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Individual Health Insurance Plans
Niva Bupa (Formerly Known Max Bupa) Health Insurance
Niva Bupa (Formerly Known Max Bupa) is one of India’s most reputable and well-known health insurance company. It’s a joint venture between India’s “True North” private equity firm and Bupa, a UK-based leading provider of healthcare services and health insurance policies. Owing to Bupa’s wide as well as diversified experiences and True North’s deep understanding of Indian customers and the healthcare industry, the company acquired the ability to meet the healthcare needs of a plethora of clients.
It features a diverse product offering that aims to save all of its customers’ money on medical expenditures. The organization employs over 34000 agents and has a large network of hospitals that provide cashless treatment. It also offers a home pick-up service for diagnostic samples and drug delivery. Niva Bupa (Formerly Known Max Bupa) claim settlement can resolve cashless claims in 30 minutes, thanks to its effective in-house claim settlement team.
|Incurred Claim Ratio (2019-20)||53.51%|
|Corporate Office Address||Niva Bupa (Formerly Known Max Bupa) Health Insurance Company Limited, 14th Floor, Capital CyberScape, Sector 59, Gurugram, Haryana|
|Recent Awards & Accolades|
|Types Of Plan|
Niva Bupa (Formerly Known Max Bupa) Health Insurance Plans
Niva Bupa (Formerly Known Max Bupa) Health Insurance has 13 different health plans to meet your financial demands in the event of a medical emergency. The following is a list of the 13 plans:
1. Niva Bupa ReAssure Plan
The Niva Bupa Reassure plan is a comprehensive policy that includes a variety of coverage options. With various outstanding benefits, this plan is specifically designed to safeguard your financial well-being.
- In-Patient Treatment: It covers all the medical costs while the insured person is in the hospital, such as room rent, operating room charges, medications, doctor’s fees, etc.
- Organ Donor Transplant: All medical expenses spent for in-patient treatment of organ donors are covered.
- Ultra-Modern Treatments: The plan covers modern therapies including robotic operations, cell therapy, and oral chemotherapy, among other things.
|Premium||Starting @ Rs. 9111/Year|
|Sum Insured||From Rs. 10 Lakhs To Rs. 1 Crore|
|Number Of Members Covered||Maximum 6 Members|
2. Niva Bupa Health Companion Plan
Medical treatments, hospitalization, pricey medical tests, and other expenses can quickly drain your hard-earned cash or savings. Niva Bupa (Formerly Known Max Bupa) Health Companion comes with a number of features, including direct claim settlement and lifelong renewability. The plan comes in three variants: Variant 1, Variant 2, and Variant 3.
- Comprehensive Coverage: The plan is specifically designed to cover individuals, their spouses, nuclear, as well as extended families.
- Lifetime Renewability: Max Bupa Health Companion plan is renewable for the lifetime.
- Reload Of Sum Insured: If the policyholder’s basic sum insured is exhausted, a refill benefit is provided, in which the insured receives a reload of 100% of the sum insured.
|Premium||Starting @ Rs. 5,085/Year (For All Variants)|
3. Niva Bupa Health Premia Plan
The Niva Bupa Health Premia plan is a comprehensive health insurance plan that covers everything from maternity and newborn care to medical emergencies. The plan is specifically designed to cover your health needs as well as those of your family members. The plan comes in three variants: Silver, Gold, and Platinum.
- Covers Modern Treatments: The plan includes procedures that need advanced surgery, such as robotics, laser, bariatric surgery, organ transplantation, and so on.
- Worldwide Maternity Coverage: The plan includes global maternity benefits for the newborn baby’s health and vaccination requirements.
- In-Patient Treatment: The plan pays for medical expenses incurred while hospitalization, such as medicine, room rent, and doctor consultations, among other things.
|Premium||Starts @ 12,488 Per Annum (For All Variants)|
4. Niva Bupa Corona Kavach Policy
The Niva Bupa Corona Kavach coverage can help you and your family members protect against COVID-19-related expenses. To be eligible for the benefits and coverage of this hospitalization plan, you must be admitted to the hospital for at least 24 hours.
- Hospitalization Expenses: The plan covers up to the sum insured expenses in case of COVID-19 hospitalization.
- Alternative Treatment: Treatments based on Ayurveda, Yoga, Siddha, Unani, and Homeopathy are included under the plan.
- Homecare Treatment Expenses: The plan also provides coverage for the treatment at home for COVID-19, in case of positive COVID-19 diagnosis.
|Premium||Starts @ Rs. 1039|
|Sum Insured||From Rs. 50,000 To Rs. 5 Lakhs|
|Tenure||3.5 Months, 6.5 Months, 9.5 Months|
Minimum Age: 18 Years
Maximum Age: 65 Years
5. Niva Bupa Go Active
The Niva Bupa Go Active plan covers your daily hospitalization needs while also allowing you to use cashless OPD and diagnostic services. The plan also includes coverage for up to two adults and four children.
- OPD Consultations: The plan provides coverage for up to 10 doctor’s consultations.
- Daycare Treatments: The plan also covers the treatments that do not need hospitalization.
- I-Protect Option: The plan also includes an I-Protect option, which boosts coverage by 10% each year following renewal.
|Premium||Starts @ Rs. 13,352 Per Year|
|Sum Insured||From Rs. 4 Lakhs To Rs. 25 Lakhs|
|Diagnostic Tests||Up To Rs. 2500 Per Person Per Year|
6. Niva Bupa Money Saver Policy
Niva Bupa Money Saver plan is a perfect amalgamation of Base and Top-Up plans. The plan is specifically designed to provide strong protection to you as well as your family members.
- AYUSH Treatments: The policyholder is covered for in-patient AYUSH therapy up to the base sum insured under the plan.
- Health Check-Ups: Schedule health checkups for yourself and other adult family members for a specific set of tests.
- 20% Of The Sum Insured: For each year without a claim, you might earn up to 20% of the money covered. The maximum limit is 100 percent of the insured amount.
|Premium||Starts @ Rs. 8,181 Per Annum|
|Sum Insured||Rs. 10.5 Lakhs To Rs. 1 Crore|
|Hospital Cash||Up To Rs. 2000 Per Day|
7. Niva Bupa Heart Beat plan
Niva Bupa Heart Beat plan is a comprehensive plan for you as well as your family members that take care of the finer details. The plan includes international cashless coverage, immediate claim settlement, and a variety of other features. It comes in two variants: Gold and Platinum.
- Loyalty Bonus: Under the plan, you can get 10% more sum insured irrespective of your claim history.
- No Room Rent Cap: Room rent is covered up to the sum insured in the event of hospitalization.
- Worldwide Coverage: Under the platinum plan, the policyholder gets the coverage even if he/she travels abroad.
|Premium||Starts @ Rs. 16,414 Per Year (For Both Variants)|
8. Niva Bupa Super Saver
The Niva Bupa Super Saver is a low-cost combo plan that covers you for up to Rs. 1 crore in medical expenses. The plan allows the insured to have as many telephonic or online consultations as he or she wants.
- Enhanced No-Claim Bonus: For every claim-free year, you will get 200% NCB.
- E-Consultations: The policyholder can have unlimited tele or online consultations under the plan.
- Alternative Treatment: The plan also provides coverage for the treatment under Ayurveda, Siddha, Unani, and Homeopathy. The coverage is up to the sum insured.
|Premium||Starts @ Rs. 9,214 Per Year|
|Sum Insured||Rs. 10.5 Lakhs To Rs. 1 Crore|
|Health Check-Up||Annual (From 2nd Policy Year)|
|Refill Benefit||150% Of The Sum Insured|
9. Niva Bupa Senior First
Niva Bupa Senior First is a tailor-made health insurance plan specifically for senior citizens. The plan comes in two variants: Gold and Platinum.
- Modern Treatments: The plan covers modern treatments, such as robotic surgeries, up to the sum insured along with the sub-limit of Rs. 1 lakh per claim.
- Room Category: Under the Gold plan, the insured gets the shared room coverage; whereas, under the Platinum plan, the insured gets a single private room.
- Pre- & Post-Hospitalization: Expenses occurring 60 days before hospitalization and 180 days after the discharge from the hospital are covered under the plan.
|Premium||Starts @ Rs. 13,453 Per Year|
|Health Check-Up (Platinum Plan)|
Up to ₹500 for every 1 lakh base sum insured
|Ambulance Cover (Gold Plan)|
10. Niva Bupa Health Pulse Plan
The Niva Bupa Health Pulse plan protects your health and provides personalized benefits for you and your family. Individuals, as well as families, can purchase the package, which comes in two variants: Classic and Enhanced.
- Direct Claim Settlements: Under the Max Bupa Health Pulse plan, there is no need for any third party to availing of the claim process.
- Lifetime Renewability: Once you have purchased this policy, you can renew it for a lifetime.
- Refill Benefit: In case you have exhausted your sum insured during the policy tenure, you can get the cover restored as a refill benefit.
|Premium||Starts @ Rs. 8,339 Per Year|
|Health Check-Up||From 2nd Policy Year (For Both Plans)|
|No Claim Bonus||20% (For Both Plans)|
11. Niva Bupa Accident Care Plan
Accidents not only cause physical pain, but they also burn a large hole in one’s wallet. The Niva Bupa Accident Care plan protects you from death or disability arising out of an accident.
- Permanent Partial & Total Disability: In case you face a permanent partial disability, the plan provides you with 100% of the sum insured. In case you face permanent total disability, you can get 125% of the sum insured.
- Accidental Death: In case there is an accidental death, the family members receive 100% of the sum insured.
- Child Education Benefit: In case of your death or permanent disability, your child will receive up to Rs. 5 lakhs.
|Premium||Starts @ Rs. 6,444 Per Year|
|Sum Insured||Rs. 5 Lakhs To Rs. 2 Crore|
12. Niva Bupa Criticare plan
Niva Bupa Criticare plan was created with the goal of providing protection against serious illnesses. After a diagnosis of any of the specified critical illnesses, the Niva Bupa Criticare plan pays a lump sum amount to the policyholder.
- Wider Coverage: The plan covers 20 major critical illnesses.
- Hospital Cash: The policyholder will get a daily cash allowance to ease the financial burden.
- Long Term Discounts: In case you choose a policy of 2 or 3 years, you will get a discount on the 2nd and 3rd year’s premium.
|Premium||Starts @ Rs. 12,521 Per Year|
|Sum Insured||Rs. 3 Lakhs To Rs. 2 Crores|
|Number Of Critical Illnesses Covered||20|
13. Niva Bupa Saral Suraksha Bima
Niva Bupa Saral Surakshabima is specifically designed to protect the policyholders against accidents. The plan is available both for individuals and family members.
- Permanent Partial Disability: In case of permanent partial disablement due to an accident, the plan covers up to 50% of the sum insured.
- Permanent Total Disability: In case of permanent total disablement due to an accident, the plan provides coverage up to the sum insured.
- Accidental Death: The plan provides coverage up to the sum insured in case of accidental death.
|Premium||Starts From Rs. 296|
|Sum Insured||Rs. 2.5 Lakhs To Rs. 1 Crore|
|Cumulative Bonus||For every claim-free year, the base Sum Insured increases by 5%. The maximum cumulative bonus is up to 50% of the base SI.|
Why Should You Buy Niva Bupa Health Insurance (Previously Max Bupa) Plans?
Here are a few of the reasons why should you purchase health insurance plans from Niva Bupa (previously Max Bupa):
- 30-Minutes Cashless Claim Processing: Max Bupa ensures its policyholders for the cashless claim processing in 30 minutes. This effort on the part of Max Bupa not only saves time for the policyholders but also gives them mental peace as well as financial security in the event of a medical emergency.
- Higher Claim Settlement Ratio: The claim settlement ratio refers to the percentage of insurance claims settled by an insurance provider out of all claim requests submitted during a fiscal year. The higher the claim settlement ratio, the better the insurance company is to settle claims. Max Bupa Health Insurance’s Claim Settlement Ratio is 96%, which assists you in understanding the history of the company.
- Good Network Of Hospitals: Max Bupa Health Insurance has partnerships with over 7000 hospitals to provide a cashless service that includes complimentary health check-ups, pre-and post-hospitalization charges, and pre-existing illness coverage.
- Lifelong Renewability: Max Bupa Health Insurance can be renewed for a lifetime, that too, without any age restrictions.
- 24/7 Customer Support: Max Bupa offers online assistance 24 hours a day, seven days a week through a chatbox on its website. Policyholders may quickly talk with specialists, seek a callback, and get help finding the right health insurance plan for them. It has a number of quick-service alternatives to pick from, as well as a comment box where you can enter your query.
- Healthy Solvency Ratio: A solvency ratio is a tool for determining a company’s capacity to satisfy its financial obligations. Every insurer must maintain a health solvency ratio of 1.5, according to the IRDAI. While talking about Max Bupa, the company maintains healthy insurance of 1.64, which fulfils the criteria of IRDAI.
- Max Bupa Health Application: This app serves as a one-stop solution for all of the customers’ everyday health and wellness needs. Policyholders of Max Bupa Health Insurance can use this health app to track their health, make cashless OPD appointments, manage their policies, check their renewal status, and much more.
- Provides Comprehensive Plans: While taking into consideration various customers’ needs and requirements, Max Bupa provides comprehensive insurance products. For example, for larger families, one can choose the plan ‘Health Premia’. Whereas, individual plans are also available for the individuals.
How Does Calculate Niva Bupa (previously Max Bupa) Calculate Premiums?
Max Bupa Health Insurance’s Premiums are calculated while taking into consideration the following factors:
- Age: Younger people are less likely to pay higher premiums. As the age increases, the chances of falling ill increases, and hence the premium of the health insurance also increases.
- Medical History: If you have a history of illness or a pre-existing illness, your premium will be higher. Your premium will be cheaper if you have never been sick and have lived a relatively healthy life.
- Amount Of Sum Insured: Your premiums are directly proportional to the level of coverage you select. It’s important to remember that the larger the sum insured, the higher the premium will be.
- BMI (Body Mass Index): People with a high BMI are more likely to develop diseases like diabetes and heart disease, which require ongoing medical care. As a result, persons with a higher BMI pay a greater premium than people with a normal BMI.
- Type Of Occupation: The nature of your career and the level of risk you incur at work have an impact on premium charges. Your premium will be reduced if you work in a school; but, if you work in an environment with a high risk of harm, such as a factory or as a pilot, your premium will be greater.
- Lifestyle: Smokers, chewers, and snuffers are more vulnerable to life-threatening diseases including cancer. As a result, premium rates for such people are higher. If you do not have such a habit, however, your premium rates will be cheaper.
How To Purchase Niva Bupa Health Insurance (previously Max Bupa)Policies?
- Visit the official website of Niva Bupa and click on ‘Buy’.
- Enter all the necessary details and click on ‘Find My Plan’.
- Select a suitable plan for yourself among the given options.
- Pay the premium through an online payment method.
- That’s all! A copy of the policy will be sent to you through email.
- Visit the branch office or call their toll-free number.
- The company’s executive will help you find a suitable plan for yourself.
- Submit all the necessary documents.
- Pay the premium.
- That’s all! You will now receive an original copy of your policy.
What’s Claim Process?
FOR CASHLESS CLAIMS
- Admission In-Network Hospitals: Before admitting to the hospital, check the network hospitals of Niva Bupa and choose a suitable one for you.
- Show Your Health Card: Now, show your health card and valid identity proof to the hospital.
- Validation Of Identity: The hospital will then verify your identity and will submit a request form to the company.
- Reviewing Of Your Request: Niva Bupa will review your request and will inform the hospital accordingly.
- Settlement Of Claim: After completion of all the formalities, Niva Bupa will pay the hospital directly.
FOR REIMBURSEMENT CLAIMS
- Notifying Niva Bupa: In case of admission to a non-network hospital or emergency hospitalization, inform the insurance company within 48 hours and 24 hours respectively.
- Collect Necessary Documents: Collect all the necessary documents after discharge, such as discharge certificates, invoices, etc.
- Send Claim Form: Along with all the documents, submit a duly filled claim form to the insurance company.
- Settlement Of Claim: Once the verification is done, Niva Bupa will reimburse the amount accordingly.
- Valid ID proof
- Post mortem report (if applicable)
- Discharge certificate
- Hospital bills
- Diagnostic test reports
- Payment receipts
What’s The Renewal Process?
- Visit the official website of Niva Bupa and click on ‘Renew’.
- Enter your 14-digit policy number and click on ‘Submit’.
- Now, your renewal premium amount will be displayed. To pay the premium amount, click on the ‘Pay Now’ option.
- After you are done with the payment, you will receive a policy transaction number.
Frequently Asked Questions
The time company takes to close a reimbursement claim varies from case to case. Niva Bupa makes every effort to handle every reimbursement claim as quickly as possible.
Go to www.nivabupa.com and select “claims.” Then, from the drop-down menu, choose claim form, then services form, and then download the form that corresponds to your plan.
If the claimed amount is equal to or greater than Rs. 1,00,000, a KYC document is required.
Medical health check-up is not mandatory in all cases. It depends upon the age of the insured person. For instance, you are at your 60. So, you will be required to undergo a medical examination at the company.
The policies under Niva Bupa are available for 1 to 2 years. The plans need to be renewed on annual basis.