Niva Bupa Incurred Claim Ratio
  • Niva Bupa ICR
  • What’s ICR?
  • What’s it used for?
Niva Bupa Health Insurance Claim Process
premium

Network hospitals

10000+

premium

Incurred claim ratio

54.05%

premium

Sum insured

Up to 3 CR

premium

No. of Plans

16

premium

Solvency Ratio

1.7

premium

Pan India Presence

200+

Recognized By Niva BupaPolicyX.com is a Recognised Niva Bupa Partner View Certificate

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Age of Eldest Member

premium

Network hospitals

10000+

premium

Incurred claim ratio

54.05%

premium

Sum insured

Up to 3 CR

premium

No. of Plans

16

premium

Solvency Ratio

1.7

premium

Pan India Presence

200+

Recognized By Niva BupaPolicyX.com is a Recognised Niva Bupa Partner View Certificate

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Niva Bupa Health Insurance Incurred Claim Ratio

Niva Bupa Health Insurance is one of the leading insurers in the Indian marketplace that offers comprehensive and wide healthcare coverage plans. You can trust them with their top-selling insurance policies, coverage benefits, and claim settlement records.

The incurred claim ratio is the total claim amount paid by the insurance company in ratio to the total premium amount collected in a financial year. This article discusses how the ICR is calculated, how it differs from the CSR, and how can you choose the best health policy based on the company’s ICR. Read on to know more about it.

How the Incurred Claim Ratio of Niva Bupa is Calculated?

The formula helps to find the incurred claim ratio of Niva Bupa health insurance:

ICR = (Net claims paid) / (Net premiums collected)*100

Let’s understand this with an example;

The Niva Bupa health insurance incurred claim ratio is 54.05% meaning Niva Bupa health insurance company has paid 54.05 lakh rupees out of every 100 lakh rupees they have collected as premium from the policyholders.

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How Much is the Incurred Claim Ratio of Niva Bupa?

The incurred claim ratio of Niva Bupa health insurance was 54.05% as per the IRDA report of the financial year 2023. (https://www.policyx.com/data-lab/claim-settlement-ratio-insurance-companies-India.phphere)

Is CSR and ICR Different From Each Other?

Specifications CSR ICR
Based on paid claims (formula) The ratio of total claims settled by the insurer upon the total claims filed to the insurer (by policyholders). The ratio of total claims paid to the insured policyholders upon the total premiums received by the insurer
Ideal ratio 90 - 100% (the higher the better) 50 - 80% or more (the higher the ICR the higher will be insurer’s credibility)
What does it signify about the insurer? Showcases the frequency of settling claims per year Signifies the insurer’s financial capability to pay the insured

How Can I Choose the Best Health Insurance Based on ICR?

Know more about an ideal percentage of the incurred claims ratio of Niva Bupa health insurance company:

Percentage of ICR Specifications
ICR more than 100% Shows that the insurer has paid more amount in claims than the premium they received in a financial year.
ICR b/w 50 to 100% This is considered a good situation for the policyholder and insurer as it also signifies the affordability of the health insurance policies.
ICR less than 50% It is not a healthy affair for the insured individuals as they are likely not to get the claim amount. But for the insurance companies, it’s good as they have paid less amount in claims than they received in premiums.

Summarizing It All

The incurred claim ratio is an important aspect that you must check before investing in a health insurance plan. However, it may be a little tricky to understand all the turns of ICR. We at PolicyX are here to help and educate you about the Niva Bupa health insurance incurred claim ratio.

Call us at 1800 4200 269 and learn about the ICR of Niva Bupa in detail.

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.

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:

Top-up plan

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

Critical Illness

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

Personal Accident

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

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

Senior Citizen

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

Comprehensive Plan

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

Comprehensive

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.

Unique Features

  • Covers a maximum of 6 members
  • Unlimited SI restoration
  • Coverage for modern treatments

Health Reassure Plan (Pros)

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

Health Reassure Plan (Cons)

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

Health Reassure Plan (Other Benefits)

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

Health Reassure Plan (Eligibility Criteria)

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

Comprehensive

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

Comprehensive

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

Affordable

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

Digital

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

Comprehensive

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

Affordable

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 Health Insurance Incurred Claim Ratio : FAQ's

1. What does the incurred claim ratio signify?

It shows the company’s ability to settle claims and build trust among new policy-seekers.

2. What is considered the ideal ICR of a company?

The incurred claims ratio of a health insurer should be somewhere between 50-80% as these ratios are considered to be ideal.

3. Can I buy a health insurance policy based on the company’s ICR?

Yes, you should buy a health policy only after checking out the latest incurred claim ratio of the company.

4. Where can I check the incurred claim ratio of Niva Bupa health insurance?

Check the Niva Bupa health insurance incurred claims ratio report by PolicyX.com.

Health Insurance Companies

Read Reviews & Ratings

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May 10, 2024

When I was sarching for an ideal maternity health plan, PolicyX insurance agents suggested me Niva Bupa Aspire and I am more than satisfied with its multiple features for women

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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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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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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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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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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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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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Simran Nirala

Written By: Simran Nirala

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.