Health Recharge

Features

  • In-Patient Care (Hospitalisation)

We cover the cost of medical treatment when you or your insured family members are hospitalised for treatment.

  • Hospital Accommodation

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.

  • Domiciliary Treatment

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.

  • Organ Transplant

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.

  • Alternative Treatments

Avail In-patient treatment under AYUSH (Ayurveda, Unani, Siddha and Homeopathy) up to the base Sum Insured.

  • Emergency Ambulance

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.

  • E-Consultation

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.

  • HIV / AIDS

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

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. 1 Adult + 1 Child
  2. 1 Adult + 2 Children
  3. 1 Adult + 3 Children
  4. 1 Adult + 4 Children
  5. 2 Adults
  6. 2 Adults + 1 Child
  7. 2 Adults + 2 Children
  8. 2 Adults + 3 Children
  9. 2 Adults + 4 Children
  • Tax Benefit

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.

  • Direct Claim Settlement

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

Cashless Facility can be availed only at our 7400+ network providers or service providers. Please contact us for more details.

  • Free Look Period

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.

Policy Term

  • The default policy term for all plans is one year. Two-year and three-year policy term options are also available under the product. The level of discount is as below:
  • 2 year term: 7.5% on the premium for second policy year
  • 3 year term: 15% on the premium for third policy year + 7.5% on the premium for second policy year

Waiting Periods

  • Pre-existing disease waiting period of 36 months since inception of the policy and continuous renewal
  • Initial waiting period of 30 days unless the treatment needed is the result of an accident.
  • Specific waiting period of 24 months for some listed illnesses, unless the condition is directly caused by cancer (covered after initial waiting period of 30 days) or an accident (covered from day 1)
  • Please note that Waiting Periods shall not apply to e-consultation and Personal Accident Cover. For Critical Illness Cover, initial waiting period of 90 days and pre-existing disease waiting period of 48 months will apply.

Exclusions

  • Investigation & Evaluation
  • Rest Cure, rehabilitation and respite care
  • Obesity/ Weight Control
  • Change-of-Gender treatments
  • Cosmetic or plastic Surgery
  • Hazardous or Adventure sports
  • Breach of law
  • Excluded Providers
  • Refractive Error
  • Unproven Treatments
  • Birth control, Sterility and Infertility
  • Maternity Expenses
  • Circumcision
  • Conflict & Disaster
  • External Congenital Anomaly
  • Unrecognized Physician or Hospital

(Note: the above is a partial listing of the policy exclusions. Please refer to the policy contract for the full list of exclusions.)

Permanent Exclusion for Personal Accident Cover (if opted)

We shall not be liable to make any payment under any benefits under the Personal Accident Cover if the claim is attributable to, or based on, or arise out of, or are directly or indirectly connected to any of the following:

  • Suicide or self inflicted injury, whether the insured person is medically sane or insane.
  • Treatment for any injury or illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations (whether war is declared or not), rebellion (act of armed resistance to an established government or a leader), acts of terrorism.
  • Service in the armed forces, or any police organisation of any country at war or at peace or service in any force of an international body or participation in any of the naval, military or air force operation during peace time.
  • Any change of profession after inception of the policy or any renewal which results in the enhancement of our risk, if not accepted and endorsed by us on the policy schedule.
  • Committing an assault, a criminal offence or any breach of law with criminal intent.
  • Taking or absorbing, accidentally or otherwise, any intoxicating liquor, drug, narcotic, medicine, sedative or poison, except as prescribed by a medical practitioner other than the policyholder or an insured person.
  • Participation in aviation/marine activities (including crew) other than as a passenger in an aircraft/water craft that is authorised by the relevant regulations to carry such passengers between established airports or ports.
  • Engaging in or taking part in professional/adventure sports or any hazardous pursuits, speed contest or racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving, polo, snow and ice sports, hunting.
  • Body or mental infirmity or any illness except where such condition arises directly as a result of an accident during the policy period. However, this exclusion is not applicable to claims made under Permanent Partial Disability.

Claim process

  • Select and approach insurance/corporate/TPA helpdesk of our network hospital [recommended at least 72 hours before treatment].
  • For identification purpose use passport, voter card, PAN card or driver's license along with your Niva Bupa health card or policy number.
  • Network hospital will check your identity for validation and submit a pre-authorisation form to us.
  • We provide our decision to the hospital within 4 hours, when no further document is required.
  • We may assign a relationship manager to make the hospitalisation simple for you.
  • Get admitted for treatment and sign all documents, forms and invoices on discharge.
  • We make payments to the hospital for pre-approved treatment and as per policy terms and conditions.

FAQs

  • What is top-up with an Annual Aggregate Deductible?
  • It becomes really difficult to decide how much cover is adequate. A cover which we find sufficient today becomes irrelevant tomorrow due to the rising medical inflation. At the same time buying a large insurance cover in the current policy may not be affordable or available. Our Niva Bupa Health Recharge’s deductible acts like a spare tire to your health insurance plan. It’s an additional coverage offered to you with a threshold limit. It comes into effect only when your total claim in the same year surpasses the threshold limit.
  • Why is top-up important?
  • Top-up is important as it takes care of the gap between your existing coverage and the actual cost incurred during the year.
  • When does it make sense to opt for a top-up?
  • It makes sense when you want to increase your total coverage without paying much. While anybody can buy our top-up option at any time, however, it is not advisable unless you have bought a base health insurance cover or the coverage offered by your employer is at least equal to the chosen deductible (threshold limit) amount of our top-up.
  • How does the plan work?

Let us understand with an example:

• Policies with you

• Policy A: Employer/regular health insurance policy with SI of Rs.5 lacs

• Policy B: Niva Bupa Health Recharge having SI of Rs.5 lacs and aggregate deductible (threshold) limit of Rs.5 lacs

• Situation 1: A single admissible claim of Rs.7 lacs

• Policy A will pay Rs. 5 lacs

• Policy B will pay remaining Rs. 2 lacs as the threshold limit is crossed

• Situation 2: 2 admissible claims in a year amounting to Rs.3 lacs each

• Policy A will pay Rs. 3 lacs for the first claim and Rs. 2 lacs for the second claim

• Policy B will pay remaining Rs. 1 lac since the total claim in the year crosses the threshold limit

• Situation 3: 2 admissible claims in a year, one amounting to Rs.6 lacs and the 2nd amounting to Rs.3 lacs in the same year

• Policy A will pay Rs. 5 lacs for the first claim and policy B will pay

Rs. 1 lac for the first claim and remaining Rs. 3 lacs for the 2nd claim since the total claim in the year crosses the threshold limit

  • How can I buy this policy?
  • There are various ways in which you can purchase this policy:
  • You can buy this plan online. On buying this plan online, your policy will be generated instantly along with your policy kit and card. This is applicable for cases which do not require further underwriting or medical check-up.
  • If you wish to buy or know more aboutNiva Bupa’s health insurance plans, feel free to get in touch with our trained sales team or your local advisor. Call us on: 1860 500 1000 (Toll Free) between 9 am and 6 pm India time (Monday to Saturday) or click on ‘Click to arrange a call’ to buy the policy over the phone or to fix up an appointment. Branch: Please visit our branch in your city. The complete list of branch locations is available in the ‘Contact Us’ section of the website
  • Is there any tax benefit that one can avail while purchasing health insurance?
  • Yes, you can avail a tax benefit available under Section 80D of the Income Tax Act 1961 by buying a health insurance policy. Every taxpayer can avail an annual deduction of Rs. 25,000 from his/her taxable income for health insurance premium for self and dependants. For senior citizens, this amount is Rs. 30,000. Please note: You will have to show the proof of payment of premium. (Section 80D benefit is different from the exemption of Rs. 1,50,000 under Section 80C). These benefits are as per applicable tax laws which can amend from time to time. We advise you to consult your tax advisor for further details or clarifications.
  • Is a medical check-up necessary before buying a policy?
  • A medical check-up may be necessary when you sign up for a new health insurance policy, depending upon the age of the person to be insured and the Sum Insured opting for. In case your proposal gets rejected by us, we will deduct the full cost of medical tests from your premium and the balance premium would be refunded.
  • My wife and children are residing at Chandigarh while I am here in Delhi. Can I cover all of us in one policy?
  • Of course, you can cover your family residing in India under one policy. You can use your health insurance policy across India. For cashless hospitalisation, all you need to do is check for a Niva Bupa network hospital near your place of residence. You can also present your claim for reimbursement if you get treated at a hospital which is not a Niva Bupa network hospital.

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Disclaimer

Disclaimer


Disclaimer

“ On clicking the “BUY NOW” option, you will be re-directed to a third party web site. This is purely a referral service and is provided on a non-participation basis. Federal Bank is only facilitating access to the services of Insurer and the same is in no context a service offered by the Bank. By clicking the above link, you are accepting these terms and will be re-directed to the website of Insurer as per your request. Necessary fees may have to be paid by you to Insurer for availing the services. Please note that by clicking the “BUY NOW” option, you will be leaving Federal Bank's website and our policies, terms and conditions, disclaimers etc., will cease to apply once you leave our website. Federal Bank and its affiliates, subsidiaries, employees, officers, directors and agents shall not be responsible in any manner whatsoever for confidentiality of the data shared by you and for any loss, damage, costs & charges, direct or indirect incurred by you, arising out of or in connection with your access to the website of Insurer or for any deficiency in the services of Insurer or for the failure or disruption of the Insurer website. The use by you of any service, products or information hosted on the website of Insurer shall be at your sole risk and discretion. The information available on the said website is subject to change, updation, revision, verification and amendment without notice and such information may change materially. Grievances & concerns in this regard shall be reported to Insurer and settled accordingly, without recourse to the Bank.”

Disclaimer

The Federal Bank Limited is a Corporate Agent having registration number - Regn. No. CA0227.  The service provided by The Federal Bank Limited is purely an agency service and is carried out strictly on a non-risk participation basis. The Federal Bank Limited, as corporate agent does not underwrite the risk or act as an insurer. Participation by the Federal Bank’s customers in the insurance product is purely on a voluntary basis and is not linked to the availment of any other facility from the Federal Bank Limited.