Niva Bupa Health Insurance Claim Settlement Ratio

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      Niva Bupa Health Insurance Claim Settlement Ratio

      Niva Bupa Health Insurance claim settlement ratio must be checked before buying a Niva Bupa health plan. It is a ratio of the total number of claims paid by the insurer versus the total claims received in a financial year. The better is the Claim Settlement Ratio (CSR) of an insurer, the higher are the chances of your claims getting paid.

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      The Niva Bupa Health Insurance Company has a claim settlement ratio of 90.1% (FY 2021-22). Since a CSR above 85% is considered ideal, it indicates that the insurer honours most of the claims filed by policyholders.

      Claim Process of Niva Bupa Health Insurance

      Policyholders can file a cashless or reimbursement claim with the Niva Bupa Health Insurance Company. To file a claim for a planned treatment, you must inform the insurance company at least 2 days before hospitalization. For emergency hospitalizations, the insurer needs to be informed within 24 hours of the hospitalization. Check out the claim process for both cashless and reimbursement claims below-

      Cashless Claim Procedure:

      You can avail cashless treatment at a network hospital only. Follow the process described below to file a cashless claim-

      • Firstly, get admitted to a network hospital. You can check the list of network hospitals online on the insurer’s website or Policybazaar.com.
      • For identification, you can furnish your health card/ PAN card/ policy number/ Voter ID card.
      • Hospital authorities will submit the pre-authorization request to Niva Bupa Health Insurance Company for cashless treatment.
      • The insurer will verify the details and send a confirmation email or fax to the hospital. You will also receive the confirmation via SMS. 
      • Once your treatment is over and all the formalities are completed, the claim amount will be settled with the hospital.

      Reimbursement Claim Procedure:

      • Get hospitalized and avail treatment for your injury/illness 
      • Pay all the bills at the hospital for the treatment at the time of discharge.
      • Do not forget to collect the medical reports, documents, discharge certificate, and original invoices before leaving the hospital.
      • Now, fill out the claim form and sign it before sending it to the insurer. Submit all the required documents with your age proof and valid ID proof. 
      • Your claim request will be reviewed by the insurer and will be accepted or rejected on its basis.
      • If approved, your claim will be settled, and the amount will be reimbursed. 

      Documents Required for Niva Bupa Health Insurance Claims

      To file a Niva Bupa health insurance claim, the following documents need to be furnished:

      • Duly filled and signed claim form
      • KYC form 
      • Hospital discharge certificate
      • Medical reports/ receipts/bills 
      • Death certificate/post-mortem report (For accidental death)
      • Doctor’s prescription and consultation letter
      • Copy of health plan
      • Address proof 
      • FIR report (For accidental cases)

      To lodge a claim, you can also call our helpline number, i.e. 1800-208-8787. You can also write a mail to us at care@policybazaar.com.

      Policybazaar exclusive benefits
      • 30 minutes claim support*(In 120+ cities)
      • Relationship manager For every customer
      • 24*7 claims assistance In 30 mins. guaranteed*
      • Instant policy issuance No medical tests*
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      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30-minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881. Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. As per the Insurance guidelines, you are allowed to cancel the policy with-in 15 days from the date of Issuance of policy. For more details, please read the Plan Brochure carefully or talk to our advisor at the time of purchase.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

      ~Source: Google Review Rating available on:- http://bit.ly/3J20bXZ

      ##On ground claim assistance is available in 114 cities

      Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

      STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

      Policybazaar is a registered Composite Broker |Registration No. 742, Valid till 09/06/2024, License category- Composite Broker (Life & General)| Visitors are hereby informed that their information submitted on the website may be shared with insurers.

      Policybazaar Insurance Brokers Private Limited | CIN: U74999HR2014PTC053454 | Registered Office - Plot No.119, Sector - 44, Gurgaon, Haryana - 122001 Contact Us | Legal and Admin Policies

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