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Niva Bupa Health Insurance Claim Settlement

Niva Bupa Health Insurance Company Limited, one of India's leading insurers, was established in 2008. The mission of Niva Bupa, formerly Max Bupa, is to meet each person's healthcare and medical needs. The Indian private equity firm True North and the multinational healthcare services provider Bupa formed the company as a joint venture. From infants to senior citizens, the insurer offers a range of health insurance policies that are tailored to fit different age and health requirements along with their budgets. Niva Bupa provides a range of insurance products, such as business, travel, and health insurance.


This page contains details regarding the claim settlement ratio of Niva Bupa Health Insurance, how to initiate a claim, information from the claim form, and how to monitor the progress of a claim. To see the progress of your claim, visit the website or contact customer service. Make sure the claim form has correct information to avoid delays. To begin a cashless or refund claim and for assistance, please contact customer support.[1]



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Claim Settlement Ratio of Niva Bupa Health Insurance

Niva Bupa Health Insurance determines its claim settlement ratio by dividing the total number of claims paid by the total number of claims settled within 30 days. Below is a list of the claim settlement ratios over the last five years:

Fiscal Year

Claim Settlement Ratio

2023

91.6%

2022

90.53%

2021

90.78%

Why is the Claim Settlement Ratio Important?

When selecting a health insurance provider, it is essential to consider the claim settlement ratio (CSR) of the insurance company. CSR helps you assess the company's ability to settle claims, which is critical for you and your family. There are two main reasons why CSR is important:

  • Assists in Evaluating Insurance Companies: When buying an insurance policy, the insurer's Claim Settlement Ratio (CSR) must be considered. One statistic that might help you choose whether or not insurance is good for you is CSR. Before making a purchase, compare the CSR of many companies to see who has the greatest ratio. You are more likely to get a claim from an insurer with a higher claim settlement ratio if the need should arise.

  • Displays the Percentage of Claims that the Insurer has Paid Out: A high claim settlement ratio is important in assessing the commitment of insurance. A high settlement ratio indicates a higher likelihood of an insurer settling claims when policyholders need them. However, should the insured fail to provide the necessary documentation, the claim may be rejected, therefore reducing the insurer's percentage of claims settled.

Niva Bupa Health Insurance Claim Initiation

If you must file a claim with Niva Bupa Health Insurance, you must do the actions indicated below:

How To File a Claim

Step 1: Initiation

  • Contact the customer service representatives of InsuranceDekho or Niva Bupa Health Insurance as soon as possible if you have an emergency or need to make an appointment for medical care.

  • The Niva Bupa Health Insurance customer service department can be contacted by phone at 1800 309 3333, which is a toll-free number, or by email at rules.nivabupa.com/customer-service/?page=grievance.[2]

  • Should you like to talk with an InsuranceDekho representative, please email us at support@insurancedekho.com or give us a call at 7551-96989.[3]


Step 2: Verification

When your paperwork is submitted, the Niva Bupa Health Insurance claim staff will review it all. If everything is in order, your claim will start to be processed.


Step 3: Tracking

Please get in touch with customer service at Niva Bupa Health Insurance to find out the status of your claim. You may also obtain frequent updates by getting in touch with an InsuranceDekho customer service representative.


Details to be Filled in the Niva Bupa Health Insurance Claim Form

To file a claim for Niva Bupa Health Insurance, you need the following documents:


  1. Duly filled claim form

  2. Discharge or daycare summary

  3. Final hospital bill

  4. Payment receipts

  5. Investigation report

  6. Pharmacy bills

  7. Implant invoice

  8. Doctor Prescriptions

  9. Consultation Papers

  10. Age Proof

  11. Indoor Case Paper

  12. Copy of cancelled cheque

  13. KYC Form

Tax Save
Save Tax upto ₹75000*
Under Section 80D

*Tax benefits are subject to changes in Income Tax Act.

Claim Process Of Niva Bupa Health Insurance

Approximately 10,000 healthcare providers offer cashless services through Niva Bupa Health Insurance. Notification to Niva Bupa Health Insurance of any scheduled procedures at non-network hospitals must be made 48 hours in advance, or within 48 hours of the patient's admission in the case of an emergency. Be aware that permission for cashless care in non-network hospitals requires meeting the requirements outlined in your Niva Bupa Health Insurance policy as well as the hospital's.

Additionally, a list of actions to do regarding cashless transactions and reimbursement requests is provided below:

Cashless Claims

  • Proceed to the closest healthcare centre.

  • Visit the front desk to have a conversation with the third-party administrator, or TPA.

  • TPA will fill out and submit your application to Niva Bupa Health Insurance on your behalf.

  • After everything is authorised, the claim executive will proceed with the processing of the claim after reviewing the reports.

  • The hospital will allow you to begin therapy as soon as you receive approval.

  • Following treatment, the hospital and your health insurance company will split the cost.


Reimbursement Claims


  • Notify Niva Bupa Health Insurance 48 hours in advance, or within 48 hours in the event of an emergency, of your hospital stay.

  • Pay all of your hospital expenses and turn in the required paperwork.

  • Complete the claim form and mail it.

  • Await the insurer's permission and status report.


Keep in mind that you must:


  • Please submit your claim form together with all supporting evidence within 15 days after your discharge.

  • Ensure that all properly completed paperwork is prepared for submission to ensure a seamless claims procedure.

How to Check the Niva Bupa Health Insurance Claim Status?

Use these procedures to check the status of your Niva Bupa Health claim both online and offline:[1]

Online:

  • Visit the official website of Niva Bupa Health Insurance.

  • Choose the "Claim" sub-header from the header.

  • On the claim page, select the type of claim to proceed further.

  • Enter the data to confirm the status.

Offline:


  • Bring a copy of your insurance documents with you when you visit the nearest Niva Bupa Health Insurance store.

  • Get in touch with a branch office executive to find out how your claim is progressing and what coverage you have.


Additionally, you may obtain the latest information by contacting any number listed on the Niva Bupa Health Insurance website or by giving the customer care agent over the phone your claim reference number at 1800 309 3333, a toll-free number.[2]



Niva Bupa Health Insurance Claim Settlement Time

The Insurance Regulatory and Development Authority of India (IRDAI) states that an insurer has thirty days from the date of payment or the filing of claim documentation to settle a claim.

Tips to Get Your Claim Settlement Faster

The settlement of your claims may go more quickly if you have the following in mind:

  • Increase your comprehension of your policies.

  • Please send only the completed paperwork.

  • You should maintain a record of every correspondence you have with your insurance.

  • Maintain the policy's implementation.

  • Examine each document you have carefully.

  • If necessary, consult a lawyer.

Niva Bupa Health Insurance Claim Assistance and Support

To get assistance and backing with your Niva Bupa Health Insurance claim, you can:[2]

  • Email: rules.nivabupa.com/customer-service/?page=grievance.

  • Contact No:1800 309 3333

InsuranceDekho’s Claim Assistance and Support

To get assistance and backing with your InsuranceDekho claim, you can:[3]

  • Email: support@insurancedekho.com

  • Contact No: +91-755 1196 989

Grievance Redressal Contact Information for InsuranceDekho

Additionally, InsuranceDekho provides prompt customer support via the following channels:[4]

  • Email:- support@insurancedekho.com / grievance@insurancedekho.com

  • Contact Number: 7551196989

  • Mail Address:- Plot no.301, Phase-2, Udyog Vihar, Gurugram-122022, Haryana, India.

References

[1]https://www.nivabupa.com/

[2]https://www.nivabupa.com/health-insurance-articles/niva-bupa-customer-care-number.html

[3]https://www.insurancedekho.com/contact-us

[4]https://www.insurancedekho.com/grievance-redressal

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    I had to make a claim recently, and I was impressed with how quickly InsuranceDekho processed it. They were efficient and handled everything smoothly. Getting my claim settled by Niva Bupa Health Insurance was hassle-free.

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    "Thanks to InsuranceDekho, I finally discovered a Niva Bupa health insurance plan that met my requirements and budget. Their website was really user-friendly, and I was able to comprehend everything without the need for an insurance professional. Niva Bupa's policies were clearly put out, allowing you to make an informed decision. I definitely recommend utilising InsuranceDekho to locate your ideal health insurance plan!"

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    On: Jun 05, 2024
  • Claim settlement made easier w...

    To be honest, one of my best decisions in life was to get Niva Bupa Health Insurance. Purchasing their Health Companion Plan changed my life, particularly during difficult times. Everything went well from the moment I submitted my claim until it was all resolved. I had assistance from the InsuranceDekho team at every turn. It was a tremendous relief not to have to worry about money and instead focus on getting healthier.

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    The Health insurance plans available on the InsuranceDekho website are quite easy to understand. In no time I was able to buy the Niva Bupa Health Insurance Plan and I am very happy. Thank You!

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