No room-rent or ICU capping; expenses are payable up to the Sum Insured
2X cover is available from Day 1
Super Reload refills up to the Base Sum Insured from the second claim onwards and can be used unlimited times in a policy year
90 days pre-hospitalization and 180 days post-hospitalization coverage
All day-care treatments are covered up to the Sum Insured
Mental illness hospitalization and HIV/AIDS/STD hospitalization are covered
Bariatric surgery is covered when policy eligibility conditions are met
AYUSH
domiciliary hospitalization
Home Health Care and organ donor expenses are covered
Optional Claim Protect can cover non-medical items from all four Annexure I lists
Optional Super Credit can add 100% of Base Sum Insured per year up to 500%
subject to a maximum of Rs. 3 crore under this benefit
Optional Chronic Care can provide Day-1 inpatient coverage for 7 listed chronic conditions subject to eligibility and acceptance
HealthReturns can be earned up to 100% of eligible premium based on wellness activity and policy rules
Watch Out For
Maternity
childbirth and most pregnancy-related expenses are excluded except stated exceptions such as ectopic pregnancy
Base PED waiting period is 3 years unless the reduction add-on is selected
Super Reload does not apply to the first claim under the NXT Product Benefit Table
Claim Protect
Super Credit
Chronic Care
Chronic Management Program and Durable Equipment cover are optional and may increase premium
Home Health Care requires pre-authorization and is provided through network or empanelled providers in select cities and for select treatments
Organ donor cover excludes donor pre-hospitalization
post-hospitalization
rgan transportation and preservation expenses
Several specific treatments such as Cyber Knife
KTP Laser
RFQMR
ECP/EECP and certain bioabsorbable devices are excluded
Air ambulance benefit is not specified in the uploaded policy documents
The optional PPN discount can create a 10% co-payment when treatment is taken outside the Preferred Provider Network
Maternity is excluded
3-year base PED waiting period
Super Reload starts only from the second claim
Several strongest benefits are optional add-ons
Home Health Care has pre-authorization
provider and location restrictions
Specific treatment exclusions include Cyber Knife
KTP Laser and ECP/EECP
Optional PPN discount can introduce a 10% co-payment outside PPN
No explicit air ambulance benefit found
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 Online Claim Tracking Personal Claim Manager Domiciliary Cover Family Floater PED Reduction Modern Treatments Reset Benefit Organ Donor Teleconsultation Preventive Checkups Complex Exclusions Restore Restrictions
Cum. Bonus
100%/yr (max 500%)
Special Benefits
•Restore Benefit
•Protect Benefit
Wellness Benefits
•Health Assessment once per policy year through digital or physical mode
•subject to eligibility
•Healthy Heart Score
•Active Dayz based on walking
•calorie burn
•gym activity or fitness assessment as defined
•HealthReturns up to 100% of eligible premium under policy rules
•HealthReturns may be used for eligible renewal premium
•OPD and other specified expenses
•Activ Health mobile app supports wellness and policy management
Modern Treatments
•Uterine Artery Embolization and HIFU
•Balloon Sinuplasty
•Deep Brain Stimulation
•Immunotherapy
•Monoclonal Antibody injection
•Oral Chemotherapy
•Intra Vitreal Injections
•Vaporisation of Prostate using Green Laser or Holmium Laser
•Robotic Surgeries
•Bronchial Thermoplasty
•Hematopoietic Stem Cells for Bone Marrow Transplant for Haematological Conditions
•Stereotactic Radio Surgeries
•IONM
•Intra Operative Neuro Monitoring
Optional Add-ons
•Reduction in Specific Disease Waiting Period
•Reduction in Pre-Existing Disease Waiting Period
•Claim Protect (Non-Medical Expense Waiver)
•Room Rent Type Options
•Per Claim Deductible
•Preferred Provider Network Discount
•Critical Illness Cover
•Personal Accident Cover
•Super Credit
•Chronic Care (Day 1 In-patient Hospitalization)
•Chronic Management Program (OPD)
•Cancer Booster
•Durable Equipment Cover
•Compassionate Visit
•Second Medical Opinion for Listed Major Illness
•Annual Screening Package for Cancer Diagnosed Patients
•Annual Health Check-up
Domiciliary Exclusions
•Data Not Available
Key Benefits (Pros)
•Fewer claim settlement complaints than peers as per user-supplied Beshak data
•Fewer after-sales complaints than peers as per user-supplied Beshak data
•Higher claim settlement ratio than peers as per user-supplied Beshak data
•Lower claim repudiation ratio than peers as per user-supplied Beshak data
•Large company-wide cashless hospital network
Policy Drawbacks
•Average response time on X (Twitter)
•Average toll-free response time
Day 31 Covered Diseases
•Data Not Available
User Testimonial
Not Available★ 5.00/5
"Not Available"
Insurer Positives
•Fewer claim settlement complaints than peers as per user-supplied Beshak data
•Fewer after-sales complaints than peers as per user-supplied Beshak data
•Higher claim settlement ratio than peers as per user-supplied Beshak data
•Lower claim repudiation ratio than peers as per user-supplied Beshak data
•Large company-wide cashless hospital network
Insurer Negatives
•Average response time on X (Twitter)
•Average toll-free response time
External Beshak Ratings - Reference Only
•User-supplied ILM Rating: 4.71/5; not mapped into root score fields because auto-scoring is enabled
•User-supplied Product Benefits Rating: 4.92/5; reference only
•User-supplied Claims Experience Rating: 5/5; reference only
•User-supplied Customer Service Rating: 3.97/5; reference only
•User-supplied pricing label: Economical / cheaper than other products
Key Add-ons Available
•Reduction in Specific Disease Waiting Period: 2 years to 1 year
•Reduction in PED Waiting Period: 3 years to 2 years or 1 year
•Claim Protect: covers non-payable items from all four Annexure I lists
•Super Credit: 100% of Base Sum Insured per year up to 500%, maximum Rs. 3 crore under this benefit
•Chronic Care: Day-1 inpatient hospitalization for 7 listed chronic conditions subject to conditions
•Chronic Management Program: OPD consultations and diagnostics on cashless basis for listed chronic conditions
•Durable Equipment Cover: listed equipment with combined limit of Rs. 5 lakh or Sum Insured, whichever is lower
•Cancer Booster: up to 100% of Base Policy Sum Insured for eligible cancer hospitalization
•Compassionate Visit: up to Rs. 50,000 two-way travel fare when eligible hospitalization exceeds 10 days
•Second Medical Opinion for listed major illnesses
•Annual Screening Package for cancer-diagnosed patients: Rs. 10,000 per member per policy year
•Annual Health Check-up: listed package on cashless basis
•Critical Illness Cover and Personal Accident Cover are available as optional benefits
•Per-claim deductible options in the uploaded Product Benefit Table: Rs. 15,000 or Rs. 25,000
•PPN Discount: 10% premium discount with 10% co-payment for treatment outside the Preferred Provider Network
Eligibility and Cover Structure
•Adult entry age: minimum 18 years; no maximum age capping
•Dependent child under floater or multi-individual: 91 days to 25 years
•Individual policy minimum child entry age: 5 years
•Policy type: Individual and Family Floater
•Policy tenure: 1, 2 or 3 years
•Family floater definition: up to 2 adults and 4 children
•Base Sum Insured options in uploaded Product Benefit Table range from Rs. 2 lakh to Rs. 6 crore
•Legally married spouse or live-in partner of same or opposite sex can be covered subject to policy relationship definitions
Insurer Track Record - User Supplied
•Gross Written Premium: Rs. 5901.52 crore
•Number of policies: 4,37,37,602
•Number of claims: 28,46,356
•Claims settled in less than 30 days: 98.82%
•Overall claim complaints: 0.180%
•Incurred Claim Ratio: 78.60%
•Claim Settlement Ratio by claim count: 96.53%
•Claims paid amount ratio: 81.58%
•Claim rejection or repudiation ratio supplied by user: 2.72%
•Solvency Ratio: 166%
•Cashless hospitals: 11,000+ company-wide network
•After-sales complaints supplied by user: 0.005%
Premium and Zone Notes
•Current official advertised starting premium found for Activ One NXT: Rs. 5,630 per annum for the insurer's stated sample profile
•Premium varies by age, Sum Insured, family composition, zone, underwriting, discounts and selected add-ons
•The policy uses zone-based premium pricing
•No insurer-declared absolute maximum premium was identified, so premium_max is left null
📌 Other Custom Details
•Source: Uploaded Activ One NXT Policy Wording/Product Benefit Table and brochure; user-supplied Beshak market metrics; official Aditya Birla Activ One NXT and claims/service pages used for current starting premium and service features
•Last Updated: 2026-08-26
•Verified By: ChatGPT source cross-check
•Founded Year: 2015
•Gross Written Premium Crore: 5901.52
•Number Of Policies: 43737602
•Number Of Claims: 2846356
•Financial Year: Not Available
•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 One NXT has a strong base structure for hospitalization: no room-rent cap, 2X cover from Day 1, broad inpatient and day-care coverage, 90/180 pre-post hospitalization and unlimited Super Reload from the second claim. Its value increases materially when key add-ons such as Claim Protect, Super Credit, PED reduction and Chronic Care are selected. Buyers should pay close attention to the 3-year base PED wait, second-claim restriction on Super Reload, maternity exclusion, Home Health Care restrictions, specific treatment exclusions and any PPN co-payment condition.
Recommendation
Suitable for individuals and families who prioritize high hospitalization coverage and wellness benefits and are willing to select add-ons carefully. Before purchase, verify the exact add-ons in the Policy Schedule, local cashless hospitals, zone-based premium, underwriting terms and final premium.
Coverage & Benefits
In-patient Hospitalisation
Room rent and ICU charges covered at actuals up to the Sum Insured
2X Cover
2X cover available from Day 1
Super Reload
From 2nd claim onwards; unlimited times in a policy year, up to Base Sum Insured per claim
Pre-Hospitalisation
Covered up to 90 days before an admissible hospitalization
Post-Hospitalisation
Covered up to 180 days after discharge
Day Care Treatments
All day-care treatments covered up to the Sum Insured
Modern Treatments
Listed modern procedures and treatments covered up to the Sum Insured
Mental Illness Hospitalization
Covered up to the Sum Insured
HIV/AIDS/STD
Hospitalization treatment covered up to the Sum Insured
Obesity/Bariatric Treatment
Covered subject to obesity and bariatric eligibility conditions in the policy
Domiciliary Hospitalization
Covered at actuals up to the Sum Insured subject to domiciliary conditions
Home Health Care
Covered at actuals up to the Sum Insured subject to written prescription, pre-authorization and network or empanelled service conditions
AYUSH Treatment
Covered at actuals up to the Sum Insured
Organ Donor Expenses
Eligible donor hospitalization expenses covered up to the Sum Insured; donor pre/post and transport or preservation expenses are excluded
Claim Protect
Optional add-on covering non-medical expenses from all four Annexure I lists for eligible claims
Super Credit
Optional add-on: 100% of Base Sum Insured per year up to 500%, maximum Rs. 3 crore under the benefit
Chronic Care
Optional Day-1 inpatient cover for 7 listed chronic conditions subject to eligibility and policy conditions
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 modes. For renewal grace period, coverage is not available; for instalment premium grace periods during an active policy year, the policy wording separately states that the policy remains in force subject to its conditions.
Free Look Period
30 days from receipt of the policy document for new individual health policies; not applicable on renewals or at portability or migration. Eligible refund requests during free-look are to be processed within 7 days.
Claim Settlement
Claims other than cashless are to be settled within 15 days from submission of claim; delayed payment attracts penal interest as specified in the policy.
Moratorium Period
After 60 continuous months of coverage, policy and claims are generally not contestable for non-disclosure or misrepresentation except established fraud, subject to policy conditions and enhanced-Sum-Insured rules.
Renewal
Renewal cannot ordinarily be denied solely because claims were made in prior policy years. No individual claims-based loading applies on renewal; fresh underwriting is generally limited to an increase in Sum Insured.
Cancellation
Policyholder may cancel by giving 7 days written notice. Refund is subject to claim history, policy term and premium-payment frequency rules.
Portability
Portability to another insurer can be requested at least 30 days before and not earlier than 60 days before the renewal date, with continuity benefits subject to IRDAI rules.
Migration
Migration to another health product of the same insurer may be requested at least 30 days before renewal, with accrued continuity benefits subject to policy and IRDAI rules.
What's Not Covered
Standard and specific exclusions under
this policy.
Permanent / Standard Exclusions
Maternity and childbirth expenses
including caesarean section
except stated policy exceptions such as ectopic pregnancy
Miscarriage unless due to an accident and lawful medical termination of pregnancy
Investigation or admission primarily for diagnostic and evaluation purposes
Rest cure
custodial care
rehabilitation and respite care as defined under the exclusion
Obesity surgery not meeting the policy's medical eligibility conditions
Change-of-gender treatments
Cosmetic or plastic surgery unless medically necessary under the stated exceptions
Professional hazardous or adventure sports treatment
Treatment arising from breach of law with criminal intent
Treatment at excluded providers
except stabilization in stated life-threatening or accident situations
Alcoholism
drug or substance abuse and addictive conditions
Treatment in health hydros
nature cure clinics
spas or similar establishments as specified
Dietary supplements unless prescribed as part of an eligible hospitalization or day-care claim
Refractive error correction below the policy threshold
Unproven treatments
Sterility
infertility
assisted reproduction
IVF
ZIFT
GIFT
ICSI and gestational surrogacy
War
military involvement
nuclear
chemical
biological or radioactive events and direct participation in terrorist acts
Suicide
attempted suicide and intentional self-harm
Routine preventive care
vaccinations and immunizations except stated policy exceptions
External congenital anomalies and related diseases or defects as specified
Stem cell therapy other than hematopoietic stem cells for bone marrow transplant for haematological conditions
Growth hormone therapy and hormone replacement therapy
Dental or oral treatment except stated accident-related hospitalization conditions
External prostheses and durable devices are excluded in base coverage unless covered by an applicable optional Durable Equipment Cover
Treatment outside India unless specifically covered in the Policy Schedule
Specific Disease / Procedure Waiting Period - 24 Months
Cataract
Glaucoma
Refractive error correction
Sinusitis
Rhinitis
Tonsillitis and adenitis
Tympanitis and non-traumatic perforation
Deviated nasal septum
Otitis media
Adenoiditis
Mastoiditis
Cholesteatoma
Cysts
masses
swelling
lumps
granulomas
polyps
fibroids and benign tumours of the female genito-urinary system
Polycystic ovarian disease
Uterine prolapse
Fibroids
Breast lumps excluding malignant lumps
Dysfunctional uterine bleeding
Endometriosis
Menorrhagia
Pelvic inflammatory disease
Gout
Rheumatism and rheumatoid arthritis
Non-infective arthritis
Osteoarthritis
Osteoporosis
Prolapse of intervertebral disc
Spondylosis
spondyloarthritis and spondylopathies
Ankylosing spondylitis
Psoriatic arthritis or arthropathy
Internal derangement of knee
ligament
tendon or meniscus tear
Joint replacement surgery
Gall bladder or bile duct stones and cholecystitis
Pancreatitis
Fissure
fistula in ano
hemorrhoids
pilonidal sinus and ano-rectal or perianal abscess
Rectal prolapse
Gastric or duodenal erosions or ulcers
gastritis
duodenitis and colitis
Gastro-esophageal reflux disease
Cirrhosis
Chronic appendicitis
appendicular lump and appendicular abscess
Urinary system stones
Benign enlargement of prostate
Hernia
hydrocele
varicocele and spermatocele
Non-malignant skin tumours and specified skin diseases
Varicose veins and varicose ulcers
Specific Treatment Exclusions
Rotational Field Quantum Magnetic Resonance (RFQMR)
External Counter Pulsation (ECP)
Enhanced External Counter Pulsation (EECP)
Hyperbaric Oxygen Therapy
KTP Laser Surgeries
Cyber Knife Treatment
Femto Laser Surgeries
Bioabsorbable stents
Bioabsorbable valves
Bioabsorbable implants
Radio Frequency probe for ablation
Domiciliary Exclusions
Official Policy PDF
Download the official
IRDAI-filed brochure from Aditya Birla Health Insurance Company Limited.
