{"uin":"NBHPAIP22153V012122","name":"Saral Suraksha Bima, Niva Bupa Health Insurance Co. Ltd.","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122","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":"personal-accident","category_name":"Personal accident","irdai_type":"Revision","kind":"product","status":"unknown","approved_on":"2021-08-24","withdrawn_on":null,"summary":"Saral Suraksha Bima is an individual personal accident policy for one year that pays 100% of the sum insured for accidental death or permanent total disablement and a percentage of it for permanent partial disablement, worldwide. Temporary total disablement, accident hospitalisation expenses (up to 10% of base sum insured, India only) and an education grant are optional, and Loyalty Additions of 5% per year up to 50% are added to the base sum insured.","analysis":{"state":"extracted","analysed_at":"2026-10-16 07:11:59.28759+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":"not-stated","value":null,"display":null,"note":"No named plans are printed; one product with three base covers and three optional covers.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"cross-checked","value":"One year.","display":"1 year","note":null,"quote":"Policy Period | 1 year","sources":[{"clause":"6","heading":"TABLE OF BENEFITS","page":15,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-6"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"conflicting","value":"At the earliest possible time; within 24 hours of admission for emergency hospitalisation.","display":"At the earliest possible time; 24 hours for emergency hospitalisation","note":"The company may relax the time limit on the merits of the case. CIS says: 'must be given within 30 days of its happening'. The CIS disclaimer says the policy document prevails.","quote":"Intimation about an event or occurrence that may give rise to a claim under this policy must be given at the earliest possible time ... that treatment requires Hospitalisation in an Emergency, the company shall be informed within 24 hours of the admission of the insured person in Hospital. ... Notification: Intimation about an event or occurrence that may give rise to a claim under this policy must be given within 30 days of its happening. ... In case of any conflict between the CIS and the policy document, the terms and conditions mentioned in the policy document shall prevail.","sources":[{"clause":"5.2.11.1(i)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-11-1-i"},{"clause":"5.2.11.1(ii)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-11-1-ii"},{"clause":"Row 9","heading":"Claims","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209#c-row-9"},{"clause":null,"heading":"Customer Information Sheet","page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209#c-customer-information-sheet-2"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"cross-checked","value":["Duly completed claim form","Photo Identity Proof of the insured person","Copy of FIR/ Panchnama /Police Inquest Report (wherever required)","Copy of Medico Legal Certificate (wherever required)","Death certificate and Post Mortem Report (if conducted) for death claims","Identity proof of Nominee or Original Succession Certificate/Original Legal Heir Certificate","Original treating Medical Practitioner's certificate describing the disablement","Original Discharge summary from the Hospital","Disability certificate issued by treating Medical Practitioner","Leave/Absence Certificate from Employer (If Employed) and Fitness Certificate for TTD","Bonafide Certificate from the educational institution for Education Grant"],"display":"Claim form, photo ID, FIR / MLC where required, plus documents for each cover","note":"Hospitalisation Expenses cover also needs discharge summary, medical and investigation reports, prescriptions and consultation papers; Education Grant needs relationship, ID and age proof of the child.","quote":"i) Duly completed claim form\nii) Photo Identity Proof of the insured person\niii) Copy of FIR/ Panchnama /Police Inquest Report (wherever these reports are required as per the circumstance of the Accident) ... iv) Copy of Medico Legal Certificate (wherever it is required as per the circumstance of the Accident) ... i) Death certificate;\nii) Post Mortem Report (if conducted);\niii) Identity proof of Nominee or Original Succession Certificate/Original Legal Heir Certificate ... i) Original treating Medical Practitioner’s certificate describing the disablement\nii) Original Discharge summary from the Hospital\niii) Disability certificate issued by treating Medical Practitioner ... iv) Leave/Absence Certificate from Employer (If Employed) ... vi) Fitness Certificate issued by the treating doctor. ... iv) Bonafide Certificate issued by the educational institution confirming that he/she is a full time student of the institution ... i) Discharge Summary from The Hospital\nii) Medical & Investigation reports\niii) Prescriptions, and consultation papers of the treatment ... i) Proof to establish relationship ... ii) Photo Identity Proof of Child\niii) Age proof of Child","sources":[{"clause":"5.2.11.2.1","heading":"Basic documents required for All claims","page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-11-2-1"},{"clause":"5.2.11.2.2","heading":"Documents required in case of Death covered under Section 3.1(a)","page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-11-2-2"},{"clause":"5.2.11.2.3","heading":null,"page":13,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-11-2-3"},{"clause":"5.2.11.2.4","heading":null,"page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-11-2-4"},{"clause":"5.2.11.2.6","heading":"Documents required for coverage under Section 3.2(c)- Education Grant","page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-11-2-6"},{"clause":"5.2.11.2.5","heading":null,"page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-11-2-5"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"conflicting","value":"The company settles or rejects a claim within 15 days from the date of claims submission; interest at 2% above bank rate for delay.","display":"15 days from claim submission","note":"CIS says: 'within 30 days from the date of receipt of last necessary document'. Interest for delay runs from receipt of claim intimation. The CIS disclaimer says the policy document prevails.","quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of claims submission. ... the Company shall be liable to pay interest to the policyholder from the date of receipt of claim intimation till the date of payment of claim at a rate of 2% above the bank rate ... The Company shall settle or reject a claim, as the case may be, within 30 days from the date of receipt of last necessary document. ... In case of any conflict between the CIS and the policy document, the terms and conditions mentioned in the policy document shall prevail.","sources":[{"clause":"5.2.11.3","heading":"Claim Settlement","page":14,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-11-3"},{"clause":"Row 9","heading":"Claims","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209#c-row-9"},{"clause":null,"heading":"Customer Information Sheet","page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209#c-customer-information-sheet-2"}],"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":["War, invasion, acts of foreign enemies, civil war, rebellion and similar","Intentional self-injury, suicide or attempted suicide","Under the influence of intoxicating liquor or drugs","Aviation or ballooning other than as a passenger in a Scheduled Airline","Breach of law with criminal intent","Participation as a professional in hazardous or adventure sports","Ionizing radiation, nuclear weapons material, nuclear, chemical and biological terrorism","Commission of or willful participation in an illegal act","Investigation & Evaluation (Code- Excl04) (hospitalisation cover)","Dietary supplements (Code-Excl14) (hospitalisation cover)","Accidental injuries which do not warrant hospitalization (hospitalisation cover)","Domiciliary Hospitalization and OPD treatment (hospitalisation cover)","Treatment outside the geographical limits of India (hospitalisation cover)","Expenses listed in Annexure-B (List I) (hospitalisation cover)"],"display":"War, self-injury and suicide, intoxication, non-scheduled aviation, criminal acts, professional hazardous sports, nuclear risks","note":"No waiting-period exclusions (CIS: waiting period not applicable). The last six items apply only to the optional Hospitalisation Expenses due to Accident cover. Intoxication exclusion does not apply where the insured is not directly responsible for the accident.","quote":"directly or indirectly due to War (whether declared or not) and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion ... a) from intentional self-injury unless in self-defense or to save life, suicide or attempted suicide; ... b) Whilst under the influence of intoxicating liquor or drugs or other intoxicants ... c) Whilst engaging in aviation or ballooning, or whilst mounting into, or dismounting from or travelling in any balloon or aircraft other than as a passenger (fare-paying or otherwise) in any Scheduled Airlines in the world. ... d) Arising or resulting from the Insured Person committing any breach of law with criminal intent. ... due to participation as a professional in hazardous or adventure sports ... A. Ionizing radiation or contamination by radioactivity from any nuclear fuel ... B. Nuclear weapons material ... D. Nuclear, chemical and biological terrorism ... (v) Any loss arising out of the Insured Person’s actual or attempted commission of or willful participation in an illegal act ... i) Investigation & Evaluation (Code- Excl04) ... ii. Dietary supplements and substances that can be purchased without prescription ... (Code-Excl14) ... iii. Expenses incurred for treatment of accidental injuries which does not warrant hospitalization. ... iv. Any expenses incurred on Domiciliary Hospitalization and OPD treatment. ... v. Treatment taken outside the geographical limits of India. ... vi. All expenses listed in Annexure-B (List I) of the Policy.","sources":[{"clause":"4.2(i)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-2-i"},{"clause":"4.2(a)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-2-a"},{"clause":"4.2(b)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-2-b"},{"clause":"4.2(c)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-2-c"},{"clause":"4.2(d)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-2-d"},{"clause":"4.1(i)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-1-i"},{"clause":"4.1(b)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-1-b"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"cross-checked","value":"Contact Niva Bupa customer services (website, toll free 1860-500-8888, e-mail platform, fax, courier) or any branch grievance cell; then the grievance officer, then GRO@nivabupa.com, then the Insurance Ombudsman.","display":"Niva Bupa customer services (1860-500-8888), then grievance officer, then GRO@nivabupa.com, then Ombudsman","note":"The CIS prints older Max Bupa e-mail addresses (customercare@maxbupa.com, GRO@maxbupa.com) and fax 011-30902010. Grievances can also be lodged at www.bimabharosa.irdai.gov.in.","quote":"In case of any grievance the insured person may contact the company through\n1. Website: www.nivabupa.com\n2. Toll free: 1860-500-8888 ... Insured person may also approach the grievance cell at any of the company’s branches with the details of grievance. If Insured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer ... If the Insured person is not satisfied with the above, they can escalate to GRO@nivabupa.com. ... the insured person may also approach the office of lnsurance Ombudsman of the respective area/region ... Email ID: customercare@maxbupa.com ... GRO@maxbupa.com","sources":[{"clause":"5.1.7","heading":"Grievances","page":10,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-1-7"},{"clause":"Row 10","heading":"Policy Servicing/Grievances/ Complaints","page":3,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209#c-row-10"}],"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":"not-stated","value":null,"display":null,"note":"No sum insured amounts are printed; the documents only say the sum insured applies on an individual basis to each family member and is as specified in the schedule.","quote":null,"sources":[],"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":0},"display":"None","note":"CIS states waiting period is not applicable; the wording prints no waiting period.","quote":"Waiting period | Not applicable","sources":[{"clause":"Row 4","heading":"Waiting period","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209#c-row-4"}],"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":"not-applicable","value":null,"display":null,"note":"Accident-only cover; CIS says waiting period not applicable, so a pre-existing disease waiting period does not arise.","quote":null,"sources":[],"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":"not-applicable","value":null,"display":null,"note":"Accident-only cover; no named-illness waiting period can apply (CIS: waiting period not applicable).","quote":null,"sources":[],"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":"not-applicable","value":null,"display":null,"note":"Accident-only cover; no named-illness waiting period can apply (CIS: waiting period not applicable).","quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":"No moratorium clause is printed.","quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":"No portability clause is printed.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"cross-checked","value":true,"display":"Yes, lifetime renewability","note":"Renewal may be refused on grounds of established fraud or non-disclosure or misrepresentation. The policy terminates for an insured person on death or payment of 100% Sum Insured.","quote":"Policy Renewal: We offer lifetime renewability under the plan. ... Implied renewability - Your policy is ordinarily renewable for life provided the due premium is paid on time ... A health insurance policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation by the insured. ... This policy shall automatically terminate upon the Insured Person’s death or payment of 100% Sum Insured.","sources":[{"clause":"1","heading":"POLICY DESIGN","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/208#c-1"},{"clause":"Row 11","heading":"Insured ’s Rights","page":3,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209#c-row-11"},{"clause":"5.1.4","heading":"Renewal of the Policy","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-1-4"},{"clause":"5.2.2","heading":"Automatic Termination of Insurance","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-2"}],"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 applies on renewal based on individual claims experience; a discount may be given for good claims experience.","display":"No loading for claims","note":null,"quote":"No loading shall apply on renewals based on individual claims experience. However, discount in premium may be provided by insurers to individual policyholders for good claims experience.","sources":[{"clause":"5.1.4","heading":"Renewal of the Policy","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-1-4"}],"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":["War, invasion, acts of foreign enemies, civil war, rebellion and similar","Intentional self-injury, suicide or attempted suicide","Under the influence of intoxicating liquor or drugs","Aviation or ballooning other than as a passenger in a Scheduled Airline","Breach of law with criminal intent","Participation as a professional in hazardous or adventure sports","Ionizing radiation, nuclear weapons material, nuclear, chemical and biological terrorism","Commission of or willful participation in an illegal act","Investigation & Evaluation (Code- Excl04) (hospitalisation cover)","Dietary supplements (Code-Excl14) (hospitalisation cover)","Domiciliary Hospitalization and OPD treatment (hospitalisation cover)","Treatment outside the geographical limits of India (hospitalisation cover)","Expenses listed in Annexure-B (List I) (hospitalisation cover)"],"display":"War, self-injury and suicide, intoxication, non-scheduled aviation, criminal acts, professional hazardous sports, nuclear risks; Excl04 and Excl14 for hospitalisation cover","note":"Only Excl04 and Excl14 of the standard codes are printed, and only for the optional Hospitalisation Expenses due to Accident cover.","quote":"directly or indirectly due to War (whether declared or not) and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion ... a) from intentional self-injury unless in self-defense or to save life, suicide or attempted suicide; ... b) Whilst under the influence of intoxicating liquor or drugs or other intoxicants ... c) Whilst engaging in aviation or ballooning, or whilst mounting into, or dismounting from or travelling in any balloon or aircraft other than as a passenger (fare-paying or otherwise) in any Scheduled Airlines in the world. ... d) Arising or resulting from the Insured Person committing any breach of law with criminal intent. ... due to participation as a professional in hazardous or adventure sports ... A. Ionizing radiation or contamination by radioactivity from any nuclear fuel ... B. Nuclear weapons material ... D. Nuclear, chemical and biological terrorism ... (v) Any loss arising out of the Insured Person’s actual or attempted commission of or willful participation in an illegal act ... i) Investigation & Evaluation (Code- Excl04) ... ii. Dietary supplements and substances that can be purchased without prescription ... (Code-Excl14) ... iv. Any expenses incurred on Domiciliary Hospitalization and OPD treatment. ... v. Treatment taken outside the geographical limits of India. ... vi. All expenses listed in Annexure-B (List I) of the Policy.","sources":[{"clause":"4.2(i)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-2-i"},{"clause":"4.2(a)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-2-a"},{"clause":"4.2(b)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-2-b"},{"clause":"4.2(c)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-2-c"},{"clause":"4.2(d)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-2-d"},{"clause":"4.1(i)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-1-i"},{"clause":"4.1(b)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-1-b"}],"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":"conflicting","value":"Cancel any time with 7 days' written notice; proportionate premium for the unexpired period is refunded on a one-year policy if no claim has been made.","display":"Proportionate refund for unexpired period if no claim (7 days' notice)","note":"CIS says: '15days' written notice' and refund 'on short term rates for the unexpired Policy Period'. The CIS disclaimer says the policy document prevails.","quote":"The policy holder may cancel his/her policy at any time during the term, by giving 7 days’ notice in writing. The insurer shall:\na) Refund proportionate premium for unexpired policy period, if the term of the policy upto one year and there is no claim(s) made during the policy period. ... The Insured may cancel this Policy by giving 15days’ written notice, and in such an event, the Company shall refund premium on short term rates for the unexpired Policy Period. ... In case of any conflict between the CIS and the policy document, the terms and conditions mentioned in the policy document shall prevail.","sources":[{"clause":"5.1.2","heading":"Cancellation","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-1-2"},{"clause":"Row 8","heading":"Cancellation","page":2,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209#c-row-8"},{"clause":null,"heading":"Customer Information Sheet","page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209#c-customer-information-sheet-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":"Worldwide, except the optional Hospitalisation Expenses due to Accident cover, which covers treatment in India only.","display":"Worldwide (hospitalisation cover India only)","note":null,"quote":"The coverage is worldwide except for the optional cover “Hospitalization expenses due to accident”. The coverage of optional cover “Hospitalization expenses due to accident”, is limited to medical treatment taken in India only.","sources":[{"clause":"5.2.5","heading":"Territorial Limit","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-5"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"conflicting","value":{"unit":"days","amount":30},"display":"30 days","note":"Not on renewals. CIS says: 'within 15 days of receipt of the Policy document'. Refund less proportionate risk premium, medical examination and stamp duty charges.","quote":"The insured person shall be allowed free look period of thirty days from date of receipt of the policy document ... you may cancel the Policy, stating your reasons within 15 days of receipt of the Policy document provided no claims have been made under any benefits. ... The Free Look Period shall be applicable on individual health insurance policies and not on renewals. ... the policyholder shall be entitled to a refund of the premium paid subject only to a deduction of a proportionate risk premium for the period of cover and the expenses, if any, incurred by the insurer on medical examination of the proposer and stamp duty charges.","sources":[{"clause":"5.1.1","heading":"Free Look Period","page":8,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-1-1"},{"clause":"Row 11","heading":"Insured ’s Rights","page":3,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209#c-row-11"}],"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":"15 days for monthly instalments.","quote":"can be renewed within the Grace Period of 30 days (annual installment) ... Grace Period of 30 days in all types of policies, and a period of 15 days in case of monthly instalments.","sources":[{"clause":"5.1.4","heading":"Renewal of the Policy","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-1-4"},{"clause":"5.2.9","heading":"Premium Payment in Instalments","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-9"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"cross-checked","value":"Adults 18 to 70 years; dependent children 3 months to 25 years.","display":"Adults 18 to 70 years; children 3 months to 25 years","note":"From the prospectus; the wording does not print entry ages.","quote":"Entry age for adults is 18 years to 70 years and entry age for children is 3 months to 25 years (dependent children)","sources":[{"clause":"1","heading":"POLICY DESIGN","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/208#c-1"}],"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":null,"quote":"Grace Period of 30 days (annual installment) ... Payment of Premium on an instalment basis i.e. Half Yearly, Quarterly or Monthly","sources":[{"clause":"5.1.4","heading":"Renewal of the Policy","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-1-4"},{"clause":"5.2.9","heading":"Premium Payment in Instalments","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-9"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"cross-checked","value":["Temporary total disablement","Hospitalisation Expenses due to Accident","Education grant"],"display":"Temporary total disablement, Hospitalisation Expenses due to Accident, Education grant","note":"Optional cover benefits are over and above the base sum insured.","quote":"Optional covers | i. Temporary total disablement ii. Hospitalisation Expenses due to Accident iii. Education grant","sources":[{"clause":"6","heading":"TABLE OF BENEFITS","page":15,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-6"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"cross-checked","value":"Yes, coverage is available during the grace period.","display":"Yes","note":null,"quote":"c) Coverage is available during the grace period. ... For policies where premium is paid in instalments only, the coverage will be given during grace period.","sources":[{"clause":"5.1.4","heading":"Renewal of the Policy","page":9,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-1-4"},{"clause":"5.2.9","heading":"Premium Payment in Instalments","page":12,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-9"}],"law":[]},{"key":"accidental_death","label":"Accidental death","section":"Cover","meaning":"What is paid if an accident causes death.","status":"cross-checked","value":"100% of Sum Insured if accidental injury during the policy period causes death within 12 months of the accident.","display":"100% of Sum Insured (death within 12 months of accident)","note":"Sum insured is shared with PTD and PPD. Loyalty Additions of 5% of base sum insured per completed year, up to 50%, are added to these base covers. Optional Education Grant pays 10% of base sum insured per dependent child.","quote":"The Company shall pay the benefit equal to 100% of Sum Insured, specified in the policy schedule, on death of the insured person, due to an Injury sustained in an Accident during the Policy Period, provided that the Insured Person’s death occurs within 12 months from the date of the Accident. ... there is a single sum insured for all the three covers namely, Accidental death, Permanent total disability and Permanent Partial Disability. ... Upon every completion of policy year, increase of 5% of the previous year’s Base Sum insured; maximum up to 50% of the Base Sum Insured. ... the company shall pay a one-time educational grant of 10% of the Base Sum insured (specified in the policy schedule), per child to all dependent children of the Insured","sources":[{"clause":"3.1(a)","heading":"Death","page":3,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-a"},{"clause":"3.1(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-a-3"},{"clause":"3.1(b)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-b-3"},{"clause":"3.2(c)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-c"}],"law":[]},{"key":"permanent_total_disability","label":"Permanent total disability","section":"Cover","meaning":"What is paid for permanent total disability.","status":"cross-checked","value":"100% of Sum Insured for PTD within 12 months of the accident: loss of sight of both eyes, loss of both hands or feet, one hand and one foot, sight of one eye and a hand or foot, or total disablement from any occupation.","display":"100% of Sum Insured","note":"Single sum insured shared with death and PPD.","quote":"The company shall pay the benefit equal to 100% of Sum Insured, specified in the policy schedule, if an insured Person suffers Permanent Total Disablement of the nature specified below, solely and directly due to an Accident during the Policy Period, provided that the Permanent Total Disablement occurs within 12 months from the date of the Accident: ... a) Total and irrecoverable loss of sight of both eyes or ... b) Physical separation or loss of use of both hands or feet or ... c) Physical separation or loss of use of one hand and one foot or ... d) loss of sight of one eye and Physical separation or loss of use of hand or foot ... permanently, and totally, disables the Insured Person from engaging in any employment or occupation of any description whatsoever. ... there is a single sum insured for all the three covers namely, Accidental death, Permanent total disability and Permanent Partial Disability.","sources":[{"clause":"3.1(b)","heading":"Permanent Total Disablement","page":3,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-b"},{"clause":"3.1(a)","heading":null,"page":3,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-a-2"},{"clause":"3.1(b)","heading":null,"page":3,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-b-2"},{"clause":"3.1(c)","heading":null,"page":3,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-c"},{"clause":"3.1(d)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-d"},{"clause":"3.1(e)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-e"},{"clause":"3.1(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-a-3"}],"law":[]},{"key":"permanent_partial_disability","label":"Permanent partial disability","section":"Cover","meaning":"The table of payouts for losing a limb, eye, hearing...","status":"cross-checked","value":"Percentage of Sum Insured by table: one hand, one foot or sight of one eye 50%; both ears 50%; one ear 20%; four fingers and thumb 40%; four fingers 35%; thumb 25% / 10%; all toes 20%; smaller finger and toe losses 1% to 10%; others as assessed by an independent Medical Practitioner.","display":"Table: 50% for a hand, foot, eye or both ears; 40% four fingers and thumb; 35% four fingers; 20% one ear","note":"Multiple disablements are capped at the sum insured, which is shared with death and PTD.","quote":"The company shall pay the following percentage of Sum Insured, specified in the policy schedule, if the Insured Person suffers Permanent Partial Disablement ... within 12 months of the date of the Accident. ... Loss of Use/ Physical Separation: One entire hand One entire foot Loss of Sight of one eye Loss of toes – all Great both phalanges Great one phalanx Other than great if more than one toe lost | 50% 50% 50% 20% 5% 2% 1% ... Loss of Use of both ears | 50% ... Loss of Use of one ear | 20% ... Loss of four fingers and thumb of one hand | 40% ... Loss of four fingers | 35% ... Loss of thumb both phalanges one phalanx | 25% 10% ... Loss of Index finger three phalanges two phalanges one phalanx | 10% 8% 4% ... Any other permanent partial disablement | Percentage as assessed by the independent Medical Practitioner ... Maximum amount payable in respect of multiple nature of disablements shall be restricted to sum insured chosen by the policyholder. ... there is a single sum insured for all the three covers namely, Accidental death, Permanent total disability and Permanent Partial Disability.","sources":[{"clause":"3.1(e)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-e"},{"clause":"3.1(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-1-a-3"}],"law":[]},{"key":"temporary_total_disability","label":"Temporary total disability","section":"Cover","meaning":"Weekly income paid while you cannot work after an accident.","status":"cross-checked","value":"Optional cover only: benefit as specified in the policy schedule, paid if disablement exceeds four consecutive weeks, for up to 100 weeks per Injury and never more than the Sum Insured; paid at quarterly intervals.","display":"Optional: benefit as per schedule, up to 100 weeks","note":"Optional cover. Must be certified to have commenced within 30 days of the accident. The benefit amount itself is in the schedule.","quote":"a) Temporary Total Disablement: ... the company shall pay the benefit as specified in the policy schedule, till the time the insured person is able to return to work ... i) The period of temporary total disablement shall exceed four consecutive weeks from the date of accident ... shall not be payable for more than 100 weeks in respect of any one Injury calculated from the date of commencement of disablement and in no case shall exceed the Sum Insured. ... The compensation shall be paid by the company at quarterly intervals ... The Temporary Total Disablement is certified in writing by the treating Medical Practitioner to have commenced within 30 days from the date of the Accident. ... The covers listed below are optional benefits","sources":[{"clause":"3.2(a)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-a"},{"clause":"3.2(a)(i)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-a-i"},{"clause":"3.2(a)(ii)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-a-ii"},{"clause":"3.2(a)(iii)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-a-iii"},{"clause":"3.2","heading":"Optional Covers","page":5,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2"}],"law":[]},{"key":"accident_medical","label":"Accident medical expenses","section":"Cover","meaning":"Treatment costs after an accident.","status":"cross-checked","value":"Optional cover only: hospitalisation medical expenses due to accident up to 10% of base sum insured, in India only; road ambulance up to Rs.2000 per hospitalisation.","display":"Optional: up to 10% of base sum insured","note":"Optional cover, over and above the base sum insured. Covers room, fees, ICU, implants, AYUSH, dental, plastic surgery and day care due to injury; non-hospitalised injuries and OPD are excluded.","quote":"Hospitalisation Expenses due to Accident: The Company shall indemnify medical expenses incurred for hospitalisation arising due to accident during the policy period, up to the limit of 10% of the base sum insured ... Expenses incurred on road Ambulance subject to a maximum of Rs.2000/- per hospitalization. ... is limited to medical treatment taken in India only. ... Room, Boarding, Nursing Expenses ... Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses ... The Cost of prosthetic and other devices or equipment if implanted internally ... i. Dental treatment.\nii. Plastic surgery.\niii. All the day care treatments. ... iii. Expenses incurred for treatment of accidental injuries which does not warrant hospitalization.\niv. Any expenses incurred on Domiciliary Hospitalization and OPD treatment. ... The benefits payable under each of the optional covers 3.2(a), 3.2(b) and 3.2(c) are independent and over and above the base sum insured.","sources":[{"clause":"3.2(b)","heading":"Hospitalisation Expenses due to Accident","page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-b"},{"clause":"3.2(b)(vi)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-b-vi"},{"clause":"5.2.5","heading":"Territorial Limit","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-5"},{"clause":"3.2(b)(i)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-b-i"},{"clause":"3.2(b)(iv)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-b-iv"},{"clause":"3.2(b)(v)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-b-v"},{"clause":"4.1(b)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-4-1-b"},{"clause":"3.2(a)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-3-2-a-2"}],"law":[]},{"key":"occupation_classes","label":"Occupation rules","section":"Eligibility","meaning":"Whether your job affects cover or premium.","status":"cross-checked","value":"Premiums are based on three risk classes by occupation (1 white collar, 2 semi-hazardous supervisory, 3 hazardous); a change of occupation must be notified.","display":"Premium depends on occupation risk class 1 to 3","note":null,"quote":"Premiums are based on Risk Class as mentioned in Annexure C. ... 1 | Persons engaged in white collar, non-hazardous occupations ... 2 | Persons engaged in semi-hazardous occupations ... 3 | Persons engaged in hazardous occupations ... The Insured Person shall immediately notify the Company in writing of any change in his business or occupation","sources":[{"clause":"1","heading":"POLICY DESIGN","page":1,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/208#c-1"},{"clause":"Annexure C","heading":"Risk Class Grid","page":21,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/208#c-annexure-c"},{"clause":"5.2.1","heading":"Material Change","page":11,"url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207#c-5-2-1"}],"law":[]}],"documents":[{"kind":"wording","label":"Saral Suraksha Bima Policy Wording","pages":24,"fetched_at":"2026-10-16 07:11:45.18104+00","source_url":"https://transactions.nivabupa.com/pages/doc/policy_wording/Saral-Suraksha-Bima_Policy-Wording.pdf?v=1.1","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/207"},{"kind":"prospectus","label":"Saral Suraksha Bima Prospectus","pages":21,"fetched_at":"2026-10-16 07:11:45.18104+00","source_url":"https://transactions.nivabupa.com/pages/doc/prospectus/Saral-Suraksha-Bima-Prospectus.pdf?v=1.0","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/208"},{"kind":"cis","label":"Saral Suraksha Bima, Niva Bupa Health Insurance Co. Ltd.","pages":5,"fetched_at":"2026-10-16 07:11:45.18104+00","source_url":"https://transactions.nivabupa.com/pages/doc/Customer-Information/CIS_Saral-Suraksha-Bima.pdf","url":"https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122/document/209"}],"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":"Saral Suraksha Bima, Niva Bupa Health Insurance Co. Ltd. (UIN NBHPAIP22153V012122), IndiaInsurances, https://indiainsurances.com/policy/niva-bupa-health-insurance/saral-suraksha-bima-niva-bupa-health-insurance-co-ltd-nbhpaip22153v012122"}