific scenarios based on age, sum insured, or underwriting terms.

Question 2

What is the minimum and maximum entry age for Activ One Max Plus by Aditya Birla Health Insurance?

Accepted Answer

Adults can enter the policy from 18 years, while dependent children are covered from 91 days. There is no maximum entry age, allowing lifelong access to comprehensive health coverage.

Question 3

Till what age can my child stay covered under Activ One Max Plus?

Accepted Answer

Dependent children can remain covered under the family floater policy up to 25 years of age, provided they are unmarried and financially dependent on the primary insured member.

Question 4

Are unmarried children eligible under Activ One Max Plus?

Accepted Answer

Yes, unmarried children are eligible for coverage under Activ One Max Plus as dependents, subject to age limits and financial dependency conditions defined in the policy.

Question 5

Can I add a new family member later under Activ One Max Plus?

Accepted Answer

Yes, new family members such as spouse, child, or dependent parents can be added at renewal or specific life events, subject to underwriting approval and policy conditions.

Question 6

Can my spouse and children be covered under a single sum insured in Activ One Max Plus?

Accepted Answer

Yes, the policy allows self, spouse, and dependent children to be covered under one shared family floater sum insured, offering flexible and cost-effective family protection.

Question 7

Can I cover my parents under Activ One Max Plus?

Accepted Answer

Yes, parents and parents-in-law can be covered under Activ One Max Plus, either under the same policy or separately, subject to eligibility, underwriting, and premium adjustments.

Question 8

Can family members be added mid-term under Activ One Max Plus?

Accepted Answer

Mid-term addition of family members is allowed only during specific life events like marriage or childbirth, subject to insurer approval and applicable policy terms.

Question 9

What is the PED waiting period if I port to Activ One Max Plus from another insurer?

Accepted Answer

When porting, the waiting period already completed with the previous insurer is credited, reducing the remaining PED waiting period under this plan.

Question 10

Can I port my existing health policy to Activ One Max Plus by Aditya Birla Health Insurance?

Accepted Answer

Yes, you can port your existing health policy to Activ One Max Plus while retaining continuity benefits, subject to underwriting and regulatory guidelines.

Question 11

What is the PED waiting period after porting into Activ One Max Plus?

Accepted Answer

After porting, the remaining waiting period is calculated after adjusting the duration already served under your previous health insurance policy.

Question 12

What unique benefits does Activ One Max Plus by Aditya Birla Health Insurance offer compared to other policies?

Accepted Answer

The plan offers day-one chronic coverage, unlimited room rent, wellness rewards, high sum insured options, and comprehensive modern treatment coverage.

Question 13

Does Activ One Max Plus come with any disease-wise sub-limits?

Accepted Answer

No, the policy generally does not impose disease-wise sub-limits, offering broader flexibility for treatment expenses unless explicitly mentioned otherwise.

Question 14

Are room rent or ICU charges capped in Activ One Max Plus?

Accepted Answer

No, there are no caps on room rent or ICU charges, ensuring full coverage without proportionate deductions during hospitalisation.

Question 15

Does Activ One Max Plus offer a No-Claim Bonus (NCB)?

Accepted Answer

Yes, a No-Claim Bonus increases the sum insured for every claim-free year, enhancing coverage without increasing premium proportionately.

Question 16

Does Activ One Max Plus provide any loyalty bonus?

Accepted Answer

Loyalty benefits are offered through wellness rewards and long-term engagement incentives, encouraging policy continuity and healthy lifestyle practices.

Question 17

Are preventive health check-ups included in all sum insured options under Activ One Max Plus?

Accepted Answer

Yes, preventive health check-ups are included across sum insured options at specified intervals to support early diagnosis and proactive healthcare.

Question 18

Is there a grace period for renewing Activ One Max Plus after expiry?

Accepted Answer

Yes, a grace period of 30 days is available after policy expiry, allowing renewal without losing continuity benefits, though coverage may pause temporarily.

Question 19

What are the available sum insured options under Activ One Max Plus?

Accepted Answer

Activ One Max Plus offers a wide range of sum insured options, typically starting from ₹2 lakh and going up to ₹6 crore, allowing coverage customization based on healthcare needs.

Question 20

Does Activ One Max Plus offer maternity and newborn benefits?

Accepted Answer

Maternity and newborn benefits are not included as standard features under this plan and may be available only through optional riders with applicable waiting periods.

Question 21

Are pregnancy-related complications covered under Activ One Max Plus?

Accepted Answer

Pregnancy-related complications are generally excluded unless maternity coverage is opted for separately, and coverage is subject to waiting periods and defined policy conditions.

Question 22

Are daycare procedures covered in Activ One Max Plus?

Accepted Answer

Yes, the plan covers a wide list of daycare procedures that do not require 24-hour hospitalization, provided the treatment is medically necessary and policy-approved.

Question 23

Are pre- and post-hospitalization expenses covered under Activ One Max Plus, and for how many days?

Accepted Answer

Pre-hospitalization expenses up to 90 days and post-hospitalization expenses up to 180 days are covered when related to a covered hospitalisation claim.

Question 24

Does Activ One Max Plus include OPD coverage?

Accepted Answer

OPD coverage is available through chronic disease management and wellness programs, supporting consultations, diagnostics, and follow-ups without requiring hospitalization.

Question 25

Are room rent or ICU charges capped under Activ One Max Plus?

Accepted Answer

No, Activ One Max Plus does not impose room rent or ICU sub-limits, allowing policyholders to choose any room category without proportionate deductions.

Question 26

Is chemotherapy covered under Activ One Max Plus?

Accepted Answer

Yes, chemotherapy, radiotherapy, and related cancer treatments are covered under the policy, either as inpatient or daycare procedures, subject to sum insured limits.

Question 27

Are lifestyle diseases like diabetes or hypertension covered from day 1 under Activ One Max Plus, or after a waiting period?

Accepted Answer

Several chronic lifestyle diseases such as diabetes and hypertension are covered from day one, while other conditions may be subject to standard waiting periods.

Question 28

Does Activ One Max Plus include mental health treatments or counselling?

Accepted Answer

Yes, hospitalization for mental health conditions is covered under Activ One Max Plus, in line with regulatory guidelines and policy-defined inpatient treatment terms.

Question 29

Does Activ One Max Plus cover AYUSH/alternative treatments?

Accepted Answer

Yes, inpatient AYUSH treatments including Ayurveda, Yoga, Unani, Siddha, and Homeopathy are covered when availed at recognised or accredited treatment centres.

Question 30

Are diagnostic tests and pathology covered under Activ One Max Plus?

Accepted Answer

Diagnostic tests and pathology expenses are covered when they are related to hospitalization or included as part of pre- and post-hospitalization treatment.

Question 31

Is ambulance service covered under Activ One Max Plus, and what is the limit?

Accepted Answer

Emergency ambulance services are covered under the policy up to defined limits per hospitalization, provided transportation is medically necessary.

Question 32

Is organ donor surgery covered under Activ One Max Plus?

Accepted Answer

Yes, expenses related to organ donor surgery are covered for the donor, provided the recipient is insured and the transplant is medically necessary.

Question 33

Are congenital conditions covered for children under Activ One Max Plus?

Accepted Answer

Congenital external conditions are generally covered, while congenital internal conditions are covered after applicable waiting periods, as specified in policy terms.

Question 34

Does Activ One Max Plus cover vaccinations for adults and children?

Accepted Answer

Vaccinations are not part of standard coverage and may only be available through wellness or preventive health programs, subject to policy-defined inclusions.

Question 35

Does Activ One Max Plus provide international coverage?

Accepted Answer

International coverage is limited and generally applicable only in defined emergency situations, subject to policy conditions and geographical restrictions.

Question 36

Are occupational hazards or accident-related injuries covered under Activ One Max Plus?

Accepted Answer

Yes, hospitalisation due to accidents, including occupational hazards, is covered under Activ One Max Plus, subject to exclusions mentioned in the policy.

Question 37

Are cosmetic or plastic surgeries covered under Activ One Max Plus, and under what conditions?

Accepted Answer

Cosmetic or plastic surgeries are covered only when medically required due to accidents, burns, congenital defects, or illness, and not for aesthetic purposes.

Question 38

Does Activ One Max Plus include chronic disease management support?

Accepted Answer

Yes, the plan offers structured chronic disease management support, including regular monitoring, consultations, and wellness assistance for long-term conditions.

Question 39

Are wellness, fitness, or reward-based benefits included in Activ One Max Plus?

Accepted Answer

Yes, wellness benefits such as HealthReturns™ reward healthy behaviour and fitness activities, helping policyholders earn incentives for maintaining an active lifestyle.

Question 40

Does Activ One Max Plus provide any death benefit?

Accepted Answer

No, Activ One Max Plus is a health insurance policy and does not provide any separate death benefit to nominees.

Question 41

What are PEDs, and when are they covered under Activ One Max Plus?

Accepted Answer

Pre-existing diseases are medical conditions present before buying the policy and are covered after completing the specified waiting period mentioned in the policy.

Question 42

Is day-1 PED coverage available under Activ One Max Plus?

Accepted Answer

Day-one coverage is available for select chronic conditions, while other pre-existing diseases are covered only after completing the standard waiting period.

Question 43

What is the waiting period for PEDs under Activ One Max Plus?

Accepted Answer

The standard waiting period for most pre-existing diseases is 36 months from policy inception, unless otherwise specified for select conditions.

Question 44

Does Aditya Birla Health Insurance offer top-up or super top-up options along with Activ One Max Plus?

Accepted Answer

Yes, top-up and super top-up plans are available and can be purchased alongside Activ One Max Plus to enhance overall coverage affordably.

Question 45

Does Activ One Max Plus offer cashless hospitalisation?

Accepted Answer

Yes, cashless hospitalisation is available at network hospitals, subject to pre-authorisation and policy terms, allowing treatment without upfront payments.

Question 46

How long does Aditya Birla Health Insurance take to approve cashless claims for Activ One Max Plus?

Accepted Answer

Cashless claims are usually approved within a few hours once pre-authorisation and required medical documents are submitted by the hospital.

Question 47

What documents are required to file a claim under Activ One Max Plus?

Accepted Answer

Required documents include claim form, discharge summary, hospital bills, prescriptions, diagnostic reports, and identity proof, depending on claim type.

Question 48

Is pre-authorisation mandatory for hospitalisation under Activ One Max Plus?

Accepted Answer

Pre-authorisation is mandatory for planned hospitalisations, while emergency hospitalisation must be intimated within the insurer’s specified timeframe.

Question 49

How many claims can I make in one policy year under Activ One Max Plus?

Accepted Answer

There is no limit on the number of claims in a policy year, provided the total claim amount does not exceed the available sum insured.

Question 50

Is the hospital network list available for Activ One Max Plus, and can I avail treatment outside the network?

Accepted Answer

Yes, a network hospital list is available, and treatment outside the network can be availed through reimbursement as per policy terms.

Question 51

What is the claim settlement ratio of Aditya Birla Health Insurance for Activ One Max Plus?

Accepted Answer

Aditya Birla Health Insurance maintains a strong overall claim settlement ratio at the company level, reflecting efficient and reliable claim handling practices.

Aditya Birla Activ One Max Plus

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Expert Review: Aditya Birla Activ One Max Plus

Final Verdict

What Is Activ One Max Plus?

Max Plus

Insurer Rating

8.21

Insurance Rating

10

Additional Benefits (Informational Only — Not part of score)

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Aditya Birla Activ One Max Plus Inclusions and Exclusions

Modern Treatment

ICU Charges

Cumulative Bonus

Consumable Cover

Initial Waiting Period

Specific Waiting Period

PED Waiting Period

Annual Health Checkup

Post-Hospitalisation

Outpatient Department Cover (OPD Expense)

Deductible Option

Coverage Options

Maternity Cover

AYUSH Treatment

Co-payment

Pre-Hospitalisation

Claim Settlement Ratio

Room Rent

Cashless Healthcare Providers

Daycare Treatment

Disease-wise sublimits

Restoration Benefit

Exclusions

Activ One Max Plus Add-Ons and Riders

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