Niva Bupa Health Insurance

A top-up policy offers you additional coverage on your existing health insurance plan. This cover comes into the scene when the sum insured of your existing health insurance policy is not enough during a medical emergency. With a top-up policy, one can avail coverage for a single claim over and above the threshold limit, known as the deductible. On the other hand, a super top-up plan allows you to get coverage on multiple hospitalisations. Top-up and super top-up health insurance plans are not mandatory to buy but are prefered by many as they are affordable and offer great benefits.

Niva Bupa Health Insurance offers a top-up plan as well as a super top-up plan namely Money Saver and Health Recharge respectively. Health Recharge Plan offers cover for sum insured options between Rs. 2 Lakh and Rs. 95 Lakh for various healthcare expenses including daycare treatments, in-patient hospitalisation expenses, pre and post-hospitalisation expenses, domiciliary hospitalisation expenses, organ donor expenses, etc. Whereas Money Saver is a combination of base and top-up plan that covers you for several healthcare expenses such as in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, domiciliary hospitalisation expenses, daycare treatments, emergency ambulance expenses, and expenses related to organ transplant, for sum insured options up to Rs. 1 crore. Both the plans come with several add-on covers which you can opt for as per your requirement. In short, both are reliable health insurance plans that can be purchased with a regular health insurance plan, for extensive coverage.

Niva Bupa Health Insurance plans come with several coverage benefits. But apart from availing cover for several healthcare expenses, you can also avail tax benefits on the premium paid for these plans, under Section 80D of the Income Tax Act, 1961. To gain a deeper understanding of tax deductions, refer to the table below:

Health Insurance Claim Settlement Ratio is the percentage of the number of claims settled by the insurance company against the total number of claims received by it during a financial year. It is an indicator of how well an insurance company handles claims of the customers. As an aware health insurance policy buyer, you must use the Claim Settlement Ratio of an insurance company before buying any plan. Niva Bupa Health Insurance Company has been attaining an impressive claim settlement ratio over the last two years, which is one of the reasons that make the insurer a trusted one among the customers. Here are the Claim Settlement Ratios of the last two years of Niva Bupa Health Insurance:

(Source: IBAI’s General Insurance Claim Insights Handbook For Policyholders - 4th & 5th Edition)

Niva Bupa Health Insurance (Formerly known as Max Bupa Health Insurance) Claim Process

Niva Bupa Health Insurance offers a quick yet smooth claim settlement process to the insured. The insurer settles claims in two ways namely cashless claims and reimbursement claims.

How to Avail Niva Bupa Health Insurance Cashless Claim?

The policyholders of Niva Bupa Health Insurance can avail of cashless treatment at the network hospitals. The insurer has a wide network of 7,000 hospitals where if the insured avails treatment, the bill will be directly settled by the insurance company, as per the policy terms and conditions.

Listed below are the steps to raise a cashless claim with Niva Bupa Health Insurance:

Step 1: Inform the Insurer

You are required to inform the insurance company within 24 hour of admission at 1860-500-8888, in case of emergency hospitalisation. However, in case of planned hospitalisation, you are required to inform the insurance company at least 2 days in advance.

Step 2: Share Your Health Insurance Card

Share your policy number or Niva Bupa Health Insurance card along with a valid IF proof at the desk of the network hospital you wish to avail treatment in. You can find the list of Niva Bupa network hospitals at InsuranceDekho.

Step 3: Pre-Authorization Request

After identification, the network hospital will send a pre-authorization form to the insurance provider.

Step 4: verification Process

The claim settlement team of Niva Bupa Health Insurance will verify the details and documents that they received. If they want any more documents for better investigation, then they may ask for it.

Step 5: Claim Settlement

Once the formalities are completed, the insurance company will settle the bill directly at the hospital. Kindly note that this will not include any co-payment. Generally, Niva Bupa Health Insurance responds to the policyholder within 30 minutes of the claim request. However, in case the claim has been rejected, then you will be informed about the same with valid reasons.

How to Make Niva Bupa Reimbursement Claim?

In case you are unable to file a cashless claim, then you can file a reimbursement claim. In this case, you can pay for the treatment availed at the hospital (network or non-network hospital) and later claim for reimbursement for the same, from the insurance company. You can file for a reimbursement claim under Niva Bupa Health Insurance policy by following the steps given below:

Step 1: Inform the Insurance Provider

Intimate Niva Bupa Health Insurance about hospitalisation within 48 hours of hospitalisation or before discharge from hospital, whichever is earlier.

Step 2: Avail the Required Treatment

Avail the required treatment and pay for the hospital bills. Collect all the relevant documents from the hospital and share them with the insurer. These documents may include discharge summary, pathology test reports, medical invoices, etc.

Step 3: Submit the Claim Documents

Fill and sign the claim request form that you can get from the official website of Niva Bupa Health Insurance. Send the claim form with medical documents.

Documents Required For Niva Bupa Health Reimbursement Claim

Following are the documents required for reimbursement claim with Niva Bupa Health Insurance:

• Valid ID proof
• Letter from medical practitioner advising letter of hospitalisation
• Prescription from medical practitioner for consultation, medicine, and medical tests
• Invoices from pharmacies (original)
• Hospital bills as well as discharge certificate duly signed by medical practitioner (original)
• In case there is a police case, then First Information Report will be required
• Post mortem report, if applicable

Step 4: Documents Verification

Your medical documents and claim request form will be reviewed by the respective team at Niva Bupa Health Insurance. The insurer may ask for more documents if required for further verification. If in case your claim request gets rejected, then the same will be conveyed to you with valid reasons.

Step 5: Claim Settlement

Once all your documents are verified, and the insurer finds them appropriate, then the insurer will approve your claim request according to the policy terms and conditions. The insurer will then reimburse the claim amount.

You can avail of the following benefits if covered under a Niva Bupa Health Insurance plan:

• 24*7 Online Assistance: Niva Bupa Health Insurance provides 24*7 online assistance to its customers through a chat box available on its website. It offers several quick service options that you can choose by commenting to enter the query. With this digital solution, you can easily chat with the experts and even request a call back and get assistance to find a suitable health insurance policy for yourself and your loved ones.
• Lifetime Renewability Benefit: Under the health insurance plans offered by Niva Bupa Health Insurance, you can get lifetime renewability benefits. This means that you can continue to renew your health insurance policy throughout life by paying the required premium on time.
• Portability Benefit: Niva Bupa Health Insurance plans offer portability benefits to the insured. This means that you can port to any similar Niva Bupa Health Insurance Plan if you are not satisfied with the existing one. This helps you to stay covered with the health insurance provider of your choice without losing any benefits that you were already availing.
• Sum Insured Refill: Health insurance plans offered by Niva Bupa Health Insurance comes into force when the sum insured amount gets exhausted. Under this benefit, the policyholders are offered an extra sum insured equal to base sum insured for subsequent health insurance claims during a financial year.
• Comprehensive Solutions: The insurer comes with comprehensive health insurance plans and innovative offerings that suit specific needs of various individuals. Some of these include GoActive plan, a comprehensive health insurance plan especially designed for fitness enthusiasts; Health Premia especially designed for large families who want top of the line care for their families; and Health Companion and Health Pulse Plans with several coverage benefits. The insurer also offers cover for personal accidents and critical illnesses.

Niva Bupa Health Insurance plans cover you for the following healthcare expenses:

• In-Patient Hospitalisation Expenses: Niva Bupa Health Insurance plans cover you for in-patient hospitalisation expenses which include room rent expenses, nursing, boarding expenses, medical tests, doctor’s fee, etc., for up to a specific limit.
• Pre-Hospitalisation And Post-Hospitalisation Expenses: If covered under Niva Bupa Health Insurance plans, you can avail cover for pre-hospitalisation and post-hospitalisation expenses for 60 days and 90 days respectively.
• Daycare Procedures: Daycare procedures are the ones that do not require 24 hours of hospitalisation, the reason may be any, including technological advancements. These include balloon sinuplasty, sinusitis, radiotherapy, chemotherapy, etc. Under Niva Bupa Health Insurance plans, you can seek cover for specific procedures like these.

• Road Ambulance Expenses: Niva Bupa Health Insurance plans cover you for road ambulance expenses for up to a specific limit. These are the expenses arising due to transportation of the insured member to the nearest hospital during a medical emergency.

• Domiciliary Hospitalisation Expenses: Niva Bupa Health Insurance plans cover you for domiciliary hospitalisation expenses that cover you for medical treatment availed at home due to unavailability of a hospital bed, as per doctor’s advice. Kindly note that the hospitalisation should be for at least 3 continuous days.

What Are The Exclusions of Niva Bupa Health Insurance Policies?

Niva Bupa Health Insurance plans do not cover you for the following healthcare expenses:

• Hospitalisation For Investigation And Evaluation Purpose: Niva Bupa Health Insurance plans do not cover you for expenses arising due to hospitalisation solely for the purpose of investigation or evaluation. Also, the plans do not cover you for diagnostic expenses that are not related or not incidental to existing diagnosis and treatments that are excluded from the policy.

• Rest Cure, rehabilitation and respite Care: If covered under Niva Bupa Health Insurance plans, you would not be able to avail coverage benefit for hospitalisation primarily for enforced bed rest and not any treatment. It also includes custodial care at home or in a nursing facility for personal care like help with activities of daily living like dressing, bathing, etc.
• Obesity or Weight Control Treatments: Under Niva Bupa Health Insurance plans, you will not be covered for expenses related to surgical treatment of obesity that does not fulfil specified conditions, some of which include surgery to be conducted is suggested by the doctor, the insured is aged at least 18 years, the surgery or procedure conducted are supported by clinical protocols, etc.
• Participation in Adventure Sports: Niva Bupa Health Insurance plans do not cover you for any treatment required due to participation in hazardous sports as a professional, such as paragliding, rock climbing, scuba diving, horse racing, hand gliding, skydiving, hand gliding, deep-sea diving, etc.

Kindly note that the inclusions and exclusions listed above are not restricted to any plan but may vary from one Niva Bupa Health Insurance plan to another.

There are several health insurance plans offered by Niva Bupa Health Insurance, which may differ in features and terms and conditions. However, some common policy terms of Niva Bupa Health Insurance plans are tabulated below:

At InsuranceDekho, you can purchase Niva Bupa Health Insurance plans online without any hassle. All you are required to do is follow these easy steps:

Step 1: Visit InsuranceDekho and click on the health tab.

Step 2: Select your Gender. Then enter your Name and Mobile Number. On the given number, you will receive an OTP (One Time Password). Please enter that.

Step 3: Select the time when you want to buy the health insurance policy and then click on ‘View Instant Quotes’.

Step 4: Choose the family members who you want to add along with yourself under the policy.

Step 5: Select the age of the family members you wish to include in the policy. Click ‘Continue’.

Step 6: Select your Email ID and City and click on the Submit and ‘View Quotes’ button. You will find various insurance plans displayed on your screen according to your selections. From them, choose the most suitable policy for yourself and your loved ones, as per your budget and other requirements.

Step 7: Select the policy term of the selected health health insurance plan, and pay the premium for the policy.

Buy Niva Bupa Health Insurance (Formerly known as Max Bupa Health Insurance) Plan Offline at InsuranceDekho

If you are unable to buy Niva Bupa Health Insurance online, then you can buy it offline as well. For this, you can get in touch with the customer care executives at InsuranceDekho on the toll-free number 7551-196-989 between 9:30 AM to 6:30 PM (Monday-Sunday). In case of further support, you can write to us at customersupport@insurancedekho.com.

Niva Bupa Health Insurance plans come with a life of 1 year, 2 years, or 3 years, which you can choose at the time of policy purchase. After these intervals, you are required to pay the premium again, in order to keep the policy active. If you fail to do so, your policy will lapse and you will lose all the accumulated benefits such as waiting period benefits etc. here are the simple steps that you need to follow to renew your Niva Bupa Health Insurance policy:

Step 1: Visit the official website of Niva Bupa Health Insurance. Navigate to the health insurance page. Then open the ‘Health Insurance Renewal’ page.

Step 2: Select the policy that you want to renew.

Step 3: Fill in the basic information like existing policy number, date of birth, etc.

Step 4: Pick your renewal quote. Include add-ons, if you want to and the policy provides so.

Step 5: Make the payment online via secured payment gateway in a mode of your choice.