Comprehensive health protection with a promise to give Standard exclusions and waiting period

our seniors a secure second innings.

Standard Exclusions – Investigation & Evaluation | OPD Treatment | Unproven Treatments,
Product Benefit Table (all limits in INR unless defined as percentage) Unrecognized Physician or Hospital, Hazardous or Adventure sports, Dental/oral treatment, Sleep
Variant Gold Platinum disorders, Treatment for alcoholism, drug or substance abuse, or any addictive condition and
5 Lacs / 10 Lacs / 15 Lacs / 20 Lacs / consequences thereof. Refer to the policy document for complete list of exclusions under Senior
Base Sum Insured 5 Lacs / 10 Lacs
25Lacs First Plan.
Benefits
Applicable waiting periods – 30-day initial waiting period | 24 months waiting period on pre-
In-patient Care Covered up to Sum Insured existing diseases | 24 months waiting period on specific diseases | 15 days free look period (30 days
Room Category(1) Shared Room Single Private Room if the policy with Policy Period as 3 years has been sold through distance marketing).
Pre-Hospitalization (60 days) Covered up to Sum Insured
Post-Hospitalization (180 days) Covered up to Sum Insured Easy to reach
Day Care Treatment Covered up to Sum Insured
If you would like to find out more, please reach out to our specialised sales team or your Niva Bupa
Covered up to Sum Insured with sub-limit of INR 1 Lac per claim on few
Modern treatments health advisor.
robotic surgeries (as specified in policy terms)
Road ambulance: up to INR 2,000 per hospitalization Say ‘Hi’ to us on WhatsApp: Helpline: Email ID: customercare@nivabupa.com
Ambulance 9811956696 1860-500-8888 Senior citizens may write to us at:
Air ambulance: up to INR 2,50,000 per hospitalization seniorcitizensupport@nivabupa.com
AYUSH Treatments Covered up to Sum Insured
Website: www.facebook.com/ www.twitter.com/

SENIOR
Treatment at home (Domiciliary www.nivabupa.com nivabupahealthinsurance nivabupa
Covered up to Sum Insured
Hospitalization)
Organ Donor Covered up to Sum Insured
In case of claim free year, increase of 10%
NIVA BUPA HEALTH INSURANCE COMPANY LIMITED

FIRST
of expiring Base Sum Insured in a Policy Registered Office Address: C-98, First Floor, Lajpat Nagar, Part 1, New Delhi-110024
No Claim Bonus Not applicable Year; maximum up to 100% of Base Sum Fax No: +91 11 41743397
Insured (In case of claim, no reduction in
No Claim Bonus)
Unlimited up to base Sum Insured
A PROMISE OF LOVE
ReAssure# Not applicable (Applicable for both same & different
illness)
Annual (From Day 1); For defined list of
tests; up to INR 500 for every INR 1 Lac
Base Sum Insured (Individual policy:
Health Check-up Not applicable
maximum INR 5,000 per Insured; Health Protection with a promise of love
Family Floater policy: maximum INR
10,000 per policy) ReAssure Benefit# No mandatory pre-issuance
Co-payment(1) 50% Disclaimer: This is only a summary of the product features and is for reference purpose only. For more details on terms and conditions, exclusions, risk factors, ReAssure Benefit will trigger after the 1 claim
st
medical tests**
waiting period & benefits, please read sales brochure carefully before concluding a sale. Insurance is a subject matter of solicitation. Niva Bupa Health Insurance itself. It is unlimited reinstatement. Each claim
Optional Benefits Company Limited (formerly known as Max Bupa Health Insurance Company Limited) (IRDAI Registration No. 145). ‘Bupa’ and ‘HEARTBEAT’ logo are registered
will be up to the base sum insured
trademarks of their respective owners and are being used by Niva Bupa Health Insurance Company Limited under license. CIN:U66000DL2008PLC182918,
Annual Aggregate Deductible(2) 1 Lacs / 2 Lacs / 3 Lacs / 4 Lacs / 5 Lacs Product Name: Senior First. Product UIN: MAXHLIP21575V012021 | Add-on Name: Safeguard, Add-on UIN: MAXHLIA21576V012021 | Add-On Name: Zero Co-
Pay UIN: NBHHLIA22175V012122. UIN: NB/BR/CA/2022-23/032. &Tax benefits are subject to changes in tax laws. Savings amount computed for an individual
Safeguard (Add-on)*
Modification in co-payment 0%## / 20% / 30% / 40% who is in highest slab of income tax and for senior citizens. Maximum deduction under section 80D is INR 50,000, when premium is paid for self or spouse Day 1 Health Check-up
only. The highest tax slab for an individual is (base rate 30%+ 37% SC = 41.1 % + 4% cess = 42.744%) INR 50,000 x 42.744% = INR 21,372. Tax saving can vary Go truly cashless with coverage even
Avail Annual Health-check up from Day 1
• Entry age: 61 to 75 years. basis individual’s income and policy coverage. Please consult your tax advisor for more details. $Niva Bupa processes pre-authorisation requests within 30
for non-payable items like gloves etc.^^
minutes for all active policies, subject to receiving all documents and information(s) up to Niva Bupa’s satisfaction. The above commitment does not include
• Family Combination: 1 Adult or 2 Adults (Self & Spouse). 2 Adults policy can be taken on pre-authorisation settlement at the time of discharge or system outage. The services can be availed at network hospitals only. $$Number of network hospitals
individual basis or floater basis sum insured. shown is an approximate figure and is subject to change without prior notice, please visit our website to access latest and updated list of network hospitals
and list of point of care desks at network hospitals. #Single claim under this benefit will be payable up to base sum insured. ^Infation rate would be computed No sub-limits on common health condition Annual Aggregate Deductible***
1)
10% additional co-payment applicable, if treatment is taken in higher room category than eligible room category.
as the average consumer price index(CPI) of the entire calendar year published by the central statistics office. @Health card can be downloaded from Niva Like cataract, joint replacements, cancer or any If deductible is opted, then co-payment
Bupa Health App or log in at www.nivabupa.com). ##Zero Co-pay is an add-on option. *Safeguard is an optional benefit and is available on payment of extra
2)
Deductible will be 1/5th of the base sum insured chosen. If deductible is opted, then co-payment will NOT apply premium. ^^As per the list I under Annexure I of policy Terms and conditions. **Pre-Policy Medical checkup may be required as per Underwriting guidelines.
other common health conditions will not apply
except as specified in point (1) for treatment taken in higher than eligible category of room. ***It is an optional benefit.
 Affordable and rewarding health protection for seniors. Complete peace of mind with hassle free
Reduce Co-payment –
claim management process
An optional benefit to reduce co payment from 50% to 0% / 20% / 30% / 40% CASHLESS HASSLE FREE
CLAIMS PROCESSING REIMBURSEMENT PROCESS
Swap co-payment*** for deductibles –
Choose your annual deductibles option as per your requirements and enjoy a co-payment Avail 30 minutes$ cashless claims Non network hospitalisation
Presenting ‘Senior First’ Health Insurance Plan free health cover. processing at 8500+ Network$$ In case you wish to get treatment
Hospitals across India. done at non-network hospital, please
A promise of love notify Niva Bupa Health Insurnace
Enhance Sum Insured up to 100% with No Claim Bonus – within 48 hours of admission.
Get rewarded for staying healthy with the no claim bonus feature. Add 10% to your base
Introducing Senior First, a tailor made health plan designed to provide unconditional support
sum insured every claim free year. Max up to 100% of base Sum Insured.
and care for our seniors in their golden years. With coverage options up to 25 lacs, no sub limits
on common health conditions, heath check-ups from day 1, hassle free claims process, we assure STEP 1 STEP 1
Safeguard – Most opted Add-on*. For a truly Cashless Experience.
healthcare and financial needs of seniors are taken care of with nothing but love.
i. Coverage for non payable items like gloves etc. Document Submission Document Collection
At the time of hospitalization, Collect all relevant documents,
ii. Inflation protection coverage^ – Increase in base sum insured on a cumulative basis
produce your Niva Bupa Health invoices, medical reports, discharge
each policy year based on Inflation Rate. Card@, or share your policy number certificate from Hospital in originals
iii. No Impact on No Claim Bonus – There will be no impact on your no claim bonus, if along with identification documents and receipt of the payment made at
claims in a policy year are up to INR 50,000. like Passport/PAN card/ Voter’s card. the time of discharge.

For any further assistance in an

Available Discounts – unknown environment, you can reach
Health Protection with a promise of love • Tenure discount - Get discount of 7.5% on the premium of second policy year if you pay out to Niva Bupa Point of care desks
at select network hospitals.
STEP 2
for a 2-year policy term in advance, and additional 15% discount on third year’s premium
Senior First Health Plan has been packaged with features that give our seniors the assurance of Insta Reimbursements
if you choose a 3-year policy term.
good health at all times. So whether it’s multiple treatments in the same year for the same illness To avail Insta reimbursement, upload
• Standing Instruction discount - Get 2.5% discount on renewal premium if standing the requisite documents on Niva Bupa
or coverage for consumables, health coverage for our seniors is constant and unconditional.
instruction for auto debit on renewal is provided and the policy is renewed using the STEP 2 website or Niva Bupa Health app.
same.
Document Verification You can alternatively send the physical
• Tax Savings - Income tax benefit up to INR 21,372 under the Section 80D of the Income
Network hospital checks and submits documents to us at Niva Bupa Health
Tax Act, 1961&. Claim additional tax-saving benefit under 80D, if you pay premium on Insurance Company Limited, 2nd Floor,
Complete peace of mind with Health Check-ups from Day 1 & Coverage for preauthorization form to Niva Bupa
your parent’s behalf. Health Insurance. Plot No D-5, Sec-59, Noida, Gautam
Day care treatments like Angiography, Dialysis, Radiotherapy, Chemotherapy
Budhnagar, Uttar Pradesh – 201301.
and more. Discount illustration to maximize savings
Individual policy (2 members)
STEP 3
At Inception STEP 3
Claims Processing and Settlement
Premium for 1 year 100 each member Claim Settlement
ReAssure# Benefit – Documents submitted by the network
Family Discount of 10% 20 We review and make payment to you
A promise of love with unlimited reinstatement base sum insured for long term hospital are verified by our in-house
as per Policy terms and conditions
Discount for opting 3 year term (7.5% on 2nd year and 15% on 3rd year) 40.5 team of doctors to ensure hassle free
treatments and multiple illness to ensure our seniors always have enough funds
and speedy payouts.
for any treatment. Final Premium for 3 years 499.5
Premium for 3 years without any discount 600
Total saving 16.8%
Assistance. Anytime. Anywhere.
No sub-limits on common health conditions – At Renewal
A promise to be there to our seniors by providing health coverage without any Additional Auto-debit discount of 2.5% 12.5 Niva Bupa Health App CIA Chatbot
sub-limits on common health conditions like cataract, joint replacements, cancer From locating a network hospital to keeping track Talk to our interactive
Final Premium for 3 years 487.0
of your health policy details or staying on top of chatbot CIA on
or any other common health conditions Premium for 3 years without any discount 600 your health with regular health tips and more, it’s all www.nivabupa.com for
Total saving 18.8% possible in just a few taps on your phone. Available anytime assistance!
on both iOS and Android.