Niva Bupa Health Insurance Claim Settlement

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. 

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) 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.