The list of network hospitals or tie-up hospitals. Almost all the major hospitals are tied-up with the Max Bupa (Niva Bupa) Health insurance Company and are a part of the network list. There are many diagnostic centres which are tied-up with Max Bupa (Niva Bupa) Health Insurance Company to provide health check-up facilities to their customers.
In case of planned treatment the insured customer can inform 24 hours prior to the date of treatment to the Max Bupa (Niva Bupa) Health Insurance Company to process the cashless claim settlement along with the details of treating hospital. In case of emergency the cashless approval would be given within 30 minutes of joining the hospital and the treatment would be carried out by the hospital. In case of cashless claim settlement at the Max Bupa (Niva Bupa) Health insurance network hospital, the claim amount would be paid to the hospital directly. 9 out of 10 claims are given cashless approval within 30 minutes from the time of intimation. In addition to this there are POC or point of care desks in few hospitals where the customer can get assistance from the bupa agent in filing the claims and other claim related documents.
The main incentive of the Max Bupa (Niva Bupa) Health insurance plans is the Cashless claim settlement which is offered by the insurance company. Cashless claim settlement facility provides the customers with a peace of mind. All the insured customer needs to do is to carry the E-card or the policy copy at the time of hospitalization. If the treatment amount exceeds the sum insured mentioned in the policy copy, then the remaining balance has to be paid by the insured customer. The maximum liability of the insurance company would be the sum insured mentioned in the policy document. It is advisable to keep the e-card ready whenever you plan for treatment in any of the network hospital. Treatment only in tired network hospital option is available only to renewal customers who opted for this cost sharing option in the expiring policy. By selecting this option customers can avail cashless treatment in certain locations with 20% co-payment. Customers opting for this option will get 10% discount.
Features of Max Bupa (Niva Bupa) Health Insurance Company:
In-House Claim Settlement: Max Bupa (Niva Bupa) Health & Allied insurance company has no Third party administrators to settle the claim. All the reimbursement and cashless claims are settled through the in house claim settlement team of Max Bupa (Niva Bupa) insurance company. This is an advantage to the customer as the in house claim settlement would be available round the clock. The customer’s reimbursement claim would also be settled within a few days as there would be no involvement of a third party in the claim settlement process. The in house claim settlement process was proved to reduce the claim settlement time and has also improved the customer satisfaction.
Faster & Hassle-free claim settlement: The main purpose of taking a health insurance policy is to avail cashless/ reimbursement facility at the time of hospitalization and to reduce the chance of going bankrupt due to the hospitalization expenses which may involve in disposing the assets such as Gold or other properties. If the claim settlement is not faster and hassle-free the insured customer would suffer a lot and the use of insurance policy would be limited. Max Bupa (Niva Bupa) Health Insurance Company provides faster claim settlement service to their customers, in case of cashless claim settlement 90% of the claims are settled within 2 hours and in case of reimbursement claim settlement would be done within 7 days from the receipt of all the required documents.
All the claims settled by Max Bupa (Niva Bupa) Health Insurance Company are hassle free as the claim settlement process is made simpler and faster. The duly filled claim settlement form should be filled by the insured customer and submitted to the insurance company along with the discharge summary and other bills for the claim to be processed within the time limit mentioned in the policy document.
Cashless facility: Max Bupa (Niva Bupa) Health Insurance Company has tied up with more than 6700 hospitals and diagnostic centres to provide cashless claim settlement service to its customers. The cashless claim settlement facility can be availed by the customers in any of the network hospitals or tie-up hospitals pan India. Most customers prefer to avail cashless service at the time of hospitalization due to the comfort it offers to the customers. Almost 90% of the cashless claims are approved and settled within 30 minutes of notifying the insurance company. All the major hospitals in India are tied-up with Max Bupa (Niva Bupa) Health and Allied insurance company.
Refill of Sum Insured: Automatic restoration of sum insured is the refill of the sum insured upon complete exhaustion during the policy period. The sum insured would be restored any number of times during the policy period without any extra premium to be paid. The sum insured restored under the policy can be used only for the new illness or a new family member for the same illness. It is to be noted that the restoration happens only after the complete exhaustion of the sum insured available in the policy. Get enhanced refill benefit up to 150% of the base sum insured. Refill benefit is utilised in case of exhaustion of sum insured under the health insurance policy. Under this add-on the sum insured would be restored up to 150% of the base sum insured under the health insurance policy.
No claim bonus: A benefit specially designed to ensure that your health coverage extends further. In case of no claim, increase of 10% of expiring base sum insured in a policy year, maximum up to 100% of base sum insured. The key feature of niva bupa health insurance is the no claim bonus which would be up to 100% of the base sum insured. The no claim bonus under the health insurance policy would be increased by 10% for each claim free year until the no claim bonus sum insured reaches the base sum insured.
15 day free look period: If you are not satisfied with the service or terms and conditions or for any other reason, you get 15 days period to cancel the policy. The free look period is 30 days in case of long term policy of 3 years. The 15 days free look period provides a window to the customers to cancel their health insurance policy in case they are not satisfied with the after sales service or the terms and conditions in the policy. There might be instances where the agent has explained one health insurance policy and sold another insurance policy, the customer would come to know of it only when they receive the policy document.
Point of Care Desk (POC): At few selected partner hospitals by the Max Bupa health insurance company, a Niva Bupa representative will be available to assist the insured customer through all the formalities like filling forms, submitting claims etc. so that the insured can be at ease in an unfamiliar hospital environment. The point of care desk in your location can be found out from Documents list of POCs and get assistance at the time of claim.
30 minutes Cashless Claim Processing:The biggest advantage of Max bupa is that the cashless claim would be processed within 30 minutes so that the patient need not wait for longer time at the hospital. 9 out of 10 claims would get approval within 30 minutes making it the most convenient insurance company for taking health insurance policy. The waiting time of the insured would be reduced as the cashless approval would come within 30 minutes of intimation.
Treatment only in Tiered network:This option is available only to renewal customers who opted for this cost sharing option in the expiring policy. By selecting this option customers can avail cashless treatment in certain locations with 20% co-payment. Customers opting for this option will get 10% discount. If the customer agrees to take treatment only in tiered network hospitals of the insurance company, there would be a discount of 10% in the premium to be paid for the health insurance policy while there would be 20% co-payment at the time of claim in case the cashless facility is availed in these tiered network hospitals.
Booster Benefit: A benefit specially designed to ensure that your health coverage extends further. With this benefit double your sum insured in just 2 claim free years. This means, if no claims are made in the preceding Policy Year, your Base Sum Insured increases by 50% subject to a maximum of 100%. The booster benefit in Niva bupa health insurance policy enables the customer to get 100% sum insured within 2 claim free years.
Shared Accommodation Cash Benefit: In case of shared room accommodation during Hospitalization in a Network Hospital, a daily cash amount is paid to the insured person for each continuous and completed period of 24 hours of hospitalization. The shared accommodation can be availed by the insured customer for whom the insurance company would compensate the customer with daily cash for the number of days the insured customer is hospitalized.
Family Discount: Up to10% discount on premium if 2 or more members are being covered under an individual policy. The family discount can be availed only once during the policy period or at the time of renewal.
Doctor Discount: Get up to 5% additional premium discount if the insured person is a medical practitioner. If the insured customer is medical doctor, then Niva bupa health insurance Company would offer additional 5% discount in the premium to be paid. This is a special feature available with Max bupa health insurance Company which encourages more health care professionals to take the health insurance policy from them.
Tax Savings: Income tax* benefit up to INR 42,744 under the Section 80D of the Income Tax Act, 1961. The income tax benefits can also be obtained by purchasing the max bupa health insurance policy.
ReAssure: ReAssure benefit offers unlimited reinstatement of sum insured for any illness for anyone insured in a policy year, so that you never run out of sum insured. Unlimited Sum insured reinstatements is triggered with the first paid claim itself and is available for all subsequent claims in a Policy Year, so that you can claim as many times as needed. The reassure benefit offers unlimited reinstatement of sum insured to the customer in case the base sum insured is exhausted due to hospitalization.
Live Healthy Benefit: Get an additional renewal premium discount of up to 30% basis the heath points collected by you on Max Bupa Health App. To avail this benefit, all you have to do is collect health points by taking steps counted on Max Bupa Health App. The more the number of points accumulated by the customer during the policy period, the more would be the discount available to the customer.
Tenure Discount Benefit: Get discount of 7.5% on the premium of second policy year if you pay for a 2-year policy term in advance, and additional 15% discount on third year’s premium if you choose a 3-year policy term. Higher the tenure of the health insurance policy, higher would be the discount under the health insurance policy from Niva bupa health insurance.
Standing instruction Discount: Get 2.5% discount on premium if standing instruction for auto debit on renewal is provided and the policy is renewed using the same. The standing instruction for auto debit of health insurance premium is a win-win situation for the insurance company and the insured customer as the customer would get continuous coverage without any break-in while the insurance company would retain the customer.
Max Bupa (Niva Bupa) Health insurance premium chart:
Max Bupa (Niva Bupa) Health insurance premium chart can be found in the brochures of the Max Bupa (Niva Bupa) Health Insurance Company website from . All the health insurance plans available are pre underwritten products where the premium is calculated for the sum insured mentioned. The premium is calculated basis the age of the insured and the sum insured, premium would increase if the add-ons are opted under the health insurance plan.
The premium chart of Max Bupa (Niva Bupa) Health Insurance is determined based on the below factors:-
Sum Insured: Sum insured is the maximum liability of the insurance company at the time of claim. The maximum claim that would be settled by the Max Bupa (Niva Bupa) Health insurance company in the event of a claim would not exceed the sum insured mentioned under the policy. The Max Bupa (Niva Bupa) Health Insurance premium depends on the sum insured option selected by the customer. Higher the sum insured, higher would be the premium to be paid by the customer. There would be no provision for the midterm increase of sum insured and any increase in sum insured would be done at the time of renewal. Hence it is important for the customer to decide on the sum insured before purchasing the health insurance plan.
Age: Max Bupa (Niva Bupa) Health insurance premium depends on the age of the insured customers in the health insurance plan. The premium would be calculated on the age of the elder person in the health insurance policy. Higher the age of the insured, higher would be the premium. The reason for this is the increase of mortality ratio and the increase in chance of getting sick as the age increases. Aging causes different illnesses such as Diabetes, Blood pressure etc which increases the chance of hospitalization and thereby the insurance companies charge heavy premium for higher age insured. Hence it is advisable for the customers to take the health insurance plans at a very young age to avoid paying hefty premium at old age.
Add-ons: Max Bupa (Niva Bupa) Health Insurance Company offers certain add-ons which can be purchased on payment of extra premium. These add-ons provide extra coverage to the insured at the time of claim settlement. There are certain add-ons such as Buy back pre existing disease waiting period, hospital daily cash etc which are available on payment of additional premium to the insurance company. The add-ons are given at the time of purchasing the health insurance plan. Midterm inclusion of add-ons is not permitted by the insurance company. More the number of add-ons, higher would be the premium to be paid by the customer.
Health Conditions: Max Bupa (Niva Bupa) Health insurance company premium rates depend on the health conditions of the applicant. If the applicant is having any adverse health condition, the premium charged by the insurance company would be higher as the chance of claim is high in this case. The applicant may even be asked to undergo a pre medical test before the policy issuance to understand the level of risk to be accepted by the insurance company. Adverse health condition leads to adverse claims for the insurance companies.