Niva Bupa Criticare (Formerly Known As Max Bupa CritiCare)
The critical illness can be contagious to life as well as to the financial security of the family. To protect your finances in such times, Max Bupa has come up with a Critical Illness plan: CritiCare. The plan provides coverage against critical illness/diseases.
Max Bupa Criticare Policy is designed especially for people who are diagnosed with any of the listed 20 critical illnesses and allows them to protect their savings from being wiped out while availing of expensive medical treatments.
Learn more about Max Bupa Critical Illness Plan :
The CritiCare Plan provides two coverage options-
Individual plan
Family Floater option (maximum 2 adults)
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All about Niva Bupa Health Insurance Company
Eligibility
Entry Age
Adults - 18 -65 years
Sum Insured (in Rs.)
Rs. 3 lakhs to Rs. 2 Crore
Provides Coverage for 20 critical illnesses
Payable Sum insured in family option
Self: 100 % of sum insured Spouse: 100% of Sum insured
**Last Updated on August, 2021
Benefit Options
Option 1
If an individual Criticare plan has been chosen, then the facility of lump sum payment is available to the insured on the sum insured. This means at the time of critical illness claims the insured will get the whole sum insured amount.
Option 2
A lump-sum payment would be made on a claim based on the detection of critical illness during the policy tenure. In addition, 10% of the sum insured will be paid to the beneficiary for a continuous 5 years from the date of a lump-sum payment. While the coverage will terminate for that member and the policy continues for the other insured.
In the case of a family floater, the benefit chosen is applicable to both the adults. In case, insured 1 is detected with critical illness, then the company will pay the lump sum amount. The rule of the policy is that in one particular year only one member can avail of the benefit option. The other insured person will get the benefit amount in the next year or when the issue of critical illness is detected but not in the same year.
15 days to review the policy/30 days in case of a 3-year policy
Tax Benefit
Save tax by paying the premiums under Section 80D of the Income-tax Act
Claim Settlement
Direct settlement of a claim by Max Bupa without the involvement of the third party
Pre-existing Disease
Covered after 48 months
Pre-policy check-up
Required for 46 years & above/ for sum insured more than 10 lakhs
Plan option
You can go for any of the following six options, Criticare + AccidentCare + HospiCash CritiCare + AccidentCare CritiCare + HospiCash AccidentCare + HospiCash CritiCare Only AccidentCare Only
Waiting periods
For Pre-existing diseases - 48 months Under HospiCash Benefit - 24 months for specific conditions
**Last Updated on August, 2021
Illnesses Covered
The Criticare plan provides financial assistance for 20 ailments listed below-
Cancer of Specified Severity
Open Chest CABG
Myocardial Infarction
Open Heart Replacement Or Repair Of Heart Valves
Stroke Resulting In Permanent Symptoms
Permanent Paralysis of limbs
Coma of specified Severity
Kidney failure requiring regular dialysis
Major Organ/Bone Marrow Transplant
Motor Neurone Disease with Permanent Symptoms
Multiple sclerosis
End-stage Liver Disease
End-stage Lung Disease
Loss of speech
Deafness
Third-degree Burns
Aplastic Anaemia
Bacterial Meningitis
Viral Hepatitis
Muscular Dystrophy
Discounts offered
Long Term Discount: On purchasing a plan of 2 or 3 years, the insured will receive a 12.5% and 15% discount on the premium paid for the year.
Online Purchase Discount: If the online medium is selected for the purchase of the policy, then a discount of 10% off will be credited to the insured's total amount of premium.
Max Bupa Health Insurance Network Hospital List
Max Bupa Health Insurance Network Hospitals are present in 32 states nationwide. With a wide network of hospitals, Max Bupa Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
This graph illustrates the premium payable by an individual at different sum insured options ranging from Rs 5 lakh to Rs. 25 lakhs. Let's understand the 1 year monthly premium price payable by the insured for two members against the indicated sums insured from the graph:
Premium Payable by an individual at a different sum insured under Criticare Plan
We have seen above that how the premium varies on the basis of the sum insured. With the increase in age, the premium amount increases due to lifestyle changes, smoking habits, pre-existed illnesses, and other factors. For your better understanding, we have prepared a graph. The graph represents how the monthly premiums payable for a sum insured of Rs. 20 Lakhs against a 1 year policy change with age.
Premium Payable by an individual at different ages under Criticare Plan
Let's understand this with the help of an example,
Ashutosh took a CritiCare plan of Rs 50 lakhs for him and her spouse. Ashutosh is 35 and his wife is 33. The annual income of primary insured i.e Ashutosh is Rs.10 lakhs.
The policy was taken for two years and the premium decided was Rs. 38,626*. The couple opted for Benefit Option 2 (please refer above to the Benefit Options).
Ashutosh was detected with a critical illness after 10 years from the inception of the policy. He claimed for the hospitalization expenses incurred on the treatment of the disease which was accepted by the company. He received a lump-sum payment of the sum insured and his share of benefit will terminate. Now, his wife is the only beneficiary of the policy and will receive 10% of 50 lakhs every year for 5 continuous years counting from the date of a lump-sum payment.
*The premium paid was after the online discount (10%) and 2 years policy discount (12.5%).
Please Note: The sum insured taken must not cross 12 times of the income, if you are salaried class and 15 times, if self-employed.
Exclusions
Self-inflicted injuries or suicides
Involvement in Adventure sports like climbing, parasailing, skydiving, etc
HIV/AIDS transmitted due to sexual interaction
Injuries due to involvement in the naval, military, air force, war, radioactivities, or nuclear bombing, an act of terrorism, etc
Injuries sustained due to criminal acts, or breach of law.
Illness arising due to consumption of alcohol, drugs, narcotics, sedatives, or poison.
How To Buy Max Bupa Health Insurance Plans?
You can either buy from the company or from PolicyX.com. Below are the steps to buy Max Bupa health plans.
Max Bupa Company's Website
Visit the official website of the company. On the top, click on the 'Buy' option.
Enter all the required details and click on 'Find My Plan'.
Among all the available plans, select the best-suited plan to meet your needs.
Pay the premium online.
Once done, a soft copy of the policy will be sent to your registered email address.
PolicyX.com
On the top right corner of this page, search for the 'Calculate Max Bupa Health Insurance Premium' form.
Fill in the necessary details to get the list of quotes.
Choose the desired Max Bupa health plan and pay the premium.
After the payment, the policy will be shared on your registered email address.
Claim Process of Max Bupa Criticare
Cashless Claims
Get admitted to any one of the network hospitals associated with Max Bupa. You can check the list of network hospitals on the company's website.
Use your Max 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.
For Reimbursement claims
If admitted to a non-network hospital, notify Max 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 the necessary documents, invoices, medical reports, and discharge certificates from the hospital.
Send the completed claim form (available on Max Bupa's website) along with the required documents to Max Bupa.
Max Bupa Health Insurance will review the documents and settle the claim (if approved) by reimbursing you for the amount.
Documents Required for the Claim process
Valid ID proof.
The claim application form that is duly signed along with KYC documents
Summary of final hospital discharge documents
Consultation notes and/or reports of investigation outside the hospital.
All medical records since the start of the complaint.
Copy of Medico Legal Certificate. The certificate is duly attested by the concerned hospital.
FIR i.e., First Information Report.
Original reports of diagnostic tests, radiology reports, and payment receipts.
Original hospital bills and discharge certificate signed by the medical practitioner.
Others requested by the company
How Can I Renew My Max Bupa Health Insurance?
Let's discuss the Max Bupa health insurance renewal process. Follow the below steps to renew your policy easily:
Visit the company's website and click on the 'Renew' option.
Enter your 14 digit policy number and click 'Submit'.
You will get the renewal premium amount.
Click on the 'Pay now' option to make the payment.
On successful payment, you will receive a policy transaction number. A new policy kit will be emailed to you within 48 hours.
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.
It totally depends on healthcare needs. If you have a history of any of the above-mentioned critical illnesses, then to be on the safer side it is a good idea to buy Max Bupa Illness Policy.
2. Do I need to undergo a Pre-medical checkup before buying Max Bupa Critical Illness?
The need to undergo a pre-medical check-up may vary from person to person. However, it is always recommended to go for a pre-medical checkup so that at the time of claims, you do not face any hassles.
3. Does Max Bupa Critical Illness offers any Tax Benefits?
Yes. As per section 80D of the Income Tax Act of 1961, one is allowed to have tax exemptions on premiums paid for the Max Bupa Criticare plan.
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