{"uin":"NBHHLIP27059V022627","name":"ReAssure 3.0","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627","insurer":{"slug":"niva-bupa-health-insurance","name":"Niva Bupa Health Insurance Co Ltd.","url":"https://indiainsurances.com/insurer/niva-bupa-health-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"ReAssure 3.0 is a Niva Bupa health indemnity policy sold in Classic, Select, Elite and Black variants, on individual or family floater basis, covering Allopathic and AYUSH treatment in India with Sum Insured options of 5 Lacs, 10 Lacs or Unlimited. It pays 60 days of pre-hospitalisation and 180 days of post-hospitalisation expenses, carries forward unused Base Sum Insured up to 10 times under Booster+, and after the first paid claim refills up to the Base Sum Insured per claim under ReAssure Forever.","analysis":{"state":"extracted","analysed_at":"2026-10-16 04:48:13.126039+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","Select","Elite","Black"],"display":"Classic, Select, Elite, Black","note":"Limits differ by variant (room category, modern treatment and ambulance limits, Booster+ multiple). Also offered on individual or floater basis with Sum Insured options 5 Lacs, 10 Lacs or Unlimited; many optional benefits.","quote":"Classic & Select Variant: Up to INR 1Lac on • Elite & Black Variant: Up to Sum Insured ... Classic | General Ward | 0%","sources":[{"clause":null,"heading":"Specific Exclusions","page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-specific-exclusions"},{"clause":"Annexure V","heading":"Co-payments for Room Category","page":62,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-annexure-v"}],"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":"Policy Period of 1, 2, 3, 4 or 5 years; multi tenure policies are offered.","display":"1 to 5 years","note":"The term options are shown in the Live Healthy discount tables for Policy Periods of 1 to 5 years; no separate term clause.","quote":"Policy Period: 1 year ... Policy Period: 2 years ... Policy Period: 3 years ... Policy Period: 4 years ... Policy Period: 5 years ... In case of multi tenure policies, the premium for the entire tenure will be charged as per the entry age.","sources":[{"clause":null,"heading":"Policy Period: 1 year","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-policy-period-1-year"},{"clause":null,"heading":"Policy Period: 2 years","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-policy-period-2-years"},{"clause":null,"heading":"Policy Period: 3 years","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-policy-period-3-years"},{"clause":null,"heading":"Policy Period: 4 years","page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-policy-period-4-years"},{"clause":null,"heading":"Policy Period: 5 years","page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-policy-period-5-years"},{"clause":"4.7","heading":"Lock the Clock","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-7"}],"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":"Intimate before admission where possible, otherwise as soon as possible after admission; a hospitalisation longer than 7 days must be intimated within 7 days of admission or an extra 10% co-payment applies.","display":"Before admission or as soon as possible after; within 7 days for stays over 7 days, else 10% co-payment","note":"Relaxed to 9 days for road traffic accidents. Live donor organ transplant: at least 7 days before; cadaveric transplant: within 48 hours of admission. Optional HeadsUp benefit: 48 hours before planned or 24 hours after emergency admission, else 20% co-payment.","quote":"We encourage you to intimate to us as much earlier as possible before any hospital admission. ... In any event if you fail to intimate to us before admission in to a hospital, please intimate as soon as possible after admission. ... You MUST intimate to us if your hospitalization duration exceeds 7 days. In event of failure to intimate within 7 days from date of hospitalization, an additional cumulative co-payment of 10% will be levied on your final admissible amount.","sources":[{"clause":"7","heading":"Coverage Standards & Protocols","page":44,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-7"}],"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","Original Discharge summary with first and subsequent consultation papers","Original Final Hospital bill with detailed break-up and payment receipt (including pharmacy bills)","Laboratory investigation reports with supporting prescriptions","MLC/First Information Report (FIR) (in accident cases)","KYC documents","Cancelled cheque"],"display":"Claim form, discharge summary, final bill, lab reports, MLC/FIR (accidents), KYC, cancelled cheque","note":"Nominee's documents in case of death of the policyholder. Delay in submission must be explained in writing.","quote":"b) Documents required with claim form: ... Original Discharge summary with first and subsequent consultation papers. ... Original Final Hospital bill with detailed break-up and payment receipt (including pharmacy bills). ... Laboratory investigation reports with supporting prescriptions. ... MLC/First Information Report (FIR) (in accident cases). ... KYC documents ... Cancelled cheque","sources":[{"clause":"6.2.4(b)","heading":null,"page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-2-4-b"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"cross-checked","value":"The insurer settles or rejects a claim within 15 days from the claim submission date; on delay it pays interest at 2% above the bank rate.","display":"Within 15 days of claim submission","note":"CIS: cashless pre-authorization within 1 Hour; final bill authorization within three hours of the discharge request.","quote":"The Company shall settle or reject a claim, as the case may ... be, within 15 days from the claim submission date. ... payment of claim at a rate of 2% above the bank rate.","sources":[{"clause":"6.1.9","heading":null,"page":37,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-9"}],"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 waiting period ends","Specified disease/procedure waiting period","30-day waiting period for illness","Admission primarily for diagnostics and evaluation","Rest Cure, rehabilitation and respite care","Obesity/ Weight Control surgery not meeting conditions","Cosmetic or plastic Surgery","Hazardous or Adventure sports as a professional","Breach of law","Alcoholism, drug or substance abuse","Maternity Expenses","Sterility and Infertility","Conflict & Disaster (nuclear, war, terrorism)","External Congenital Anomaly","All dental treatments other than due to accidents and cancers"],"display":"PED and waiting periods, diagnostics-only admissions, cosmetic surgery, maternity, infertility, substance abuse, war, dental and others","note":"Also excluded: refractive error under 7.5 dioptres, unproven treatments, excluded providers, health hydros/spas, unrecognised physicians or hospitals, non Reasonable and Customary costs, artificial life maintenance for brain death, items in Annexure I, Personal Waiting Period conditions.","quote":"Pre-existing Diseases (Code–Excl01) ... Specified disease/procedure waiting period (Code- Excl02) ... 30-day waiting period (Code- Excl03): ... Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded. ... Rest Cure, rehabilitation and respite care (Code-Excl05) ... Obesity/ Weight Control (Code-Excl06) ... Cosmetic or plastic Surgery (Code-Excl08) ... Hazardous or Adventure sports (Code-Excl09) ... Breach of law (Code-Excl10) ... Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Maternity Expenses (Code-Excl18) ... Sterility and Infertility (Code-Excl17) ... Treatment for any Injury or Illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations ... Screening, counseling or treatment related to external Congenital Anomaly. ... All dental treatments other than due to accidents and cancers.","sources":[{"clause":"5.1.1","heading":"Pre-existing Diseases (Code–Excl01)","page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-1"},{"clause":"5.1.2","heading":"Specified disease/procedure waiting period (Code- Excl02)","page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-2"},{"clause":"5.1.3","heading":"30-day waiting period","page":31,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-3"},{"clause":"5.1.4","heading":"Investigation & Evaluation (Code-Excl04)","page":31,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-4"},{"clause":"5.1.5","heading":"Rest Cure, rehabilitation and respite care (Code-Excl05)","page":31,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-5"},{"clause":"5.1.6","heading":"Obesity/ Weight Control (Code-Excl06)","page":31,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-6"},{"clause":"5.1.7","heading":"Cosmetic or plastic Surgery (Code-Excl08)","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-7"},{"clause":"5.1.8","heading":"Hazardous or Adventure sports (Code-Excl09)","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-8"},{"clause":"5.1.9","heading":"Breach of law (Code-Excl10)","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-9"},{"clause":"5.1.11","heading":null,"page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-11"},{"clause":"5.1.16","heading":"Maternity Expenses (Code-Excl18)","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-16"},{"clause":"5.1.15","heading":"Sterility and Infertility (Code-Excl17)","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-15"},{"clause":"5.2.2","heading":"Conflict & Disaster","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-2-2"},{"clause":"5.2.3","heading":"External Congenital Anomaly","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-2-3"},{"clause":"5.2.4","heading":"Dental treatment","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-2-4"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"cross-checked","value":"First contact Niva Bupa customer service (website, toll-free number, email platform, courier or any branch grievance cell); if not satisfied, the Grievance Redressal Officer, then GRO@nivabupa.com; then the Insurance Ombudsman or IRDAI Bima Bharosa.","display":"Niva Bupa customer service, then Grievance Redressal Officer, then GRO@nivabupa.com, then Insurance Ombudsman","note":"Toll-free 1860-500-8888; senior citizens: seniorcitizensupport@nivabupa.com.","quote":"ln case of any grievance the insured person may contact the company through: ... lnsured person may also approach the grievance cell at any of the company's branches with the details of grievance. If lnsured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer at: ... If the Insured person is not satisfied with the above, they can escalate to GRO@nivabupa.com. lf lnsured person is not satisfied with the redressal of grievance through above methods, the insured person may also approach the office of lnsurance Ombudsman","sources":[{"clause":"6.1.8","heading":"Redressal of Grievance","page":36,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-8"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"5 Lacs, 10 Lacs or Unlimited.","display":"5 Lacs, 10 Lacs, Unlimited","note":"From the CIS; the wording leaves amounts to the Policy Schedule. The CIS prints '5 Lacs10 Lacs' without a separator; its limits table names the 'Sum Insured Option 5 & 10L' and the 'Unlimited Sum Insured Option'. ReAssure Forever does not apply to the Unlimited Sum Insured option.","quote":"Sum Insured Options are: 5 Lacs10 Lacs, Unlimited ... Sum Insured Option 5 & 10L","sources":[{"clause":"Row 4","heading":"Sum Insured","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-row-4"},{"clause":"6(a)","heading":"Sum Insured Option 5 & 10L","page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-6-a-2"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Not for accidents or continuous cover of more than twelve months. Optional Initial Wait Period Modification reduces it to 7, 10 or 15 days (CIS).","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.","sources":[{"clause":"5.1.3","heading":"30-day waiting period","page":31,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-3"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"cross-checked","value":{"unit":"months","amount":36},"display":"36 months","note":"Optional Pre-Existing Disease Waiting Time Modification at purchase: to 12 or 24 months (CIS). Personal Waiting Period for specified conditions can be up to 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.","sources":[{"clause":"5.1.1","heading":"Pre-existing Diseases (Code–Excl01)","page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-1"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"cross-checked","value":{"unit":"months","amount":24},"display":"24 months","note":"Not for accidents; Cancer covered after a 30-day waiting period. Optional modification at purchase: increase to 36 months or reduce to 12 months (CIS).","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.","sources":[{"clause":"5.1.2","heading":"Specified disease/procedure waiting period (Code- Excl02)","page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"cross-checked","value":["Pancreatitis and stones in biliary and urinary system","Cataract, glaucoma and retinal detachment","Hyperplasia of prostate, hydrocele and spermatocele","Prolapse uterus or cervix, endometriosis, Fibroids, Polycystic ovarian disease (PCOD), hysterectomy (unless necessitated by Malignancy)","Hemorrhoids, fissure, fistula or abscess of anal and rectal region","Hernia of any site or type","Osteoarthritis, joint replacement, osteoporosis, systemic connective tissue disorders, inflammatory polyarthropathies, Rheumatoid Arthritis, gout, intervertebral disc disorders, arthroscopic surgeries for ligament repair","Varicose veins of lower extremities","All internal or external benign neoplasms/ tumours, cyst, sinus, polyps, nodules, mass or lump","Ulcer, erosion or 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"],"display":"Listed conditions including cataract, hernia, joint replacement and benign tumours","note":null,"quote":"i) Pancreatitis and stones in biliary and urinary system ... ii) Cataract, glaucoma and retinal detachment ... iii) Hyperplasia of prostate, hydrocele and spermatocele ... iv) Prolapse uterus or cervix, endometriosis, Fibroids, Polycystic ovarian disease (PCOD), hysterectomy (unless necessitated by Malignancy) ... v) Hemorrhoids, fissure, fistula or abscess of anal and rectal region ... vi) Hernia of any site or type, ... vii) Osteoarthritis, joint replacement, osteoporosis, systemic connective tissue disorders, inflammatory polyarthropathies, Rheumatoid Arthritis, gout, intervertebral disc disorders, arthroscopic surgeries for ligament repair ... viii) Varicose veins of lower extremities ... ix) All internal or external benign neoplasms/ tumours, cyst, sinus, polyps, nodules, mass or lump ... x) Ulcer, erosion or varices of gastro intestinal tract ... xi) Surgical treatment for diseases of middle ear and mastoid (including otitis media, cholesteatoma, perforation of tympanic membrane), Tonsils and adenoids, nasal septum and nasal sinuses","sources":[{"clause":"5.1.2","heading":"Specified disease/procedure waiting period (Code- Excl02)","page":30,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-2"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"cross-checked","value":{"unit":"years","amount":5},"display":"sixty continuous months (5 years)","note":"Counted afresh from the date of enhancement for any increase in sum insured.","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. ... After 5 years, no health insurance claim shall be contestable except for proven fraud and permanent exclusions.","sources":[{"clause":"6.1.10","heading":"Moratorium Period","page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-10"},{"clause":"6.1.12","heading":"Migration","page":38,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-12"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"cross-checked","value":"Yes. The policy can be ported to another insurer, subject to that insurer's underwriting, carrying credit for the Sum Insured, No Claim Bonus, specific and pre-existing disease waiting periods and the moratorium period.","display":"Yes, with credit for waiting periods","note":"Migration to another Niva Bupa product is also allowed with 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.","sources":[{"clause":"6.1.13","heading":"Portability","page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-13"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"cross-checked","value":true,"display":"Yes, renewal cannot be denied except for fraud, non-disclosure or misrepresentation","note":"No maximum renewal age is printed and renewal cannot be denied except for established fraud, non-disclosure or misrepresentation; the documents do not use the word lifelong. Renewal may end if the product is withdrawn (option to migrate).","quote":"A health insurance policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation by the insured. An insurer shall not deny the renewal of a health insurance policy on the ground that the insured had made a claim or claims in the preceding policy years","sources":[{"clause":"6.1.3","heading":"Renewal of Policy","page":34,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-3"}],"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 loading on renewal based on individual claims experience. However, under Lock the Clock the premium stays at entry age only until a claim is paid; after a claim it moves to current age.","display":"No claim-based loading, but a paid claim ends the Lock the Clock entry-age premium","note":"In a floater policy a claim for anyone unlocks the age for the whole policy; in multi-year policies additional premium for remaining years is deducted from the claim payout. Underwriting risk loading, once applied, continues at all renewals.","quote":"No loading shall apply on renewals based on individual claims experience. ... Your age is locked at entry when you buy the policy, till a claim is paid. ... Post the claim is paid, the premium charged will be as per your current age and will continue to change as per the age slabs at each renewal.","sources":[{"clause":null,"heading":"Simplified for you","page":34,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-simplified-for-you-2"},{"clause":"4.7","heading":"Lock the Clock","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-7"}],"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":["Excl04 Investigation & Evaluation","Excl05 Rest Cure, rehabilitation and respite care","Excl06 Obesity/ Weight Control","Excl08 Cosmetic or plastic Surgery","Excl09 Hazardous or Adventure sports","Excl10 Breach of law","Excl11 Excluded Providers","Excl12 Alcoholism, drug or substance abuse or any addictive condition","Excl13 Health hydros, nature cure clinics, spas or similar establishments","Excl15 Refractive Error","Excl16 Unproven Treatments","Excl17 Sterility and Infertility","Excl18 Maternity Expenses","Conflict & Disaster","External Congenital Anomaly","Dental treatment (other than due to accidents and cancers)","Unrecognized Physician or Hospital","Costs which are not Reasonable and Customary and treatments which are not Medically Necessary","Artificial life maintenance for brain dead or vegetative state"],"display":"Standard exclusion codes Excl04 to Excl18 (some not used), plus six specific exclusions","note":"Excl01 to Excl03 are waiting periods, not permanent. Excl07 and Excl14 are not used in this policy. Refractive error is excluded below 7.5 dioptres.","quote":"Investigation & Evaluation (Code-Excl04) ... Rest Cure, rehabilitation and respite care (Code-Excl05) ... Obesity/ Weight Control (Code-Excl06) ... Cosmetic or plastic Surgery (Code-Excl08) ... Hazardous or Adventure sports (Code-Excl09) ... Breach of law (Code-Excl10) ... Excluded Providers (Code-Excl11) ... 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) ... Refractive Error (Code-Excl15) ... Unproven Treatments (Code-Excl16) ... Sterility and Infertility (Code-Excl17) ... Maternity Expenses (Code-Excl18) ... Conflict & Disaster ... External Congenital Anomaly ... All dental treatments other than due to accidents and cancers. ... Unrecognized Physician or Hospital ... Costs which are not Reasonable and Customary and treatments which are not Medically Necessary. ... Artificial life maintenance for the Insured Person who has been declared brain dead or in vegetative state.","sources":[{"clause":"5.1.4","heading":"Investigation & Evaluation (Code-Excl04)","page":31,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-4"},{"clause":"5.1.5","heading":"Rest Cure, rehabilitation and respite care (Code-Excl05)","page":31,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-5"},{"clause":"5.1.6","heading":"Obesity/ Weight Control (Code-Excl06)","page":31,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-6"},{"clause":"5.1.7","heading":"Cosmetic or plastic Surgery (Code-Excl08)","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-7"},{"clause":"5.1.8","heading":"Hazardous or Adventure sports (Code-Excl09)","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-8"},{"clause":"5.1.9","heading":"Breach of law (Code-Excl10)","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-9"},{"clause":"5.1.10","heading":"Excluded Providers (Code-Excl11)","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-10"},{"clause":"5.1.11","heading":null,"page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-11"},{"clause":"5.1.12","heading":null,"page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-12"},{"clause":"5.1.13","heading":"Refractive Error (Code-Excl15)","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-13"},{"clause":"5.1.14","heading":"Unproven Treatments (Code-Excl16)","page":32,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-14"},{"clause":"5.1.15","heading":"Sterility and Infertility (Code-Excl17)","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-15"},{"clause":"5.1.16","heading":"Maternity Expenses (Code-Excl18)","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-16"},{"clause":"5.2.2","heading":"Conflict & Disaster","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-2-2"},{"clause":"5.2.3","heading":"External Congenital Anomaly","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-2-3"},{"clause":"5.2.4","heading":"Dental treatment","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-2-4"},{"clause":"5.2.5","heading":"Unrecognized Physician or Hospital","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-2-5"},{"clause":"5.2.6","heading":null,"page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-2-6"},{"clause":"5.2.7","heading":null,"page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-2-7"}],"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 can cancel at any time with 7 days' written notice. If no claim was made, the proportionate premium for the unexpired period is refunded for terms up to one year; for longer terms, premium for policy years not yet started is refunded. No refund if a claim has been paid.","display":"Proportionate refund for unexpired period if no claim; nothing if a claim was paid","note":"Clause 6.2.1 refers to a refund 'table in Section 6.1.2' but no table is printed.","quote":"The policy holder may cancel his/her policy at any time during the term, by giving 7 days' notice in writing. ... Refund proportionate premium for unexpired policy period, if the term of the policy upto one year and there is no claim(s) made during the policy period. ... 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 ... We will NOT refund any premium if we have paid a claim.","sources":[{"clause":"6.1.2","heading":"Cancellation","page":34,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-2"},{"clause":null,"heading":"Simplified for you","page":34,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-simplified-for-you-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"cross-checked","value":"India only for the base cover. Optional Borderless, Borderless for Specific Illness and International Cover extend cover abroad.","display":"India only","note":"Optional Borderless (treatment anywhere in the world) and International Cover (outside India, 45 days per trip) change this for extra premium; not available to non-Indian citizens or non-permanent residents.","quote":"This Policy covers Allopathic and AYUSH treatments taken in India ONLY. ... All claims shall be payable in India in Indian Rupees only.","sources":[{"clause":"1","heading":"Preamble","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-1"},{"clause":"6.2.6","heading":"Territorial Jurisdiction","page":42,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-2-6"}],"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 is less proportionate risk premium, medical examination and stamp duty costs, if no claim made.","quote":"The insured person shall be allowed free look period of thirty days from date of receipt of the policy document ... Free look is a 30 days period during which you can return back your policy","sources":[{"clause":"6.1.1","heading":"Free Look Period","page":34,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-1"},{"clause":null,"heading":"Simplified for you","page":34,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-simplified-for-you"}],"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 (15 days for monthly instalments)","note":"The wording is inconsistent on cover during the grace period: 6.1.3 says 'Coverage is available during the grace period' while a Simplified note says 'You are NOT insured during the grace period'; 6.1.17 gives cover during grace only for instalment premiums.","quote":"Grace Period of 30 days in all types of policies, and a period of 15 days in case of monthly instalments.","sources":[{"clause":"6.1.17","heading":"Premium Payment in Instalments","page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-17"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"not-stated","value":null,"display":null,"note":"Neither the wording nor the CIS gives minimum or maximum entry ages.","quote":null,"sources":[],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"cross-checked","value":["Annual","Half Yearly","Quarterly","Monthly"],"display":"Annual, Half Yearly, Quarterly or Monthly","note":"Multi-year policies charge premium for the entire tenure; in the event of a claim all remaining instalments become due.","quote":"lf the insured person has opted for Payment of Premium on an instalment basis i.e. Half Yearly, Quarterly or Monthly ... can be renewed within the Grace Period of 30 days (annual installment)","sources":[{"clause":"6.1.17","heading":"Premium Payment in Instalments","page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-17"},{"clause":null,"heading":"Simplified for you","page":34,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-simplified-for-you-2"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["Cash-Bag+","NivaBupaOne","ElderOne","Annual Health Check-up (Cashless)","Annual Health Check-up (Cashless + Reimbursement)","HeadsUp","Tiered Network","Pre-Existing Disease Waiting Time modification","Specific Disease Wait Time Modification","Co-Payment","Personal Accident","Personal Accident Lite","Personal Accident Pro","Hospital Daily Cash","Annual Aggregate Deductible","Claim Safeguard+","WellConsult+","Borderless","Borderless for Specified Illnesses","Third Medical Opinion","Second Medical Opinion Express","Medical Equipment","Emotional Wellness for Adults","Mind Wellness Counselling","Sexual Health Wellness","Health Risk Assessment","Wellness for Women","EyeGuard","Live-Fit","Accident Care","Health Vouchers","Critical Illness","Compassionate Visit","Pre-Hospitalization Modification","Post-Hospitalization Modification","Flight-Mode","Initial Wait Period Modification","Vaccination Cover","Convalescence Benefit","Dependent Accommodation Benefit","International Cover","Modern Treatments+","Air Ambulance+"],"display":"Cash-Bag+, NivaBupaOne, ElderOne, annual health check-ups, HeadsUp, Tiered Network, waiting time modifications, Co-Payment, Personal Accident, Hospital Daily Cash, Annual Aggregate Deductible, Claim Safeguard+, WellConsult+, Borderless, International Cover, Modern Treatments+, Air Ambulance+ and more","note":"Listed under Optional Coverage in the CIS and described in wording section 4. Modern Treatments+ and Air Ambulance+ only for Classic & Select. Not together: Co-Payment and Annual Aggregate Deductible; HeadsUp and Tiered Network; Borderless and Borderless for Specific Illness; the three health check-up options (with NivaBupaOne); Flight-Mode with International Cover or Borderless. The waiting time and pre/post-hospitalisation modifications can be chosen only at purchase. Borderless, Borderless for Specific Illness and Flight-Mode are not available to non-Indian citizens or non-permanent residents.","quote":"Optional Coverage: 1. Cash-Bag+ ... 2. NivaBupaOne ... 3. ElderOne ... Annual Health Check-up (Cashless) ... Annual Health Check-up (Cashless + Reimbursement) ... HeadsUp ... 7. Tiered Network ... 8. Pre-Existing Disease Waiting Time: Modify ... 9. Specific Disease Wait Time Modification ... 10. Co-Payment ... 11. Personal Accident: ... 12. Personal Accident Lite ... 13. Personal Accident Pro ... 14. Hospital Daily Cash ... 15. Annual Aggregate Deductible ... 16. Claim Safeguard+ ... 17. WellConsult+ ... 18. Borderless: ... 19. Borderless for Specified Illnesses ... 20. Third Medical Opinion ... 21. Second Medical Opinion Express ... 22. Medical Equipment ... 23. Emotional Wellness for Adults ... 24. Mind Wellness Counselling ... 25. Sexual Health Wellness ... 26. Health Risk Assessment ... 27. Wellness for Women ... 28. EyeGuard ... 29. Live-Fit ... 30. Accident Care ... 31. Health Vouchers ... 32. Critical Illness ... 33. Compassionate Visit ... 34. Pre-Hospitalization Modification ... 35. Post-Hospitalization Modification ... 36. Flight-Mode ... 37. Initial Wait Period Modification ... 38. Vaccination Cover ... 39. Convalescence Benefit ... 40. Dependent Accommodation Benefit ... 41. International Cover ... 42. Modern Treatments+ ... 43. Air Ambulance+","sources":[{"clause":"Row 5","heading":"Policy Coverage","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-row-5"},{"clause":"4","heading":"Annual Health Check-up (Cashless)","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-4"},{"clause":"5","heading":"Annual Health Check-up (Cashless + Reimbursement): Day 1. 4.23","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-5"},{"clause":"6","heading":"HeadsUp: Call 48 hours before any hospitalization and get treated 4.26","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-6"},{"clause":"6(c)","heading":"Black","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-6-c"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"The wording contradicts itself: the renewal clause says coverage is available during the grace period, but a 'Simplified for you' note says you are NOT insured during the grace period. For instalment premiums, cover is given during the grace period.","display":"Contradictory: renewal clause says covered, a Simplified note says not insured; instalment payers covered","note":"The wording contradicts itself on this. Clause 6.1.3(c) says 'Coverage is available during the grace period'; the Simplified note beside clause 6.1.6 says 'You are NOT insured during the grace period'; clause 6.1.17 (instalments, 'notwithstanding any terms contrary elsewhere') gives cover during grace for instalment premiums only. For an annual premium a claim in the grace period may be disputed.","quote":"c) Coverage is available during the grace period. ... Note: You are NOT insured during the grace period. ... ii) For policies where premium is paid in instalments only, the coverage will be given during grace period.","sources":[{"clause":null,"heading":"Simplified for you","page":34,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-simplified-for-you-2"},{"clause":"6.1.6","heading":"Fraud","page":35,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-6"},{"clause":"6.1.17","heading":"Premium Payment in Instalments","page":39,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-1-17"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"cross-checked","value":"No rupee limit is printed; the eligible room category is fixed by the variant. Annexure V shows no co-payment for General Ward under Classic, Twin Sharing Room under Select, and All Room Categories except deluxe and Suite under Elite.","display":"Room category by variant: General Ward (Classic), Twin Sharing Room (Select), all except deluxe and Suite (Elite)","note":"Eligible categories read from the 0% rows of Annexure V. Black variant is not in Annexure V. Higher room: co-payment of 20% to 50% on the entire claim (Annexure V). Borderless covers up to standard private room only.","quote":"Basis the plan you choose; the hospital room (like single private room, general ward, twin sharing) you are eligible for will get fixed. ... If you choose a room outside your plan's category, the Copayment (as per Annexure V) will apply on the entire claim. ... Classic | General Ward | 0% ... Select | Twin Sharing Room | 0% ... Elite | All Room Categories except deluxe and Suite | 0%","sources":[{"clause":"4.2.1","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-2-1"},{"clause":"Annexure V","heading":"Co-payments for Room Category","page":62,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-annexure-v"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"quote-verified","value":"Fixed by variant: General Ward for Classic, Twin Sharing Room for Select, and All Room Categories except deluxe and Suite for Elite (no co-payment for these in Annexure V).","display":"General Ward (Classic), Twin Sharing Room (Select), all except deluxe and Suite (Elite)","note":"Read from the 0% rows of Annexure V. The Black variant is not in Annexure V, so its room category is not printed. A higher category draws a co-payment of 20% to 50% on the entire claim (Annexure V); clause 6.2.4(d) also pro-rates Associated Medical Expenses. Borderless and Borderless for Specific Illness cover up to standard private room only.","quote":"Basis the plan you choose; the hospital room (like single private room, general ward, twin sharing) you are eligible for will get fixed. ... Classic | General Ward | 0% ... Select | Twin Sharing Room | 0% ... Elite | All Room Categories except deluxe and Suite | 0%","sources":[{"clause":"4.2.1","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-2-1"},{"clause":"Annexure V","heading":"Co-payments for Room Category","page":62,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-annexure-v"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"not-stated","value":null,"display":null,"note":"No ICU limit is printed; ICU appears only in definitions.","quote":null,"sources":[],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"cross-checked","value":"Yes. If a room higher than the eligible category is chosen, only a pro-rated portion of Associated Medical Expenses (room rent, nursing, doctors' fees, operation theatre) is paid, by the ratio of eligible to actual room rent.","display":"Yes, pro-rated Associated Medical Expenses","note":"Clause 4.2.1 instead says a room outside the plan's category triggers the Annexure V co-payment on the entire claim; the wording has both mechanisms.","quote":"If you opt for a Hospital room which is higher than the eligible room category as specified in your Policy Schedule, then We will pay only a pro-rated portion of the total Associated Medical Expenses (including surcharge or taxes thereon) as per the following formula: (Eligible Room Rent limit / Room Rent actually incurred) * total Associated Medical Expenses","sources":[{"clause":"6.2.4(d)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-2-4-d"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"No co-payment by default. Optional co-payment of 20%, 30%, 40% or 50% on every claim for a lower premium. A room-category co-payment (Annexure V) applies if a room above the plan's category is chosen.","display":"None by default; optional 20% / 30% / 40% / 50%; room-category co-payment if a higher room is chosen","note":"Also: 10% extra if a stay over 7 days is not intimated within 7 days; 20% for non-network organ transplant without intimation; 20% under optional HeadsUp or Tiered Network when their conditions are not met; 20% on WellConsult+ reimbursement. No age or zone co-payment is printed. Co-payment and Annual Aggregate Deductible cannot be opted together.","quote":"H. Co-payment- Optional benefit with following options- 20%, 4.19 30%, 40% and 50%. ... 10. Co-Payment: Co-payment Options of 20% / 30% / 40% / 50% ... It is the percentage of admissible claim amount You would have to bear for every claim, Rest we will pay. ... If you choose a room outside your plan's category, the Copayment (as per Annexure V) will apply on the entire claim.","sources":[{"clause":"6(b)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-6-b-3"},{"clause":"6","heading":"HeadsUp: Call 48 hours before any hospitalization and get treated 4.26","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-6"},{"clause":"4.19","heading":"Co-Payment","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-19"},{"clause":"4.2.1","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-2-1"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"cross-checked","value":"None unless the optional Annual Aggregate Deductible is chosen (INR 10,000 to INR 5,00,000)","display":"None unless the optional Annual Aggregate Deductible is chosen (INR 10,000 to INR 5,00,000)","note":"Optional only: options INR 10,000 / 20,000 / 30,000 / 50,000 / 1,00,000 / 2,00,000 / 3,00,000 / 4,00,000 / 5,00,000 a year, aggregate. Cannot be combined with co-payment. CIS row I misprints 20,000 as '20,0000'.","quote":"Annual Aggregate Deductible- Optional benefit with ... Option to choose a deductible 4.18 from INR 10,000 / INR 20,000 / INR 30,000 / INR 50,000 / INR 1,00,000 / INR 2,00,000/ INR 3,00,000/ INR 4,00,000/ INR 5,00,000 ... This is an aggregate amount in a year that is incurred by you on Expenses in reaching a Hospital, Expenses during Hospitalization, Expenses before and after hospitalization, Home Care / Domiciliary Treatment, Organ Donor, which we will NOT pay.","sources":[{"clause":"6(b)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-6-b-3"},{"clause":"6(c)","heading":"Black","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-6-c"},{"clause":"4.18","heading":"Annual Aggregate Deductible","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-18"}],"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":["Modern Treatments: up to INR 1Lac for Classic & Select Variant; up to Sum Insured for Elite & Black Variant","Cataract: Classic & Select Variant covers only Mono-focal Lens"],"display":"Modern treatments capped at INR 1Lac (Classic & Select); mono-focal lens only for cataract (Classic & Select)","note":"Optional Modern Treatments+ removes the modern treatment sub-limit for Classic & Select. No other disease sub-limits are printed.","quote":"A. Modern Treatments: • Classic & Select Variant: Up to INR 1Lac on • Elite & Black Variant: Up to Sum Insured ... Cataract: Classic & Select Variant covers only Mono-focal Lens.","sources":[{"clause":null,"heading":"Specific Exclusions","page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-specific-exclusions"},{"clause":"4.2.1","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-2-1"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"cross-checked","value":{"unit":"days","amount":60},"display":"60 days","note":"Optional modification at purchase: reduce to 30 days or increase to 90/180 days (CIS).","quote":"We will pay expenses incurred on consultations, medicines, physiotherapy, diagnostic tests for 60 days before the date of admission","sources":[{"clause":"4.3","heading":"Expenses before and after hospitalization (Pre & Post hospitalization)","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-3"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"cross-checked","value":{"unit":"days","amount":180},"display":"180 days","note":"Optional modification at purchase: reduce to 30, 60 or 90 days or increase to 270/365 days (CIS).","quote":"180 days after date of discharge IF these are related to the condition for which hospitalization claim is paid.","sources":[{"clause":"4.3","heading":"Expenses before and after hospitalization (Pre & Post hospitalization)","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-3"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"cross-checked","value":"Hospitalisation of 2 hours or more is covered (minimum 24 hours for AYUSH treatment), so treatments needing less than 24 hours are covered without a list.","display":"Covered for admissions of 2 hours or more","note":"No list of day-care procedures is printed. Admissions with only investigations (MRI, CT Scan, Endoscopy) are not paid.","quote":"Admitted for 2 hours or more (minimum 24 hours for AYUSH treatment in a AYUSH Hospital) ... 2. Expenses during Hospitalization: 2 hours and more covered (AYUSH covered for 24 hours and more).","sources":[{"clause":"4.2.1","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-2-1"},{"clause":"Row 5","heading":"Policy Coverage","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-row-5"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"cross-checked","value":"Yes. Home Care / Domiciliary Treatment is covered up to Sum Insured when a medical practitioner advises treatment at home, with daily monitoring.","display":"Yes, up to Sum Insured","note":"Requires a continuous active line of treatment and a signed daily monitoring chart. Covers peritoneal dialysis and chemotherapy at home; not medical or ambulatory devices used at home.","quote":"The medical practitioner advices the insured person to undergo treatment at home ... 5. Home Care/Domiciliary treatment covered up to Sum Insured.","sources":[{"clause":"4.4.1","heading":"The medical practitioner advices the insured person to undergo treatment at home","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-4-1"},{"clause":"Row 5","heading":"Policy Coverage","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-row-5"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"cross-checked","value":"Covered in India when admitted for a minimum of 24 hours in an AYUSH Hospital; no separate limit is printed.","display":"Yes, for admissions of minimum 24 hours in an AYUSH Hospital","note":null,"quote":"This Policy covers Allopathic and AYUSH treatments taken in India ONLY. ... Admitted for 2 hours or more (minimum 24 hours for AYUSH treatment in a AYUSH Hospital)","sources":[{"clause":"1","heading":"Preamble","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-1"},{"clause":"4.2.1","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-2-1"}],"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":"Listed modern treatments (including robotic surgeries, oral chemotherapy, stem cell therapy, deep brain stimulation, intra vitreal injections) are covered, up to INR 1 Lac for Classic & Select Variant and up to Sum Insured for Elite & Black Variant.","display":"Covered; up to INR 1Lac (Classic & Select), up to Sum Insured (Elite & Black)","note":"The wording numbers 12 items but items 1 and 2 are the same (Uterine Artery Embolization and HIFU), so 11 distinct treatments. CIS describes it as a 1L per claim limit; optional Modern Treatments+ removes it for Classic & Select.","quote":"We pay for the below specified Modern treatments, up to what your plan covers, ... 6. Oral Chemotherapy | 7. Robotic surgeries ... Classic & Select Variant: Up to INR 1Lac on • Elite & Black Variant: Up to Sum Insured","sources":[{"clause":"4.2.2","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-2-2"},{"clause":null,"heading":"Specific Exclusions","page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-specific-exclusions"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"cross-checked","value":"Yes. The donor's hospitalisation expenses for harvesting the organ are paid, only when the insured's hospitalisation claim is paid, up to Sum Insured.","display":"Yes, up to Sum Insured","note":"Also pays harvesting expenses if the insured donates an organ.","quote":"If you ever undergo an organ transplant, we will pay the hospitalization expenses of the donor for harvesting the organ, ONLY when your Hospitalization claim is paid. ... 6. Organ donor expenses covered up to Sum Insured","sources":[{"clause":"4.5","heading":"Organ donor","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-5"},{"clause":"Row 5","heading":"Policy Coverage","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-row-5"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"cross-checked","value":"Road ambulance: up to INR 2000 per hospitalization for Classic & Select, up to Sum Insured for Elite & Black. Air ambulance: up to INR 5L per hospitalization for Elite & Black, not available for Classic & Select unless Air Ambulance+ is opted.","display":"Road: INR 2000 per hospitalization (Classic & Select), up to Sum Insured (Elite & Black); Air: up to INR 5L (Elite & Black)","note":"Wording leaves the limit to the Policy Schedule; air ambulance only in Emergency and only if the hospitalization claim is paid. Optional Air Ambulance+ for Classic & Select: up to INR 2.5L (CIS).","quote":"B. Road Ambulance • Classic & Select Variant: Up to INR 2000 per hospitalization. • Elite & Black Variant: Up to Sum Insured C. Air Ambulance • Classic & Select Variant: NA • Elite & Black Variant: Up to INR 5L per hospitalization","sources":[{"clause":null,"heading":"Specific Exclusions","page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-specific-exclusions"}],"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":"ReAssure Forever: the first paid claim triggers it and it stays for life if renewed without break; it pays up to the Base Sum Insured for any single claim and can trigger unlimited times.","display":"Unlimited refills, up to Base Sum Insured per claim, after the first paid claim","note":"Not for the Unlimited Sum Insured option. The documents do not say whether it applies to the same illness.","quote":"The first paid claim in the life of the policy triggers ReAssure “Forever”. Once Triggered it stays for life, provided that the policy is renewed without break. ... Maximum amount ReAssure Forever pays for any single claim is up to Base Sum Insured. ... (this 10 Lakh will trigger unlimited times)","sources":[{"clause":"4.6","heading":"ReAssure Forever","page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#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":"Booster+: unutilised Base Sum Insured carries forward each year, up to a maximum of 10 times the Base Sum Insured depending on the plan.","display":"Unused Base Sum Insured carries forward, up to 10 times","note":"Only the unused amount carries forward, so a claim reduces the carry-forward; reducing the Base Sum Insured reduces Booster+ proportionately. Optional Cash-Bag+ gives 10% of premium on 1st claim-free renewal and 5% thereafter.","quote":"Unutilized Base Sum Insured carries forward. Maximum it will accumulate up 10 times (based on the plan you have chosen) of the Base Sum Insured.","sources":[{"clause":"4.8","heading":"Booster+","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-8"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"cross-checked","value":"Not covered in the base policy (Annexure I lists non-payable items such as gloves and masks); optional Claim Safeguard+ covers Lists I to IV of Annexure I.","display":"Not covered unless optional Claim Safeguard+ is taken","note":"Claim Safeguard+ is optional; Reasonable and Customary Charges still apply.","quote":"The expenses that are not covered or subsumed into room charges / procedure charges / costs of treatment are placed as Annexure I. ... We will cover non-payable items mentioned in 'List I, II, III, IV of Annexure I.","sources":[{"clause":"6.2.4(c)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-2-4-c"},{"clause":"4.17","heading":"Claim Safeguard+","page":17,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-17"}],"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 and lawful termination of pregnancy are excluded under the Maternity Expenses exclusion.","display":"Not covered","note":"Ectopic pregnancy and miscarriage due to an Accident are not excluded. Optional Wellness for Women gives app-based pregnancy content only.","quote":"Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic pregnancy;","sources":[{"clause":"5.1.16","heading":"Maternity Expenses (Code-Excl18)","page":33,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-5-1-16"}],"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":null,"quote":null,"sources":[],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":"In-patient mental illness cover is not mentioned; optional Mind Wellness Counselling offers online sessions only.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"No check-up in the base cover. The optional Annual Health Checkup (cashless only, or cashless plus reimbursement) gives a check-up once every Policy Year from day 1, booked through the app.","display":"None in the base cover; optional check-up once every Policy Year from day 1","note":"The base cover list in the CIS has no check-up. Test lists by variant in Annexure III; optional NivaBupaOne gives an executive health check-up instead. The three check-up options cannot be opted together.","quote":"Optional Coverage: 1. Cash-Bag+ ... Annual Health Check-up (Cashless): Day 1. Once in the policy 4.22 year. ... Annual Health Check-up (Cashless + Reimbursement): Day 1. 4.23 ... Available once every Policy Year, from day 1 of the policy. The tests MUST be booked through our digital assets (e.g. Mobile App). This benefit is available ONLY on cashless and no re-imbursement is allowed. ... This benefit is available on cashless and re-imbursement basis.","sources":[{"clause":"Row 5","heading":"Policy Coverage","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-row-5"},{"clause":"4","heading":"Annual Health Check-up (Cashless)","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-4"},{"clause":"5","heading":"Annual Health Check-up (Cashless + Reimbursement): Day 1. 4.23","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-5"},{"clause":"4.22","heading":"Annual Health Checkup (Cashless Only)","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-22"},{"clause":"4.23","heading":"Annual Health Checkup (Cashless + Reimbursement)","page":18,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-23"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"cross-checked","value":"The base policy includes unlimited e-consultations with partners but no other OPD cover. Optional WellConsult+ covers consultations, pharmacy, diagnostics, dental and more up to 5X of the premium paid.","display":"Unlimited e-consultations; OPD only with optional WellConsult+","note":"WellConsult+ limit chosen from 1X to 5X; 20% co-payment on reimbursement; India only. Optional Personal Accident (Pro) adds accidental OPD.","quote":"e-Consultation You can take Unlimited e-consultations from our Partners. ... 17. WellConsult+: Covers OPD benefits up to 5X of the premium paid.","sources":[{"clause":"4.12","heading":null,"page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-12"},{"clause":"6(c)","heading":"Black","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-6-c"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"cross-checked","value":"Yes. Premium depends on the residential city, with the country divided into Zones 1 to 8.","display":"Yes, premium by residential city (Zones 1 to 8)","note":"The clause says '2 zones' but lists 8 zones. No zone-based co-payment is printed.","quote":"For the purpose of calculating premium, the country has been divided into the following 2 zones: ... h) Zone 8: ... Your premium depends upon your residential city.","sources":[{"clause":"6.2.8","heading":"Zonal pricing","page":43,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-2-8"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"cross-checked","value":"Yes. Cashless is available at network hospitals; the wording also offers 'Cashless Everywhere' in hospitals outside the network.","display":"Yes, at network hospitals (and Cashless Everywhere at non-network hospitals)","note":"The two wording clauses contradict each other (network ONLY vs Cashless Everywhere). CIS: pre-authorization within 1 Hour, final authorization within three hours. Annual Health Checkup is cashless-only unless the reimbursement option is chosen.","quote":"Cashless claim facility is available at our network hospitals ONLY. ... We offer Cashless Everywhere, even in hospitals which are not part of our network.","sources":[{"clause":"6.2.4(a)","heading":null,"page":41,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-2-4-a"},{"clause":"6.2.4(e)(ii)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-6-2-4-e-ii"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"not-stated","value":null,"display":null,"note":"The documents do not say whether claims are handled in-house or by a TPA; TPAs appear only in standard definitions.","quote":null,"sources":[],"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":"Individual and multi-individual cover also available.","quote":"Coverage opted on family floater basis with overall Sum Insured (Only one Sum Insured is available for the entire family) ... If you add a member to the floater plan, then the premiums will be charged as per the entry age of the eldest member","sources":[{"clause":null,"heading":"Benefit Illustration (5 Lac Sum Insured, Policy Term 1 year)","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4#c-benefit-illustration-5-lac-sum-insured-policy-te"},{"clause":"4.7","heading":"Lock the Clock","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3#c-4-7"}],"law":[]}],"documents":[{"kind":"wording","label":"ReAssure 3.0 Policy Wording","pages":62,"fetched_at":"2026-10-16 04:47:16.742617+00","source_url":"https://transactions.nivabupa.com/pages/doc/policy_wording/ReAssure30_Policy_Wordings.pdf?v=1.6","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/3"},{"kind":"cis","label":"ReAssure 3.0","pages":13,"fetched_at":"2026-10-16 04:47:17.444613+00","source_url":"https://transactions.nivabupa.com/pages/doc/Customer-Information/CIS_ReAssure-3-0.pdf","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627/document/4"}],"versions":[],"where_to_buy":[],"claims_and_complaints":[],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"ReAssure 3.0 (UIN NBHHLIP27059V022627), IndiaInsurances, https://indiainsurances.com/policy/niva-bupa-health-insurance/reassure-3-0-nbhhlip27059v022627"}