Niva Bupa Health Insurance

Network Hospitals:
Claim Settlement
Ratio: 90.7%
PED Coverage
Covered from day 1
Save Tax Under
Section 80D

About Niva Bupa Health

Niva Bupa Health Insurance Company Limited, previously known as Max Bupa Health Insurance, is a collaboration between Fettle Tone LLP, a renowned Indian private equity firm, and Bupa Singapore Holdings Pte. Limited, a UK-based healthcare services expert. Bupa, with over 60 years of experience and a customer base of 29 million across 190 countries, brings valuable expertise to the partnership.

Niva Bupa Health Insurance offers a diverse range of health insurance plans to cater to different individual needs. These plans are affordable and designed for various segments, including individuals, families, senior citizens, women, parents, self-employed individuals, and children. One notable advantage is the simplified claims process, as the company settles claims directly without the involvement of third-party agents. Additionally, Niva Bupa Health Insurance boasts an extensive network of over 10131+ hospitals nationwide, enabling policyholders to avail cashless treatment.

Niva Bupa Health Insurance Plans Summary

Discover the wide range of health insurance plans offered by Niva Bupa Health Insurance. Look at the list below:

  • Niva Bupa Corona Kavach Policy: This short-term policy covers COVID-19-related expenses, including hospitalization, pre- and post-hospitalization, ambulance services, and AYUSH treatment.
  • Niva Bupa Health Premia Policy: With coverage options up to Rs. 3 crore, this comprehensive policy offers variants like Gold, Silver, and Platinum, providing coverage for hospitalization, pre- and post-hospitalization, organ transplants, and more.
  • Niva Bupa Health Companion: This policy offers smart features and coverage for in-patient hospitalization, pre- and post-hospitalization, emergency ambulance services, and more, with sum insured options ranging from Rs. 3 lakh to Rs. 1 crore.
  • Niva Bupa Money Saver: Combining a base and top-up plan, this policy provides extensive protection for in-patient hospitalization, organ transplants, daycare procedures, and more, with coverage options up to Rs. 1 crore.
  • Niva Bupa ReAssure: Offering comprehensive coverage for various healthcare expenses, including hospitalization, organ donor expenses, and emergency ambulance services, this policy provides additional features like ReAssure and Booster benefits.
  • Niva Bupa Arogya Sanjeevani Policy: Designed as a standard health insurance plan, it covers hospitalization, pre- and post-hospitalization, ambulance services, and more, with sum insured options ranging from Rs. 1 lakh to Rs. 5 lakh.
  • Niva Bupa Health Pulse: This affordable policy offers coverage for in-patient hospitalization, emergency ambulance services, health check-ups, and more, with sum insured options ranging from Rs. 3 lakh to Rs. 25 lakh.
  • Niva Bupa Health Recharge: With coverage for hospitalization, pre- and post-hospitalization, organ transplants, and more, this top-up plan allows you to add extra coverage through add-on covers.
  • Niva Bupa Criticare: Specifically covering 20 critical illnesses, this policy offers protection against conditions like cancer, stroke, and permanent paralysis, providing coverage for up to two adults.
  • Niva Bupa Heartbeat: Offering comprehensive coverage with options like Gold and Platinum, this policy covers in-patient hospitalization, alternative treatments, emergency ambulance services, and more.
  • Niva Bupa GoActive: This modern health insurance plan provides cashless access to OPD and diagnostic services, covering daycare treatments, consultations, health coaching, and more.
  • Niva Bupa SuperSaver Policy: This affordable combo plan provides coverage up to Rs. 1 crore for individuals and families, including hospitalization, emergency ambulance services, and more, with multi-year discount options.

Explore the variety of Niva Bupa Health Insurance plans and choose the one that best suits your needs and budget.

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Why Choose Niva Bupa Health Insurance?

Niva Bupa Health Insurance provides numerous advantages to policyholders, making it a preferred choice for many. Here are some key reasons to consider:

Seamless Health Insurance Claim Settlement:

Niva Bupa Health Insurance ensures a hassle-free claim settlement process. It offers a wide network of cashless hospitals, quick doctor consultations, doorstep diagnostics, and pharmacy services. Cashless claims are processed within 30 minutes, with direct settlement and personalized assistance. Reimbursement claims are handled transparently with prompt disbursal.

Extensive Hospital Network:

With a network of 7,000 hospitals, Niva Bupa Health Insurance enables policyholders to access cashless treatments effortlessly. Whether it's planned or emergency hospitalization, policyholders can enjoy the benefits by informing the insurance company within the specified time, as per policy terms and conditions.

High Claim Settlement Ratio:

Niva Bupa Health Insurance boasts a commendable claim settlement ratio of 89.46%. This indicates the insurer's proficiency in handling and settling claims promptly, ensuring policyholders receive their entitled benefits.

Recognitions and Awards:

Niva Bupa Health Insurance has earned multiple accolades, including The Economic Times Best Brands 2019, The Super Brand 2019, and the 'Technology Maturity' award. These honors reflect the insurer's reputation and credibility in the industry.

Health App Convenience:

Niva Bupa Health Insurance provides a user-friendly Health App, empowering policyholders to book OPD appointments, access e-consultations, order medicines, and explore health insurance plans. The app has been recognized as the Best Tech for Health Category 2019, with over 1.5 lakh downloads.

Choose Niva Bupa Health Insurance for its seamless claim settlement, extensive hospital network, high claim settlement ratio, industry recognition, and the convenience offered through their Health App. Experience peace of mind and comprehensive healthcare coverage with Niva Bupa Health Insurance.

Niva Bupa Health Insurance Claim Settlement Ratio

The Claim Settlement Ratio of a health insurance company represents the percentage of claims successfully settled by the company compared to the total number of claims received during a financial year. It serves as an important indicator of an insurance company's efficiency in handling customer claims.

As a prudent health insurance buyer, it is essential to consider the Claim Settlement Ratio of an insurer before purchasing a plan. Niva Bupa Health Insurance Company has consistently achieved an impressive claim settlement ratio in the past two years, earning the trust of its customers. Here are the Claim Settlement Ratios for Niva Bupa Health Insurance in the last two financial years:

Financial Year | Claim Settlement Ratio

FY 2018-2019 | 84.15%
FY 2019-2020 | 89.46%

These figures demonstrate the insurer's commitment to efficiently settling claims and providing timely support to policyholders when they need it most. Niva Bupa Health Insurance stands out as a reliable and trustworthy option for individuals seeking comprehensive health coverage.

Dedicated Whatsapp Claim Assistance

Niva Bupa Health Insurance Claim Process

Niva Bupa Health Insurance ensures a prompt and seamless claim settlement process for its policyholders. The insurer facilitates two types of claim settlements: cashless claims and reimbursement claims.

How to Avail Niva Bupa Health Insurance Cashless Claim?

Policyholders of Niva Bupa Health Insurance can avail cashless treatment at the network hospitals. With a vast network of 7,000 hospitals, the insurance company settles the bill directly with the hospital, subject to the policy's terms and conditions.

Follow the steps below to initiate a cashless claim with Niva Bupa Health Insurance:

Step 1: Inform the Insurer
Contact the insurance company within 24 hours of emergency hospitalization or at least 2 days in advance for planned hospitalization. Inform them by calling 1860-500-8888.

Step 2: Present Health Insurance Card
Provide your policy number or Niva Bupa Health Insurance card, along with a valid ID proof, at the network hospital's reception desk where you intend to receive treatment. You can access the list of Niva Bupa network hospitals at InsuranceDekho.

Step 3: Pre-Authorization Request
The network hospital will send a pre-authorization form to the insurance provider for approval.

Step 4: Verification Process
Niva Bupa Health Insurance's claim settlement team will verify the details and documents submitted. If any additional documents are required for further investigation, the insurer may request them.

Step 5: Claim Settlement
Once the verification process is complete, the insurance company will settle the bill directly with the hospital. Please note that this does not include any co-payment. Generally, Niva Bupa Health Insurance responds to the policyholder's claim request within 30 minutes. However, if the claim is rejected, you will receive notification with valid reasons.

How to Make Niva Bupa Reimbursement Claim for Non Network Hospitals?

If you are unable to avail cashless claim facility, you can opt for a reimbursement claim. In this case, you need to pay for the treatment at the hospital (whether it's a network or non-network hospital) and later claim reimbursement from the insurance company. Follow the steps below to file a reimbursement claim under Niva Bupa Health Insurance:

Step 1: Inform the Insurance Provider
Notify Niva Bupa Health Insurance about hospitalization within 48 hours of admission or before discharge, whichever comes earlier.

Step 2: Receive Treatment
Undergo the required treatment and settle the hospital bills. Collect all relevant documents, including discharge summary, pathology test reports, and medical invoices.

Step 3: Submit Claim Documents
Obtain the claim request form from the official website of Niva Bupa Health Insurance and fill it out. Sign the form and submit it, along with the necessary medical documents.

Required Documents for Niva Bupa Health Reimbursement Claim:

  1. Valid ID proof
  2. Letter from the medical practitioner advising hospitalization
  3. Prescription from the medical practitioner for consultation, medicine, and tests
  4. Original invoices from pharmacies
  5. Original hospital bills and discharge certificate signed by the medical practitioner
  6. First Information Report (FIR), if applicable
  7. Post-mortem report, if applicable

Step 4: Document Verification
The respective team at Niva Bupa Health Insurance will review your medical documents and claim request form. If further verification is necessary, the insurer may request additional documents. If your claim request is rejected, you will be informed with valid reasons.

Step 5: Claim Settlement
Once all your documents are verified and deemed appropriate, the insurer will approve your claim request in accordance with the policy terms and conditions. The claim amount will then be reimbursed by the insurer.

Niva Bupa Health Insurance Benefits

Enjoy the following advantages when you are covered under a Niva Bupa Health Insurance plan:

  • 24/7 Online Assistance: Niva Bupa Health Insurance provides round-the-clock online assistance through a chat box on its website. You can quickly access various service options by commenting and entering your query. This digital solution allows you to chat with experts, request callbacks, and receive guidance in finding the right health insurance policy for yourself and your loved ones.
  • Lifetime Renewability Benefit: Niva Bupa Health Insurance plans offer lifetime renewability, allowing you to renew your health insurance policy throughout your life by paying the required premium on time. This ensures continuous coverage and peace of mind.
  • Portability Benefit: With Niva Bupa Health Insurance, you can avail portability benefits. If you are not satisfied with your current plan, you have the flexibility to switch to any similar Niva Bupa Health Insurance Plan without losing the benefits you were already enjoying. This enables you to stay covered with the health insurance provider of your choice.
  • Sum Insured Refill: Niva Bupa Health Insurance plans include a sum insured refill benefit. When the sum insured amount is exhausted, this benefit provides an additional sum insured equal to the base sum insured for subsequent claims during a financial year. It ensures extended coverage and financial support.
  • Comprehensive Solutions: Niva Bupa Health Insurance offers comprehensive health insurance plans and innovative offerings tailored to specific individual needs. Examples include the GoActive plan designed for fitness enthusiasts, Health Premia for large families seeking top-of-the-line care, and Health Companion and Health Pulse Plans with various coverage benefits. Additionally, the insurer provides coverage for personal accidents and critical illnesses, offering comprehensive protection.

Embrace the benefits of Niva Bupa Health Insurance, including 24/7 online assistance, lifetime renewability, portability, sum insured refill, and a range of comprehensive solutions to meet your specific requirements. Stay protected and secure with Niva Bupa Health Insurance.

Inclusions and Exclusions of Niva Bupa Health Insurance Policies


  • Hospitalisation For Investigation And Evaluation Purpose: Expenses solely for the purpose of investigation or evaluation, as well as diagnostic expenses not related to existing diagnoses and treatments, are not covered by Niva Bupa Health Insurance plans.
  • Rest Cure, Rehabilitation, and Respite Care: Coverage benefits are not applicable for hospitalisation primarily for enforced bed rest without any treatment. Additionally, custodial care at home or in a nursing facility for personal care, such as assistance with activities of daily living, including dressing and bathing, is excluded.
  • Obesity or Weight Control Treatments: Expenses related to surgical treatment of obesity that does not fulfill specified conditions are not covered. These conditions may include a doctor's recommendation, the insured being at least 18 years old, and adherence to clinical protocols for the surgery or procedure.
  • Participation in Adventure Sports: Niva Bupa Health Insurance plans exclude coverage for any treatment required due to participation in hazardous sports as a professional. This includes activities like paragliding, rock climbing, scuba diving, horse racing, hand gliding, skydiving, and deep-sea diving.

Please note that the inclusions and exclusions mentioned above are not specific to any plan but may vary across different Niva Bupa Health Insurance plans.

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Niva Bupa
Health Insurance

Network Hospitals:
Claim Settlement
Ratio: 97%
PED Coverage
Covered after 2 Year
Starting From:*
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