Niva Bupa Health Insurance Benefits: Plan Inclusions & Exclusions

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.

Easy to apply: Niva Bupa offers digital solutions that make all healthcare procedures simple and quick- from application to claim submission.
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).
High coverage: Depending on your healthcare needs,you can opt for a plan with a sum insured as high as ₹3 crores.
Low cost: Get coverage for yourself and your loved ones with affordable plans. Enjoy up to 30% discounts when you renew your health plan.
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.
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.
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.
International coverage: Some Niva Bupa Health Insurance plans also allow international coverage.
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.

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.
HIV and STD: HIV, AIDS or any other variant of STD (sexually transmitted diseases) or venereal diseases are usually not covered unless specifically mentioned.
War-related: Any injury or ailment that occurs due to mutiny, war, civil unrest, rebellion or any nuclear perils is usually not covered.
Self-inflicted and cosmetic: Self-inflicted injuries are excluded - Cosmetic treatments, unless medically required, are not covered, etc.

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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.