Niva Bupa Health Insurance Claim Settlement Ratio

Health insurance has become a necessity today. An ideal health insurance plan protects you and your family from financial strain during unforeseen medical emergencies. However, have you considered what would happen if your insurance company fails to settle your claims on time? If your loved ones cannot avail the benefits of health insurance, your savings could be wiped out, leading to significant hardship.

To protect your family from such a scenario, it is always recommended to check the claim settlement ratio before choosing a health insurance plan.

You might be wondering what a Claim Settlement Ratio is and why it’s important. Read on to find out.

What is a Claim Settlement Ratio?

Claim Settlement Ratio (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 choose a company with a higher claim settlement ratio. Generally, a higher ratio indicates a more reliable health insurance company. This factor reflects the insurer’s ability to settle claims and provides insight into its historical performance.

If you are considering buying a health insurance plan from Niva Bupa Health Insurance, let’s discuss its claim settlement ratio in more detail.

As per IRDAI, Niva Bupa Health Insurance’s Claim Settlement Ratio is 94.4%. A higher claim settlement ratio indicates a better ability of an insurance company to settle claims. This high ratio makes Niva Bupa Health Insurance a trustworthy choice for its customers.

According to the IRDAI Annual Report 2025-26, Niva Bupa’s Claim Settlement Ratio ranks among the top five compared to other companies.

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 your proof of identification.
• 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 confirmation to the network hospital via fax or email, and will also inform you via text or email.
• The company will settle the claim with the hospital after all formalities are completed.

Reimbursement Claim Settlement Process

• If admitted to a non-network hospital, notify Niva Bupa within 48 hours of hospitalization, or within 24 hours in emergency cases.
• You will need to pay the treatment expenses to the hospital. During discharge, collect all necessary documents, including invoices, medical reports, and discharge certificates.
• Submit 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, if approved, settle the claim by reimbursing the amount to you.