सुरक्षा	निवेश	फाइनेंस	सलाह
लाइफ इंश्योरेंस	म्यूचुअल फंड	होम फाइनेंस	मनी-फॉर-लाइफ प्लैनर
हेल्थ इंश्योरेंस	स्टॉक व सिक्योरिटीज़	व्यक्तिगत फाइनेंस	पैसों की ABC
मल्टीप्लाई वेलनेस	वेल्थ मैनेजमेंट	SME फाइनेंस
वाहन इंश्योरेंस	पोर्टफोलियो मैनेजमेंट सेवाएं	सिक्योरिटीज़ पर लोन
ट्रैवल इंश्योरेंस	पेंशन फंड	रियल एस्टेट फाइनेंस
	रियल एस्टेट इन्वेस्टमेंट

सुरक्षा	निवेश	फाइनेंस	सलाह
कॉर्पोरेट जनरल इंश्योरेंस	पोर्टफोलियो मैनेजमेंट सेवाएं	कॉर्पोरेट फाइनेंस	मनी-फॉर-लाइफ प्लैनर
ग्रुप लाइफ इंश्योरेंस	पेंशन फंड	मॉरगेज फाइनेंस	पैसों की ABC
ग्रुप हेल्थ इंश्योरेंस	स्टॉक व सिक्योरिटीज़	सिक्योरिटीज़ के खिलाफ लोन
	म्यूचुअल फंड	DCM और लोन सिंडिकेशन

सुरक्षा	निवेश	फाइनेंस	सलाह
लाइफ इंश्योरेंस एडवाइजर	म्यूचुअल फंड एडवाइजर	फाइनेंशियल एडवाइजर	एडवाइजर चुनें
हेल्थ इंश्योरेंस एडवाइजर	स्टॉक व सिक्योरिटीज़ एडवाइजर्स

आदित्य बिरला हेल्थ इंश्योरेंस कंपनी लिमिटेड

प्रोडक्ट्स
- हेल्थ और वेलनेस प्लान
  - Activ One NXT Newअधिकतम सुरक्षाHealthReturns™ + No Capping on Medical Expenses + Super Reload₹5,630*/वर्षविवरण देखें
  - Activ Fitअधिकतम सुरक्षाHealth Insurance + Health Benefits + Rewards₹6,863*/वर्षविवरण देखें
  - ऐक्टिव केयर क्लासिकपैरेंट केयर माता-पिता के लिए हेल्थ इंश्योरेंस ₹28,373*/वर्षविवरण देखें
  - Activ Assure Diamond + Super Health Top Upअधिकतम सुरक्षा 1 Crore Cover + Health insurance + Health benefit ₹10,768*/वर्षविवरण देखें
  - ऐक्टिव हेल्थ प्लेटिनम एनहांस्डअधिकतम सुरक्षाहेल्थ इंश्योरेंस + वेलनेस बेनेफिट + क्रॉनिक केयर₹8,215*/वर्षविवरण देखें
- Large payout plans
  - निजी दुर्घटनाएक्सीडेंट के लिए हेल्थ इंश्योरेंस कवर₹212*/वर्षविवरण देखें
  - कैंसर सिक्योरकैंसर के खिलाफ कवर के लिए हेल्थ इंश्योरेंस₹428*/वर्षविवरण देखें
  - गंभीर बीमारीगंभीर बीमारी के बाद आपके भविष्य की सुरक्षा₹5,463*/वर्षविवरण देखें
- कॉर्पोरेट प्लान
  - ग्रुप ऐक्टिव हेल्थComprehensive corporate health insurance planविवरण देखें
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- इंटरनेशनल कवर
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आदित्य बिरला हेल्थ इंश्योरेंस कंपनी लिमिटेड

ऐक्टिव हेल्थ प्लेटिनम एनहांस्ड

Q: What’s Covered?

In Patient Hospitalisation, Pre-hospitalization Medical Expenses, Post-hospitalization Medical Expenses, Day care Treatment, Domiciliary Hospitalization, Road Ambulance Cover, Organ Donor Expenses, Reload of Sum Insured, AYUSH In-patient Hospitalization, Mental Illness Hospitalization, Obesity Treatment, Home Care Treatment Expenses, Second E-Opinion on Critical Illness, Health Check-up program, Domestic / International Emergency Assistance Services (including Air Ambulance), OPD Cover, Chronic Management Program, HealthReturns, Health Assessment, Premium Waiver, Cumulative Bonus , Dental Consultation and Investigations , Expert Health Coach, Modern Treatment Methods and Advancement in Technologies , Hospital Cash Benefit, Personal Accident Cover, International Coverage for Major Illnesses, Critical Illness Cover

Q: Why Aditya Birla Health Insurance?

Activ Health app, Healthcare Network, Anytime, anywhere 24x7 support, Quick and easy claim settlement, Trusted care managers

Q: How do I know if a hospital is your network hospital or not?

The list of our network hospital is available on our website by clicking here. Alternatively, you can also call at our toll free no. 1800 103 1033 to get this information.

Q: Will you always accept my cashless pre-authorization request?

There can be instances where we may deny the cashless facility for hospitalization due to insufficient sum insured or insufficient information to determine admissibility or where the treatment is not covered under the policy in which case you may be required to pay for the treatment and submit the claim for reimbursement to us which will be considered subject to the policy terms & conditions.

Q: Are co-pay and deductible paid to you?

In case of cashless hospitalization, you will be required to settle all non-admissible expenses, co-payment and / or deductibles (if applicable), directly with the hospital).In case of reimbursement of claim, admissible claim amount (after adjusting for co-pay and / or deductible and / or earned HealthReturns™) will be paid by us to you.

Q: What if there is a delay in submission of claim documents?

Completed claim forms and documents must be furnished to us within the stipulated timelines. Failure to furnish such evidence within the time required shall not invalidate nor reduce any claim if you can convince us that it was not reasonably possible for you to submit / give proof within such time. If there are any deficiencies in the necessary, claim documents which are not met or partially met, we will send a maximum of 3 (three) reminders following which we will send a rejection letter or make a part-payment if we have not received the deficiency documents after 45 days from the date of the initial request for such documents.

Q: In how many days will my claims will be settled?

We shall settle a claim within 30 days of the receipt of the last necessary information and documentation as stated in the policy wordings.

Your Health Journey Partner

हेल्थ इंश्योरेंस + वेलनेस लाभ + क्रॉनिक केयर

Do you like it when life rewards you for your hard work? How would you feel if your health insurance plan rewarded you for your efforts towards staying healthy?

Presenting the Activ Health Platinum Enhanced Plan that rewards you with up to 100% HealthReturnsTM for staying active and healthy! What’s more – it partners with you on your health journey with its Chronic Management Program.

Want to know something even more extraordinary? The Activ Health Platinum Enhanced Plan also provides a Sum Insured of up to ₹2 crores along with a host of exceptional benefits.

प्रीमियम की शुरुआत

₹8,215* /annum

ब्रोशर डाउनलोड करें कोटेशन प्राप्त करें

फीचर्ड वीडियो

यह प्लान क्या है?

देखने का समय - 2 मिनट

UNIQUE FEATURES OF THE ACTIV HEALTH PLATINUM ENHANCED PLAN

100% तक HealthReturns™

Why just stop at gaining muscles and losing weight when such healthy behaviour can earn you rewards? Earn up to 100% of your premium back as HealthReturnsTM on staying active and healthy.

एक्सपर्ट हेल्थ कोच

Forget the days of spending a lot on nutritionists or fitness guides. With the Activ Health Platinum Enhanced plan, you will have a dedicated Health Coach who will give you personalized workout, nutrition plans and mental health guidance along with an expert review of medical reports.

केवल 2 क्लेम-फ्री वर्षों में डबल सम इंश्योर्ड

Wondering what happens when you stay healthy and keep paying your premium on time? We will reward you with a double sum insured, free of any additional cost, on having two successive claim-free years.

100% Sum Insured Reload

When uncertain times come knocking and you need more than your Sum Insured, this plan has got you covered. You can get 100% of your Sum Insured as a refill during the policy year.

डेंटल सलाह और जांच के लिए कवर

Forget the days of complaining about health insurance policies not providing Dental cover as we will provide you with cover for listed dental treatments on a cashless basis.

Coverage for Mental Illness Hospitalization

We understand the need for and importance of good mental health along with your physical health. With Activ Health Platinum Enhanced, we will offer you a piece of mind with cover for pre and post hospitalization expenses for mental illnesses.

UNDERSTAND ACTIV HEALTH PLATINUM ENHANCED PLAN BETTER

HealthReturns™

Did you know that by just walking 10,000 steps daily, you can earn up to 100% of your premium back in the form of HealthReturnsTM. Here’s all that you need to know:

1 Complete your complimentary Health Assessment on our Activ Health App and generate your healthy heart score

2 Start your fitness journey to earn Activ Dayz*

3 Earn HealthReturns™ based on accumulated Activ Dayz and your Healthy Heart Score

*1 Activ Dayz = Walking 10,000 steps daily or burning 300 calories a day or 30 min gym session at any of our affiliated gyms across the country.

HealthReturns™ can be used to pay your premium from the first renewal of your policy. Furthermore, they can be utilised for buying medicines or for surgical interventions which are not covered due to a waiting period or exclusions as per the policy documents.

क्रॉनिक केयर मैनेजमेंट प्रोग्राम

Illnesses can come knocking at any point in life, but we promise to be there with you during your troubles. Our Chronic Care Management Program is specially designed to keep these lifestyle conditions in check and enable an empowered life for you and your loved ones.

हेल्थ असेसमेंट

Measure your MER (Medical Examination Report) on demand including BP (Blood Pressure), BMI (Body Mass Index) HWR, Smoking Status, Blood Sugar, and Total Cholesterol with a complimentary Health Assessment feature on our Activ Health app. On getting a Healthy Hearth Score, you will become eligible for multiple rewards.

प्रीमियम में छूट

We offer a premium waiver feature which you can use to have a premium-free year.
This can be used only once in the lifetime of your policy within 365 days from the date of the accident or diagnosis of the listed 20 critical illnesses during the policy period.

क्यूमुलेटिव (संचयी) बोनस

When you don’t make any claim in a Policy Year and successfully renew the policy on a timely basis, you will be eligible to earn a Cumulative Bonus – i.e. 50% increase in your Sum Insured without any associated increase in premium (maximum up to 100% of Sum Insured or up to INR 1 Cr.)

डेंटल कंसल्टेशन व इन्वेस्टिगेशन

Forget the days when Dental Expenses were not covered under your Health Insurance Policy. With the Activ Health Platinum Enhanced Plan, you can avail of Cashless Dental Consultation and Investigation services at any of our network hospitals and empanelled service providers.
You get a cover for oral evaluation, oral prophylaxis and the cost of an x-ray. (All 3 services listed above shall be availed on a single appointment scheduled by us.)

एक्सपर्ट हेल्थ कोच

Have you also wished for a Health Coach who would provide guidance in your health journey?
Your wishes will be fulfilled with an Expert Health Coach who will study your medical history and health goals and provide personalized guidance on nutrition, fitness, medical counselling and teleconsultation with homoeopathy doctors along with mental health counselling which includes screening for mental health status and consultation sessions.

Modern Treatment Methods and Advancements in Technologies

If in future, you need to undergo a treatment which requires the use of advanced technologies, you need not worry about the cost.
The Activ Health Platinum Enhanced Plan provides cover for modern treatment methods like robotic surgeries, oral chemotherapy, stem cell therapy and more as a part of in-patient hospitalization or daycare treatments.

इन-पेशेंट हॉस्पिटलाइज़ेशन

In case of a planned treatment or an unforeseen emergency which leads to hospitalization for more than 24 hours, Aditya Birla Health Insurance will cover expenses like room rent, doctor’s fees, operation theatre expenses, medicines, drugs and other consumables under the policy as per your eligibility.
If you have a sum insured of up to INR 3 lakhs, choose from a shared room or a single private AC room. For sum insured with INR 4 lacs and above, pick any room, and we would cover the costs incurred, no questions asked.

Pre and Post Hospitalization Medical Expenses

Expenses for consultations, medicines or diagnostic tests before your hospitalization or after hospitalization will be covered for up to 60 days before hospitalization and up to 180 days after discharge from the hospital, once the hospitalization claim is accepted by us.

डे-केयर ट्रीटमेंट

Due to advancements in medical science, certain medical procedures like dialysis, may not require a 24-hour hospitalization. Such procedures will also be covered under the Activ Health Platinum Enhanced plan.

घर पर हॉस्पिटल की सुविधा

For times you consider taking medical treatment at home rather than a hospital, we would want you to receive the best quality treatment. Hence, with the Activ Health Platinum Enhanced plan, you can get covered up to Sum Insured for medical treatment at home for a period exceeding at least 3 consecutive days which would otherwise have necessitated hospitalization.

रोड एंबुलेंस कवर

We will ensure there is no roadblock to your speedy and quality treatment by covering your ambulance costs up to the sum insured at our network hospitals. In the case of non-network hospitals, you will be covered up to ₹5000 per hospitalization.

अंगदान के खर्च

All medical expenses for organ transplantation ranging from harvesting organs to transplantation surgeries will be covered as per the Sum Insured for the donor.

सम इंश्योर्ड रीलोड करने की सुविधा

Your policy will be your friend in times of need with the Binge Refill feature. If your Sum Insured, inclusive of the accumulated No Claim Bonus/Super No Claim Bonus is exhausted/insufficient for covering a claim, we will provide a 100% complete refill of the Sum Insured,once a year, for any illness/injury covered as per your policy documents.

आयुष कवर

Your Activ Health Platinum Enhanced plan will cover medical expenses incurred by you towards your in-patient hospitalization under AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy). We will cover reasonable and customary charges on a reimbursement basis.

मानसिक बीमारी के लिए हॉस्पिटलाइज़ेशन

Mental illnesses can be difficult to manage and you would want to go for the best medical care possible. We at Aditya Birla Health Insurance understand this and hence we provide cover for your medical expenses incurred by you, up to the Sum Insured, towards hospitalization, especially for any mental illnesses. Please note that the mental illness needs to be clinically significant and should not be related to intentional self-inflicted injury or attempted suicide by any means.

मोटापे का उपचार

Nowadays, the problem of obesity is commonly faced by many. We know how it can have a negative impact on your physical and mental well-being. Hence, we provide cover for medical expenses for Bariatric Surgery, if found to be medically necessary on the written advice of a medical practitioner. However, prior approval should be taken from us before the Bariatric Surgery is performed and the minimum age of the patient is 18 years.

होम केयर ट्रीटमेंट के खर्च

Avail home care treatment expenses up to the Sum Insured on a cashless basis for illnesses/injuries such as chemotherapy, dengue, gastroenteritis, hepatitis, and peritoneal dialysis. This service can only be availed through our network provider/empanelled service providers providing such facilities.

क्रिटिकल इलनेस पर दूसरा ई-ओपिनियन

You may feel the need of taking a second opinion in case of major illnesses (such as cancer, kidney failure and many more). In order to prioritize your comfort, you could get a second e-opinion through our consortium of doctors and medical experts at our network hospitals.
Please note that this facility will be available on a cashless basis only.

हेल्थ चेक-अप प्रोग्राम

Do you also skip your mandatory annual health check-ups? We suggest you keep a tab on your health with a free health check-up, once per policy year, on a cashless basis.

डोमेस्टिक/इंटरनेशनल एमरजेंसी सहायता सेवाएं (एयर एम्बुलेंस सहित)

You may travel for work or to get away from your busy lives and sometimes you may end up going to remote places where an adequate medical facility may not be available and you need medical help. In such a scenario, we will help you reach a medical facility and then take you back to your home.

OPD खर्च

During the policy period, if you incur any medical expenses for Out-Patient Consulations, we will cover them on a cashless basis through our Empanelled Service Providers in selected cities.

हॉस्पिटल कैश बेनिफिट

For each day that you get hospitalized, you will get an added benefit of a per-day allowance with us. A deductible of 24 hours shall apply under this benefit. This benefit shall be payable for a maximum limit of 30 days in a policy year and 10 days for each claim. You can choose the amount of INR 500 and INR 5000 (in multiple of INR 500) based on your needs. This is an optional cover.

पर्सनल एक्सीडेंट कवर

Unforeseen events, which come in the shape of accidents and injuries, may often cause setbacks. With personal accident cover, you can secure yourself and your family from the financial implications of severe accidents.
the payout will be as per the Sum Insured and both, accidental death and permanent total disablement are covered under personal accident cover. This is an optional cover.

प्रमुख बीमारियों के लिए इंटरनेशनल कवरेज

Sometimes, for a major illness, doctors may advise you to take treatment from a more specialized doctor in a different country. For such cases, we cover planned in-patient hospitalization expenses for 16 major illnesses. This benefit is applicable only for the Insured Person(s) who is an Indian Citizen residing in India and with a base sum insured of INR 10lacs and above.
You can get covered for a sum insured of INR 3 Cr and INR 6 Cr. This is an optional cover.

क्रिटिकल इलनेस कवर

Any critical illness poses a great risk. Along with physical and emotional stress, it can drain you financially.
With the Activ Health Platinum Enhanced plan, you get covered for up to 20 listed critical illnesses.
A short survival period of 15 days is required following the initial diagnosis of a critical illness and an initial waiting period of 90 days is applicable. This is an optional cover.

वापस जाएं

अगला

WHAT IS NOT COVERED UNDER THE POLICY?

The coverage scope of Activ Health Platinum Enhanced is quite comprehensive. But there are some things which are not covered under any policy and are called exclusions. Some of them are mentioned below:

Self-inflicted injuries

Criminal activities or acts that breach the law

Alcohol or drug abuse

War, mutiny, or nuclear threat

Cosmetic treatments or treatments that are taken to alter your aesthetic look

Unproven treatments are not the established mode of treating an illness or injury

Any mental disorder

Any congenital abnormality

Cost of hearing aids, lenses, spectacles, crutches, etc

If you want to know the complete list of exclusions, check the policy wording.

योग्यता जांचें
प्रतीक्षा अवधि

ऐक्टिव हेल्थ-प्लेटिनम एनहांस्ड के लिए प्रवेश की न्यूनतम आयु 91 दिन है.

प्रवेश पर कोई अधिकतम आयु नहीं है.

Minimum age at entry :

फैमिली फ्लोटर पॉलिसी:
91 दिन (आश्रित बच्चों के लिए) और 18 वर्ष (वयस्कों के लिए).
· 91 दिन से 5 वर्ष की आयु तक के आश्रित बच्चों को तभी कवर किया जाएगा, जब कोई वयस्क फैमिली फ्लोटर पॉलिसी के तहत कवर किया गया हो.
इंडिविजुअल पॉलिसी:
· इंडिविजुअल पॉलिसी के मामले में, प्रवेश की न्यूनतम आयु 5 वर्ष है

कवर किए गए संबंध:
क) फैमिली फ्लोटर पॉलिसी:
स्वयं और कानूनी रूप से विवाहित पति/पत्नी, 3 महीने से 25 वर्ष की आयु के 3 आश्रित बच्चे तक (प्राकृतिक या कानूनी रूप से गोद लिए गए).
b) इंडिविजुअल पॉलिसी:
स्वयं, कानूनी रूप से विवाहित पति/पत्नी (जब तक वे शादीशुदा हैं), बेटा, बेटी, माता, पिता, भाई, बहन, सास, ससुर, दादा/नाना, दादी/नानी, पोता/नवासा, पोती/नवासी, दामाद, बहू, जीजा/साली, भतीजा, भतीजी.

A. Initial Waiting Period - 30 Days (not applicable in case of accident), subsequent renewal.

B. विशेष बीमारी या प्रोसीज़र के लिए- 24 महीने

C. पहले से मौजूद बीमारी के लिए- 36 महीने

आदित्य बिरला हेल्थ इंश्योरेंस क्यों चुनें?

अधिक जानकारी के लिए, हमारे पॉलिसी डॉक्यूमेंट डाउनलोड करें

प्रोडक्ट ब्रोशर

पॉलिसी शब्दावली

डाउनलोड सेंटर पर जाएं

अपने आस-पास कैशलेस हॉस्पिटल नेटवर्क खोजें.

एमरजेंसी हो या रुटीन चेक-अप, हमने पूरे भारत में कैशलेस हॉस्पिटल्स के साथ भागीदारी की है.

मेरे आस-पास खोजें

हम आपके विश्वास को बेहतर बनाते हैं, हम पर भरोसा करने के लिए धन्यवाद!

Aditya Birla Health Insurance inspired me to maintain an active lifestyle by adopting healthy habits and rewarded me with 100% HealthReturns™. I earned it by walking 10000 steps daily and I'll use my HealthReturns™ to renew my policy.

Mr. Radhey Shyam Laddha

आदित्य बिरला हेल्थ इंश्योरेंस ने 17 किलोग्राम वज़न कम करने और बीमारी मुक्त रहने में एक साथी के रूप में मेरी मदद की है. हेल्थ रिटर्न्स मेरे पूरे परिवार को ऐक्टिव बनाए रखने और फिट रहने के लिए प्रेरित रखता है और हर व्यक्ति अपनी पसंद से एक्सरसाइज कर सकता है

श्री राजिंदर बल्हारा

कंस्ट्रक्शन बिज़नेस ओनर

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स्वस्थ रहना जीवन जीने का एक तरीका बन गया है. मैं ऐक्टिव हेल्थ ऐप का उपयोग करके खुश हूं, जो एक ही स्थान पर मुझे सभी हेल्थ सॉल्यूशन देता है.

श्री हिमांशु चतुर्वेदी

IT प्रोफेशनल और मैराथोनर

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मुझे तीन बार हॉस्पिटल में भर्ती किया गया और पूरी क्लेम प्रक्रिया 100% झंझट-मुक्त थी. विशेष रूप से मुझे पॉलिसी के समर्पित केयर मैनेजर से बहुत सहायता मिली.

श्रीमती प्रजक्ता बुधिवंत

गृहणी

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अपने बच्चे के बीमार होने पर, आप केवल बेस्ट इलाज प्राप्त करने पर ही ध्यान देंगे. पूरी क्लेम प्रोसेस हमारे केयर मैनेजर द्वारा मैनेज की गई थी और यह बहुत आसान थी, जिसकी वजह से हम आराम से अपने बेटे पर पूरा ध्यान दे सके.

गोविंद और दीपिका शुक्ला

IT सेल्स प्रोफेशनल्स

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पिछला

अगला

क्या आप इंश्योरेंस लेने के लिए तैयार हैं?

हमारे 90% सदस्यों का मानना है कि हेल्थ इंश्योरेंस से न केवल उनके समय और पैसे की बचत हुई है बल्कि उनकी जीवनशैली में भी सुधार हुआ है.

Activ Health Platinum Enhanced Insurance Plan

Our Other Health Insurance Plans

ऐक्टिव अश्योर डायमंड

हेल्थ इंश्योरेंस + स्वास्थ्य लाभ

प्रीमियम की शुरुआत

₹7,149*/वर्ष

अधिक जानें

ऐक्टिव अश्योर डायमंड + सुपर हेल्थ टॉपअप

हेल्थ इंश्योरेंस + स्वास्थ्य लाभ

प्रीमियम की शुरुआत

₹10,768*/वर्ष

अधिक जानें

ऐक्टिव सिक्योर - क्रिटिकल

20-64 गंभीर बीमारी के लिए कवरेज

प्रीमियम की शुरुआत

₹8,336*/वर्ष

अधिक जानें

Looking for more answers? Check out our Health Insuarnce FAQs

1.
मुझे कैसे पता चलेगा कि हॉस्पिटल आपका नेटवर्क हॉस्पिटल है या नहीं?

हमारे नेटवर्क हॉस्पिटल की लिस्ट हमारी वेबसाइट पर उपलब्ध है. यहां क्लिक करके. वैकल्पिक रूप से, इस जानकारी के लिए, आप हमारे टोल फ्री नंबर 1800 103 1033 पर कॉल भी कर सकते हैं.

2 Will you always accept my cashless pre-authorization request?

हम अपर्याप्त सम इंश्योर्ड के कारण हॉस्पिटलाइज़ेशन या प्रवेश निर्धारित करने के लिए अपर्याप्त जानकारी या जहां पॉलिसी के अंतर्गत बीमारी कवर नहीं की गई है, वहां कैशलेस सुविधा को अस्वीकार कर सकते हैं. इस मामले में आपको उपचार के लिए भुगतान करना होगा और रीइम्बर्समेंट के लिए हमारे पास क्लेम जमा करना होगा, जिसे पॉलिसी के नियम व शर्तों के अधीन माना जाएगा.

3 Are co-pay and deductible paid to you?

कैशलेस हॉस्पिटलाइज़ेशन के मामले में, आपको सभी गैर-स्वीकार्य खर्चों, को-पेमेंट और/या कटौती (अगर लागू हो) को सीधे हॉस्पिटल के साथ सेटल करना होगा.

क्लेम के रीइम्बर्समेंट के मामले में, स्वीकार्य क्लेम राशि (को-पेमेंट और/या कटौती और/या अर्जित HealthReturns™ के लिए एडजस्ट करने के बाद) का भुगतान हमारे द्वारा किया जाएगा.

4 What if there is a delay in submission of claim documents?

क्लेम फॉर्म और डॉक्यूमेंट हमारे पास निर्धारित समय-सीमा के भीतर भेजा जाना चाहिए. समय-सीमा के तहत प्रमाण जमा न करने / प्रमाण न देने के पीछे उचित कारण न होने पर इस तरह के साक्ष्य को अमान्य ठहराया जाएगा और किसी भी क्लेम को कम नहीं किया जाएगा.

अगर आवश्यक क्लेम डॉक्यूमेंट में कोई कमी है, जो पूरे नहीं हैं या आंशिक रूप से पूरे हैं, तो हम अधिकतम 3 (तीन) रिमाइंडर भेजेंगे, जिसके बाद हम रिजेक्शन लेटर भेजेंगे या पार्ट-पेमेंट करेंगे. ऐसा तब होगा जब हमें ऐसे डॉक्यूमेंट के लिए, शुरुआती अनुरोध की तिथि से 45 दिनों के बाद पूरे डॉक्यूमेंट प्राप्त नहीं होते हैं.