Activ One (MAX) - Policy Details

Quick Information

Basic Details

Entry Age 18 to 65 years

Coverage Amount ₹200,000 to ₹60,000,000

Claim Settlement 96.53% (FY 2025-26)

Claim Repudiation 0.00%

Incurred Claim Ratio 78.60%

Claims Paid Amount 81.58%

Best For

Individuals and families seeking high Sum Insured options

no room-rent cap

unlimited refill from the second claim

strong cumulative Super Credit

consumables cover

mental illness/HIV/bariatric coverage and optional Day-1 chronic disease hospitalization.

What Works Well

No room rent limit; room rent and ICU are payable at actuals up to Sum Insured

All Day Care Treatments covered

90 days pre-hospitalization and 180 days post-hospitalization

Claim Protect covers non-payable items from all four Annexure I lists

Unlimited Super Reload from the second claim of Policy Life

Super Credit increases by 100% of Base Sum Insured every year irrespective of claims

Watch Out For

Base Super Reload does not apply to the first claim in the life of the policy

PED waiting period is 3 years unless an eligible optional reduction/Chronic Care benefit applies

Specific disease/procedure waiting period is 2 years unless reduction option is selected

Maternity expenses are excluded

Home Health Care requires pre-authorization and is not available on reimbursement basis

No monthly premium payment option according to supplied market review

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

⚡ At a Glance

Cashless Available No Room Rent Limit Domiciliary Cover Family Floater PED Reduction Modern Treatments Reset Benefit Organ Donor Teleconsultation Preventive Checkups Restore Restrictions

Cum. Bonus

100%/yr (max 500%)

Special Benefits

•Restore Benefit

Wellness Benefits

•HealthReturns up to 100% of premium

•Health Assessment

•Healthy Heart Score

•Active Dayz

•Annual Health Check-up

Modern Treatments

•Uterine Artery Embolization and HIFU

•Balloon Sinuplasty

•Deep Brain Stimulation

•Immunotherapy

•Monoclonal Antibody injection

•Oral Chemotherapy

Optional Add-ons

•Reduction in Specific Disease Waiting Period

•Reduction in Pre-Existing Disease Waiting Period

•Room Rent Type Options

•Per Claim Deductible

•Preferred Provider Network Discount

•Critical Illness Cover

Domiciliary Exclusions

•Data Not Available

Key Benefits (Pros)

•Fewer claim settlement complaints

•Fewer after-sales complaints

•Higher claim settlement ratio than many competing insurers

•Lower claim rejection and repudiation ratio than many competing insurers

Policy Drawbacks

•Response time on X (Twitter) is relatively average

Day 31 Covered Diseases

•Diabetes Type 1 / Type 2

•Hypertension

•Asthma

•Hyperlipidemia

•Chronic Obstructive Pulmonary Disease (COPD)

•Obesity

Insurer Positives

•Fewer claim settlement complaints

•Fewer after-sales complaints

•Higher claim settlement ratio than many competing insurers

•Lower claim rejection and repudiation ratio than many competing insurers

Insurer Negatives

•Response time on X (Twitter) is relatively average

Eligibility and Family

•Adult entry age: minimum 18 years; no maximum age capping

•Individual policy minimum entry age: 5 years

•Dependent child: 91 days to 25 years

•Policy type: Individual and Floater

•Family size: up to 2 adults and 4 children

•Live-in partner of same or opposite sex is eligible as defined in the policy

Day-1 Chronic Care Conditions

•Diabetes Type 1 / Type 2

•Hypertension

•Asthma

•Hyperlipidemia

•Chronic Obstructive Pulmonary Disease (COPD)

•Obesity

Optional Covers

•Reduction in Specific Disease Waiting Period: 2 years to 1 year

•Reduction in PED Waiting Period: 3 years to 2 years or 1 year

•Room Rent Type: Single Private Room or Shared Accommodation

•Per Claim Deductible: ₹15,000 or ₹25,000

•Preferred Provider Network Discount: 10%

•Critical Illness Cover

Wellness

•Health Assessment

•Healthy Heart Score

•Active Dayz

•HealthReturns up to 100% of premium

•Cashless annual health check-up

Market Premium Verification

•Current Aditya Birla Health Insurance website lists Activ One MAX starting premium at ₹6,177 per annum.

•The insurer website notes starting plan prices are indicative and depend on customer profile / Sum Insured.

•Highest directly verified published Activ One MAX Zone 1 standard premium found: ₹3,67,080 excluding GST.

•₹3,67,080 corresponds to a published Zone 1 rate-chart case for 2 Adults + 4 Children, age band 75+, Sum Insured ₹2 Crore.

•The current Activ One MAX product allows Base Sum Insured up to ₹6 Crore, so ₹3,67,080 should be treated as the highest verified published premium sample found, not an insurer-declared absolute premium ceiling.

•Actual premium may be higher or lower depending on age, family composition, Sum Insured, zone, optional covers, discounts, health declarations and underwriting loading.

📌 Other Custom Details

•Source: Uploaded Activ One MAX Policy Wording/Product Benefit Table and uploaded Activ One brochure; insurer/claims/ILM metrics supplied by the user in the current message. Policy wording and Product Benefit Table were given priority where marketing information differed. Premium update: current Aditya Birla Health Insurance Activ One MAX webpage used for premium_min ₹6,177; published Activ One MAX Zone 1 rate chart used for premium_max ₹3,67,080 as the highest directly verified standard-rate sample found.

•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: 30

•Is Editors Choice: 1

🤖 AI Policy Analysis

Summary

Activ One MAX is a feature-rich plan with Base Sum Insured options from ₹2 lakh to ₹6 crore, no base room-rent cap, all day-care treatment, Claim Protect for non-medical items, mental illness/HIV/bariatric coverage, 90/180-day pre-post hospitalization, unlimited Super Reload from the second claim of policy life and Super Credit that can rise to 500% subject to a ₹3 crore cap under the benefit. Current market pricing starts around ₹6,177/year on the insurer website. For database validation, premium_max is filled as ₹3,67,080, the highest directly verified published MAX Zone 1 standard premium sample found, rather than claiming it is the product's absolute maximum.

Recommendation

Strong shortlist candidate for buyers prioritising broad hospitalization coverage, high Sum Insured, consumables cover and restoration. The most important checks before purchase are the 3-year PED waiting period, first-claim restriction on Super Reload, any selected PPN co-pay/deductible, and whether optional Day-1 Chronic Care is actually shown as active in the final policy schedule. Always generate the final insurer quote for the exact age, family size, city/zone, Sum Insured and add-ons; do not use premium_max as a guaranteed quote ceiling.

Coverage & Benefits

In-patient Hospitalisation

Actuals up to Sum Insured

Room Rent

Actuals up to Sum Insured; no base room-rent cap

ICU Charges

Actuals up to Sum Insured

Road Ambulance

Actuals up to Sum Insured per hospitalization

Day Care Treatments

All Day Care Treatments; actuals up to Sum Insured

Modern Procedures / Treatments

Listed procedures covered up to Sum Insured

HIV / AIDS and STD Cover

Actuals up to Sum Insured

Mental Illness Hospitalization

Actuals up to Sum Insured

Obesity Treatment

Bariatric surgery covered subject to policy conditions

Pre-Hospitalization

Up to Sum Insured for 90 days

Post-Hospitalization

Up to Sum Insured for 180 days

Claim Protect

Non-payable items under all four Annexure I lists covered for admissible claims

Domiciliary Hospitalization

Actuals up to Sum Insured; minimum 3 consecutive days and policy conditions apply

Home Health Care

Actuals up to Sum Insured; pre-authorization required and reimbursement not available

AYUSH Treatment

Actuals up to Sum Insured

Organ Donor Expenses

Actuals up to Sum Insured for eligible harvesting expenses

Annual Health Check-up

Listed check-up available once every policy year

Super Reload

100% of Base Sum Insured, unlimited times from the second claim of Policy Life

Super Credit

100% of Base Sum Insured per year up to 500%, maximum ₹3 crore under the benefit

What's Not Covered

Standard and specific exclusions under this policy.

Maternity

Medical treatment expenses traceable to childbirth

including complicated delivery and caesarean section

except ectopic pregnancy

Miscarriage unless due to accident and lawful medical termination of pregnancy

Specific Medical Exclusions

Physical

psychiatric or psychological examinations/testing not otherwise covered

Admission for nutritional and electrolyte supplements unless medically necessary for a covered claim

Stem cell therapy except hematopoietic stem cells for bone marrow transplant for haematological conditions

and growth hormone or hormone replacement therapy

Hearing aids

spectacles/contact lenses

wigs/toupees and specified external durable equipment unless otherwise covered

RFQMR

ECP/EECP

Hyperbaric Oxygen Therapy

KTP Laser

Cyber Knife

Femto Laser and specified bioabsorbable devices

Use of Radio Frequency probe for ablation

Organ Donor Limitations

Donor pre-hospitalization expenses

Donor post-hospitalization expenses

Organ transportation or preservation

Other medical expenses or hospitalization of donor consequent to harvesting

Domiciliary Exclusions

Official Policy PDF

Download the official IRDAI-filed brochure from Aditya Birla Health Insurance Company Limited.

Download (0.6 MB)

MyInsureBuddy Score

Recommended

Among top 20% in category

Claim Settlement 88%

Coverage Quality 82%

Policy Terms 86%

Value for Money 55%

Network & Features 76%

Product Benefits 4%

Hidden Risk Safety 0%

Rider Strength NULL

Flexibility NULL

Risk Level Very Low Risk (2/10)

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Activ One (MAX) ⭐ Editor's Choice

Quick Information

What Works Well

Watch Out For

Hidden Clauses - Read Very Carefully!

⚡ At a Glance

Special Benefits

Wellness Benefits

Modern Treatments

Optional Add-ons

Domiciliary Exclusions

Key Benefits (Pros)

Policy Drawbacks

Day 31 Covered Diseases

Insurer Positives

Insurer Negatives

Eligibility and Family

Day-1 Chronic Care Conditions

Optional Covers

Wellness

Market Premium Verification

📌 Other Custom Details

🤖 AI Policy Analysis

Coverage & Benefits

Terms & Conditions (Simplified)

Grace Period

Initial Waiting Period

Pre-existing Disease Waiting Period

Specific Disease/Procedure Waiting Period

PED Waiting Reduction

Specific Waiting Reduction

Super Reload

Super Credit

PPN Discount

Policy Tenure

What's Not Covered

Official Policy PDF

MyInsureBuddy Score

Quick Actions

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