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Niva Bupa Heartbeat Family First Insurance

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Key Highlights of Health Heartbeat Family First Insurance

Heartbeat family first is a comprehensive plan that offers coverage for up to 19 family members with an individual sum insured for each one, and a floating sum insured that is accessible to any family member.

Key features of Health Heartbeat Family First Insurance

  • Room Rent: Covered upto Sum Insured (except for suite/high room category)
  • Co-pay: NIL co-pay for all inpatients, Upto 10% & 20% depending on Plan chosen
  • Restoration (Refil) Benefit: Upto 100% of Base Sum Insured per year

Niva Bupa Health Insurance review

Niva Bupa Health Insurance
Niva Bupa Health Insurance sum insured
2 lacs − 300 lacs options available
Incurred Claims Ratio *
54.00%
Niva Bupa Health Insurance tenure options
1 year
Claims Settlement Ratio **
85.96%
Niva Bupa Network hospitals list
6,900+ hospitals
Number of policies issued *
696,107
Maximum family floater coverage
Self, Spouse + 4 dependent children
Number of lives covered *
54,33,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

Niva Bupa HealthHeartbeat Family First Insurance features

  • Unique features
  • Benefits
  • Coverages

Unique features of Niva Bupa Heartbeat family first Insurance:

  • Covers ranging from ₹5 lacs to ₹100 lacs.
  • Up to 19 relationships covered in one policy.
  • Pre & post hospitalisation coverage upto 60/90 days respectively.
  • No room rent capping for Gold/ Platinum Plans.
  • Plans include Maternity benefits.
  • All day care treatments covered.
  • Alternative treatments like Ayurveda& Unani also covered.

Benefits of Niva Bupa Heartbeat Family First Insurance:

  • Cashless facility – Niva Bupa aims to process all cashless claims within 30 minutes at over 4500 (and growing) quality hospitals in their network.
  • Hospitalisation expenses : Coverage for room rental expenses up to the sum insured for Gold (except for Suite or above room category) and Platinum Plans. Pre and post hospitalisation expenses are covered up to the sum insured, 60 days prior and 90 days post hospitalisation.
  • Maternity and New born Child Benefits : Heartbeat provides maternity benefits for up to two deliveries under family floater & family first plans. The benefit is available to the insured after two years of continuous coverage. The new born baby is automatically covered from day 1 up to sum insured until the policy year end. First year vaccinations for the new born are covered as well.
  • Health Check up : Policy provides health check-up as per the applicable plan as specified in the Product Benefits Table. For Gold and Platinum plans, customers can choose the diagnostic tests they want to undergo up to the limit applicable as specified in the Product Benefits Table.
  • Loyalty Benefits Increase Sum Insured
    • Increase of 10% in expiring base sum insured each policy year.
    • The additional sum insured can be accumulated maximum up to 100% of base Sum Insured for Gold and Platinum plan and 50% of base Sum Insured for Silver plan. This benefit is applicable irrespective of claim status.
  • Refill Benefit : When the same or different illness strikes in the same policy year, the policy base sum insured is re-filled and made available to the insured.
  • Additional benefits the insured can opt for:
    • Hospital cash – Covers numerous ‘non-medical’ expenses such as transportation, attendant’s cost and other daily expenses that one may not be able to foresee.
    • Personal accident cover - a lump sum payout covering Accidental Death, permanent total or partial disability can be opted by any member of your family who is aged 18 years or above.
    • Critical illness cover - For enhanced protection, an optional coverage against 20 major critical illnesses like Cancer, Open Heart surgery, Kidney Failure, Strokes etc. is available. Upon first diagnosis of any of these illnesses you get an additional coverage as a one time lump sum payout. This payment will be over and above your hospitalisation expenses which are paid through the base policy. This cover can be opted by any member of your family who is aged 18 years or above.
    • E-consultation - We understand the importance of time especially when the insured needs to consult a doctor. Under this plan one can get the option to get unlimited tele/online consultations with qualified doctors.
    • Premium Waiver - If an insured policy holder passes away or is diagnosed with a specified illness during the policy period, then the premium for next year will be waived (Not available under individual plan).
    • Discount on two year plan - When one takes a policy for two years, they get 12.5% discount on the second year premium.
  • Zonal Coverage - India being a vast country, the cost of healthcare varies across cities. If the insured would like the flexibility of getting treated anywhere in India, then one can opt for Zone 1 pricing. But if the insured lives in a city other than Mumbai (including Navi Mumbai and Thane), Delhi NCR, Kolkata & Gujarat one can avail of a lower premium by opting for Zone 2 pricing.
  • One can get coverage for Emergency assistance services like medical referral, air ambulance, medical repatriation, compassionate visit, etc so that at no moment one ever feels that healthcare is far away.
  • Niva Bupa indemnifies the expenses incurred by the Insured Person for Inpatient treatment for HIV / AIDS and mental illness.
  • Lifelong Renewability : Niva Bupa assures you renewability for life without any extra loadings based on the claims.

Plan Coverages of Niva Bupa Heartbeat Family First Insurance

Plan Details Silver Plan Gold Plan Platinum Plan
Base Sum Insured (per Insured Person & in ₹ Rs) 1Lacs, 2Lacs, 3Lacs, 4Lacs & 5Lacs 1Lacs, 2Lacs, 3Lacs, 4Lacs, 5Lacs, 10Lacs & 15Lacs 5Lacs, 10 Lacs & 15 Lacs
Floater Sum Insured – (available on a floating basis over Base Sum Insured & in ₹ Rs) 3Lacs, 4Lacs, 5Lacs, 10Lacs &15Lacs 3Lacs, 4Lacs, 5Lacs, 10Lacs, 15Lacs, 20Lacs, 30Lacs & 50Lacs 15Lacs, 20 Lacs, 30 Lacs & 50 Lacs
In-patient treatment Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
Room Rent Rs 3,000 per day or Shared Room Covered up to Sum Insured (except for Suite or above room category) Covered up to Sum Insured
Pre hosptitalization medical expenses (60 days) Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
Post hosptitalization medical expenses (90 days) Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
Alternative Treatment Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
Day Care Treatment Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
Domiciliary Hospitalization Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
Maternity Benefit* Covered up to Rs 35,000 per Policy Year Covered up to Rs 50,000 per Policy Year Covered up to Rs 100,000
New Born Baby (covered upto the end of Policy Year)* Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
Vaccination of the new born baby Covered until new born baby completes one year, vaccinations as per defined list
Living Organ Donor Transplant Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
Emergency Ambulance Network Hospital Covered up to Sum Insured
Non-network Hospital: Covered up to Rs 2,000 per event
Pharmacy and diagnostic services Available through Niva Bupa empanelled service provider
HIV / AIDS Covered up to Rs 50,000
Emergency assistance services (only within India) Covered up to Sum Insured Covered up to Sum Insured Covered up to Sum Insured
Mental disorder treatment Covered up to Sum Insured (sub-limit of Rs 50,000 applicable on few conditions)
Loyalty Additions Increase of 10% of expiring Base Sum Insured in a Policy Year; maximum up to 50% of Base Sum Insured Increase of 10% of expiring Base Sum Insured in a Policy Year; maximum up to 100% of Base Sum Insured
Health Check-up ** Once in two years, tests as per defined list Annual Tests covered up to worth Rs 2,500 per Insured Person Annual Tests covered up to worth Rs 5,000 per Insured Person
OPD Treatment and Diagnostic Services Not Applicable Covered up to Rs 35,000
Child Care Benefits (Vaccinations for children up to 12 years including one consultation for nutrition and growth during the visit for vaccination) Not Applicable Covered up to Sum Insured (As per defined list)
Emergency Medical Evacuation Not Applicable Covered up to Sum Insured ( for worldwide excluding USA, Canada & India)
Emergency Hospitalization Not Applicable Covered up to Sum Insured ( for worldwide excluding USA, Canada & India)
Specified Illness Cover *** Not Applicable Covered up to Sum Insured ( for worldwide excluding USA, Canada & India)
Second Medical Opinion Not Applicable Covered, One opinion per Insured Person per Specified Illness / planned Surgery / Surgical Procedure
Hospital Cash **** Rs 1,500/day Rs 3,000/day Rs 6000/day
Personal Accident cover (for insured aged 18 years & above on individual basis) Personal Accident cover will be equal to 5 times of base Sum Insured; subject to maximum of 50 lacs
Critical illness cover (for insured 18 years & above on individual basis) Critical illness cover will be equal to base Sum Insured; subject to maximum of 10 lacs
e-consultation Unlimited tele / online consultations
Premium Waiver One time premium waiver if the Policyholder (who is also an Insured Person) dies or suffers from specified illnessy
Enhanced Geographical Scope for International coverage Not Applicable USA & Canada included for ‘Emergency Medical Evacuation', 'Emergency Hospitalization' & 'Specified illness cover'
Co-payment a. If you select Zone 2, then 20% co-payment will apply for treatment in Mumbai (including Navi Mumbai & Thane), Delhi NCR, Kolkata & Gujarat State
b. Options of 10% and 20% co-payment
Options of 10% and 20% co-payment Product.

Niva Bupa Health Insurance FAQ's

What is a waiting period?

A waiting period is the length of time you, the insured, will have to wait before the benefits under the health policy can be utilised.

A ‘Free Look Period’ is a period of 15 days from the date of receipt of the policy that a policyholder, in this case you, have to review the entire health insurance plan. If you disagree with any of the terms or conditions mentioned in the policy, you have the option of returning the policy by stating the reasons for the objection. Following this, you are entitled to a refund of the premium paid, provided no claim has been made under this mediclaim insurance policy (subject only to a deduction of the expenses incurred by the company on medical examination and the stamp duty charges). Please note that this facility is not applicable on renewal and portability cases.

A grace period refers to a period of 30 days immediately following the premium due date of the medical insurance policy. During this period you can pay the premium of your expired policy and avail continuity benefits such as waiting periods and coverage of pre-existing disease.

Hospital cash is a daily benefit which provides the insured person with a lump sum amount in case of hospitalisation. You can use the money for meeting additional expenses or for compensating the loss of income during the period of hospitalisation.

Brochure

Review Health Heartbeat Family First health brochure to understand coverage details.


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Proposal form

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Policy wordings

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
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