Niva Bupa Health Insurance

The Niva Bupa Health Insurance Company was founded in 2008. They offer 12 health insurance plans that provide their policyholders with financial support against unforeseen medical emergencies. These plans cover expenses surrounding hospitalisation, critical illnesses, diagnostics, medicines, and much more. 

You can access the benefits of these policies at 8600+ network hospitals. Moreover, this plan can be purchased online in just 5 steps. You can buy a Niva Bupa Health Insurance plan on Bajaj Markets starting at just ₹596/month.

Here are the insurance plans offered by Niva Bupa Health Insurance.

Niva Bupa Health Insurance offers three types of plan that can cater to the medical needs of multiple categories of people. Here is a breakdown of these plan types.

1. Individual Health Insurance

This health insurance type caters to the needs of an individual policyholder only. You cannot list other family members under this plan. Through individual health insurance plans, you will not be required to share the total sum insured of a plan with others listed under the policy.

2. Family Floater Health Insurance

Under this health insurance type, you can add your entire family as beneficiaries of the coverage. This includes your parents, spouse, and dependent children. The total sum insured and other benefits will be shared by all members of this policy.

3. Senior Citizen Health Insurance

You can access special plans under this health insurance type to secure the health of your senior citizen parents. You can get each parent their own plan or list both your parents under the same policy. 

Here are some of the key highlights of a Niva Bupa Health Insurance plan.

• Maximum sum insured up to ₹3 Crores

•  add-on covers

• 8600+ network hospitals

• 91.6% claim settlement ratio

• Premium starting at ₹596/month

Purchasing a Niva Bupa Health Insurance can bring you closer to accessing various benefits that can make your medical treatments less burdensome. Here are a few of those benefits. 

1. Cashless Medical Facilities

With more than 8600 network hospitals, Niva Bupa Health Insurance can offer you access to top-notch medical services. Moreover, these hospitals allow you to use your cashless claims benefit. Under this benefit, there is no need for you to pay the expenses stated in the medical bills. The insurance company and the hospital will settle the costs internally.

2. No-claim Bonus

If you do not file a single claim for more than a year, you can earn a benefit in the form of a no-claim bonus. Through this bonus, you will either find an increment of coverage or get a discount on your subsequent renewal premium. 

3. Medical Check-ups

Niva Bupa Health Insurance plans can provide your free medical health checkups. Depending on the plan, a particular number of health checkups could be covered, or health check-up expenses up to a certain coverage amount could be allowed.

4. Tax Benefits

You can get up to ₹75,000 as tax benefits as per Section 80D of the Income Tax Act for owning health insurance. Not only does your Niva Bupa Health Insurance offer you financial support, it also gives you access to tax benefits.

5. Paperless Application

Bajaj Markets offers you an entirely paperless purchasing process for your health insurance plans. Moreover, you need to complete only 5 steps to get your and your loved ones’ health insured. 

6. Niva Bupa Maternity Plan

The Aspire plan from Niva Bupa offers maternity coverage, including IVF, surrogacy, and adoption. It covers delivery costs, prenatal and postnatal care, and newborn health expenses. The plan also allows unused maternity sum to be carried forward, ensuring long-term support for family planning and childbirth-related needs. 

The table given below can help you understand all the inclusions and exclusions of Niva Bupa Health Insurance:

Note: Reading all inclusions and exclusions of Niva Bupa Health Insurance is advisable before purchasing a plan. You can find them in the Niva Bupa Health Insurance policy document or brochure.

Follow the steps given below to purchase your very own Niva Bupa Health Insurance plan. 

• Step 1: Navigate to the health insurance premium calculator page.
• Step 2: Enter your name, age, mobile number, and other details.
• Step 3: Choose a health plan that caters to your insurance needs and budget.
• Step 4: Add any optional covers, as per your preference.
• Step 5: Proceed to make the premium payment online.

Shortly after this, your policy documents should be sent to you on your registered mobile number or email address.

You will find a premium calculator page on Bajaj Markets which can help you greatly to derive an estimate of your health insurance premium price. This calculator is very easy to use. You only need to enter basic details about yourself such as your age, name, location, desired coverage, etc. Once you proceed, multiple health insurance plan options should be displayed on your screen with their subsequent insurance premiums.

Your Niva Bupa Health Insurance plan can financially support you in times of a medical peril. Moreover, it can also offer you tax benefits. Here’s how that works.

Niva Bupa Health Insurance offers you add-on covers that can enhance your health plan immensely. Here are the optional covers offered by this insurer. 

ReAssure 2.0

• Disease Management Add-on

Claim coverage for diabetes and hypertension along with a 20% discount of renewals. 

• Acute Care Add-on

You can access unlimited tele-consultations with general doctors, specialists, and super specialists at Apollo 24x7, along with diagnostics and pharmacy expenses. 

• Safeguard and Safeguard+ Covers

Among other benefits, these covers can offer a variation in the sum insured of your health insurance policy depending on healthcare inflation. Non-payable items will also be covered as per the clauses stated under both add-ons in the policy document.

• Personal Accident Cover

This can protect your family’s financial interest in the event of an accident. 

• Hospital Cash

If your hospitalisation period extends 48 hours, you can claim a daily cash allowance through your health insurance policy. 

Here are the different kinds of claims that you can file under your Niva Bupa Health Insurance plan. 

Cashless Claims

• Approach one of Niva Bupa Health Insurance network hospitals for your treatment
• Use your Niva Bupa Health Card or policy number to initiate the claim
• Submit an identification proof
• Allow the hospital to verify your documents and send a pre-authorisation request to the insurer
• Wait for 30 minutes as Niva Bupa works on processing your claim

Once the claim is processed and approved off, the settlement process will begin which will be handled by the insurer and the network hospital. 

Reimbursement Claims

• Inform the insurer about your wish to file a claim within 48 hours of hospitalisation
• Settle the bills at the hospital independently
• Collect all original documents pertaining to your hospitalisation and its subsequent expenses
• Visit the Niva Bupa Health Insurance claims portal to fill out the claims form
• Submit the aforementioned documents including your policy document, age proof, and identity proof

From this point onwards, the verification and approval process should begin. Soon, the coverage amount should be reimbursed to you if the claim is approved. 

OPD Reimbursement Claims

• Acquire an original copy of the invoices or bills from the network hospital or clinic
• Visit the Niva Bupa Health Insurance website and log into your account
• Navigate to the OPD tab where you can click on ‘Raise a Claim’
• Search for the doctor who treated you
• Select the ‘Raise a Claim’ option before your chosen doctor’s name
• Enter details such as bill details, bank details, and upload all the documents as asked
• Submit the claim

If the claim is approved thereafter, the OPD expenses will be reimbursed soon. 

Diagnostic Centre Reimbursement Claim

• Get a valid copy of the bill that states the expenses you incurred for diagnosis
• Log into the Niva Bupa Health Insurance online portal
• Navigate to ‘My Account’
• FInd the annual health checkup tab and click on ‘Reimbursement Claim’
• Fill the claim form with accurate details of the bills and your bank account
• Upload all the documents listed there
• Submit the claim

Upon verification and approval, the claim amount should be reimbursed to you shortly. 

Here’s the Niva Bupa Health Insurance Claim Settlement Ratio for your understanding.

Here are all the documents you will need in order to complete your Niva Bupa Health Insurance claim process. 

Documents Required for Cashless Claims

1. Discharge summary

2. All bills and receipts 

3. Final bill 

   1. Detailed breakup of final bill 

   2. Medicine bills 

   3. Investigation bills 

   4. Payment receipts 

4. Indoor case reports 

5. FIR or MLC in case of road accidents 

6. Investigation reports 

7. Cancelled cheque with name printed on it

Should your claim amount exceed ₹1 Lakh:

1. A recent photo of the patient 

2. A copy of Aadhaar Card, Driving Licence or Passport

Documents Required for Reimbursement Claims

1. Health Card number 

2. Photo ID of the patient

3. OPD prescription

4. Investigation reports confirming the diagnosis

Should your claim amount exceed ₹1 Lakh:

1. A recent photo of the patient 

2. A copy of Aadhaar Card, Driving Licence or Passport

You will find that many health insurance providers offer access to network hospitals. These network hospitals are medical facilities that have formed partnerships with insurance providers. The policyholders benefit from such partnerships since they can enjoy perks like cashless services. 

The Niva Bupa Health Insurance hospital list consists of 8600+ network medical facilities. You can access the best of healthcare at these medical facilities. Should you choose to file a cashless claim at one of these hospitals, you can sit back and allow the insurance company and hospital to settle the expenses.

Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited) (IRDAI Registration No. 145). ‘Bupa’ and ‘HEARTBEAT’ logo are registered trademarks of their respective owners and are being used by Niva Bupa Health Insurance Company Limited under license. Registered office:- C-98, First Floor, Lajpat Nagar, Part 1, New Delhi - 110024; Fax: +911141743397; Customer Helpline: 1860-500-8888; www.nivabupa.com. CIN: U66000DL2008PLC182918. For more details on risk factors, terms and conditions please read the sales brochure carefully before concluding sales.* 

Niva Bupa processes pre-auth requests within 30 minutes for all active policies, subject to receiving all documents and information(s) up to Niva Bupa’s satisfaction. The above commitment doesn’t include pre-authorisation settlement at the time of discharge or system outage. Bajaj Markets is a registered corporate agent of Niva Bupa Health Insurance Company Ltd. For Bajaj Markets, IRDAI Registration Number CA0551.