Niva Bupa ReAssure 2.0 (Platinum+)

Niva Bupa Health Insurance Company Limited offers the health insurance policy Niva Bupa ReAssure 2.0 (Platinum+). The plan provides comprehensive, robust features and benefits to all clients, such as covering unforeseen medical expenses. The plan comes with unique benefits and features that allow you to tailor your healthcare requirements. One notable benefit of the plan is that you can carry forward the unused base sum insured to the next policy year up to a maximum of five times. While purchasing the plan, your age will get locked, and you will be able to pay the premium as per the entry age till your first claim.

Additionally, the plan covers non-medical expenses such as oxygen masks and gloves and required hospitalisation expenditures. However, there is no provision for monthly premium payments. Research also indicates that there is a higher rate of policy and claim settlement complaints. Thus, enhanced strategies need to be implemented to mitigate its poor track record. 

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

• Inpatient hospitalisation coverage: Inpatient hospitalisation coverage refers to those expenses when the patient is admitted to the hospital for more than 24 hours. Inpatient expenses generally comprise nursing care, ICU charges, hospital room and necessary consultations. Niva Bupa - ReAssure 2.0 (Platinum+) plan provides coverage for the expenses related to inpatient hospitalisation. The plan provides provisions for both room and ICU rent to all insured patients. Expenses for automation machines used in peritoneal dialysis are not covered during hospitalisation for inpatient treatments. 
• Pre-hospitalisation coverage: Pre-hospitalisation coverage is the specific medical expenses that occur before the admission of the patient to the hospital. These expenses comprise necessary laboratory and diagnostic tests, checkups and doctor consultations. Pre-hospitalisation coverage is only approved when the hospitalisation is directly related to the specific medical illness. The Niva Bupa - ReAssure 2.0 (Platinum+) plan provides pre-hospitalisation coverage for 60 days till the sum is insured. 
• Post-hospitalisation coverage: Post-hospitalisation expenses are the expenditures incurred after the discharge of the patient from the hospital. Charges for regular follow-ups, doctor consultations, and medical tests come under post-hospitalisation coverage. Post-hospitalisation coverage should be related to your expenses incurred with in-patient hospitalisation. The Niva Bupa - ReAssure 2.0 (Platinum+) covers post-hospitalisation expenses for 180 days. These expenses can be covered up to the sum insured.  
• Daycare treatment coverage: Daycare treatment coverage refers to the medical procedures that can be performed within 24 hours of hospital admission. Treatment procedures such as chemotherapy, radiotherapy and dialysis often come under daycare treatment coverage. The Niva Bupa - ReAssure 2.0 (Platinum+) plan covers all daycare treatments with no financial limit up to the sum insured.  Additionally, for daycare treatment coverage, there will be no coverage of the expenses incurred due to automation machines for peritoneal dialysis.  
• Domiciliary treatment coverage: Domiciliary treatments are those specific treatments provided to the patient when he/she is not admitted to the hospital. It can be very risky to transfer the patient to the patient due to the seriousness of the disease or due to the unavailability of hospital beds. The Niva Bupa - ReAssure 2.0 (Platinum+) plan covers all kinds of domiciliary treatments up to the sum insured. All diseases and ailments are included in the treatment plan. Moreover, the plan also covers chemotherapy and peritoneal dialysis performed at home. However, domiciliary treatments can only be covered when the patient's daily monitoring chart is duly signed by the treating doctor. The daily monitoring chart should contain all treatment records. Ambulatory and medical devices such as BP monitors, pulse oximeters, CPAP, automation devices for peritoneal dialysis, and sugar monitors are not covered in the plan.   
• Organ donor coverage: The Niva Bupa - ReAssure 2.0 (Platinum+) plan provides sufficient coverage for organ donor expenses. The plan covers the inpatient expenses up to the sum insured. Furthermore, it also covers the costs associated with harvesting the organs up to the sum insured if you are the donor.
• Modern treatment coverage: Modern treatment coverage refers to the immense development of medical technologies leading to unimaginable treatment modalities. Treatments such as oral chemotherapy, stem cell therapy and robotic surgeries come under modern treatment coverage.  The Niva Bupa - ReAssure 2.0 (Platinum+) plan provides provisions for modern treatment coverage with no financial limit except for robotic surgeries. A limit of Rs 1 lakh has been imposed for robotic surgeries except for robotic cardiac surgeries, robotic total radical prostatectomy, robotic surgeries for malignancies and robotic partial nephrectomy. 
• Non-medical expenses coverage: Expenses of oxygen masks, gloves, self-care, and nebulisation kits come under non-medical expenses. The Niva Bupa - ReAssure 2.0 (Platinum+) plan also covers non-medical expenses. However, it is only available as an add-on option up to the sum insured. There is no financial limit on coverage for non-medical expenses. These non-medical expenses refer to the cost of consumables, such as gloves, nebulisation kits, oxygen masks, and other items necessary for treatment. 
• No claim bonus: It is the reward provided by the insurance company when the insurance company does not make any claim in the given policy period. The Niva Bupa - ReAssure 2.0 (Platinum+) plan provides provisions for no claim bonus. There is a 100% bonus each year, where you can accumulate a maximum bonus of 500%. Furthermore, there will be no reduction in the accumulated bonus due to any claim.   
• Super no claim bonus: The super no claim bonus is a refurbished version of the no claim bonus. Super no claim bonus is known to provide increased coverage in the insured sum during each claim-free year. However, there is no super no claim bonus in the Niva Bupa - ReAssure 2.0 (Platinum+) plan.  
• Restoration benefit: The restoration benefit is the specific feature that allows for providing an additional insured sum amount after the exhaustion of the primary sum insured in a specific policy year. With the Niva Bupa - ReAssure 2.0 (Platinum+) plan, you can enjoy this benefit for both related illnesses and unrelated illnesses. The refill can be applied for unlimited times in a given policy year. Furthermore, the refill gets triggered during the partial exhaustion of the sum insured and the no claim bonus. The refill of cover can also be applied in the first paid claim. An important point to note in this segment is that the restoration benefit stays triggered forever after the first paid claim. 

Niva Bupa - ReAssure 2.0 (Platinum+): Financial Limits

• Room rent limit: The room rent limit refers to the maximum cost that will be covered by the insurance company for your hospital room. You do not need to pay any extra charges when you choose within the limit of your insurance company. However, extra costs will be incurred when you decide on a pricier room. The Niva Bupa - ReAssure 2.0 (Platinum+) plan ensures that you can cover your room rent without any financial limit. 
• ICU rent limit: The ICU rent limit is the maximum rate your insurance company will pay for your stay in the intensive care unit of the hospital. The Niva Bupa—ReAssure 2.0 (Platinum+) plan ensures that your ICU rent is paid without any financial limit. The plan covers the entire cost of the duration of your stay in the ICU. 
• Copayment: A copayment, also known as a copay, is the fixed percentage of the claim that needs to be paid by the insured out of his own pocket. The insurance agent will start paying the rest of the expenses once this payment has been made. Once this payment is made, the insurer will cover the remaining expenses. However, there is no copayment for the Niva Bupa - ReAssure 2.0 (Platinum+) plan. 
• Deductible: A deductible is the specific amount paid by the insured person, after which the insurance company will start paying for the remaining covered expenses. The Niva Bupa - ReAssure 2.0 (Platinum+) plan has several options for deductible, but it is available as an add-on. They are available at the rate of 20K/30K/50K/100K as options. 
• Limits on surgeries/treatments: Limits on surgeries and treatments refer to the maximum amount that will be paid by the health insurance policies for specific medical treatments. Certain medical procedures may have a predetermined limit, as mentioned by the insurance company. There are specific limits as determined by the Niva Bupa - ReAssure 2.0 (Platinum+) plan. The expenses for cataract and joint replacement surgery are covered up to the sum insured. 

Niva Bupa - ReAssure 2.0 (Platinum+): Waiting Periods & Exclusions

👉Waiting period

The waiting period or the cooling period is a compulsory timeframe during which your medical conditions and illnesses will not get immediately covered after obtaining your health insurance. You will be able to make the claims once your waiting period has been completed. 

Here are some of the different types of waiting periods- 

• Initial waiting period: All healthcare insurance policies follow an initial waiting period of 30 days for most medical conditions. During this time, the insured will not be able to make any claims except in the case of an accident. 
• Waiting period for pre-existing conditions: Any health illness or medical condition experienced by you within 36 months before purchasing the healthcare policy is referred to as a pre-existing condition. For pre-existing conditions, the Niva Bupa - ReAssure 2.0 (Platinum+) plan provides a 36-month waiting period. You will not be able to make any claims associated with your pre-existing disease during this timeframe. 
• Waiting period for specific diseases: There are certain medical illnesses or conditions having specific waiting periods as determined by the insurers. It does not depend on whether you have experienced the disease previously or not and also does not depend on your current health status. The waiting period for the Niva Bupa - ReAssure 2.0 (Platinum+) plan is 24 months for specific illnesses. 

👉Exclusions

Exclusions refer to specific medical conditions or situations for which the health insurance policies do not provide any coverage. 

Below are some of the types of exclusions -

• Standard Permanent Exclusions: All insurance providers should follow the standard permanent exclusions established by the IRDAI. These exclusions include -

1. Investigation and evaluation: Regular monitoring and observation during hospital admission.
2. Rest, rehabilitation, and respite care: Admission to a medical facility for bed rest without the need for any active treatment. 
3. Obesity/weight control: Medical treatments or surgery for weight loss and obesity. 
4. Gender reassignment: Medical treatments to alter the characteristics of the body to match the opposite sex. 
5. Plastic/Cosmetic surgery: Modification of one’s body traits and appearance through surgeries or treatments. 
6. Profession in hazardous or adventure sports: Treatment expenditures incurred due to the participation in various adventurous activities such as scuba diving, mountaineering, and skiing as a professional.  
7. Breach of law: Treatment expenses incurred due to treating a person who has committed a criminal offence. 
8. Excluded providers: Treatment received in medical facilities and hospitals that have been excluded by the insurance company. 
9. Narcotics: Treatment of substance abuse disorders such as drugs and alcohol. 
10. Treatments in establishments arranged for domestic purposes: Treatments received in nursing homes and health spas are specifically arranged for domestic purposes. 
11. Dietary supplements, substances purchased without subscription: Expenses incurred due to supplements such as vitamins and minerals not prescribed by any medical practitioner. 
12. Refractive error: Correction of the refractive errors up to 7.5 diopters for improving eyesight. 
13. Unproven treatments: Expenses incurred due to medical treatments or surgeries that are deemed to be ineffective. 
14. Expenses related to birth control, sterility, and infertility: Treatment expenses due to reproductive technologies such as IVF, GIFT, and gestational surrogacy, along with sterilisation and contraception procedures. 
15. Maternity expenses: Expenses incurred due to childbirth along with pre- and post-natal costs. 

• Additional permanent exclusions: Insurance providers can implement any additional exclusions for certain medical circumstances or conditions besides the standard permanent exclusions. This generally occurs when medical insurers think that certain medical conditions can be way too risky for them to cover. So, this provides them the provision to exclude them from the policy permanently. On the other hand, the insurance providers also need to follow the list of illnesses determined by the Insurance Regulatory and Development Authority of India. They are not allowed to enforce further exclusions beyond the standard permanent exclusions.  
• Non-standard exclusions (Specific exclusions): Non-standard exclusions or specific exclusions can go beyond the list provided by the IRDAI. Different insurance companies can have different exclusion lists depending on their terms and conditions. Below are the non-standard exclusions provided under the Niva Bupa - ReAssure 2.0 (Platinum+) plan -

1. Any act of illness or injury caused directly or indirectly due to war, radiological and nuclear emissions, terrorism and rebellion. 
2. Expenses incurred due to any dental treatment except when it is caused due to an accident or cancer. 
3. Treatment expenses incurred due to counselling, screening and treatment of external birth defects. 
4. The usage of a ventilator by a patient who is already in a brain-dead or vegetative state without any recovery chance. 

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

• Speed of claims: The Niva Bupa Health Insurance Company Limited has settled  99.95% of its claims within 30 days, ensuring that clients have a smooth and timely claim settlement experience. 
• Claim-related complaints: Research indicated that Niva Bupa Health Insurance Company Limited has a higher complaint rate of 0.49% as compared to other insurers.
• Claims incurred ratio: The financial performance of the insurance company can be determined through the claims incurred ratio. This indicates the ratio between the total claims settled to the total claims received.  The Niva Bupa Health Insurance Company Limited has a claims incurred ratio of 65.44%.
• Claim settlement ratio: Niva Bupa Health Insurance Company Limited has an 85.18% claim settlement ratio. This indicates the total number of claims which have been successfully settled by the company in one fiscal year. 
• Network hospitals: Niva Bupa Health Insurance Company Limited provides access to an extensive network of 10,000+ hospitals. Thus, clients are provided with a broad network of hospitals where they can receive cashless treatment.

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: Research indicates that the response time of Niva Bupa Health Insurance Company Limited on their toll-free is average, as compared to other insurers. 
• Response on Twitter: The Niva Bupa Health Insurance Company’s response time on Twitter is slow as compared to other similar insurance plans. 

About Niva Bupa Health Insurance Company Limited

Niva Bupa Health Insurance Company is also known as Max Bupa Health Insurance Company Limited. It was founded in 2008 and is a joint venture between Bupa Singapore Holdings Pte. Limited and Fettle Tome LLP. The company has a turnover of 1025.99 Crores. There are 61,36,225 policies with 1,53,167 total number of claims. The company provides a range of healthcare insurance products, such as top-up policies, family floaters, and individual health plans. This allows to provide customised solutions to the clients. The company is headquartered in New Delhi, India, where Mr Ashish Mehrotra is the CEO and MD.