Niva Bupa Health Companion Plan

Niva Bupa Health Companion Plan is your best health companion that secures you and your family from medical expenses arising from health emergencies, personal accidents, and critical illness. The plan helps you avail of a cashless claim facility in just 30 minutes in more than 5000+ Niva Bupa network hospitals. Overall, this plan is cost-effective and reliable, coupled with all the smart features you may want to secure every member of your family against unforeseen medical contingencies.

Key Features and Benefits

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  Cashless Claims

  You need not worry about finances when facing medical emergencies. There is a cashless treatment approval in the hospital within 30 minutes with no third party (TPA) involvement in more than 5000+ network hospitals.

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  Day care treatments

  Day-care treatments refer to those medical treatments and procedures that need hospitalisation, but not for more than 24-hours. Some examples of day-care treatments include cataract surgeries, nasal sinus aspiration, cancer chemotherapy, cancer radiotherapy, etc. All the costs incurred such treatments are also covered under the Niva Bupa Health Companion Plan.

• 

  Restore sum insured

  If the insured’s sum insured is exhausted, it gets reinstated if the current claim is made for an illness or an injury different from the one already claimed during the same policy year.

• 

  No Room Rent Capping

  Get coverage for all hospital accommodations except suite & above room category without any room rent capping under this policy.

• 

  Pre and post hospitalization

  You will also get the Pre-Hospitalisation and Post-Hospitalisation cover in this plan. All the expenses are done 30 days before hospitalising and 60 days after discharge are covered in the Health Companion Plan.

• 

  OPD expense cover

  The plan covers OPD treatment charges for vaccinations and immunisations after an animal bite, and the cover ranges from Rs. 2,500 to Rs. 7,500 depending on which variant of the plan is selected.

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  Domiciliary cover

  If in case, you are not hospitalised, and all your treatments are done at home, then all those expenses are also covered in this plan. Some individuals prefer their treatment to be done at home rather than in a hospital. On the other hand, some doctors also advise staying at home for the treatment.

• 

  Organ donor expenses

  Medical Expenses incurred for an organ donor’s treatment for the harvesting of the organ donated will be covered under the policy.

• 

  Emergency ambulance

  The policy covers ambulance expenses needed to transfer the insured following an emergency to the nearest hospital. These expenses are paid up to Rs. 3000 per hospitalisation only if the insurer has accepted the in-patient claim.

• 

  AYUSH Treatment Cover

  You will also get a cover for the in-patient treatment under the AYUSH treatment. AYUSH stands for Ayurveda, Unani, Siddha, and Homeopathy treatments, and the maximum coverage would be up to the maximum amount of the Sum Assured.

• ADD ONS

• Hospital Cash Cover

  Get the benefit of these add-ons as it takes care of all your daily hospital expenses from Rs. 1000 to Rs. 4000 depending on the plan variant selected.

• Safeguard Rider

  This is a genuinely cashless feature with coverage even for non-payables like gloves and more.

To purchase the policy, follow these steps:

• To apply for the product, click on 'Apply Now' and fill in the necessary details
• Make the fee payment online using your preferred mode of payment
• Fill in your name and mobile number
• Complete the process by clicking 'Buy Now', you can also request a call back

Cashless Claims

• With the Niva Bupa Health Companion Plan, you can avail the benefit of cashless treatment with our 5000+ network hospitals by following the following process:
• Get admitted to any one of Niva Bupa network hospitals.
• Use your Niva Bupa Health Card or share your policy number with the concerned team at a hospital along with your Passport/PAN card/ Voter’s ID as identification proof.
• Now, the network hospital will verify your identity for validation and submit the pre-authorisation request to the insurer
• After validation, the insurer will review and confirm their confirmation by fax and email to the network hospital. The insurer ensures you are also notified of the same through text message and email. The insurer will respond to your request within 30 minutes of filing the claim request.
• The only activity left to do now is the final settlement of your claim (as per policy terms & conditions) with the hospital after completion of all the necessary formalities

Reimbursement claim:

• If you get hospitalised, notify the insurer within 48 hours of admission in our network or non-network hospital. After getting admitted, pay the amount directly to the hospital you are in.
• After you are discharged from the hospital, make sure you have all the relevant documents, invoices, medical reports and discharge certificates with you. The insurer would need the originals of all the mentioned documents to process your reimbursement.
• Send all the documents to the insurer, which should be filled and signed in the claim form. Send your valid ID proof and age proof as well.
• After receiving your documents, the insurer will review your claim request and accordingly will give our approval, raise a query or reject the same (as per policy terms & conditions)
• Finally, the insurer will settle the claim (as per policy terms & conditions) and reimburse the approved amount.

Collect below mentioned relevant document in original from the hospital and submit them to us within 15 days of discharge from the hospital

• Original investigation reports
• Final hospital discharge summary FIR or post-mortem report if happened
• Pharmacy bills along with the prescription
• Cancelled cheque or NEFT details for payment
• Original bills, receipts, and discharge report
• Indoor case papers and duly filled claim form
• Original hospital bills and a valid photo ID proof Treating doctor's report
• Original consultation notes Nature of operation performed and surgeon's bill and receipt
• Test reports along with attending doctor’s or surgeon’s report.

• Dental treatments and cosmetic surgeries
• Ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction.
• Breach of law with Criminal Intent, intentional self-injury.
• Cosmetic, aesthetic and re-shaping treatments & surgeries.
• Psychiatric or psychological disorders, mental disorders.
• Waiting Period:
• The insurer will not cover any treatment during the first 30 days since the commencement of the policy unless the treatment needed is the result of an accident.
• Waiting Period for Variant 1 – 48 months
• Waiting Period for Variant 2, Variant 3 & Family First Plan-36 months
• Specific diseases/conditions waiting period: 2 years
• A minimum of 48 hours of hospitalisation is required to avail of the hospital cash benefit. Maximum coverage is offered for 30 days /policy year / insured person.

*Refer to the policy document to know more exclusions in detail

BFL Helpline Number:  08698010101

Niva Bupa Helpline Number:   For your family’s health insurance Call: 1860-500-8888

E-mail –  wecare@bajajfinserv.in

Mailing address: Ground Floor, Bajaj Finserv Corporate Office, Off Pune-Ahmednagar Road, Viman Nagar, Pune – 411014.

*For claim related issues, please refer to your policy document or certificate of insurance (COI).