Aditya Birla Health Insurance Co. Limited

1. About the Company

Aditya Birla Health Insurance Co. Limited (ABHI) is a jointventure between the Aditya Birla Group, one of Indias leading diversified conglomerates, and Global Health Insurance Services Ltd.. Established in 2020, the company leverages the Birla brands reputation for trust and the global insurers underwriting expertise to deliver comprehensive healthinsurance solutions to individuals, families and corporates across India.

ABHIs mission is simple: make quality healthcare accessible, affordable and hasslefree. The insurer operates under a customerfirst philosophy, designing plans that combine extensive coverage with innovative services such as wellness rewards, telemedicine, and cashless hospitalization.

2. Core Insurance Products

Individual & Family Floater Plans

These plans cover a wide range of medical expenses, from inpatient hospitalization to daycare procedures, pre and posthospitalization costs, and even alternative therapies like AYUSH. The family floater option allows multiple members to share a single sum insured, reducing premiums while ensuring comprehensive protection.

Critical Illness Policies

ABHI offers standalone critical illness cover for 35+ major diseases. The benefit is paid directly to the policyholder on diagnosis, giving financial freedom to manage treatment costs, travel, and related expenses.

Senior Citizens Health Plans

Specialised coverage for individuals aged 60+, featuring higher roomrent caps, more frequent health checkups, and added benefits for chronic conditions.

Corporate Health Solutions

Tailored group policies for small, medium and large enterprises. Benefits include employee wellness programmes, optional addons like maternity cover, and streamlined claim administration for HR.

3. Key Features & Benefits

• Cashless Hospitalisation: Over 10,000 network hospitals across India enable direct settlement without outofpocket payment.
• NoClaim Bonus (NCB): Up to 50% increase in sum insured for every claimfree year, capped at three years.
• Wellness Rewards: Points earned for healthcheck ups, gym memberships and stepcount goals can be redeemed against premiums.
• Preexisting Disease Waiting Period: 24 months (12 months for senior citizens) with a provision for partial coverage after 12 months.
• Ayush & Home Care: Coverage for approved AYUSH treatments and home care services, a rare offering in the Indian market.
• Instant Renewals & Portable Coverage: Policies can be renewed online; coverage follows the insured across states.

4. Claims Process

ABHI has streamlined the claim journey into three clear steps:

1. Notification: Call the 247 claim helpline or submit a claim through the mobile app within 48 hours of discharge.
2. Documentation: Upload discharge summary, invoices, doctors prescription and any other required documents. The portal accepts PDFs, JPEGs and scanned copies.
3. Settlement: For cashless claims, the amount is settled directly with the hospital. For reimbursement claims, the settled amount is transferred to the policyholders bank account within 57 working days after approval.

The insurer claims an average turnaround time of 3 days for cashless settlements and 6 days for reimbursements, positioning it among the faster claim processors in the sector.

5. Hospital & Doctor Network

ABHIs network includes premier hospitals such as Apollo, Fortis, Max Healthcare, and Narayana Health, along with a wide range of regional hospitals. The insurer also partners with accredited diagnostic labs and specialist doctors to ensure that policyholders receive quality care irrespective of geography.

Members can verify network status instantly on the website or mobile app by entering the hospital name or PIN code.

6. Digital Experience

Technology is a cornerstone of ABHIs offering. The responsive website and native iOS/Android apps provide:

• Online quote generation and policy purchase.
• Digital policy issuance with QRcode for easy verification.
• Realtime claim tracking.
• Healthwallet where wellness points, medical records and prescriptions are stored securely.
• Telemedicine consultations with partner doctors 15 minutes free per policy per year.

7. Customer Service & Support

The company operates a 247 tollfree helpline (18004255000) and an email support centre. A dedicated Relationship Manager is assigned to corporate clients, while individual policyholders can chat with AIenabled bots for quick FAQs and claim status updates.

ABHI also conducts periodic health camps and webinars on preventive care, reinforcing its focus on longterm wellness.

8. Financial Strength & Ratings

Backed by the Indian conglomerates robust balance sheet and the global insurers reinsurance capacity, ABHI has consistently posted a growthoriented premium trajectory since inception. The insurer holds an A+ rating from the Insurance Regulatory and Development Authority of India (IRDAI) and a Stable outlook from independent rating agencies, indicating sound solvency and claimpaying ability.

9. Future Outlook

Looking ahead, ABHI aims to:

• Expand its network to tier2 and tier3 cities, targeting underserved demographics.
• Introduce AIdriven underwriting for quicker policy issuance.
• Launch a microinsurance product that bundles health cover with lifestyle benefits for gigworkers.
• Strengthen collaborations with pharmaceutical companies for discounted medicines.

These initiatives reflect a commitment to blend traditional insurance reliability with modern, customercentric innovation.

10. How to Reach Us

Head Office: 44, Zircon Plaza, 4th Floor, Nariman Point, Mumbai 400021, India

Customer Care: 18004255000 (tollfree, 247)

Email: care@adityabirlahealth.com

Website: www.adityabirlahealth.com