Niva Bupa Health Plus Plan

Niva Bupa Health Plus Plan is an optimal health policy that secures you from medical expenses arising from health emergencies, personal accidents, and critical illness. Cost-effective and reliable, this plan comes with all the smart features you need to secure yourself against unforeseen medical contingencies.

Key features and benefits

• 

  In-patient hospitalisation expenses cover

  Niva Bupa Health Plus Plan covers in-patient hospital expenses which include:
  • Room rent/ boarding and nursing expenses
  • ICU rent/ boarding and nursing expenses
  • Fees of the medical practitioner, surgeon, anaesthetist, nurses and specialist doctor
  • Charges for the operation theatre, anaesthesia, surgical appliances, diagnostic tests, medicines, blood, oxygen, and the cost of prosthetics and other devices or equipment if implanted internally, like a pacemaker, during a surgical process

• 

  Get hospital accommodation charges

  This plan covers up to 2% of the sum insured hospital accommodation charges.

• 

  Hospital ICU charges covered

  The insurer can get the ICU charges covered in this plan and up to double the room rent charges per day.

• 

  Daycare treatments cover

  Daycare treatments refer to those medical treatments and procedures that need hospitalisation, but not for more than 24 hours. All the costs incurred for such treatments are also covered under this policy up to the sum assured.

• 

  Pre- and post-hospitalisation

  You will also get the pre-hospitalisation and post-hospitalisation cover up to the sum insured, including doctor's consultation, diagnostics tests, medicines, drugs, and consumables. This includes all the expenses incurred 30 days before hospitalisation and 60 days after discharge. These charges can be claimed as reimbursement only.

• 

  Domiciliary cover

  This plan also covers all the expenses if you are not hospitalised and get your treatments done at home instead. Some individuals prefer receiving treatment at home rather than at a hospital. On the other hand, some doctors also advise staying at home for the treatment.

• 

  Organ donor expenses cover

  Medical expenses incurred for an organ donor's treatment for harvesting the organ donated are covered under the policy up to the sum assured.

• 

  Emergency road ambulance cover

  The policy covers ambulance expenses needed to transfer the insured individual following an emergency to the nearest hospital. These expenses are paid up to Rs. 1,000 per hospitalisation.

• The Niva Bupa Health Plus Plan can be easily applied online by filling in your basic information and health details.
• Ensure that the information given in the form is complete and accurate.
• You may be required to undergo a pre-policy medical examination at our network diagnostic centres.
• On buying this plan online, your policy will be generated instantly, along with your policy kit and card. This is applicable for cases that do not require further underwriting or medical check-up.
• This plan is available for existing Bajaj Finance Ltd customers only.

The following mandatory documents will be needed to purchase the policy 

• Photograph of the applicant
• Age proof, such as birth certificate, Voter’s ID, PAN card, passport, etc.
• Identity proof, such as passport, Aadhaar card, PAN card, Voter’s ID, etc.
• Income proof, such as Form 16, salary slips, employment certificate, etc.
• Address proof, such as telephone bill, electricity bill, passport, bank statement, Voter’s ID, etc.
• Medical test that the insurer requires you to undergo

Cashless claims

With the Niva Bupa Health Plus Plan, you can avail the benefit of cashless treatment at one of 5000+ network hospitals by following the process below:

• 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 validate your identity and submit the pre-authorisation request to the insurer.
• After validation, the insurer will review and provide their confirmation by fax and e-mail to the network hospital. The insurer ensures you are also notified of the same through text message and e-mail. 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 (per policy terms and conditions) with the hospital after completing all the necessary formalities.

Reimbursement claim

• If you get hospitalised, notify the insurer within 48 hours of admission to a 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. The insurer would need the originals of all the mentioned documents to process your reimbursement.
• Send all the documents to the insurer along with the filled and signed 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 give their approval, raise a query, or reject the same (per policy terms and conditions).
• Finally, the insurer will settle the claim (per policy terms and conditions) and reimburse the approved amount.

Collect the relevant documents mentioned below in original from the hospital and submit them to the insurer within 15 days of discharge from the hospital.

• Original investigation reports
• Final hospital discharge summary, FIR or post-mortem report (if any)
• 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

1. Dental treatments and cosmetic surgeries
2. Ailments requiring treatment due to use or abuse of any substance, drug or alcohol, and treatment for de-addiction
3. Circumcision, unless required for the treatment of illness or accidental bodily injury
4. Breach of law with criminal intent and intentional self-injury
5. Cosmetic, aesthetic, and re-shaping treatments and surgeries
6. Psychiatric or psychological disorders and mental disorders
7. Ailment-wise capping and ambulance charges
8. Hearing aids, spectacles or contact lenses, including optometric therapy
9. Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances

Waiting Period:
Initial waiting period: 30 days
Pre-existing waiting period: 48 months

Refer to the policy document to know more about exclusions in detail.

BFL helpline number:  08698010101

Niva Bupa Helpline Number:  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).