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Niva Bupa Health Insurance Claim Settlement

174 reviews Rate This
Cashless Approval TAT30 mins Cashless Claim Processing
Claim Settlement Ratio90.70%
Network Hospitals10,000+
Pre-existing Disease Coverage FromDay 1
Special BenefitsUnlimited restoration
Starting Premium for Rs. 5 lakhs SIRs. 550/month

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Claim Settlement of Niva Bupa Health Insurance

Niva Bupa Health Insurance is a popular health insurance company that offers a smooth claim settlement process. The insurer settles claims in two ways-cashless and reimbursement. The insurer has a wide network of more than 7,000 hospitals where the insured can avail cashless treatment, which can be either planned hospitalisation or emergency hospitalisation. If the treatment is availed at a non-network hospital, then the insured is required to pay from his/her own pocket at the hospital and later claim for reimbursement. Niva Bupa Health Insurance settles the claim according to the policy terms and conditions, whether the treatment is availed at network hospital or non-network hospital. The insurance company brags about cashless claim pre-authorisation within 30 minutes and settling claims without involvement of any third party.

  • Claim Process for Cashless Treatment

    If covered under Niva Bupa Health Insurance plans, you can avail cashless treatment at a network hospital. The insurance company has more than 7,000 such hospitals, the list of which can be found on the network hospital page of the insurer at InsuranceDekho. Following are the steps to be followed to make a cashless claim with the insurer:

    • Find a network hospital in the city that you wish to avail the cashless treatment in.
    • Inform the insurance company within 24 hours of emergency hospitalisation and 48 hours prior in case of planned hospitalisation. Do not forget to carry your Niva Bupa health card or policy number and photo ID proof at the hospital.
    • Fill the pre-authorisation form at the hospital and submit it there.
    • After checking your identity, the hospital will submit the pre-authorisation request form to Niva Bupa Health Insurance.
    • The insurance company will then review your documents, confirm with the hospital, and inform you about the claim status within 30 minutes.  
    • Once the formalities are complete, the insurer will then settle the claim at the hospital according to the terms and conditions of the policy. 

    How to Check Niva Bupa Health Insurance Plan Claim Status?

    You can check Niva Bupa Health Insurance claim status either online or offline. 

    Online Process 

    • Visit the official website of Niva Bupa Health Insurance.
    • Visit the claim section and navigate to the claim status portal.
    • Enter your username and password and log in to your account. You will be able to check the claim status there.  

    Offline Process 

    In case you are not able to track your health insurance claim status online, then you can opt for the offline mode too. In the offline process, all you need to do is visit the nearest Niva Bupa Health Insurance company’s branch and enquire about the claim status. 

  • Reimbursement Treatment

    If you were not able to file a cashless claim or if your request for a cashless claim gets rejected, then you can file for a reimbursement claim. A reimbursement claim can be made if the treatment is availed at a non-network hospital.

    Following are the steps to do so: 

    • You are required to inform the insurance company within 24 hours in case of emergency hospitalisation and within 48 hours in case of planned hospitalisation.
    • Send invoices, discharge documents, medical reports, with completely signed and filled claim forms.
    • Submit the insurance company photo ID proof and age proof.
    • Your claim request will either be approved, rejected, or enquired upon, as per the terms and conditions of the policy. 
  • Documents Needed

    Following are the documents required for claims under Niva Bupa Health Insurance: 

    • Final hospital discharge summary
    • Original investigation reports
    • Pharmacy bills along with the prescription
    • FIR or post-mortem report if happened
    • Original bills, receipts, and discharge report
    • Original hospital bills
    • A valid photo ID proof
    • Indoor case papers and duly-filled claim form
    • Documents specifying the nature of operation performed along with surgeon's bill and receipt
    • Treating doctor's report, and original consultation notes
    • Attending doctor’s or surgeon’s report along with test reports
    • If the claim is made for accidental death, then the claim form along with original death certificate, proposer’s income proof, FIR copy, copy of medico-Legal Certificate, last 3 month’s salary slip, employer’s certificate, and audited accounts are required.

    In case of any doubt or query, you can connect with the customer care executives at InsuranceDekho and get your queries solved. 

  • Incurred Claim Ratio (ICR) of Niva Bupa Health Insurance

    Incurred Claim Ratio (ICR) is a reliable way to ensure if an insurance company is reliable or not. It indicates the claim procedure and the productivity of an insurance company in terms of revenue. Niva Bupa Health Insurance has an ICR of 53.51% for the financial year 2019-20. 

Save Tax upto ₹75000*
Under Section 80D

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

Niva Bupa Health Insurance User Reviews

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What users are saying
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  • InsuranceDekho's customer support team was extremely helpful. They guided me through the selection process of ...

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    Niva Bupa
    By Fatima Faizal
    On: Oct 31, 2023
  • I appreciate how InsuranceDekho's Niva Bupa Health Insurance Plan allows me to customize my coverage based on ...

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    Niva Bupa
    By Vidya Rao
    On: Oct 30, 2023
  • InsuranceDekho's claims process is incredibly smooth and efficient. I recently had to file a claim for my Niva...

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    Niva Bupa
    By Naveen Chander
    On: Oct 26, 2023
  • I've had the pleasure of interacting with InsuranceDekho's support team, and they're top-notch. They guided me...

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    Niva Bupa
    By Puja Batra
    On: Oct 24, 2023
  • InsuranceDekho provides great value for money with their health insurance plans. The Niva Bupa Health Insuranc...

    Read More
    Niva Bupa
    By Pranjal Grover
    On: Oct 23, 2023
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Niva Bupa Health Insurance Contact Details

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Claim Process at Niva Bupa Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

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