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All about Niva Bupa Health Insurance Company
Niva Bupa Health Insurance
Personal Accident Care Plan
A comprehensive personal accident health plan from Niva Bupa, offering ...Read More
Up to 1 Cr
Sum insured
1
No. of plans
320+
Pan India presence
94.4%
Claim settlement ratio
🛡️ IRDAI Approved
⭐ 4.4/5 · 2,747 reviews
🏥 10,000+ hospitals
📊 3.03 solvency ratio
✅ 94.4% claim settlement
About Personal Accident Care Plan
A quick read on what this Niva Bupa Health Insurance plan covers and why it might be a fit for you.
The Niva Bupa Personal Accident Plan is designed to provide financial support in case of accidents. It offers a lump sum payout for accidental death or disability, and weekly income support if you are unable to work due to injury. The plan also includes ambulance cover and a daily hospital cash benefit to help manage immediate expenses after an accident.
It is important to understand that this is not a regular health insurance plan. It does not cover illnesses or most routine medical expenses. In the sections below, we have clearly explained what is covered and what is not, so you know exactly what to expect.
Plan at a glance
Eligibility, sum insured options and policy mechanics — pulled straight from the policy wording.
Entry age
Adult Entry Age: Minimum: 18 years, Maximum: 65 years. For Dependent Children (Maximum 2): Minimum:
Plan type
Individual and Family Health Insurance
Waiting period
No Waiting Period
Renewability
Lifelong
Policy term
1/2/3 Years
*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
Pros & cons
A quick honest summary — the strengths and the trade-offs.
Pros
- Child education benefit
- Funeral expenses covered
- Total and partial disability covered
Cons
- Adventure sports not covered
- No coverage for cosmetic procedures
- Self-harm not covered
What's covered
Every CMS-driven coverage flag from the plan wording — only items with a published value render below.
Hospitalization
- Room rent Not covered
- ICU charges Not covered
- Pre-hospitalization Not covered
- Post-hospitalization Not covered
- Domiciliary hospitalization Not covered
- Day-care treatment Not covered
- OPD charges Not covered
- Covid-19 treatment Not covered
- Cataract Not covered
Bonuses & restoration
- No-claim bonus Not covered
- Automatic restoration of SI Not covered
- Daily hospital cash Not covered
Family & special care
- Maternity cover Not covered
- New-born baby cover Not covered
- IVF treatment Not covered
- AYUSH treatment Not covered
- Organ donor expenses Not covered
Modern & preventive care
- Modern treatment Not covered
- Road ambulance Covered
- Air ambulance Not covered
- E-consultation Not covered
- Health check-up Not covered
- Second medical opinion Not covered
- Vaccination Not covered
Conditions & global
- Co-payment Not covered
- Sub-limits Not covered
- Compassionate travel Covered
- Global coverage Not covered
Video reviews
Walkthroughs from the PolicyX team — pros, cons, real claim experiences and who should buy.
Niva Bupa Health Insurance Plan Detailed Review
Niva Bupa Personal Accident Plan Coverage Allocation Table
| Family /Individual | Percentage Allocation |
| Self | 100% of the Sum Assured |
| Spouse | 50% of the Sum Assured or ₹10 Lakhs, whichever is lower. |
| 2 Children | 20% of the Sum Assured or ₹2 Lakhs, whichever is lower. |
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.
Inclusions & exclusions
What the plan pays for, and what it doesn't.
Inclusions
- Guaranteed Cash Benefit:Customers can receive guaranteed cash benefits as permissible under the policy terms and conditions.
- Coverage from Day One:Coverage starts from the first day of the policy period, ensuring immediate protection with no waiting period.
- Enhanced ProtectionThe plan offers additional options for comprehensive coverage, allowing policyholders to choose between temporary total disability and accidental hospitalization.
- Tenure Options-The plan offers two- and three-year tenure options with discounts of 12.5% for two years and 15% for three years.
- Choose Sum Assured-Policyholders can choose from various sum insured options based on their risk assessment.
- Direct Claim Settlement:Claims are processed by the company's in-house service team, ensuring timely and hassle-free settlements.
- Lifetime Renewability:Customers can enjoy lifetime renewability, ensuring protection for life.
- Worldwide Coverage:The plan provides worldwide coverage for accidents, ideal for frequent travelers.
- Free Look Period:A 15-day free look period is available to review the policy and make necessary changes.
Exclusions
- Pre-existing conditions:Any medical condition existing before policy purchase is not covered. If an accident is related to a pre-existing condition, benefits cannot be claimed.
- Intentional harm:Accidents caused intentionally by the policyholder are not covered. For example, injuries sustained from an intentional fight will not be eligible for claims.
- Illegal activities:Accidents occurring while engaging in illegal activities, such as driving under the influence of drugs or alcohol or participating in illegal street races, are not covered.
- Self-harm:Intentional self-harm, including attempted suicide or self-inflicted injuries, is not covered.
- War and terrorism:Accidents due to war or terrorism are not covered, as these events are considered beyond the insurance company's control.
- Dangerous sports and activities:Accidents sustained while participating in dangerous sports or activities like skydiving, bungee jumping, or mountain climbing are not covered.
- Professional sports:Accidents occurring during participation in professional sports are not covered due to the higher risk of injury.
- Medical procedures:Accidents occurring during medical procedures, including cosmetic procedures and experimental treatments, are not covered.
Who can buy this plan
Eligibility criteria pulled straight from the policy wording.
- Minimum Entry Age: 18 Years
- Maximum Entry Age: 65 Years
- Sum Insured: ₹5 Lakhs: ₹5 Crores
- Initial Waiting Period: 30 Days
Other features & benefits
Niva Bupa Personal Accident Plan Benefits
- Accidental Death Coverage
Niva Bupa Personal Accident Plan provides 100% accidental death coverage, reimbursing the full sum insured in the event of the insured individual's accidental death. - Permanent Total Disability Coverage
If the insured person is unable to work or suffers total and permanent loss of any body part, the Niva Bupa Personal Accident Plan covers 125% of the sum insured under permanent total disability. Total disability scenarios include:- Unable to Work: The insured individual is permanently unable to work in any occupation or employment due to the accident.
- Loss of Limbs or Sight: Complete and permanent loss of use of two limbs, both eyes, or both eyes and one limb.
- Loss of Independence: Inability to perform three or more daily activities independently, such as dressing, feeding, mobility, toileting, transferring, and washing.
- Permanent Partial Disability Coverage
Compensation for Permanent Partial Disability (PPD) varies based on the extent of disability and policy terms. It is typically calculated as a percentage of the sum insured, as specified in the policy's schedule of benefits. - Child Education Benefits Coverage
In case of accidental death or permanent total disability, dependent children receive an education benefit of 5% of the sum assured or ₹50,000, whichever is lower. - Funeral Expenses Coverage
Niva Bupa Personal Accident Plan includes a payment of ₹5,000 for funeral expenses in case of the insured person's accidental death.
Temporary Total Disability Coverage Table of Niva Bupa Personal Accident Plan
It is a condition where the insured person suffers from a bodily injury resulting from an accident, which renders them unable to engage in any type of employment or occupation, whether or not it is related to their usual work, training, or education. Here is the coverage table:
| Optional Benefits available under Accident Care | |||
| Temporary Total Disability (TTD) Sum Insured Available | ₹10 Lakhs | ₹20 Lakhs | |
| Temporary Total Disability Benefits | 1% of Sum Insured (SI) per week, up to a maximum of 100 weeks. TTD Sum Insured (SI) not to exceed 2 times of annual income. | ||
| Surgical Operations | Covered up to Accidental Hospitalization Limit | ||
| Nursing Care, Drugs and Surgical Dressing | |||
| Medical Practitioners/ Surgeon's Fee | |||
| Room Rent | |||
| Operation Theater Charges | |||
| Anesthetics Fee (Including Administration) | |||
| X-Ray Examination or Treatment's (Including CT) | |||
| Diagnostic's Procedures and Therapies | |||
| Prosthetic Implant | |||
| Emergency Ambulance | Limited to ₹2,000 per claim | ||
| Physiotherapy | Limited to 10% of Accidental Hospitalization Limit | ||
Permanent Partial Disability Coverage List of Niva Bupa Personal Accident Plan
The specific list of permanent partial disabilities and their corresponding coverage percentage may vary by policy and insurer. Below is a general list:
| Type of Partial Permanent Disability | Percentage of the Sum Insured | |
| 1. | Loss of use of both hands or loss of function in wrist joint | 100% |
| 2. | Loss of use of both feet or loss of function in ankle joint | 100% |
| 3. | Permanent loss of use of one hand from the wrist joint and one foot from the ankle joint | 100% |
| 4. | Permanent loss of vision in one eye and loss of one hand from the wrist joint. | 100% |
| 5. | Total and permanent blindness in one eye and loss of use of one foot from the ankle joint. | 100% |
| 6. | Permanent blindness in one eye and loss of function of one foot from the ankle joint. | 100% |
| 7. | Permanent loss of speech and hearing in both ears | 100% |
| 8. | Permanent loss of hearing in both ears | 50% |
| 9. | Quadriplegia | 100% |
| 10. | Permanent loss of use of one hand from the wrist joint | 50% |
| 11. | Permanent loss of use of one foot from the ankle joint | 50% |
| 12. | Permanent loss of sight in one eye. | 50% |
| 13. | Permanent loss of speech | 50% |
| 14. | Uniplegia | 25% |
Niva Bupa Accident care: FAQs
The 7 most-asked questions about Personal Accident Care Plan, answered.
A maximum of 2 dependent children are covered under Niva Bupa Accident Care Plan.
The money is deposited into the insured person’s account 90 days after the occurrence of the event.
No funds will be transferred to the insured person’s account if they pass away prior to the processing of a claim under this accident care plan.
The plan offers discounts of 12.5% for two years and 15% for three years.
Prosthetic implantation is covered by this plan, and the costs are reimbursed up to the policy’s accident hospitalization maximum.
Yes, emergency ambulance charges are covered by Niva Bupa Accident Care, which is limited to Rs. 2,000 per claim.
Yes, this plan pays the costs associated with accidental hospitalization which is covered up to the accident hospitalization limit of the policy.
Conclusion
The Niva Bupa Personal Accident Plan provides comprehensive coverage for accidental injuries, death,
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