Niva Bupa Health Insurance

Get complete details about Niva Bupa health insurance online on Coverfox. Niva Bupa Health Insurance is a stand-alone health insurance company operating in the India Market. It has an extensive portfolio of products that comes to rescue all its consumers from large medical bills. Niva Bupa is a joint venture between a leading Indian private equity firm, True North, and Bupa, UK’s 70-year-old healthcare services expert.

Niva Bupa Health Insurance has a vast network of 4500+ hospitals for cashless treatments & 2000+ doctors for cashless OPD treatments. It also provides home pick-up service for diagnostic samples & delivery of medicines. With an in-house claim settlement team, Niva Bupa claim settlement can process cashless claims within 30 minutes.

Please Note: Max Bupa Health Insurance Company Limited was renamed to Niva Bupa Health Insurance Company Limited on 5th July 2021.

Some Important Facts

Incurred Claim Ratio
54%
Niva Bupa Network Hospitals
3500+
Renewability
Lifelong
Customers
11.3 million customers
Customer Care Toll Free No
1800-3010-3333

Niva Bupa Health Insurance Company Overview

Niva Bupa Health Insurance Company Ltd. is a joint venture between Max India Ltd. and Bupa, a UK-based healthcare services company. It combines two of the best global minds of the healthcare and insurance industry to create effective health insurance plans that are tailor-made to meet varied health insurance needs of individuals and families.

Niva Bupa Health Insurance Plans

Niva Bupa Health Companion

Health @ Companion plan offers the most basic coverage when compared to all the other plans by Niva Bupa. It has option of individual or family floater coverage. There are two variants of this plan offered by Niva Bupa Health Insurance. Given below are the details of coverage offered on individual or family floater basis under both the variants:

Health @ Companion - Silver

Health @ Companion- Gold

If you are looking out for a health insurance plan to cover your basic hospitalization expenses then know more about Health @ Companion click here.

Niva Bupa Heartbeat Policy

Heartbeat covers basic medical expenses along with offering a loyalty benefit for its customers. There are three variants under which different benefits offered. Given below are details of each variant of individual and family floater basis.

Heartbeat- Gold Policy

Heartbeat- Platinum Policy

Heartbeat- Silver Plan

Health Assurance

This is a unique plan which offers coverage for critical illness, hospital cash and personal accident at 4 different range/ levels of sum assured. It is available as individual and family floater coverage. Given below are the details:

Family First- Silver Policy

Family First- Gold Policy

Family First- Platinum Policy

Employee First Health Insurance Plan

Employee First Classic Health Insurance Plan

Features of Niva Bupa Health Insurance

  • No. of members - The Max health insurance plan covers maximum 4 members of your family with up to 2 children and 2 adults.

  • Lifelong Renewal – The Max health insurance plans offered are lifelong renewable hence it saves you from the financial burden and stress caused by a medical emergency and keeps you well prepared to handle any situation.

  • Pre & Post hospitalization cover - The Max health insurance plan covers medical expenses for 30 days prior to hospitalization and 60 days post hospitalization only for related medical expenses.

  • Pre-existing diseases - Max health insurance covers Pre-existing diseases after 4 years of waiting period.

  • Room-rent- There are zero or no sub-limits on room rent in Max health insurance.

Benefits of Niva Bupa Health Insurance

  • Niva Bupa health insurance has no involvement of the TPA, direct liaison with the company initiates quicker resolutions.

  • No age restriction for enrolment in the Max health insurance plans.

  • Max health insurance plans also offer Maternity and New Born Child benefits.

  • Claim Settlement Ratio - The incurred claim settlement ratio of Niva Bupa Health Insurance for F.Y. 2018 - 19 is 54%.

What is Covered in Niva Bupa Health Insurance?

  • Convenience of quick and easy online purchase of Niva Bupa health insurance policies.

  • Health insurance policies offer a sum insured of a maximum of Rs. 1 crore.

  • Offers coverage for the entire family, including new born babies and senior citizens, through its range of individual and family floater plans.

  • Covers maternity related expenditures for mothers and new born babies after the completion of 2-year waiting period since the purchase of a Niva Bupa HeartBeat health insurance policy.

  • Certain health insurance plans from Niva Bupa cover pre-existing illnesses as well.

  • Includes lifetime renewal option.

  • Offers an attractive 12.5% discount on the premium amount during renewal for the second policy term.

  • Covers medical expenses like hospital room rent, pre and post hospitalization, OPD expense cover, organ donation, and day care.

  • Also includes home hospitalization and domiciliary hospitalization.

  • Includes Restore Benefits that enables the policyholder to refill the base annual sum insured in case it has been totally or partially exhausted. This benefit is applicable on all plans except the Family First plan.

  • Covers regular health check-ups once or twice annually.

  • Niva Bupa has an extensive list of 3,500+ network hospitals in India where the insured can avail cashless facilities on being hospitalized.

  • Certain Niva Bupa health insurance plans are designed to offer international cashless facilities for specific critical illnesses such as cancer, organ transplant, etc.

What is Not Covered of Niva Bupa Health Insurance?

  • Health concerns arising from overuse of alcohol or drugs

  • AIDS

  • Congenital disease

  • Medical treatment required due to attempted suicide

  • Medical conditions and treatments related to pregnancy, miscarriage, childbirth, and abortion

  • Treatments related to infertility and in vitro fertilization

  • Hospitalization owing to injuries caused in certain situations like riot, war, terrorist activities, nuclear weapons, etc.

Claims Process at Niva Bupa Health Insurance

Bupa Health Insurance, India offers two ways to make claim under its Max Health Insurance plans: on cashless basis and on reimbursement basis. In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of Niva Bupa health insurance company servicing policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form. In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for the claim on reimbursement are obtained after hospitalization.

Niva Bupa Health Insurance plans has a well-defined claim processing system.

Cashless Service: Seeking Pre-Authorization

  • Complete the pre-authorization form available at the hospital's insurance/TPA Desk.
  • Send the completed form via email or fax.
  • Approved letter will be sent by the claim management team. Remember that the claim management team could send an inquiry to the hospital or you before authorization.
  • In case the authorization is rejected, initiate the treatment and file for reimbursement claim.

Reimbursement Claim: Claim Submission

  • Complete the necessary form and submit along with required documents, as per the policy terms and conditions.
  • Necessary documents include discharge summary, prescriptions, bills etc.
  • Approved letter will be sent by the claim management team. Remember that you will be answerable to any queries raised by the claim management team before the letter is issued.
  • In case the claim is rejected, the reasons will be communicated by the team.

In case of any emergencies, you need to inform Niva Bupa within 24 hours of the admission. In case of planned emergencies, the notification has to reach the company 48 hours prior to the hospitalization. The claim intimation can be done via Niva Bupa's toll-free number 1800-3010-3333. The same could also be emailed to customercare@maxbupa.com .

Note: If you are a Coverfox customer, you can directly reach out to us for all your claim-related issues and queries.

Niva Bupa Health Insurance Premium Calculator

Niva Bupa’s health insurance premium calculator generates the estimate for the premium you will have to pay, based on your chosen sum insured, unique needs and add-on riders that you may have selected. For instance, premium for an individual health insurance plan from Niva Bupa health insurance will be lower than that of a family insurance plan.

Accessible on the insurance company’s website, all you need to do to check your premium eligibility is select your preferred health insurance plan from Niva Bupa, choose the sum insured, followed by entering a few personal details like name, phone number, email ID, date of birth, city, etc. In case you are planning to opt for co-pay, you can get a clear idea about the percentage that you have to pay towards the total premium amount.

Why Purchase Niva Bupa Health Insurance?

There are many reasons why you should buy health insurance. Whether you are rich or poor, young or old, or have been diagnosed with a disease that needs hospitalization - insurance plans of health are necessary to have. Here we will discuss why it is important to buy health insurance from Niva Bupa.

  • Convenience of quick and easy online purchase of Niva Bupa health insurance policies

  • Health insurance policies offer a sum insured up to Rs. 1 crore

  • Offers coverage for the entire family, including new born babies and senior citizens

  • Covers maternity related expenditures for mothers and new born babies after the completion of 1-year waiting period since the purchase of a Niva Bupa health insurance policy

  • Includes lifetime renewal option

  • Niva Bupa has an extensive list of 3,500+ network hospitals in India where the insured can avail cashless facilities on being hospitalized

  • Certain Niva Bupa health insurance plans are designed to offer international cashless facilities through its global network of hospitals for specific critical illnesses such as cancer, organ transplant, etc.

  • Offers direct claim settlement and, hence, does not include TPA (Third Party Aggregator)

  • Emphasizes on their customer-first approach that is focussed on customer satisfaction

  • Includes tax benefits as per Section 80D of the Income Tax Act, 1961

How Can I Purchase Niva Bupa Health Insurance?

Online process:

  • Visit the official website of Niva Bupa health insurance and fill up the relevant form with required details like name, contact number, email ID, etc., and request for a call back. You can call Niva Bupa health insurance customer service for assistance with the process.
  • Niva Bupa health insurance plans that are available online can be purchased through an online third-party aggregator or third-party website.

Offline process:

  • Visit any branch of Niva Bupa health insurance of your convenience for the executives to guide you through the process of purchase.

Niva Bupa Health Insurance Renewal Process

Niva Bupa health insurance offers the flexibility of offline as well as online renewal facility. For offline renewal, you can visit any branch of Niva Bupa health insurance to initiate the renewal process. If you prefer to renew it online, you can visit the company’s official website and click on the ‘Renew’ button and then pay online to complete the renewal procedure.

Review of Niva Bupa Health Insurance

If you are looking to invest in a plan that has no age restrictions, no sub-limits on room rent, offers a decent No Claim Bonus up to 100% and Maternity and New Born Child benefits, Niva Bupa is one of the top 5 picks. With no involvement of TPA, they claim to have a quicker resolution process including claims handling. The Niva Bupa health insurance renewal is for life long. However, if you do not appreciate the element of co-payment, you may get disappointed. Overall, Bupa Health Insurance is one of the top players in India's health insurance market and its Niva Bupa Mediclaim policy is worth considering if you are looking for a health insurance.

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Faqs on Niva Bupa Health Insurance

Why it is important to buy Max Bupa health insurance policies?

Max Bupa Health Insurance policies offer loads of features and benefits to fulfil your requirement. Let’s now have a look why you should buy a health insurance policy from Max Bupa:

  • Offers assured lifelong renewability
  • It doesn’t have any sub-limits under room rent
  • Offers maternity as well as new-born child benefits which makes them the most preferred health plans
  • Offers a direct claim settlement without involvement of any third-party
  • Offers international coverage with its Heartbeat Platinum Plan by providing international cashless treatment. This treatment is offered for 9 critical illnesses like cancer and organ transplant etc.
  • Offers tailor-made health insurance plan that offers coverage for the entire family right from new born babies to senior citizens

How to apply for Max Bupa health insurance policies?

You can buy Max Bupa Health Insurance policies through different channels:

  • You may directly call on the sales helpline number of Max Bupa and take an expert advice
  • You may visit the company website and fill in details like your name, age, mobile number, email id etc. and arrange for an advisor’s call back
  • You may visit the company website. Research the different plans available and click the ‘Buy Now’ button against the different plans available
  • You may also visit any Max Bupa branch and buy a plan that suits your requirement
  • You may visit Coverfox.com and buy a plan of your choice

Renewal process of Max Bupa health insurance?

The health insurance renewal process is very simple. Mentioned below are the steps:

  • Visit the company website and click on the ‘renew’ option
  • Enter your Max Bupa health insurance policy number and click the ‘submit’ option
  • You will get the renewal premium amount
  • All you need to do is click on the ‘pay now’ option and make the payment to renew your health insurance policy

Can I Apply for Max Bupa Health Insurance Plans Online?

Yes, Max Bupa’s health insurance plans can be bought online. The following are the different modes of applying for Max Bupa Health Insurance Plan online:

  • Visit the official website of Max Bupa health insurance and fill up the relevant form with required details like your name, contact number, email ID, etc., and request for a call back. You can call Max Bupa health insurance customer service for assistance with the process.
  • Max Bupa health insurance plans that are available online can be purchased through any online third-party aggregator or third-party website

What is the difference between a network and non-network hospital?

A network hospital refers to a hospital that Max Bupa Health Insurance has collaborated with for hospitalization and medical treatments. Max Bupa Health Insurance policyholders can avail cashless facilities on being hospitalized in a network hospital.

In contrast, non-network hospitals are those that are not a part of the list of network hospitals and, therefore, policyholders are not eligible for cashless benefits on hospitalization or medical treatments.

Can a non-Indian individual purchase Max Bupa Health Insurance policy?

Foreigners living in India can be covered under Max Bupa’s health insurance policy. The coverage, however, will be applicable within the country only.

What does Max Bupa Health Insurance consider a pre-existing illness or condition?

Any medical ailment or condition that has been diagnosed or treated before buying a Max Bupa health insurance policy is termed as a pre-existing disease by the insurance company.

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