Niva Bupa Health Pulse Health Insurance

Niva Bupa Health Pulse insurance plan details

• Key Features of Niva Bupa Health Pulse Individual & Family Floater Insurance

  • Room Rent : : Covered upto Sum Insured (except for suite/high room category)
  • Co-pay : NIL co-pay for all inpatients, 20% for treatment in certain Metro cities
  • Restoration (Refil) Benefit :Upto 100% of Base Sum Insured per year
  • Pre & Post Hospitalisation : Expenses covered up to Sum Insured.
  • Refill Benefit : Sum Insured reinstates (up to 100% or 150% of base sum insured) if subsequent claim is made of a different illness/injury during the same policy year.
  • Boost Your Plan : Flexibility to boost health cover with optional benefits such as personal accident, critical illness, e-consultation etc.
  • No Claim Bonus : Every claim free year adds up 10% or 20%# of base sum insured as bonus. Maximum up to 100% or 200% of base sum insured respectively.
  • Annual Health Check-up : Available from second policy year onwards.
  • Hassle-free Claims : 30 minutes cashless claim processing and in-house claim settlement.

• Eligibility of Niva Bupa Health Pulse Individual & Family Floater Insurance

  • The entry age for adults under this policy can be from 18 to 65 years. The entry age for dependent children is from 91 days to 25 years.
  • The policy can be taken individually or for the family. The family floater policy is available in any of the following combinations:
    • 1 Adult
    • 1 Adult + 1 Child
    • 1 Adult + 2 Children
    • 1 Adult + 3 Children
    • 1 Adult + 4 Children
    • 2 Adults
    • 2 Adults + 1 Child
    • 2 Adults + 2 Children
    • 2 Adults + 3 Children
    • 2 Adults + 4 Children

• Coverages under Health Pulse

  Policy Coverages / Base Sum Insured (all figs in ₹INR)	3,00,000 / 4,00,000	5,00,000 / 7,50,000 / 10,00,000
  In Patient Treatment	Covered Upto Sum Insured
  Nursing Charges for Hospitalisation as an inpatient excluding Private Nursing charges	Covered Upto Sum Insured
  Medical Practitioner's fees, excluding any charges or fees for Standby Services	Covered Upto Sum Insured
  Physiotherapy, investigation and diagnostic procedures directly related to the current admission	Covered Upto Sum Insured
  Medicines, drugs and consumables as prescribed by the treating medical practitioner	Covered Upto Sum Insured
  Intravenous fluids, blood transfusion, injection administration charges and/or consumables	Covered Upto Sum Insured
  Operation Theatre charges	Covered Upto Sum Insured
  Cost of prosthetics and other devices or equipment if implanted internally during surgery	Covered Upto Sum Insured
  Room Rent (per day)	Up to 1% of Base Sum Insured per day or Single Private Room, whichever is lower	Single Private Room
  Intensive Care Unit charges	Up to 2% of Sum Insured per day	Covered up to Sum Insured
  Pre - Hospitalisation Medical Expenses (30 days)	Covered Upto Sum Insured
  Post-Hospitalisation Medical Expenses (60 days)	Covered Upto Sum Insured
  Day Care Treatment	Covered Upto Sum Insured
  Domiciliary Treatment	Covered Upto Sum Insured
  Alternative Treatment	Covered Upto Sum Insured
  Living Organ Donor Transplant	Covered Upto Sum Insured
  Emergency Ambulance	Up to 1,500 per hospitalisation	Up to 2,000 per hospitalisation
  Pharmacy and Diagnostic Services	Available
  No Claim Bonus	Increase of 10% of expiring Base Sum Insured in a Policy Year; maximum up to 100% of Base Sum Insured; no increase in sub-limits; no reduction in No Claim Bonus in case of claim
  Re - fill Benefit	Up to 100% of Base Sum Insured
  Health Check Up	Annual, from 2nd policy year onwards
  Mental Disorders Treatment	Covered up to Sum Insured (sub-limit applicable on few conditions)
  HIV/AIDS	Covered up to 10% of Base Sum Insured, subject to maximum of ₹50,000
  Co - Payment	20% co-payment applicable for treatment in Delhi NCR, Mumbai (including Navi Mumbai and Thane), Kolkata and Gujarat.
  Optional Benefits
  Personal Accident cover - Accident Death / Accident Permanent Total Disability (125 % of PA cover SI) / Accident Permanent Partial Disability Optional	Personal Accident cover will be equal to 5 times of Base Sum Insured; maximum up to 50 Lac
  Critical Illness Cover	Critical illness cover will be equal to Base Sum Insured; maximum up to 10 Lac
  e-Consultation	Unlimited tele / online consultations
  Hospital Cash(2)	For Base Sum Insured of 5 Lac and below: 1,000 per day; For Base Sum Insured greater than 5 Lac: 2,000 per day
  Enhanced No Claim Bonus	Increase of 20% of expiring Base Sum Insured in a Policy Year; maximum up to 200% of Base Sum Insured; no increase in sub-limits; no reduction in No Claim Bonus in case of claim
  Enhanced Re - fill Benefits	Refill Upto 150%of Base Sum Insured
  Notes:	(1) Re-Fill benefit - Reinstate up to 100% of Base Sum Insured. Applicable for different illness (2) Hospital Cash - Minimum 48 hrs of continuous hospitalization required. Maximum coverage offered for 30 days/policy year/insured person. Payment made from day one subject to hospitalization claim being admissible (3) Enhanced Re-Fill benefit - Reinstate up to 150% of Base Sum Insured. Applicable for different illness

• Exclusions of Niva Bupa Health Pulse Insurance

  Some of the key policy exclusions include:
  • Ancillary hospital charges
  • Hazardous activities
  • Artificial life maintenance
  • Circumcision
  • AYUSH treatments, except inpatient treatments taken under Ayurveda, Unani, Sidha and Homeopathy
  • Conflict & disaster
  • External congenital anomaly
  • Convalescence & rehabilitation
  • Cosmetic and plastic surgery
  • Dental/oral treatment
  • Eyesight & optical services
  • Experimental or unproven treatment
  • Hormone Replacement Therapy
  • Hospitalisation not justified
  • Inconsistent, irrelevant or incidental diagnostic procedures
  • Non-medical expenses
  • Obesity and weight control programs
  • Reproductive medicine & other maternity expenses
  • Robotic Assisted Surgery, 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
  • Generally excluded expenses - Any costs or expenses specified in the list of expenses generally excluded at Annexure II of the Policy Document