Niva Bupa health insurance plans

Niva Bupa Heartbeat Individual & Family Floater Insurance

Niva Bupa Heart Beat Individual Quotes


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Key Highlights of Heartbeat Individual and Family Floater Insurance

Heartbeat Individual and Family Floater plan protects the insured and their immediate family through comprehensive blanket coverage for the medical expenses incurred.

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
  • Exclusions

Unique features of Niva Bupa Health Heartbeat Individual/Family Floater Insurance

  • Inpatient hospitalization coverage for nuclear family.
  • International Cashless Coverage.
  • Guaranteed Loyalty Bonus at no extra premium (regardless of claims).
  • Comprehensive Pre & Post hospitalisation coverage of 60/90 days.
  • Maternity and New Born baby benefits.
  • Alternative Treatments are covered like Ayurveda and Unani.
  • Comprehensive Health check up available under the plan.
  • Cashless claims processed within 30** minutes.

Benefits of Niva Bupa Health Heartbeat Individual/Family Floater Insurance

  • International Coverage - Specified illness cover for treatment abroad: Platinum customers can avail treatment abroad for 9 specified illnesses. These specified illnesses include critical illnesses like Cancer, Myocardial Infarction (Heart Attack), Coronary Artery Bypass Graft (CABG), Major Organ Transplant, Stroke, Surgery of Aorta, Coronary Angioplasty, Primary Pulmonary Arterial Hypertension, and Brain Surgery. They are covered if detected in India by a Medical practitioner within the policy period on cashless basis.
  • Emergency Medical Evacuation and Hospitalisation: Niva Bupa also covers evacuation and hospitalisation for medical emergencies outside India as per terms and conditions.
  • OPD Treatment and Diagnostic Services - Charges incurred for OPD treatment and/ or diagnostic services and/ or prescribed medicines for the OPD treatment as per terms and conditions are covered under this plan.
  • Second Medical Opinion : Platinum policy holders can obtain a second medical opinion, if they are diagnosed with a specified illness or are planning to undergo a planned surgery as per terms and conditions.

Plan Coverages of Niva Bupa Health Heartbeat Individual/Family Floater Insurance

Plan Details Gold Plan Platinum Plan
Base Sum Insured (in Rs) 5 lacs, 7.5 lacs, 10 lacs, 15 lacs, 20 lacs, 30 lacs, 50 lacs 15 lacs, 20 lacs, 50 lacs, 1 Cr (100 lacs)
Inpatient care Covered up to Sum Insured Covered up to Sum Insured
Room rent Covered up to Sum Insured (except for Suite or above room category) Covered up to Sum Insured
Pre-Hospitalization Medical Expenses (60 days) Covered up to Sum Insured Covered up to Sum Insured
Post-Hospitalization Medical Expenses (90 days) Covered up to Sum Insured Covered up to Sum Insured
Alternative Treatment Covered up to Sum Insured Covered up to Sum Insured
Day Care Treatment Covered up to Sum Insured Covered up to Sum Insured
Domiciliary Hospitalization Covered up to Sum Insured Covered up to Sum Insured
Maternity Benefit *(Covered Upto) Rs 40,000, Rs 60,000, Rs 70,000, Rs 75,000, Rs 80,000, Rs 1,00,000, Rs 1,00,000 Rs 120,000, Rs 160,000, Rs 200,000, Rs 200,000
New Born Baby (covered uptill the end of Policy Year) * 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
Emergency Ambulance Network Hospital : Covered up to Sum Insured
Non-network Hospital : Covered up to Rs 2,000 per event
Re-fill benefit Reinstate up to base Sum Insured. Applicable for same & different illness as well
Pharmacy and diagnostic services Available through empanelled service provider
HIV / AIDS Covered up to Rs 50,000 Covered up to Rs 50,000
Emergency assistance services (only within India) 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 100% of Base Sum Insured
Health Check-up (per Insured Person) ** Annual, Tests covered up to worth Rs 1,250 Annual, Tests covered up to worth Rs 1,875 Annual, Tests covered up to worth Rs 2,500 Annual, Tests covered up to worth Rs 2,500 Annual, Tests covered up to worth Rs 2,500 Annual, Tests covered up to worth Rs 2,500 Annual, Tests covered up to worth Rs 2,500 Annual, tests covered up to worth Rs 3750 Annual, tests covered up to worth Rs 5,000 Annual, tests covered up to worth Rs 5,000 Annual, tests covered up to worth Rs 5,000
OPD Treatment and Diagnostic Services Not Applicable Covered up to Rs 15,000 Covered up to Rs 20,000 Covered up to Rs 35,000 Covered up to Rs 50,000
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 3,000/day Rs 6,000/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 illness
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

What is not covered?

  • Pre-existing conditions: Benefits will not be available for pre existing conditions as per policy plans below:
    • Gold & Platinum plan : until 24 months of continuous coverage from first policy start date
    • Silver plan : until 48 months of continuous coverage from first policy start date
  • 30 days initial waiting period: The policy will not cover treatment during the first 30 days of the plan, unless the treatment needed is a result of an accident. This waiting period does not apply for renewal policies.
  • Specific waiting periods: There is no specific waiting period for people aged 45 years and below. For persons above 45 years of age, some conditions will be subject to a waiting period of 24 months.
  • HIV/AIDS : There will be a waiting period of 48 months since inception of the policy and subject to continuous renewal.
  • Mental disorder : There will be a waiting period of 36 months since inception of the policy and subject to continuous renewal.

Exclusions of Niva Bupa Health Heartbeat Individual/Family Floater Insurance

  • These include Ancillary Hospital Charges
  • Hazardous Activities
  • rtificial life maintenance
  • Circumcision
  • Conflict & Disaster
  • External Congenital Anomaly
  • Convalescence & Rehabilitation
  • Cosmetic or plastic Surgery
  • Dental/oral treatment
  • Eyesight & Optical Services
  • Experimental or Unproven Treatment
  • Hormone Replacement Therapy
  • Hospitalization not justified
  • Inconsistent, Irrelevant or Incidental Diagnostic procedures
  • Non-Medical Expenses
  • Obesity and Weight Control Programs
  • Reproductive medicine & other Maternity Expenses
  • Robotic Assisted Surgery, Specialized Light Amplification by Stimulated Emission of Radiation (LASER) & Cyber Knife Treatments
  • Sexually transmitted Infections & diseases
  • Sleep disorders
  • Substance related and Addictive Disorders
  • Unlawful Activity
  • Unrecognized Physician or Hospital
  • Generally Excluded Expenses.

Niva Bupa Health Insurance FAQ's

What do you understand by Restoration / Refill of Base Sum Insured?

If you exhaust your entire sum insured & cumulative bonus (if any) and still require further hospitalisation for any related or unrelated illness, we will refill the full Sum Insured at no extra cost upto the original Base Sum Insured.

The premium paid on a health insurance policy is eligible for deduction under Section 80D of the Income Tax Act. So save with your policy now!

No, it is not possible to revise the sum insured during the policy period, the same can be carried out at the time of renewal of the policy.

Co-payment is a cost-sharing requirement under a health insurance policy, where the Policy Holder / insured will bear a specified percentage of the admissible costs.

Brochure

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


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Proposal form

Fill the online Health Heartbeat Family First health 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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