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About Niva Bupa Health Insurance

With a family of over 1 crore customers,Niva Bupa Health Insurance Company Limited,earlier known as Max Bupa Health Insurance Company Limited,is a well-known health insurance company in India.

Niva Bupa is a collaboration between Fettle Tone LLP,which is a leading private equity firm in India,and the UK-based Bupa,which has been a prominent expert in providing healthcare services for over 60 years.

With the aim of offering easy access to the best healthcare services, Niva Bupa Health Insurance also provides its knowledge and expertise to all its customers. A network of over 10,000 hospitals all across the country allows Niva Bupa, to facilitate quick and convenient claim settlements within 30 minutes.

Niva Bupa Claim Settlement Ratio

91.6%

Niva Bupa

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. Niva Bupa has a claim settlement ratio of 91.6%, as compared to the industry average of 94.21%.

Niva Bupa Health Insurance Plans Overview

Niva Bupa health insurance offers 13 health insurance plans. The premium of these plans starts from Rs. 1039/yr. The sum insured ranges from Rs. 50,000 - 5 Cr. Details of the comprehensive coverage provided by the following 13 Niva Bupa health insurance plans are listed below:

Max Bupa Accident Care Plan

Starting Premium- ₹ 6,444/yr

This personal accident plan covers a host of benefits along with death and disability so that you can enjoy a comprehensive scope of coverage.The plan’s salient features are as follows

  1. In case of accidental death and permanent disability, the plan also pays a lump sum benefit towards your child’s education.This is called Child Education Benefit
  2. Funeral expenses are also covered under the plan in case of accidental deaths
  3. Temporary total disability coverage can be availed by paying an additional premium. This coverage pays a portion of the sum insured weekly in case of temporary disablements
  4. Accidental hospitalisation cover can also be chosen at an additional premium. This cover would pay the costs incurred on accidental hospitalisation
  5. Coverage under the plan is allowed not only in India but throughout the world

Eligible Age

2 years - 65 years

PED Waiting Period

NA

Coverage

5 Lakh - 5 Cr

NCB

NA

Max Bupa Arogya Sanjeevani Policy

Starting Premium- ₹ 3,000/yr

Arogya Sanjeevani policy launched by Max Bupa Health Insurance is a standard policy derived under the guidelines of IRDAI.This is a very efficient policy with affordable rates that comes with numerous benefits and quality service provided by Max Bupa Health Insurance.Arogya Sanjeevani policy offers financial coverage over accidents, daycare treatments, alternative treatments, and much more to protect you and your family from any kind of economic crisis at the time of an emergency

Main features of Max Bupa Arogya Sanjeevani policy:

  1. This policy is offered in two different types of plans, the Individual and the Family Floater plan
  2. Under the Family Floater plan, you can insure yourself along with your spouse, parents, parents-in-law, and their dependent children
  3. Expenses incurred in the in-patient’s hospitalization:* The charges incurred in room rent, nursing, and boarding as specified by the hospital shall be covered up to 2% of the sum insured or to a maximum of INR 5,000 per day. * The charges of the Intensive Care Unit (ICU) shall be covered up to 5% of the sum insured or to a maximum of INR 10,000 per day
  4. Pre-and-post hospitalization charges are covered for up to 30 days and 60 days respectively
  5. This policy offers coverage over alternative AYUSH treatments for the insured person
  6. Expenses incurred in specific modern treatments of the insured person up to 50% of the sum insured is included in the policy
  7. Max Bupa Arogya Sanjeevani policy provides medical expenses for cataract treatment for up to 25% or INR 40,000 per eye for its policyholders
  8. This policy has a feature of mandatory co-payment of 5% of the claim amount
  9. A no-claim bonus of 5% on the sum insured is awarded for every claim-free year
  10. Under section 80D of the Income Tax Act, the policyholders can avail tax benefits if investing in the policy
  11. Max Bupa Health Insurance promises direct claim settlement and cashless facility at all network hospitals for its clients

Eligible Age

90 days - 65 years

PED Waiting Period

4 years

Coverage

50,000 - 10 Lakh

NCB

5% increase in cover;max upto 50%

Max Bupa Corona Kavach Policy

Starting Premium- ₹ 1,039/yr

With the rising numbers of COVID-19 cases across the nation, the requirement of a good health insurance policy is a must-have to stand against this deadly virus. Max Bupa Corona Kavach policy launched by Max Bupa Health Insurance is one such policy that offers you numerous benefits at affordable rates so that you are never alone in your battle against COVID-19.

The exclusive features of this policy include in-patient hospitalization coverage, pre, and post-hospitalization expenses, and coverage for different treatments for the insured members. Main features of the Max Bupa Corona Kavach Policy:

  1. The policy offers two types of plans, the Individual and Family Floater policy
  2. The policy provides hospitalization coverage for the treatment of COVID-19 up to INR 5,00,000: * Room rent, nursing, and boarding charges are to be borne by the company. * Expenses incurred due to ICU and ICCU are included in the policy. * Fee payment of medical practitioners/specialists/consultants shall be done by the company. * Charges for road ambulance shall be covered up to INR 2000
  3. Pre-and-post hospitalization expenses for the insured members are covered for up to 15 days and 30 days respectively
  4. On being diagnosed positive with COVID-19 the insured person can avail home care treatments, the expenses of which shall be borne by the company
  5. Expenses incurred in the treatment of COVID-19 with AYUSH procedures shall be borne by the company
  6. Max Bupa Corona Kavach policy includes the coverage of medical expenses incurred due to the treatments of comorbid conditions of the insured person
  7. The policy provides an optional cover of hospital daily cash of 0.5% of the sum insured for each day of hospitalization of the insured person
  8. Max Bupa Health Insurance offers quick,cashless claim-settlement for its clients making this policy a great option

Eligible Age

1 day - 65 years

PED Waiting Period

NA

Coverage

50,000 - 5 Lakh

NCB

NA

Niva Bupa Top-up Plans

Niva Bupa health insurance provides 1 top-up plan. The premium of these top-up plans start from Rs. 3,762/yr. The sum insured ranges from Rs. 2 Lakh - 95 Lakh. Niva Bupa top-up plans provide enhanced coverage and added protection for your well-being. Explore the details of each Niva Bupa top-up insurance policy below:

Max Bupa Health Recharge Plan

Starting Premium- ₹ 3,762/yr

This is an indemnity health plan which covers the actual costs of hospitalisation.You also get the option to enhance the scope of the plan by adding optional coverage benefits

  1. Free e-consultations are allowed under the plan
  2. There are four optional covers under the plan which can be chosen at additional premiums
  3. You can buy medicines and diagnostic tests through the company’s application right from your Smartphone
  4. Premium discounts can be enjoyed by opting for long term coverage

Eligible Age

91 days - 65 years

PED Waiting Period

3 years

Coverage

2 Lakh - 95 Lakh

NCB

5% increase in cover;max upto 50%

Top Features From Niva Bupa Health Plans

Let us take a look at some of the features and benefits of Niva Bupa Health Insurance that make the company one of the best health insurance companies in India.

  1. Easy to apply: Niva Bupa offers digital solutions that make all healthcare procedures simple and quick- from application to claim submission.
  2. Claims: Super no claim bonuses for staying fit and not filing a claim in one entire policy year. An in-house claims team eliminates the hassle and delays that are often seen with TPAs (Third Party Administrators).
  3. High coverage: Depending on your healthcare needs,you can opt for a plan with a sum insured as high as ₹3 crores.
  4. Low cost: Get coverage for yourself and your loved ones with affordable plans. Enjoy up to 30% discounts when you renew your health plan.
  5. Flexibilities: Most Niva Bupa Health Insurance plans have no caps on the room rent. You also have the option to carry forward the sum insured. Give your spouse a jump start on the waiting period with the future-ready feature.
  6. No Pre-policy health check-up: Several plans allow you to enjoy the convenience of no pre-policy medical tests for quick issuance only on a declaration of good health.
  7. Maternity Benefits: Unlike many other plans,Niva Bupa offers maternity coverage beyond normal childbirth. You can avail coverage for C-section,IVF,adoption as well as surrogacy.
  8. International coverage: Some Niva Bupa Health Insurance plans also allow international coverage.
  9. Trusted brand: A customer base of 1 crore shows Niva Bupa's reliability and trustworthiness.

Exclusions Across Niva Bupa Health Plans

Given below are some of the common exclusions in most Niva Bupa Health Insurance plans. Please keep in mind that the exclusion list may vary depending on the selected plan.

  1. Waiting period: Hospitalisation during the waiting period is not covered. Only accidental injuries are covered from day 1. Certain illnesses and procedures come with a waiting period of 2 to 4 years. Pre-existing illnesses come with a specified waiting period. Coverage is allowed only when the waiting period is over.
  2. HIV and STD: HIV, AIDS or any other variant of STD (sexually transmitted diseases) or venereal diseases are usually not covered unless specifically mentioned.
  3. War-related: Any injury or ailment that occurs due to mutiny, war, civil unrest, rebellion or any nuclear perils is usually not covered.
  4. Self-inflicted and cosmetic:  Self-inflicted injuries are excluded - Cosmetic treatments, unless medically required, are not covered, etc.

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Niva Bupa Claim Process

Niva Bupa supports both cashless claims and reimbursement claims. This section covers the information on how to check Niva Bupa health insurance claim status, fill Niva Bupa health insurance claim form, and the claim settlement process.

Cashless claims are a hassle-free way to settle your claims. You can take advantage of a cashless claim only when you seek treatment at a Niva Bupa network hospital.Take a look at the steps you need to follow to ensure a smooth claim.

Step 1: Choose a cashless hospital:
Choose a Niva Bupa cashless hospital for your treatment. You can always choose the hospital at your convenience from the Niva Bupa Hospital list on the company’s website

Step 2: Admission procedure:
On admission, you will have to produce your Health Card at the hospital help desk. In case you do not remember to carry the same or have the Health Card handy, you can always provide the Niva Bupa policy number along with your KYC documents.

Step 3: Pre-authorisation form:
You also need to fill the pre-authorisation form for claim approval which would be sent to the claims department of Niva Bupa from the hospital TPA desk.

Step 4: Cashless treatment:
Once the pre-authorisation is approved by Niva Bupa Health Insurance, your cashless treatment will begin with initial approval

Step 5: Discharge formalities:
At the time of discharge, the hospital would share the final bill along with the line of treatment, discharge summary, original bills and invoices, etc.,to Niva Bupa Health Insurance for final approval. In case additional information is needed, the insurer will share an email with the hospital.

Step 6: Claim settlement:
Once the claims department approves the claim, the bills would be directly settled by the insurer to the hospital. In case of any part of the claim that is not covered, would need to be paid by you such as consumables or deductibles.

If, for some reason, you were not able to seek treatment at a Niva Bupa network hospital, you can always file a reimbursement claim.

Step 1: Hospitalisation:
In case you get admitted to a non-network hospital, you need to inform the Niva Bupa Claims department as a claim “intimation” within a timeframe of 48 hours of the hospitalisation in case of emergency hospitalisation or before 3-5 days for planned treatment.

Step 2: Pay and get the treatment done:
In this case, you would have to pay for the entire treatment on your own.
However, remember to carry all original bills, receipts, prescriptions, discharge summaries specifying the line of treatment, test reports for diagnosis, etc.

Step 3: File a reimbursement claim:
After discharge, you need to file a reimbursement claim with all relevant documents along with your Niva Bupa Health Insurance card, the insured person’s identity and age proof and the policyholder’s bank account details.

Step 4: Verification:
Once Niva Bupa Health Insurance receives all your documents, the same will be verified.

Step 5: Claim settlement:
Thereafter, you will be reimbursed for the hospitalisation expenses, as per your Niva Bupa health plan. Typically, you would be reimbursed within 7 days of submission.

Niva Bupa Health Insurance Renewal Process

Online Renewal Process of Niva Bupa Health Insurance

After a 1 year validity of a health insurance policy, there is a need for renewal of the policy to avoid the lapse for the policyholder and to continue enjoying accumulated benefits.

Below are the steps to renew Niva Bupa Health insurance policy online:

Step 1: Visit the official website of Niva Bupa Health Insurance or use their mobile app. Enter your 14-digit policy number to initiate the renewal process.

Step 2: Provide your date of birth or enter the DoB of any insured family member associated with the Niva Bupa Health policy.

Step 3: Verify your policy by entering the One Time Password to access and review your policy details.

Step 4: Submit the information provided to calculate your annual health insurance premium.

Step 5: Now click on the pay button and make the requisite payment through your debit/credit card/net banking.

Step 6: Upon successful payment, you will receive a policy transaction number along with a link to complete the application form. Please note that your policy will be issued only after you have filled out the complete application form.

Offline Renewal Process of Niva Bupa Health Insurance

Niva Bupa Health Insurance Renewal can also be done offline by visiting the nearest Niva Bupa branch office or reaching out to a Niva Bupa customer care executive to initiate your Niva Bupa Health policy renewal.

Renewal of your Niva Bupa health insurance policy can also be done through Turtlemint. Turtlemint allows you an easy online process to renew your existing plan. To renew, visit Turtlemint’s home page www.turtlemint.com or download the Turtlemint App here.

FAQs

Niva Bupa is among the most well-known health insurance companies in India. It has won various recognitions and awards, which is also trusted by many. An exhaustive list of Niva Bupa cashless hospitals allows you to seamlessly settle your claims. Niva Bupa is one of the exclusive health insurance providers who focus on settling claims within a matter of 30 minutes. They are customer-centric in their approach, and they also offer a range of products to suit everyone’s needs at affordable pricing with the latest features and benefits. This is why you should opt for Niva Bupa Health Insurance policies for all your health insurance requirements.

A cashless facility is available only at a Niva Bupa network hospital. If you are admitted to a non-network hospital, you’ll have to pay the bills upfront and file for a claim after your discharge from the hospital. You can check the Niva Bupa hospital list on the company website.

A network hospital is a specific hospital that has a tie-up with the insurer so that cashless claim facilities are provided to its clients. This helps in the speedy claim settlement process as well. 

So, in a network hospital, you only need to provide your insurance and KYC details at the time of hospitalisation and the hospital takes care of the entire documentation process. Claims are settled directly by the insurer to the hospital without you having to pay the upfront amount for treatment.

On the other hand, non-network hospitals do not provide cashless treatment facilities. In these hospitals, you need to pay for the entire bill yourself and then claim the same from the insurer as a reimbursement along with all documentation, treatment details, original bills and receipts and your bank account details.

This is the basic difference between the two.

There are certain eligibility criteria that you need to fulfil to be eligible to buy a health plan by Niva Bupa. Being a citizen of India and meeting the age criteria are generic criteria. Generally, Niva Bupa Health Insurance policies cover all dependent children when they are in the age group of 91 days to up to 25 years. However, most policies allow adults upto 65 years of age to enter a plan, unless it is a specifically designed Senior Citizen Plan. However, some plans also have a lifelong entry age.

Also, remember that all Niva Bupa Health Insurance policies can be renewed lifelong as long as the premiums are paid on time and there is no lapse.

Niva Bupa Health Insurance plan allows you a grace period of 30 to 60 days of grace period after the premium due date during which the premium needs to be paid. However, the health insurance coverage would lapse if the premium is not paid within the due date and no claim would be admissible. So, in case you wish to file a claim within the grace period, you would first need to pay the premium to get the policy in force and then file a claim. The grace period is given so that you can retain your no-claim bonus for that duration.

Niva Bupa makes the claim process very easy and simple. Depending on the hospital that you seek treatment in, you can file your claim. The advantage of a network hospital is that you can get the benefit of making cashless claims. Your medical bills will be settled directly by Niva Bupa, and you will only have to cover the uncovered expenses. As Niva Bupa Health Insurance has an in-house claim settlement team, they are very quick to settle claims.

You have the option of buying Niva Bupa health insurance online from the Niva Bupa website. However, with Turtlemint, you can experience a smooth and pocket-friendly purchase.

Claim Settlement Ratio varies from time to time as it is a representation of the claims settled by an insurance company against the total number of claims made in a financial year. Niva Bupa claims to have settled 91.6%⁶ of their claims.
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