Niva Bupa Claim Settlement Ratio
  • Explore What is CSR
  • Check And Compare The CSR of Niva Bupa
  • Learn how to file Niva Bupa Claims
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Niva Bupa Health Insurance Claim Settlement Ratio

Health Insurance these days is nothing less than a necessity. Having an ideal Health Insurance plan ensures that you and your family are protected from a financial bubble during announced medical emergencies.But have you ever thought about what will happen if your Insurance company is not able to settle your claims on time? What will happen to your loved ones if they are not able to avail the benefit of having Health Insurance? All your savings will be wiped off. Your family might have to suffer due to these untoward situations.

To avoid yourself and your family from such a senario, it is recommended to always check the claim settlement ratio before buying your ideal health insurance company.

Now you must be wondering what is a Claim Settlement Ratio, and how is it important? Read along to find out yourself.

What is a Claim Settlement Ratio?

Claim settlement ratio or CSR is the percentage of claims that an insurance company settles during a financial year against the total number of claims raised. It acts as an indicator of their credibility.

It is recommended to go with a company that has a higher claim settlement ratio, as the general rule is the higher the ratio, the more reliable the health insurance company is. This factor tells you the ability of the company to settle claims and helps you understand the history and performance of the insurer.

If by now you have decided to buy a health insurance plan by Niva Bupa Health Insurance, then, lets discuss the Niva Bupa Health Insurance claim settlement ratio in a little more precise way.

As per IRDAI, Niva Bupa Health Claim Settlement Ratio is 99.99%. The higher the percentage of claim settlement ratio, the better the ability of an insurance company to settle claims. Hence, the high claim settlement ratio makes Niva Bupa Health Insurance trustworthy for its valued customers.

As per the IRDAI Annual Report 2021-22, if we look at the Claim Settlement ratio of other companies, the Niva Bupa settlement ratio comes in the top five.

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Status of Niva Bupa Claim Settlement Ratio - 2021-22

Status of Niva Bupa Claim Settlement Ratio - 2021-22
Age Analysis of Number of Claims Paid (%) < 3 months 3 months to 6 months 6 months to <1 year 1 year to <3 year 3 years to <5 years 5 years
Claims Settled 99.99 0.01 0.00 0.00 0.00 0.00

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How To File a Niva Bupa Health Insurance Claim?

For Cashless Claims:

  • Get admitted to any one of the network hospitals associated with Niva Bupa. You can check the list of network hospitals on the company’s website.
  • Use your Niva Bupa Health Card and show them your identification proof.
  • After validating your identity, the network hospital will submit the pre-authorization request form to the company.
  • The company will review your request and provide the confirmation to the network hospital by fax or email and share the same with you via text or email.
  • The company will settle the claim with the hospital after the completion of all formalities.

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.

Reimbursement Claim Settlement Process

  • If admitted to a non-network hospital, notify Niva Bupa within 48 hours of hospitalization. In emergency cases, inform them within 24 hours of hospitalization.
  • You need to pay the treatment expenses to the hospital. During discharge, collect all necessary documents, invoices, medical reports, and discharge certificates from the hospital.
  • Send the completed claim form (available on Niva Bupa’s website) along with the required documents to Niva Bupa.
  • Niva Bupa will review the documents and settle the claim (if approved) by reimbursing you for the amount.

Explore More Plans from Niva Bupa

Niva Bupa Health Insurance company offers several tailored health plans that are designed to serve you in the best way possible. Take a look:

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.

Unique Features

  • No room rent capping
  • 20% no-claim bonus on SI
  • 100% SI restoration

Health Companion V2022 (Pros)

  • 5% Doctor Discount
  • 10% Family discount
  • Tenure Discounts of upto 15 %
  • Annual Aggregate Deductible
  • Home Care Treatments

Health Companion V2022 (Cons)

  • No OPD Cover
  • No Maternity Cover
  • Cosmetic Surgery Uncovered
  • Specific Diseases after 2 yrs
  • No Alcoholism Cover

Health Companion V2022 (Other Benefits)

  • Air Ambulance
  • Modern Treatments
  • Vaccination on Animal Bite
  • Organ Donor Benefit
  • Domiciliary treatments

Health Companion V2022 (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - No Age Limit
  • SI - 3 L to 1 Cr
  • Waiting Period - 30 Days

A policy for you and your family which covers modern treatments, laser surgery, e-consultations, annual health check-ups, and coverage of 3 Crores.

Unique Features

  • Maternity Cover
  • International coverage
  • In-Built travel insurance

NivaBupa Health Premia (Pros)

  • Refill benefit for any illness
  • 10% Loyalty Additions in SI
  • Tenure Discounts of upto 15 %
  • Worldwide Maternity Benefit
  • In-patient care

NivaBupa Health Premia (Cons)

  • No OPD Cover
  • No HIV/AIDS Covered
  • 20% co-payment
  • Pre-existing Diseases after 2 yrs
  • Treatment for Alcoholism

NivaBupa Health Premia (Other Benefits)

  • Zonal Coverage available
  • Pharmacy and diagnostic services
  • Opt for additional features
  • Living Organ Donor Benefit
  • Premium waiver and portability

NivaBupa Health Premia (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 3 L to 1 Cr
  • Waiting Period - 30 Days

A budget-friendly health insurance plan that offers coverage to individuals and families with tailor-made benefits and great value for money.

Unique Features

  • No room rent capping
  • Up to 100% of SI restoration
  • 20% No Claim Bonus

NivaBupa Health Pulse (Pros)

  • Optional benefits available
  • 150% Refill Benefit
  • Annual Health Checkup
  • Emergency Ambulance
  • Living Organ Donor Benefit

NivaBupa Health Pulse (Cons)

  • Conflict and Disaster cases
  • 20% co-payment
  • No Maternity Benefit
  • Cosmetic surgeries
  • Treatment for Alcoholism

NivaBupa Health Pulse (Other Benefits)

  • Operation Theatre Coverage
  • Modern Treatments
  • Personal Accident Cover
  • e-Consultation
  • Daily Hospital Cash

NivaBupa Health Pulse (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 3 L to 25 L
  • Waiting Period - 30 Days

A super top-up plan providing extra coverage to you and your family on the basis of deductible with SI options of up to 95 lakhs.

Unique Features

  • No room rent capping
  • Unlimited E-consultation available
  • Pharmacy and diagnostic services

NivaBupa Health Recharge (Pros)

  • Loyalty Additions up to 50%
  • Pharmacy and Diagnostic Services
  • Personal Accident Cover
  • Easy Plan Convertibility
  • Day Care Treatments Coverage

NivaBupa Health Recharge (Cons)

  • Maternity Treatment not covered
  • Pre-existing Diseases not covered
  • Alcoholism not covered
  • Dietary Supplements not covered
  • No COVID-19 cover

NivaBupa Health Recharge (Other Benefits)

  • Intensive Care Unit charges
  • Domiciliary treatment
  • HIV / AIDS Treatment Covered
  • Artificial Life Maintenance Benefit
  • Room Rent (per day) Up to 1%

NivaBupa Health Recharge (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 2 Lakh - 95 Lakh
  • Waiting Period - 30 Days

Buy a cover of up to 2 crores to secure you and your loved ones against 20 major critical illnesses with the Niva Bupa CritiCare plan.

Unique Features

  • Daily hospital cash
  • Accident care available
  • Lifelong renewability

NivaBupa CritiCare (Pros)

  • 20 critical illnesses Covered
  • Long-term tenure savings
  • Different pay-out options
  • Tax benefits
  • Direct claim settlement

NivaBupa CritiCare (Cons)

  • Accident Death
  • No Total Disability Cover
  • AIDS Not Covered
  • Child Education Benefit
  • Funeral Expenses

NivaBupa CritiCare (Other Benefits)

  • Flexibility Plan Options
  • Surgeon's Fee Covered
  • Renewal for life
  • Diagnostic Procedures/Therapies
  • Prosthetic Implants Covered

NivaBupa CritiCare (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 3 L to 3 Cr
  • Waiting Period - 30 Days

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

A modern-day digital insurance plan offering you cashless OPD and diagnostic services along with basic coverage and healthcare benefits.

Unique Features

  • Early age enrolment discounts
  • Annually 10 OPD consultations
  • No room rent capping

NivaBupa Go Active (Pros)

  • Pharmacy and Diagnostic Services
  • Domiciliary hospitalization
  • Personal Accident Benefit
  • Refill Benefit
  • Daily health coaching

NivaBupa Go Active (Cons)

  • Maternity Benefit Not available
  • Adventure Sports not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery Not Covered
  • War Injuries not covered

NivaBupa Go Active (Other Benefits)

  • Behavioural Assistance Program
  • Alternate Treatment
  • I-Protect option to increase SI
  • 2 % ICU Cover (per Day)
  • No Room Rent Sub Limit

NivaBupa Go Active (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 4 L to 25 L
  • Waiting Period - 30 Days

A complete health plan, providing a wide range of medical benefits along with global emergency coverage.

Unique Features

  • Maternity & New born coverage
  • No room rent capping
  • 10% increase in SI annually

NivaBupa Heart Beat (Pros)

  • Additional Coverage
  • 10% Loyalty Benefit
  • Annual Health Check ups
  • Refill benefits
  • Coverage out of hospitals

NivaBupa Heart Beat (Cons)

  • Obesity Treatment not covered
  • Hazardous Activities not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable
  • Injuries due to breach of law

NivaBupa Heart Beat (Other Benefits)

  • OPD Consultations
  • Alternative Treatments
  • New Born Baby Cover
  • Pharmacy and diagnostic services
  • No WP up to 45 years

NivaBupa Heart Beat (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 5 L to 1 Cr
  • Waiting Period - 30 Days

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.

Unique Features

  • 100% SI restoration
  • Unlimited e-consultation
  • No room rent capping

NivaBupa Money Saver (Pros)

  • All Day Care Procedures covered
  • Accumulated Bonus
  • 100% Refill Benefit
  • 20% cumulative bonus
  • Organ Transplantation Covered

NivaBupa Money Saver (Cons)

  • No Maternity Benefit
  • Adventure Sports not covered
  • STDs not covered
  • Cosmetic Surgery Not Covered
  • Self Inflicted Injuriesnot covered

NivaBupa Money Saver (Other Benefits)

  • Road Ambulance Cover
  • Alternate Treatment
  • Pharmacy and Diagnostic Services
  • Hassle-Free Claims
  • Pre & Post Hospitalisation

NivaBupa Money Saver (Eligibility Criteria)

  • Entry Age - 3 Months
  • Max Entry Age - 65 Years
  • SI - 10.5 L to 1 Cr
  • Waiting Period - 30 Days

A plan providing comprehensive protection to senior citizens with multiple coverage options counting from 5 - 25 Lakhs.

Unique Features

  • Coverage for modern treatments
  • Multiple co-payment options
  • Unlimited SI restoration

NivaBupa Senior First (Pros)

  • 3 Variant Available
  • No pre-issuance medical tests
  • Day 1 Health Check-up
  • Safeguard (Add-on)
  • Day Care Treatment

NivaBupa Senior First (Cons)

  • No Critical Illness Cover
  • 50% Co-payment
  • No Specific Diseases Covered
  • No Pre-existing Disease Cover
  • Self Inflicted Injuriesnot covered

NivaBupa Senior First (Other Benefits)

  • ReAssure Benefit
  • Domiciliary Hospitalization
  • Organ Donor Benefit
  • Ayush Benefit
  • Annual Aggregate Deductible

NivaBupa Senior First (Eligibility Criteria)

  • Entry Age - 61 Years
  • Max Entry Age - 75 Years
  • SI - 5 L to 25 L
  • Waiting Period - 30 Days

An individual and family health plan, providing a cover of up to 1 crore at affordable premiums combined with advanced features and benefits.

Unique Features

  • Up to 200% of SI as NCB
  • Up to 150% of SI restoration
  • Unlimited e-consultation

NivaBupa Super Saver (Pros)

  • Day 1 Health check-up
  • No pre-issuance medical tests
  • Ambulance cover up to Rs 2000
  • ReAssure Benefit
  • No sub-limits

NivaBupa Super Saver (Cons)

  • No Maternity Benefit
  • Adventure Sports not covered
  • STDs not covered
  • Cosmetic Surgery Not Covered
  • Self Inflicted Injuriesnot covered

NivaBupa Super Saver (Other Benefits)

  • Air Ambulance Cover
  • Health Checkup
  • Organ Donor Benefit
  • Ayush Benefit
  • Room selection Option

NivaBupa Super Saver (Eligibility Criteria)

  • Entry Age - 61 Years
  • Max Entry Age - 75 Years
  • SI - 5 L to 25 L
  • Waiting Period - 30 Days

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

Health Insurer Claim Settlement Ratio

Read Reviews & Ratings

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Raghoba Phadke

Guwahati

April 8, 2024

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.

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Akshat R Verma

Allahabad

April 8, 2024

PolicyX suggested buying Niva Bupa Senior First health insurance for my old age parents. I& 039;m happy to gift them good health, thank you PolicyX.

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Akash Banerjee

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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Sarthak Parmal

Delhi

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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Trishna Rohilla

Bengaluru

April 8, 2024

I got hospitalized due to an accident and my base policy was not sufficient for treatment. So, PolicyX made me buy the Niva Bupa Health Recharge add-on plan. Now, I’ll be prepared for any...

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Sunaina Khanna

Ahmedabad

April 8, 2024

All my queries related to claim settlement ratio for Niva Bupa and claim process were resolved by PolicyX insurance agents

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Babita Thapa

Allahabad

April 8, 2024

I had some reimbursement claim queries related to the Niva Bupa Aspire policy, the customer support team of PolicyX understood my requirement and they stood by me to get the claim.

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Ritu Mandotkar

Guwahati

April 8, 2024

I lost my grandmother because my family did not have so much wealth or savings to get her treatment done. But I decided to buy health insurance for my parents and now I feel relieved because my...

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Naval Goel

Reviewed By : Naval Goel

Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.