Niva Bupa Arogya Sanjeevani Policy Health Insurance

1. In-patient Care: The policy covers most of the medical expenses for you and your insured family members in case of hospitalisation.
2. Hospital Accommodation: The policy covers room rent, nursing charges, etc., up to 2% of the insurance sum, up to Rs.5000/day. In case of the ICU / ICCU, the charges covered are up to 5% of the insurance sum, up to Rs.10,000/day.
3. Pre and Post Hospitalisation Expenses: The policy covers medical expenses incurred 30 days before getting admitted to the hospital and 60 days after getting discharged from the hospital.
4. Day Care Treatment: The policy covers day care treatment expenses.
5. Road Ambulance: The policy covers road ambulance expenses up to Rs.2000 per hospitalisation only if the in-patient clam has been accepted.
6. Ayush Treatments: The policy covers expenses incurred for Yoga, Ayurveda, Naturopathy, Siddha, Homeopathy, and Unani treatments
7. Cataract Treatments: The policy covers the cataract treatment expenses up to a limit of 25% of the insurance amount or Rs. 40,000, whichever is lower, per eye in one policy year. For cataract treatment, a waiting period of 24 months would also be applicable.
8. Modern Treatments: The policy also covers expenses incurred in modern treatments like Robotic Surgeries, Oral Chemotherapy, etc., up to a maximum of 50% of the insurance amount.

Exclusions of Niva Bupa Arogya Sanjeevani Policy

Following are the exclusions of Niva Bupa Arogya Sanjeevani policy:

• The policy does not include weight control treatments, gender-change treatments, maternity expenses, injury during adventure sports, etc.
• The policy does not include treatment for substance abuse, alcoholism, or any addictive condition.
• The policy does not include treatments received in spas, nature clinics, or at similar places.
• The policy does not include expenses incurred while purchasing dietary supplements without prescription.
• The policy does not include treatments taken on foreign land.
• The policy does not include expenses incurred on OPD treatment and domiciliary hospitalisation.
• The policy does not include injury caused during war-like occurrence (whether declared or not) or use of nuclear, biological or chemical weapons.

Claim process for Niva Bupa Arogya Sanjeevani Policy

Follow the steps mentioned below for the policy claim process:

1. Step 1: Choose and approach the insurer/ network hospital helpdesk at least 72 hours before the treatment.
2. Step 2: Submit all the required valid documents like PAN card, driving licence, Passport, etc., along with the policy number.
3. Step 3: The papers will get validated at the network hospital and a pre-authorisation form will be sent to the insurer by the hospital.
4. Step 4: The insurer will provide its decision to the hospital within four hours.
5. Step 5: Start the treatment at the hospital.
6. Step 6: All the pre-approved treatments, as per the policy terms and conditions, will be paid by the insurer.

GST rate of 18% applicable for all financial services effective July 1, 2017.

Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.