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.

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

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.

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.

Niva Bupa Health Insurance Network Hospital List

Niva Bupa Health Insurance Network Hospitals are present in 31 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.

Delhi

Mumbai

Bengaluru

Chennai

Kolkata

Hyderabad

Pune

Ahmedabad

Jaipur

Lucknow

Know More About Network Hospital

Explore other Niva Bupa Health Insurance

To cater to the different medical needs of an individual & their family, Niva Bupa Health Insurance offers several Health Plans ranging from senior citizen plans to specialized plans for autistic children, to health insurance for cardiac patients, and many more.Take a look below to Niva Bupa Health Insurance plans explore more:

Critical Illness Health Insurance

Niva Bupa Critical Illness

Health dangers are rapidly increasing in today's fast-paced world, which includes some chronic life-threatening diseases. Anyone can have a critical i...

Unique Features

Features and Benefits
Eligibility and Coverage
Need For Critical Illness Plans?

Niva Bupa Critical Illness (Pros)

Covers 20 critical illness
Accident care benefits
Direct claim settlement

Niva Bupa Critical Illness (Cons)

Cosmetic procedures not covered
Self-harm not covered
Obesity-related treatments not covered

Niva Bupa Critical Illness (Other Benefits)

Cataract treatments
Domestic emergency evacuation
Compassionate travel

Niva Bupa Critical Illness (Eligibility Criteria)

Entry age: 18 - 65 Years
SI: 5 L - 5 Cr
Policy Term: 1/2/3 Years
Initial Waiting Period: 90 Days

Individual and Family Health Insurance

Niva Bupa Aspire Plan

"Introducing a health insurance that rewards you for starting young." A plan that allows you to go for overseas treatment. Several health insurance p...

Unique Features

Global Treatment
Provides Maternity Cover
Lock the Clock

Niva Bupa Aspire Plan (Pros)

Overseas treatment coverage
Booster benefit
Covers organ donor transplant
Second medical opinion
Teleconsultation

Niva Bupa Aspire Plan (Cons)

No suicide cover
No war injury cover
Baby food & utility charges excluded
Laundry charges excluded
No certificate charges

Niva Bupa Aspire Plan (Other Benefits)

4 unique variants of the plan
Cash-bag benefit
WellConsult OPD Wallet
Cashless claim settlement
AYUSH Treatment

Niva Bupa Aspire Plan (Eligibility Criteria)

Entry age - 18 years
Max entry age - No age limit
SI - INR 3L to 1 Cr
Waiting Period - 30 days

Individual and Family Health Insurance

Arogya Sanjeevani Policy

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...

Unique Features

COVID-19 treatment coverage
Pre and post-hospitalisation cover
Lower co-pay on your claims

Arogya Sanjeevani Policy (Pros)

COVID-19 coverage
Cumulative bonus
AYUSH treatment
Room rent cover
Preventive health check-ups

Arogya Sanjeevani Policy (Cons)

No maternity cover
COVID-19 care not covered
Home care treatment is not covered
OPD not covered
Ambulance cover not available

Arogya Sanjeevani Policy (Other Benefits)

Individual & family floater plan
Cashless claim settlement
Upto 2 Cr SI
Premiums are affordable

Arogya Sanjeevani Policy (Eligibility Criteria)

Min. Entry Age - 3 Months - 25 Years
Adult Entry Age - 18 - 65 Years
SI - 50000 - 10 L
Initial Waiting Period - 30 Days

Top Up and Super Top Up

Niva Bupa Health Recharge

Go an extra mile for the health of your family with Niva Bupa Health Recharge Niva Bupa Health Recharge (formerly known as Max Bupa Health Recharge) i...

Unique Features

Get covered for HIV/AIDS
Loyalty addition of 5% on SI
Discounts on pharmacy and diagnostic services

Niva Bupa Health Recharge (Pros)

Loyalty addictions up to 50%
Pharmacy and diagnostic services
Personal accident cover
Easy plan convertibility
Easy plan convertibility
Day care treatment coverage

Niva Bupa Health Recharge (Cons)

Maternity treatment not covered
Pre-exisiting diseases not covered
Alcoholism not covered
Dietary supplements not covered
No COVID-19 cover

Niva Bupa Health Recharge (Other Benefits)

Intensive care unit charge
Domiciliary treatment
HIV/AIDS treatment covered
Artificial life maintenance benefits
Room rent per day up to 1%

Niva Bupa Health Recharge (Eligibility Criteria)

Min- 18 years
Max- 65 years

Individual and Family Health Insurance

Niva Bupa GoActive

Your Niva Bupa GoActiveTM plan has exclusive features to provide for all your health insurance needs. There could be several incidences that lead us t...

Unique Features

Personal accident coverage
Home health care cover
Early age AdvantAGE benefit

Niva Bupa GoActive (Pros)

Pharmacy and diagnostic services
Domiciliary hospitalisation
Personal accident benefits
Refill benefits
Daily health coaching

Niva Bupa GoActive (Cons)

Maternity benefit not available
Adventure sports not covered
HIV/AIDS not covered
Cosmetic surgery not covered
War injuries not covered

Niva Bupa GoActive (Other Benefits)

Behavioural Assistance Program
Alternative treatment
I-Protect options to increase SI
2% ICU cover per day. No room rent capping

Niva Bupa GoActive (Eligibility Criteria)

Min. Entry age- 18 Years
Max. Entry Age- 65 Years
SI - 4 - 10 L
Initial Waiting Period - 30 Days

Individual and Family Health Insurance

Niva Bupa Super Saver Policy

Niva Bupa Super Saver is a comprehensive health insurance plan that consists of two separate plans- Niva Bupa Health Pulse and Niva Bupa Health Recha...

Unique Features

Lifetime renewability
Unlimited e-consultations
Cover for modern treatments

Niva Bupa Super Saver Policy (Pros)

Annual health check-up included
Pharmacy and diagnostic services included
Domiciliary treatment covered

Niva Bupa Super Saver Policy (Cons)

Investigation and evaluation not included
Any conflict or disaster not included
Maternity expenses is excluded

Niva Bupa Super Saver Policy (Other Benefits)

Lifetime renewability
Unlimited e-consultations
Cover for modern treatments

Niva Bupa Super Saver Policy (Eligibility Criteria)

Min. Entry Age - 18 Years
Max. Entry Age - 65 Years
SI - 10.5 L - 1 Cr
Initial Waiting Period - 30 Days

Individual and Family Health Insurance

Niva Bupa Money Saver Plan

Niva Bupa Money Saver health insurance plan is a combination of two separate health plans- Niva Bupa Health Companion and Niva Bupa Health Recharge. I...

Unique Features

Unlimited e-consultations
No Room Rent Capping
Lifelong Renewability

Niva Bupa Money Saver Plan (Pros)

All day care procedures covered
Every claim free year adds up to 20% of base sum insured as bonus
Accumulated bonus doesn& 039;t reduce even after claim

Niva Bupa Money Saver Plan (Cons)

Oral or dental treatment not covered
Cure and rehabilitation not covered
Incidental diagnostic procedures not covered

Niva Bupa Money Saver Plan (Other Benefits)

Niva Bupa Money Saver Plan (Eligibility Criteria)

Minimum- 3 Months Maximum- 65 Years

Individual and Family Health Insurance

Niva Bupa ReAssure Plan

A plan that keeps giving you more. Niva Bupa Health ReAssure is specially designed to protect you and your family during medical emergencies. It gives...

Unique Features

Coverage for Modern Treatments
Live Healthy Benefit
Get Personal Accident Coverage

Niva Bupa ReAssure Plan (Pros)

Booster benefit
Organ donor transplant
ReAssure
Live Healthy Benefit
Second Medical Opinion

Niva Bupa ReAssure Plan (Cons)

No OPD Cover
No Maternity Cover
No Sleep Disorder Covered
No Suicide Cover
No War Injury Cover

Niva Bupa ReAssure Plan (Other Benefits)

Air Ambulance
Hospital Cash
Personal Accident Cover
Domiciliary hospitalization
Day care treatment

Niva Bupa ReAssure Plan (Eligibility Criteria)

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

Individual and Family Health Insurance

Niva Health Companion

The Smart Just Got Smarter The all-new, improved and comprehensive plan that will keep you and your family, financially secure during any unexpected m...

Unique Features

No-claim Bonus up to 100% of SI
No Room Rent Capping
Vaccination for Animal Bite

Niva Health Companion (Pros)

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

Niva Health Companion (Cons)

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

Niva Health Companion (Other Benefits)

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

Niva Health Companion (Eligibility Criteria)

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

Individual and Family Health Insurance

Niva Bupa Reassure 2.0 Health Plan

Nothing Seems Impossible A comprehensive plan that gives coverage against any medical emergency for you and your family members. One of the various fu...

Unique Features

High Sum Insured
Lock Your Premiums
Booster+ Benefit

Niva Bupa Reassure 2.0 Health Plan (Pros)

Personal accidents covered
Acute Care
Emergency Ambulance
Three Plan variants
Home Care Treatments

Niva Bupa Reassure 2.0 Health Plan (Cons)

No OPD Cover
No Maternity Cover
No Sleep Disorder Covered
Pre-Existing Diseases after 3 yrs.
Alcoholism not covered

Niva Bupa Reassure 2.0 Health Plan (Other Benefits)

Air Ambulance
Modern Treatments
Second Opinion
Booster Benefit
Shared Accommodation Benefit

Niva Bupa Reassure 2.0 Health Plan (Eligibility Criteria)

Entry Age - 18 Years
Max Entry Age - No Age Limit
SI - 5 L to 1 Cr
Waiting Period - 30 Days

Individual and Family Health Insurance

Niva Bupa Health Premia Plan

Niva Bupa Health Premia is a comprehensive health insurance plan that offers complete coverage to an individual and their family. The plan offers wide...

Unique Features

Benefits and Features of Health Premia
Comparison of Silver Gold and Platinum
Sample Premium Rates of Plan

Niva Bupa Health Premia Plan (Pros)

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

Niva Bupa Health Premia Plan (Cons)

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

Niva Bupa Health Premia Plan (Other Benefits)

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

Niva Bupa Health Premia Plan (Eligibility Criteria)

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

Individual and Family Health Insurance

Niva Bupa Health Pulse

Go an extra mile for the health of your family with Niva Bupa Health Recharge Niva Bupa Health Pulse Plan protects you and your family's health and pr...

Unique Features

Know About Max Bupa Health Pulse Plan
Eligibility and Age Restrictions
Learn More About Its Key Features

Niva Bupa Health Pulse (Pros)

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

Niva Bupa Health Pulse (Cons)

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

Niva Bupa Health Pulse (Other Benefits)

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

Niva Bupa Health Pulse (Eligibility Criteria)

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

Senior Citizen Health Insurance

Niva Bupa Senior First Plan

Niva Bupa Senior First is a senior citizen health plan packaged with features that give policyholders the assurance of good health at all times. So wh...

Unique Features

High-sum insured options
Rewards and loyalty benefits
Multiple plan variants

Niva Bupa Senior First Plan (Pros)

High-sum insured options
Rewards and loyalty benefits
Multiple plan variants

Niva Bupa Senior First Plan (Cons)

ICU charges not covered
OPD coverage not available
Second medical opinion not available

Niva Bupa Senior First Plan (Other Benefits)

No sub-limits are applicable for common health conditions
Waive off co-payment on applying deductibles
No mandatory pre-issuance medical tests

Niva Bupa Senior First Plan (Eligibility Criteria)

Min. Entry Age - 61 Years
Max. Entry Age - 75 Years
SI - 5 - 25 L
Initial Waiting Period - 30 Days

Individual and Family Health Insurance

Personal Accident Care Plan

Niva Bupa, formerly known as Max Bupa, is a leading health insurance company in India with a collaboration between Max India Limited and Bupa, a UK-ba...

Unique Features

Child Education
Funeral Expenses Cover
TTD/PTD Cover

Personal Accident Care Plan (Pros)

Child education benefit
Funeral expenses covered
Total and partial disability covered

Personal Accident Care Plan (Cons)

Adventure sports not covered
No coverage for cosmetic procedures
Self-harm not covered

Personal Accident Care Plan (Other Benefits)

Lifetime renewability offered
Long-term discounts
High sum insured options

Personal Accident Care Plan (Eligibility Criteria)

Min. Entry Age - 18 Years
Max. Entry Age - 65 Years
SI - 5 L - 5 Cr
Initial Waiting Period - 30 Days

Critical Illness Health Insurance

Criti Care Plan

CritiCare, a plan that gives health and financial protection to you and your family against 20 critical illnesses! The critical illness can be contagi...

Unique Features

Enhanced Coverage
Eligibility
Sample Premium

Criti Care Plan (Pros)

20 critical illnesses covered
Long-term tenure savings
Different pay-out options
Tax benefits
DIrect claim settlement

Criti Care Plan (Cons)

Accident death
No total disability cover
AIDS not covered
Child education benefit
Funeral expenses

Criti Care Plan (Other Benefits)

Flexibility plan options
Surgeon fees covered
Renewal for life
Diagnostic Procedures/Therapies
Prosthetic implants covered

Criti Care Plan (Eligibility Criteria)

Min- 18 years
Max- 65 years

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