CritiCare

1. Who can buy CritiCare plan? What are the plan options?

• Adults between the ages of 18 years to 65 years can opt for this plan.
• Both Individual (Self) and floater (Self & Spouse) plans are available.
  
  

2. In CritiCare option 2, the income benefit will be sent to me automatically or I need to fill form every year to claim it from Niva Bupa?
At the time of claim, the lump sum amount (100% of Sum Insured) will be paid. Subsequently, 10% of Sum Insured will be paid every year for a period of 5 years. No separate form is required to be filled-up every year for the same.
For Example: If the sum insured chosen at inception is Rs.50,00,000 then as per the chosen option:

• Option 1 - Rs.50,00,000 shall be paid as lump sum.
• Option 2 - Rs.50,00,000 shall be paid as lump sum. In addition from next year onwards at the beginning of each year for subsequent 5 years, payout equal to Rs.5,00,000 (10% of sum insured opted) shall be paid to the beneficiary.
  
  

3. In CritiCare, can I renew my policy if I have taken claim during the year?
An insured person can only claim once during his/her lifetime post which CritiCare benefit coverage cannot be renewed for that insured person.

4. Does the maximum sum insured limit in CritiCare have any relation to my income?
Yes, for salaried persons the sum insured opted can be maximum 12 times of annual income & for Self Employed it can be maximum 15 times of annual income.

5. Can I propose a policy for my family members without being the insured?
No, the proposer has to be insured under the policy.

6. How much discount will I get if I buy a multi tenure policy?

• You can opt for 1 year, 2 year or 3 year term in your policy.
  
• Policy Term of 2 years: Avail 12.5% discount on 2nd year premium
• Policy Term of 3 years: Avail 12.5% discount on 2nd year premium and 15% discount on 3rd year premium.
  
  

7. Can I buy multiple policies of Health Assurance? If yes is there any limit to number of policies or sum insured coverage?
Yes, you can apply for multiple policies subject to maximum limit as per your income and subject to company’s underwriting guidelines.

8. What is the maximum timeline defined to file the claim under Health Assurance CritiCare plan and what is time frame given by Niva Bupa to pay the claim?

• The claims have to be notified to Niva Bupa within 30 days from the date of diagnosis of the illness.
• All necessary documents must be submitted within 30 days from the date of intimation of the claim or date of discharge, whichever is earlier.
• Upon acceptance of a claim, the payment of the amount due shall be made within 30 days from the date of receipt of last necessary document.
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9. Is income proof mandatory for buying the policy?
Yes, Income Proof is mandatory if sum Insured is equal to or more than 50 Lacs only