Niva Bupa Health Companion Health Insurance

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Key Features of Niva Bupa Health Companion insurance

  • Medical treatment abroad for 9 selected diseases (platinum plan only)
  • Buy policy for 2 years and get 12.5% discount on 2nd year premium
  • All day care procedures covered after 90 days (only in Niva Bupa)
  • All life threatning medical situations and accidents are covered from day one.
  • Maternity up to Rs. 1Lac and new born baby coverage from day one.
  • Direct claim settlement, no third party involved.
  • Cashless hospitalization across network of quality hospitals.
  • Free health checkups on renewal.

Niva Bupa Health Insurance review

Niva Bupa Health Insurance
Sum Insured
2 lacs - 300 lacs options available
Tenure Options
1 year
Claims Incurred Ratio *
54.00%
Claims Settlement Ratio **
85.96%
List of Network Hospitals
4,500+ hospitals
Number of Policies issued *
696,107
Number of Lives Covered *
54,33,000
Maximum Family Floater Coverage
Self, Spouse + 4 dependent children
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

Niva Bupa Health Companion insurance plan details

  • Benefits
  • Features
  • Exclusions
Benefits Variant 1 Variant 2 Variant 3
Sum Insured 2, 3 & 4 Lakhs 5, 7.5, 10 & 12.5 Lakhs 15, 20, 30, 50 Lakhs & 1 Crore
Baseline cover benefits (1), (2)
IN - PATIENT TREATMENT
Doctor's fees Covered Covered Covered
Diagnostic Tests Covered Covered Covered
Medicines, drugs and consumables Covered Covered Covered
Nursing Charges Covered Covered Covered
Intravenous fluids, blood transfusion, injection administration charges Covered Covered Covered
Operation theatre charges Covered Covered Covered
Cost of prosthetics and other devices or equipment if implemented internally during a Surgical Operation Covered Covered Covered
Intensive Care Unit Charges Covered Covered Covered
Hospital accommodation Covered Covered Covered
Pre and Post hospitalization expenses including doctor's consultation, diagnostics tests, medicines, drugs and consumables Covered Covered Covered
Day care procedures Covered Covered Covered
Organ Donor Covered Covered Covered
OTHER BENEFITS
Emergency ambulance Up to Rs.3,000 Up to Rs.3,000 Up to Rs.3,000
No Claim Bonus 20% of Base Sum Insured upto a max of 100% 20% of Base Sum Insured upto a max of 100% 20% of Base Sum Insured upto a max of 100%
Refill Benefit (3) Up to Base Sum Insured Up to Base Sum Insured Up to Base Sum Insured
Vaccination (in case of Animal Bite) (4) Upto Rs.2,500 Upto Rs.5,000 Upto Rs.7,500
Ayush Up to Base Sum Up to Base Sum Insured Up to Base Sum Insured
Treatment (5) Insured - -
Health Check-up Once in 2 years Annual Annual
Domiciliary Hospitalization Covered upto Base Sum Insured Covered up to Base Sum Insured Covered up to Base Sum Insured
CUSTOMER LEVEL ENDORSEMENT
Top-up plan on annual aggregate basis Deductible of Rs.1,2,3,4,5 and 10 lacs Deductible of Rs.1,2,3,4,5 and 10lacs Deductible of Rs.1,2,3,4,5 and 10lacs
Treatment only in Tiered Network (6) Option available to Zone 2 customers Option Available to Zone 2 customers Option Available to Zone 2 customers
Hospital Cash (7) 1,000/day 2,000/day 4,000/day
Notes:
(1) Baseline cover includes a
- 48 month waiting period for Variant 1 and 36 months waiting period for Variant 2 and Variant 3 for pre-existing conditions
- a 2 year waiting period for specific diseases/conditions
- a 30 day Initial waiting period from inception
- Entry age for Adults is 18 years onwards and from 91 days to 21 years for children. New born children can be added to existing policies at renewal.
(2) No co-payment for insured of any age
(3) Re-Fill benefit - Reinstate upto base sum insured. Applicable for different illness
(4) Vaccination for Animal Bite (Post Bite Treatment) - OPD Benefit upto defined limit as part of overall limit
(5) AYUSH Treatment - Inpatient Treatment taken up in authorized Government Hospitals
(6) Tiered Network - Zone 2 customers can avail cashless treatment in Niva Bupa's network hospitals in Zone 2 locations. Customers can also avail treatment (reimbursement basis) in Zone 1 hospitals with 20% co-payment. Customer opting for this option will get a 10% discount
(7) Hospital Cash - Minimum 48 hrs of continuous hospitalization required. Maximum coverage offered for 30 days/policy year. Payment made from day one subject to hospitalization claim being admissible.
  1. In-patient treatment - (Up to Sum Insured)
    • Medical practitioners fees, Diagnostics tests, Medicines, Drugs and Consumables, Nursing charges, Intravenous fluids, Blood transfusion, Injection administration charges, Operation theatre charges, The cost of prosthetics and other devices or equipment if implanted internally during a Surgical procedure,Intensive Care Unit charges
  2. Hospital Accommodation
    • Reasonable and customary charges for hospital accommodation upto Sum Insured
  3. Pre & Post Hospitalization Expenses - (Up to Sum Insured)
    • Reimbursement of claim amount, 30 days for pre-hospitalization and 60 days for post-hospitalization
  4. All Day-care Procedures – (Up to Sum Insured)
    • Including Chemotherapy, Radiotherapy, Hemodialysis, or any procedure which needs a period of specialized observation or care after completion of the procedure
  5. Organ donor
    • Expenses for an organ donor’s treatment for the harvesting of the organ donated covered upto Sum Insured
  6. Emergency Ambulance
    • Covered upto Rs. 3,000 per hospitalization for all hospitalization (network/non-network)
  7. Domiciliary Treatment
    • Covered upto Sum Insured
  8. Free Heath Check-ups
    • Once in 2 years for 4 lakh coverage, once a year for others. Insured Person whos age is of 18 years at the time of Renewal shall be eligible for a health check-up.
  9. No Claim Bonus
    • 20% increase on the expiring Base Sum Insured up to a maximum of 100% of the Base Sum Insured of that Policy Year. NCB once accrued does not get reduced in case of claim
  10. Refill Benefit for New Illness (Individual/Family Floater Only)
    • If the base sum insured and No Claim Bonus is partially or completely exhausted (in case of Individual and Floater),We will provide Refill Sum Insured upto 100% of Base Sum Insured.
  11. Vaccination and Immunization Post an Animal Bite
  12. AYUSH Benefit
    • Reimbursement of medical expenses for alternative treatment taken under AYUSH provided the treatment has been undergone in a government hospital or in any institute recognized by government and/or accredited by Quality Council of India/National Accreditation Board on Health(Ayurvedic, Homeopathic, Sidda & Unani)
  13. No Copayment
    • No Mandatory or Optional Co-payment for any age
  14. High Deductible Top-up Option Discount
    • Customers can opt to start utilizing Niva Bupa Cover after exhausting their existing over with other company.
  15. Option Available with 10% Discount.
  16. Hospital Cash Option
    • Optional
  17. Discount for 2 year Policy
    • 12.5% on 2nd year premium
  18. Disease Based Risk Loading
    • Newly introduced
  19. Waiting Periods And Exclusions
    • 30 days waiting period except accidents. 48m Pre-Existing Diseasein Variant 1(upto 4 lac),36m PED in Variant 2, 3 & Family First
  20. Pricing
    • Best In the Industry.
  21. Cashless facility is available across quality hospitals in our network.
  1. Addictive conditions and disorders
  2. Ageing and puberty
  3. Artificial life maintenance
  4. Circumcision
  5. Conflict and disaster
  6. Congenital conditions
  7. Convalescence and Rehabilitation
  8. Cosmetic surgery
  9. Dental/oral treatment
  10. Drugs and dressings for OPD Treatment or take-home use
  11. Eyesight
  12. Unproven/Experimental treatment
  13. Health hydros, nature cure, wellness clinics etc
  14. HIV and AIDS
  15. Hereditary conditions
  16. Alternative treatment
  17. Psychiatric and Psychosomatic Conditions
  18. Obesity
  19. OPD Treatment
  20. Reproductive medicine - Birth control & Assisted reproduction
  21. Self-inflicted injuries
  22. Sexual problems and gender issues
  23. Sexually transmitted diseases
  24. Sleep disorders
  25. Speech disorders
  26. Treatment for developmental problems
  27. Treatment received outside India
  28. Unrecognized physician or Hospital
  29. Unlawful Activity
  30. Policy will not cover any treatment during the first 30 days unless the treatment needed is a result of an accident.
  31. Pre-existing disease for a sum-insured upto 4 lakhs will be covered after 48 months and for 5 lakhs onwards pre-existing condition will cover after 36 months.

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