{"uin":"NBHHLIP22156V032122","name":"Health Recharge","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122","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-topup","category_name":"Top-up and super top-up","irdai_type":"Revision","kind":"product","status":"unknown","approved_on":"2021-09-03","withdrawn_on":null,"summary":"Health Recharge is a Niva Bupa top-up indemnity health policy for individuals or families, sold as E-saver (annual aggregate deductible Rs. 10,000, 25,000 or 50,000) or Super Top-up (Rs. 1 lakh to 10 lakh), with base Sum Insured from Rs. 2 lakh to Rs. 95 lakh. It has a 30-day initial wait, 24 months for 15 listed conditions, 36 months for pre-existing diseases, cover in India only, and optional Personal Accident, Critical Illness and room rent covers.","analysis":{"state":"extracted","analysed_at":"2026-10-16 07:11:56.563522+00","note":"Every stated fact carries a verbatim quote found in the cited clause."},"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":"cross-checked","value":["E-saver","Super Top-up"],"display":"E-saver and Super Top-up","note":"The two variants differ by the annual aggregate deductible: E-saver Rs. 10k, 25k or 50k; Super Top-up Rs. 1L to 10L. The prospectus grid offers E-saver only with Sum Insured 2 to 5 lakh.","quote":"Annual aggregate Deductible | E-saver: 10k, 25k, 50k Super Top-up: 1L to 10L in multiples of 1L ... Critical Illness benefit can be offered subject to acceptance of base cover under ‘E-saver’ or ‘Super Top-up’. ... Ded \\ SI | 200,000 | 300,000 | 400,000 | 500,000","sources":[{"clause":"Annexure I","heading":null,"page":40,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-annexure-i"},{"clause":null,"heading":"Underwriting Grid","page":29,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-underwriting-grid"},{"clause":null,"heading":"E-saver","page":36,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-e-saver"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"cross-checked","value":"One year by default; two-year and three-year policy terms are also available.","display":"1 year (2 and 3 year options)","note":"From the prospectus. 2 year term: 7.5% discount on the second year premium; 3 year term: 15% on the third year plus 7.5% on the second year.","quote":"The default policy term for all plans is one year. Two year and three year policy term options are also available under the product.","sources":[{"clause":null,"heading":"Policy Design","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-policy-design"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"cross-checked","value":"Reimbursement claims: written notice within 48 hours of admission or before discharge, whichever is earlier. Cashless: planned treatment pre-authorised at least 72 hours before; emergency within 48 hours of hospitalisation or before discharge, whichever is earlier.","display":"Within 48 hours of admission or before discharge (whichever is earlier); 72 hours before planned treatment","note":"Critical Illness Cover (optional): written notice within 7 days of the diagnosis, surgery or condition. Delays are condoned on merits if beyond the claimant's control.","quote":"We shall be given written notice 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 ... 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 given written notice immediately and in any event within 7 days of the aforesaid Illness/ condition/ Surgical Procedure. ... We will condone such delay on merits where the delay has been proved to be for reasons beyond the claimant’s control.","sources":[{"clause":"7.2(XII)(b)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-b-2"},{"clause":"7.2(XII)(a)(i)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-a-i"},{"clause":"4.2(II)(c)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-4-2-ii-c-3"},{"clause":"7.2(XII)(f)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-f-2"}],"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":"cross-checked","value":["Claim form duly completed and signed by the claimant","Details of past medical history record, first and subsequent consultation","Age / Identity proof document","Cancelled cheque/ bank statement / copy of passbook","Original discharge summary","Bar code sticker and invoice for implants and prosthesis","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","MLC/ Panchnama / First Information Report (FIR) copy (Accident cases)","Original laboratory investigation, diagnostic, radiological & pathological reports with supporting prescriptions"],"display":"Claim form, medical history, ID/age proof, bank details, discharge summary, hospital bills, pharmacy bills, investigation reports, FIR/MLC for accidents","note":"Bar code sticker only for implants in surgery; room tariff only for non-network hospitals. Optional covers need extra documents (death certificate, disability certificate, survival certificate).","quote":"a) Claim form duly completed and signed by the claimant. ... b) Details of past medical history record, first and subsequent consultation. ... c) Age / Identity proof document of Insured Person ... d) Cancelled cheque/ bank statement / copy of passbook ... e) Original discharge summary. ... f) Bar code sticker and invoice for implants and prosthesis ... g) Original final bill from Hospital with detailed break-up and paid receipt. ... h) Room tariff of the entitled room category ... i) Original bills of pharmacy/medicines purchased ... MLC/ Panchnama / First Information Report (FIR) copy ... k) Original laboratory investigation, diagnostic, radiological & pathological reports with supporting prescriptions.","sources":[{"clause":"7.2(XII)(a)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-a-3"},{"clause":"7.2(XII)(b)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-b-3"},{"clause":"7.2(XII)(c)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-c-2"},{"clause":"7.2(XII)(d)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-d-2"},{"clause":"7.2(XII)(e)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-e"},{"clause":"7.2(XII)(f)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-f"},{"clause":"7.2(XII)(g)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-g"},{"clause":"7.2(XII)(h)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-h"},{"clause":"7.2(XII)(i)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-i"},{"clause":"7.2(XII)(j)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-j"},{"clause":"7.2(XII)(k)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-k"}],"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":"conflicting","value":"The insurer settles or rejects a claim within 15 days from the claim submission date; if payment is delayed it pays interest at 2% above the bank rate from the date of receipt of claim intimation.","display":"15 days from claim submission","note":"CIS says: 'We shall settle or repudiate a claim within 30 days of the receipt of the last necessary information and documentation'. CIS also gives a pre-authorisation turnaround of 4 hours; the wording says discharge authorisation within three hours.","quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the claim submission date. ... ln the case of delay in the payment of a claim, the Company shall be liable to pay interest to the policyholder from the date of receipt claim intimation till the date of payment of claim at a rate of 2% above the bank rate. ... We shall settle or repudiate a claim within 30 days of the receipt of the last necessary information and documentation ... Once the final authorization request is received for discharge, the same will be processed within three hours from the final documents received. ... Turn Around Time (TAT) for issue of Pre-Auth – 4 hours","sources":[{"clause":"7.2(XII)(a)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-a-5"},{"clause":"7.2(XII)(b)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-b-5"},{"clause":null,"heading":"Please refer to the policy clauses for the full listing)","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/176#c-please-refer-to-the-policy-clauses-for-the-full"},{"clause":"7.2(XII)(a)(i)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-a-i"}],"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":"cross-checked","value":["Pre-existing Diseases until 36 months of continuous coverage (Excl01)","Listed conditions, surgeries/treatments until 24 months of continuous coverage (Excl02)","Treatment of any Illness within 30 days from the first Policy commencement date (Excl03)","Admission primarily for diagnostics and evaluation purposes (Excl04)","Rest Cure, rehabilitation and respite care (Excl05)","Obesity/ Weight Control surgery not meeting the conditions (Excl06)","Cosmetic or plastic Surgery (Excl08)","Hazardous or Adventure sports as a professional (Excl09)","Alcoholism, drug or substance abuse or any addictive condition (Excl12)","Unproven Treatments (Excl16)","Maternity Expenses (Excl18)","Conflict & Disaster: nuclear, war, rebellion, acts of terrorism","Dental/oral treatment, except while Hospitalized due to an Accident","Any treatment or medical services received outside the geographical limits of India","Any expenses incurred on OPD treatment"],"display":"36-month PED, 24-month listed-condition and 30-day waiting periods; diagnostics-only admissions; rest cure; obesity surgery; cosmetic surgery; adventure sports; addiction; unproven treatment; maternity; war and terrorism; dental; treatment outside India; OPD","note":"Accidents are not subject to the 30-day or 24-month waits; cancer is covered after the 30-day wait. Excl01 to Excl03 do not apply to e-Consultation, Personal Accident Cover or Critical Illness Cover. Full list in Section 6 (see permanent exclusions).","quote":"I) Pre-existing Diseases (Code–Excl01): ... Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first Policy. ... Specified disease/procedure waiting period- Code- Excl02 ... Expenses related to the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us. ... 30-day waiting period (Code- Excl03): ... 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. ... Investigation & Evaluation (Code-Excl04) ... Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded. ... Rest Cure, rehabilitation and respite care (Code-Excl05) ... Obesity/ Weight Control (Code-Excl06) Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions ... Cosmetic or plastic Surgery (Code-Excl08) ... Hazardous or Adventure sports (Code-Excl09) Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports ... Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code-Excl12) ... Unproven Treatments (Code-Excl16) ... Maternity Expenses (Code-Excl18) ... Conflict & Disaster: ... Treatment for any Injury or Illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations (whether war is declared or not), rebellion (act of armed resistance to an established government or leader), acts of terrorism. ... Dental/oral treatment: ... except if required by an Insured Person while Hospitalized due to an Accident. ... XI) Any treatment or medical services received outside the geographical limits of India. ... XII) Any expenses incurred on OPD treatment ... This exclusion shall not be applicable for claims arising due to an Accident (covered from day 1) or Cancer (covered after 30-day waiting period). ... Note: Exc01, Excl02, Excl03 shall not apply to Section 3.9 (e-Consultation), Section 4.1 (Personal Accident Cover) and Section 4.2 (Critical Illness Cover).","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-1"},{"clause":"6.1(II)(d)(ii)","heading":null,"page":26,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-1-ii-d-ii"},{"clause":"Excl14","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-excl14"},{"clause":"6.2(IV)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-iv"},{"clause":"6.2(VI)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-vi"},{"clause":"6.2(XI)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-xi"},{"clause":"6.2(XII)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-xii"}],"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":"cross-checked","value":"Contact Niva Bupa customer services (website www.nivabupa.com, toll free 1860-500-8888, service platform, or any branch grievance cell); if not satisfied, the grievance officer (Head - Customer Services, Noida), then escalate to GRO@nivabupa.com, before the Insurance Ombudsman.","display":"Niva Bupa customer services (1860-500-8888), then Head - Customer Services, then GRO@nivabupa.com","note":"Senior citizens may write to seniorcitizensupport@nivabupa.com. CIS gives a different fax (011-30902010) and e-mail customercare@nivabupa.com.","quote":"ln case of any grievance the insured person may contact the company through Website: www.nivabupa.com Toll free: 1860-500-8888 ... lnsured person may also approach the grievance cell at any of the company’s branches with the details of grievance lf lnsured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer at: Head – Customer Services Niva Bupa Health Insurance Company Limited D-5, 2nd Floor, Logix Infotech Park opp. Metro Station, Sector 59, Noida ... If the Insured person is not satisfied with the above, they can escalate to GRO@nivabupa.com.","sources":[{"clause":"7.1(VIII)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-viii"}],"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":"cross-checked","value":"Base Sum Insured from Rs. 2 lakh to Rs. 95 lakh: 2, 3, 4, 5, 7.5, 10, 15, 25, 40, 45, 65, 70, 90 or 95 lakh.","display":"Rs. 2 lakh to Rs. 95 lakh","note":"Each Sum Insured is allowed only with certain deductibles (prospectus grid); E-saver is offered for Sum Insured 2 to 5 lakh.","quote":"Sum Insured ranges from Rs. 2 lacs to Rs. 95 lacs. ... Base Sum Insured (SI) per Policy Year (in Lacs) | 2 L | 3 L / 4 L | 5 L / 7.5 L / 10L / 15L / 25L / 40L / 45L / 65L / 70L / 90L / 95L ... Ded \\ SI | 200,000 | 300,000 | 400,000 | 500,000","sources":[{"clause":null,"heading":"Coverage Options","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-coverage-options"},{"clause":"Annexure I","heading":null,"page":40,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-annexure-i"},{"clause":null,"heading":"E-saver","page":36,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-e-saver"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Not for accidents; does not apply if continuously covered for more than twelve months. Critical Illness Cover (optional) has its own 90-day wait.","quote":"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. ... This exclusion shall not, however, apply if the Insured Person has continuous coverage for more than twelve months ... All the listed Critical Illnesses under the optional benefit, which occurs or manifests itself within 90 days from the first Policy commencement date shall be excluded","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-1"},{"clause":"4.2(II)(a)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-4-2-ii-a-3"}],"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":"cross-checked","value":{"unit":"months","amount":36},"display":"36 months","note":"Reduced by prior continuous cover under portability. CIS says the optional Critical Illness Cover has a 48-month PED wait; the wording says 36 months for it too.","quote":"Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first Policy. ... If the Insured Person is continuously covered without any break as defined under the portability norms of the extant IRDAI (Health Insurance) regulations, then waiting period for the same would be reduced to the extent of prior coverage. ... All the listed Critical Illnesses under the optional benefit, which occurs or manifests itself as a result of any Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months ... For critical illness cover, 90 days initial waiting period along with Pre-existing Disease waiting period of 48 months","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-1"},{"clause":"4.2(II)(a)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-4-2-ii-a-2"},{"clause":null,"heading":"Please refer to the policy clauses for the full listing)","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/176#c-please-refer-to-the-policy-clauses-for-the-full"}],"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":"cross-checked","value":{"unit":"months","amount":24},"display":"24 months","note":"Personal Waiting Periods of 24 months may also be set in the schedule for an individual's declared conditions.","quote":"Expenses related to the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us. This exclusion shall not be applicable for claims arising due to an Accident (covered from day 1) or Cancer (covered after 30-day waiting period). ... Conditions specified for an Insured Person under Personal Waiting Period in the Policy Schedule will be subject to a Waiting Period of 24 months from the inception of the First Policy with Us for that Insured Person","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-1"},{"clause":"6.2(I)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-i"}],"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":"cross-checked","value":["Pancreatitis and stones in biliary and urinary system","Cataract, glaucoma and other disorders of lens, 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, arthroscopic surgeries for ligament repair","Chronic kidney disease and failure","Varicose veins of lower extremities","All internal or external benign or in situ neoplasms/tumours, cyst, sinus, polyp, nodules, swelling, mass or lump","Ulcer, erosion and varices of gastro intestinal tract","Surgical treatment for diseases of middle ear and mastoid (including otitis media, cholesteatoma, perforation of tympanic membrane), Tonsils and adenoids, nasal septum and nasal sinuses","Internal Congenital Anomaly","Surgery of Genito-urinary system unless necessitated by malignancy","Spinal disorders"],"display":"Pancreatitis and stones, cataract and retina, prostate, gynaecological conditions, piles and fistula, hernia, joint and spine disorders, chronic kidney disease, varicose veins, benign growths, GI ulcers, ENT surgery, internal congenital anomaly, genito-urinary surgery, spinal disorders","note":null,"quote":"a) Pancreatitis and stones in biliary and urinary system b) Cataract, glaucoma and other disorders of lens, disorders of retina c) Hyperplasia of prostate, hydrocele and spermatocele d) Abnormal utero-vaginal bleeding, female genital prolapse, endometriosis/adenomyosis, fibroids, PCOD, or any condition requiring dilation and curettage or hysterectomy e) Hemorrhoids, fissure or fistula or abscess of anal and rectal region f) Hernia of all sites, g) Osteoarthritis, systemic connective tissue disorders, dorsopathies, spondylopathies, inflammatory polyarthropathies, arthrosis such as RA, gout, intervertebral disc disorders, arthroscopic surgeries for ligament repair h) Chronic kidney disease and failure i) Varicose veins of lower extremities j) All internal or external benign or in situ neoplasms/tumours, cyst, sinus, polyp, nodules, swelling, mass or lump k) Ulcer, erosion and varices of gastro intestinal tract l) Surgical treatment for diseases of middle ear and mastoid (including otitis media, cholesteatoma, perforation of tympanic membrane), Tonsils and adenoids, nasal septum and nasal sinuses m) Internal Congenital Anomaly n) Surgery of Genito-urinary system unless necessitated by malignancy o) Spinal disorders","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-1"}],"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":"cross-checked","value":{"unit":"months","amount":60},"display":"60 months","note":"For an enhanced sum insured, the sixty months run from the date of enhancement on the enhanced limit.","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.","sources":[{"clause":"7.1(IX)","heading":null,"page":31,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-ix"}],"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":"cross-checked","value":"Yes. The policyholder can port to another insurer, subject to the insurers' underwriting policy, and transfer credits for sum insured, no claim bonus, specific waiting periods, the pre-existing disease waiting period and moratorium period.","display":"Yes, with waiting-period credit","note":"Migration to another Niva Bupa policy carries the same credits. CIS: porting is at the time of renewal.","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. The 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 ... In case of migration of one policy to another with the same Insurer, the policyholder (including all members under family cover and group insurance policies) can transfer the credits gained ... You can port your policy at the time of renewal according to the IRDAI guidelines.","sources":[{"clause":"7.1(XIII)","heading":null,"page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-xiii"},{"clause":"7.1(XIV)","heading":null,"page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-xiv"},{"clause":null,"heading":"Please refer to the policy clauses for the full listing)","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/176#c-please-refer-to-the-policy-clauses-for-the-full"}],"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":"cross-checked","value":true,"display":"Yes, renewable for life","note":"Renewal can be refused for established fraud, non-disclosure or misrepresentation. Children who complete 26 years must move to a separate policy with waiting-period credit.","quote":"We assure you renewability of your policy for lifetime, if you pay renewal premium within the grace period of 30 days of expiry of your previous policy. ... Your policy is ordinarily renewable for life provided the due premium is paid on time ... A health insurance policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation by the insured. ... If any Insured Person who is a child and has completed Age 26 years at the time of Renewal, then such Insured Person will have to take a separate policy","sources":[{"clause":null,"heading":"Health Recharge - Start a healthy relationship","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-health-recharge-start-a-healthy-relationship"},{"clause":null,"heading":"Please refer to the policy clauses for the full listing)","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/176#c-please-refer-to-the-policy-clauses-for-the-full"},{"clause":"7.1(III)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-iii"},{"clause":"7.2(III)(d)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-iii-d"}],"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":"cross-checked","value":"No. No loading applies on renewal based on individual claims experience, and there is no premium loading based on health status.","display":"No loading for claims","note":"Renewal premium changes with age (eldest member for floaters) and with IRDAI-approved rate revisions.","quote":"IV) No loading shall apply on renewals based on individual claims experience. ... There is no premium loading applicable basis the health status of the Insured under the Policy. ... Renewal premium will alter based on individual Age. The reference of Age for calculating the premium for Family Floater Policies shall be the Age of the eldest Insured Person. ... The Company, with prior approval of lRDAl, may revise or modify the terms of the policy including the premium rates.","sources":[{"clause":"7.1(IV)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-iv"},{"clause":"7.2","heading":"Specific Terms and Clauses","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2"},{"clause":"7.2(III)(a)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-iii-a"},{"clause":"7.1(VI)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-vi"}],"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":"cross-checked","value":["Investigation & Evaluation (Excl04)","Rest Cure, rehabilitation and respite care (Excl05)","Obesity/ Weight Control (Excl06)","Change-of-Gender treatments (Excl07)","Cosmetic or plastic Surgery (Excl08)","Hazardous or Adventure sports (Excl09)","Breach of law (Excl10)","Excluded Providers (Excl11)","Alcoholism, drug or substance abuse or any addictive condition (Excl12)","Treatments received in heath hydros, nature cure clinics, spas (Excl13)","Dietary supplements and substances that can be purchased without prescription (Excl14)","Refractive Error less than 7.5 dioptres (Excl15)","Unproven Treatments (Excl16)","Birth control, Sterility and Infertility (Excl17)","Maternity Expenses (Excl18)","Charges related to a Hospital stay not expressly mentioned as being covered (RMO charges, surcharges, service charges)","Circumcision unless necessary for the treatment of a disease or necessitated by an Accident","Conflict & Disaster","External Congenital Anomaly","Dental/oral treatment","Hormone Replacement Therapy","Multifocal Lens and ambulatory devices","Sexually transmitted Infections & diseases (other than HIV / AIDS)","Sleep disorders","Any treatment or medical services received outside the geographical limits of India","Any expenses incurred on OPD treatment","Unrecognized Physician or Hospital"],"display":"IRDAI standard exclusions Excl04 to Excl18, plus hospital charges not listed, circumcision, war and nuclear, external congenital anomaly, dental, hormone therapy, multifocal lens and walking aids, STDs, sleep disorders, treatment outside India, OPD, unrecognised doctors or hospitals","note":"Excl14's code is printed in the prospectus; the wording prints the dietary supplements exclusion without its code. The Personal Accident option has its own exclusions (suicide, armed forces, aviation, adventure sports and others). Underwriting may add a permanent exclusion for a declared condition, named in the schedule.","quote":"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) ... Hazardous or Adventure sports (Code-Excl09) ... Breach of law (Code-Excl10) ... Excluded Providers (Code-Excl11) ... Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code-Excl12) ... Treatments received in heath hydros, nature cure clinics, spas ... (Code-Excl13) ... Dietary supplements and substances that can be purchased without prescription, including but not limited to vitamins, minerals and organic substances unless prescribed by a Medical Practitioner as part of Hospitalization claim or Day Care procedure (Code-Excl14) ... Refractive Error (Code-Excl15) Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres. ... Unproven Treatments (Code-Excl16) ... Birth control, Sterility and Infertility (Code-Excl17) ... Maternity Expenses (Code-Excl18) ... II) Charges related to a Hospital stay not expressly mentioned as being covered. This will include charges for RMO charges , surcharges and service charges levied by the Hospital. ... Circumcision unless necessary for the treatment of a disease or necessitated by an Accident. ... IV) Conflict & Disaster: ... V) External Congenital Anomaly: ... VI) Dental/oral treatment: ... VII) Hormone Replacement Therapy: ... VIII) Multifocal Lens and ambulatory devices ... IX) Sexually transmitted Infections & diseases (other than HIV / AIDS): ... X) Sleep disorders: ... XI) Any treatment or medical services received outside the geographical limits of India. ... XII) Any expenses incurred on OPD treatment ... XIII) Unrecognized Physician or Hospital: ... XIV) Permanent Exclusions for Personal Accident Cover ... A permanent exclusion will be applied on any medical or physical condition or treatment of an Insured Person, if specifically mentioned in the Policy Schedule and has been accepted by You.","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-1"},{"clause":"6.1(II)(d)(ii)","heading":null,"page":26,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-1-ii-d-ii"},{"clause":"Excl12","heading":"Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences there of.","page":22,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-excl12"},{"clause":"Excl14","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-excl14"},{"clause":"6.2(II)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-ii"},{"clause":"6.2(III)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-iii"},{"clause":"6.2(IV)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-iv"},{"clause":"6.2(V)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-v"},{"clause":"6.2(VI)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-vi"},{"clause":"6.2(VII)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-vii"},{"clause":"6.2(VIII)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-viii"},{"clause":"6.2(IX)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-ix"},{"clause":"6.2(X)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-x"},{"clause":"6.2(XI)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-xi"},{"clause":"6.2(XII)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-xii"},{"clause":"6.2(XIII)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-xiii"},{"clause":"6.2(XIV)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-xiv"},{"clause":"Excl02(c)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-excl02-c-2"}],"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":"cross-checked","value":"The policyholder can cancel any time with 7 days' written notice. For a policy term up to one year, proportionate premium for the unexpired period is refunded if no claim has been made; for terms over 1 year, premium for policy years whose cover has not started is refunded.","display":"Proportionate premium for the unexpired period, if no claim","note":"The prospectus prints clause (b) as a copy of (a). On automatic cancellation (death), a refund is due only if no claim was made and e-Consultation was not used.","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: a) 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 b) 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 ... b) 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. ... A refund in accordance with Section 7.1 shall be payable if there is an automatic cancellation of the Policy provided that no claim has been made and e-Consultation has not been availed","sources":[{"clause":"7.1(II)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-ii"},{"clause":"28(XI)(b)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-28-xi-b-3"},{"clause":"7.2","heading":"Specific Terms and Clauses","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2"}],"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":"cross-checked","value":"India only. All benefits are available in India and claims are paid in India in Indian Rupees.","display":"India only","note":"The optional Personal Accident Cover applies to accidents at any location worldwide.","quote":"All benefits are available in India only and all claims shall be payable in India in Indian Rupees only. ... XI) Any treatment or medical services received outside the geographical limits of India. ... dies or sustains any Injury resulting solely and directly from an Accident occurring during the Policy Period at any location worldwide","sources":[{"clause":"7.2(IV)(c)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-iv-c"},{"clause":"6.2(XI)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-6-2-xi"},{"clause":"4.1","heading":"Personal Accident Cover","page":16,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-4-1"}],"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":"conflicting","value":{"unit":"days","amount":30},"display":"30 days","note":"CIS says: 'within 15 days of receipt of the Policy document'. Not available on renewals. Refund less proportionate risk premium, medical examination and stamp duty costs.","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. ... you may cancel the Policy, stating your reasons within 15 days of receipt of the Policy document provided no claims have been made under any benefits. ... The Free Look Period shall be applicable on individual health insurance policies and not on renewals. ... the policyholder shall be entitled to a refund of the premium paid subject only to a deduction of a proportionate risk premium for the period of cover and the expenses, if any, incurred by the insurer on medical examination of the proposer and stamp duty charge.","sources":[{"clause":"7.1(I)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-i"},{"clause":null,"heading":"Please refer to the policy clauses for the full listing)","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/176#c-please-refer-to-the-policy-clauses-for-the-full"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":null,"quote":"At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days (annual installment) to maintain continuity of benefits without break in policy.","sources":[{"clause":"7.1(III)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-iii"}],"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":"cross-checked","value":"Adults 18 to 65 years (last birthday); dependent children 91 days to 25 years.","display":"18 to 65 years (children 91 days to 25 years)","note":"From the prospectus. A child who completes 26 years at renewal must take a separate policy.","quote":"The range of entry ages for Adults under the policy is from 18 years (last birthday) to 65 Years (last birthday). The range of entry ages for dependent children is from 91 days to 25 years. ... Please note if any Insured Person who is a child and has completed 26 years at the time of Renewal, then such Insured Person will have to take a separate policy","sources":[{"clause":null,"heading":"Policy Design","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-policy-design"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"not-stated","value":null,"display":null,"note":"The documents mention payment of full premium in advance and a 30-day grace period for annual instalments but do not list payment frequencies.","quote":null,"sources":[],"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":"cross-checked","value":["Personal Accident Cover","Critical Illness Cover","Modification in Room Rent"],"display":"Personal Accident, Critical Illness, Modification in Room Rent","note":"Personal Accident: Rs. 1 lakh, 2 lakh, 5 lakh to 50 lakh (multiples of 5 lakh). Critical Illness (20 illnesses): Rs. 1 lakh to 10 lakh, 30-day survival period. Room rent option only for deductible above Rs. 50,000 (CIS also limits it to Sum Insured up to Rs. 4 lakh).","quote":"4.1 Personal Accident Cover ... 4.2 Critical Illness Cover ... 4.3 Modification in Room Rent ... OPTIONAL BENEFITS (which may be added at customer level at an additional premium) ... Options available: 1Lac, 2Lacs, 5Lacs to 50Lacs (in multiple of 5Lacs) ... Options available: 1Lac to 10Lacs (in multiple of 1 Lac) ... Single private room; covered up to Sum Insured (optional available only for deductible more than 50,000) ... provided that the Insured Person survives the Survival Period of 30 days from the diagnosis of the Critical Illness ... Critical Illness coverage for 20 major illnesses ... This option can is available only for Sum Insured up to Rs. 4 Lacs and deductible more than Rs. 50,000","sources":[{"clause":"4.1","heading":"Personal Accident Cover","page":16,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-4-1"},{"clause":"4.2","heading":"Critical Illness Cover","page":19,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-4-2"},{"clause":"4.3","heading":"Modification in Room Rent","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-4-3"},{"clause":null,"heading":"Baseline cover benefits","page":40,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-baseline-cover-benefits"},{"clause":"Row 2","heading":"What am I covered for","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/176#c-row-2"}],"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":"cross-checked","value":"Yes. The policy states that coverage is available during the grace period.","display":"Yes, covered during the grace period","note":"The standard definition of Grace Period says coverage need not be available for the period without premium; the renewal clause says coverage is available.","quote":"III. Coverage is available during the grace period. ... Coverage need not be available during the period for which no premium is received.","sources":[{"clause":"7.1(III)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-1-iii"},{"clause":"2.1","heading":"Standard Definitions","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-2-1"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"The amount (per claim or per year) that must be crossed before this policy pays. Your base policy or you pay this part.","status":"cross-checked","value":"A mandatory annual aggregate deductible chosen at purchase: Rs. 10,000, 25,000 or 50,000 (E-saver) or Rs. 1 lakh to 10 lakh in multiples of 1 lakh (Super Top-up). The insurer pays only after all admissible claims in the policy year exceed it.","display":"Rs. 10,000 to Rs. 10 lakh per policy year (aggregate, chosen)","note":"Does not apply to e-Consultation, Personal Accident or Critical Illness. Can be changed once in a lifetime at renewal after 5 policy years if the eldest member is under 50; waiving it moves you to an equivalent indemnity policy.","quote":"You have to mandatorily choose any one of the annual aggregate claim deductible amount from Rs. 10,000, 25,000, 50,000, 1Lac to 10Lacs (in multiples of 1Lac). ... Our liability to make payment under the Policy in respect of any claim made in that Policy Year will only commence once the Deductible has been exhausted. ... E-saver: 10k, 25k, 50k Super Top-up: 1L to 10L in multiples of 1L ... Deductible will not apply to any claim under Section 3.9 (e-Consultation), Section 4.1 (Personal Accident Cover) and Section 4.2 (Critical Illness Cover). ... This option can be availed only once in a lifetime and at the time of Renewal, post completion of 5 Policy Years; and ... The eldest member’s Age in the Policy has not crossed 50 years. ... In case of waiver of Deductible, We will offer an option, at the time of renewal, to opt for an equivalent indemnity health insurance Policy (without any Deductible)","sources":[{"clause":"Row 2","heading":"What am I covered for","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/176#c-row-2"},{"clause":"5.1","heading":"Annual Aggregate Deductible","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-5-1"},{"clause":"Annexure I","heading":null,"page":40,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-annexure-i"}],"law":[]},{"key":"deductible_basis","label":"Per claim or aggregate","section":"Limits and co-pay","meaning":"Top-up: deductible applies to each claim. Super top-up: to the total of all claims in the year.","status":"cross-checked","value":"aggregate","display":"Annual aggregate (all claims in the policy year)","note":null,"quote":"The Deductible (if applicable) shall be applied to the aggregate of all claims that are either paid or payable under this Policy. Our liability to make payment shall commence only once the aggregate amount of all eligible claims as per policy terms and conditions exceeds the Deductible limit within the same Policy Year.","sources":[{"clause":"7.2(XII)(e)(ii)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-e-ii"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"Daily room limit, if any.","status":"cross-checked","value":"Sum Insured below Rs. 5 lakh: up to 1% of Sum Insured per day. Sum Insured Rs. 5 lakh and above: no amount limit, but room category limited to a Single Private Room.","display":"1% of Sum Insured per day (below Rs. 5 lakh); single private room from Rs. 5 lakh","note":"The wording's benefit table loses its column split; the CIS gives the Sum Insured split. Higher rooms trigger proportionate deduction of associated expenses. The optional Modification in Room Rent raises the limit to a Single Private Room.","quote":"Room Rent (per day) | Up to 1% of Base Sum Insured per day | Single private room; up to Sum Insured ... Room rent (for Sum Insured less than 5 Lac) – 1% of Sum Insured per day. For Sum Insured 5 Lacs and above, no restriction on amount, however room category is limited to Single Private Room. ... then We shall be liable to pay only a pro-rated portion of the total Associated Medical Expenses ... If this optional benefit is in force under the Policy, then the maximum eligibility for a room category in case of Hospitalization of the Insured Person payable by Us will be limited to stay in a Single Private Room.","sources":[{"clause":null,"heading":"Baseline cover benefits","page":40,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-baseline-cover-benefits"},{"clause":null,"heading":"Please refer to the policy clauses for the full listing)","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/176#c-please-refer-to-the-policy-clauses-for-the-full"},{"clause":"3.1","heading":"Inpatient Care","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-3-1"},{"clause":"4.3","heading":"Modification in Room Rent","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-4-3"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"Share of each admissible claim you pay.","status":"not-stated","value":null,"display":null,"note":"Claim cost sharing (Section 5) lists only the annual aggregate deductible; no co-payment percentage is printed.","quote":null,"sources":[],"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":"cross-checked","value":"Yes, at Niva Bupa network providers after pre-authorisation; the insurer also states it offers 'Cashless Everywhere', even in non-network hospitals.","display":"Yes, at network hospitals (and 'Cashless Everywhere')","note":"Pre-hospitalisation, post-hospitalisation and domiciliary expenses are reimbursement only. Optional Personal Accident and Critical Illness pay on reimbursement basis.","quote":"Cashless Facility can be availed only at Our Network Providers or Service Providers (as applicable). ... Note: We offer Cashless Everywhere, even in hospitals which are not part of our network. ... We will indemnify on Reimbursement basis only, the Insured Person’s Pre-hospitalization Medical Expenses ... We will indemnify on Reimbursement basis only, the Insured Person’s Post-hospitalization Medical Expenses ... We will indemnify on Reimbursement basis only, the Medical Expenses incurred for the Insured Person’s Domiciliary Hospitalization ... The optional benefits ‘Personal Accident Cover’ and ‘Critical Illness Cover’ will be payable (only on Reimbursement basis)","sources":[{"clause":"7.2(XII)(a)","heading":"For Availing Cashless Facility","page":35,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-a-2"},{"clause":"7.2(XII)(a)(ii)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-7-2-xii-a-ii"},{"clause":"3.2","heading":"Pre-hospitalization Medical Expenses","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-3-2"},{"clause":"3.3","heading":"Post-hospitalization Medical Expenses","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-3-3"},{"clause":"3.5","heading":"Domiciliary Hospitalization","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-3-5"},{"clause":"3.16","heading":null,"page":15,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-3-16"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"cross-checked","value":"Niva Bupa itself; the prospectus says you deal with the insurer directly, not through any third parties.","display":"Insurer (in-house)","note":"From the prospectus introduction. The wording refers to 'We/Our Service Provider' for claim investigation.","quote":"You talk to us directly, not through any third parties. We will be there for you when you need us. Because you should concentrate on getting healthier, not chasing your claims.","sources":[{"clause":null,"heading":"Health Recharge - Start a healthy relationship","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-health-recharge-start-a-healthy-relationship"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"cross-checked","value":true,"display":"Yes","note":"Wording defines a Family Floater Policy covering the primary insured, spouse and up to 4 children under 25. Floater premium is based on the eldest member's age.","quote":"‘Health Recharge’ product can be issued to an individual customer or to a family with up to 4 children (refer to as family floater). ... The family includes spouse and dependent children and can comprise up to a unit of 6 insured persons of which up to 4 can be children. ... Primary Insured Person’s children who are less than 25 years of Age on the commencement of the Policy Period (a maximum 4 children can be covered under the Policy as Insured Persons). ... The premium for family floater policies depends on the age of the eldest insured person.","sources":[{"clause":null,"heading":"Policy Design","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175#c-policy-design"},{"clause":"2.2(VII)(c)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174#c-2-2-vii-c"}],"law":[]}],"documents":[{"kind":"wording","label":"Health Recharge Policy Wording","pages":50,"fetched_at":"2026-10-16 07:11:41.647286+00","source_url":"https://transactions.nivabupa.com/pages/doc/policy_wording/health-recharge-t-and-c.pdf?v=1.0","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/174"},{"kind":"prospectus","label":"Health Recharge Prospectus","pages":42,"fetched_at":"2026-10-16 07:11:41.647286+00","source_url":"https://transactions.nivabupa.com/pages/doc/prospectus/Health-Recharge-Prospectus.pdf?v=1.0","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/175"},{"kind":"cis","label":"Health Recharge","pages":5,"fetched_at":"2026-10-16 07:11:41.647286+00","source_url":"https://transactions.nivabupa.com/pages/doc/Customer-Information/CIS_HealthRecharge.pdf","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122/document/176"}],"versions":[],"where_to_buy":[],"claims_and_complaints":[],"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 Recharge (UIN NBHHLIP22156V032122), IndiaInsurances, https://indiainsurances.com/policy/niva-bupa-health-insurance/health-recharge-nbhhlip22156v032122"}