Niva Bupa (Formerly known as Max Bupa) Heartbeat Platinum Plan

Niva Bupa (Formerly known as Max Bupa) Heartbeat Platinum plan is a comprehensive health cover to protect you against those unplanned expenses arising out of a medical emergency. The policy can be availed in individual and floater sum insured basis with two variants namely Gold and Platinum. Let’s know about one of its variants Heartbeat Platinum.

Why Choose Niva Bupa (Formerly known as Max Bupa) Heartbeat Platinum Plan?

The advantages of Heartbeat Platinum card that make it worth buying are:

The policy can be availed two different variants like Gold & Platinum with a higher sum insured
The insurer offers discounts on premium for a long-term policy of 2 years
There is no minimum or a maximum age limit to avail this policy
The insured is eligible to avail reward on premium paid
Tax benefit on premium paid under Section 80D of the Income Tax Act, 1961
Loyalty rewards are offered if the policy is renewed continuously
The policy comes with lifelong renewability

Niva Bupa (Formerly known as Max Bupa) Heartbeat Policy Features and Coverage

Coverage Category	Scope of Cover
Multiple sum insured options to choose from	Rs. 15/20/50 lakh and 1 cr.
In-patient hospitalisation	Covered
Pre-Hospitalisation Expense	60 days
Post-Hospitalisation Expense	90 days
Global treatment for specific illnesses	Covered
Non-allopathic Treatment	Covered
Day-care procedure	Covered
Childcare Benefit	Covered up to the age of 12 years
Enrollment age	Any age enrollment
Domiciliary Treatment	Covered
Emergency Ambulance	Covered
Hospital Cash	In case of hospitalisation for a minimum period of 48 hours, hospital cash for 30 days
Loyalty Addition	10% enhancement of sum insured for continuous renewal of the policy
Second medical opinion	Available in case of specific illness
Organ Transplant Cover	Expenses of an organ donor while transplanting an organ

Waiting Period Clause

Cooling Off Period: A 90 days cooling-off period is applied for all claims. During which no claim will be accepted, except the accidental claims
Specific Illnesses: The policy will cover some specific illnesses such as Cataract, Myomectomy for Fibroids, Hysterectomy, after a waiting period of 2 years.
Pre-existing Illness: Any claim arising out of a pre-existing illness will be entertained after a waiting period of 24 months.

Permanent Exclusions of Niva Bupa (Formerly known as Max Bupa) Platinum Policy

The Platinum plan of Niva Bupa (Formerly known as Max Bupa) will not cover any liabilities arising out of the following conditions-

Attempted suicide
Congenital disease
Treatment of AIDS/HIV
Injury due to abuse of alcohol or drug
Pregnancy, childbirth, miscarriage, and abortion
Hospitalization out of war, riot, strike and nuclear weapons
Infertility and in vitro fertilization.

For the comprehensive list of exclusions, please refer to the fine print of the policy.

Niva Bupa (Formerly known as Max Bupa) Heartbeat Policy Claim Settlement Process

Niva Bupa (Formerly known as Max Bupa) health insurance can be claimed in two ways:

Cashless Claims

Cashless claims are only available at Niva Bupa (Formerly known as Max Bupa) network hospitals where the insured can avail healthcare services free of cost. To avail this service:

Carry your Niva Bupa (Formerly known as Max Bupa) health card and submit along with an ID such as PAN Card/Voter’ ID/Passport etc.
The hospital authority will verify your identity and submit the pre-authorisation request on your behalf
After receiving the application, the insurer will review the request and takes a decision. The same will be conveyed to the hospital. If the insurer approves your request, you can avail cashless services.
The hospital bills are directly settled by the insurance company

Reimbursement Claims

If Niva Bupa (Formerly known as Max Bupa) heartbeat policyholder has not chosen a network hospital and availed the treatment from a non-network hospital, he/she can claim the insurance through the reimbursement process. To initiate the process first settle the bills on your own and collect all the related documents including the original bills, discharge summary, doctor’s report etc.

Fill the claim form and submit along with the supporting documents. Don’t forget to attach the original bills along with the receipts.

The insurer will review your case and after verifying the documents, will make a decision on whether to approve or reject your claim.

The insurer reimburses you the approved amount in your bank account. If not then the insurer will intimate the reason of rejection within a stipulated time frame.