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Robotic Surgery Sublimit Clause in Niva Bupa Reassure Plan

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24 Mar, 2022 by  Vijay Kumar

In the Niva Bupa Reassure Policy, there is a sublimit on modern treatments for the robotic surgery which states that they will reimburse up to 1 lakh for a robotic surgery.


My question is, in such cases, is robotic surgery the only option or I can choose the alternative treatment at the same hospital and the insurance company will pay for it as it is not robotic surgery anymore.

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You can choose another alternative for which the company shall pay fully.

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Hi Vijay, 


In Niva Bupa Reassure, 

A limit of maximum INR 1 Lac will apply to all robotic surgeries, except the following:

a) Robotic total radical prostatectomy

b) Robotic cardiac surgeries

c) Robotic partial Nephrectomy

d) Robotic surgeries for malignancies


Yes, the choice is absolutely yours whether you want to go for a robotic surgery or traditional procedure.


If it is a traditional procedure, full claim will be paid.


Thanks

Gurleen Kaur Tikku

Hareepatti




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24 Mar, 2022

Hi Vijay,


As per mandate of IRDAI, wef 01.10.2018 all insurers have been asked to cover 'Modern Treatment Methods and Advancement in Technologies', however sub limits for such procedures can be set by insurers.


Robotic Surgery is one such procedure, if you want to get the surgery done in modern manner, sub limits will be there like in your case. Go for traditional surgery to avoid any capping but not before checking the policy terms for any disease wise/age wise capping imposed in the policy for all surgeries.

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24 Mar, 2022
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24 Mar, 2022
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Correct, you can go ahead and choose whether you want traditional or robotic surgery, choice is yours, company will honor the claim fully in case of traditional and in robotic, except the following, limit of 1 lakh will apply.


1. Robotic total radical prostatectomy

2. Robotic cardiac surgeries

3. Robotic partial Nephrectomy

4. Robotic surgeries for malignancies


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