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Niva Bupa CritiCare Insurance Plan
Niva Bupa is an Indian Insurance Company based out of New Delhi. Founded in 2008, it is a joint venture between Max India Limited and Bupa, a British healthcare multi-insurance company. In 2019, Niva Bupa was acquired by True North.
Awards and Recognition
The Economic Times Best Brands 2019 award by The Economic Times and Nielsen
GoActive Health Insurance Plan recognized as Product of the Year 2018 by research agency Nielsen
Golden Peacock Award 2015 Heartbeat Health Insurance Plan
IT Management Best Practices at the Celent Model Insurer Asia Awards 2016
Best Product Innovation Award for Heartbeat Family First at Indian Insurance Awards 2011
Note: All information has been sourced from the official website of Niva Bupa Health Insurance.
Acquired Immune Deficiency Syndrome (AIDS), AIDS-related complex or infection by Human Immunodeficiency Virus (HIV)
Attempted suicide or self-inflicted injuries while sane or insane
Narcotics used by the insured unless taken as prescribed by a Medical Practitioner, or the Insured Person’s abuse of drugs and/or consumption of alcohol
Failure to seek or follow Medical Advice
War (whether war be declared or not), invasion, an act of a foreign enemy, hostilities, armed or unarmed truce, civil war, mutiny, rebellion, revolution, insurrection, military or usurped power, riot or civil commotion, strikes
Taking part in any naval, military or air force operation during peacetime
Participation in aviation/marine activities including crew other than as a fare-paying passenger in an aircraft/watercraft that is authorised by the relevant regulations to carry such passengers between established airports or ports
Including but not limited to engaging in or taking part in professional/adventure sports or any hazardous pursuits, such as speed contest or racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving using hard helmet and breathing apparatus, polo, snow and ice sports, hunting etc.
Participation by the Insured Person in a criminal or a breach of law with criminal intent
Nuclear contamination: the radioactive, explosive or hazardous nature of nuclear fuel materials or property contaminated by nuclear fuel materials or accident arising from such nature
Eligibility Criteria for CritiCare Insurance Plan
The age at entry for adults is 18 years to 65 years and for dependent children 2 years to 21 years (maximum two children covered).
Documents Required to Buy Niva Bupa CritiCare Insurance Plan
The documents required to purchase this plan are:
Application/Proposal Form
KYC - Proof of Address and ID
Medical check-up/report, if required
Bank Mandate Form - SI/SIP
Easy Procedure to Renew Niva Bupa CritiCare Insurance Plan
You can renew your Niva Bupa CritiCare Insurance Plan by simply visiting the official website of Niva Bupa. Login in with your registered User ID and Password. Once logged-in, the details of your policy will be visible along with the renewal amount and date.
What is the Claim Procedure for Niva Bupa CritiCare Insurance Plan?
All claims under this policy will be adjudicated after the occurrence of the event and further submission of necessary documents. The benefits will be paid in line with the coverage in the insurance plan opted by you and will be irrespective of the actual costs incurred by you
Documents Required to Claim Niva Bupa CritiCare Insurance Plan
Accident Death
Duly filled and signed claim form and KYC documents
Copy of Death Certificate (issued by the office of Registrar of Births and Deaths)
Copy of First Information Report (FIR) / Panchnama
Copy of Medico Legal Certificate duly attested by the concerned hospital, if applicable
Copy of Hospital Record, if applicable
Copy of Postmortem Report wherever applicable
Accident Permanent Total Disability
Duly filled and signed claim form and KYC documents
Hospital Discharge Summary (in original)/self-attested copies if the originals are submitted with another insurer
Final Hospital Bill (in original)/self-attested copies if the originals are submitted with another insurer
Medical consultations and investigations done from outside the hospital
Certificate of Disability issued by a Medical Board duly constituted by the Central and/or the State Government
Copy of First Information Report (FIR)/Panchnama if applicable
Copy of Medico Legal Certificate duly attested by the concerned hospital, if applicable
Accident Permanent Partial Disability
Duly filled and signed claim form and KYC documents
Hospital Discharge Summary (in original)/self-attested copies if the originals are submitted with another insurer
Final Hospital Bill (in original)/self-attested copies if the originals are submitted with another insurer
Medical consultations and investigations done from outside the hospital
Certificate of Disability issued by a Medical Board duly constituted by the Central and/or the State Government
Copy of First Information Report (FIR)/Panchnama if applicable
Copy of Medico Legal Certificate duly attested by the concerned hospital, if applicable
Accident Temporary Total Disability
Duly filled and signed claim form and KYC documents
Hospital Discharge Summary (in original)/self-attested copies if the originals are submitted with another insurer
Final Hospital bill (in original)/self-attested copies if the originals are submitted with another insurer
Copy of First Information Report (FIR)/Panchnama/Inquest report if applicable
Copy of Medico Legal Certificate duly attested by the concerned hospital if applicable
Attendance record of employer/Certificate of employer confirming period of absence
Disability certificate from treating doctor with seal and stamp
Medical certificate and Fitness certificate with seal and stamp
Accident Hospitalization
Duly filled and signed claim form and KYC documents
Hospital Discharge Summary (in original)/self-attested copies if the originals are submitted with another insurer
Copy of First Information Report (FIR)/Panchnama/Inquest report if applicable
Copy of Medico Legal Certificate duly attested by the concerned hospital if applicable
Final Hospital bill with receipt /copies attested by other insurer if the originals are submitted with them
Original bills with supporting prescriptions and reports for investigations done outside the hospital/copies attested by other insurer if the originals are submitted with them
Original bills with supporting prescriptions for medicines purchased from outside the hospital/copies attested by other insurer if the originals are submitted with them
CritiCare
Duly filled and signed claim form and KYC documents
Final Hospital Discharge Summary in original/self-attested copies if the originals are submitted with another insurer, if applicable
Final Hospital Bill in original/self-attested copies if the originals are submitted with another insurer, if applicable
Consultation notes and/or investigation reports from outside the hospital prior to hospitalization
First consultation notes and all medical record since onset of complaint
Copy of First Information Report (FIR) (if CritiCare being claimed for is admissible in event of an Accident)
Copy of Medico Legal Certificate duly attested by the concerned hospital (if CritiCare being claimed for is admissible in event of an Accident) if applicable
HospiCash
Duly filled and signed claim form with KYC documents
Final Hospital Discharge Summary in original/self-attested copies if the originals are submitted with another insurer
Final Hospital Bill in original/self-attested copies if the originals are submitted with another insurer
Consultation notes and/or investigation reports from outside the hospital prior to hospitalization
Copy of First Information Report (FIR)/Panchnama (In case of accidental injury) if applicable
Copy of Medico Legal Certificate (In case of accidental injury) if applicable
Note: No documents are to be provided for claiming Funeral Expenses and Children Education Expenses
