Aditya Birla Activ Health Platinum Essential vs Oriental Insurance Happy Family Floater Policy Diamond
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Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Activ Health Platinum Essential is sold by Aditya Birla and Happy Family Floater Policy Diamond is sold by Oriental Insurance. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products have massive differences in their core structure. Activ Health Platinum Essential is specifically designed for senior citizens. However, Happy Family Floater Policy Diamond is quite basic. It offers little protection and it’s a generic policy that anybody could pick off the shelf. So in many ways, you’re comparing apples and oranges here.
And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?
That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.
Let’s start with Activ Health Platinum Essential. The product comes from Aditya Birla’s stable:
The company only began operations in the year 2016 as a subsidiary of Aditya Birla Capital Ltd., which in turn happens to be a joint venture between the famed Aditya Birla Group and MMI Holdings (South Africa).
While the company boasts a claim settlement ratio of 95% along with a network of more than 11,000+ hospitals, do remember they’ve only been in the market for a few years now. So they don’t have an extensive track record.
Happy Family Floater Policy Diamond meanwhile comes from Oriental Insurance’s stable:
Oriental Insurance is a government-owned company that offers health, vehicle, business, and farmer insurance. The company is a fully-owned component of the Oriental Government Security Life Assurance Company Ltd.
Now because it is a government-owned insurance firm, you can’t expect operational efficiencies across the board. Although, the company does boast a fairly high claim settlement ratio with over 3,264 network hospitals across the country.
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Compare Insurances Insurance Parameters Recommended Not Recommended | Activ Health Platinum Essential | Happy Family Floater Policy Diamond |
|---|---|---|
| Network hospitals | 11,000+ | 3,264 |
| Claim settlement ratio (avg. of last 3 years) | 95% | 96% |
| Co-payment | 20% | No |
| Room rent | Any Room | Any room (with limits) |
| Disease sub-limit | Yes | No |
| Pre existing diseases waiting | - | 4 years |
| Pre/Post hospitalization | 30/60 days | 30/60 days |
| No claim bonus | 10% per year (up to 100%) | |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | ||
| Health check-up | Once every year | |
| Maternity | Available (2.5% of sum insured) | |
| Out Patient Department | ||
| Day care |
Feature Comparison
Co payment
With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. However in this case Activ Health Platinum Essential imposes a mandatory co-payment of 20% whereas Happy Family Floater Policy Diamond doesn’t impose a mandatory co-payment clause.
Sub limits
Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, Activ Health Platinum Essential imposes disease-wise sub-limits on Angioplasty, Knee or hip replacement, Cataract, Cholecystectomy whereas Happy Family Floater Policy Diamond doesn’t impose a disease wise sub-limit.
Waiting periods for pre-existing diseases
If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. In this case, Activ Health Platinum Essential imposes a waiting period of null years on pre-existing diseases while Happy Family Floater Policy Diamond extends a waiting period of 4 years on existing conditions.
Pre and post Hospitalization expenses
Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Activ Health Platinum Essential covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Happy Family Floater Policy Diamond covers expenses incurred 30 days before hospitalization and expenses incurred 60 after hospitalization, although there may be different sub-limits
No claim bonus
Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. In this case, however, Activ Health Platinum Essential offers a no-claim bonus whereas Happy Family Floater Policy Diamond doesn’t offer a no-claim bonus.
Domiciliary
Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, Activ Health Platinum Essential offers domiciliary cover. And Happy Family Floater Policy Diamond also coves domiciliary expenses.
Ayush treatments
Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, Activ Health Platinum Essential covers Ayush procedures and Happy Family Floater Policy Diamond also extends coverage for Ayush treatments.
Maternity benefits
If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, however, Activ Health Platinum Essential doesn’t offer protection for maternity-related hospitalizations whereas Happy Family Floater Policy Diamond offers maternity cover.
Out Patient Department (OPD)
Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, neither Activ Health Platinum Essential extends coverage for outpatient consultations, nor does Happy Family Floater Policy Diamond.
Final Conclusion
Since this isn’t a fair comparison, to begin with, we will only tell you this much. If you want something that’s affordable, you could go for Happy Family Floater Policy Diamond. However, if you are specifically looking to buy a policy for senior citizens, then it’s a no brainer, Activ Health Platinum Essential is your go-to option.
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