Individuals and families who want high coverage up to ₹2 crore
strong wellness rewards
chronic-condition management
mental illness and bariatric treatment cover
and are willing to configure room/add-ons carefully and accept a 36-month PED waiting period.
What Works Well
Sum Insured options from ₹2 lakh to ₹2 crore
60 days pre-hospitalization and 180 days post-hospitalization
Mental illness hospitalization covered up to Sum Insured
Medically necessary bariatric surgery covered subject to policy conditions
AYUSH covered up to Sum Insured
Home Treatment covered up to Sum Insured for specified illnesses
50% cumulative bonus per claim-free year up to 100%
subject to maximum ₹1 crore
HealthReturns can earn up to 100% of premium
Premium waiver for one policy year on first diagnosis of listed critical illnesses
subject to conditions
Optional maternity cover includes newborn and vaccination benefits
No mandatory base co-payment is shown for Platinum Enhanced in verified current-UIN policy schedules
For Sum Insured ₹4 lakh and above
the higher-zone co-payment rule is not applicable
Future Secure add-on can waive listed non-medical expenses and can include NCB Shield and Sum Insured Inflation Protector
Watch Out For
Room category must be selected; choosing a higher room than eligibility can trigger proportionate deductions
For Sum Insured of ₹3 lakh and below
treatment in a higher zone can attract 10%
15% or 25% co-payment
Base reload is once per policy year and is restricted to subsequent unrelated claims
Pre-existing disease waiting period is 36 months
Maternity is an optional cover with a 48-month waiting period
Non-medical consumables are excluded in the base policy unless covered through an applicable add-on/rider
The published premium does not have a fixed absolute maximum; actual premium varies materially by age
Sum Insured
zone
room option
family composition
add-ons and underwriting
Super Reload should not be assumed to be available under Platinum Enhanced merely because it exists in generic Activ Health policy wording
36-month PED waiting period
Room entitlement must be selected and proportionate deduction may apply if exceeded
Conditional higher-zone co-payment for SI up to ₹3 lakh
Base reload is restricted to subsequent unrelated claims
Maternity has a 48-month waiting period and is optional
Base policy excludes many non-medical expenses
Hidden Clauses - Read Very Carefully!
These clauses are often buried in fine print.
MyInsureBuddy surfaces them so you're never surprised at claim time.
Data Not Available
Doctor must confirm in writing that domiciliary treatment was medically necessary and all conditions were met
‘Any room’ rent limit is available as an upgrade option
Organ donor cover does not include pre/post-hospitalisation expenses
⚡ At a Glance
Cashless Available No Room Rent Limit Maternity Cover Online Claim Tracking Personal Claim Manager Domiciliary Cover Family Floater Modern Treatments Reset Benefit Organ Donor Teleconsultation Health Coaching Preventive Checkups Co-payment Applies Room Rent Cap Complex Exclusions Restore Restrictions Claim Restrictions
Road Ambulance
₹5,000
Cum. Bonus
50%/yr (max 100%)
Special Benefits
•Restore Benefit
Wellness Benefits
•HealthReturns up to 100% of premium
•Healthy Heart Score
•Active Dayz
•Health Assessment
•Health Check-up Program
•Expert Health Coach
•Nutrition coaching
•Mental health coaching
•Homeopathy tele-consultation
Modern Treatments
•Uterine Artery Embolization and HIFU
•Balloon Sinuplasty
•Deep Brain Stimulation
•Oral Chemotherapy
•Immunotherapy
•Monoclonal Antibody injection
•Intra-vitreal injections
•Robotic surgeries
•Stereotactic radio surgeries
•Bronchial Thermoplasty
•Vaporisation of the prostate (Green laser or holmium laser)
•Intra Operative Neuro Monitoring
•Hematopoietic stem cell therapy for bone marrow transplant for haematological conditions
•Reduction in PED Waiting Period add-on (availability must be confirmed in quote/policy schedule)
Domiciliary Exclusions
•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 types of dysenteries including gastroenteritis
•Diabetes mellitus and insipidus
•Epilepsy
•Hypertension
•Psychiatric or psychosomatic disorders of all kinds
•Pyrexia of unknown origin
Key Benefits (Pros)
•Fewer claim settlement complaints
•Fewer after-sales complaints
•Higher claim settlement ratio than many competitors
•Lower claim rejection and repudiation ratio than many competitors
Policy Drawbacks
•Response time on X is average compared with other insurers
Day 31 Covered Diseases
•Data Not Available
•Diabetes Hypertension Hyperlipidemia / High Cholesterol Asthma
Insurer Positives
•Fewer claim settlement complaints
•Fewer after-sales complaints
•Higher claim settlement ratio than many competitors
•Lower claim rejection and repudiation ratio than many competitors
Insurer Negatives
•Response time on X is average compared with other insurers
Eligibility and Sum Insured
•Family Floater: dependent child from 91 days and adult from 18 years
•Individual policy minimum entry age: 5 years
•No maximum entry age stated in brochure
•Sum Insured options: ₹2 lakh to ₹2 crore
Chronic Management and Wellness
•Chronic Management Program for asthma, hypertension, high cholesterol and diabetes
•HealthReturns up to 100% of premium
•Health Assessment and Healthy Heart Score
•Expert Health Coach
•Mental health coaching
•Homeopathy tele-consultation for eligible Platinum Enhanced configurations
Optional Covers
•Personal Accident Cover
•International Coverage for Major Illnesses
•Critical Illness Cover
•Maternity Expenses
•OPD Expenses
•Hospital Cash Benefit
•Room option/upgrade configurations
•Future Secure/non-medical expense protection as a separately paid market-listed rider/add-on
Policy Selection Checklist
•Prefer Sum Insured of ₹4 lakh or above to avoid the plan's higher-zone co-payment rule; for meaningful urban hospitalization protection, evaluate substantially higher cover based on your budget and family profile.
•Choose the room option carefully. If Any Room is selected and shown in the schedule, room-linked proportionate deductions are much less likely to become an issue.
•Do not buy this plan assuming unlimited restoration. The verified Platinum Enhanced schedule shows base Reload once per policy year and Super Reload not available.
•If consumables/non-payable items matter, verify that Future Secure / Non-Medical Expense Waiver is actually selected in the quote and policy schedule.
•Maternity is useful only when the 48-month waiting period fits your planning horizon.
•For diabetes, hypertension, high cholesterol or asthma, the Chronic Management Program is a meaningful differentiator, but hospitalization waiting-period rules still need to be checked separately.
•Before payment, verify five items on the final quote: Sum Insured, room option, zone, add-ons, and any co-payment/underwriting loading.
Premium Interpretation
•Current insurer-advertised starting premium: ₹8,215 per year.
•premium_max in this JSON is ₹53,008, the highest directly verified annual premium sample found under the current UIN in public market policy documents.
•₹53,008 is not an insurer-declared absolute maximum. The product has no single fixed maximum premium because pricing varies by age, Sum Insured, city/zone, room option, family size, add-ons, health disclosures and underwriting.
📌 Other Custom Details
•Source: Uploaded Activ Health Platinum Enhanced brochure and Activ Health policy wording (primary); FY2025-26 insurer metrics and ILM/Beshak data supplied by user; current Aditya Birla official product pages/prospectus; current-UIN public policy schedule samples used for premium range and add-on verification. premium_max=53008 is the highest verified current-UIN annual market sample found, not an insurer-declared absolute ceiling.
•Founded Year: 2015
•Gross Written Premium Crore: 5901.52
•Number Of Policies: 43737602
•Number Of Claims: 2846356
•Financial Year: 2025-26
•Claims Settled 30 Days Percent: 98.82
•Claim Settlement Time Days: 15
🤖 AI Policy Analysis
Powered by MyInsureBuddy AI - Automatically analysed from official IRDAI documents.
Summary
Activ Health Platinum Enhanced is feature-rich: up to ₹2 crore Sum Insured, 60/180-day pre/post hospitalization, mental illness, bariatric surgery, AYUSH, home treatment, modern treatments, chronic management and HealthReturns. Its main decision risks are not basic coverage gaps but configuration details: selected room category, zone rule for SI up to ₹3 lakh, 36-month PED wait, optional maternity/consumables, and the fact that the base Reload is once per year for subsequent unrelated claims rather than unlimited restoration.
Recommendation
Good shortlist candidate if you value chronic-care and wellness features. For a safer configuration, choose SI of at least ₹4 lakh to remove the higher-zone co-pay rule, select Any Room when available and affordable, add Future Secure if non-medical expenses are important, and verify the final policy schedule does not introduce underwriting co-pay/loading. Avoid choosing it mainly for restoration if you specifically want unlimited same-illness restore; compare a plan with stronger in-built restoration.
Coverage & Benefits
In-patient Hospitalisation
Covered up to Sum Insured, subject to selected room option
ICU
Covered up to Sum Insured
Pre-Hospitalization
Covered for 60 days
Post-Hospitalization
Covered for 180 days
Day Care Treatment
Covered up to Sum Insured; all eligible day care procedures under policy terms
Domiciliary Hospitalization
Covered up to Sum Insured, subject to listed exclusions
Road Ambulance
Network provider: actual expenses per event; non-network provider: up to ₹5,000 per hospitalization
Organ Donor Expenses
Covered up to Sum Insured for harvesting expenses; donor pre/post hospitalization and screening excluded
Reload of Sum Insured
Up to 100% of Sum Insured once per policy year for subsequent unrelated claims
AYUSH
Covered up to Sum Insured
Mental Illness Hospitalization
Covered up to Sum Insured
Obesity Treatment
Medically necessary bariatric surgery covered up to Sum Insured subject to BMI, procedure and pre-approval conditions
Home Treatment
Covered up to Sum Insured for specified treatments through eligible cashless providers
Modern Treatment
Listed modern treatment procedures covered up to Sum Insured
Premium Waiver
One policy year premium waiver on first diagnosis of listed critical illnesses for insured persons aged 18+
Chronic Management Program
Available, including day-1 access in specified circumstances
Health Check-up Program
Available once per policy year
HealthReturns
Up to 100% of premium based on program conditions
Maternity Expenses
Optional cover; maternity, newborn and vaccination benefits subject to 48-month waiting period and limits
Terms & Conditions (Simplified)
MyInsureBuddy translates
complex insurance language into plain English so you actually understand what you're signing.
Grace Period
15 days for monthly premium mode and 30 days for other premium modes.
Initial Waiting Period
30 days, not applicable for accident and subsequent renewal as stated in brochure.
Pre-existing Disease Waiting Period
36 months.
Specified Disease/Procedure Waiting Period
24 months.
Maternity Waiting Period
48 months from inception of the maternity optional cover, subject to continuous coverage.
Room Option
Up to ₹3 lakh SI: Shared Room or Single Private A/C Room; ₹4 lakh SI and above: Shared Room, Single Private A/C Room or Any Room.
Higher-Zone Co-payment
For SI ₹3 lakh and below: Zone II to I 10%; Zone III to II 15%; Zone III to I 25%. For SI ₹4 lakh and above: not applicable.
Reload
Up to 100% of SI once per policy year; not for first claim and only for subsequent unrelated illness/injury under the base reload.
Cumulative Bonus
50% of Sum Insured for each claim-free year up to 100% of Sum Insured, maximum ₹1 crore.
Maternity Event Limit
Maximum two maternity events during the lifetime of an eligible insured person.
What's Not Covered
Standard and specific exclusions under
this policy.
Specific Exclusions
Admission for nutritional and electrolyte supplements unless medically necessary for an otherwise covered claim
Hearing aids
spectacles
contact lenses
optometric therapy and multifocal lenses
Alopecia
baldness
wigs
toupees and related treatment
Medical supplies including elastic stockings
diabetic test strips and similar products
External durable medical equipment and prosthetic/corrective devices unless otherwise specifically covered
Parkinson and Alzheimer's disease
general debility or exhaustion
sleep-apnea and stress
External congenital anomalies
diseases or defects
Stem cell therapy except hematopoietic stem cells for bone marrow transplant for haematological conditions
and growth hormone therapy
Venereal and sexually transmitted diseases other than HIV/AIDS
Spinal/skeletal manipulation and muscle stimulation except specified fracture/dislocation treatment
Certain therapies including RFQMR
ECP/EECP
hyperbaric oxygen therapy
KTP laser surgeries and specified bioabsorbable devices
Radio Frequency probe procedures unless specifically approved in writing in advance
Organ Donor Limitations
Donor pre-hospitalization expenses
Donor post-hospitalization expenses
Donor screening expenses
Organ transportation or preservation expenses
Medical treatment or complications of donor consequent to harvesting
Domiciliary Exclusions
Asthma
bronchitis
tonsillitis and upper respiratory tract infections including cough
cold and influenza
Arthritis
gout and rheumatism
Chronic nephritis and nephritic syndrome
Diarrhea and dysenteries including gastroenteritis
Diabetes mellitus and insipidus
Epilepsy
Hypertension
Psychiatric or psychosomatic disorders
Pyrexia of unknown origin
Domiciliary Exclusions
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 types of dysenteries including gastroenteritis
Diabetes mellitus and insipidus
Epilepsy
Hypertension
Psychiatric or psychosomatic disorders of all kinds
Pyrexia of unknown origin
Official Policy PDF
Download the official
IRDAI-filed brochure from Aditya Birla Health Insurance Company Limited.
