Features
‘Niva Bupa Health Pulse’ provides health insurance coverage for you and your family. It not only gives you the flexibility to choose the right cover for your needs, but also gives you the option to choose from a varied list of benefits as per your requirements.
In-patient Care (Hospitalisation)
We cover cost of medical treatment when you or your insured family members are hospitalised for treatment.
Hospital Accommodation
We cover cost of ‘Single Private Room’ for Sum Insured Rs. 5 Lac & above. ICU charges are covered up to Sum Insured.
For Rs. 3 Lac and 4 Lac Sum Insured, room rent limit is covered up to 1% of base Sum Insured per day or single private room, whichever is lower. ICU charges are covered up to Up to 2% of base Sum Insured per day.
Pre & Post Hospitalisation Medical Expenses
We reimburse pre & post hospitalisation medical expenses incurred due to illness/injury. The period of the treatment covered is 30 days before you get admitted to the hospital and 60 days after you get discharged from the hospital. This is subject to Niva Bupa accepting the In-patient Care hospitalisation, Day Care or Domiciliary hospitalisation claim.
Day care treatments covered
We cover day care treatments under the product. Please refer to Annexure IV of the policy document to know the day care procedures covered under the product.
Domiciliary Hospitalisation
In case a bed in the hospital is unavailable or on advice of the attending medical practitioner, treatment is administered at home; we pay for medical treatment taken at home, which would otherwise have required hospitalisation. Such treatment should continue for at least 3 consecutive days and confirmation from treating medical practitioner/insured that insured person could not be transferred to the hospital or hospital bed was unavailable, as the case may be.
Alternative Treatments
We will indemnify the medical expenses incurred on the insured person’s gospitalization for Inpatient Care on treatment taken under Ayurveda, Unani, Siddha and Homeopathy.
Organ Transplant
Medical expenses for an organ donor’s In-patient treatment for the harvesting of the organ donated is also covered provided the organ is for the use of the insured person.
Emergency Ambulance
We also cover the ambulance expenses to transfer the insured following an emergency to the nearest hospital. These expenses are paid up to Rs 1,500 (for Sum Insured Rs 3 Lac and 4 Lac) and Rs. 2,000 (for Sum Insured Rs. 5 Lac & above) per hospitalisation only if we have accepted the In-patient claim.
Health Checkup
You can avail health checkup for yourself and your spouse (if insured under the policy) annually from 2nd policy year onwards, so that you live a healthier and happier life. You can undergo a health checkup through our service provider on cashless basis. The tests covered under health checkup package are Complete Blood Count, Urine Routine, ESR, HBA1C, S Cholesterol, Sr. HDL, Sr LDL and Kidney Function Test.
Refill Benefit
In case you have exhausted your Base Sum Insured and No Claim Bonus (if any) partially or completely, you are entitled for an additional sum insured equal to the base sum insured for a subsequent claim in the same year, provided it is for an unrelated illness.
No Claim Bonus
For every claim free year, you will get an increase of 10% of expiring base Sum Insured at renewal, subject to maximum of 100% of base Sum Insured. There will be no reduction in No Claim Bonus in case of claim
Pharmacy and Diagnostic Services
You may purchase medicines and diagnostic services from the empanelled service provider through our mobile application or website. The cost for the purchase of the medicines or diagnostic services shall be borne by you.
Personal Accident Cover (Optional)
Personal Accident coverage against accidental death, permanent total and partial disability.
Critical Illness Cover (Optional)
Critical illness coverage against major illnesses like cancer, CABG, open heart replacement, kidney failure, stroke, major organ/bone marrow transplant etc.
e-Consultation (Optional)
Unlimited tele / online consultations available under this product.
Hospital Cash (Optional)
Daily hospital cash benefit of Rs. 1,000 (for Sum Insured Rs. 5 Lac & below) and Rs. 2,000 (for Sum Insured above Rs. 5 Lac) in case of hospitalization. Minimum 48 hours of continuous hospitalization required, however claim would be paid from day one subject to hospitalization claim being admissible. Maximum coverage offered for 30 days/policy year/insured person.
Enhanced No Claim Bonus (Optional)
Enhanced no claim bonus of 20% of expiring base Sum Insured at renewal, subject to maximum of 200% of base Sum Insured.
Enhanced Re-fill benefit (Optional)
Enhanced Re-fill benefit up to 150% of base Sum Insured
Co-payment
There will be no co-payment under ‘Enhanced’ plan. Under ‘Classic’ plan, a 20% co-payment will apply for treatment in Mumbai (including Navi Mumbai and Thane), Delhi NCR, Kolkata & Gujarat state.
Entry Age and family coverage
The entry age for adults under this policy can be from 18 to 65 years. The entry age for dependent children is from 91 days to 25 years.
The policy can be taken individually or for the family. The family floater policy is available in any of the following combinations:
1 Adult + 1 Child
1 Adult + 2 Children
1 Adult + 3 Children
1 Adult + 4 Children
2 Adults
2 Adults + 1 Child
2 Adults + 2 Children
2 Adults + 3 Children
2 Adults + 4 Children
Tax Benefit
Save tax under Section 80D of the Income Tax Act when you buy a Niva Bupa health insurance policy. Tax benefits are subject to changes in the tax laws, please consult your tax advisor for more details.
Assured Policy Renewal for Life
Once insured with us, you will always remain our customers subject to continued payment of premium. We assure you renewability for life with no extra loadings based on your claim history.
Direct Claim Settlement
We believe you should focus on the treatment of your loved ones rather than running after claim settlement. Therefore, all claims are processed directly by our customer service team.
Cashless Facility
Cashless Facility can be availed only at our Network Providers or Service Providers. Please contact us for more details.
Free Look Period
We endeavor for transparency and complete satisfaction and therefore, our policies are transparent and easy to understand. If you are not satisfied, we provide a 15-day free look period (30 days if the policy has been sold through distance marketing) within which you can cancel your plan stating the reason.
Information at your fingertips
Get quick and easy access to your claims history, your health information, your health profile, including records of tests and other details on our website.
Click Here to read the policy wording.
