{"uin":"NBHHLIP27055V052627","name":"Health Pulse","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627","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":"New","kind":"product","status":"active","approved_on":"2019-04-30","withdrawn_on":null,"summary":"Niva Bupa Health Pulse is an individual or family floater indemnity health policy with a Classic plan (20% co-payment for treatment in Delhi NCR, Mumbai, Kolkata and Gujarat) and an Enhanced plan (no co-payment), for Base Sum Insured of Rs 3 lakh to 25 lakh. It adds Loyalty Additions of 10% a year up to 100%, a Re-fill of up to 100% of Base Sum Insured, and has 30-day, 24-month and 36-month waiting periods.","analysis":{"state":"extracted","analysed_at":"2026-10-16 07:11:58.55705+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":["Classic plan","Enhanced plan"],"display":"Classic plan, Enhanced plan","note":"The plans differ in co-payment only; room rent, ICU and ambulance limits differ by sum insured band, not by plan.","quote":"There are 2 plans under the product ... a) Classic plan where 20% co-payment applicable for treatments undertaken in in Delhi NCR, Mumbai (including Navi Mumbai and Thane), Kolkata and Gujarat; ... b) Enhanced plan where there is no co-payment.","sources":[{"clause":null,"heading":"Coverage Options","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/199#c-coverage-options"}],"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":"Multi-year terms carry a term discount: 7.5% on the second year premium; 15% on the third year plus 7.5% on the second for a 3 year term.","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. ... o 2 year term: 7.5% on the premium for second policy year o 3 year term: 15% on the premium for third policy year + 7.5% on the premium for second policy year","sources":[{"clause":null,"heading":"Policy Design","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/199#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: written notice within 48 hours of admission or before discharge, whichever is earlier. Cashless: pre-authorisation at least 72 hours before planned treatment, or within 48 hours of emergency admission or before discharge, whichever is earlier.","display":"Within 48 hours of admission (or before discharge, if earlier); 72 hours before planned treatment for cashless","note":"Optional Critical Illness Cover: written notice within 7 days of diagnosis or surgery. Delay is 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. ... then 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":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-b-2"},{"clause":"7.2(XII)(a)(i)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-a-i"},{"clause":"4.2(II)(d)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-4-2-ii-d-3"},{"clause":"7.2(XII)(e)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-e-3"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"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 (Non-Network provider)","Original bills of pharmacy/medicines purchased","MLC/ Panchnama / First Information Report (FIR) copy, for Accident cases","Original laboratory investigation, diagnostic, radiological & pathological reports with supporting prescriptions"],"display":"Claim form, discharge summary, final bill, reports, ID proof, bank details and others","note":"Optional Personal Accident claims also need a death certificate and post mortem report, or a disability certificate from a Medical Board; Critical Illness claims need the doctor's certificate of survival past the survival period.","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 (in case of a Non-Network provider ... i) Original bills of pharmacy/medicines purchased ... j) For Medico-legal cases (MLC) or in case of Accident ... i) MLC/ Panchnama / First Information Report (FIR) copy ... k) Original laboratory investigation, diagnostic, radiological & pathological reports with supporting prescriptions. ... i) Copy of death certificate ... ii) Copy of post mortem report wherever applicable ... i. Certificate of disability issued by a Medical Board ... 1. Treating Medical Practitioner’s certification for insured person’s survival post survival period.","sources":[{"clause":"7.2(XII)(a)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-a-3"},{"clause":"7.2(XII)(b)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-b-3"},{"clause":"7.2(XII)(c)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-c-2"},{"clause":"7.2(XII)(d)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-d-2"},{"clause":"7.2(XII)(e)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-e-2"},{"clause":"7.2(XII)(f)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-f"},{"clause":"7.2(XII)(g)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-g"},{"clause":"7.2(XII)(h)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-h"},{"clause":"7.2(XII)(i)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-i"},{"clause":"7.2(XII)(j)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-j"},{"clause":"7.2(XII)(k)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-k"},{"clause":"7.2(XII)(k)(i)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-k-i"},{"clause":"7.2(XII)(k)(ii)","heading":null,"page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-k-ii"}],"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; if payment is delayed it pays interest at 2% above the bank rate from claim intimation.","display":"Within 15 days of claim submission","note":"Cashless discharge authorisation is processed within three hours of the final documents; any extra hospital charge from delay is borne by the insurer.","quote":"I. The Company shall settle or reject a claim, as the case may be, within 15 days from the claim submission date. ... 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. ... Once the final authorization request is received for discharge, the same will be processed within three hours from the final documents received. In case of delay from our end, any additional amount charged by the hospital will be borne by us.","sources":[{"clause":"7.1(IX)","heading":null,"page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-1-ix"},{"clause":"7.2(XII)(a)(i)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#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 diseases and procedures until 24 months of continuous coverage (Excl02)","Any illness in the first 30 days, except accidents (Excl03)","Personal Waiting Period conditions in the Policy Schedule for 48 months","Investigation & Evaluation (Excl04)","Rest cure, rehabilitation and respite care (Excl05)","Obesity/ Weight Control surgery not meeting the conditions (Excl06)","Change-of-Gender treatments (Excl07)","Cosmetic or plastic Surgery (Excl08)","Hazardous or Adventure sports (Excl09)","Alcoholism, drug or substance abuse (Excl12)","Sterility and Infertility (Excl17)","Maternity (Excl18)","Dental/oral treatment, except while hospitalised due to an Accident","Any treatment or medical services received outside India"],"display":"Waiting periods, standard IRDAI exclusions, maternity, dental, treatment outside India and others","note":"Full list in Section 6 of the wording; non-payable items are listed in Annexure II.","quote":"I) Pre-existing Diseases (Code–Excl01): ... shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first Policy. ... II) Specified disease/procedure Waiting Period (Code–Excl02): ... shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy. ... III. 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 ... IV. Investigation & Evaluation (Code-Excl04) ... V. Rest Cure, rehabilitation and respite care (Code-Excl05) ... VI. Obesity/ Weight Control (Code-Excl06) Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions: ... VII. Change-of-Gender treatments (Code-Excl07) ... VIII. Cosmetic or plastic Surgery (Code-Excl08) ... IX. Hazardous or Adventure sports (Code-Excl09) ... XII. Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code-Excl12) ... XVII. Sterility and Infertility (Code-Excl17) ... XVIII. Maternity (Code-Excl18) ... I) Personal Waiting Periods Conditions specified for an Insured Person under Personal Waiting Period in the Policy Schedule will be subject to a Waiting Period of 48 months ... Treatment, procedures and preventive, diagnostic, restorative, cosmetic services related to disease, disorder and conditions related to natural teeth and gingiva 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.","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-1"},{"clause":"6.1(II)(d)(ii)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-1-ii-d-ii"},{"clause":"Excl14","heading":null,"page":26,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-excl14"},{"clause":"6.2(I)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-i"},{"clause":"6.2(VI)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-vi"},{"clause":"6.2(XI)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-xi"}],"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":"First contact Niva Bupa customer services (website www.nivabupa.com, toll free 1860-500-8888, e-mail 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 Grievance Officer, then GRO@nivabupa.com","note":"Grievances can also be lodged on IRDAI's Bima Bharosa portal. Senior citizens may write to seniorcitizensupport@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 ... insured person may contact the grievance officer at Head – Customer Services Niva Bupa Health Insurance Company Limited ... If the Insured person is not satisfied with the above, they can escalate to GRO@nivabupa.com. ... the insured person may also approach the office of lnsurance Ombudsman","sources":[{"clause":"7.1(VIII)","heading":null,"page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#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 per policy year of Rs 3L, 4L, 5L, 7.5L, 10L, 15L, 20L or 25L.","display":"Rs 3 lakh to 25 lakh (3L/4L/5L/7.5L/10L/15L/20L/25L)","note":"Loyalty Additions can raise the Sum Insured above the Base Sum Insured.","quote":"The Sum Insured ranges from Rs.3L to 25L. ... Base Sum Insured (SI) per Policy Year (in Lacs) | 3L/4L | 5L/7.5L/10L/ 15L/20L/25L","sources":[{"clause":null,"heading":"Coverage Options","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/199#c-coverage-options"},{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#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":"Accidents covered from day 1. Optional Critical Illness Cover has its own 90-day initial waiting period.","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. ... ii. 90-day Initial waiting period:","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-1"},{"clause":"4.2(II)(d)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-4-2-ii-d-2"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"cross-checked","value":{"unit":"months","amount":36},"display":"36 months","note":"Applies afresh to any Sum Insured increase. Conditions named as Personal Waiting Period in the Policy Schedule wait 48 months.","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. ... will be subject to a Waiting Period of 48 months from the inception of the First Policy","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-1"},{"clause":"6.2(I)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-i"}],"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. HIV / AIDS benefit has a 36 month waiting period (the CIS says 48 months). Personal Waiting Period conditions: 48 months.","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). ... This benefit is provided subject to a Waiting Period of 36 months from inception of the cover with Us, with HIV / AIDS covered as a benefit ... will be subject to a Waiting Period of 48 months from the inception of the First Policy ... HIV / AIDS benefit is provided subject to a waiting period of 48 months from inception of the cover.","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-1"},{"clause":"3.14","heading":"HIV / AIDS","page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-14"},{"clause":"6.2(I)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-i"},{"clause":"15","heading":"Spinal disorders","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/200#c-15"}],"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, cataract, prostate, hernia, joint and spine disorders, benign tumours and others","note":null,"quote":"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 condi-tion 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","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#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 part.","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. ... Wherever, the sum insured is enhanced, completion of sixty continuous months would applicable from the date of enhancement of sums insured only on the enhanced limits.","sources":[{"clause":"7.1(X)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-1-x"}],"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, transferring credit for Sum Insured, No Claim Bonus, specific and pre-existing disease waiting periods and moratorium.","display":"Yes, with waiting-period credit","note":"Migration to another Niva Bupa policy carries the same credits.","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.","sources":[{"clause":"7.1(XV)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-1-xv"}],"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, lifetime renewability","note":"A child who has completed age 26 at renewal 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. ... 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 Pulse","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/199#c-health-pulse"},{"clause":"7.1(III)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-1-iii"},{"clause":"7.2(III)(d)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#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. Renewal premium is not loaded for individual claims experience.","display":"No loading for claims","note":"Premium changes with age band; a risk loading of up to 50% may apply at inception based on health disclosures.","quote":"No loading shall apply on renewals based on individual claims experience. ... An insurer shall not deny the renewal of a health insurance policy on the ground that the insured had made a claim or claims in the preceding policy years ... The maximum risk loading applicable shall not exceed 50%. ... the renewal premium may vary from one policy period to another on account of Insured Person attaining a higher age band","sources":[{"clause":"7.1(III)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-1-iii"},{"clause":"7.2","heading":"Specific Terms and Clauses","page":34,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2"},{"clause":"7.1(VI)","heading":null,"page":31,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#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 (Excl12)","Health hydros, nature cure clinics, spas (Excl13)","Dietary supplements bought without prescription (Excl14)","Refractive Error below 7.5 dioptres (Excl15)","Unproven Treatments (Excl16)","Sterility and Infertility (Excl17)","Maternity (Excl18)","Ancillary Hospital Charges (RMO charges, surcharges, service charges)","Circumcision unless for disease or Accident","Conflict & Disaster (nuclear, war, terrorism)","External Congenital Anomaly","Dental/oral treatment, except while hospitalised due to an Accident","Hormone Replacement Therapy","Multifocal Lens and ambulatory devices","Sexually transmitted infections & diseases (other than HIV / AIDS)","Sleep disorders","Treatment outside the geographical limits of India","Unrecognized Physician or Hospital","Artificial life maintenance for brain dead or vegetative state","AYUSH Treatment, except as under Section 3.6"],"display":"Standard exclusions Excl04 to Excl18 plus the policy's own specific exclusions","note":"Excl14 quoted from the prospectus because the wording splits its code across a page break. Optional Personal Accident and Critical Illness covers have their own exclusion lists (Section 6.2 XV and XVI).","quote":"IV. Investigation & Evaluation (Code-Excl04) ... V. Rest Cure, rehabilitation and respite care (Code-Excl05) ... VI. Obesity/ Weight Control (Code-Excl06) ... VII. Change-of-Gender treatments (Code-Excl07) ... VIII. Cosmetic or plastic Surgery (Code-Excl08) ... IX. Hazardous or Adventure sports (Code-Excl09) ... X. Breach of law (Code-Excl10) ... XI. Excluded Providers (Code-Excl11) ... XII. 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 or similar establishments ... (Code-Excl13) ... Dietary supplements and substances that can be purchased without prescription ... (Code-Excl14) ... XV. Refractive Error (Code-Excl15) Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres. ... XVI. Unproven Treatments (Code-Excl16) ... XVII. Sterility and Infertility (Code-Excl17) ... XVIII. Maternity (Code-Excl18) ... II) Ancillary Hospital Charges Charges related to a Hospital stay not expressly mentioned as being covered. This will include RMO charges, surcharges ... Circumcision unless necessary for the treatment of a disease or necessitated by an Accident. ... IV) Conflict & Disaster: ... Treatment for any Injury or Illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations ... acts of terrorism. ... Screening, counseling or treatment related to external Congenital Anomaly. ... VI) Dental/oral treatment: ... except if required by an Insured Person while Hospitalized due to an Accident. ... 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) Unrecognized Physician or Hospital: ... XIII) Artificial life maintenance for the Insured Person who has been declared brain dead or in vegetative state ... XIV) AYUSH Treatment Any form of AYUSH Treatments, except as mentioned under Section 3.6","sources":[{"clause":"6.1","heading":"Standard Exclusions","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-1"},{"clause":"6.1(II)(d)(ii)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-1-ii-d-ii"},{"clause":"Excl14","heading":null,"page":26,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-excl14"},{"clause":"Excl12","heading":"Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","page":22,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/199#c-excl12"},{"clause":"6.2(II)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-ii"},{"clause":"6.2(III)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-iii"},{"clause":"6.2(IV)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-iv"},{"clause":"6.2(V)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-v"},{"clause":"6.2(VI)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-vi"},{"clause":"6.2(VII)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-vii"},{"clause":"6.2(VIII)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-viii"},{"clause":"6.2(IX)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-ix"},{"clause":"6.2(X)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-x"},{"clause":"6.2(XI)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-xi"},{"clause":"6.2(XII)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-xii"},{"clause":"6.2(XIII)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-xiii"},{"clause":"6.2(XIV)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-xiv"}],"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":"You may cancel at any time with 7 days' written notice. For a policy term up to one year with no claim, proportionate premium for the unexpired period is refunded; for longer terms, premium for policy years not yet started is refunded.","display":"Proportionate refund for unexpired period if no claim (7 days' notice)","note":"The prospectus prints point (a) twice and omits the multi-year refund rule.","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 up to 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","sources":[{"clause":"7.1(II)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-1-ii"}],"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 only and claims are payable in Indian Rupees.","display":"India only","note":"Optional Personal Accident Cover applies to accidents at any location worldwide.","quote":"VIII) Territorial Jurisdiction 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. ... 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":35,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-iv-c"},{"clause":"6.2(XI)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-6-2-xi"},{"clause":"4.1","heading":"Personal Accident Cover","page":15,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Not on renewals. Refund less proportionate risk premium, medical examination costs and stamp duty.","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. ... The Free Look Period shall be applicable on individual health insurance policies and not on renewals. ... 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":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-1-i"}],"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":"The definition of Grace Period says fifteen days where premium is paid monthly; no monthly mode is described for this product.","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. ... fifteen days where premium payment mode is monthly and thirty days in all other cases.","sources":[{"clause":"7.1(III)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-1-iii"},{"clause":"2.1(XIV)","heading":"Grace Period","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-2-1-xiv"}],"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 to 65 years (last birthday); dependent children from 91 days to 25 years.","display":"Adults 18 to 65 years; children 91 days to 25 years","note":"Children who complete 26 years must move to a separate policy at renewal.","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.","sources":[{"clause":null,"heading":"Policy Design","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/199#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":"No premium payment frequency is described; the renewal clause mentions only a 30 day grace period for 'annual installment'.","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","e-Consultation","Hospital Cash","Enhanced Loyalty Additions","Enhanced Re-fill Benefits"],"display":"Personal Accident, Critical Illness, e-Consultation, Hospital Cash, Enhanced Loyalty Additions, Enhanced Re-fill","note":"PA: 5 times Base Sum Insured up to Rs 50 lakh. CI: equal to Base Sum Insured up to Rs 10 lakh (20 illnesses, 30 day survival). Hospital Cash: Rs 1,000 or 2,000 per day up to 30 days. Enhanced Loyalty Additions: 20% a year up to 200%. Enhanced Re-fill: 150%.","quote":"Optional Benefits (which may be added at customer level at an additional premium) ... Personal Accident cover -Accident Death -Accident Permanent Total Disability (125 % of PA cover SI) -Accident Permanent Partial Disability | Personal Accident cover will be equal to 5 times of Base Sum Insured; maximum up to Rs. 50 Lac ... Critical Illness Cover | Critical illness cover will be equal to Base Sum Insured; maximum up to Rs. 10 Lac ... e-Consultation | Unlimited tele / online consultations ... Hospital Cash (2) | For Base Sum Insured of 5 Lac and below: Rs. 1,000 per day; For Base Sum Insured greater than 5 Lac: Rs. 2,000 per day ... Enhanced Loyalty Additions | Increase of 20% of expiring Base Sum Insured in a Policy Year; maximum up to 200% of Base Sum Insured ... Enhanced Re-fill Benefits(3) | Re-fill up to 150% of Base Sum Insured","sources":[{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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":"Not if you renew after the due date: the policy says coverage need not be available for the period for which no premium is received, and the prospectus says to renew on or before the renewal date to stay covered during the grace period.","display":"No cover in the grace period unless renewed by the renewal date","note":"Renewal within the 30 day grace period keeps continuity of waiting-period credit.","quote":"You should renew on or before the renewal date of the policy to ensure you have continued medical insurance cover even during the grace period. ... Coverage need not be available during the period for which no premium is received.","sources":[{"clause":null,"heading":"Health Pulse","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/199#c-health-pulse"},{"clause":"2.1(XIV)","heading":"Grace Period","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-2-1-xiv"}],"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":"Base Sum Insured 3L/4L: up to 1% of Base Sum Insured per day or a Single Private Room, whichever is lower. Base Sum Insured 5L and above: Single Private Room. Same in Classic and Enhanced plans.","display":"1% of Base Sum Insured per day or Single Private Room, whichever is lower (3L/4L); Single Private Room (5L and above)","note":"A costlier room leads to proportionate deduction of associated medical expenses.","quote":"Base Sum Insured (SI) per Policy Year (in Lacs) | 3L/4L | 5L/7.5L/10L/ 15L/20L/25L ... Room Rent (per day) | Up to 1% of Base Sum Insured per day or Single Private Room, whichever is lower | Single Private Room","sources":[{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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":"Single Private Room for Base Sum Insured 5L and above; for 3L/4L, a Single Private Room capped at 1% of Base Sum Insured per day.","display":"Single Private Room (capped at 1% of Base SI per day for 3L/4L)","note":null,"quote":"Base Sum Insured (SI) per Policy Year (in Lacs) | 3L/4L | 5L/7.5L/10L/ 15L/20L/25L ... Room Rent (per day) | Up to 1% of Base Sum Insured per day or Single Private Room, whichever is lower | Single Private Room ... Single Private Room means an air conditioned room in a Hospital where a single patient is accommodated and which has an attached toilet (lavatory and bath).","sources":[{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"},{"clause":"2.2(VII)(c)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-2-2-vii-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":"cross-checked","value":"Base Sum Insured 3L/4L: up to 2% of Sum Insured per day. Base Sum Insured 5L and above: covered up to Sum Insured.","display":"2% of Sum Insured per day (3L/4L); up to Sum Insured (5L and above)","note":null,"quote":"Base Sum Insured (SI) per Policy Year (in Lacs) | 3L/4L | 5L/7.5L/10L/ 15L/20L/25L ... Intensive Care Unit charges | Up to 2% of Sum Insured per day | Covered up to Sum Insured","sources":[{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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 the room category or Room Rent is above the eligible limit, only a pro-rated share of the total Associated Medical Expenses (Room Rent, nursing, doctors' fees, operation theatre) is paid: eligible Room Rent limit / Room Rent actually incurred.","display":"Yes, associated medical expenses cut in proportion","note":null,"quote":"If the Insured Person is admitted in a Hospital room where the room category opted or Room Rent incurred is higher than the eligibility as specified in the Policy Schedule, then We shall be liable to pay only a pro-rated portion of the total Associated Medical Expenses (including surcharge or taxes thereon) as per the following formula: (eligible Room Rent limit / Room Rent actually incurred) * total Associated Medical Expenses ... Associated Medical Expenses shall include Room Rent, nursing charges, Medical Practitioners’ fees and operation theatre charges","sources":[{"clause":"3.1","heading":"Inpatient Care","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-1"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"cross-checked","value":"Classic plan: 20% co-payment on claims for treatment in Delhi NCR, Mumbai (including Navi Mumbai and Thane), Kolkata and Gujarat. Enhanced plan: no co-payment.","display":"20% in Delhi NCR, Mumbai, Kolkata and Gujarat (Classic plan); none (Enhanced plan)","note":"Not applied to ambulance, pharmacy, health check-up or optional benefit claims.","quote":"A 20% Co-payment will apply under Classic plan available under the product for treatment in Delhi NCR, Mumbai (including Navi Mumbai and Thane), Kolkata & Gujarat State. ... Co-payment will not apply to any claim under Section 3.8 (Emergency Ambulance) ... Co-Payment | 20% co-payment applicable for treatment in Delhi NCR, Mumbai (including Navi Mumbai and Thane), Kolkata and Gujarat. | No co-payment","sources":[{"clause":"5","heading":"Claim Cost Sharing","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-5"},{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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":"No deductible.","display":"None","note":"From the CIS; the wording has no deductible clause.","quote":"iii. Annual Aggregate Deductible - NA","sources":[{"clause":"15","heading":"Spinal disorders","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/200#c-15"}],"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":["Cataract: Mono focal lens only for Sum Insured up to 10 lacs","Listed mental disorders: 10% of Base Sum Insured or Rs. 50,000, whichever is lower","HIV / AIDS: 10% of Base Sum Insured or Rs. 50,000, whichever is lower","Robotic surgeries: INR 1 Lac, except listed robotic surgeries"],"display":"Cataract lens, listed mental disorders, HIV / AIDS, robotic surgeries","note":"Robotic exceptions: radical prostatectomy, cardiac, partial nephrectomy and malignancy surgeries. Mental disorder sub-limit covers severe depression, schizophrenia, bipolar disorder and other listed conditions.","quote":"e) Cataract: We will pay only for Mono focal lens for Sum Insured up to 10 lacs ... a) The following disorders / conditions shall be covered only up to 10% of Base Sum Insured or Rs. 50,000, whichever is lower. ... a) This benefit is covered up to 10% of Base Sum Insured or Rs. 50,000 whichever is lower. ... A limit of maximum INR 1 Lac will apply to all robotic surgeries, except the following: ... i) Robotic total radical prostatectomy ... ii) Robotic cardiac surgeries ... iii) Robotic partial nephrectomy ... iv) Robotic surgeries for malignancies","sources":[{"clause":"3.1","heading":"Inpatient Care","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-1"},{"clause":"3.13(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-13-a-3"},{"clause":"3.14","heading":"HIV / AIDS","page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-14"},{"clause":"3.15(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-15-b"}],"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":30},"display":"30 days","note":"Reimbursement only.","quote":"We will pay above mentioned Pre-hospitalization Medical Expenses only for period up to 30 days immediately preceding the Insured Person’s admission ... We will indemnify, on Reimbursement basis only, the Insured Person’s Pre-hospitalization Medical Expenses","sources":[{"clause":"3.2(a)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-2-a-2"},{"clause":"3.2","heading":"Pre-hospitalization Medical Expenses","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-2"}],"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":60},"display":"60 days","note":"Reimbursement only. The CIS misprints it as 60 days 'preceding' the hospitalization.","quote":"We will pay Post-hospitalization Medical Expenses only for period up to 60 days immediately following the Insured Person’s discharge ... We will indemnify, on Reimbursement basis only, the Insured Person’s Post-hospitalization Medical Expenses ... Post-hospitalization medical expenses- up to 60 days immediately preceding the hospitalization","sources":[{"clause":"3.3","heading":"Post-hospitalization Medical Expenses","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-3"},{"clause":"15","heading":"Spinal disorders","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/200#c-15"}],"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, but only the day care treatments listed in Annexure IV.","display":"Listed day care treatments only (Annexure IV), up to Sum Insured","note":"OPD treatment and diagnostic costs are not covered under this benefit.","quote":"Only those Day Care Treatments are covered that are mentioned under list of Day Care Treatments under Annexure IV. ... Day Care Treatment | Covered up to Sum Insured ... OPD Treatment and Diagnostic Services costs are not covered under this benefit.","sources":[{"clause":"3.4","heading":"Day Care Treatment","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-4"},{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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":"Covered up to Sum Insured on reimbursement basis when treatment at home lasts at least 3 consecutive days and the doctor confirms the patient could not be moved to hospital or no hospital bed was available.","display":"Yes, up to Sum Insured (at least 3 days)","note":null,"quote":"We will indemnify on Reimbursement basis only, the Medical Expenses incurred for the Insured Person’s Domiciliary Hospitalization ... a) The Domiciliary Hospitalization continues for at least 3 consecutive days ... b) The treating Medical Practitioner confirms in writing that the Insured Person’s condition was such that the Insured Person could not be transferred to a Hospital OR the Insured Person satisfies Us that a Hospital bed was unavailable. ... Domiciliary Treatment | Covered up to Sum Insured","sources":[{"clause":null,"heading":"Domiciliary Hospitalization","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-domiciliary-hospitalization"},{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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":"In-patient treatment under Ayurveda, Unani, Siddha and Homeopathy in an AYUSH Hospital is covered up to Sum Insured, with 30 days pre- and 60 days post-hospitalisation; Yoga and Naturopathy claims need prior approval.","display":"Yes, up to Sum Insured in an AYUSH Hospital","note":null,"quote":"We will indemnify the Medical Expenses incurred on the Insured Person’s Hospitalization for Inpatient Care during the Policy Period on treatment taken under Ayurveda, Unani, Siddha and Homeopathy. ... a) The treatment should be taken in AYUSH Hospital: ... Pre-hospitalization Medical Expenses incurred for up to 30 days immediately preceding the Insured Person’s admission and Post-hospitalization Medical Expenses incurred for up to 60 days ... c) Claims under Yoga and Naturopathy system of treatment will be payable subject to prior approval from the Insurance Company. ... Alternative Treatment | Covered up to Sum Insured","sources":[{"clause":"3.6","heading":"Alternative Treatments","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-6"},{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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 as in-patient or day care: UAE and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, immunotherapy, intra vitreal injections, robotic surgeries, stereotactic radio surgeries, bronchial thermoplasty, prostate vaporisation, IONM and stem cell therapy. Robotic surgeries are capped at INR 1 Lac except radical prostatectomy, cardiac, partial nephrectomy and malignancy surgeries.","display":"Covered up to Sum Insured; most robotic surgeries capped at Rs 1 Lac","note":null,"quote":"i) Uterine Artery Embolization and HIFU (High intensity focused ultrasound) ... ii) Balloon Sinuplasty ... iii) Deep Brain stimulation ... iv) Oral chemotherapy ... v) Immunotherapy- Monoclonal Antibody to be given as injection ... vi) Intra vitreal injections ... vii) Robotic surgeries ... viii) Stereotactic radio surgeries ... ix) Bronchical Thermoplasty ... x) Vaporisation of the prostrate (Green laser treatment or holmium laser treatment) ... xi) IONM - (Intra Operative Neuro Monitoring) ... xii) Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered. ... A limit of maximum INR 1 Lac will apply to all robotic surgeries, except the following: ... i) Robotic total radical prostatectomy ... ii) Robotic cardiac surgeries ... iii) Robotic partial nephrectomy ... iv) Robotic surgeries for malignancies ... Modern Treatments | Covered up to Sum Insured with sub-limit of Rs. 1Lac on few robotic surgeries","sources":[{"clause":"3.15(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-15-a"},{"clause":"3.15(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-15-b"},{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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 living donor's in-patient costs for harvesting the organ are covered up to Sum Insured; donor pre- and post-hospitalisation costs are not.","display":"Yes, up to Sum Insured","note":"Recipient's claim must be accepted under Inpatient Care; organ transport and preservation excluded.","quote":"We will indemnify the Medical Expenses incurred for a living organ donor’s treatment as an Inpatient for the harvesting of the organ donated. ... b) Pre-hospitalization Medical Expenses or Post-hospitalization Medical Expenses of the organ donor. ... Living Organ Donor Transplant | Covered up to Sum Insured ... c) We have accepted the recipient Insured Person’s claim under Section 3.1 (Inpatient Care). ... e) Expenses related to organ transportation or preservation.","sources":[{"clause":"3.7","heading":"Living Organ Donor Transplant","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-7"},{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"cross-checked","value":"Road ambulance in an emergency, one transfer per hospitalisation: up to Rs.1,500 per hospitalisation for Base Sum Insured 3L/4L and Rs.2,000 for 5L and above.","display":"Road ambulance up to Rs.1,500 (3L/4L) or Rs.2,000 (5L and above) per hospitalisation","note":"No air ambulance. Paid only if the in-patient claim is accepted.","quote":"We will indemnify the costs incurred, on transportation of the Insured Person by road Ambulance to a Hospital for treatment in an Emergency following an Illness or Injury. ... c) This benefit is available for only one transfer per Hospitalization. ... Base Sum Insured (SI) per Policy Year (in Lacs) | 3L/4L | 5L/7.5L/10L/ 15L/20L/25L ... Emergency Ambulance | Up to Rs.1,500 per hospitalization | Up to Rs.2,000 per hospitalization","sources":[{"clause":"3.8","heading":"Emergency Ambulance","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-8"},{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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. If the Base Sum Insured and Loyalty Additions are partly or fully used up, a Re-fill of up to 100% of Base Sum Insured is available for later claims in that policy year, but not for an illness already claimed for that person in the year. Unused Re-fill does not carry forward.","display":"Up to 100% of Base Sum Insured; not for the same illness","note":"Optional Enhanced Re-fill Benefit raises it to 150% of Base Sum Insured. A single claim cannot exceed Base Sum Insured plus Loyalty Additions.","quote":"then We will provide a Re-fill amount of maximum up to 100% of the Base Sum Insured (excluding Loyalty Additions) which may be utilized for claims arising in that Policy Year ... a) The Re-fill amount may be used for only subsequent claims in respect of the Insured Person and shall not be for any Illness / Injury (including its complications or follow up) for which a claim has been paid or accepted as payable in the current Policy Year for the same Insured Person. ... c) If the Re-fill amount is not utilized in whole or in part in a Policy Year, it cannot be carried forward to any extent in any subsequent Policy Year. ... the Re-fill benefit stated in Section 3.11 shall become 150% of Base Insured instead of 100% of Base Sum Insured ... d) The maximum liability for a single claim after applying Re-fill benefit shall not be more than Base Sum Insured and accumulated Loyalty Additions (if any).","sources":[{"clause":"3.11","heading":"Re-fill Benefit","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-11"},{"clause":"4.6","heading":"Enhanced Re-fill Benefit","page":23,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-4-6"}],"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":"Loyalty Additions: at every policy anniversary 10% of the previous year's Base Sum Insured is added, up to a maximum of 100% of Base Sum Insured; sub-limits do not increase.","display":"10% of Base Sum Insured a year, up to 100%","note":"The base benefit is not tied to claim-free years. Optional Enhanced Loyalty Additions: 20% for every claim-free policy year, up to 200%.","quote":"a) Upon every completion of policy year, at the policy anniversary, 10% of the previous year’s Base Sum insured will be provided as Loyalty Additions subject to a maximum of 100% of the Base Sum Insured. ... b) There will be no change in the sub-limits of any benefit due to increase in Sum Insured under this benefit. ... the Loyalty Additions stated in Section 3.10 (a) shall automatically increase to 20% of Base Insured for every claim free Policy Year and the maximum Loyalty Additions shall not exceed 200% of the Base Sum Insured.","sources":[{"clause":"3.10(a)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-10-a"},{"clause":"3.10(b)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-10-b"},{"clause":"4.5","heading":"Enhanced Loyalty Additions","page":23,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-4-5"}],"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":"Allowable consumables are paid as part of hospitalisation, but items on Annexure II List I of expenses not covered (such as gloves, masks, diapers) are not paid.","display":"Allowable consumables paid; listed items such as gloves and masks not paid","note":null,"quote":"v) Intravenous fluids, blood transfusion, injection administration charges, allowable consumables and/or enteral feedings; ... Annexure II - The expenses that are not covered or subsumed into room charges / procedure charges / costs of treatment List I – Expenses not covered ... 17 | DIAPER OF ANY TYPE ... 56 | GLOVES ... 60 | MASK","sources":[{"clause":"3.1","heading":"Inpatient Care","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-1"},{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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 expenses (including caesarean) and miscarriage or lawful termination are excluded, except ectopic pregnancy.","display":"Not covered (except ectopic pregnancy)","note":null,"quote":"XVIII. Maternity (Code-Excl18) ... a) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic pregnancy; ... b) Expenses towards miscarriage (unless due to an Accident) and lawful medical termination of pregnancy during the Policy Period.","sources":[{"clause":"Excl14","heading":null,"page":26,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-excl14"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"not-stated","value":null,"display":null,"note":"No newborn cover is described. Dependent children can enter from 91 days; maternity is excluded.","quote":null,"sources":[],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"cross-checked","value":"In-patient treatment of Mental Illness is covered up to Sum Insured; listed disorders (severe depression, schizophrenia, bipolar disorder and others) are limited to 10% of Base Sum Insured or Rs. 50,000, whichever is lower, together.","display":"Covered up to Sum Insured; listed disorders capped at 10% of Base SI or Rs. 50,000","note":"Diagnosis by a psychiatrist or clinical psychologist; self-inflicted injury and substance disorders excluded.","quote":"We will indemnify the expenses incurred by the Insured Person for Inpatient treatment for Mental Illness up to the limit as specified in Your Policy Schedule. ... a) The following disorders / conditions shall be covered only up to 10% of Base Sum Insured or Rs. 50,000, whichever is lower. This sub-limit shall apply for all the following disorders / conditions on cumulative basis. ... Severe Depression | ... Schizophrenia | ... Bipolar Disorder | ... Mental Disorders Treatment | Covered up to Sum Insured (sub-limit applicable on few conditions)","sources":[{"clause":"3.13","heading":"Mental Disorders Treatment","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-13"},{"clause":"3.13(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-13-a-3"},{"clause":"Annexure I","heading":"List of Insurance Ombudsmen","page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-annexure-i"}],"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":"One health check-up each policy year from the 2nd policy year, cashless at empanelled providers, for adults: Complete Blood Count, Urine Routine, ESR, HBA1C, S Cholesterol, Sr. HDL, Sr LDL and Kidney Function Test.","display":"Annual, from 2nd policy year (adults)","note":"Unused check-up does not carry forward.","quote":"the Insured Person may avail a health check-up, each Policy Year starting from 2nd Policy Year, on Cashless Facility basis. ... a) Health check-up will be arranged only at Service Providers empanelled with Us. ... b) Health check-up shall be available to Insured Person covered as adult under the Policy. ... e) The tests covered under this benefit are Complete Blood Count, Urine Routine, ESR, HBA1C, S Cholesterol, Sr. HDL, Sr LDL and Kidney Function Test.","sources":[{"clause":"3.12","heading":"Health Check-up","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-3-12"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"not-stated","value":null,"display":null,"note":"No out-patient cover is described; the Day Care benefit says OPD treatment is not covered under it. Optional e-Consultation offers unlimited tele / online consultations; the Pharmacy and Diagnostic Services feature is at the customer's own cost.","quote":null,"sources":[],"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 for co-payment: under the Classic plan a 20% co-payment applies to treatment in Delhi NCR, Mumbai (including Navi Mumbai and Thane), Kolkata and Gujarat. No zone-based premium is described.","display":"Classic plan co-pay depends on city of treatment","note":"Enhanced plan has no co-payment.","quote":"A 20% Co-payment will apply under Classic plan available under the product for treatment in Delhi NCR, Mumbai (including Navi Mumbai and Thane), Kolkata & Gujarat State.","sources":[{"clause":"5","heading":"Claim Cost Sharing","page":24,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-5"}],"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 Providers after pre-authorisation; the policy also says 'Cashless Everywhere' is offered in hospitals not in the network.","display":"Yes, at network hospitals; also 'Cashless Everywhere' at non-network hospitals","note":"The wording says both 'only at Our Network Providers' and 'Cashless Everywhere'; pre- and post-hospitalisation are reimbursement only.","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.","sources":[{"clause":"7.2(XII)(a)","heading":"For Availing Cashless Facility","page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-a-2"},{"clause":"7.2(XII)(a)(ii)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-a-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 (Niva Bupa) handles claims itself; no TPA is named.","display":"Niva Bupa directly","note":null,"quote":"You talk to us directly, not through any third parties. ... For Hospitalization on a Cashless Facility basis, We will make the payment of the amount assessed to be due, directly to the Network Provider / Service Provider.","sources":[{"clause":null,"heading":"Health Pulse","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/199#c-health-pulse"},{"clause":"7.2(XII)(a)(i)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-7-2-xii-a-i"}],"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":"Up to 6 members, of whom up to 4 children; self, spouse and children under 25 at entry.","quote":"Family Floater Policy means a Policy described as such in the Policy Schedule where the family members (two or more) named in the Policy Schedule are Insured Persons under this Policy. ... ‘Health Pulse’ product can be issued to an individual customer or to a family with up to 4 children (referred to as a ‘family floater’ policy). ... 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.","sources":[{"clause":"2.2","heading":"Specific Definitions","page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198#c-2-2"},{"clause":null,"heading":"Policy Design","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/199#c-policy-design"}],"law":[]}],"documents":[{"kind":"wording","label":"Health Pulse Policy Wording","pages":63,"fetched_at":"2026-10-16 07:11:44.102292+00","source_url":"https://transactions.nivabupa.com/pages/doc/policy_wording/health-pulse-t-and-c.pdf?v=1.2","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/198"},{"kind":"prospectus","label":"Health Pulse Prospectus","pages":60,"fetched_at":"2026-10-16 07:11:44.102292+00","source_url":"https://transactions.nivabupa.com/pages/doc/prospectus/Health-Pulse-Prospectus.pdf?v=1.2","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/199"},{"kind":"cis","label":"Health Pulse","pages":13,"fetched_at":"2026-10-16 07:11:44.102292+00","source_url":"https://transactions.nivabupa.com/pages/doc/Customer-Information/CIS_Health-Pulse.pdf?v=1.2","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627/document/200"}],"versions":[{"uin":"MAXHLIP20017V011920","version":null,"approved_on":null},{"uin":"NBHHLIP27055V052627","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 Pulse (UIN NBHHLIP27055V052627), IndiaInsurances, https://indiainsurances.com/policy/niva-bupa-health-insurance/health-pulse-nbhhlip27055v052627"}