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About Niva Bupa Health Insurance

Max Bupa is a standalone health insurance company which is formed as a joint venture between two reputed companies – Max India Limited and Bupa. While Max India Limited is an Indian company, Bupa is a UK based expert in providing healthcare services with experience of more than 60 years. Bupa is a multinational company with a presence across 190 countries and a customer base of more than 29 million individuals. Max India Limited, on the other hand, is an expert in both the insurance and health sector. Overall, both these promoters bring in value-addition to Max Bupa which is a reputed health insurance company in India.

Niva Bupa Claim Settlement Ratio

95%

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 95%, as compared to the industry average of 94.21%.

Niva Bupa Health Insurance Plans

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

Features and benefits of Max Bupa Health Insurance policies Here are the salient features of health insurance plans offered by Max Bupa

  • The company enjoys a high claim settlement ratio of 92%
  • It promises to settle your health insurance claims within 30 minutes
  • The company has an in-house claim settlement team thereby eliminating the need for TPAs (Third Party Administrators)
  • The company offers international coverage for critical illnesses through its hospital network in 190 countries
  • Max Bupa has been rated to be the ‘Most Trusted Health Insurance Brand’ for three consecutive years
  • The company allows cashless claim settlements across 7000+ hospitals in India
  • The company received the “Economic Times Best Brands 2019 award”
  • With their app going over 1.5 downloads, the Max Bupa Health App was also awarded the Best Tech for Health Category 2019
  • Inpatient hospitalisation: Coverage for hospital costs incurred when you are hospitalised for 24 hours or more. The coverage is allowed for the following  Room rent,ICU room rent, Doctor’s fee,Surgeon’s fee,OT charges Blood, medicines, etc.Nurse’s fee, among others
  • Pre hospitalisation Medical costs incurred before you are hospitalised
  • Post hospitalisation Medical costs incurred after you are discharged from the hospital
  • Ambulance expenses Costs incurred and transporting you to the hospital in an ambulance
  • Daycare treatments Treatments which do not require a hospital stay of 24 hours or more due to advanced medical technologies
  • Domiciliary treatments Cost of treatments taken at home because of non-availability of hospital beds or when you are in no condition to be shifted to the hospital
  • Organ donor treatments Costs incurred in harvesting the organ from an organ donor for organ transplant procedures
  • Free health check-ups Preventive health check-ups allowed once in a specified period to monitor your health
  • AYUSH treatments Non-allopathic treatments including Ayurveda, Unani, Siddha and Homeopathy
  • Maternity cover This cover is available in some plans where the costs of childbirth and pre and post-natal expenses are covered

Exclusions Across Niva Bupa Health Plans

While the exact exclusion list depends on the plan that you choose, here is a list of some of the most common exclusions which are found in Max Bupa Health Insurance plans

  • Pre-existing illnesses are not covered during a specified waiting period. Coverage is allowed only when the waiting period is over
  • There is a waiting period for specific treatments and illnesses like hernia, piles, joint replacement surgeries, etc.
  • Illnesses within the first 30 to 90 days of buying the policy are not covered unless they are accidental in nature
  • Cosmetic treatments are not covered
  • HIV, AIDS and any other type of sexually transmitted or venereal diseases are not covered
  • Pregnancy and childbirth are not covered unless otherwise specified
  • Dental treatments are not covered under most plans
  • Illnesses or injuries due to war, rebellion, mutiny, civil unrest and nuclear perils are not covered

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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.

  1. Choose a networked hospital for treatment of your illness or injury. The list of hospitals can be found on the company’s website
  2. At the time of admission, the Health Card should be produced. If you don’t have the Health Card handy, you can provide your health insurance policy number and a photo identity proof
  3. After your identity is verified by the hospital, the pre-authorization form would be sent by the hospital to the insurance company
  4. Max Bupa would verify the form and confirm the approval for cashless claims. The approval would be sent to the hospital as well as to you, the policyholder
  5. Once the claim is approved, you can take treatments in the hospital and the insurance company would pay the hospital bills itself

  1. Reimbursement claims occur when you take treatments at a non-networked hospital. In such cases, you should inform Max Bupa within 48 hours of your hospitalisation
  2. You should, then, pay all the relevant medical bills which incur on your hospitalisation and treatment
  3. When you are being discharged from the hospital, collect all the relevant medical bills and reports for making a claim. The Discharge Certificate should also be collected from the hospital
  4. You should then fill up a claim form and send the form with all the medical reports, bills and Discharge Certificate which you collected from the hospital. You should also send your valid identity proof and age proof
  5. When the insurance company receives the documents, your claim would be verified and authenticated 6) Thereafter, the insurance company would reimburse you for the medical costs that you incurred

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

Max Bupa is a leading health insurance provider in the country. It has worn various awards and recognitions and is trusted by many. The company also has an exhaustive list of cashless hospitals which allow you to get your claims settled easily. Moreover, the company promises cashless claim approvals within 30 minutes making the claim process as customer-friendly as possible. The range of plans offered by Max Bupa Health Insurance not only provides a comprehensive scope of coverage, they are also reasonably priced. You should, therefore, choose Max Bupa Health insurance policies for your health insurance needs.

You can pay premiums online or offline. To pay online you can use your credit cards, debit cards, mobile wallets or the UPI platform and pay the premiums from your bank accounts. Alternatively, if you are choosing the offline mode of paying the premium, you can pay the premiums through cash, cheque, demand drafts, etc.

A networked hospital is one which is tied up with the insurance company to offer you cashless claim settlements. If you are admitted to a networked hospital, your claims would be taken care of by the insurance company directly. Non-networked hospitals, on the other hand, are those which are not tied-up with the insurance company. If you are admitted to a non-networked hospital, you would have to bear your medical costs and the insurance company would later reimburse the costs that you incur.

To buy Max Bupa Health insurance plans you should be an Indian citizen and meet the age criteria listed down in the policy that you want. Different policies have a different age limit. Usually, most policies cover dependent children from 91 days to up to 21 or 25 years. For adults, the age limit is usually from 18 years to 65 years. If you fulfil the age criterion, you can buy Max Bupa Health insurance plans.

Yes, Max Bupa Health insurance plans allow you a grace period to pay the premiums which are due. The period depends on the policy that you buy. You can, usually, get a grace period of 30 days to 60 days for paying the due premium. However, during the grace period the policy would remain in a lapsed state and you would not get coverage. Your existing no claim bonus would, however, continue to remain valid if you renew the policy within the grace period.

No, it won’t. The indemnity health plan would cover your medical costs if you are hospitalised. The critical illness plan, on the other hand, would pay a lump sum benefit if you are diagnosed with any of the covered illnesses. This benefit would not depend on the claim that you receive under the indemnity health plan. The claim payable under critical illness plans would be independent of all other claims that you receive.

Premiums paid up to INR 25,000 qualify for tax deduction under Section 80(D). Since you have paid INR 20,000, the entire premium would be allowed as a deduction from your taxable income. The premium paid would, therefore, reduce your taxable income and bring down your tax liability.

To make a claim in your Max Bupa health insurance policy, you should inform the company and follow the specified claim process. The claim process depends on whether you are making a cashless claim or a reimbursement one. The claim process has been described earlier using which you can make claims under your Max Bupa health insurance plans.

You can apply for and buy Max Bupa health insurance policy online either from the website of Max Bupa itself or from the website of Turtlemint.

The Claim Settlement Ratio (CSR) represents the claims settled by an insurance company against the total number of claims made on it in one financial year. The CSR changes every financial year and Max Bupa offers a high CSR of 92% ensuring a speedy claim settlement. (Source: Max Bupa)

Yes, porting is allowed by Max Bupa health insurance. You can port out of Max Bupa health insurance plans as well as port into a Max Bupa health insurance plan of your choice. Portability is allowed at the time of renewals and to port you have to inform the insurance company at least before 45 days of renewal.

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