Niva Bupa Health Insurance

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Overview of Niva Bupa Health Insurance

Niva Bupa Health Insurance, formerly known as Max Bupa Health Insurance, has established itself as a trustworthy standalone health insurance partner in the Indian health insurance market. Their range of affordable and comprehensive healthcare policies is designed to meet the diverse needs of their consumers.

Niva Bupa Health Insurance is committed to ensuring that all Indias have access to quality healthcare by offering health insurance plans tailored to individual needs. With their innovative and extensive health policies, they have established as a prominent provider of health and medical insurance in the country.

Niva Bupa Health Insurance has a substantial customer base of over 14 million individuals and an outstanding claim settlement ratio of 92%, having settled claims amounting to 1,141 crores since its establishment in 2008. Setting it apart is its direct claim settlement process, which removes the requirements for third-party administrators (TPAs). Additionally, Niva Bupa health insurance offers critical illness coverage across an extensive international network of 190 countries.

Niva Bupa offers cashless treatment through its extensive network of 10,000+ hospitals across the country, making it incredibly convenient for individuals to access medical services. They have also integrated digital solutions into their processes to ensure efficiency, shorter turnaround times and an exceptional consumer experience.

Niva Bupa, a joint venture between Bupa Singapore Holdings and Fettle Tone LLP, aims to be India’s top health insurance company. With strong backing from a well-established British healthcare services company and an experienced private equity firm, Niva Bupa offers customer-centric features that make it an ideal choice in the Indian health insurance sector.

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Coverage Benefits
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Eligibility Criteria
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Coverage Benefits
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Eligibility Criteria
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Coverage Benefits
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Eligibility Criteria
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs

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Key Features of Niva Bupa Health Insurance Company

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Niva Bupa Health Insurance Contact Details

For any assistance or query regarding Niva Bupa health insurance, kindly use the following channels to get in touch with Niva Bupa representatives.

  • Reach Out Website: Bupa Health Insurance
  • Customer Fax : +91 11 41743397
  • Inquiries Toll-Free Number : 1860-500-8888
  • Support Office Address : 14th Floor, Capital Cyberscape, Sector 59, Gurgaon
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Niva Bupa Health Insurance Add-On Riders

What’s Covered and Not Covered in Niva Bupa Health Insurance

Niva Bupa Health Insurance Inclusions

  • Inpatient hospitalization
  • Pre and post-hospitalization care
  • Daycare procedures
  • Ambulance charges
  • Covid-19 coverage

Niva Bupa Health Insurance Exclusions

  • Dental treatment that is not related to cancer or acute trauma
  • Purchase of items like glasses, hearing aids, artificial limbs, crutches, false teeth and veneers are not covered
  • Self-inflicted injuries are not covered by Niva Bupa health insurance
  • Excluded cosmetic surgeries, except for burn or injury treatments and cancer surgeries.
 

Niva Bupa Health Insurance Claim Process

Below is the Niva Bupa health insurance claims procedure for your convenience.

Cashless Claims

1
Admit yourself at a Niva Bupa network hospital
2
Use the Niva Bupa Health Card or provide the policy number at the hospital with ID proof
3
The Network hospital will verify your identity and submit the pre-authorization request to the insurer
4
The insurer validates, reviews and confirms the network hospital by fax and email. You will be notified by text message and email. Niva Bupa usually responds within 30 minutes of filing the claim request
5
Finalize the insurance claim settlement with the hospital after completing the formalities

Reimbursement Claim Process

1
Notify the insurer within 48 hours of admission in its network or non-network hospital. Pay the amount directly to the hospital.
2
Get your documents after leaving the hospital for reimbursement
3
Send the completed and signed claim form along with your valid ID proof and age proof to the insurer. The claim form can be found on Niva Bupa’s website or in your policy document
4
The insurer will review the claim request upon receipt of your documents and either approve, query or reject it based on the policy terms and conditions
5
The insurer will settle and reimburse the approved amount according to the policy terms

OPD Reimbursements

1
Access “My Account” and then select “Raise a Claim” under the OPD tab
2
Search for the doctor by entering the details
3
Click “Raise a Claim” from the search results against the doctor who provided OPD services
4
Complete the health claim form with accurate bill and bank details, along with the required documents uploaded. Submit after completion
5
The insurer will review the insurance claim and approve, send a query or reject based on the policy terms

Diagnostic Center Reimbursements

1
Have a valid copy of the diagnostic claim reimbursement
2
Access “My Account” and select “Reimbursement Claim” in the annual health check-up tab
3
Fill out the claim form with accurate bill and bank details and upload specified documents. Submit after completion
4
The insurer will review your claim and then approve/send a query\reject it according to the policy terms

Documents Required to Buy Niva Bupa Health Insurance

  • Identification Proof
  • Address Proof
  • Age Proof
  • Income Proof
  • Medical Reports
  • Passport-size Photographs

Documents Required for Niva Bupa Health Insurance Reimbursement Claim Process

  • Completed and signed claim form
  • A discharge certificate from the hospital
  • Doctor's consultation notes and receipts
  • Hospital bills with proper stamps and signatures
  • Reports and diagnostics including X-ray films, blood tests, urine tests, etc.
  • Invoices for medications and any other relevant treatment documents.

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