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All you need to know

EXCLUSIONS

Permanent Exclusion

  • Investigation & Evaluation

  • Rest Cure, rehabilitation and respite care

  • Obesity/ Weight Control

  • Change-of-Gender treatments

  • Cosmetic or plastic Surgery

  • Hazardous or Adventure sports

  • Breach of law

  • Excluded Providers

  • Refractive Error

  • Unproven Treatments

  • Birth control, Sterility and Infertility

  • Maternity Expenses

  • Circumcision

  • Conflict & Disaster

  • External Congenital Anomaly

  • Unrecognized Physician or Hospital

(Note: the above is a partial listing of the policy exclusions. Please refer to the policy contract for the full list of exclusions.)

Permanent Exclusion for Personal Accident Cover (if opted)

We shall not be liable to make any payment under any benefits under the Personal Accident Cover if the claim is attributable to, or based on, or arise out of, or are directly or indirectly connected to any of the following:

  • Suicide or self inflicted injury, whether the insured person is medically sane or insane.

  • Treatment for any injury or illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations (whether war is declared or not), rebellion (act of armed resistance to an established government or a leader), acts of terrorism.

  • Service in the armed forces, or any police organization of any country at war or at peace or service in any force of an international body or participation in any of the naval, military or air force operation during peace time.

  • Any change of profession after inception of the policy or any renewal which results in the enhancement of our risk, if not accepted and endorsed by us on the policy schedule.

  • Committing an assault, a criminal offence or any breach of law with criminal intent.

  • Taking or absorbing, accidentally or otherwise, any intoxicating liquor, drug, narcotic, medicine, sedative or poison, except as prescribed by a medical practitioner other than the policyholder or an insured person.

  • Participation in aviation/marine activities (including crew) other than as a passenger in an aircraft/water craft that is authorized by the relevant regulations to carry such passengers between established airports or ports.

  • Engaging in or taking part in professional/adventure sports or any hazardous pursuits, speed contest or racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving, polo, snow and ice sports, hunting.

  • Body or mental infirmity or any illness except where such condition arises directly as a result of an accident during the policy period. However, this exclusion is not applicable to claims made under Permanent Partial Disability.

Card Reward and Redemption

Frequently Asked Questions

It becomes really difficult to decide how much cover is adequate. A cover which we find sufficient today becomes irrelevant tomorrow due to the rising medical inflation. At the same time buying a large insurance cover in the current policy may not be affordable or available. Our Niva Bupa Health Recharge’s deductible acts like a stepney to your health insurance plan. It’s an additional coverage offered to you with a threshold limit. It comes into effect only when your total claim in the same year surpasses the threshold limit.

Yes, Pre existing waiting period – 36 months, initial waiting period – 30 days, personal waiting period – 24 months, specific waiting period – 24 months.

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. (Subject to underwriting guidelines) 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.

Let us understand with an example:

  • Policies with you

    Policy A: Employer/regular health insurance policy with SI of Rs.5 lacs

    Policy B: Niva Bupa Health Recharge having SI of Rs.5 lacs and aggregate deductible (threshold) limit of Rs.5 lacs

  • Situation 1: A single admissible claim of Rs.7 lacs

    Policy A will pay Rs. 5 lacs

    Policy B will pay remaining Rs. 2 lacs as the threshold limit is crossed

  • Situation 2: 2 Admissible claims in a year amounting to Rs.3 lacs each

    Policy A will pay Rs. 3 lacs for the first claim and Rs. 2 lacs for the second claim

    Policy B will pay remaining Rs. 1 lac since the total claim in the year crosses the threshold limit

  • Situation 3: 2 Admissible claims in a year, one amounting to Rs.6 lacs and the 2nd amounting to Rs.3 lacs in the same year

    Policy A will pay Rs. 5 lacs for the first claim and policy B will pay Rs. 1 lac for the first claim and remaining Rs. 3 lacs for the 2nd claim since the total claim in the year crosses the threshold limit.

Yes, you can take Niva Bupa Health Recharge, irrespective of having plan from us or somewhere else.

It makes sense when you want to increase your total coverage without paying much. While anybody can buy our top-up option at any time, however, it is not advisable unless you have bought a base health insurance cover or the coverage offered by your employer is at least equal to the chosen deductible (threshold limit) amount of our top-up.

Yes, it covers (all sub-limits as mentioned in the policy schedule will apply).

Yes, you can avail a tax benefit available under Section 80D of the Income Tax Act 1961 by buying a health insurance policy. These benefits are as per applicable tax laws which can amend from time to time. We advise you to consult your tax advisor for further details or clarifications.

Yes, policy for 1, 2, & 3 years is available. Customer is eligible for tenure discount too.
2 yrs. policy: – 7.5 % discount on 2nd year premium
3 yrs. policy: - 7.5 % discount on 2nd year premium & 15% discount on 3rd year premium

Of course, you can cover your family residing in India under one policy. You can use your health insurance policy across India. For cashless hospitalization, all you need to do is check for a Niva Bupa network hospital near your place of residence. You can also present your claim for reimbursement if you get treated at a hospital which is not a Niva Bupa network hospital.