Get Niva Bupa Health Premia insurance online quotes

Key Features of Niva Bupa Health Premia Insurance

  • Health Premia is a Comprehensive health insurance plan.
  • Comprehensive coverage up to 3 crore.
  • Health Premia International coverage for specified illness and medical emergencies.
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Niva Bupa Health Insurance review

Niva Bupa Health Insurance
Sum Insured
2 lacs - 300 lacs options available
Tenure Options
1 year
Claims Incurred Ratio *
54.00%
Claims Settlement Ratio **
85.96%
List of Network Hospitals
4,500+ hospitals
Number of Policies issued *
696,107
Number of Lives Covered *
54,33,000
Maximum Family Floater Coverage
Self, Spouse + 4 dependent children
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

Niva Bupa Health Premia insurance plan details

  • Unique features
  • Exclusions
  • Claims procedure
  • Cancellation procedure

Unique features of Niva Bupa Health Premia Health Insurance

  • High Coverage option
  • income tax benefit upto INR 42,744 under the section 80D.
  • Tenure Discount: If you pay 2 year policy term,you get a discount of 7.5% on the premium of second policy year.On the other hand.
  • If you choose 3 year policy term, you get an additional discount of 15% on the third year's premium.
  • 15 Day Free look period.
  • Pre and post hospitalisation expensex are covered up to the sum insured, 90 days prior and 180 days post hospitalisation.
  • Worldwide Maternity benefit cover.
  • Direct claim settlement, no third party involved.
  • Re-fill Benefit:When the same or different illness strikes in the same policy year,your base sum insured is re-filled and made available to you.
  • Cashless hospitalization across network of quality hospitals.
  • Life long renewal.

Exclusions of Niva Bupa Health Premia Health Insurance

  • Pre-existing conditions: Benefits will not be available for pre-existing conditions as per your policy plan until 24 months of continuous coverage from first policy start date.
  • 30 days initial waiting period: Treatment during the first 30 days of the plan will nt be covered,unless the treatment needed is a result of an accident.This waiting period does not apply for renewal polices.
  • Specific Waiting Periods:Few conditions like cataract,hernia,internal congenital anomaly,spinal disorder,etc. will be subject to a waiting period of 12 months.
  • The following benefits will have a waiting period of 36 months since inception of the policy and subject to continuous renewal: weight loss(bariatric) surgery| Mental disorder treatment| LASER surgery cover.
  • For HIV/AIDS cover.there will be a waiting period of 48 months since inception of the policy and subject to continuous renewal.
  • For Critical illness cover,a 90 days initial waiting period along with the pre-existing disease waiting period of 4 years and survival period exclusion of 30 days will apply for all conditions.
    (The aforementioned waiting periods shall not apply to e-consultation, health check-up, premium waiver, pharmacy and diagnostic services,personal accident cover and health coach).

Permanent exclusions

  • Ancillary Hospital Charges
  • Hazardous Activities
  • Artificial life maintenance
  • Circumcision
  • AYUSH Treatments
  • Conflict & Disaster
  • External Congenital Anomaly
  • Convalescence & Rehabilitation
  • Cosmetic or plastic Surgery
  • Dental/oral treatment
  • Eyesight & Optical Services
  • Experimental or Unproven Treatment
  • Hormone Replacement Therapy
  • Hospitalization not justified
  • Inconsistent, Irrelevant or Incidental Diagnostic procedures
  • Non-Medical Expenses
  • Obesity and Weight Control Programs
  • Reproductive medicine & other Maternity Expenses
  • Robotic Assisted Surgery, Specialized Light Amplification by Stimulated Emission of Radiation (LASER) & Cyber Knife Treatments
  • Sexually transmitted Infections & diseases
  • Sleep disorders
  • Substance related and Addictive Disorders
  • Unlawful Activity
  • Treatment received outside India
  • Unrecognized Physician or Hospital

Claims Procedure of Niva Bupa Health Insurance

Assistance Contact Numbers:

For Health Claims
Call at : Toll Free 1860-500-8888
Call at : 011-66326666
Fax at : 011-30902010
Email ID : customercare@maxbupa.com
Write at : Niva Bupa Health Insurance Company Limited,
B-1/I-2,
Mohan Cooperative Industrial Estate Mathura Road,
New Delhi-110044 Website : www.maxbupa.com

For Health Claims (International Treatment Assistance) – as per plan availability
Call at : Customer helpline number1860-3010-3333
Email ID at : customercare@maxbupa.com
For Emergency Medical Evacuation Call at: +45 7923 2403
Email id : mergency@ihi.com

Cashless Claims Process

Step 1 Get admitted to any one of Niva Bupa network hospitals, currently they have 4500+ hospitals across the country…check out the hospital list at Niva Bupa
(Note: Cashless Facility is only available at hospitals in the company’s cashless network)
Step 2 Use your Niva Bupa Health Card or share your Policy number and Passport / PAN card / voter’s ID for identification purposes
Step 3 The Network Hospital will check your identity for validation and submit the pre-authorisation request form to Niva Bupa as per the defined process / format
Step 4 Niva Bupa will review and provide our confirmation to the Network Hospital by fax and E-mail and also send a text message and an E-mail confirming the same to you. We will respond to your request within 30 Minutes.
Step 5 Niva Bupa will settle the claim (as per policy terms & conditions) with the hospital after completion of all formalities of documentation as per submission by the hospital.

Reimbursement Claims Process

Step 1 In case of hospitalization notify Niva Bupa within 48 hours of your admission in our network or non network hospital. After getting admitted settle bills directly to the hospital.
Step 2 On discharge, please ensure you collect all relevant documents, invoices, medical reports and discharge certificate from the Hospital in originals.
Step 3 Send these documents and the completely filled and signed claim form to us along with your valid ID proof and age proof. The claim form is available on the company website and in your policy document kit as well.
Step 4 We review your claim request and the supporting documents provided along with the claim form. Accordingly based on policy terms & conditions, Niva Bupa will approve, query or reject the same.
Step 5 Subject to the claim being approved, Niva Bupa will settle the claim (as per policy terms & conditions) and reimburse the approved amount to the insured.

Cancellation Procedure of Niva Bupa Health Insurance

PERIOD ON RISK RATE OF PREMIUM TO BE CHARGED
Up to 15 days Full policy premium refundable
Up to one-month 1/3rd of the policy premium
Up to three months 1/2nd of the policy premium
Up to six months 3/4th of the policy premium
Exceeding six months Full policy premium

Information to be kept ready while intimating the claim:

  • Policy Number
  • Insured/Claimant contact details (phone no. , email id, address, landmark etc.)
  • Name of Insured/ claimant person, who is hospitalised
  • Relationship of insured with the person who is hospitalised.
  • Name of the hospital
  • Health Claims - Nature of ailment
  • Commencement date of the symptom of ailment
  • Accident Claims
    • Nature of accident
    • Date & time of accident
    • Location of accident

Niva Bupa health insurance useful links

buy Niva Bupa health insurance How to buy Niva Bupa health insurance?

You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque.

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Insurance FAQ Insurance FAQ

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Niva Bupa Claims Procedure Claims Procedure

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Portability Portability

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Niva Bupa Network of hospitals Niva Bupa Network of hospitals

Niva Bupa insurance plan network hospital list.

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Tax benefits Tax benefits

Tax deduction on health insurance premium paid for you, your family and your parents.

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