Product Benefit Table (all limits in ` unless defined as percentage)

Waiting period and exclusions

Base sum insured 3L, 4L, 5L, 7.5L, 10L, 12.5L, 15L, 20L, 25L, 50L, 75L, 1Cr
PRESENTING
Inpatient care (without any
room rent capping)
Home care treatment • Treatment during the first 30 days of the plan will not be • Change-of-Gender treatments, Hormone Replacement Therapy,
covered, unless the treatment needed is a result of an accident. Cosmetic or plastic Surgery
Pre and post
Benefits covered upto
Day care treatment Domiciliary hospitalization
hospitalization This waiting period does not apply for renewal policies • Sleep disorders, treatment for alcoholism, drug or substance
sum insured expenses - 60 and 180 days
respectively
• Any pre-existing conditions will be covered after a waiting abuse or any addictive condition
period of 3 years. Whereas, conditions specified in your policy • Dental/oral treatment
Alternative treatments Living organ donor transplant under Personal Waiting Period will be covered after a waiting
period of 2 years
• Sterility and Infertility, Maternity Expenses

• 2 years exclusion for specified disease/procedures like cataract,

• Circumcision, External Congenital Anomaly
•
ReAssure
Unlimited reinstatement of Sum Insured applicable for any illness or anyone insured (Single claim
under this benefit will be payable up to base sum insured)
pancreatitis, chronic kidney disease, hernia, internal congenital
anomaly, spinal disorder, etc •
Sexually transmitted Infections & diseases (other than HIV / AIDS)
Any treatment or medical services received outside the
Keeps giving you more!
• Investigation & Evaluation, OPD treatment
geographical limits of India

Booster benefit In case of claim free year, increase of 50% of base sum insured in a policy year; maximum up to • Unproven Treatments, Unrecognized Physician or Hospital • Intentional self-inflicted Injury or attempted suicide,
Neuro-developmental delays and disorders, Mental retardation
100% (In case of a claim, reduction of accumulated cumulative bonus by 50% of base sum insured) • Breach of law, Conflict & Disaster, Excluded Providers
• Hazardous or Adventure sports

Annual (From Day 1); For defined list of tests; up to 500 for every 1 Lac sum insured Refer to the policy document for further details on sub-limits, waiting period and exclusions.
Health check-up
(Individual policy: maximum 5,000 per Insured; Family Floater policy: maximum 10,000 per policy)

Live healthy benefit(1)

Collect health points by taking steps counted on our Niva Bupa Health App and get discount
up tp 30% on renewal premium
Easy to reach
If you would like to find out more, please reach out to our specialised sales team or your Niva Bupa advisor. We are available to fully
Modern treatments Covered up to sum insured with sub-limit of 1 Lac on few robotic surgeries
understand your requirements and help you select the right plan for you and your family.

Second medical opinion Once for any condition for which hospitalization is triggered Say ‘Hi’ to us on WhatsApp: Helpline: Email ID:
9811956696 1860-500-8888 [email protected]

Emergency ambulance Covered upto 2,000 per hospitalization Website: www.facebook.com/ www.twitter.com/
www.nivabupa.com nivabupahealthinsurance nivabupa

Cashless claim: Covered up to sum insured

Air ambulance
Reimbursement claim: Covered up to 2.5 Lacs NIVA BUPA HEALTH INSURANCE COMPANY LIMITED
Registered Office Address: C-98, First Floor, Lajpat Nagar, Part 1, New Delhi-110024,
Shared accommodation Up to 15 Lacs base sum insured: 800 per day (maximum 4,800)
cash benefit A bove 15 Lacs base sum insured: 1,000 per day; (maximum 6,000)

Optional benefits E
M PLET CE
CO URAN
a. Claim safeguard: Non-payable items paid up to sum insured
SS
b. Booster benefit safeguard: No impact on Booster benefit if claims in a policy year is up to 50,000 REA WITH
-19 E˜
Safeguard
c. Sum insured safeguard: CPI (Consumer Price Index) linked increase in base sum insured
V ID
CO ERAG
COV
Disclaimer: This is only a summary of the product features and is for reference purpose only. The details of benefits available shall be as described in the
Up to 5 Lac base sum insured: 1,000/day prospectus, and will be subject to the policy terms, conditions and exclusions. Please call our customer service if you require any further information or
Hospital cash(2) 7.5 Lacs to 15 Lacs base sum insured: 2,000/day clarification.

ReAssurance at every step

Insurance is a subject matter of solicitation. Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited)
Above 15 Lacs base sum insured: 4,000/day
(IRDAI Registration No. 145). ‘Bupa’ and ‘HEARTBEAT’ logo are registered trademarks of their respective owners and are being used by Niva Bupa Health
Insurance Company Limited under license. *Tax benefits are subject to changes in tax laws. Savings amount computed for an individual who is in highest slab
of income tax and surcharge. Maximum deduction under section 80D is ` 100000. The highest tax slab for an individual is (base rate 30%+ 37% SC = 41.1 %
Personal accident cover + 4% cess = 42.744%) ` 100000 x 42.744% = 42744. Tax saving can vary basis individual’s income and policy coverage. Please consult your tax advisor for
(for insured aged 18 5 times of base sum insured; subject to maximum of 1 Crore more details. $Niva Bupa processes pre-authorisation requests within 30 minutes for all active policies, subject to receiving all documents and information(s) ReAssure - Unlimited reinstatement of sum Safeguard features – Truly cashless
years & above) up to Niva Bupa’s satisfaction. The above commitment does not include pre-authorisation settlement at the time of discharge or system outage. ##Number
of network hospitals shown is an approximate figure and is subject to change without prior notice, please visit our website to access latest and updated list insured for any illness or any person in the feature with coverage even for
of network hospitals. #Single claim under this benefit will be payable up to base sum insured. ^As per IRDAI guidelines. ***Only for retail products. $$This is same year, triggered from the 1st claim itself so non-payables like gloves and more$$
Eligible insured person for this benefit will be: a. All members except son / daughter under a Family Floater policy
(1) an optional cover which will be available post payment of additional premium. ~ReAssure plan covers COVID-19 related hospitalisation. For more details on that you can claim as many times as needed#
b. Any member of age at least 18 years under an Individual policy inclusions, waiting period, risk factors, terms and conditions, please read sales brochure carefully before concluding the sale. CIN:
U66000DL2008PLC182918, Product Name: ReAssure. Product UIN: MAXHLIP21060V012021. UIN: NB/BR/CA/2021-22/375.
Hospital cash - Minimum 48 hrs of continuous hospitalization required. Maximum coverage offered for 30 days/policy
(2) Live healthy benefit – Get up to 30%
Statutory Warning: Booster benefit - Doubles the sum discount on renewal premium basis
year/insured person. Payment made from day one subject to hospitalization claim being admissible.
Prohibition of Rebates (Under Section 41 of the Insurance Act 1938) insured in 2 claim free years step count in Niva Bupa Health App
Inbuilt feature to give you more protection in times of COVID-19 1. No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an insurance
in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the
premium shown on the Policy, nor shall any person taking out or renewing or continuing a Policy accept any rebate, except such rebate as may be
No impact on Booster benefit if the claim is

3
allowed in accordance with the published prospectuses or tables of the insurer. 2. Any person making default in complying with the provisions of
made for COVID-19 related hospitalization this section shall be liable for a penalty which may extend to ten lakh rupees. Health check-up starting from day 1 30 min. cashless claims processing$
 Make the most of your policy and take greater charge
ReAssure benefits, discounts and more of your health with these optional benefits
Hospital Cash(2)
Niva Bupa Health Insurance is a leading standalone health insurance provider serving 3 million plus customers since 2010. At Niva Bupa, our mission is Booster Benefit ReAssure Get an additional pay-out to cover miscellaneous expenses that you may incur during hospitalization, provided there has been a minimum
to help our customers live healthier and more successful lives by providing expertise as their healthcare partners. For us, health insurance is not just an A benefit specially designed to ensure that your ReAssure benefit offers unlimited reinstatement of period of 48 hours of continuous hospitalization.
annual transaction. Rather, it is about building a long-term relationship with our customers. health coverage extends further. With this benefit sum insured for any illness for anyone insured in a
double your sum insured in just 2 claim free years. policy year, ensuring you never run out of sum
Personal Accident Cover
This means, if no claims are made in the preceding insured. Unlimited Sum insured reinstatements is
With this optional cover, a lump sum pay-out is offered in case of accidental death, total, or partial disability.
Policy Year, your Base Sum Insured increases by triggered with the first paid claim itself and is
50% subject to a maximum of 100%. available for all subsequent claims in a Policy Year, so
that you can claim as many times as needed#. Safeguard
Presenting We make sure that you have the freedom you need in order to secure your health up to your requirements, which is why the Safeguard benefit
lets you go even further and control different aspects of your policy, such as:

Niva Bupa Health Insurance Plan Shared Accommodation Cash benefit

In case of shared room accommodation during
Live Healthy benefit(1)
Get an additional renewal premium discount of up
Hospitalization in a Network Hospital, a daily
cash amount is paid to the insured person for
to 30% basis the heath points collected by you on
Niva Bupa Health App. To avail this benefit, all you
1. Claim safeguard lets you claim on otherwise non-payable
items up to the sum insured in case of hospitalization, like 3. Sum Insured Safeguard increases the base sum insured on a
cumulative basis each policy year based on inflation rate.
Inflation rate would be computed as the average Consumer Price
gloves, and more.
A health insurance plan designed to give you and your family more than you expect from a health insurance plan. each continuous and completed period of 24 have to do is collect health points by taking steps index (CPI) of the entire calendar year published by the Central
ReAssure health insurance plan is tailored to secure you and your family's health and financial well being with features that hours of hospitalization. counted on Niva Bupa Health App. Statistical Organization (CSO). There is no maximum limit on increase
keep giving you more, like coverage options up to ` 1 Cr, unlimited reinstatement of base sum insured, safeguard against
medical inflation, to giving you a complete cashless experience with coverage for even the consumables, ReAssure just
2. Booster benefit safeguard means there will be no impact
on your Booster benefit if claims in a policy year are up to in Sum Insured under this optional cover.
Tenure Discount Rs. 50,000.
keeps giving you more. This plan comes with the promise to keep you motivated to stay fit with its Live Healthy Benefit, so Family discount Get discount of 7.5% on the premium of second
that you stay healthy and keep getting more! Get 10% discount on premium if 2 or more members policy year if you pay for a 2-year policy term in

ReAssure Policy coverage

are being covered under an individual policy. advance, and additional 15% discount on third
year’s premium if you choose a 3-year policy term.

The policy can be purchased on individual and family floater basis. Relationships covered for adults is / are self, spouse, father, father in law,
Doctor discount Standing Instruction discount mother and mother in law. Parent & parent-in-law cannot be covered in the same policy.
We realize how important the contribution of the Get 2.5% discount on premium if standing
Thoughtfully designed plan to keep you medical community is, and are extremely grateful instruction for auto debit on renewal is provided

more secure and comfortable at the time of hospitalization

for the selfless service they provide. Which is why
we offer an additional premium discount of 5%, if an
and the policy is renewed using the same.
Claims
insured person is a certified medical practitioner.
Direct Claims Settlement*** ##
7600+ Wide Network Hospitals
15-Day Free Look Period^ For quick claims processing we ensure all claims are Avail cashless facility across India at ##
7600+
Inpatient Care Day Care Treatment Tax Savings processed by our team of in-house doctors. network hospitals.
Coverage for all medical expenses one could Coverage for all medical expenses incurred during Income tax* benefit upto INR 42,744 under the 15
DAYS
You get the freedom to change your decision of
continuing with the policy within a period of 15 days
generally incur at the time of hospitalization, Day Care Treatment requiring more than 2 hours of Section 80D of the Income Tax Act, 1961. (30 days if the policy with Policy Period as 3 years
including room rent coverage with no capping, to hospitalization, including angiography, dialysis,
has been sold through distance marketing).
medical practitioners’ fees, investigative tests, radiotherapy and more. 30 Minute Cashless Claims Processing$ Hassle-free Reimbursements

3
medicines, OT charges and many more. We aim to process all cashless claims in 30 minutes Sometimes, you may not be able to access a network
so that you can be with your loved ones in their hour hospital for availing cashless facility. In such cases, to
Modern Treatments Alternative Treatments
Coverage for modern treatments like deep brain Coverage for inpatient treatment under AYUSH that Discount illustration to maximize your savings of need. get your claim reimbursed as fast as possible, all you
need do is submit the requisite documents to us.
stimulation, oral chemotherapy to robotic surgeries allows you to opt for Ayurveda, Unani, Siddha, and
and stereotactic radio surgeries, stem cell therapy Homeopathy treatments. Point of Care Desk (POC)
and more. At our select partner hospitals, a Niva Bupa representative is available to assist you through all the formalities like filling forms,
Individual policy (2 members)
submitting claims etc. so that you are at ease in an unfamiliar hospital environment.
Pre and Post-Hospitalization Expenses Living Organ Donor Transplant
At inception Visit www.nivabupa.com for a list of hospitals with this facility (some POC desks may not be operational in COVID-19 times).
Coverage for pre and post hospitalization expenses Coverage of all medical expenses for organ donor’s
up to the sum insured, 60 days prior and 180 days in-patient treatment for harvesting of the organ Premium 100 each member
post hospitalization. donated.
Family Discount of 10% 20
Renewal Process
Term discount on 3 years (7.5% on 2nd year + 15% on 3rd year) 40.5

Doctor discount of 5% 25 1. Life-long Renewal - Get life-long renewal, regardless of your health status or previous claims made under your policy. Your renewal
premium will increase as your age increases but will not alter based on your claim experience.
Ensuring care beyond hospitalisation and more Final premium 474.5

Premium without any discount 600 2. Sum Insured Enhancement - To protect yourself from rising medical expenses, you can enhance your sum insured or add more members
of your family in your existing policy at the time of renewal. We may reach out to you for additional information/medicals in case needed.

Coverage for Domiciliary Treatment and

Total saving 20.9%
3. Portability and Migration^ -
regarding migration and portability.
You can port or migrate your policy at the time of renewal. Please reach out to us for any query

home care treatments like Chemotherapy Second medical opinion

and Dialysis At renewal

Additional Auto-debit discount of 2.5% 11.9

Take greater charge of your policy and
Additional Live healthy discount of max 30% 138.8 manage it at your convenience
Emergency road and air ambulance Final Premium 323.8
Health Check-ups from day 1 Niva Bupa Health App CIA Chatbot
coverage
Premium without any discount 600 Manage your Niva Bupa policy on the go and access Talk to our interactive chatbot CIA on
various health services like scheduling diagnostic www.nivabupa.com to manage your policy, track
Total saving 46% tests, locating nearest network hospitals, door step renewals, update policy details or find your nearest
delivery of medicines and more. Available on both network hospital at the click of a button!
IOS & Google play store.