Niva Bupa ReAssure 2.0 (Gold)

Niva Bupa ReAssure 2.0 (Gold) is a health insurance policy offered by Niva Bupa Health Insurance Company Limited. Not only is the Niva Bupa - ReAssure 2.0 (Gold) plan cost-effective, but it also distinguishes itself with its exceptional features and advantages, tailored specifically to meet your healthcare requirements. One notable feature is the ability to carry forward any unused base sum insured to the following policy year, up to a maximum of 10 times the base sum insured. Additionally, once you make your initial claim, you can benefit from an unlimited sum insured for the entire duration of the policy. In addition to covering hospitalisation and related expenses, this policy also takes care of various costs, such as consumables like gloves and oxygen masks.

However, it's important to note that there is no monthly premium payment option available. Furthermore, our research indicates that the insurer has received a higher number of complaints regarding claim settlements and policy purchases. This suggests that their track record in both purchase and claims service may be unsatisfactory.

What are the benefits offered by the Niva Bupa - ReAssure 2.0 (Gold)?

• Inpatient hospitalisation coverage: The Niva Bupa - ReAssure 2.0 (Gold) plan provides coverage for your inpatient hospital expenses, ensuring that you are well taken care of during longer stays exceeding 24 hours. This comprehensive plan includes the cost of your hospital room, nursing care, consultations, prescription medications, ICU charges, and any other relevant expenses that may arise. With this coverage, you can have peace of mind knowing that your healthcare needs will be fully supported.
• Pre-hospitalisation coverage: Before being admitted to the hospital, there is a possibility that you may come across certain medical expenses. These expenses, known as pre-hospitalisation charges cover costs such as consultations, laboratory tests, checkups, and medical reports, among other services. It is important to keep in mind that your insurance company will only reimburse these expenses if they are directly related to the medical condition that led to your hospitalisation and if the claim is approved as part of your inpatient hospitalisation coverage. With the Niva Bupa - ReAssure 2.0 (Gold) plan, your pre-hospitalisation expenses will be taken care of for up to 60 days prior to your hospitalisation, up to the sum insured.
• Post-hospitalisation coverage: After your hospital discharge, you may come across additional medical expenses referred to as post-hospitalisation costs. These costs typically include fees for consultations, check-ups, medical tests, and other related charges. It is important to note that for these expenses to be covered, they must be directly linked to your hospital stay and approved as part of your inpatient hospitalisation coverage. Experience the extensive coverage of the Niva Bupa - ReAssure 2.0 (Gold) plan, where you can receive full protection for post-hospitalisation costs up to the sum insured for a generous 180-day period after your hospital discharge.
• Daycare treatment coverage: This remarkable feature allows you to undergo medical procedures or surgeries that previously required an extended hospital stay, all within a mere 24 hours, thanks to the incredible advancements in medical technology. Experience the extensive benefits of our Niva Bupa - ReAssure 2.0 (Gold) plan, where you can receive comprehensive coverage for all your daycare treatments, without any limitations up to the sum insured. 
• Domiciliary treatment coverage: Domiciliary treatments refer to medical interventions for illnesses or injuries that necessitate urgent care in a hospital setting. Nevertheless, there are instances when it might not be advisable to transport a patient to a hospital, especially if their illness or injury is severe. You will find this coverage particularly beneficial when there are no hospital beds available nearby. In such situations, domiciliary treatments offer the option of receiving necessary medical interventions in the comfort of your own home. With the Niva Bupa - ReAssure 2.0 (Gold) plan, all expenses related to domiciliary treatments are fully covered up to the sum insured. With this plan, Coverage will be provided for peritoneal dialysis and home-based chemotherapy treatments. 

Please note that domiciliary treatments will be eligible for coverage if a daily monitoring chart, which includes records of the treatment administered and is duly signed by the treating doctor, is maintained. Also, any medical and ambulatory devices used at home, such as Pulse Oxymeters, BP monitors, Sugar monitors, automation devices for peritoneal dialysis, CPAP, BiPAP, crutches, wheelchairs, etc., will not be covered.

• Organ donor coverage: With the Niva Bupa - ReAssure 2.0 (Gold) plan, you can have peace of mind knowing that your organ donor expenses are taken care of. This comprehensive coverage ensures that all the inpatient costs associated with harvesting the organ are covered, up to the sum insured, when you are the recipient. In the event that you generously choose to donate any of your organs, the expenses related to the extraction process will be fully covered.
• Modern treatment coverage: Thanks to the ongoing advancements in medical technology, you now have access to groundbreaking treatments that were once beyond imagination. These innovative procedures, including stem cell therapy and radio surgeries, have been developed to specifically target conditions that were previously considered untreatable. The Niva Bupa - ReAssure 2.0 (Gold) plan has been carefully crafted to stay up-to-date with the latest advancements in medical treatments. It offers coverage for the expenses associated with these modern treatments, up to the sum insured. The only exception is robotic surgeries, which are not covered.

Please note, within the scope of modern treatment cover, robotic surgeries are subject to a maximum coverage limit of Rs. 1 Lakh, with the exception of specific procedures such as robotic total radical prostatectomy, robotic cardiac surgeries, robotic partial nephrectomy, and robotic surgeries for malignancies.

• Non-medical expenses coverage: Non-medical expenses refer to essential items like gloves, nebulization kits, oxygen masks, and other consumables necessary for your treatment. By choosing the Niva Bupa - ReAssure 2.0 (Gold) plan, you can have these non-medical expenses covered up to the sum insured. However, it's important to note that this benefit is available as an add-on option.
• No Claim Bonus: If you avoid making any claims during the entire duration of your policy, the insurance company will kindly reward you with a benefit called No Claim Bonus. With the Niva Bupa - ReAssure 2.0 (Gold) plan, you have the chance to receive a bonus amounting to 100% of your sum insured, up to a maximum limit of 1000%. Even if you need to make a claim within the policy year, please be assured that your bonus will not be impacted.
• Super No-Claim Bonus: The Super No Claim Bonus is an enhanced version of the No Claim Bonus, operating in a similar way. Regrettably, the Niva Bupa - ReAssure 2.0 (Gold) plan does not incorporate this benefit.
• Restoration benefit: The restoration benefit is an exclusive feature tailored to restore your sum insured in the unfortunate event of fully utilising it within a policy year. By opting for the Niva Bupa - ReAssure 2.0 (Gold) plan, you can fully avail this benefit for both related and unrelated illnesses. This highly valuable feature comes into action once you have partially utilised both your sum insured and no claim bonus. You can take advantage of this benefit multiple times throughout the policy year, starting from your very first claim. 

Please note that once the restoration benefit is activated following the first ever paid claim, it remains in effect indefinitely. This means that there is no need for another initial claim to reactivate this benefit during policy renewals.

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

Niva Bupa - ReAssure 2.0 (Gold): Financial Limits

• Room rent limit: The room rent limit is the maximum amount that your insurance provider will cover for your hospital room expenses. By choosing a room within this limit, you can avoid any extra charges. However, if you decide to go for a more expensive room, you will be responsible for a portion of the total hospital bill, not just the difference in room rent. With the Niva Bupa - ReAssure 2.0 (Gold) plan, you have the freedom to select any room without any restrictions.
• ICU rent limit: With the Niva Bupa - ReAssure 2.0 (Gold) plan, you can have peace of mind knowing that there are no limitations on your ICU accommodation. This means that your plan will comprehensively cover all the costs associated with your stay in the intensive care unit, up to the sum insured.
• Co-payment: With the Niva Bupa - ReAssure 2.0 (Gold) plan, you can enjoy peace of mind, as copayments are no longer a worry. In most cases, copayments would require you to contribute a portion of the approved claim amount from your own pockets. However, this plan ensures that once you've made your payment, the insurer will cover the rest of the expenses without any additional cost to you.
• Deductible: The deductible refers to the initial sum that you are responsible for paying before your insurance provider starts covering your medical costs. However, under the Niva Bupa - ReAssure 2.0 (Gold) plan, there are no deductible restrictions.
• Limits on surgeries/treatments: When evaluating your health insurance policy, it is crucial to understand the limitations on surgeries and treatments. These restrictions determine the maximum coverage that your policy will offer for specific medical procedures or treatments. Some plans have predetermined limits on coverage for certain procedures, while others do not. With the Niva Bupa - ReAssure 2.0 (Gold) plan, you can be confident that cataract treatment and joint replacement 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 - ReAssure 2.0 (Gold): Waiting Periods & Exclusions

👉Waiting Periods

A waiting period is a designated period of time in which certain illnesses and medical conditions are not covered by your health insurance policy right away. It's important to note that claims for these specific conditions can only be made once the waiting period has passed. Here are some of the waiting periods that you should keep in mind:

• Initial waiting period: Please note that there is a short waiting period of 30 days from the date of policy purchase for all medical conditions, except for accidents. It's important to be aware that during this period, you will be unable to make a claim for any hospitalisation unless it is a result of an accident.
• Waiting period for pre-existing conditions: If you have experienced any medical conditions or illnesses within the 36 months prior to applying for health insurance, they will be classified as pre-existing conditions. Under the Niva Bupa - ReAssure 2.0 (Gold) plan, there is a waiting period of 36 months for pre-existing conditions. During this waiting period, you will not be eligible to make claims for expenses associated with your pre-existing condition.
• Waiting period for specific diseases: Alongside any pre-existing conditions you may have, insurers also maintain a list of particular medical conditions or illnesses that necessitate waiting periods. This waiting period is applicable regardless of whether you have previously experienced those ailments or not, and they are determined by the insurer rather than your present state of health. For the Niva Bupa - ReAssure 2.0 (Gold) plan, there is a waiting period of 24 months for specified illnesses.

👉Exclusions

Health insurance policies have certain exclusions, which refer to situations or medical conditions that are not covered. Some of the exclusions are as follows -

• 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, and 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 providers possess the authority to enforce additional exclusions for specific illnesses and circumstances, alongside the mandatory permanent exclusions mandated by the IRDAI. In cases where an illness is considered to be of high risk, insurers may choose to permanently exclude it from coverage. It is important to note that insurers can only implement permanent exclusions for diseases that are included in the pre-approved list of illnesses established by the IRDAI.
• Non-standard exclusions (Specific exclusions): The Niva Bupa - ReAssure 2.0 (Gold) plan includes certain exclusions in addition to the standard ones set by the IRDAI. It's important to keep in mind that these exclusions can differ among insurance providers and are specified in the terms and conditions of the plan. Here are a few specific exclusions that apply to this particular plan:

1. Injury or illness resulting from terrorism, nuclear incidents, radiological emissions, war, or rebellion.
2. Expenditures for screening, counselling, or treatment of external birth defects.
3. Dental treatment coverage other than caused by cancer or accidents.
4. Ventilator usage for patients 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 Limited has settled  99.95% of its claims within 30 days.  This assures you of a smooth and timely claim settlement experience. 
• Claim-related complaints: As per our research, we found that Niva Bupa Health Insurance Company Limited has a complaint rate of  0.49% for claims in comparison to other insurance providers. This indicates that their claim settlement process is average.
• Claims incurred ratio: The claims incurred ratio is a measure of an insurer's financial performance. It shows the total claims paid out in relation to the premiums received in a specific fiscal year. Niva Bupa Health Insurance Company Limited has a claims incurred ratio of 65.44%.
• Claim settlement ratio: Niva Bupa Health Insurance Company Limited's claim settlement ratio stands at 85.18%. This figure reflects the proportion of total claims received to those successfully settled by the company in a specific fiscal year.
• Network hospitals: Niva Bupa Health Insurance Company Limited provides access to an extensive network of 10,000+ hospitals. This broad network allows customers to receive cashless treatment without any financial worry.

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

About Niva Bupa Health Insurance Company Limited

Niva Bupa Health Insurance Company Limited, formerly known as Max Bupa Health Insurance Company Limited, is a partnership between Fettle Tone LLP and Bupa Singapore Holdings Pte. Limited. Their main focus is to offer a diverse selection of health insurance products that are customised to meet your specific needs. Whether you require individual health plans, family floaters, top-up policies, or other alternatives, Niva Bupa is committed to serving you. Niva Bupa Health Insurance Company Limited was founded in 2008 and has its headquarters in New Delhi, India. Under the capable leadership of Mr. Ashish Mehrotra, who serves as the CEO and MD, the company operates with great expertise and unwavering dedication.