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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 4 health insurance plans. The premium of these plans starts from Rs. 3762/yr. The sum insured ranges from Rs. 2 Lakh - 1 Cr. Details of the comprehensive coverage provided by the following 4 Niva Bupa health insurance plans are listed below:

Niva Bupa Health Companion Policy

Starting Premium- 8,056/Yr

Eligible Age

90 days onwards

Coverage

3 Lakh - 1 Cr

Niva Bupa Health Recharge Policy

Starting Premium- 3,762/Yr

Eligible Age

91 days - 65 years

Coverage

2 Lakh - 95 Lakh

Niva Bupa Reassure Policy

Starting Premium- 10,431/Yr

Eligible Age

90 days - 65 years

Coverage

3 Lakh - 1 Cr

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.

Niva Bupa Premium Calculator

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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.