All you need to know
Features
‘Arogya Sanjeevani’ provides health insurance coverage for you and your family. The policy is a simple, easy to understand and no-frill product which provides all essential benefits needed in a health insurance policy. Apart from offering you this health insurance cover, we are also committed to provide you with quality services when you need it the most.
In-patient Care (Hospitalisation)
We cover cost of medical treatment when you or your insured family members are hospitalised for treatment.
Hospital Accommodation
The room rent, boarding, nursing expenses (as provided by the Hospital/ Nursing Home) limit under this policy is up to 2% of sum insured, subject to a maximum of Rs. 5,000 per day.
ICU/ ICCU charges are covered up to 5% of sum insured, subject to a maximum of Rs. 10,000 per day.
Pre & Post Hospitalisation Medical Expenses
We will reimburse pre & post hospitalisation medical expenses incurred due to illness/injury. The period of the treatment covered is 30 days before you get admitted to the hospital and 60 days from the date of discharge from the hospital. This is subject to Niva Bupa accepting the In-patient Care hospitalization.
Day care treatments covered
We will cover all the day care treatments under the product.
AYUSH Treatments
We will cover the medical expenses incurred on the insured person’s hospitalisation for Inpatient Care on treatment taken under Ayurveda, Yoga or Naturopathy, Unani, Siddha and Homeopathy.
Road Ambulance
We will also cover the ambulance expenses up to Rs. 2,000 per hospitalization only if we have accepted the In-patient claim.
Cataract Treatment
We will cover the expenses for a treatment of cataract, subject to a limit of 25% of sum insured or Rs. 40,000, whichever is lower, per eye in one policy year. A specific waiting period of 24 months would also be applicable for cataract treatment.
Modern Treatments
The following treatments will be covered as in-patient or day care procedures up to a maximum of 50% of sum insured.
Uterine Artery Embolization and HIFU (High Intensity Focused Ultrasound)
Balloon Sinuplasty
Deep Brain Stimulation
Oral Chemotherapy
lmmunotherapy- Monoclonal Antibody to be given as injection
Intra Vitreal Injections
Robotic Surgeries
Stereotactic Radio Surgeries
Bronchical Thermoplasty
Vaporisation of the Prostrate (Green Laser treatment or Holmium Laser Treatment)
IONM-(Intra Operative Neuro Monitoring)
Stem Cell Therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.
Cumulative Bonus
For every claim free year, you will get an increase of 5% of expiring Sum Insured at renewal (without break), subject to a maximum of 50% of Sum Insured. The cumulative bonus accrued will be reduced at the same rate in case of a claim. However, sum insured will be maintained and will not be reduced.
Co-payment
Each and every claim, which is payable according to the terms and conditions of the policy, will be subject to a co-payment of 5% on the claim amount.
Tax Benefit
Save tax under Section 80D of the Income Tax Act when you buy a Niva Bupa health insurance policy. Tax benefits are subject to changes in the tax laws, please consult your tax advisor for more details.
Assured Policy Renewal for Life
Once insured with us, you will always remain our customers subject to continued payment of premium. We assure you renewability for life with no extra loadings based on your claim history.
Direct Claim Settlement
We believe you should focus on the treatment of your loved ones rather than running after claim settlement. Therefore, all claims are processed directly by our customer service team.
Cashless Facility
Cashless Facility can be availed only at our Network Providers or Service Providers. Please contact us for more details.
Free Look Period
We endeavor for transparency and complete satisfaction and therefore, our policies are transparent and easy to understand. If you are not satisfied, we provide a 15-day free look period (30 days if the policy has been sold through distance marketing) within which you can cancel your plan stating the reason.
Information at your fingertips
Get quick and easy access to your claims history, your health information, your health profile, including records of tests and other details on our website.
Click Here to read the policy wording.
Frequently Asked Questions
Yes, as below
a) Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home
Up to 2% of the sum insured subject to maximum of Rs.5,000 per day
b) Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses Up to 5% of sum insured subject to maximum of Rs.10,000 per day
Yes, you will get Tax benefit under section 80D.
Min Sum Insured: 1L Max Sum Insured: 5 L ( In Multiples of 50000)
Yes, 5. % Cumulative Bonus will be increased by 5% in respect of each claim free policy year (where no claims are reported), provided the policy is renewed with the company without a break . If a claim is made in any particular year, the cumulative bonus accrued shall be reduced at the same rate at which it has accrued.
a) Can include: Husband / Wife / Kids / Parents and Parents in Laws,
b) No. of insured allowed in the policy:- max. 6 Adults and no capping on Number of Child 3. Will I get tax benefit if
A medical check-up may be necessary when you sign up for a new health insurance policy, depending upon the age of the proposed to be insured and the deductible opting for. In case your proposal gets rejected by us, we will deduct the full cost of medical tests from your premium and the balance premium would be refunded.
No Discount
In case of a claim, if monthly or quarterly or half yearly premium payment mode is opted, then the remaining premium payable for the policy year will be deducted from the admissible claim amount
Each and every claim under the Policy shall be subject to a Copayment of 5% applicable to claim amount admissible and payable as per the terms and conditions of the Policy.