{"uin":"NBHHLGP27057V042627","name":"Health Plus","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627","insurer":{"slug":"niva-bupa-health-insurance","name":"Niva Bupa Health Insurance Co Ltd.","url":"https://indiainsurances.com/insurer/niva-bupa-health-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":"2018-03-28","withdrawn_on":null,"summary":"Health Plus is a group health product with hospitalization indemnity cover and optional benefit sections such as OPD, international, accidental and critical illness covers. The hospitalization cover has configurable sum insured, room rent, waiting periods, co-payments, deductibles and optional benefits as specified in the policy schedule or certificate of insurance.","analysis":{"state":"machine","analysed_at":"2026-10-19 21:49:03.626963+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Individual","Floater","Combination of the two"],"display":"Individual, Floater or Combination of the two","note":"The documents do not name retail plan tiers for the hospitalization cover; the stated variants are individual, floater or a combination.","quote":"Plans | Individual Or Floater Or Combination of the two which includes following relationships- Self, Legally married spouse, up to 4 children","sources":[{"clause":"Annexure XV","heading":"Product Benefit Table","page":178,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"Non-loan linked policies can run up to 5 years and loan linked policies up to 5 years. A term of less than 1 year is available for Accidental Cover only.","display":"Up to 5 years; less than 1 year for Accidental Cover only","note":null,"quote":"Policy Tenure | Non- loan linked – up to 5 years; Loan linked- Up to 5 years Option of less than 1 year available for Accidental Cover only","sources":[{"clause":"Annexure XV","heading":"Product Benefit Table","page":178,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For cashless planned treatment, contact the insurer at least 72 hours before treatment. In emergencies and for reimbursement hospitalization claims, contact or inform the insurer within 48 hours of hospitalization or before discharge, whichever is earlier; accidental cover notices must be given as soon as practicable and within 30 days.","display":"Planned cashless: 72 hours before; emergency/reimbursement: within 48 hours or before discharge; accidental cover: within 30 days","note":null,"quote":"We must be contacted to pre-authorize Cashless Facility for planned treatment at least 72 hours prior to the proposed treatment. ... We must be contacted to pre-authorize Cashless Facility within 48 hours of the Insured Person’s Hospitalization or before discharge from the Hospital, whichever is earlier. ... We shall be informed of the claim along with the following details within 48 hours of admission to the Hospital or before discharge from the Hospital, whichever is earlier ... Written notice of any occurrence which may give rise to a claim under this Policy must be given to Us as soon as practicable and in any case within thirty (30) Days after such occurrence.","sources":[{"clause":"3.1.3(a)(i)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-3-a-i"},{"clause":"3.1.3(a)(ii)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-3-a-ii"},{"clause":"3.1.3(XI)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-3-xi"},{"clause":"3.6.3","heading":"Claims Process and Requirements","page":98,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-6-3"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Claim form duly completed and signed by the claimant","Age/identity proof document of the Insured Person","Cancelled cheque/bank statement/copy of passbook mentioning account holder’s name, IFSC code and account number","Original Hospital discharge summary","Bar code sticker and invoice for implants and prosthesis (if used)","Original final bill from Hospital with detailed break-up and paid receipt","Room tariff of the entitled room category","Original bills of pharmacy/medicines purchased, or of any other investigation done outside Hospital with reports and requisite prescriptions","Copy of death certificate","MLC/First Information Report (FIR) copy","Original laboratory investigation, diagnostic and pathological reports with supporting prescriptions","Original X-Ray/MRI/ultrasound films and other radiological investigations"],"display":"Claim form, age/identity proof, bank details, discharge summary, final hospital bill and receipts, investigation reports, prescriptions and other applicable documents","note":"The company may call for additional documents wherever required.","quote":"a) Claim form duly completed and signed by the claimant. ... b) Age/identity proof document of the Insured Person ... c) Cancelled cheque/bank statement/copy of passbook mentioning account holder’s name, IFSC code and account number printed on it ... d) Original Hospital discharge summary. ... e) Additional documents required in case of Surgery/Surgical Procedure. Bar code sticker and invoice for implants and prosthesis (if used); ... f) Original final bill from Hospital with detailed break-up and paid receipt. ... g) Room tariff of the entitled room category ... h) Original bills of pharmacy/medicines purchased, or of any other investigation done outside Hospital with reports and requisite prescriptions. ... i) Copy of death certificate ... j) For Medico-legal cases (MLC) or in case of Accident ... k) Original laboratory investigation, diagnostic and pathological reports with supporting prescriptions. ... l) Original X-Ray/MRI/ultrasound films and other radiological investigations.","sources":[{"clause":"3.1.3(viii)","heading":null,"page":45,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-3-viii-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The company shall settle or reject a claim within 15 days from the claim submission date. If payment is delayed, interest is payable from claim intimation until payment at 2% above the bank rate.","display":"15 days from claim submission date","note":null,"quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the claim submission date. ... In the case of delay in the payment of a claim, the Company shall be liable to pay interest from the date of receipt of claim intimation until the date of payment of claim at a rate of 2% above the bank rate.","sources":[{"clause":"5.8(I)","heading":null,"page":131,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-8-i"},{"clause":"5.8(II)","heading":null,"page":131,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-8-ii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Pre-existing Diseases (Code–Excl01)","Specified disease/procedure waiting period (Code- Excl02)","30 days waiting period (Code- Excl03)","Investigation & Evaluation (Code-Excl04)","Rest Cure, rehabilitation and respite care (Code-Excl05)","Obesity/ Weight Control (Code-Excl06)","Change-of-Gender treatments (Code-Excl07)","Cosmetic or plastic Surgery (Code-Excl08)","Excluded Providers (Code-Excl11)","Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code-Excl12)","Refractive Error (Code-Excl15)","Unproven Treatments (Code-Excl16)","Sterility and Infertility (Code-Excl17)","Maternity (Code-Excl18)","Any Act of Self Destruction or Self Inflicted Injury, attempted suicide or suicide while sane or insane"],"display":"Waiting period exclusions plus investigation, rest cure, obesity, gender change, cosmetic surgery, excluded providers, substance abuse, refractive error, unproven treatment, infertility, maternity and self-inflicted injury exclusions","note":"Some benefits override particular exclusions when expressly opted, for example maternity and AYUSH/alternative treatment benefits.","quote":"I) Pre-existing Diseases (Code–Excl01): ... II) Specified disease/procedure waiting period (Code- Excl02) ... III. 30 days waiting period (Code- Excl03): ... I. Investigation & Evaluation (Code-Excl04) ... II. Rest Cure, rehabilitation and respite care (Code-Excl05) ... III) Obesity/ Weight Control (Code-Excl06) ... IV) Change-of-Gender treatments (Code-Excl07) ... V) Cosmetic or plastic Surgery (Code-Excl08) ... VI) Excluded Providers (Code-Excl11) ... VII) Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code-Excl12) ... IX. Refractive Error (Code-Excl15) ... X. Unproven Treatments (Code-Excl16) ... XI. Sterility and Infertility (Code-Excl17) ... XII. Maternity (Code-Excl18) ... iv) Any Act of Self Destruction or Self Inflicted Injury, attempted suicide or suicide while sane or insane.","sources":[{"clause":"3.1.2","heading":"Section Specific Conditions","page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2"},{"clause":"3.1.2(I)(d)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2-i-d"},{"clause":"3.1.2(II)(f)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2-ii-f"},{"clause":"3.1.2(II)(c)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2-ii-c-2"},{"clause":"3.1.2(II)(c)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2-ii-c-3"},{"clause":"3.1.2(II)(b)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2-ii-b-4"},{"clause":"Excl13","heading":null,"page":40,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-excl13"},{"clause":"4","heading":null,"page":127,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-4"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"First contact Niva Bupa through its website, customer services department, customer care number, service platform, senior citizen email or branch grievance cell. If not satisfied, contact the Head – Customer Services/grievance officer, then escalate to GRO@nivabupa.com before approaching the Insurance Ombudsman or IRDAI Bima Bharosa.","display":"Contact Niva Bupa customer service/branch first, then Head – Customer Services or grievance officer, then GRO@nivabupa.com","note":null,"quote":"ln case of any grievance the insured person may contact the company through: Website: www.nivabupa.com Courier: Customer Services Department ... Customer Care no: 1860-500-8888 ... Senior citizens may write to us at: seniorcitizensupport@nivabupa.com ... lnsured person may also approach the grievance cell at any of the company's branches ... insured person may contact the grievance officer at Head – Customer Services ... If the Insured person is not satisfied with the above, they can escalate to GRO@nivabupa.com.","sources":[{"clause":"5.11(a)","heading":null,"page":132,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-11-a"},{"clause":"5.11(b)","heading":null,"page":132,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-11-b"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"For Hospitalisation Cover, Base Sum Insured options are INR 25,000 to INR 5 Crores or Unlimited. Other sections and optional benefits have separate sum insured ranges as specified in the policy schedule or certificate of insurance.","display":"Hospitalisation Cover: INR 25,000 to INR 5 Crores, Unlimited","note":"In a family floater, a separate floater can be created for parents and parents-in-law up to the Primary Insured's sum insured.","quote":"Base Sum Insured | INR 25,000 to INR 5 Crores, Unlimited ... Sum insured will be different for every section and/or subsection/optional benefits.","sources":[{"clause":"Annexure XV","heading":"Product Benefit Table","page":178,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"The product benefit table also says Initial Waiting Period can be up to 90 Days for Hospitalisation Cover and lists 15/30/45/60/75/90 day options for some other sections.","quote":"III. 30 days waiting period (Code- Excl03): ... a) Expenses related to the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered.","sources":[{"clause":"3.1.2(II)(f)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2-ii-f"},{"clause":"3.1.2(II)(a)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2-ii-a-2"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"Up to 36 months","note":"The exact PED waiting period for an insured person is the number of months mentioned in the Policy Schedule/Certificate of Insurance.","quote":"Waiting period for Pre-Existing Diseases (PED) | Up to 36 Months ... Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of the number of months (as mentioned in Policy Schedule/Certificate of Insurance)","sources":[{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"},{"clause":"3.1.2(I)(a)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2-i-a"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"Up to 36 months","note":"The exact specific waiting period is the number of months mentioned in the Policy Schedule/Certificate of Insurance. The product benefit table text says 'Up to 36 Days', but the definition and exclusion clause state months.","quote":"Specific Waiting period means a period up to 36 months from the commencement of a health insurance policy during which period specified diseases/treatments (except due to an accident) are not covered. ... Expenses related to the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of number of months (as mentioned in Policy Schedule/Certificate of Insurance)","sources":[{"clause":"2(XVII)(b)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-2-xvii-b-7"},{"clause":"3.1.2(II)(a)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2-ii-a"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Pancreatitis and stones in biliary and urinary system","Cataract, Glaucoma and other disorders of lens and disorders of retina","Hyperplasia of prostate, hydrocele and spermatocele","Abnormal utero-vaginal bleeding, female genital prolapse, endometriosis/adenomyosis, fibroids, PCOD, or any condition requiring dilation and curettage or hysterectomy","Hemorrhoids, fissure or fistula or abscess of anal and rectal region","Hernia of all sites","Osteoarthritis, Systemic Connective Tissue disorders, Dorsopathies, Spondylopathies, inflammatory Polyarthropathies, Arthrosis such as RA, Gout, Intervertebral Disc disorders","Chronic kidney disease and failure","Varicose veins of lower extremities","Disease of middle ear and mastoid including Otitis Media, Cholesteatoma, Perforation of Tympanic Membrane","All internal or external benign or in situ neoplasms/tumours, cyst, sinus, polyp, nodules, swelling, mass or lump","Ulcer, erosion and varices of upper gastro intestinal tract","Tonsils and adenoids, nasal septum and nasal sinuses","Internal Congenital Anomaly"],"display":"Pancreatitis and stones; cataract/glaucoma/retina disorders; prostate/hydrocele/spermatocele; specified gynaecological conditions; piles/fissure/fistula; hernia; specified joint/spine/connective tissue disorders; chronic kidney disease; varicose veins; middle ear/mastoid diseases; benign/in situ tumours/cysts/polyps/lumps; upper GI ulcer/erosion/varices; tonsils/adenoids/nasal septum/sinuses; internal congenital anomaly","note":null,"quote":"i) Pancreatitis and stones in biliary and urinary system.\nii) Cataract, Glaucoma and other disorders of lens and disorders of retina.\niii) Hyperplasia of prostate, hydrocele and spermatocele.\niv) Abnormal utero-vaginal bleeding, female genital prolapse, endometriosis/adenomyosis, fibroids, PCOD, or any condition requiring dilation and curettage or hysterectomy.\nv) Hemorrhoids, fissure or fistula or abscess of anal and rectal region.\nvi) Hernia of all sites.\nvii) Osteoarthritis, Systemic Connective Tissue disorders, Dorsopathies, Spondylopathies, inflammatory Polyarthropathies, Arthrosis such as RA, Gout, Intervertebral Disc disorders.\nviii) Chronic kidney disease and failure.\nix) Varicose veins of lower extremities.\nx) Disease of middle ear and mastoid including Otitis Media, Cholesteatoma, Perforation of Tympanic Membrane.\nxi) All internal or external benign or in situ neoplasms/tumours, cyst, sinus, polyp, nodules, swelling, mass or lump.\nxii) Ulcer, erosion and varices of upper gastro intestinal tract.\nxiii) Tonsils and adenoids, nasal septum and nasal sinuses.\nxiv) Internal Congenital Anomaly","sources":[{"clause":"3.1.2(II)(f)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-2-ii-f"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"60 continuous months","note":"Applies to sums insured of the first policy; enhanced sums insured need sixty continuous months from enhancement.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on the grounds of non-disclosure, misrepresentation, except on grounds of established fraud. The period of sixty continuous months is called as moratorium period.","sources":[{"clause":"5.12","heading":"Moratorium Period","page":133,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-12"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The policyholder can port the policy from one insurer to another and transfer credits for sum insured, no claim bonus, specific waiting periods, PED waiting period, moratorium period and similar accrued credits.","display":"Yes, with transfer of waiting-period and other credits","note":null,"quote":"A Policyholder has the choice to port his/ her policies from one Insurer to another irrespective of individual or group policy subject to the Board approved underwriting policy of the insurers.\nThe policyholder is entitled to transfer the credits gained to the extent of the Sum Insured, No Claim Bonus, specific waiting periods, waiting period for pre-existing disease , Moratorium period etc. from the Existing Insurer to the Acquiring Insurer in the previous policy.","sources":[{"clause":"5.17","heading":"Portability","page":134,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-17"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Renewable except on grounds of established fraud or non-disclosure or misrepresentation","note":"The clause does not use the phrase lifelong renewal or state a maximum renewal age.","quote":"A health insurance policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation by the insured. An insurer shall not deny the renewal of a health insurance policy on the ground that the insured had made a claim or claims in the preceding policy years","sources":[{"clause":"5.5","heading":"Renewal of Policy","page":130,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-5"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"No loading shall apply on renewals based on individual claims experience, though discounts may be provided for good claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"No loading shall apply on renewals based on individual claims experience. However, discount in premium may be provided by insurers to individual policyholders for good claims experience.","sources":[{"clause":"5.5","heading":"Renewal of Policy","page":130,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-5"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"The policyholder may cancel at any time by giving 7 days’ written notice. For policy terms up to one year, the insurer refunds proportionate premium for the unexpired period if no claim has been made; for terms over one year, it refunds premium for unexpired policy years where risk coverage has not commenced.","display":"7 days’ notice; proportionate/unexpired premium refund subject to conditions","note":null,"quote":"The policy holder may cancel his/her policy at any time during the term, by giving 7 days’ notice in writing. The insurer shall:\na) Refund proportionate premium for unexpired policy period, if the term of the policy upto one year and there is no claim(s) made during the policy period.\nb) Refund premium for the unexpired policy period, in respect of policies with term more than 1 year and risk coverage for such policy years are not commenced.","sources":[{"clause":"5.3","heading":"Cancellation","page":129,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-3"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"All benefits are available in India only and claims are payable in India in Indian rupees, except that International Coverage benefits, if opted, are available outside India only in territories specified in the policy schedule/certificate of insurance.","display":"India only, except specified International Coverage territories if opted","note":null,"quote":"All Benefits are available in India only, and all claims shall be payable in India in Indian Rupees only. ... The following Benefits shall be available only outside the geographical boundaries of India and only in those territories specified in the Policy Schedule/Certificate of Insurance.","sources":[{"clause":"5.29","heading":"Territorial Jurisdiction","page":137,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-29"},{"clause":"3.5","heading":"International Coverage","page":71,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-5"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Applicable on individual health insurance policies and not on renewals.","quote":"The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy.","sources":[{"clause":"5.2","heading":"Free Look Period","page":128,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days; 15 days for monthly instalments","note":"The definitions clause also states fifteen days where premium payment mode is monthly and thirty days in all other cases.","quote":"Grace Period of 30 days in all types of policies, and a period of 15 days in case of monthly instalments.","sources":[{"clause":"5.4","heading":"Premium Payment in Installments","page":129,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-4"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"Adults can enter from 18 years to 100 years. Children can enter from Day 0 onwards; for a children-only policy, the age is 2 years to 18 years.","display":"Adult: 18 years to 100 years; Child: Day 0 onwards; children-only: 2 years to 18 years","note":null,"quote":"Entry Age | (Adult- 18 years to 100 years Child- Day 0 onwards) For children only policy- Age to be 2 years to 18 years","sources":[{"clause":"Annexure XV","heading":"Product Benefit Table","page":178,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Daily","Monthly","Quarterly","Half Yearly","Annual","Single Premium"],"display":"Daily, Monthly, Quarterly, Half Yearly, Annual, Single Premium","note":null,"quote":"Premium instalment Option | Option A: Daily Option B: Monthly Option C: Quarterly Option D: Half Yearly Option E: Annual Option F: Single Premium","sources":[{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["OPD Treatment","International Coverage","Accidental Cover","Critical Illness Cover","Wellness","Concierge Services","Maternity Expenses","Maternity+","New Born Baby Cover","New Born Vaccination Cover","Air Ambulance Cover","Road Ambulance+","Modern Treatments+","ReAssure","Booster+","Smart Claim","Smart Renew"],"display":"OPD, International, Accidental, Critical Illness, Wellness, Concierge and multiple optional hospitalization benefits","note":"The product is modular; benefits in force are those specified in the Policy Schedule/Certificate of Insurance.","quote":"Section 4 | This section can be opted only with Hospitalization Cover. Sub Sections can opted in any combination.\nOPD Treatment ... Section 5 | This section can be opted only with Hospitalization Cover. Sub Sections can opted in any combination.\nInternational Cover ... Section 6 | Benefit can be offered on standalone basis.\nAccidental Cover ... Section 7 | Benefit can be offered on standalone basis.\nCritical Illness Cove ... Section 8 | Optional to any section. Any or all of the following Wellness Services ... Section 9 | Optional to any section. Any or all of the following Wellness Services\nConcierge Services","sources":[{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"For policies where premium is paid in instalments, coverage is given during the grace period. The definition also states that coverage need not be available during a period for which no premium is received, but insurers shall offer coverage during the grace period if premium is paid in instalments during the policy period.","display":"Available during grace period for instalment premium policies","note":null,"quote":"For policies where premium is paid in instalments only, the coverage will be given during grace period. ... Coverage need not be available during the period for which no premium is received. ... Provided the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period.","sources":[{"clause":"5.4","heading":"Premium Payment in Installments","page":129,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-4"},{"clause":"2(XVII)","heading":"Grace Period","page":3,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-2-xvii"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room rent is configurable: from 1% to 10% of Base Sum Insured, Rs 1,000 to Rs 30,000, a combination, actuals up to Base Sum Insured, or a room-category restriction.","display":"1% to 10% of Base Sum Insured, or Rs 1,000 to Rs 30,000, or actuals/category options","note":"The actual room rent limit is as specified in the Policy Schedule/Certificate of Insurance.","quote":"Hospital accommodation- Room Rent/day | Option A: From 1% to 10% of Base Sum Insured Option B: Rs 1,000 to Rs 30,000 Option C: Combination of Option A & Option B Option D: Actuals upto Base Sum Insured Option E: Room category wise restriction as given in below:","sources":[{"clause":"Annexure XV","heading":"Product Benefit Table","page":178,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"quote-verified","value":"Room-category options are General Ward, Air Conditioned Twin Sharing room, Air Conditioned Single Private Room, Air Conditioned Single Private Deluxe Room and Suite (above deluxe room).","display":"General Ward to Suite, depending on option","note":"Applies when room-category restriction is selected.","quote":"i) General Ward ... ii) Air Conditioned Twin Sharing room ... iii) Air Conditioned Single Private Room ... iv) Air Conditioned Single Private Deluxe Room ... v) Suite (above deluxe room)","sources":[{"clause":"Annexure XV(i)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-i"},{"clause":"Annexure XV(ii)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-ii"},{"clause":"Annexure XV(iii)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-iii"},{"clause":"Annexure XV(iv)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-iv"},{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU cover is either double the room rent per day subject to a maximum of Rs 50,000, or actuals up to Base Sum Insured.","display":"Double of Room rent/day subject to maximum of Rs 50,000, or actuals up to Base Sum Insured","note":"The selected option is as stated in the Policy Schedule/Certificate of Insurance.","quote":"Hospital accommodation- ICU/day | Option A: Double of Room rent/day subject to maximum of Rs 50,000 Option B: Actuals upto Base Sum Insured","sources":[{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"quote-verified","value":"If the insured person is admitted to a room where the room category or room rent is higher than the eligible limit, the insurer pays only a pro-rated portion of associated medical expenses using the formula in the policy. Proportionate deductions are not applied for hospitals without differential billing or expenses where differential billing is not adopted based on room category.","display":"Yes, pro-rated associated medical expenses if room chosen is above eligibility","note":null,"quote":"If the Insured Person is admitted in a Hospital room where the room category opted or Room Rent incurred is higher than the eligibility as specified in the Policy Schedule, then We shall be liable to pay only a pro-rated portion of the total Associated Medical Expenses (including surcharge or taxes thereon) as per the following formula:\n(Eligible Room Rent limit / Room Rent actually incurred) * total Associated Medical Expenses\nAssociated Medical Expenses shall include Room Rent, nursing charges, Medical Practitioners’ fees and operation theatre charges.\nProportionate deductions will not be applied If the claim is of a hospital which do not follow differential billing or for those expenses in respect of which differential billing is not adopted based on the room category.","sources":[{"clause":"3.1.1.1","heading":"Inpatient Care","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-1"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"Co-payment is configurable; the insured pays the pre-determined percentage specified in the Policy Schedule/Certificate of Insurance and the insurer pays the remaining admissible amount. Hospitalization cover options allow co-payment up to 50%, and Cyberknife/Robotic Surgery has a 50% co-payment.","display":"Up to 50% if selected; Cyberknife/Robotic Surgery 50% co-payment","note":"Co-payment applies only if specified in the schedule/certificate, with listed benefit exceptions.","quote":"The Insured Person will pay the pre-determined percentage as specified in the Policy Schedule/ Certificate of Insurance as Co-Payment and We will pay the remaining part of the amount ... Co-Payment (applicable only for Hospitalisatin Cover) | Option 1- Co-payment upto 50% ... Option 3- upto 50% applicable for all ... If the Insured Person is undergoingSurgery for the removal and/or treatment of a malignant tumor through cyber knife or robotic Surgery, the Insured Person will bear a 50% Co-Payment","sources":[{"clause":"3.1.1.35","heading":"Co-payment","page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-35"},{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"},{"clause":"3.1.1.39","heading":"Inclusion of Cyberknife/ Robotic Surgery","page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-39"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"quote-verified","value":"The hospitalization cover may have an Annual Aggregate Deductible or Annual Catastrophic Claim Deductible specified in the Policy Schedule/Certificate of Insurance; liability starts only after the deductible is exhausted. Deductible options range from Rs 10,000, Rs 25,000 or Rs 50,000 to Rs 10 lacs in multiples of Rs 50,000.","display":"Annual aggregate or annual catastrophic claim deductible, Rs 10,000/25,000/50,000 to Rs 10 lacs","note":"Annual Aggregate Deductible is on cumulative claim basis; Annual Catastrophic Claim Deductible is on per claim basis and cannot be opted if Annual Aggregate Deductible is opted.","quote":"The Insured Person shall bear on his/her own account an amount equal to the Annual Aggregate Deductible specified in the Policy Schedule/ Certificate of Insurance ... Our liability to make payment under the Policy in respect of any claim made in that Policy Year will only commence once the Annual Aggregate Deductible has been exhausted. ... Deductible Range from 10,000/25,000/50,000 to 10 lacs in multiple of 50,000 ... Annual Catastrophic Claim Deductible (applicable on per claim basis) | Deductible options of 10,000/25,000/50,000 to 10 lacs in multiple of 50,000","sources":[{"clause":"3.1.1.36","heading":"Annual Aggregate Deductible","page":29,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-36"},{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Tonsillectomy: 25,000 / 21,000 / 18,000","Mastoidectomy: 40,000 / 34,000 / 29,000","Septoplasty: 35,000 / 30,000 / 26,000","Haemorrhoidectomy including Cost of stapler: 40,000 / 34,000 / 29,000","Hernia unilateral: 45,000 / 38,000 / 32,000","Hernia bilateral: 50,000 / 43,000 / 37,000","Cataract per eye including Cost of Lens: 25,000 / 21,000 / 18,000","Hysterectomy (Abdominal/Vaginal): 55,000 / 47,000 / 40,000","Total Knee Replacement (Unilateral): 1,00,000 / 85,000 / 72,000","Total Knee Replacement (Bilateral): 1,50,000 / 1,28,000 / 1,09,000","CABG: 2,00,000 / 1,70,000 / 1,45,000","Angioplasty including cost of implants and angiography: 1,50,000 / 1,28,000 / 1,09,000"],"display":"Specified illness/procedure sub-limits are available with Option A/B/C amounts","note":"The table contains more procedures; the actual sub-limit applies only if specified in the Policy Schedule/Certificate of Insurance.","quote":"List for Sub-limits\nOptions\nSr Procedure | Group | Specialisation\nA B | C\n1 Tonsillectomy | Tonsillectomy | E.N.T | 25,000 | 21,000 | 18,000 ... 2 Mastoidectomy | Mastoidectomy | E.N.T | 40,000 | 34,000 | 29,000 ... 3 Septoplasty | Deviated Nasal Septum | E.N.T | 35,000 | 30,000 | 26,000 ... 4 Haemorrhoidectomy including Cost of stapler | Piles/Haemorrhoid | General Surgery | 40,000 | 34,000 | 29,000 ... 12 of mesh and tacker | Hernia | General Surgery | 45,000 | 38,000 | 32,000 ... 13 of mesh and tacker | Hernia | General Surgery | 50,000 | 43,000 | 37,000 ... 22 Cataract per eye including Cost of Lens | Cataract | Opthalmology | 25,000 | 21,000 | 18,000 ... 23 Hysterectomy (Abdominal/Vaginal) | Uterus/Endometriosis | Obstretics & Gynae. | 55,000 | 47,000 | 40,000 ... 24 of implants | Knee replacement | Orthopaedics | 1,00,000 | 85,000 | 72,000 ... 25 implants | Knee replacement | Orthopaedics | 1,50,000 1,28,000 1,09,000 ... 29 CABG | CABG | Cardiology | 2,00,000 1,70,000 1,45,000 ... 30 angiography | IHD | Cardiology | 1,50,000 1,28,000 1,09,000","sources":[{"clause":"Annexure VII","heading":null,"page":156,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-vii"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30, 60, 90 or 120 days","note":"The chosen number of days is specified in the Policy Schedule/Certificate of Insurance.","quote":"Pre - hospitalization Medical Expenses (including Medical Practitioner's consultation, diagnostics tests, medicines, drugs and consumables) | Up to Base Sum Insured Option A: 30 days Option B: 60 days Option C: 90 days Option D: 120 days","sources":[{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60, 90, 120 or 180 days","note":"The chosen number of days is specified in the Policy Schedule/Certificate of Insurance.","quote":"Post- hospitalization Medical Expenses(including Medical Practitioner's consultation, diagnostics tests, medicines, drugs and consumables) | Up to Base Sum InsuredOption A: 60 days Option B: 90 daysOption C: 120 daysOption D: 180 days","sources":[{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Day Care Treatment covers medical expenses for listed day care procedures. Day Care Treatment+ can cover either Annexure IX procedures or treatments where the insured is admitted for more than 2 hours and less than 24 hours, including angiography, dialysis, radiotherapy or chemotherapy for cancer.","display":"Listed day care treatments; Day Care Treatment+ can cover >2 hours and <24 hours including angiography, dialysis, radiotherapy or chemotherapy","note":"Whether the list option or the >2 hours/<24 hours option applies is as mentioned in the Policy Schedule/Certificate of Insurance.","quote":"The list of admissible Day Care Treatment would be as per the list attached. ... The Day Care Treatment would be covered if the Insured Person is admitted for more than 2 hours and less than 24 hours and would also cover treatment taken for Angiography, Dialysis, Radiotherapy or Chemotherapy for cancer","sources":[{"clause":"3.1.1.4","heading":"Day Care Treatment","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-4"},{"clause":"3.1.1.5","heading":"Day Care Treatments+","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-5"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary Hospitalization is covered on a reimbursement basis when medically necessary home treatment is taken after illness or injury and continues for at least 3 consecutive days.","display":"Yes, if domiciliary hospitalization continues for at least 3 consecutive days","note":null,"quote":"We will indemnify the Medical Expenses incurred for the Insured Person’s Domiciliary Hospitalization following an Illness or Injury that occurs during the Policy Period. ... Medical Expenses can be claimed under this Section on a Reimbursement basis only. ... The Domiciliary Hospitalization continues for at least 3 consecutive days in which case We will make payment under this Benefit in respect of Medical Expenses incurred from the first day of Domiciliary Hospitalization.","sources":[{"clause":"3.1.1.7","heading":"Domiciliary Hospitalization","page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-7"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"Inpatient Care under Alternative Treatment covers medical expenses for treatment under Ayurveda, Unani, Sidha and Homeopathy in an AYUSH Hospital, subject to the amount specified in the Policy Schedule/Certificate of Insurance.","display":"Ayurveda, Unani, Sidha and Homeopathy in AYUSH Hospital, up to schedule limit","note":null,"quote":"We will indemnify the Charges for Medical Expenses incurred during the Policy Periodon treatment taken under Ayurveda, Unani, Sidha and Homeopathy in AYUSH Hospital ... Our maximum, total and cumulative liability under this Benefit shall be limited to the amount specified in the Policy Schedule/Certificate of Insurance.","sources":[{"clause":"3.1.1.6","heading":"Inpatient Care under Alternative Treatment","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-6"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Modern Treatments covers listed procedures including uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, immunotherapy, intra vitreal injections, robotic surgeries, stereotactic radio surgeries and hematopoietic stem cell therapy for bone marrow transplant. Robotic surgeries have a maximum INR 1 Lac limit except specified robotic prostate, cardiac, partial nephrectomy and malignancy surgeries; Modern Treatments+ may instead apply limits specified in the schedule.","display":"Listed modern treatments covered; robotic surgery generally capped at INR 1 Lac unless exception applies","note":"Modern Treatments+ covers the same listed treatments up to limits specified in the Certificate of Insurance/Policy Schedule.","quote":"The following procedures / treatments will be covered either as Inpatient Care or as part of Day Care Treatment ... i) Uterine Artery Embolization and HIFU (High intensity focused ultrasound)\nii) Balloon Sinuplasty\niii) Deep Brain stimulation\niv) Oral chemotherapy\nv) Immunotherapy- Monoclonal Antibody to be given as injection\nvi) Intra vitreal injections\nvii) Robotic surgeries\nviii) Stereotactic radio surgeries ... xii) Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered. ... A limit of maximum INR 1 Lac will apply to all robotic surgeries, except the following:","sources":[{"clause":"3.1.1.44","heading":"Modern Treatments","page":35,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-44"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"The policy indemnifies medical expenses for a living organ donor’s inpatient treatment for harvesting of the organ donated, when the donation conforms to law, is for the insured person, the recipient claim is accepted under inpatient care and expenses are reasonable and customary. Donor stay needed to donate, donor pre/post-hospitalization, screening, organ acquisition, transport/preservation and donor complications are not covered.","display":"Yes, living organ donor inpatient harvesting expenses; donor stay/screening/pre-post/transport not covered","note":null,"quote":"We will indemnify the Medical Expenses incurred for a living organ donor’s Inpatient treatment for the harvesting of the organ donated during the Policy Period. ... The donation conforms to The Transplantation of Human Organs Act 1994 and amendments thereafter and the organ is for the use of the Insured Person. ... We shall not be liable to make any payment in respect of:\na) The living organ donor's stay in a Hospital that is needed for them to donate their organ. ... c) Pre-hospitalization Medical Expenses or Post-Hospitalization Medical Expenses of the organ donor.\nd) Screening or any other Medical Expenses of the organ donor.","sources":[{"clause":"3.1.1.8","heading":"Organ Transplant","page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-8"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Emergency ground ambulance within India is covered for one surface transfer per hospitalization; for non-network ambulance providers the amount is limited to the Policy Schedule/Certificate of Insurance. Road Ambulance+, Air Ambulance and Air Ambulance+ within India may also be available up to schedule limits.","display":"Ground ambulance within India, one transfer per hospitalization; air ambulance options within India up to schedule limits","note":"Exact road and air ambulance limits depend on the option in the Policy Schedule/Certificate of Insurance.","quote":"We will indemnify the expenses incurred on an ambulance during the Policy Period to transfer the Insured Person by surface transport following an Emergency. ... This Benefit is available for only one transfer per period of Hospitalization. ... If the ambulance is provided by a Non-Network Provider, we will cover expenses incurred only up to the amount specified in the Policy Schedule/Certificate of Insurance. ... We will indemnify the expenses incurred on an air ambulance during the Policy Period to transport the Insured Person to the nearest Hospital following an Emergency within India","sources":[{"clause":"3.1.1.15","heading":"Emergency Ground Ambulance- Within India","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-15"},{"clause":"3.1.1.17","heading":"Air Ambulance Cover","page":19,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-17"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"quote-verified","value":"Re-fill provides up to 100% of the Base Sum Insured after Base Sum Insured, Loyalty Credit and No Claim Bonus have been partially or completely exhausted, for subsequent claims in the same policy year, but not for the same illness for the same insured person. ReAssure provides additional sum insured during the policy year after the first paid claim, unlimited times, for subsequent claims up to the percentage of Base Sum Insured specified in the schedule, and can apply to same illness, different illness or both as specified.","display":"Re-fill up to 100% of Base Sum Insured; ReAssure additional sum insured unlimited times after first paid claim","note":"Benefits apply only if opted and as specified in the Policy Schedule/Certificate of Insurance.","quote":"If the Base Sum Insured, Loyalty Credit (if any) and No Claim Bonus (if any) has been partially or completely exhausted ... We will provide a Re-fill amount of maximum up to 100% of the Base Sum Insured ... The re-fill amount may be used for only subsequent claims ... and not against any Illness ... for which a claim has been paid ... We will provide additional sum insured during the policy year. The first paid claim in the policy year will trigger ReAssure benefit, unlimited times and will be available for all subsequent claims in a Policy Year up to the percentage of Base Sum Insured as specified in your Policy Schedule / Certificate of Insurance. ... The benefit will be applicable for Same Illness or Different Illness or Both, as specified in your Policy Schedule / Certificate of Insurance.","sources":[{"clause":"3.1.1.34","heading":"Re-fill Benefit","page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-34"},{"clause":"3.1.1.28","heading":"ReAssure","page":25,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-28"},{"clause":"3.1.1.28(b)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-28-b"}],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"No Claim Bonus can increase sum insured by 5%, 10%, 15%, 20% or 25% per claim-free year up to 100% of Base Sum Insured, and decrease by the same percentage in case of a claim. It cannot be opted if Loyalty Credit is opted; Loyalty Credit instead enhances sum insured by 5%, 10%, 15% or 20% per year up to 200% irrespective of claim.","display":"No Claim Bonus 5%/10%/15%/20%/25% per claim-free year up to 100%; reduces by same % after claim","note":"The operative wording for Loyalty Credit says maximum 100% of Base Sum Insured, while the product benefit table says 200%; this is an internal difference in the same document.","quote":"No Claim Bonus - Sum Insured to increase by selected % for every claim free year - Sum Insured to decrease by same % in case of claim | Options- 5%/10%/15%/20%/25% per annum upto 100% of Base Sum Insured Benefit cannot be opted if 'Loyalty Credit' is opted ... Loyalty Credit: SI enhancement irrespective of claim | Sum insured will be enhanced per annum by selected % up to 200% Base Sum Insured Options for enhancement- 5%/ 10%/ 15%/ 20% of Base Sum Insured","sources":[{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"Inpatient Care includes allowable consumables and enteral feedings, but Annexure III lists many expenses not covered or subsumed into room, procedure or treatment costs, including gloves, masks, nebulisation kit, PPE-like gowns and other non-medical items.","display":"Allowable consumables covered; listed non-medical items are not covered or subsumed","note":"The detailed non-payable/subsumed items are in Annexure III.","quote":"vi) Intravenous fluids, blood transfusion, injection administration charges, allowable consumables and / or enteral feedings. ... EXPENSES NOT COVERED OR SUBSUMED INTO ROOM CHARGES / PROCEDURE CHARGES / COSTS OF TREATMENT ... 56 | GLOVES ... 60 | MASK ... 57 | NEBULISATION KIT ... 9 | GOWN","sources":[{"clause":"3.1.1.1","heading":"Inpatient Care","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-1"},{"clause":"Annexure III","heading":null,"page":146,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-iii"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity Expenses covers medically necessary treatment for normal delivery, routine or elective Caesarean or complicated pregnancy, only if the female insured is 18 years or above and both spouses are covered under a family floater. Waiting period options are no waiting period, 9 months, 12 months, 24 months, 36 months or 48 months, and limits range from INR 10,000 to INR 10 lacs for normal and caesarean options.","display":"Covered if opted; INR 10,000 to INR 10 lacs; waiting period no waiting period/9/12/24/36/48 months","note":"Benefit cannot be availed under an Individual Cover and applies only if maternity is in force.","quote":"We will indemnify the Medical Expenses incurred towards Medically Necessary Treatment of the Insured Person in case of normal delivery, routine or elective Caesarean or Complicated Pregnancy during the Policy Period. ... This Benefit is available only if\ni) the female Insured Person is Age 18 years or above\nii) Both the Insured Person and his / her legally married spouse are covered under a Family Floater Policy. ... Maternity Sum Insured Options Normal - INR 10,000 to INR 10 lacs Caesarean - INR 10,000 to INR 10 lacs Maternity Waiting Period Options Option A - No waiting Period Option B - 9 months Option C - 12 months Option D - 24 months Option E - 36 months Option F - 48 months","sources":[{"clause":"3.1.1.9","heading":"Maternity Expenses","page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-9"},{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New Born Baby Cover pays medical expenses for medically necessary treatment of the newborn up to the schedule limit for up to 90 days from delivery, if the mother is insured, maternity cover is in force, and the maternity claim for the same delivery is accepted.","display":"Covered for up to 90 days from delivery if maternity cover/claim conditions are met","note":null,"quote":"We will indemnify the Medical Expenses incurred during the Policy Period, towards the Medically Necessary Treatment of the New Born Baby up to the limit specified in the Policy Schedule/Certificate of Insurance for up to 90 days from the date of delivery.\nConditions:\na) The mother is an Insured Person under the Policy.\nb) The Maternity Benefit Cover is in force for the mother under the Policy.\nc) We have accepted a claim under Section 3.1.1.9 (Maternity Expenses) and/or 3.1.1.10 (Maternity+) above in respect of the same delivery","sources":[{"clause":"3.1.1.11","heading":"New Born Baby Cover","page":16,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-11"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"Health Check-up allows the insured person to avail a health check-up during the policy period as per Annexure IV or up to the schedule limit, only for diagnostic tests at the insurer's network provider arranged by the insurer. The product table gives INR 1,000 to INR 25,000 per member/family and frequency options of 06, 12, 24, 36 or 48 months.","display":"Health check-up during policy period; INR 1,000 to INR 25,000; frequency 06/12/24/36/48 months","note":"Eligibility and frequency are as specified in the Policy Schedule/Certificate of Insurance.","quote":"The Insured Person may avail a health check-up during the Policy Period as per the list specified in Annexure IV or up to the limit specified in the Policy Schedule/Certificate of Insurance only for Diagnostic Tests taken at Our Network Provider which will be arranged by Us: ... Health Check-up | INR 1,000 to INR 25,000 per member/family as per option A/ option B/ option C/ option D or a flat amount (with no listed health checkups) Frequency options - 06/ 12/ 24/ 36/ 48 months","sources":[{"clause":"3.1.1.22","heading":"Health Check-up","page":22,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-1-22"},{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"OPD Treatment & Diagnostic Cover, if specified in the Policy Schedule/Certificate of Insurance, indemnifies reasonable and customary OPD treatment charges including consultations, OPD procedures, diagnostic tests and prescribed medicines. OPD options in the product table range from INR 1,000 to Rs 100,000 with optional co-payment of 10%, 20%, 30%, 40% or 50%.","display":"OPD cover available if specified; INR 1,000 to Rs 100,000 with optional 10%/20%/30%/40%/50% co-payment","note":"OPD is a separate section that can be opted only with Hospitalization Cover.","quote":"We will indemnify the Reasonable and Customary Charges incurred in respect of the Insured Person for OPD Treatment taken during the Policy Period, as specified to be applicable to the Insured Person in the Policy Schedule/Certificate of Insurance.\nFor the purpose of this Benefit, OPD Treatment will include the following provided that it is specified to be applicable for the Insured Person in the Policy Schedule/Certificate of Insurance:\na) Consultation changes\nb) OPD procedures\nc) Diagnostic Tests based on the written advice of a Medical Practitioner\nd) Prescribed medicines followed by consultation and Diagnostic Test. ... OPD Treatment & Diagnostic Cover | OPD options: a)consultation, b)diagnostic test, c)pharmacy d) procedures INR 1,000 to Rs 100,000 with optional co-payment of 10%/20%/30%/40%/ 50%","sources":[{"clause":"3.4.1.1","heading":null,"page":63,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-4-1-1"},{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"quote-verified","value":"Treatment network choices can affect premium or co-payment: the Tiered Network option can give a premium discount up to 50% based on selected network or a co-payment up to 50% based on selected network; treatment outside a specified provider network may be settled on reimbursement with 10%, 20% or 30% co-payment.","display":"Network-based discount/co-payment, not city-zone pricing","note":"The documents state network-based premium discount/co-payment; they do not state city-zone pricing.","quote":"Tiered Network | Option 1: Discount up to 50% on Premium basis selected network Option 2: Co-Payment up to 50% basis selected network Option 3: Any combination of the above ... Restriction of cashless treatment in Specified Provider Network | Claims outside of 'Specified Provider Network' would be settled on reimbursement basis with co-payment Options of Co-payment for Treatment outside 'Specified Provider Network'. Option A: 10% Option B: 20% Option C: 30%","sources":[{"clause":"Annexure XV(v)","heading":null,"page":179,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv-v"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless Facility is available at network providers or service providers, with pre-authorization. The policy also states Cashless Everywhere is offered even in hospitals not part of the network, with process details on the insurer's website.","display":"Cashless at network providers with pre-authorization; Cashless Everywhere also offered","note":"Some options may restrict claim settlement to network providers only or reimbursement only, as specified in the schedule.","quote":"Cashless Facility can be availed only at Our Network Providers or Service Providers. The complete list of Network Providers is available on Our website and at Our branches and can also be obtained by contacting Us over the telephone. ... For Cashless Facility Hospitalization, We will make the payment of the amount assessed to be due, directly to the Network Provider. ... Note: We offer Cashless Everywhere, even in hospitals which are not part of our network.","sources":[{"clause":"3.1.3(c)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-3-c"},{"clause":"3.1.3(XI)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-3-1-3-xi"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Policy servicing and claims-related assistance are done directly by Niva Bupa. The policy also uses service providers for some services and says network providers may be enlisted by an insurer, TPA or jointly.","display":"Niva Bupa directly, with service providers where applicable","note":null,"quote":"Any subsequent Policy servicing or claims related assistance shall directly be done by Us. ... Network Provider means Hospital or health care providers enlisted by an insurer, TPA or jointly by an insurer and TPA to provide medical services to an insured by a Cashless Facility.","sources":[{"clause":"5.30","heading":"Role of Group Administrator","page":137,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-5-30"},{"clause":"2(XVII)(d)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-2-xvii-d-2"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes, Family Floater Policy available","note":null,"quote":"Family Floater Policy means a Policy described as such in the Policy Schedule where the family members (two or more) named in the Policy Schedule are Insured Persons under this Policy. ... Plans | Individual Or Floater Or Combination of the two","sources":[{"clause":"2(XVII)(b)(ii)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-2-xvii-b-ii-2"},{"clause":"Annexure XV","heading":"Product Benefit Table","page":178,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649#c-annexure-xv"}],"law":[]}],"documents":[{"kind":"wording","label":"Health Plus Policy Document","pages":206,"fetched_at":"2026-10-17 19:51:54+00","source_url":"https://transactions.nivabupa.com/pages/doc/policy_wording/healthplus-policydocument.pdf?v=1.7","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13649"},{"kind":"wording","label":"Max Health Plus (IRDAI copy)","pages":129,"fetched_at":"2026-10-20 02:28:41+00","source_url":"https://irdai.gov.in/documents/37343/931203/Max_MaxHealthPlus+-_2017-2018.pdf/f1e88726-72f3-1e62-7b0d-11b600330285?version=1.1&t=1668425987312&download=true","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/28487"},{"kind":"prospectus","label":"Health_Plus(V4)-Prospectus","pages":174,"fetched_at":"2026-10-17 19:53:26+00","source_url":"https://transactions.nivabupa.com/pages/doc/prospectus/Health_Plus-(V4)-Prospectus.pdf?v=1.0","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13689"},{"kind":"cis","label":"Health Plus","pages":24,"fetched_at":"2026-10-17 19:52:50+00","source_url":"https://transactions.nivabupa.com/pages/doc/Customer-Information/CIS_Health-Plus-Group.pdf?v=1.0","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627/document/13666"}],"versions":[{"uin":"MAXHLGP18130V011718","version":null,"approved_on":null},{"uin":"NBHHLGP27057V042627","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Niva Bupa Health Insurance official website","url":"https://www.nivabupa.com/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Health claims","url":"https://transactions.nivabupa.com/claims/pages/health-claim.aspx","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal","url":"https://transactions.nivabupa.com/pages/grievance-redressal.aspx","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"renew","kind":"insurer","name":"Renewals","url":"https://transactions.nivabupa.com/renewal/renewpolicies.aspx","note":null}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Health Plus (UIN NBHHLGP27057V042627), IndiaInsurances, https://indiainsurances.com/policy/niva-bupa-health-insurance/health-plus-nbhhlgp27057v042627"}