{"uin":"NBHHLIP26051V092526","name":"Health Companion","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526","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":"2017-04-27","withdrawn_on":null,"summary":"Health Companion is a Niva Bupa indemnity health policy for individuals or families, sold as Variant 2022 (no room cap) and Variant 2023 (Shared Room cap with 20% co-payment for a higher room), with sum insured from Rs. 3 lac to 1 crore and cover in India only. It pays 60 days pre and 180 days post hospitalisation, adds a full Refill of the base sum insured once a year, and a No Claim Bonus of 20% a year up to 100%.","analysis":{"state":"extracted","analysed_at":"2026-10-16 07:11:58.044034+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":["Variant 2022","Variant 2023"],"display":"Variant 2022 and Variant 2023","note":"Variant 2023 caps the room at a Shared Room (20% co-payment for a higher room) and is offered with lesser commission; Variant 2022 has no room cap. Each can be Individual or Family Floater.","quote":"Policy Document Variant 2022 and Variant 2023 ... For Variant 2023 there is a room type capping up to Shared Room. 20% co-payment will apply in case of higher room category ... Note: Variant 2023 will be offered with lesser commission ... Plan Type (all limits in Rs unless defined as percentage) | Individual / Family Floater","sources":[{"clause":null,"heading":"Health Companion","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-health-companion"},{"clause":"3.2(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-2-a"},{"clause":null,"heading":"Optional benefit","page":19,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-optional-benefit-2"},{"clause":null,"heading":"Variant 2023","page":19,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-variant-2023"}],"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; 2-year and 3-year terms are also available.","display":"1 year (2 or 3 years optional)","note":"Term discount of 7.5% (2-year) or up to 15% + 7.5% (3-year), not with instalment payment.","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-companion-nbhhlip26051v092526/document/193#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":"not-stated","value":null,"display":null,"note":"No deadline for telling the insurer about a claim is printed; documents must be submitted \"at the earliest possible time\" and delays are condoned on merits.","quote":null,"sources":[],"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":["Original Discharge summary with first and subsequent consultation papers","Original Final Hospital bill with detailed break-up and payment receipt (including pharmacy bills)","Laboratory investigation reports with supporting prescriptions","MLC/First Information Report (FIR) (in accident cases)","KYC documents","Cancelled cheque"],"display":"Discharge summary, final hospital bill, lab reports, MLC/FIR for accidents, KYC, cancelled cheque","note":"Documents for expenses within the deductible must also be submitted.","quote":"Original Discharge summary with first and subsequent consultation papers. ... Original Final Hospital bill with detailed break-up and payment receipt (including pharmacy bills). ... Laboratory investigation reports with supporting prescriptions. ... MLC/First Information Report (FIR) (in accident cases). ... KYC documents ... Cancelled cheque","sources":[{"clause":"5.2.4(b)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-2-4-b"}],"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":"cross-checked","value":"The insurer settles or rejects a claim within 15 days from the claim submission date; delay attracts interest at 2% above bank rate from receipt of claim intimation.","display":"15 days from claim submission","note":"The wording table is garbled; its plain-language column says \"within 15 days from submission of all necessary claim documents\". Cashless final bill authorisation within three hours of the discharge request.","quote":"i) The Company shall settle or reject a claim, as the case may be, within 15 ... days from the claim submission date. ... interest on the claim amount at a rate ... of 2% above bank rate.","sources":[{"clause":"5.1.9(i)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-9-i"},{"clause":"5.1.9(ii)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-9-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":"cross-checked","value":["Pre-existing diseases for 36 months (Excl01)","Listed diseases/procedures for 24 months (Excl02)","Any illness in the first 30 days except accidents (Excl03)","Admission primarily for investigation and evaluation (Excl04)","Rest cure, rehabilitation and respite care (Excl05)","Obesity/weight control surgery outside set conditions (Excl06)","Cosmetic or plastic surgery (Excl08)","Hazardous or adventure sports (Excl09)","Breach of law (Excl10)","Alcoholism, drug or substance abuse (Excl12)","Sterility and infertility (Excl17)","Maternity expenses (Excl18)","Conflict and disaster (war, nuclear, terrorism)","External congenital anomaly","Dental/oral treatment unless due to accident","Any expenses incurred on OPD treatment","Intentional self inflicted injury or attempted suicide"],"display":"Waiting-period exclusions, standard IRDAI exclusions, and specific exclusions such as OPD, dental, war and external congenital anomaly","note":"Also excluded: excluded providers (Excl11), health hydros/spas (Excl13), refractive error below 7.5 dioptres (Excl15), unproven treatments (Excl16), circumcision, home medical devices, unrecognised doctors or hospitals, non-medically-necessary costs, artificial life maintenance, and personal waiting periods up to 48 months set in the schedule.","quote":"Pre-existing Diseases (Code–Excl01) ... until the expiry of 36 months ... Specified disease/procedure waiting period (Code- Excl02) ... until the expiry of 24 months ... 30-day waiting period (Code- Excl03) ... Investigation & Evaluation (Code-Excl04) ... Rest Cure, rehabilitation and respite care (Code-Excl05) ... Obesity/ Weight Control (Code-Excl06) ... Cosmetic or plastic Surgery (Code-Excl08) ... Hazardous or Adventure sports (Code-Excl09) ... Breach of law (Code-Excl10) ... alcoholism, drug or substance abuse ... (Code-Excl12) ... Sterility and Infertility (Code-Excl17) ... Maternity Expenses (Code-Excl18) ... Conflict & Disaster ... External Congenital Anomaly ... Dental/oral treatment ... except if required by an Insured Person while Hospitalized due to an Accident. ... Any expenses incurred on OPD treatment. ... Treatment related to intentional self inflicted Injury or attempted suicide by any means.","sources":[{"clause":"4.1.1","heading":"Pre-existing Diseases (Code–Excl01)","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-1"},{"clause":"4.1.2","heading":"Specified disease/procedure waiting period (Code- Excl02)","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-2"},{"clause":"4.1.3","heading":"30-day waiting period","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-3"},{"clause":"4.1.4","heading":"Investigation & Evaluation (Code-Excl04)","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-4"},{"clause":"4.1.5","heading":"Rest Cure, rehabilitation and respite care (Code-Excl05)","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-5"},{"clause":"4.1.6","heading":"Obesity/ Weight Control (Code-Excl06)","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-6"},{"clause":"4.1.7","heading":"Cosmetic or plastic Surgery (Code-Excl08)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-7"},{"clause":"4.1.8","heading":"Hazardous or Adventure sports (Code-Excl09)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-8"},{"clause":"4.1.9","heading":"Breach of law (Code-Excl10)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-9"},{"clause":"4.1.11","heading":"Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-11"},{"clause":"4.1.15","heading":"Sterility and Infertility (Code-Excl17)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-15"},{"clause":"4.1.16","heading":"Maternity Expenses (Code-Excl18)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-16"},{"clause":"4.2.3","heading":"Conflict & Disaster","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-3"},{"clause":"4.2.4","heading":"External Congenital Anomaly","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-4"},{"clause":"4.2.5","heading":"Dental/oral treatment","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-5"},{"clause":"4.2.7","heading":null,"page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-7"},{"clause":"4.2.9","heading":null,"page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-9"}],"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, toll-free 1860-500-8888, e-mail platform, courier or any branch grievance cell); if unresolved, the Grievance Redressal Officer, then GRO@nivabupa.com, then the Insurance Ombudsman.","display":"Niva Bupa customer services, then the Grievance Redressal Officer, then GRO@nivabupa.com","note":"Grievances can also be lodged at IRDAI Bima Bharosa (www.bimabharosa.irdai.gov.in). Senior citizens: seniorcitizensupport@nivabupa.com.","quote":"ln case of any grievance the insured person may contact the company through: ... Toll- Free: | 1860-500-8888 ... insured person may contact the grievance officer at: ... If the Insured person is not satisfied with the above, they can escalate to GRO@nivabupa.com. lf lnsured person is not satisfied with the redressal of grievance through above methods, the insured person may also approach the office of lnsurance Ombudsman","sources":[{"clause":"5.1.8","heading":"Redressal of Grievance","page":15,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-8"}],"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 of Rs. 3 lac, 4 lac, 5 lac, 7.5 lac, 10 lac, 12.5 lac, 15 lac, 20 lac, 30 lac, 50 lac, 75 lac or 100 lac.","display":"Rs. 3 lac to Rs. 1 crore","note":"Same options for Variant 2023. The CIS list leaves out 50 Lacs.","quote":"Health Companion variant 2022 has sum insured options from Rs.3 Lac to 1crore. ... Base Sum Insured | 3 lac | 4 lac | 5 lac | 7.5 lac | 10 lac | 12.5 lac | 15 lac | 20 lac | 30 lac | 50 lac | 75 lac | 100 lac","sources":[{"clause":null,"heading":"Coverage Options","page":3,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-coverage-options"},{"clause":"Annexure I","heading":"Product Benefits Table Variant 2022","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-annexure-i"}],"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":"Does not apply to accidents, or if the person has had continuous coverage for more than twelve months.","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 ... This exclusion shall not, however, apply if the Insured Person has continuous coverage for more than twelve months","sources":[{"clause":"4.1.3","heading":"30-day waiting period","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-3"}],"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 coverage under portability. A personal waiting period of up to 48 months may be set in the schedule for specified conditions.","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. ... Conditions specified for an Insured Person under Personal Waiting Period in the Policy Schedule will be subject to a Waiting Period of up to 48 months","sources":[{"clause":"4.1.1","heading":"Pre-existing Diseases (Code–Excl01)","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-1"},{"clause":"4.2.1","heading":"Personal Waiting Period","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-1"}],"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":"Not for accidents or cancer. A personal waiting period of up to 48 months may apply to conditions named in the schedule.","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. 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 up to 48 months","sources":[{"clause":"4.1.2","heading":"Specified disease/procedure waiting period (Code- Excl02)","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-2"},{"clause":"4.2.1","heading":"Personal Waiting Period","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-1"}],"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 retinal detachment","Hyperplasia of prostate, hydrocele and spermatocele","Prolapse uterus and cervix, endometriosis, Fibroids, PCOD, hysterectomy (unless necessitated by Malignancy)","Hemorrhoids, fissure or fistula or abscess of anal and rectal region","Hernia of all sites","Osteoarthritis, joint replacement, osteoporosis, systemic connective tissue disorders, inflammatory polyarthropathies, Rheumatoid Arthritis, gout, intervertebral disc disorders, arthroscopic surgeries for ligament repair","Varicose veins of lower extremities","All internal or external benign or neoplasms/ tumours, cyst, sinus, polyp, nodules, mass or lump","Ulcer, erosion and varices of gastro intestinal tract","Surgical treatment for diseases of middle ear and mastoid, Tonsils and adenoids, nasal septum and nasal sinuses"],"display":"Pancreatitis, stones, cataract, prostate, uterus conditions, piles, hernia, joint conditions, varicose veins, benign tumours, GI ulcers, ENT surgery","note":null,"quote":"i) Pancreatitis and stones in biliary and urinary system ... ii) Cataract, glaucoma and retinal detachment ... iii) Hyperplasia of prostate, hydrocele and spermatocele ... iv) Prolapse uterus and cervix, endometriosis, Fibroids, PCOD, hysterectomy (unless necessitated by Malignancy) ... v) Hemorrhoids, fissure or fistula or abscess of anal and rectal region ... vi) Hernia of all sites, ... vii) Osteoarthritis, joint replacement, osteoporosis, systemic connective tissue disorders, inflammatory polyarthropathies, Rheumatoid Arthritis, gout, intervertebral disc disorders, arthroscopic surgeries for ligament repair ... viii) Varicose veins of lower extremities ... ix) All internal or external benign or neoplasms/ tumours, cyst, sinus, polyp, nodules, mass or lump ... x) Ulcer, erosion and varices of gastro intestinal tract ... xi) 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","sources":[{"clause":"4.1.2","heading":"Specified disease/procedure waiting period (Code- Excl02)","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-2"}],"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 enhancement for the increased amount only.","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":"5.1.10","heading":"Moratorium Period","page":17,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-10"}],"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 policy can be ported to another insurer, carrying credit for sum insured, No Claim Bonus, specific and pre-existing disease waiting periods and moratorium.","display":"Yes, with waiting-period credit","note":"Subject to the acquiring insurer's Board approved underwriting policy (prospectus). The wording's portability clause is printed as a garbled two-column table. Migration to another Niva Bupa product is also allowed; the migration clause says NCB credit transfers, while the NCB clause says NCB cannot be carried on migration.","quote":"A Policyholder has the choice to port his/ her policies from one Insurer to ... 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","sources":[{"clause":"5.1.13","heading":null,"page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-13"}],"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","note":"Renewal can be refused only for established fraud, non-disclosure or misrepresentation.","quote":"There is no maximum cover ceasing age on renewals. ... We assure you renewability of your policy for lifetime, if you pay renewal premium within the grace period.","sources":[{"clause":null,"heading":"Policy Design","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-policy-design"},{"clause":null,"heading":"Health Companion - Start a healthy relationship","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-health-companion-start-a-healthy-relationship"}],"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, though the renewal discount level (0% to 39%) moves down after claims.","display":"No loading for claims","note":"Favourable Claim Experience Discount: new policies start at 30%; claim-free years move up (max 39%), claims above Rs 40,000 move down (min 0%). Risk loading applied at issue continues on all renewals.","quote":"iii) No loading shall apply on renewals based on individual claims experience. ... Claim up to INR 40,000 | Stays in the same level ... More than INR 1,50,000 | Moves down the gird by 3 levels ... Level -3 is the highest level a customer can be at with 39% discount. And Level 10 can be the lowest level a customer can reach, with 0% discount.","sources":[{"clause":"5.1.3","heading":null,"page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-3"},{"clause":null,"heading":"Level Grid","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-level-grid"}],"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)","Cosmetic or plastic Surgery (Excl08)","Hazardous or Adventure sports (Excl09)","Breach of law (Excl10)","Excluded Providers (Excl11)","Alcoholism, drug or substance abuse (Excl12)","Health hydros, nature cure clinics, spas (Excl13)","Refractive Error below 7.5 dioptres (Excl15)","Unproven Treatments (Excl16)","Sterility and Infertility (Excl17)","Maternity Expenses (Excl18)","Circumcision unless medically necessary or due to accident","Conflict & Disaster","External Congenital Anomaly","Dental/oral treatment unless due to accident","Medical & ambulatory devices used at home","Any expenses incurred on OPD treatment","Unrecognized Physician or Hospital","Intentional self inflicted Injury or attempted suicide","Costs not Reasonable and Customary or not Medically Necessary","Artificial life maintenance for a person declared brain dead or in vegetative state"],"display":"Standard exclusions Excl04 to Excl18 as printed, plus the product's specific exclusions","note":"Excl07 and Excl14 are not printed in this product.","quote":"Investigation & Evaluation (Code-Excl04) ... Rest Cure, rehabilitation and respite care (Code-Excl05) ... Obesity/ Weight Control (Code-Excl06) ... Cosmetic or plastic Surgery (Code-Excl08) ... Hazardous or Adventure sports (Code-Excl09) ... Breach of law (Code-Excl10) ... Excluded Providers (Code-Excl11) ... alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code-Excl12) ... nature cure clinics, spas or similar establishments ... (Code-Excl13) ... Refractive Error (Code-Excl15) ... refractive error less than 7.5 dioptres. ... Unproven Treatments (Code-Excl16) ... Sterility and Infertility (Code-Excl17) ... Maternity Expenses (Code-Excl18) ... Circumcision unless necessary for the treatment of a disease or necessitated by an Accident. ... Conflict & Disaster ... External Congenital Anomaly ... Dental/oral treatment ... Medical & ambulatory devices used at home ... Any expenses incurred on OPD treatment. ... Unrecognized Physician or Hospital ... Treatment related to intentional self inflicted Injury or attempted suicide by any means. ... Costs which are not Reasonable and Customary and treatments which are not Medically Necessary. ... Artificial life maintenance for the Insured Person who has been declared brain dead or in vegetative state","sources":[{"clause":"4.1.4","heading":"Investigation & Evaluation (Code-Excl04)","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-4"},{"clause":"4.1.5","heading":"Rest Cure, rehabilitation and respite care (Code-Excl05)","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-5"},{"clause":"4.1.6","heading":"Obesity/ Weight Control (Code-Excl06)","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-6"},{"clause":"4.1.7","heading":"Cosmetic or plastic Surgery (Code-Excl08)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-7"},{"clause":"4.1.8","heading":"Hazardous or Adventure sports (Code-Excl09)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-8"},{"clause":"4.1.9","heading":"Breach of law (Code-Excl10)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-9"},{"clause":"4.1.10","heading":"Excluded Providers (Code-Excl11)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-10"},{"clause":"4.1.11","heading":"Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-11"},{"clause":"4.1.12","heading":null,"page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-12"},{"clause":"4.1.13","heading":"Refractive Error (Code-Excl15)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-13"},{"clause":"4.1.14","heading":"Unproven Treatments (Code-Excl16)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-14"},{"clause":"4.1.15","heading":"Sterility and Infertility (Code-Excl17)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-15"},{"clause":"4.1.16","heading":"Maternity Expenses (Code-Excl18)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-16"},{"clause":"4.2.2","heading":"Circumcision","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-2"},{"clause":"4.2.3","heading":"Conflict & Disaster","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-3"},{"clause":"4.2.4","heading":"External Congenital Anomaly","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-4"},{"clause":"4.2.5","heading":"Dental/oral treatment","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-5"},{"clause":"4.2.6","heading":null,"page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-6"},{"clause":"4.2.7","heading":null,"page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-7"},{"clause":"4.2.8","heading":"Unrecognized Physician or Hospital","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-8"},{"clause":"4.2.9","heading":null,"page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-9"},{"clause":"4.2.10","heading":null,"page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-10"},{"clause":"4.2.11","heading":null,"page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-11"}],"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":"On 7 days' written notice, a proportionate premium for the unexpired period is refunded if no claim has been made; no refund if a claim has been paid.","display":"Proportionate refund if no claim; nothing after a paid claim","note":"For 2- and 3-year policies, premium for policy years not yet started is refunded.","quote":"The policy holder may cancel his/her policy at any time during the term, by giving 7 days’ notice in writing. ... 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. ... NOTE: We will NOT refund any premium if we have paid a claim.","sources":[{"clause":"5.1.2","heading":"Cancellation","page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-2"},{"clause":"5.1.2(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-2-a"},{"clause":"5.1.2(b)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-2-b"}],"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.","display":"India only","note":"All claims are payable in India in Indian Rupees only.","quote":"This Policy covers Allopathic and AYUSH treatments taken in India ONLY.","sources":[{"clause":"1","heading":"Preamble","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Not 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.","sources":[{"clause":"5.1.1","heading":"Free Look Period","page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-1"}],"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":"15 days for monthly instalments.","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) ... i) Grace Period of 30 days in all types of policies, and a period of 15 days in case of monthly instalments.","sources":[{"clause":"5.1.3","heading":null,"page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-3"},{"clause":"5.1.17","heading":"Premium Payment in Instalments","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-17"}],"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 from 18 years with no maximum entry age; dependent children from 91 days to 25 years.","display":"Adults 18+ (no maximum); children 91 days to 25 years","note":"A child must move to a separate policy at renewal after age 26.","quote":"The minimum entry age for adult is 18 years and for dependent child is 91 days. There is no maximum entry age limit for adults in this product. The maximum entry age allowed for dependent child is 25 years.","sources":[{"clause":null,"heading":"Policy Design","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#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":"cross-checked","value":["Yearly","Half-yearly","Quarterly","Monthly"],"display":"Yearly, half-yearly, quarterly or monthly","note":"Term discount does not apply to instalment payment.","quote":"(annual installment) ... Payment of Premium on an instalment basis i.e. Half Yearly, Quarterly or Monthly","sources":[{"clause":"5.1.3","heading":null,"page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-3"},{"clause":"5.1.17","heading":"Premium Payment in Instalments","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-17"}],"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":["Hospital Cash (Rs. 1,000, 2,000 or 4,000 per day, up to 30 days)","Personal Accident (up to 5 times Base Sum Insured, maximum INR 1 Crore)","Annual Aggregate Deductible (INR 10,000 to 10 lac)"],"display":"Hospital Cash, Personal Accident, Annual Aggregate Deductible","note":"Hospital Cash pays only after 48 hours or more of continuous admission. Personal Accident covers accidental death and permanent total or partial disability.","quote":"Hospital Cash | 1,000/day | 2,000/day | 4,000/day ... Personal Accident | Up to 5 times of Base Sum Insured. Maximum up to INR 1 Crore ... Annual Aggregate Deductible (INR) | 10,000 / 20,000 / 30,000 / 50,000 / 1 lac / 2 lac / 3 lac / 4 lac / 5 lac / 10 lac ... maximum up to 30 days for an insured person.","sources":[{"clause":null,"heading":"Optional benefit","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-optional-benefit"},{"clause":"10","heading":"Hospital Cash","page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-10"}],"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":"conflicting","value":"No for annual premiums: the wording says you are not insured during the grace period. If premium is paid in instalments, cover continues during the grace period.","display":"Not covered (covered only for instalment premiums)","note":"Prospectus says: 'iii) Coverage is available during the grace period.'","quote":"NOTE: You are NOT insured during the ... grace period. ... ii) For policies where premium is paid in instalments only, the coverage will be given during grace period.","sources":[{"clause":"5.1.3","heading":null,"page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-3"},{"clause":"5.1.17","heading":"Premium Payment in Instalments","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-1-17"},{"clause":"11.3(XI)(b)(iii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-11-3-xi-b-iii"}],"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":"cross-checked","value":"No room limit in Variant 2022 (covered up to sum insured); Variant 2023 caps the room at a Shared Room, with 20% co-payment for a higher room category.","display":"No limit (Variant 2022); Shared Room (Variant 2023)","note":"Choosing a room above the eligible category also triggers proportionate deduction of associated expenses.","quote":"Room Type Capping: Up to Shared room for variant 2023 and up to sum insured for variant 2022 ... For Variant 2023 there is a room type capping up to Shared Room. 20% co-payment will apply in case of higher room category","sources":[{"clause":"Excl13(c)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/194#c-excl13-c"},{"clause":"3.2(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-2-a"}],"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":"cross-checked","value":"Variant 2022: any room up to sum insured. Variant 2023: Shared Room.","display":"Any room (Variant 2022); Shared Room (Variant 2023)","note":"Variant 2023: 20% co-payment if a higher room category is chosen.","quote":"Room Type Capping: Up to Shared room for variant 2023 and up to sum insured for variant 2022","sources":[{"clause":"Excl13(c)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/194#c-excl13-c"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"not-stated","value":null,"display":null,"note":"No separate ICU limit is printed; the wording only says admission can be in ICUs, CCUs or NICU, and inpatient care is covered up to sum insured.","quote":null,"sources":[],"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":"cross-checked","value":"Yes. If you choose a room above your eligible category, associated medical expenses (room rent, nursing, doctors' fees, OT charges) are paid in the proportion of eligible to actual room rent.","display":"Yes, if room above eligible category","note":"Room category cap applies to Variant 2023 (Shared Room); Variant 2022 has no room cap.","quote":"If you opt for a Hospital room which is higher than the eligible room category as specified in your Policy Schedule, then We will pay only a pro-rated portion of the total Associated Medical Expenses ... Associated Medical Expenses shall include Room Rent, nursing charges, Medical Practitioners’ fees and operation theatre charges.","sources":[{"clause":"5.2.4(d)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-2-4-d"}],"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":"conflicting","value":"20% co-payment in Variant 2023 when a room above Shared Room is chosen; no other co-payment is printed.","display":"20% in Variant 2023 for a room above Shared Room","note":"CIS says: 'Co-payment – NA'.","quote":"For Variant 2023 there is a room type capping up to Shared Room. 20% co-payment will apply in case of higher room category ... Co-payment – NA","sources":[{"clause":"3.2(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-2-a"},{"clause":"Excl13(c)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/194#c-excl13-c"}],"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":"cross-checked","value":"None unless the optional Annual Aggregate Deductible is chosen.","display":"None unless opted","note":"Optional aggregate deductible of INR 10,000, 20,000, 30,000, 50,000, 1 lac, 2 lac, 3 lac, 4 lac, 5 lac or 10 lac per year, with a premium discount; does not apply to health check-up, animal bite vaccination or hospital cash.","quote":"Claim cost sharing option: ... The deductible options available are INR 10,000, 20,000, 30,000. 50,000, 1 lac, 2 lac, 3 lac, 4 lac, 5 lac and 10 lac.","sources":[{"clause":"11.3","heading":"Permanent Partial Disability","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-11-3"}],"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":"cross-checked","value":["Vaccination for Animal Bite: up to Rs. 5,000"],"display":"No caps on named diseases; animal bite vaccination up to Rs. 5,000","note":"Inpatient care, day care, AYUSH, modern treatments, organ donor and home care are all covered up to sum insured in the benefit table. Ambulance, health check-up and the Variant 2023 room cap have their own limits. The CIS coverage row says vaccination is \"covered up to Sum Insured\" but its own sub-limit row says up to Rs.5,000.","quote":"Vaccination required post an animal bite is covered up to Rs.5,000. ... Modern treatments | Covered up to Sum Insured","sources":[{"clause":"3.8","heading":"Vaccination for Animal Bite","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-8"},{"clause":null,"heading":"Base benefits","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-base-benefits"}],"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":"cross-checked","value":{"unit":"days","amount":60},"display":"60 days","note":"Only if the hospital admission claim is paid.","quote":"We will pay expenses incurred on consultations, medicines, physiotherapy, diagnostic tests 60 days before date of admission","sources":[{"clause":"3.3","heading":"Expenses before and after hospitalization (Pre & Post hospitalization)","page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-3"}],"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":"cross-checked","value":{"unit":"days","amount":180},"display":"180 days","note":null,"quote":"diagnostic tests 60 days before date of admission and 180 days after date of discharge IF these are related to the condition for which hospital admission claim is paid.","sources":[{"clause":"3.3","heading":"Expenses before and after hospitalization (Pre & Post hospitalization)","page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-3"}],"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":"cross-checked","value":"Covered up to sum insured; any treatment needing admission of 2 hours or more is paid, as are dialysis, radiotherapy and chemotherapy.","display":"Covered up to sum insured (admission of 2 hours or more)","note":"No list of day care procedures; admission only for investigations is not paid.","quote":"Admitted for 2 hours or more ... You had Dialysis (Hemo / Peritoneal), Radiotherapy or Chemotherapy for cancer ... Day Care Treatment | Covered up to Sum Insured","sources":[{"clause":"3.2(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-2-a"},{"clause":null,"heading":"Base benefits","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-base-benefits"}],"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":"cross-checked","value":"Yes. Home Care / Domiciliary Treatment is covered up to sum insured when a doctor advises treatment at home with daily monitoring.","display":"Yes, up to sum insured","note":"Pre and post hospitalisation is also paid for home care.","quote":"The medical practitioner advices the insured person to undergo treatment at home ... Home Care / Domiciliary Treatment | Covered up to Sum Insured","sources":[{"clause":"3.9","heading":"Home Care / Domiciliary Treatment","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-9"},{"clause":null,"heading":"Base benefits","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-base-benefits"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"cross-checked","value":"Covered up to sum insured for treatment in an AYUSH Hospital with at least 24 hours' admission.","display":"Up to sum insured; minimum 24 hours admission","note":null,"quote":"NOTE: minimum 24 hours admission in AYUSH Hospital MUST for AYUSH treatment ... AYUSH Treatment | Covered up to Sum Insured","sources":[{"clause":"3.2(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-2-a"},{"clause":null,"heading":"Base benefits","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-base-benefits"}],"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":"cross-checked","value":"Covered up to sum insured, including robotic surgeries, oral chemotherapy, immunotherapy (monoclonal antibody injections), stem cell therapy, deep brain stimulation, intra vitreal injections and others listed.","display":"Covered up to sum insured","note":"Also listed: Uterine Artery Embolization and HIFU, Balloon Sinuplasty, Stereotactic radio Surgeries, Bronchical Thermoplasty, IONM.","quote":"2. Immunotherapy- Monoclonal Antibody to be given as injection | 3. Vaporisation of the prostrate (Green laser treatment or holmium laser treatment) | 4. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions ... 6. Oral Chemotherapy | 7. Robotic surgeries ... 9. Deep Brain stimulation | 10. Intra vitreal injections ... Modern treatments | Covered up to Sum Insured","sources":[{"clause":"3.2(b)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-2-b"},{"clause":null,"heading":"Base benefits","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-base-benefits"}],"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":"cross-checked","value":"Yes. The donor's hospitalisation expenses for harvesting the organ are covered up to sum insured, only when the recipient's hospital admission claim is paid.","display":"Yes, up to sum insured","note":null,"quote":"we will pay the hospitalization expenses of the donor for harvesting the organ ONLY when your Hospital admission claim is paid. ... Organ Donor | Covered up to Sum Insured","sources":[{"clause":"3.4","heading":"Organ donor","page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-4"},{"clause":null,"heading":"Base benefits","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-base-benefits"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"cross-checked","value":"Road ambulance up to Rs. 2,000 and air ambulance up to Rs. 2,50,000 per hospitalisation, only when the hospital admission claim is paid.","display":"Road Rs. 2,000; air Rs. 2,50,000 per hospitalisation","note":"Registered provider required; air ambulance only for Emergency care.","quote":"By road, maximum Rs.2,000 & by air maximum Rs.2,50,000 per hospitalization. Applies ONLY when Hospital admission claim is paid.","sources":[{"clause":"3.1","heading":"Expenses to reach hospital (Ambulance)","page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-1"}],"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":"cross-checked","value":"Yes. An amount equal to the base sum insured is added once a policy year after the first claim is paid, even on partial use, for the same or a different illness.","display":"Yes, equal to base sum insured, once a year","note":"Refill is used after base sum insured and accumulated NCB.","quote":"We will add an amount equal to the base sum insured, after the first claim is paid. This will be added even at partial utilization of base sum insured. ... a) Benefit applies ONLY once in a policy year. ... b) Benefit applies for any illness (same or different).","sources":[{"clause":"3.6","heading":"Refill","page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-6"},{"clause":"3.6(a)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-6-a"},{"clause":"3.6(b)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-6-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":"cross-checked","value":"20% of the expiring base sum insured is added for each claim-free year, up to 100%; a claim does not reduce the bonus already earned.","display":"20% a year, maximum 100%","note":"NCB cannot be carried on migration to another product. A flat INR 49 renewal discount is given in years where NCB is earned.","quote":"For every claim free year, we will add 20% of expiring policy base sum insured as NCB, maximum up to 100%. ... (In case of claim, no reduction in No Claim Bonus)","sources":[{"clause":"3.5","heading":"No Claim Bonus (NCB)","page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-5"},{"clause":null,"heading":"Base benefits","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-base-benefits"}],"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":"cross-checked","value":"Not paid. Items such as gloves, masks, nebulisation kits and other listed items are expenses not covered (Annexure I, List I).","display":"Not covered (Annexure I list)","note":"Other items are subsumed into room, procedure or treatment charges (Lists II to IV).","quote":"List I – Expenses not covered ... 56 | GLOVES ... 57 | NEBULISATION KIT ... 60 | MASK","sources":[{"clause":"5.2.10(iii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-2-10-iii"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"cross-checked","value":"Not covered: childbirth, caesarean, miscarriage and medical termination expenses are excluded (except ectopic pregnancy).","display":"Not covered","note":null,"quote":"Maternity Expenses (Code-Excl18) ... a) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic pregnancy;","sources":[{"clause":"4.1.16","heading":"Maternity Expenses (Code-Excl18)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-1-16"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"cross-checked","value":"No. The policy covers persons aged 91 days and above; the minimum entry age for a dependent child is 91 days.","display":"Not covered from birth; children from 91 days","note":"Maternity expenses are excluded (Excl18). No newborn benefit is printed.","quote":"This policy covers persons in the age group 91 days and above. The minimum entry age for adult is 18 years and for dependent child is 91 days.","sources":[{"clause":null,"heading":"Policy Design","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-policy-design"}],"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":"Mental illness cover is not mentioned in the documents.","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":"cross-checked","value":"Once every policy year from day 1, cashless only, for listed tests up to Rs. 500 per Rs. 1 lac base sum insured (maximum Rs. 5,000 per insured, Rs. 10,000 per floater policy).","display":"Yearly from day 1; Rs. 500 per Rs. 1 lac SI","note":"Tests must be booked through the insurer's app and done within 7 days of each other.","quote":"Available once every Policy Year, from day 1 of the policy. ... This benefit is available ONLY on cashless and no re-imbursement is allowed ... up to Rs. 500 for every Rs. 1L Base Sum Insured (Individual policy: maximum Rs. 5,000 per Insured; Family Floater policy: maximum Rs. 10,000 per policy)","sources":[{"clause":"3.7","heading":"Health Checkup","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-3-7"},{"clause":null,"heading":"Base benefits","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-base-benefits"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"cross-checked","value":"Not covered: any expenses incurred on OPD treatment are excluded.","display":"Not covered","note":"Health check-up and animal bite vaccination are separate benefits.","quote":"Any expenses incurred on OPD treatment.","sources":[{"clause":"4.2.7","heading":null,"page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-4-2-7"}],"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":"cross-checked","value":"Yes. Premium depends on the residential city, in 3 zones (Zone 1 metros such as Delhi and Mumbai, Zone 2 cities such as Pune and Jaipur, Zone 3 rest of India).","display":"Yes, 3 zones by residential city","note":"No zone-based co-payment is printed.","quote":"For the purpose of calculating premium, the country has been divided into the following 3 zones: ... Zone 1: Delhi, Gurgaon, Faridabad, Gautam Buddha Nagar, Ghaziabad, Noida, Surat, Kolkata, Mumbai, Thane ... iii) Zone 3: Rest of India Your premium depends upon your residential city.","sources":[{"clause":"5.2.8","heading":"Zonal pricing","page":21,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-2-8"}],"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 network hospitals; the insurer also offers \"Cashless Everywhere\", including non-network hospitals.","display":"Yes, network hospitals and Cashless Everywhere","note":"The two sentences in the wording contradict each other. Cashless pre-authorisation in 1 hour (CIS) and final authorisation within three hours.","quote":"Cashless claim facility is available at our network hospitals ONLY. ... We offer Cashless Everywhere, even in hospitals which are not part of our network.","sources":[{"clause":"5.2.4(a)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-2-4-a"},{"clause":"5.2.4(e)(ii)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192#c-5-2-4-e-ii"}],"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":"The insurer itself; the prospectus says you deal directly with Niva Bupa, not through third parties.","display":"Niva Bupa directly (no TPA)","note":null,"quote":"You talk to us directly, not through any third parties.","sources":[{"clause":null,"heading":"Health Companion - Start a healthy relationship","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-health-companion-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":"Floater: 1 or 2 adults with up to 4 children; premium on the eldest member's age. Individual policies with 2 or more members get a 10% discount.","quote":"Health Companion’ variant 2022 can be issued to individual customer(s) or to a family with up to 4 children (refer to as family floater).","sources":[{"clause":null,"heading":"Policy Design","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193#c-policy-design"}],"law":[]}],"documents":[{"kind":"wording","label":"Health Companion Policy Wording - Variant 2022","pages":27,"fetched_at":"2026-10-16 07:11:43.525572+00","source_url":"https://transactions.nivabupa.com/pages/doc/policy_wording/Health-Companion-Variant2022-PolicyWording.pdf?v=1.4","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/192"},{"kind":"prospectus","label":"Health Companion Variant 2022 Prospectus","pages":23,"fetched_at":"2026-10-16 07:11:43.525572+00","source_url":"https://transactions.nivabupa.com/pages/doc/prospectus/Health-Companion-Variant-2022-Prospectus-revised_v1.pdf?v=1.6","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/193"},{"kind":"cis","label":"Health Companion","pages":11,"fetched_at":"2026-10-16 07:11:43.525572+00","source_url":"https://transactions.nivabupa.com/pages/doc/Customer-Information/CIS_Health-Companion-Variant-2022-2023.pdf","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526/document/194"}],"versions":[{"uin":"IRDAI/HLT/MBHI/P-H/V.III/2/2017-18","version":null,"approved_on":null},{"uin":"NBHHLIP26051V092526","version":null,"approved_on":null}],"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 Companion (UIN NBHHLIP26051V092526), IndiaInsurances, https://indiainsurances.com/policy/niva-bupa-health-insurance/health-companion-nbhhlip26051v092526"}