Waiting period and exclusions
Easy to reach
NIVA BUPA HEALTH INSURANCE COMPANY LIMITED
Registered Oce Address: C-98, First Floor, Lajpat Nagar, Part 1, New Delhi-110024.
Fax No: +91 11 41743397
If you would like to find out more, please reach out to our specialised sales team or your Niva Bupa advisor. We are available to fully
understand your requirements and help you select the right plan for you and your family.
Email ID:
customercare@nivabupa.com
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Helpline:
1860-500-8888
Website:
www.nivabupa.com
Say ‘Hi’ to us on WhatsApp:
9811956696
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nivabupa
PRESENTING
Keeps giving you more!
•
Treatment during the first 30 days of the plan will not be
covered, unless the treatment needed is a result of an accident.
This waiting period does not apply for renewal policies
•
Any pre-existing conditions will be covered after a waiting
period of 3 years. Whereas, conditions specified in your policy
under Personal Waiting Period will be covered after a waiting
period of 2 years
•
2 years Waiting period for specified disease/procedures like
cataract, pancreatitis, hernia, etc.
•
Investigation & Evaluation, OPD treatment
•
Unproven Treatments, Unrecognized Physician or Hospital
•
Breach of law, Conflict & Disaster, Excluded Providers
•
Hazardous or Adventure sports
•
Change-of-Gender treatments, Hormone Replacement Therapy,
Cosmetic or plastic Surgery
•
Sleep disorders, treatment for alcoholism, drug or substance
abuse or any addictive condition
•
Dental/oral treatment
•
Sterility and Infertility, Maternity Expenses
•
Circumcision, External Congenital Anomaly
•
Sexually transmitted Infections & diseases (other than HIV / AIDS)
•
Any treatment or medical services received outside the
geographical limits of India
•
Intentional self-inflicted Injury or attempted suicide
Booster benefit** - Doubles the sum
insured in 2 claim free years
Safeguard features
$$
– Go truly
cashless with coverage even for
non-payable items like gloves etc.^^
ReAssure
#
- ReAssure Benefit will trigger after
the 1
st
claim itself. It is unlimited. Each claim will
be up to the base sum insured.
ReAssurance at every step
30 min. cashless claims processing
$
3
Live healthy benefit – get up to 30%
discount on renewal premium basis
step count in Niva Bupa Health App
Health check-up – starting from day 1
Refer to the policy document for further details on sub-limits, waiting period and exclusions.
Disclaimer: This is only a summary of the product features and is for reference purpose only. The details of benefits available shall be as described in the
prospectus, and will be subject to the policy terms, conditions and exclusions. Please call our customer service if you require any further information or
clarification.
Insurance is a subject matter of solicitation. Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited)
(IRDAI Registration No. 145). ‘Bupa’ and ‘HEARTBEAT’ logo are registered trademarks of their respective owners and are being used by Niva Bupa Health
Insurance Company Limited under license. *Tax benefits are subject to changes in tax laws. Savings amount computed for an individual who is in highest slab
of income tax and surcharge. Maximum deduction under section 80D is ` 100000. The highest tax slab for an individual is (base rate 30%+ 37% SC = 41.1 %
+ 4% cess = 42.744%) ` 100000 x 42.744% = 42744. Tax saving can vary basis individual’s income and policy coverage. Please consult your tax advisor for
more details.
$
Niva Bupa processes pre-authorisation requests within 30 minutes for all active policies, subject to receiving all documents and information(s)
up to Niva Bupa’s satisfaction. The above commitment does not include pre-authorisation settlement at the time of discharge or system outage.
##
Number
of network hospitals shown is an approximate figure and is subject to change without prior notice, please visit our website to access latest and updated list
of network hospitals.
#
Single claim under this benefit will be payable up to base sum insured. ^As per IRDAI guidelines. ***Only for retail products.
$$
Safeguard
is an optional benefit and is available on payment of extra premium. ^^As per the list I under Annexure II of policy Terms and conditions.
**
In case of a claim,
Booster Benefit will be reduced by 50% of Sum Insured.
~
ReAssure plan covers COVID-19 related hospitalisation. For more details on risk factors, terms and
conditions, please read sales brochure carefully before concluding the sale. CIN: U66000DL2008PLC182918, Product Name: ReAssure. Product UIN:
NBHHLIP23107V022223. UIN: NB/BR/CA/2022-23/423.
COVID-19
COVERAGE
˜
COMPLETE
REASSURANCE
WITH
Product Benefit Table (all limits in ` unless defined as percentage)
Base sum insured 3L, 4L, 5L, 7.5L, 10L, 12.5L, 15L, 20L, 25L, 50L, 75L, 1Cr
Benefits covered upto
sum insured
Pre and post
hospitalization
expenses - 60 and 180 days
respectively
Home care treatment
Inpatient care (without any
room rent capping)
Day care treatment Domiciliary hospitalization
Alternative treatments Living organ donor transplant
ReAssure
Unlimited reinstatement of Sum Insured applicable for any illness or anyone insured (Single claim
under this benefit will be payable up to base sum insured)
Booster benefit
In case of claim free year, increase of 50% of base sum insured in a policy year; maximum up to
100% (In case of a claim, reduction of accumulated cumulative bonus by 50% of base sum insured)
Health check-up
Annual (From Day 1); For defined list of tests; up to 500 for every 1 Lac sum insured
(Individual policy: maximum 5,000 per Insured; Family Floater policy: maximum 10,000 per policy)
Live healthy benefit
(1)
Collect health points by taking steps counted on our Niva Bupa Health App and get discount
up tp 30% on renewal premium
Modern treatments
Covered up to sum insured with sub-limit of 1 Lac on few robotic surgeries
(as specified in policy terms)
Second medical opinion
Once for any condition for which hospitalization is triggered
Emergency ambulance Covered upto 2,000 per hospitalization
Air ambulance
Cashless claim: Covered up to sum insured
Reimbursement claim: Covered up to 2.5 Lacs
Shared accommodation
cash benefit
Up to 15 Lacs base sum insured: 800 per day (maximum 4,800)
A bove 15 Lacs base sum insured: 1,000 per day; (maximum 6,000)
Optional benefits
Safeguard
a. Claim safeguard: Non-payable items paid up to sum insured
b. Booster benefit safeguard: No impact on Booster benefit if claims in a policy year is up to 50,000
c. Sum insured safeguard: CPI (Consumer Price Index) linked increase in base sum insured
Hospital cash
(2)
Up to 5 Lac base sum insured: 1,000/day
7.5 Lacs to 15 Lacs base sum insured: 2,000/day
Above 15 Lacs base sum insured: 4,000/day
Personal accident cover
(for insured aged 18
years & above)
5 times of base sum insured; subject to maximum of 1 Crore
(2)
Hospital cash - Minimum 48 hrs of continuous hospitalization required. Maximum coverage oered for 30 days/policy
year/insured person. Payment made from day one subject to hospitalization claim being admissible.
(1)
Eligible insured person for this benefit will be: a. All members except son / daughter under a Family Floater policy
b. Any member of age at least 18 years under an Individual policy
Niva Bupa Health Insurance is a leading standalone health insurance provider serving 3 million plus customers since 2010. At Niva Bupa, our mission is
to help our customers live healthier and more successful lives by providing expertise as their healthcare partners. For us, health insurance is not just an
annual transaction. Rather, it is about building a long-term relationship with our customers.
Thoughtfully designed plan to keep you
more secure and comfortable at the time of hospitalization
A health insurance plan designed to give you and your family more than you expect from a health insurance plan.
ReAssure health insurance plan is tailored to secure you and your family's health and financial well being with features that
keep giving you more, like coverage options up to ` 1 Cr, unlimited reinstatement of base sum insured, safeguard against
medical inflation, to giving you a complete cashless experience with coverage for even the consumables, ReAssure just
keeps giving you more. This plan comes with the promise to keep you motivated to stay fit with its Live Healthy Benefit, so
that you stay healthy and keep getting more!
Niva Bupa
Presenting
Health Insurance Plan
ReAssure benefits, discounts and more
Make the most of your policy and take greater charge
of your health with these optional benefits
Hospital Cash
(2)
Get an additional pay-out to cover miscellaneous expenses that you may incur during hospitalization, provided there has been a minimum
period of 48 hours of continuous hospitalization.
With this optional cover, a lump sum pay-out is oered in case of accidental death, total, or partial disability.
Personal Accident Cover
Safeguard
We make sure that you have the freedom you need in order to secure your health up to your requirements, which is why the Safeguard benefit
lets you go even further and control dierent aspects of your policy, such as:
Claim safeguard lets you claim on otherwise non-payable
items up to the sum insured in case of hospitalization, like
gloves, and more.
1.
Booster benefit safeguard means there will be no impact
on your Booster benefit if claims in a policy year are up to
Rs. 50,000.
2.
Sum Insured Safeguard increases the base sum insured on a
cumulative basis each policy year based on inflation rate.
Inflation rate would be computed as the average Consumer Price
index (CPI) of the entire calendar year published by the Central
Statistical Organization (CSO). There is no maximum limit on increase
in Sum Insured under this optional cover.
3.
ReAssure Policy coverage
The policy can be purchased on individual and family floater basis. Relationships covered for adults is / are self, spouse, father, father in law,
mother and mother in law. Parent & parent-in-law cannot be covered in the same policy.
Ensuring care beyond hospitalisation and more
Claims
30 Minute Cashless Claims Processing
$
We aim to process all cashless claims in 30 minutes
so that you can be with your loved ones in their hour
of need.
3
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8800+ Wide Network Hospitals
Avail cashless facility across India at
##
8800+
network hospitals.
Hassle-free Reimbursements
Sometimes, you may not be able to access a network
hospital for availing cashless facility. In such cases, to
get your claim reimbursed as fast as possible, all you
need do is submit the requisite documents to us.
Direct Claims Settlement
***
For quick claims processing we ensure all claims are
processed by our team of in-house doctors.
Point of Care Desk (POC)
At our select partner hospitals, a Niva Bupa representative is available to assist you through all the formalities like filling forms,
submitting claims etc. so that you are at ease in an unfamiliar hospital environment.
Visit www.nivabupa.com for a list of hospitals with this facility (some POC desks may not be operational in COVID-19 times).
Discount illustration to maximize your savings
Renewal Process
Life-long Renewal - Get life-long renewal, regardless of your health status or previous claims made under your policy. Your renewal
premium will increase as your age increases but will not alter based on your claim experience.
1.
Sum Insured Enhancement - To protect yourself from rising medical expenses, you can enhance your sum insured or add more members
of your family in your existing policy at the time of renewal. We may reach out to you for additional information/medicals in case needed.
2.
Portability and Migration^ - You can port or migrate your policy at the time of renewal. Please reach out to us for any query
regarding migration and portability.
3.
Take greater charge of your policy and
manage it at your convenience
Coverage for Domiciliary Treatment and
home care treatments like Chemotherapy
and Dialysis
Second medical opinion
Health Check-ups from day 1
Emergency road and air ambulance
coverage
ReAssure
ReAssure benefit oers unlimited reinstatement of
sum insured for any illness for anyone insured in a
policy year, ensuring you never run out of sum
insured. Unlimited Sum insured reinstatements is
triggered with the first paid claim itself and is
available for all subsequent claims in a Policy Year, so
that you can claim as many times as needed
#
.
Booster Benefit
A benefit specially designed to ensure that your
health coverage extends further. With this benefit
double your sum insured in just 2 claim free years.
This means, if no claims are made in the preceding
Policy Year, your Base Sum Insured increases by
50% subject to a maximum of 100%.
Tenure Discount
Get discount of 7.5% on the premium of second
policy year if you pay for a 2-year policy term in
advance, and additional 15% discount on third
year’s premium if you choose a 3-year policy term.
Shared Accommodation Cash benefit
In case of shared room accommodation during
Hospitalization in a Network Hospital, a daily
cash amount is paid to the insured person for
each continuous and completed period of 24
hours of hospitalization.
Live Healthy benefit
(1)
Get an additional renewal premium discount of up
to 30% basis the health points collected by you on
Niva Bupa Health App. To avail this benefit, all you
have to do is collect health points by taking steps
counted on Niva Bupa Health App.
Doctor discount
We realize how important the contribution of the
medical community is, and are extremely grateful
for the selfless service they provide. Which is why
we oer an additional premium discount of 5%, if an
insured person is a certified medical practitioner.
Standing Instruction discount
Get 2.5% discount on premium if standing
instruction for auto debit on renewal is provided
and the policy is renewed using the same.
15-Day Free Look Period^
You get the freedom to change your decision of
continuing with the policy within a period of 15 days
(30 days if the policy with Policy Period as 3 years
has been sold through distance marketing).
15
DAYS
Individual policy (2 members)
At inception
Premium 100 each member
Family Discount of 10% 20
Term discount on 3 years (7.5% on 2nd year + 15% on 3rd year) 40.5
Doctor discount of 5% 25
Final premium 474.5
Premium without any discount 600
Total saving 20.9%
At renewal
Additional Auto-debit discount of 2.5% 11.9
Additional Live healthy discount of max 30% 138.8
Final Premium 323.8
Premium without any discount 600
Total saving 46%
Tax Savings
Income tax* benefit upto INR 42,744 under the
Section 80D of the Income Tax Act, 1961.
Family discount
Get 10% discount on premium if 2 or more members
are being covered under an individual policy.
Pre and Post-Hospitalization Expenses
Coverage for pre and post hospitalization expenses
up to the sum insured, 60 days prior and 180 days
post hospitalization.
Alternative Treatments
Coverage for inpatient treatment under AYUSH that
allows you to opt for Ayurveda, Unani, Siddha, and
Homeopathy treatments.
Living Organ Donor Transplant
Coverage of all medical expenses for organ donor’s
in-patient treatment for harvesting of the organ
donated.
Modern Treatments
Coverage for modern treatments like deep brain
stimulation, oral chemotherapy to robotic surgeries
and stereotactic radio surgeries, stem cell therapy
and more.
Inpatient Care
Coverage for all medical expenses one could
generally incur at the time of hospitalization,
including room rent coverage with no capping, to
medical practitioners’ fees, investigative tests,
medicines, OT charges and many more.
Day Care Treatment
Coverage for all medical expenses incurred during
Day Care Treatment requiring more than 2 hours of
hospitalization, including angiography, dialysis,
radiotherapy and more.
Niva Bupa Health App
Manage your Niva Bupa policy on the go and access
various health services like scheduling diagnostic
tests, locating nearest network hospitals, door step
delivery of medicines and more. Available on both
IOS & Google play store.
CIA Chatbot
Talk to our interactive chatbot CIA on
www.nivabupa.com to manage your policy, track
renewals, update policy details or find your nearest
network hospital at the click of a button!
