Reach out to us, as

YOUR HEALTH
deser ves nothing less.

If you would like to find out more, please reach out to our specialised sales team or your Niva Bupa advisor. We are available
to fully understand your requirements and help you select the right plan for you and your family.

Customer Helpline: Fax: www.twitter.com/

1860-500-8888 +91 11 41743397 nivabupa
Your health deserves nothing less.

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www.nivabupa.com nivabupahealthinsurance

NIVA BUPA HEALTH INSURANCE COMPANY LIMITED

Registered Office Address: C-98, First Floor, Lajpat Nagar, Part 1, New Delhi-110024,

Disclaimer: This is only a summary of the product features and is for reference purpose only. The details of benefits available shall be as described in the prospectus,
and will be subject to the policy terms, conditions and exclusions. Please call our customer service if you require any further information or clarification. Insurance is
a subject matter of solicitation. Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited) (IRDAI Registration
No. 145). ‘Bupa’ and ‘HEARTBEAT’ logo are registered trademarks of their respective owners and are being used by Niva Bupa Health Insurance Company Limited
under license. $$For details, please refer to the policy document on our website. #For details, please refer to the Product Benefit Table. ^Maternity and newborn baby
cover not available under individual plan. *Tax benefits are subject to changes in tax laws. Please consult your tax advisor for more details. $Niva Bupa processes
pre-authorisation requests within 30 minutes for all active policies, subject to receiving all documents and information(s) upto Niva Bupa’s satisfaction. The above
commitment does not include pre-authorisation settlement at the time of discharge or system outage. ##Number of network hospitals shown is an approximate figure
and is subject to change without prior notice, please visit our website to access latest and updated list of network hospitals. ∞By default, coverage is not available for
USA & Canada. However, coverage can be extended to USA & Canada on payment of additional premium. ~Health Premia plan covers COVID-19 related hospitalisation.
“For more details on risk factors, terms, conditions and exclusions, please read sales brochure carefully before concluding the sale”. CIN: U66000DL2008PLC182918,
Product Name: Health Premia. Product UIN: MAXHLIP21176V022021. UIN: NB/BR/CA/2022-23/222.
 HEALTH PREMIA PLATINUM PLAN
Niva Bupa A comprehensive health insurance plan, ‘Health
Premia’ provides the perfect coverage for you and
Niva Bupa Health Insurance Company Ltd. is a leading your family according to your needs and lifestyle.
standalone health insurance provider serving 7 million So, whether it’s going in for newborn child benefits
plus customers. At Niva Bupa, our mission is to help our or emergency medical treatments abroad, Health
customers live healthier and more successful lives by Premia ensures that you get the best in healthcare.
providing expertise as their healthcare partners. For After all, your health deserves nothing less.
us, health insurance is not just an annual transaction.
Rather, it is about building a long-term relationship
with our customers.

International coverage
Maternity (worldwide)∞
Comprehensive Modern Treatments for specified illness and
and newborn baby
coverage up to ` 3 Crore coverage medical emergencies∞
cover^

In-built travel insurance Annual health

coverage for multiple Refill benefit for Loyalty Additions of 10% in
check-up of your
trips in a year∞ any illness in a sum insured per year
choice from day 1
policy year
Health Premia is thoughtfully designed keeping you in mind,
so that your focus is on getting healthy, while we take care
of the rest.
Higher Coverage Options In-patient Care
Every individual is different and so are their requirements. Getting a medical treatment done can have its share
Hence, we provide multiple sum insured options, up to INR of uncertainty, especially when it comes to money.
3 Crore, to give you flexibility to choose the coverage that So, we make sure we cover all your expenses upon
suits your requirements. hospitalisation like room rent, doctor consultations,
medicine expenses, day care treatment. In-patient
treatments taken under Ayurveda, Unani, Siddha and
Homeopathy are also covered.
Worldwide Maternity Benefit Cover∞
Welcoming a newborn into the family is a moment that
one treasures for life. And just like you take care of Day Care Treatments
your little one, we partner with you by providing you Some treatments require hospitalisation but do not
maternity benefit worldwide post serving a waiting require for you to stay overnight in hospital such
period#. In addition to this, your newly born gets as dialysis, angiography, endoscopy among other
covered under New Born Baby benefit # from the very procedures$$. Our comprehensive policy provides
first day, which includes defined vaccinations. (Not coverage for such treatments.
available under individual plan).

Pre and Post Hospitalisation

Pre and post hospitalisation expenses are covered up
to the sum insured, 90 days prior and 180 days post
hospitalisation.

International Coverage and Inbuilt Travel Insurance.

Sometimes, there are certain planned procedures that you or your loved ones need to undergo. In such cases, you can avail
cashless treatments (post diagnosis in India) anywhere outside India, excluding USA & Canada. Our plan covers 9 specific
illnesses under this facility: Cancer, Myocardial Infarction (Heart Attack), Coronary Artery Bypass Graft, Major Organ Transplant,
Stroke, Surgery of Aorta, Coronary Angioplasty, Brain Surgery and Primary Pulmonary Arterial Hypertension.

Keeping your lifestyle in mind, we have created a plan that covers new age There are times when you travel abroad, and an unplanned need for medical care arises. Health Premia comes with an inbuilt

treatments to cater to all your needs. travel insurance of INR 1 Crore per member that covers emergency hospitalisation, emergency medical evacuation, OPD cover,
compassionate visit, care and/or transportation of minor children, medical referral and medical repatriation in foreign countries,
excluding USA & Canada. We also give coverage for loss of passport, loss of checked-in baggage, return of mortal remains, trip
01 Laser Surgery cancellation & interruption, trip delay and delay of checked-in baggage.
Use of new age technology is now a part of many major medical practises. Which is why, we cover expenses incurred, post serving
a waiting period#, while undergoing a laser assisted surgery.
We’ve got you covered, even outside hospital.
02 Living Organ Donor Transplant We understand that not all treatments require hospitalisation. Which is why, we offer coverage to you even outside hospital by taking care
of health check-ups from day 1, pharmacy & diagnostic services, domiciliary treatment coverage as prescribed by a medical practitioner and
In case of an organ transplant, medical expenses for the organ donor’s in-patient treatment for the harvesting of the organ
e-consultations. You even get coverage for emergency assistance services and ambulance costs, so that at no moment you ever feel that
donated are covered by us.
healthcare is far away.
Good health comes with great benefits. One policy, no matter how big the family.
01 Tax Saving* 05 Tenure Discount With Family First variant, you can get coverage for 19 relationships$$ in a single policy.
Income tax benefit* as per Section 80D of the Income Tax If you pay for 2 year policy term, you get a discount of 7.5%
Act, 1961. on the premium of second policy year. On the other hand, Your family will be covered at the following two levels:
02 Zonal Coverage if you choose 3 year policy term, you get an additional
discount of 15% on the third year’s premium. 01 Individual Sum Insured 02 Floater Sum Insured
India being a vast country, the cost of healthcare varies across This cover provides an individual sum insured for each member of This cover is available as a pool for all family members and can
cities. If you would like the flexibility of getting treated anywhere
in India, then, you can opt for Zone 1 pricing. 06 Premium Waiver the family. The individual sum insured is the same for each of the
family members.
be used by any member once his/her individual sum insured is
exhausted.
But if you live in a city other than Mumbai (including Navi If an insured policy holder passes away or is diagnosed
Mumbai and Thane), Delhi NCR, Kolkata & Gujarat you can avail with a specified illness during the policy period, then the FAMILY MEMBERS AGE BASE SUM INSURED (IN LACS)
of a lower premium by opting for Zone 2 pricing, all you need premium for next year will be waived off. (Not available
to do is to bear 20% co-payment in the aforementioned cities. under individual plan). FATHER 56 5
03 Re-fill Benefit
When the same or different illness strikes in the same policy year, 07 Loyalty Additions MOTHER 55 5
your base sum insured is re-filled and made available to you. For us, loyalty is a virtue. So, even if you’ve claimed in the
SON 30 5
04 15 Day Free Look Period previous year, you get an additional coverage i.e. 10% (or
20% if Enhanced Loyalty addition is opted) of your base
As per IRDAI guidelines, you get the freedom to change your sum insured annually, subject to a maximum of 100% of the DAUGHTER-IN LAW 25 5
decision of continuing with the policy for a period of 15 days. For
base sum insured.
other cancellation clauses, please refer to the policy document BASE SUM INSURED FOR ALL INSURED
on our website. 20 Lacs
PERSONS TAKEN TOGETHER

We know that there is always room for more, which is why our FAMILY FLOATER SUM INSURED 20 Lacs
care comes with additional benefits you can opt for. SUM INSURED 40 Lacs

01 Personal Accident Cover 04 International Coverage Extension

In the most difficult times, we make sure we’re by your side. Through
this optional cover, a lump sum payout is offered in case of accidental
When you decide to travel abroad, we give you the option to increase
your international coverage sum insured from INR 1 Crore to INR 2
6 Simple steps to purchase any Niva Bupa health insurance policy.
death, permanent total or partial disability. This cover can be opted Crore to cover all your international travel needs. In case you travel
by any member of your family who is aged 18 years or above. to USA/Canada, you can opt for enhanced geographical coverage#. STEP STEP STEP STEP STEP STEP

02 Critical Illness Cover 05 Hospital Cash 6

For enhanced protection, an optional coverage against 20 major
We know that your journey of getting better is not yours alone.
critical illnesses like Cancer, Open Heart surgery, Kidney Failure,
There are loved ones who spend day and night by your side at the
Strokes etc. is available. Upon first diagnosis of any of these illnesses
hospital. Which is why, our plan provides additional payout to cover
you get an additional coverage as a one time lump sum payout. This
miscellaneous expenses that you may incur during hospitalisation. Fill the application
payment will be over and above your hospitalisation expenses which form. At this stage An offer is made Read the offer
document carefully
post evaluating
are paid through the base policy. This cover can be opted by any please ensure you Undergo pre-policy your case and the and ask the sales In case of any doubt,
disclose details medical check-up, if representative for reach out to us
member of your family who is aged 18 years or above. correctly for all premium may Accept the offer.
applicable at our be loaded basis the details on your on our
members to ensure network centre. policy features, customer helpline
health disclosures of

03 Enhanced Loyalty Addition

smooth claims benefits, exclusions number or website.
processing when the all proposed
insured. and waiting
need arises. periods.
We make sure that your loyalty is rewarded, no matter what your
claim history has been. You get an additional coverage of 20%
instead of 10% of the expiring base sum insured every year as loyalty
addition, subject to a maximum of 200% of the base sum insured. Pro Tip - At the time of purchase, ensure you opt for the auto debit option to ensure timely and hassle-free renewals.
We believe in making things seamless and effortless for you. Our smooth renewal process only requires you to say yes and we
And that’s why, we ensure all genuine claims are processed as will do the rest.
fast as possible. 01 Life-long Renewal
01 Direct Claims Settlement 04 Hassle-free Reimbursements We offer life-long renewal, regardless of your health status or previous claims made under your policy. Your renewal premium will in-
crease as your age increases but will not alter based on your claim experience. Renewal premium rates for the product may be revised
For quick claims processing we ensure all claims are processed Sometimes, you may not be able to access a network hospital in future subject to IRDAI approval and in accordance with the IRDAI’s rules and regulations as applicable from time to time.
by our team of in-house doctors. for availing cashless facility. In such cases, to get your claim

02 ##
8800+ Wide Network Hospitals
reimbursed as fast as possible, all you need do is submit the
requisite documents to us.
02 Sum Insured Enhancement
To protect yourself from rising medical expenses, you can enhance your sum insured or add more members of your family in your
Avail cashless facility across India at ##8800+ network hospitals. 05 Point of Care Desk (POC) existing policy at the time of renewal. We may reach out to you for additional information/medicals in case needed.
At our select partner hospitals, a Niva Bupa representative
is available to assist you through all the formalities like filling
03 Loyalty Additions
On completion of each policy year, you get an additional coverage i.e. 10% (or 20% if Enhanced Loyalty addition is opted) of base sum
03 30 Minute Cashless Claims Processing$
forms, submitting claims etc. so that you are at ease in an
unfamiliar hospital environment.
insured under this benefit subject to policy terms & conditions.
We aim to process all cashless claims in 30 minutes so that you
can be with your loved ones in their hour of need. Visit our company website for a list of hospitals with this facility.
04 Portability and Migration
You can port your policy at the time of renewal according to the IRDAI guidelines. Please reach out to us for any query regarding
migration and portability.

Waiting period and exclusions under Health Premia**

01 Pre-existing Conditions 04 The following benefits will have a waiting period of 36 months
since inception of the Policy and subject to continuous
Benefits will not be available for pre-existing conditions as per your
renewal: Mental disorder treatment | LASER surgery cover
policy plan until 24 months of continuous coverage from first policy
start date.

02 30 Days Initial Waiting Period 05 For HIV /AIDS cover, there will be a waiting period of 48
months since inception of the Policy and subject to continuous
Treatment during the first 30 days of the plan will not be covered, renewal.

06 For
unless the treatment needed is a result of an accident. This waiting
Critical Illness cover, a 90 days initial waiting period along
period does not apply for renewal policies.
with the Pre-existing Disease waiting period of 4 years and
Survival Period exclusion of 30 days will apply for all conditions.
03 Specific Waiting Periods (The aforementioned waiting periods shall not apply to
Conditions like cataract, hernia, internal congenital anomaly, spinal disorder, e-Consultation, Health Check-up, Premium Waiver, Pharmacy
will be subject to a waiting period of 12 months. and Diagnostic Services, Personal Accident Cover and Health
Coach)
** Waiting period and exclusions are indicative, please refer to the policy wording for complete details.

Permanent exclusions.
Investigation & Evaluation | Unproven Treatments, Unrecognized Physician or Hospital, Hazardous or Adventure sports, Dental/oral treatment, Sleep
disorders, Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof. | Refer to the policy document for
complete list of Exclusions under this Plan.
PRODUCT BENEFIT TABLE - HEALTH PREMIA - PLATINUM VARIANT
Plan Platinum (Individual and Family Floater) Platinum ( Family First)
Base Individual Sum Insured (per Insured Person): 10 Lacs, 11 Lacs, 12 Lacs, 13 Lacs, 14 Lacs & 15 Lacs
Base Sum Insured (in Rs) 1 Crore / 2 Crore / 3 Crore Floater Sum Insured (available on a floating basis over Base Individual Sum Insured): Number of Insured Persons (value to be considered as 10 for more than 6
members) *Base Individual Sum Insured *Multiplier factor (1.5 for 2 member policy & 1 for others)
Benefits
In-patient care
Room rent
Pre-Hospitalisation Medical Expenses (90 days)
Post-Hospitalisation Medical Expenses (180 days)
Day Care Treatment
Domiciliary Hospitalisation
Alternative Treatment
Living Organ Donor Transplant
Child Care Benefits (Vaccinations for children up to 12 years including one consultation for nutrition and growth during the visit for vaccination) Covered up to Sum Insured
Specified Illness Cover (1) (outside the geographical boundaries of India for worldwide excluding USA & Canada)
Emergency assistance services (only within India)
- Medical referral
- Emergency medical evacuation (air ambulance)
- Medical repatriation
- Compassionate visit
- Care and/or transportation of minor children
- Return of mortal remains
New Born Baby (covered uptill the end of Policy Year) (2)
Vaccination of the new born baby Covered until new born baby completes one year, vaccinations as per pre-defined list
Emergency Ambulance Network Hospital: Covered up to Sum Insured Non-network Hospital: Covered up to Rs. 2,000 per event
HIV / AIDS (waiting period of 4 years) Covered up to Rs 50,000
Modern Treatments Covered up to Sum Insured with sub-limit of Rs. 1 Lac on few robotic surgeries
LASER surgery cover (waiting period of 3 years) Covered up to Rs 1,00,000
Mental disorder treatment (waiting period of 3 years) Covered up to Sum Insured (sub-limit of Rs 1,00,000 applicable on few conditions)
Second Medical Opinion Covered worldwide, One opinion per Insured Person per Specified Illness / planned Surgery
Premium Waiver One-time premium waiver if the Policyholder dies or suffers from specified illness
Pharmacy and diagnostic services Available through our empanelled service provider
e-Consultation Unlimited tele / online consultations
International coverage (outside the geographical boundaries of India for worldwide excluding USA & Canada) Condition: Annual multi trip (Max 45 days coverage in a single trip); International Sum Insured: up to Rs. 1 Crore per insured person
Emergency Hospitalisation
Emergency Medical Evacuation
Compassionate Visit
Care and/or transportation of Minor Children Covered up to International Sum Insured
Return of Mortal Remains
Medical Referral
Medical Repatriation
OPD Cover Covered up to International Sum Insured with a co-payment of 20%
Loss of Passport Covered up to Rs 20,000
Loss of Checked-in baggage Covered up to Rs 10,000
Trip Cancellation & Interruption Rs 25,000
Trip Delay Rs 10,000
Delay of Checked-in Baggage Rs 5,000
OPD Treatment and Diagnostic Services (3) Covered up to Rs 50,000 per policy Covered up to Rs 35,000 per policy
Health Check-up (from Day 1) Annual, tests covered up to worth Rs 10,000 per Insured Person Annual, tests covered up to worth Rs 5000 per Insured Person
Maternity Benefit (covered for up to 2 pregnancies or terminations) (2) Covered up to Rs 200,000 (worldwide excluding USA & Canada) Covered up to Rs 1,00,000 (worldwide excluding USA & Canada)
Loyalty Additions Increase of 10% of expiring Base Sum Insured in a Policy Year; maximum up to 100% of Base Sum Insured Increase of 10% of expiring Base Individual Sum Insured in a Policy Year; maximum up to 100% of Base Individual Sum Insured
Re-fill Benefit Reinstate up to base Sum insured. Applicable for same & different illness as well Not available
Optional Benefits
Personal Accident Cover (for insured aged 18 years & above on individual basis) 1 Crore
Critical illness cover (for insured 18 years & above on individual basis) 25 lacs / 50 lacs / 1 Crore
Enhanced Loyalty Addition Increase of 20% of expiring Base Sum Insured in a Policy Year; maximum up to 200% of Base Sum Insured Increase of 20% of expiring Base Individual Sum Insured in a Policy Year; maximum up to 200% of Base Individual Sum Insured
International Coverage Extension (outside the geographical boundaries of India for worldwide excluding USA & Canada) Double Sum Insured for ‘international coverage’ benefit
Hospital Cash (4) Rs 7,500/day Rs 6,000/day
Enhanced Geographical Scope for International Coverage USA & Canada included for Maternity Benefit, Specified Illness and International coverage
Health Coach Personalised health coaching for insured aged 18 years & above for any 90 days per Policy Year
(1)
The symptoms of the Specified Illness first occur or manifest itself during the Policy Period and after completion of the 90 day from the inception of 1st Policy with us.
(2)
Subject to a continuous coverage of 24 months of that Insured Person since the inception of the first Policy which offers Maternity benefit with us.
(3)
80% of the untilized amount in a policy year gets carried forward to next year; provided the total amount shall not exceed 2.5 times of the benefit limit.
(4)
Hospital Cash - Minimum 48 hrs of continuous hospitalisation required. Maximum coverage offered for 30 days/policy year/insured person. Payment made from day one subject to hospitalisation claim being admissible.