Niva Bupa Insurance Company

Niva Bupa, formerly known as Max Bupa, is a standalone health insurance provider in India. The company is a joint venture between Fettle Tone LLP and Bupa Singapore Holdings Private Limited. Fettle Tone LLP is an affiliate of True North Fund VI LLP and is a private equity firm of India. Bupa, on the other hand, is a leading healthcare provider globally. Niva Bupa’s health insurance plans are meant for individuals, families, senior citizens as well as corporates.

Highlights of Niva Bupa Health Insurance Company

Claim Settlement Ratio 100%
NCB* 10% of SI*
PED Waiting# 48 months
Network Hospital 10,000+
Top Health Insurance Plans by Niva Bupa Health Insurance

Compare Top Health Plans from Niva Bupa Health Insurance Company

Senior First
ReAssure 2.0 Bronze
ReAssure 2.0 Platinum
ReAssure 2.0 Titanium
Features
Modern treatments
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Pre-and post-hospitalization
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Annual Health Check-up
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AYUSH
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Individual/Family Floater
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Lifetime renewability
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Day Care Treatment
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Features
Modern treatments
Pre-and post-hospitalization
Annual Health Check-up
AYUSH
Individual/Family Floater
Lifetime renewability
Day Care Treatment

Awards and accolades won by Niva Bupa Health company

The company has won many awards in the industry for its innovative products, services and performance. Here’s a look at some of them –

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 Niva Bupa Health Insurance was recognised as one the Best BFSI Brands 2024 by Economic Times.

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Niva Bupa Health Insurance Company also won the Great Place to Work certification for the fourth year in a row this year and got recognized amongst the Top 25 India’s Best Workplaces in BFSI 2024.

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The Company was declared Gold winner in the category of Healthcare Insurance Company of the Year by IAMAI.

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The Company was awarded the Best Health Insurer among standalone health insurance companies at the Mint BFSI Summit and Awards, declared the winner under the category of ‘Highest Growth- SAHI’ and ‘Overall achievement- SAHI’ at ASSOCHAM Global Insurance Summit & Awards.

Key Highlights of Niva Bupa Health Insurance Company

Features

Meaning

Cashless hospitals

10000+

Cashless claim settlement

30 minute processing for 9 out of 10 claims

Existing customers

More than 1 Crore+

Agent network

More than 1,45,385 (2022-23)

Features of Niva Bupa Health Insurance

Features

Meaning

Inpatient-hospitalization cover

During inpatient hospitalization, you undergo treatment for an illness or injury in a hospital. The cost of hospitalization and treatments are covered, if you are admitted for 24 hours or more

Pre-hospitalization cover

When you incur medical costs before hospitalization for the same illness or injury for which you are being hospitalized, such medical costs are covered for a certain number of days.

Post-hospitalization cover

Following treatment and discharge, if there are medical expenses incurred for recovery or post-operative care, those expenses will be covered for a set period.

Day-care cover

A day-care treatment does not require hospitalization for 24 hours. The plan covers these types of treatments as well.

Ambulance cover

In this category, you will find the costs associated with using an ambulance for transport to the hospital.

Organ donor cover

A policy covering your organ transplant would also cover the costs of a donor’s hospitalization and subsequent transplantation surgery.

Daycare procedures

Medical treatments wherein a hospital stay of 24 hours is not needed are called daycare procedures. Such procedures are covered under the policy

AYUSH cover

Many Niva Bupa health insurance plans also cover non-allopathic treatments such as Ayurveda, Unani, Homeopathy, and Siddha.

Domiciliary cover

Patients are hospitalized at home either because of insufficient hospital beds or because they cannot afford a hospital stay. The practice of receiving care at home rather than in a hospital is known as domiciliary hospitalization. Niva Bupa health plans provide coverage for such hospitalizations.

Free health check-ups

Additionally, Niva Bupa policies allow you to monitor and assess your health by having health check-ups, free of charge, after regular intervals.

No claim bonus

If you don’t claim within a policy year, you earn a no claim bonus. Many Niva Bupa plans allow the sum insured to be enhanced under the bonus while in some cases you might avail of a discount on renewal premiums.

Exclusions in Niva Bupa Health Insurance

Like every health insurance company, Niva Bupa also has a list of exclusions that won’t be covered. It is possible to find the exact exclusion list in the policy wordings. Nevertheless, some common exclusions include the following:
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When purchasing a policy, if you suffer from any illness or condition, it will be considered as a pre-existing illness and excluded for a specific waiting period

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There may be a 2-year waiting period before certain illnesses or treatments are covered. There are many examples of such treatments like cataracts, joint replacement treatments, fissures, piles, etc.

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There is no coverage for illnesses that occur within the first 30 days of purchasing the insurance

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There is no coverage for cosmetic treatments or weight-loss surgeries

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The following claims are excluded: war, nuclear threats, mutiny, rebellion, etc.

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Adventure sports, hazardous activities, and crimes, as well as the claims arising from them, are excluded from coverage

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Instances of suicide attempts, self-inflicted injuries, and alcohol and drug abuse excluded from this list as well

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No coverage is provided for treatments that are unscientific or do not follow the doctor’s advice

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No reimbursement is provided for lenses, hearing aids, spectacles, etc.

Health insurance plans offered by Niva Bupa

Niva Bupa has a wide variety of health insurance plans in its kitty. Some of the leading policies of the company, also available at PayBima, include the following –
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Reassure Health Insurance

A comprehensive health insurance plan available both on an individual and family floater basis, Reassure can provide all the coverage benefits that your family needs.

Features of Niva Bupa Reassure Health Insurance: 

  • Unlimited sum insured reinstatement: The plan allows unmatched coverage by allowing unlimited sum insured reinstatement. If you suffer multiple claims in a year and your sum insured gets used up, the plan would refill the sum insured, as many times as you want.

  • Healthy living benefits: The plan has a wellness program wherein you can accumulate reward points every time you go walking and take a specified number of steps. Your steps would be tracked and depending on the count you can accumulate your reward points. These points can then be used to claim a discount on the premium on renewal.

  • Double your sum insured in just 2 years: The plan has the booster no claim benefit wherein the sum insured would increase by 50% if you don’t  claim in a policy year. So, if you don’t claim for two successive policy years, you can double the sum insured and that too is free of cost.

  • Air ambulance cover: Coverage for air ambulance expenses is also allowed if you require such transportation for hospitalisation. In the case of cashless claims, coverage is allowed up to the sum insured. However, for reimbursement claims the coverage limit is Rs.2.5 lakhs.

  • Range of optional benefits: There are different types of optional coverage benefits under the policy that can help you enhance the coverage as per your needs at affordable premiums.

Eligibility Conditions of Niva Bupa Reassure Health Insurance

  Sum insured   Rs.3 lakhs to Rs.1 crore
  Pre-existing waiting period   3 years
  Number of members covered   Up to 6 members

 

 

 

 

 

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Companion

This is also an indemnity-based health insurance policy that covers your actual medical costs. The policy has the following salient features: 

  • Different coverage variants: The plan has four coverage variants with different coverage benefits, limits and sum insured levels. You can choose a variant that best matches your coverage needs and affordability.

  • Refill benefit: The plan allows the sum insured refill benefit wherein if your sum insured is used on a previous claim in the same policy year, the sum insured would be refilled to the original amount to pay for any subsequent claims.

  • Vaccination cover: In the case of animal bites, coverage for the cost of vaccines is allowed.

  • Coverage for modern treatments: The plan covers modern and robotic surgeries and treatments up to the sum insured. However, in the case of some treatments, coverage is allowed up to Rs.1 lakh.

Eligibility conditions of Niva Bupa Health Companion Plan

  Sum insured   Rs.2 lakhs to Rs.1 crore
  Entry age   91 days onwards
  Pre-existing waiting period   Variant 1 – 48 months
  Variants 2,3 and 4 – 36 months
  Policy term   1 year or 2 years

 

 

 

 

 

 

 

 

 

 

 

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Health Recharge

Health Recharge is a super top-up policy that has a sum insured and a deductible. If your aggregate claims exceed the chosen deductible, the policy pays the excess claim. Some of the highlights of the policy are as follows –

  • The facility of online consultations: You can avail of multiple online and teleconsultations with expert medical practitioners. You just have to get in touch with a networked service provider and then consult with a doctor free of cost.

  • Coverage for treatments due to mental disorders: If you are hospitalised due to mental disorders, the costs incurred on treating such disorders would be covered by the policy. Moreover, there is no coverage restriction as you can enjoy coverage up to the sum insured

  • Loyalty benefit: Every year that you don’t claim your policy, you earn a loyalty benefit of a 5% increase in the sum insured without any additional premium. You can continue accumulating the increase for each claim-free year up to a maximum of 50%.

  • Coverage for HIV/AIDS and artificial life maintenance: Coverage for HIV/AIDS as well as for maintaining artificial life is allowed under the plan while other plans might not include it. Moreover, you can avail of coverage up to the sum insured

Eligibility conditions of Health Recharge Plan

 Sum insured  Rs.2 lakhs to Rs.95 lakhs
 Deductible limit  Rs.10,000 to Rs.10 lakhs
 Pre-existing waiting period  4 years
 Number of members covered  Up to 2 children and 4 adults

 

Eligibility conditions

Minimum entry age

18 years for adults and 15 days for children

Maximum entry age

65 years for adults and 18 years for children

Sum insured

INR 5 lakh – INR 1 Crore

Policy term

1 year – 2 years

Number of family members covered

Self, spouse, children, elderly parents

Renewability

Lifetime renewability

Waiting period (Initial waiting period)

30 days

Waiting period (PED)

24 months - 48 months

How to buy Niva Bupa Health Insurance Plan?

Go to the official portal of Niva Bupa Health Insurance. Go to "Plans”. Select plan according to your requirement and submit your mobile number. 

Or visit the Paybima portal and select  Health Insurance from the options available.

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Visit the Paybima homepage and click on the ‘Health Insurance’ tab in the dropdown menu.

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Fill in your required details and request a callback.

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A Paybima representative will help you buy the most suitable plan.

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You may also reach us at 1800 267 67 67 from 10 AM to 7 PM, or

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You can visit a Paybima branch near you.

The process of renewing Niva Bupa Health Insurance Policy

What is the Process for Filing a Claim for Niva Bupa Health Insurance Plan?

You just need to complete the following steps:
1
Finding a network hospital

You can make a cashless claim only at a hospital that is networked with Niva Bupa. Go to the insurance company’s website to find the nearest network hospital to make a cashless claim. You can also contact the company’s claim department and locate a hospital for cashless claims.

2
Admission

Upon finding a networked hospital, you can be admitted by showing your ID proof and health card.

3
Pre-authorization Claim form

The insurance company must receive a pre-authorization claim form to process a cashless settlement of your claim. The pre-authorization form is available online or at the nearest branch. In the case of planned hospitalization, the form must be submitted at least three to four days before the event. During an emergency, the form can also be submitted within 24 hours after hospitalization.

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Cashless approval

Based on the details entered in the pre-authorization claim form, Niva Bupa would approve the cashless claim. You can, then, receive treatments and the costs would be handled directly by the company.

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Reimbursement Claim Facility

If you are admitted to a hospital that is not in the company’s network, your claim will be reimbursed. Alternatively, if your cashless claim is not approved, you can claim on a reimbursement basis. You must notify your insurance company before you plan to be admitted to a non-network hospital. You can notify the insurance company after you have been admitted and before you are discharged if you have an emergency admission. You will need to pay the medical bills incurred. When you submit a claim form along with original receipts, bills, and medical records, the hospital will reimburse you after it assesses your claim and validates your documents.

Guaranteed Claim Support

When you buy or renew a health insurance plan from us, we guide at every step till your claim is settled.

Start your claim process with us to get our support

Review of Niva Bupa Health Insurance Company

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The company offers the facility of comparing the different plans that it offers. You can compare the plans and choose those that give the best protection as per your needs.

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The company does not have any TPAs for claim handling. It handles its claims internally to give you the smoothest settlement.

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You can contact the company 24*7 for any complains or queries.

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Most health plans cover COVID-19 claims.

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