Max Bupa CritiCare Insurance Plan

Max 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, Max 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 Max Bupa Health Insurance.

Max Bupa CritiCare is a critical insurance policy offered by Max Bupa Health Insurance Company. This plan is specifically designed to protect you and your family for 20 major critical illnesses. The plan can be availed on an individual or family floater basis.

Features and Benefits of Max Bupa CritiCare Insurance Plan

Here are the key features and benefits of Max Bupa CritiCare Insurance Plan:

Tax BenefitsAs per Section 80D of the Income Tax Act, 1961
Pre-existing DiseasePost 48 months of continuous coverage for Criticare and Hospicash
Flexibility Plan OptionsFlexibility to select from 3 cover options - CritiCare, HospiCash and AccidentCare
Sum Insured
  • CritiCare - Rs. 3 lakhs to Rs. 2 Crores
  • AccidentCare - Rs. 5 lakhs to Rs. 5 Crores
  • HospiCash - Rs. 1000 to Rs. 4000 per day
  • Coverage
  • 20 Critical Illnesses
  • Accident Death
  • Accident Permanent Total Disability
  • Accident Permanent Partial Disability
  • Child Education Benefit
  • Funeral Expenses
  • Accident Temporary Total Disability
  • Accident Hospitalization
  • Premium ChargesPremium starts at Rs. 12,521 per year
    Plan OptionYou can opt for any of the following six options:
  • CritiCare + AccidentCare + HospiCash
  • CritiCare + AccidentCare
  • CritiCare + HospiCash
  • AccidentCare + HospiCash
  • CritiCare Only
  • AccidentCare Only
  • Waiting Period48 months for pre-existing diseases, 24 months under HospiCash Benefit for specific conditions

    Value-Added Benefits of Max Bupa CritiCare Insurance Plan

    20 Critical Illnesses Covered

    • Cancer of specified severity
    • Open chest CABG
    • First Heart Attack
    • Open heart replacement/repair of heart valves
    • Stroke
    • Permanent paralysis of limbs
    • End stage liver disease
    • End stage lung disease
    • Comatose
    • Dialysis
    • Major Organ/Bone Marrow Transplant
    • Third degree burns
    • Loss of speech
    • Deafness
    • Aplastic Anemia
    • Bacterial meningitis
    • Fulminant Viral Hepatitis
    • Muscular dystrophy
    • Multiple sclerosis
    • Motor Neuron Disease

    Additional value-added benefits under accident care

    • Accident Temporary Total Disability (TDD) sum insured of Rs. 10 Lakhs and 20 Lakhs
    • Long Term Discount
    • Renewal for life
    • TDD Sum Insured Multiple
    • Accident Hospitalization
    • Surgical Operations/Nursing Care/Drugs/Surgical Dressing
    • Surgeon's Fee
    • Room Rent
    • Operation Theatre Charges
    • Anaesthetics Fees
    • Diagnostic Procedures and Therapies
    • Prosthetic Implants
    • Emergency Ambulance
    • Physiotherapy

    Inclusion of Max Bupa CritiCare Insurance Plan

    The inclusions under this plan are:

    • 20 Critical Illnesses
    • Accident Death
    • Accident Permanent Total Disability
    • Accident Permanent Partial Disability
    • Child Education Benefit
    • Funeral Expenses
    • Accident Temporary Total Disability
    • Accident Hospitalization

    Exclusions of Max Bupa CritiCare Insurance Plan

    The exclusions under this plan are:

    • 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 Max 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 Max Bupa CritiCare Insurance Plan

    You can renew your Max Bupa CritiCare Insurance Plan by simply visiting the official website of Max 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 Max 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 Max 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

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