With all the haze of ‘this policy is not gonna work for every medical emergency’, don’t get fooled again. Niva Bupa Arogya Sanjeevani health policy is an indemnity plan that is here to provide coverage for what many insurance plans couldn’t offer you at an affordable premium. The plan is available as an individual and a family floater health policy with a sum insured valued at a maximum of INR 10 Lakhs which is sufficient for the primary members in your family like your spouse, children, parents, and parents-in-law.
Especially in times of an emergency, you would majorly require health insurance that covers all your medical expenses related to hospitalisation including pre & post-hospitalisation, ICU charges, and room rent with the sub-limit of INR 5,000 on a per-day basis. More than this, unlike other Arogya Sanjeevani policies, Niva Bupa covers COVID-19 treatment or any medical expenses related to AYUSH treatment or alternative therapies. You can further get coverage for specified daycare procedures with this plan.
Providing a streamlined and fundamental medical facilitation, the coverage under this plan is designed in such a way that ensures your overall safety. The Niva Bupa Arogya Sanjeevani policy is curated for your family’s health interests which lines up with every section of society, as the affordability of the plan justifies it all.
Arogya Sanjeevani policy is a good purchase for those who have just begun buying a health insurance policy that comes with a co-payment clause at just a rate of 5% on every claim raised during a policy tenure. This page covers all the answers to your curiosity that may arise about the Niva Bupa Arogya Sanjeevani policy, its eligibility criteria, specific benefits, and the process for getting a claim settlement.
Read further to know more about this all-in-all policy.
Eligibility Criteria for Niva Bupa Arogya Sanjeevani Policy
Know here the eligibility criteria, sum insured, waiting period, etc of the Arogya Sanjeevani Policy by Niva Bupa:
Entry Age
3 Months - 25 Years (Family plan)
Max Entry Age
18 - 65 Years (Individual plan)
Policy Type
Individual / Family Floater
Policy Tenure
1 year
Sum Insured
INR 50,000 - 10 Lakhs
Initial Waiting Period*
30 Days
*The Initial Waiting Period is the period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
To know more about the plan, read the policy brochure provided below:
Choose your Niva Bupa Arogya Sanjeevani Policy
Here are the specifications of Arogya Sanjeevani Policy of Niva Bupa:-
In-patient & Out-patient coverage
Room Rent
Covered
ICU Charges
Covered
Pre-Hospitalization
Covered
Post-Hospitalization
Covered
Domiciliary Hospitalization
Not covered
Daycare Treatment
Covered
OPD Charges
Not Covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Covered
No Claim Bonus
Available
Automatic Restoration
Not Applicable
Daily Hospital Cash
Not Covered
Organ Donor
Not Covered
Maternity Cover
Not Covered
New Born Baby Cover
Not Covered
Alternative Treatments
AYUSH Treatment
Covered
IVF Treatment
Not Applicable
Modern Treatment
Not Applicable
Emergency Coverage
Ambulance
Not Covered
Air Ambulance
Not Covered
Compassionate Travel
Not Applicable
Global Coverage
Not Applicable
Wellness Programmes
E-Consultation
Not Applicable
Health Check-Up
Not Applicable
Second Medical Opinion
Not Applicable
Vaccination
Not Applicable
Limitations
Co-payment
Applicable
Sub-limits
Applicable
What is Room Rent?
Room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.
Common Room categories covered under room rent are:
Private Single AC Room
Twin Sharing
General Ward
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Room rent, boarding, and nursing expenses all inclusive as provided by the hospital/ nursing home, doctors’ fees up to 2% of the sum insured subject to a maximum of Rs.5,000/- per day.
What are ICU Charges?
It is a special department in the hospitals where patients with serious medical conditions are treated.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Intensive Care Unit (ICU) charges/ Intensive Cardiac Care Unit (ICCU) charges all inclusive as provided by the hospital/nursing home up to 5% of the sum insured subject to a maximum of INR 10,000 per day.
What is Pre Hospitalization?
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Covered from 30 days before hospitalisation.
What is Post Hospitalization?
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Covered up to 60 days after hospitalisation
What is Domiciliary Hospitalization?
Home hospitalization arrangement for the insured person due to unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get the financial coverage.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not covered.
What is Daycare Treatment?
Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Covered.
What are OPD charges?
The cost of doctor consultation and prescribed medical tests that may not require hospitalization.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not covered.
What is COVID-19 Treatment?
COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. approved Centre.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Covered.
What is Cataract Treatment?
A common eye condition in which your vision gets blurred.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not available
What is a No-Claim Bonus?
For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain
percentage that varies from plan to plan.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
A cumulative bonus of 5% for each claim-free year (up to 50% of the SI) is applicable.
What is Automatic Restoration?
Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not applicable.
What is Daily Hospital Cash?
It is a cash amount that you receive each day during the time of hospitalization.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not covered.
What is an Organ Donor Cover?
It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not applicable.
What is a Maternity Cover?
It refers to the cover that includes expenses for normal and c-section procedures deliveries.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not Available
What is a New Born Baby Cover?
It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the newborn cover and these common treatments
can vary from plan to plan:
Congenital anomaly (conditions since birth)
Acute condition
Chronic condition
Premature delivery
Birth asphyxia
Day care treatment
Coverage status under Niva Bupa Arogya Sanjeevani Policy
New Born Baby Cover or related expenses are not available
What is AYUSH Treatment?
Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Covered up to the specified limit.
What is IVF Treatment?
In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:
Full infertility
No fertility
Infertility diagnosis
Infertility diagnosis and limited fertility treatment
Medication (which may or may not include fertility drug prescriptions)
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not covered.
What is a Modern Treatment?
Medical treatments that demand the use of modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not available.
What is an Ambulance Cover?
An ambulance is used to move the patient from home to hospital, transfer to another hospital, and take them for different tests outside the hospitals.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not covered
What is an Air Ambulance?
Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not applicable
What is Compassionate Travel?
Refers to the traveling expenses of a family member of the insured person in case the policyholders get admitted to a hospital outside his/her residential city.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not available
What is Global Coverage?
Any kind of medical/health emergency when you are outside of India.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not covered
What is E-Consultation?
If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not applicable.
What is a Health Checkup?
A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not applicable
What is a Second Medical Opinion?
If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company's network of medical practitioners.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not applicable.
What is Vaccination cover?
Coverage against the expenses incurred on vaccinations is provided by the insurance companies.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Not covered.
What is Co-payment?
In the co-payment clause, policyholders have to pay a portion of the hospitalization expense on their own and the insurer will pay the rest of the amount.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Applicable, 5% on all claims
What is the Sub limit?
Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder.
Coverage status under Niva Bupa Arogya Sanjeevani Policy
Available.
Benefits of Niva Bupa Arogya Sanjeevani Policy
Below are some of the notable benefits of the Arogya Sanjeevani Policy of Niva Bupa:
Family coverage
Arogya Sanjeevani policy indemnity plan ensures the safety of your family members first (with a floater plan). It provides medical support to the policyholder, legally married spouse, children, parents, and parents-in-law under a single plan.
COVID-19 treatment cover
You need no other plans especially for COVID-19 coverage, as the Niva Bupa Arogya Sanjeevani policy is sufficient to provide you with the hospital cost for coronavirus treatment.
Daycare procedure covers
The plan offers specified daycare procedures that require hospitalisation for less than or equal to 24 hours. The procedures for daycare cover are mentioned during the policy commencement.
Grace period
If you pay your premiums once for one policy year (on an annual basis), you get facilitated with a grace period of 30 days. However, by choosing any other mode of payment, the policy gives you a grace period of 15 days.
Tax benefits
All the premiums paid towards the Niva Bupa Arogya Sanjeevani Policy are eligible for tax benefits under Section 80D of the Income Tax Act, 1961.
What is not covered (Exclusions) under the Niva Bupa Arogya Sanjeevani Plan
This policy schedule has some exclusions that are mentioned below:
Any kind of external congenital illnesses or voluntary treatments like cosmetic therapies/beautification/plastic surgery, etc
OPD and home care treatments
Unproven treatments, rest care, rehabilitation, etc
Sterility and infertility, birth control, gender change treatments, etc
Maternity expenses like childbirth, miscarriage, and lawful medical termination of pregnancy during the policy period
Hypertension, diabetes, cardiac arrests, organ transplants, donor expenses, etc
Breach of the law, alcoholism, drug, or substance abuse cases, etc
How to claim Niva Bupa Arogya Sanjeevani Policy?
To avail of the claim settlement or reimbursement services of Niva Bupa Arogya Sanjeevani policy, the policyholder needs to follow the process below:
For cashless claim settlement
Visit the official website of Niva Bupa Health Insurance.
Or notify your insurer 48 hours before your hospitalisation and 24 hours after an emergency hospitalisation
For claim intimation, the official website has a pre-authorized form you can fill in with your contact number/policy number/email and proceed
The insurer will verify the submitted documents and send you an approval mail
All the legitimate and specified medical bills will be settled between the insurer and the hospital
Individuals can call the toll-free number 1860 500 8888 / 1800 309 3333 or email their details to get their claim settlement procedure info.
Reach out to PolicyX.com for further assistance.
For Reimbursement claim settlement
Get treatment at a networking hospital with a pre-authorization of the Niva Bupa concerned executives
After receiving the authorization form, the company will verify and issue the authorized letter to the hospital
On the discharging day, you must verify and undersign the form against the claim of your medical or non-medical expenses.
You need to pay the medical expenses on your own first and attach all the necessary details of medical relevance in the claim submission form.
Later, submit all the required documents to your insurer for claiming reimbursement for the total of your medical bills, which gets settled upon verification.
Documents to be submitted while raising a claim:
Completed claim form with the policyholder’s photographs
Doctor’s prescription for admission of treatment
All the original medical bills and payment receipts
Discharge summary and all the related details of the policyholder
KYC documents along with the bank’s cancelled cheque details
Other documents that the company may ask to submit at the time of claim settlement
Connecting the dots
Arogya Sanjeevani policy is an indemnity policy specially designed to offer basic and standard medical coverage to policyholders of all sections of society. Niva Bupa’s Arogya Sanjeevani policy ensures you optimum coverage for hospitalisation (pre and post), AYUSH treatment, hospital costs related to COVID-19 care, and so on. In simpler words, the Arogya Sanjeevani policy is affordable and yet it provides the required medical coverage to the insured.
Want to know more? Contact our customer care executives on 18003450330 or visit the official website of PolicyX.com.
A complete health insurance policy that covers you and your family with a wide range of SI (3 Lakh to 1 Crore) and continues to give you more benefits.
An individual and family plan that covers all day care treatments, modern treatments, comes with a safeguard add-on and provides annual health check-ups.
Offers personal accident cover of up to 2 crores on an individual and family floater basis. Pays 100% of SI to your family in case of accidental death.
Unique Features
Global coverage available
Child education benefit
Permanent Disability Cover
AccidentCare (Pros)
Funeral Expenses
Accidental OPD
Adventure Sports Cover
Elderly Care Cover
Burns Cover
AccidentCare (Cons)
No Alcohol Ailment Cover
No Cosmetic Surgery
No Obesity Surgery
No Suicide Cover
No War Injury Cover
AccidentCare (Other Benefits)
Air Ambulance
Broken Bone/Fracture
Head & Spinal Injury
Marriage Expenses for Children
Comatose Cover
AccidentCare (Eligibility Criteria)
Entry Age - 18 Years
Max Entry Age - No Age Limit
SI - 3 L to 5l
Waiting Period - 30 Days
Comprehensive and Top-Up plan
NivaBupa Money Saver
A unique health insurance plan that combines the benefits of basic SI and top-up cover to offer enhanced protection to individuals and families.
Niva Bupa Reassure 2.0 provides insurance holders with a high sum insured through their platinum, titanium, and bronze variants along with a multitude of other features.
Unique Features
Booster+ Benefit
Lock premiums at entry age
Health check-ups from day 1
Health ReAssure 2.0 Plan (Pros)
Personal accidents covered
Acute Care
Emergency Ambulance
Three Plan variants
Home Care Treatments
Health ReAssure 2.0 Plan (Cons)
No OPD Cover
No Maternity Cover
No Sleep Disorder Covered
Pre-Existing Diseases after 3 yrs.
Alcoholism not covered
Health ReAssure 2.0 Plan (Other Benefits)
Air Ambulance
Modern Treatments
Second Opinion
Booster Benefit
Shared Accommodation Benefit
Health ReAssure 2.0 Plan (Eligibility Criteria)
Entry Age - 18 Years
Max Entry Age - No Age Limit
SI - 5 L to 1 Cr
Waiting Period - 30 Days
Suraksha Plan
Niva Bupa Saral Suraksha Bima
A personal accident insurance policy that offers a lump sum compensation in case of permanent disability or death resulting from an accident.
Unique Features
Large Sum Insured
High sum insured
Up to 50 % Cumulative Bonus
Saral Suraksha Bima (Pros)
Accidental Death Covered
Pay Rs 296 monthly as premium
Education Grant to children
Temporary Total Disablement
Hospitalisation due to an accident
Saral Suraksha Bima (Cons)
No Maternity Benefit
No Disablement Claims
War Injuries not covered
Accident through intoxication
COVID-19 death not covered
Saral Suraksha Bima (Other Benefits)
30-minute cashless claims
Paperless Reimbursement
Road Ambulance Covered
Emergency Treatment Covered
Hassle Free Renewal Process
Saral Suraksha Bima (Eligibility Criteria)
Entry Age - 18 Years
Max Entry Age - 65 Years
SI - 2.5 L to 1 Cr
Waiting Period - 30 Days
Corona Plan
Niva Bupa Corona Kavach
The plan covers you and your family against COVID-19, covers the Comorbidities arising out of COVID, and imposes no room rent capping.
Unique Features
Ventilator Expenses Included
PPE Kit expense Included
Covers ICU Charges
Niva Bupa Corona Kavach (Pros)
Home Care Treatment Expenses
Hospitalisation Coverage
Pre and Post Hospitalisation
Hassle-free Claims
AYUSH Treatments Coverage
Niva Bupa Corona Kavach (Cons)
OPD and Day Care Treatment
Evaluation and Investigations
Rehabilitation
Dietary supplements
COVID Claim
Niva Bupa Corona Kavach (Other Benefits)
Coverage for Parents & PILs
Coverage for Dependent Children
Road Ambulance Covered
Hospital Daily Cash
Spouse Cover Available
Niva Bupa Corona Kavach (Eligibility Criteria)
Entry Age - 18 Years
Max Entry Age - 65 Years
SI - 50 Thousand to 5 Lakh
Waiting Period - 30 Days
Niva Bupa Health Insurance Network Hospital List
Niva Bupa Health Insurance Network Hospitals are present in 32 states nationwide. With a wide network of hospitals, Niva Bupa Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
1. What is the total amount of sum insured for the Niva Bupa Arogya Sanjeevani Policy?
The maximum sum insured under this plan is up to INR 3 Lakhs to a maximum of 2 Crores.
2. Is there any coverage for COVID-19 under this plan?
Yes, the Niva Bupa Arogya Sanjeevani Policy covers the treatment for COVID-19.
3. Can I buy the Niva Bupa Arogya Sanjeevani Policy for my family?
Yes, this plan is designed for all. Either you want an individual policy for you and your family separately. Or all the family members can be covered under the same family floater plan.
4. How many members can be covered under this policy?
It offers family floater plan benefits so your spouse, parents/ in-laws/ children (3 months-25 years) or all can be covered under the same policy.
5. Is there any variant under Niva Bupa Arogya Sanjeevani plan?
No, there is no variant of Arogya Sanjeevani's policy of Niva Bupa.
PolicyX made me buy the Niva Bupa Reassure 2.0 health policy. And the customer care executives are so soft-spoken and compassionate about their customer needs.
Akshat R Verma
Allahabad
April 8, 2024
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Pune
April 8, 2024
The team of PolicyX is always open to clear any doubts. I highly recommend buying Niva Bupa health policy from them.
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April 8, 2024
I bought Niva Bupa health insurance for my parents, thanks to PolicyX that now I can be prepared for their health needs.
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All my queries related to claim settlement ratio for Niva Bupa and claim process were resolved by PolicyX insurance agents
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Simran has an experience of 3 years in insurance content writing. She transitioned from hospitality to the insurance industry after her emerging interest in how vast insurance is. With her ability to write complex insurance concepts in a simple, relatable manner she keeps her audience hooked and solves their doubts smoothly.
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