- In-Patient Care (Hospitalisation)
We cover the cost of medical treatment when you or your insured family members are hospitalised for treatment.
We cover the cost of hospital accommodation up to a single private room without any capping on room rent charges (for Sum Insured of Rs.5 lacs and above).
- Pre & Post Hospitalisation Medical Expenses
We reimburse pre & post hospitalisation medical expenses incurred due to illness/injury. The period of the treatment covered is 60 days before you get admitted to the hospital and till 90 days after you get discharged from the hospital. This is subject to Niva Bupa accepting the In-patient Care hospitalisation, day care or domiciliary hospitalisation claim.
- Day Care Treatments Covered
We cover all day care treatments under the product.
In case a bed in the hospital is unavailable or on advice of the attending medical practitioner, treatment is administered at home; we pay for medical treatment taken at home, which would otherwise have required hospitalisation. Such treatment should continue for at least 3 consecutive days and confirmation from treating medical practitioner that insured person could not be transferred to the hospital or the hospital bed was unavailable, as the case may be.
Medical expenses for an organ donor’s In-patient treatment for the harvesting of the organ donated is also covered provided the organ is for the use of the insured person.
Avail In-patient treatment under AYUSH (Ayurveda, Unani, Siddha and Homeopathy) up to the base Sum Insured.
We also cover the ambulance expenses to transfer the insured following an emergency to the nearest hospital. These expenses are paid up to Rs. 1,500 per hospitalisation only if we have accepted the In-patient claim.
- Pharmacy And Diagnostic Services
You may purchase medicines and diagnostic services from the empanelled service provider through our mobile application or website. The cost for the purchase of the medicines or diagnostic services shall be borne by you.
If the insured person is diagnosed with an illness or is planning to undergo a planned surgery or a surgical procedure, the insured person can obtain an e-consultation during the policy period.
- Loyalty Additions (applicable only for Sum Insured up to Rs.25 Lac)
For each policy year, we offer an additional 5% of expiring base Sum Insured up to a maximum of 50% of base Sum Insured of that policy year. This benefit is applicable only for Base Sum Insured up to Rs.25 Lac.
- Mental Disorder Treatment
Expenses incurred for inpatient treatment for mental illness are covered under the policy subject to sub-limit for specific conditions as specified in the policy contract.
Expenses incurred for hospitalization (including day care treatment) due to condition caused by or associated with HIV / AIDS are covered under the policy.
- Artificial Life Maintenance
Expenses incurred for artificial life maintenance, including life support machine are covered under the policy subject to terms and conditions of the policy.
Modern treatments such as oral chemotherapy, robotic surgeries, intra vitreal injections, deep brain stimulation etc. will be covered either as inpatient care or as part of day care treatment in a hospital subject to sub-limit for specific conditions as specified in the policy contract.
- Personal Accident Cover (Optional)
Personal Accident coverage against accident death, permanent total and permanent partial disability.
- Critical Illness Cover (Optional)
Critical illness coverage against major illnesses and procedures like cancer, CABG, open heart replacement, kidney failure, stroke, major organ/bone marrow transplant, etc.
- Modification Of Room Rent (Optional)
If your room rent in the base plan is capped at 1% of base Sum Insured per day, you can modify it to single private room; covered up to Sum Insured (available only for deductible more than INR 50,000 and Sum Insured up to INR 4 Lacs).
- Annual Aggregate Deductible
Choosing an Annual Aggregate Deductible is mandatory under this product and they vary from Rs. 10,000 to Rs. 10 lacs Post completion of 5 years in this policy and before the eldest member turns 50 years of age, there is a one-time option to either modify the deductible chosen or convert the policy to an indemnity policy (without deductible), without any medical underwriting or pre-policy medical check-up.
- Entry Age And Family Coverage
The entry age for adults under this policy is 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 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
Save tax under Section 80D of the Income Tax Act when you buy a Niva Bupa health insurance policy. Tax benefits are subject to changes in the tax laws. Kindly consult your tax advisor for more details.
- Assured Policy Renewal For Life
Once insured with us, you will always remain our customer subject to continued payment of premium. We assure you renewability for life with no extra loadings based on your claim history.
We believe you should focus on the treatment of your loved ones rather than running after claim settlement. Therefore, all claims are processed directly by our customer service team.
Cashless Facility can be availed only at our 7400+ network providers or service providers. Please contact us for more details.
We endeavor for transparency and complete satisfaction and therefore, our policies are transparent and easy to understand. If you are not satisfied, we provide a 15-day free look period within which you can cancel your plan stating the reason.
- Information At Your Fingertips
Get quick and easy access to your claims history, your health information, your health profile, including records of tests and other details on our website.