- Policy Name
- Aditya Birla Health Insurance – Activ One NXT (policy bazar)
- Company Name
- Aditya Birla Health Insurance – Activ One NXT, policy bazar
- Customer Care Number
- 1800-270-7000
- Loss Amount
- 335000
- Ratings
- Opposite Party Address
- Registered & Head Office:
Aditya Birla Health Insurance Co. Ltd.
Aditya Birla Centre, S. K. Ahire Marg, Worli, Mumbai – 400 030, Maharashtra, India., Regional Office (Chhattisgarh – for correspondence):
Aditya Birla Health Insurance Co. Ltd.
2nd Floor, Shyam Plaza, Near Pandri Bus Stand, Raipur – 492 004, Chhattisgarh.
Body / Description (to paste in online complaint form)
Complainant: Nikesh Kumar Manhar (on behalf of Miss Khushi Rani, 20 yrs)
Policy: Aditya Birla Health Insurance – Activ One NXT
Claim ID: 1122585258254 Member ID: PT25863390
Contact: 7828173845 Email: nikesh.manhar@gmail.com
Address: Bilaspur, Chhattisgarh
Summary of Grievance
I am filing this complaint against Aditya Birla Health Insurance Co. Ltd. and PolicyBazaar Insurance Web Aggregator for harassment, procedural negligence, and wrongful claim repudiation.
Policy ported from Star Health → Aditya Birla on 23-May-2025 via PolicyBazaar.
Minor RTA on 25-Apr-2025 (no fracture, no diagnosis, no hospitalization).
AVN diagnosis in June 2025 → Surgery at Yashoda Hospital (27–29 Jul 2025).
Claim ₹ 3,35,285 submitted 25-Aug 2025.
SMS received: “Since the claim is payable, ₹ 552 has been deducted forthe premium.”
After 90 days of silence, the claim was rejected on 12-Nov-2025 under Clause E.1.14(a) – pre-policy accident.
The accident produced no medical diagnosis and AVN was detected after policy inception.
Both Aditya Birla and PolicyBazaar repeated only automated “under process” responses, denied access to the medical review team, and gave no written reasoning for repudiation.
This constitutes a deficiency in service and unfair trade practice, violating:
IRDAI Reg. 17(1) – non-disclosure cannot justify rejection without proven fraud,
Insurance Act § 45 – misrepresentation must be intentional and material,
Consumer Protection Act § 2(1)(g) – misleading communication = service deficiency.
Reliefs Requested
Immediate reversal of repudiation and settlement of ₹ 3,35,285 + pharmacy bills.
Written medical review report and apology from Aditya Birla.
Inquiry into PolicyBazaar’s negligence during porting.
Compensation for mental agony and financial loss.
Confirmation that Clause E.1.14(a) will not be misused for post-policy conditions.
Complainant: Nikesh Kumar Manhar (on behalf of Miss Khushi Rani, 20 yrs)
Policy: Aditya Birla Health Insurance – Activ One NXT
Claim ID: 1122585258254 Member ID: PT25863390
Contact: 7828173845 Email: nikesh.manhar@gmail.com
Address: Bilaspur, Chhattisgarh
Summary of Grievance
I am filing this complaint against Aditya Birla Health Insurance Co. Ltd. and PolicyBazaar Insurance Web Aggregator for harassment, procedural negligence, and wrongful claim repudiation.
Policy ported from Star Health → Aditya Birla on 23-May-2025 via PolicyBazaar.
Minor RTA on 25-Apr-2025 (no fracture, no diagnosis, no hospitalization).
AVN diagnosis in June 2025 → Surgery at Yashoda Hospital (27–29 Jul 2025).
Claim ₹ 3,35,285 submitted 25-Aug 2025.
SMS received: “Since the claim is payable, ₹ 552 has been deducted forthe premium.”
After 90 days of silence, the claim was rejected on 12-Nov-2025 under Clause E.1.14(a) – pre-policy accident.
The accident produced no medical diagnosis and AVN was detected after policy inception.
Both Aditya Birla and PolicyBazaar repeated only automated “under process” responses, denied access to the medical review team, and gave no written reasoning for repudiation.
This constitutes a deficiency in service and unfair trade practice, violating:
IRDAI Reg. 17(1) – non-disclosure cannot justify rejection without proven fraud,
Insurance Act § 45 – misrepresentation must be intentional and material,
Consumer Protection Act § 2(1)(g) – misleading communication = service deficiency.
Reliefs Requested
Immediate reversal of repudiation and settlement of ₹ 3,35,285 + pharmacy bills.
Written medical review report and apology from Aditya Birla.
Inquiry into PolicyBazaar’s negligence during porting.
Compensation for mental agony and financial loss.
Confirmation that Clause E.1.14(a) will not be misused for post-policy conditions.