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.

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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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