Niva Bupa (Formerly known as Max Bupa), a standalone Health Insurance Company is collaboration between Max India Limited and Bupa-the UK based healthcare services. Max India Group is a leader in the Indian Health and Insurance segment whereas Bupa has six decades of experience in healthcare industry. Hence Niva Bupa (Formerly known as Max Bupa) is a ideal mix of the international healthcare know how, proficiency and local knowledge of health and insurance requirements and needs. Niva Bupa (Formerly known as Max Bupa) has several health insurance plans as well as personal accident plans which forms a comprehensive insurance plans covering all types of risks .
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Health Assurance by Niva Bupa (Formerly known as Max Bupa) is a Fixed Benefit Plan which gives the flexibility to cover the sudden eventualities and unforeseen circumstances. Health Assurance is a combination of three health plans which are Critical Illness, Hospital Cash and Personal Accident Plans.
We will see a brief overview of Niva Bupa (Formerly known as Max Bupa)’s Personal Accident Plan.
Personal Accident Plan covers a host of risks which is associated with an unforeseen circumstance like accidents. Accidents not only change an individual’s life but members who are associated with the victim also gets affected very badly. Hence one should always look for a complete plan which will not only take care of one own self but also will look after the family members and the associated expenses. The coverage or the specified events under the plan can be summarized as follows:
Let’s look into the above plans individually:
In case of Death within 90 days from the occurrence of the accidental bodily injury which is caused due to Accident solely and directly, the sum assured is paid which is specified in the Schedule of Insurance Certificate.
This plan will cover upto 125% of principal sum insured under this. Permanent Total Disability under this plan will mean disablement of the Insured Person in performing at least one of the below mentioned actions:
This plan will cover certain percentage ( As per the Grid below) of the sum insured under Permanent partial Disability if the insured person suffers from Permanent Partial Disability occurring due to solely and directly due to an accident and within 90 days of such unforeseen incident the amount will be paid. The claim will be admitted only when the Permanent Partial Disability continues for a period of atleast 6 calender months from the commencement of Permanent Partial Disability. No amount will be paid if the insured person dies before a claim has been processed under this plan. No further claim will be entertained if a claim has been submitted and processed under this plan. The Permanent Partial Disability grid is as follows:
Serial Nos |
Nature of Permanent Partial Disability |
% of Sum Insured |
1. |
Loss or total and permanent loss of use of both the hands from the wrist joint |
100% |
2. |
Loss or total and permanent loss of use of both feet from the ankle joint |
100% |
3. |
Loss or total and permanent loss of use of one hand from the wrist joint and of one foot from the ankle joint |
100% |
4. |
Loss or total and permanent loss of use of one hand from the wrist joint and total and permanent loss of one eye sight. |
100% |
5. |
Loss or total and permanent loss of use of one foot from the ankle joint and total and permanent loss of one eye sight. |
100% |
6. |
Loss or total and permanent loss of use of one foot from the ankle joint and total and permanent loss of one eye sight. |
100% |
7. |
Total and permanent loss of speech and hearing in both ears |
100% |
8. |
Total and permanent loss of hearing in both ears |
50% |
9. |
Quadriplegia |
100% |
10. |
Loss or total and permanent loss of use of one hand from wrist joint |
50% |
11. |
Loss or total and permanent loss of use of one foot from ankle joint |
50% |
12. |
Total and permanent loss of sight in one eye. |
50% |
13. |
Total and permanent loss of speech |
50% |
14. |
Uniplegia |
25% |
Applicable for plans where children are covered only. In case of Accidental Death or Permanent Total Disability, 5% of sum assured or Rs 50000/- whichever is lower.
In case of accidental death, an amount of Rs 5000 is paid towards the funeral expenses of any insured person.
Plan Coverage : Individuals and Family both are covered under the plan.
For individuals its 100% of sum assured
For Family (Self, Spouse and upto 2 children)
Self -100% of sum assured
Spouse-50% of sum assured or Rs 10 Lakhs whichever is lower.
Children- 20% of sum assured or Rs 2 lakhs whichever is lower.
Eligibility
Individuals aged between 18 years to 65 years are eligible to apply for this plan. And children aged between 5 years to 21 years are covered under this plan.
Features
Exclusions
Following are the exclusions which are applicable under this plan:
Premium & Sum Insured
There are four categories of Sum Insured and depending on the same the premium varies. The table can be drawn as under:
Premium is exclusive of service tax and cess.
Age Band |
Level 1 |
Level 2 |
Level 3 |
Level 4 |
Sum Insured |
500000 |
1000000 |
2000000 |
2500000 |
18-65 years |
Rs 694 |
Rs 1382 |
Rs 2788 |
Rs 3483 |
Claims
Simple and hassle free claims are provided by Niva Bupa (Formerly known as Max Bupa) for their insurance plans. The steps for Accidental Death Plan are as follows:
The steps for Accidental Permanent Total Disability Plan are as follows:
Policy Tenure
The Niva Bupa (Formerly known as Max Bupa) Plans can be purchased through various channels for example Niva Bupa (Formerly known as Max Bupa)’s direct sales person, Niva Bupa (Formerly known as Max Bupa)’s telesales team, or independent advisor or through the official website, licensed brokers and agents. However the most common ones are as under:
In Personal Accident Cover plans, the sum insured is decided on the income of the proposed primary insured. The proof of income will be verified at the time of claim:
Example 1: Mr Arvind Gupta has an annual salary/ annual net profit of Rs 2 lakhs. So the maximum sum assured which Mr Gupta can avail is the 8 times of Rs 2 lakhs which is Rs 16 lakhs. And since Personal Accident Plans have the sum assured of Rs 5 lakhs, Rs 10 lakhs, Rs 20 lakhs and Rs 25 lakhs, maximum sum assured which Mr Gupta is eligible for are Rs 5 lakhs and Rs 10 lakhs.
Example 2: Mrs Arundhati Sen has an annual salary/ annual net profit of Rs 50000. So the maximum sum assured which Mrs Sen can avail is the 8 times of Rs 50000 which is Rs 4 lakhs. Since the lowest sum assured available under Personal Accident Plans is Rs 5 lakhs, hence Mrs Sen will be eligible for Rs 5 lakhs of Sum Assured.
1. How to pay a premium? What are the modes of payment available?
The Niva Bupa (Formerly known as Max Bupa) Health General Insurance company Ltd. offers 4 modes of premium payment namely:
For the online payment mode, the policyholder can pay via;
2. How can I check policy status for Niva Bupa (Formerly known as Max Bupa) personal accident insurance?
You need to visit the website and click on the Login portal with your username and password.
3. What is the policy renewal process for Niva Bupa (Formerly known as Max Bupa) personal accident insurance ?
Registered users can pay online,
Step1: Enter your Client ID and Date of Birth to login into e-portal
Step2: Choose the policy and payment option – Debit/Credit Card or Net Banking
Step3: Upon successful payment, save/print the premium deposit receipt
Alterantively, you can pay via cash/cheque at any of the nearest branch.
4. What is the company’s process to settle claim for Niva Bupa (Formerly known as Max Bupa) personal accident insurance ?
You just need to admit at any of the network hospitals and provide your Niva Bupa (Formerly known as Max Bupa) Health Card or you can provide the policy number and PAN card copy, Passport copy, Voter ID copy as ID proof. The hospital will send the pre-authorization form to Niva Bupa (Formerly known as Max Bupa) Health General Insurance Companyand in 4 hours the company will settle the claim.
5. What is the policy cancellation process for Niva Bupa (Formerly known as Max Bupa) personal accident insurance ?
For cancellation of the policy you just need to visit the nearest branch with your policy documents and surrender form, and submit it at the service desk. The policy will be cancelled and payments refunded within 7 bsuiness days.
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