Niva Bupa Aspire (Titanium+)

Niva Bupa Aspire (Titanium+) Plan is a health insurance policy provided by the Niva Bupa Health Insurance Company Limited. 

This plan stands out with its array of distinctive features and advantages, making it a compelling option for those seeking a health insurance policy tailored to their specific needs. It presents several features for younger individuals to enrol early, such as the flexibility to pay premiums based on entry age until the first claim and the transfer of the served waiting period to a future spouse, among other perks.

Besides covering hospitalisation expenses, the plan extends its reach to encompass a wide range of costs, including maternity expenses, overseas treatment expenses, consumables costs, etc. However, it's worth noting that the plan lacks the flexibility of monthly premium payments. Furthermore, our research indicates that the insurer has received a higher number of complaints related to both claim settlements and policy purchases. This suggests a less favourable track record in terms of both the purchase and claims service.

What are the benefits offered by the Niva Bupa Aspire (Titanium+) Plan? 

• Inpatient hospitalisation coverage: Niva Bupa Aspire (Titanium+) Plan provides coverage for hospitalisation expenses, which include all costs associated with admission that exceed 24 hours, such as nursing care, medical consultations, prescription medication, intensive care unit (ICU), and any other related expenses.
• Pre-hospitalisation coverage: Pre-hospitalisation coverage includes the expenses incurred before hospitalisation, like consultations, tests, checkups, etc. To be eligible for this coverage, these expenses must be related to the medical condition that resulted in hospitalisation and should be approved as part of the inpatient hospitalisation coverage. The Niva Bupa Aspire (Titanium+) Plan provides coverage for pre-hospitalisation expenses for 60 days before hospitalisation, up to the sum insured. 
• Post-hospitalisation coverage: Post-hospitalisation expenses are the medical costs incurred after hospitalisation, including follow-up consultations with your doctor, medical check-ups, rehabilitation sessions, physiotherapy, and other related expenses. However, these expenses are eligible for coverage only if they are related to the medical condition for which you required hospitalisation and are approved as part of inpatient hospitalisation coverage. Niva Bupa Aspire (Titanium+) Plan covers post-hospitalisation expenses for 180 days after hospitalisation up to the sum insured. 
• Daycare treatment coverage: Daycare treatments are medical procedures or surgeries that previously required an extended hospital stay but can now be completed within 24 hours because of advances in medical technology. The Niva Bupa Aspire (Titanium+) Plan offers coverage for all daycare treatments without any limit, which implies that the costs will be covered up to the sum insured.   
• Domiciliary treatment coverage: Domiciliary treatments are medical treatments for illnesses or injuries that necessitate immediate attention at the hospital but are given at home due to the severity of the patient’s condition or the absence of hospital beds in the vicinity. The Niva Bupa Aspire (Titanium+) Plan covers expenses incurred for all domiciliary treatments up to the sum insured. Please note that the expenses for peritoneal dialysis and chemotherapy administered at home are covered. However, a daily monitoring chart, inclusive of treatment records administered and duly signed by the treating doctor, must be diligently maintained to be eligible for coverage. And, the expenses related to any medical and ambulatory devices used at home, such as pulse oximeters, BP monitors, sugar monitors, automation devices for peritoneal dialysis, CPAP, BiPAP, crutches, wheelchairs, etc., will not be covered by the policy.
• Organ donor coverage: The Niva Bupa Aspire (Titanium+) Plan covers the inpatient expenses of the organ donor up to the sum insured, where you are the recipient. And, if you donate any of your organs, expenses associated with harvesting the organ from you will also be covered.
• Modern treatment coverage: With technological advancements, healthcare is rapidly progressing, and modern treatments are emerging. These treatments, including stem cell therapy, robotic surgery, etc., treat diseases that were previously considered incurable. The Niva Bupa Aspire (Titanium+) Plan covers the expenses of such modern treatments up to the sum insured.
• Non-medical expenses coverage: In addition to medical expenses, non-medical expenses, such as gloves, oxygen masks, nebulization kits, and other similar items, are covered by some health insurance policies. Niva Bupa Aspire (Titanium+) Plan covers such expenses up to the sum insured if you opt for an add-on.
• No Claim Bonus: Health insurers offer a No Claim Bonus as a reward if no claims are made during a policy year. Niva Bupa Aspire (Titanium+) Plan provides 100% of the sum insured as No Claim Bonus, regardless of whether any claims are made during a policy year. It does not reduce the accumulated bonus even if a claim is filed. Furthermore, you can accumulate a maximum bonus of 300%, 500% or 1000% of the sum insured under the policy based on your age of entry.
• Super No Claim Bonus: The  Super No Claim Bonus is an enhanced version of the No Claim Bonus and works similarly. The Niva Bupa Aspire (Titanium+) does not offer a Super No Claim Bonus.
• Restoration Benefit: The refill benefit is a feature that restores the sum insured after it has been used up during a policy year. The Niva Bupa Aspire (Titanium+) Plan provides this benefit after the first paid claim for related and unrelated illnesses. This feature is activated when both the sum insured and the No Claim Bonus have been partially used up. Moreover, you can enjoy this benefit unlimited times in a policy year. Once the restoration benefit is activated following the first-ever paid claim, it remains in effect forever. This signifies that there is no necessity for another initial claim to re-trigger this benefit at renewals.

Please remember that the limitations and conditions mentioned in the benefits above apply to a sum insured of Rs. 10 lakhs. 

Niva Bupa Aspire (Titanium+) Plan: Financial Limits

• Room rent limit: A room rent limit covers the expenses related to the room you stay in during your hospitalisation. If the room you choose falls within the limit specified by your health insurance policy, you won’t have to pay any additional costs. However, if the room you select exceeds the eligibility limit, a proportionate deduction applies. And you will be responsible for paying a proportionate share of the total bill, not just the difference in the room rent. Niva Bupa Aspire (Titanium+) Plan offers the flexibility to select any type of room, as per your preference without any restrictions.
• ICU rent limit: It is the maximum amount covered by your health insurance policy for your ICU stay in the hospital. The Niva Bupa Aspire (Titanium+) Plan provides coverage for the ICU rent without any limit. This means the plan covers the entire cost up to the sum insured.
• Co-payment: A co-payment refers to a certain percentage of the claim amount that you must pay out of your own pocket. Once this amount is paid, the insurer will cover the remaining expenses. Under the Niva Bupa Aspire (Titanium+) Plan,  there is no co-payment unless you choose the borderless add-on, which offers several co-payment options. Among these options, you have the flexibility to select a 0% co-payment by opting for a slightly higher premium.
• Deductible: A deductible refers to the amount of medical expenses that you must pay from your end before your coverage kicks in to cover your medical expenses. In the Niva Bupa Aspire (Titanium+) Plan, you can voluntarily choose deductible from options 20K / 30K / 50K / 100K.
• Limits on surgeries/treatments: It is the maximum amount that a health insurance policy will pay for certain medical procedures or treatments. While some insurers have limits on the amount they will cover for certain procedures, others may not. Under the Niva Bupa Aspire (Titanium+) Plan, there are no such limitations. Important surgeries/procedures such as joint replacement surgery and cataract treatment are covered up to the sum insured. 

Please note that the above financial limits are taken for a 30-year-old individual, opting for a sum insured of Rs. 10 lakhs. 

Niva Bupa Aspire (Titanium+) Plan: Waiting Periods & Exclusions

👉Waiting period

After you purchase a health insurance policy, some illnesses and diseases may not be covered for a certain period of time. This duration is referred to as the waiting period. But, once the waiting period has ended, you can claim for these conditions -

• Initial waiting period: An initial waiting period of 30 days applies for all medical conditions except accidents. This means that you will not be able to make a claim for any hospitalisation, except for accidents, for the initial 30 days of policy purchase.
• Waiting period for pre-existing diseases: A pre-existing disease refers to a medical condition you have experienced in the past 36 months before purchasing a health insurance policy. Under the Niva Bupa Aspire (Titanium+) Plan, there is a waiting period of 36 months for pre-existing diseases. During this period, you cannot claim for medical expenses related to such diseases. 
• Waiting period for specific diseases: Apart from pre-existing conditions, insurers will have a list of specific medical conditions or illnesses that are subject to a waiting period, irrespective of whether you have had those diseases before or not. The duration of this waiting period is decided by the insurer and is not based on your current health status. The Niva Bupa Aspire (Titanium+) Plan has a waiting period of 24 months for specific diseases, except cancer (covered from the 31st day) and accidents. 

👉Exclusions

Health insurance policies do not cover certain medical conditions. These are known as exclusions. Here are some of the types of exclusions -

• Standard permanent exclusions: All insurance providers are required to adhere to the ‘standard permanent exclusions’ established by IRDAI. These include -

1. Investigation and evaluation: Hospital admission for observation or monitoring.
2. Rest, rehabilitation, and respite care: Admission to a facility for bed rest without active treatment. 
3. Obesity/weight control: Treatment or surgery related to weight control or obesity.
4. Gender reassignment: Treatments aimed at altering the body’s characteristics to match the opposite sex. 
5. Plastic/Cosmetic surgery: Treatment or surgery intended to modify body characteristics or appearance.
6. Profession in hazardous or adventure sports: Treatment expenses resulting from participating in adventurous activities such as river rafting, mountaineering, scuba diving, etc. as a professional.  
7. Breach of law: Expenses incurred in treating a person who has committed or attempted to commit a criminal act.
8. Excluded providers: Treatment received from medical practitioners or hospitals excluded by the insurance company.
9. Narcotics: Treating addiction to substances such as alcohol, drugs, etc.
10. Treatments in establishments arranged for domestic purposes: Expenses incurred due to the treatment received in health spas, nursing homes, or similar establishments arranged entirely or partially for domestic reasons. 
11. Dietary supplements are substances purchased without subscription, such as vitamins, minerals, etc., that a medical practitioner does not prescribe.
12. Refractive error: Expenses associated with correcting refractive errors of up to 7.5 diopters to improve eyesight.
13. Unproven treatments: Surgeries, medical procedures, or treatments that are not proven to be effective.
14. Expenses related to birth control, sterility, infertility: Contraception, sterilisation, artificial insemination, advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc. 
15. Maternity expenses: Pre/post-natal costs, childbirth-related hospitalisation expenses, etc. 

• Additional permanent exclusions: Insurance companies can impose additional exclusions for certain medical conditions or situations apart from the standard permanent exclusions. In case you have a severe medical condition or a specific disease that is considered risky by the insurer, they may choose to permanently exclude it from the policy. The IRDAI has established a list of illnesses for which insurance companies can enforce permanent exclusions. However, insurance companies cannot impose permanent exclusions on illnesses or diseases that are not on this list. 
• Non-standard exclusions (Specific exclusions): Specific Exclusions are the medical conditions that are excluded from a health insurance policy beyond the standard permanent exclusions listed by the IRDAI. These specific exclusions are determined by the individual insurance company and can differ based on the policy’s terms and conditions. The specific exclusions under the Niva Bupa Aspire (Titanium+) Plan are- 

1. Expenses incurred for an injury or illness directly or indirectly due to terrorism, nuclear, radiological emissions, war like situations, rebellion, etc.
2. Expenses related to screening, counselling or external birth defects.
3. Expenses related to dental treatment unless it's caused due to cancer and accidents.
4. Ventilator for a patient in a vegetative state (brain dead) with no possibility of recovery.

What to expect in terms of claims experience if you buy from Niva Bupa Health Insurance Company Limited?

• Speed of claims: Niva Bupa Health Insurance Company has a record of settling claims quickly and efficiently. It has settled 99.95% of claims in less than 30 days.  
• Claim-related complaints: As per our research, Niva Bupa Health Insurance Company has received 0.49% of complaints related to claims, which is significantly higher than other insurance companies. 
• Claims incurred ratio: The claims incurred ratio measures the company’s financial performance and represents the number of claims incurred compared to the total premiums collected in a financial year. Niva Bupa Health Insurance Company has a claims incurred ratio of 65.44%.
• Claim settlement ratio: The claim settlement ratio is the percentage of claims settled by the insurer as compared to the total number of claims they received in a financial year. Niva Bupa Health Insurance Company has a claim settlement ratio of 85.18%. 
• Network hospitals: Niva Bupa Health Insurance Company has a network of over 10,000+ hospitals across various locations. Such a vast network enables you to receive cashless treatments from a wide range of healthcare providers across various locations.

How is the customer service of Niva Bupa Health Insurance Company Limited?

• Policy purchase-related complaints: Based on our research, Niva Bupa Health Insurance Company has received 0.01% of complaints related to its after-sales service, which is significantly higher than other insurance companies. 
• Response on Toll-Free: Our research suggests that Niva Bupa Health Insurance Company’s response time on their toll-free number is average, as compared to other insurers.
• Response on Twitter: As per our research, Niva Bupa Health Insurance Company’s response time on Twitter is also average, as compared to other insurers. 

About Niva Bupa Health Insurance Company Limited

Niva Bupa Health Insurance Company, previously known as Max Bupa Health Insurance Company Limited, is a health insurance company in India. It is a joint venture between Fettle Tone LLP and Bupa Singapore Holdings Private Limited. It offers a wide range of products including individual health plans, family floaters, top-up policies, and more. It was established in 2008 and is headquartered in New Delhi, India. The company's CEO and MD is Mr. Ashish Mehrotra.