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Niva Bupa  Niva Bupa Health Companion insurance

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Key Highlights of Health Companion medical insurance

Health care is very expensive nowadays. More than the disease itself, it is often the cost of treatment that takes its toll. Health insurance policy covers medical expenses incurred during pre and post hospitalisation stages. Buy Indian health insurance policy for you and your family and get rid of health care expense worries.

Niva Bupa insurance review

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Sum Insured

3 lac - 300 lacs options available

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Claims settlement ratio **

8.0%

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Incurred claims ratio

88%

policy
Number of policies issued *

23,330

person
Number of lives covered *

23,330

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Tenure options

1 year options available

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List of network hospitals

8,600+ hospitals

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Maximum family floater coverage

Self, Spouse + 4 dependent children

* As per IRDAI report   |   ** As per NL25 data published on the Insurance Company website

Niva Bupa Health Companion insurance features

  • Key features of Niva Bupa Health Companion Health insurance

    • Room Rent: Covered upto Sum Insured (except for suite/high room category)
    • Co-pay: NIL co-pay for all inpatients, 10% for OPD treatment
    • Restoration (Refil) Benefit: Upto 100% of Base Sum Insured per year
    Unique features of Niva Bupa Health Companion Health insurance
    • High Coverage option
    • income tax benefit upto INR 42,744 under the section 80D.
    • Tenure Discount: If you pay 2 year policy term,you get a discount of 7.5% on the premium of second policy year.On the other hand.
    • If you choose 3 year policy term, you get an additional discount of 15% on the third year's premium.
    • 15 Day Free look period.
    • Pre and post hospitalisation expensex are covered up to the sum insured, 90 days prior and 180 days post hospitalisation.
    • Worldwide Maternity benefit cover.
    • Direct claim settlement, no third party involved.
    • Re-fill Benefit:When the same or different illness strikes in the same policy year,your base sum insured is re-filled and made available to you.
    • Cashless hospitalization across network of quality hospitals.
    • Life long renewal.
  • Individual Health insurance Plan

    Key Features
    • No medical test require upto 60
    • Cashless at quality hospitals
    • Assured policy renewal for lifelong
    • Tax benefit
     Policy Wordings
    Benefits Niva bupa health companion Variant 1 Niva bupa health companion Variant 2 Niva bupa health companion Variant 3
    2 Lacs 3 Lacs 4 Lacs 5 Lacs 7.5 Lacs 10 Lacs 12.5 Lacs 15 Lacs 20 Lacs 30 Lacs 50 Lacs 100 Lacs
    Benefits
    In-patient treatment Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Room Rent Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Pre hosptitalization medical expenses (30 days) Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Post hosptitalization medical expenses (60 days) Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Day Care tTreatment Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Living Organ Donor Transplant Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Emergency Ambulance Up to 3,000 Up to 3,000 Up to 3,000
    No Claim Bonus In case of any claim, increase of 20% of expiring Base Sum Insured in a policy year; maximum upto 100% of Base Sum Insured In case of any claim, increase of 20% of expiring Base Sum Insured in a policy year; maximum upto 100% of Base Sum Insured In case of any claim, increase of 20% of expiring Base Sum Insured in a policy year; maximum upto 100% of Base Sum Insured
    Refil Benefit* Up to Base Sum Insured Up to Base Sum Insured Up to Base Sum Insured
    Vacination for Animal Bite** Up to 2,500 Up to 5,000 Up to 7,500
    Alternate Treatments Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Health Check-up Once in 2 years, as per Annexure Annual, as per Annexure Annual, as per Annexure
    Domicialiary Hospitalisation Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Optional Benefits
    Hospital Cash*** 1000 per day 2000 per day 4000 per day
    Claim Cost Sharing Options
    Annual Aggregate Deductible Deductible of 1,2,3,4,5 and 10 lacs Deductible of 1,2,3,4,5 and 10 lacs Deductible of 1,2,3,4,5 and 10 lacs
    Treatment only in Tiered Network Available only to renewal customers (for life) who opted this cost sharing option in the expiring policy Available only to renewal customers (for life) who opted this cost sharing option in the expiring policy Available only to renewal customers (for life) who opted this cost sharing option in the expiring policy
    Notes:
    1. (*) Re-Fill benefit - Reinstate upto Base Sum Insured. Applicable for different illness
    2. (**) Vaccination for Animal Bite (Post Bite Treatment) - OPD Benefit upto defined limit as part of overall limit
    3. (***) 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.
  • Family Floater Plan

    Key features
    • Option for Individual+Spouse+Child1+Child2
    • No medical test require upto 60
    • Cashless at quality hospitals
    • Assured policy renewal for lifelong
    • Tax benefit
    Benefits Variant 1 Variant 2 Variant 3 Family First
    2 Lacs 3 Lacs 4 Lacs 5 Lacs 7.5 Lacs 10 Lacs 12.5 Lacs 15 Lacs 20 Lacs 30 Lacs 50 Lacs 100 Lacs Base Sum Insured: 1Lacs, 2Lacs, 3Lacs, 4Lacs, 5Lacs & 10Lacs per Insured Person
    Floater Base Sum Insured - (available on a floating basis over Base Sum Insured): 3Lacs, 4Lacs, 5Lacs, 10Lacs, 15Lacs & 20Lacs.
    Benefits
    In-patient treatment Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Room Rent Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Pre hosptitalization medical expenses (30 days) Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Post hosptitalization medical expenses (60 days) Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Day Care tTreatment Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Living Organ Donor Transplant Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Emergency Ambulance Up to 3,000 Up to 3,000 Up to 3,000 Up to 3,000
    No Claim Bonus In case of any claim, increase of 20% of expiring Base Sum Insured in a policy year; maximum upto 100% of Base Sum Insured In case of any claim, increase of 20% of expiring Base Sum Insured in a policy year; maximum upto 100% of Base Sum Insured In case of any claim, increase of 20% of expiring Base Sum Insured in a policy year; maximum upto 100% of Base Sum Insured In case of any claim, increase of 20% of expiring Base Sum Insured in a policy year; maximum upto 100% of Base Sum Insured
    Refil Benefit* Up to Base Sum Insured Up to Base Sum Insured Up to Base Sum Insured Not Available
    Vacination for Animal Bite** Up to 2,500 Up to 5,000 Up to 7,500 Upto 5,000
    Alternate Treatments Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Health Check-up Once in 2 years, as per Annexure Annual, as per Annexure Annual, as per Annexure Annual, as per Annexure
    Domicialiary Hospitalisation Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
    Optional Benefits
    Hospital Cash*** 1,000 per day 2,000 per day 4,000 per day 1,000/day or 2,000/day
    Claim Cost Sharing Options
    Annual Aggregate Deductible Deductible of 1,2,3,4,5 and 10 lacs Deductible of 1,2,3,4,5 and 10 lacs Deductible of 1,2,3,4,5 and 10 lacs Deductible of Rs.1,2,3,4,5 & 10Lacs
    Treatment only in Tiered Network Available only to renewal customers (for life) who opted this cost sharing option in the expiring policy Available only to renewal customers (for life) who opted this cost sharing option in the expiring policy Available only to renewal customers (for life) who opted this cost sharing option in the expiring policy Available only to renewal customers (for life) who opted this cost sharing option in the expiring Policy
    Notes:
    1. (*)Re-Fill benefit - Reinstate upto Base Sum Insured. Applicable for different illness
    2. (**)Vaccination for Animal Bite (Post Bite Treatment) - OPD Benefit upto defined limit as part of overall limit
    3. (***)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.
    Zone 1: Any of the following cities and their sub-urban areas: Delhi/NCR, Mumbai (inc. Thane and Vashi),Bengaluru, Chennai, Pune, Hyderabad, Kolkata, Ahmedabad.

    Zone 2: Any of the following cities and their sub-urban areas: Itanagar, Dispur, Patna, Raipur, Panaji,Gandhinagar, Chandigarh, Shimla, Srinagar & Jammu, Ranchi, Thiruvananthapuram, Bhopal, Imphal,Shillong, Aizwal, Kohima, Bhubaneshwar, Jaipur, Gangtok, Agartala, Dehradun and Lucknow.
    Zone 3: Rest of India.
  • Exclusions of Niva Bupa Companion Health insurance

    Other than accidental injury/emergency, all other treatments are not covered during the first 30 days. For persons above 60 years of age some conditions will be subject to a waiting period of 24 months and will be covered after two years of continuous renewal.
    • Pre-existing conditions are covered after a waiting period of 4 years.
    • Coverage for expenses occurring from treatment of HIV or AIDS and related diseases.
    • Treatments for congenital diseases, mental disorder or insanity, cosmetic surgery and weight control.
    • Coverage for Non Allopathic treatments.
    • Coverage for expenses arising from abuse of intoxicant or hallucinogenic substances like alcohol and drugs.
    • Hospitalization due to events like war, damage caused from nuclear, chemical or biological weapons and any kind of harmful radiations.
    • Items of personal comfort and convenience.
    Co-pay: If a person is above 65 years of age, 80% of hospital expenses have been paid by max-bupa and remaining 20% customer has to pay. Experimental, investigative and unproven treatment devices, psychiatric and psychosomatic conditions, reproductive medicine - birth control & assisted reproduction, self-inflicted injuries, sexual problems and gender issues, sexually transmitted diseases, sleep disorders, speech disorders, treatment for developmental problems, treatment received outside India, unlawful activity, unrecognised physician or hospital.
  • Claims Procedure of Niva Bupa Health insurance

    Niva Bupa claims Niva Bupa claims

  • Cancellation Procedure of Niva Bupa Health insurance

    PERIOD ON RISK RATE OF PREMIUM TO BE CHARGED
    Up to 15 days Full policy premium refundable
    Up to one-month 1/3rd of the policy premium
    Up to three months 1/2nd of the policy premium
    Up to six months 3/4th of the policy premium
    Exceeding six months Full policy premium

Niva Bupa Health insurance - FAQ's

The medical expenses traceable to childbirth (including complicated deliveries and caesarean sections during hospitalisation) and the expenses incurred towards any lawful medical termination of pregnancy during the policy period will be covered.

Do they only need to pay the difference for the room or for other services as well?

If the insured person is admitted in the hospital in a room category higher than their eligibility as specified in the product benefits table, then we shall only pay a pro-rated proportion of the total associated medical expenses (including surcharge or taxes thereon) in the proportion of the difference between the room rent actually incurred and the entitled room category.

Reasonable and customary charges refer to the expenses incurred for medical services/supplies as long as they are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services. We also take into account the nature of the illness/injury involved.

In-patient hospitalisation refers to the admission of an insured person in a hospital for a minimum of 24 consecutive hours. This is barring specified procedures/treatments, where such admission could be for a period of less than 24 consecutive hours. Our network hospitals are institutions established for in-patient care and day-care treatment for sickness and/or injuries and have been registered as a hospital with the local authorities, under the Clinical Establishments (Registration and Regulation) Act, 2010 or under the enactments specified under the Schedule of Section 56(1) of the said Act. It must comply with all the following criteria like-
  • Should have a qualified nursing staff under its employment round the clock.
  • Should have atleast 10 in-patient beds, in towns having a population of less than 10,00,000 and 15 in-patient beds in all other places.
  • Should have qualified medical practitioners who are in-charge round the clock.
  • Must have a fully equipped operation theatre of its own where surgical procedures are carried out.
  • Must maintain a daily record of patients which can be accessible for our authorised personnel.
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Policy wordings

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