Health Recharge

• The default policy term for all plans is one year. Two-year and three-year policy term options are also available under the product. The level of discount is as below:
• 2 year term: 7.5% on the premium for second policy year
• 3 year term: 15% on the premium for third policy year + 7.5% on the premium for second policy year

• Pre-existing disease waiting period of 36 months since inception of the policy and continuous renewal
• Initial waiting period of 30 days unless the treatment needed is the result of an accident.
• Specific waiting period of 24 months for some listed illnesses, unless the condition is directly caused by cancer (covered after initial waiting period of 30 days) or an accident (covered from day 1)
• Please note that Waiting Periods shall not apply to e-consultation and Personal Accident Cover. For Critical Illness Cover, initial waiting period of 90 days and pre-existing disease waiting period of 48 months will apply.

• Investigation & Evaluation
• Rest Cure, rehabilitation and respite care
• Obesity/ Weight Control
• Change-of-Gender treatments
• Cosmetic or plastic Surgery
• Hazardous or Adventure sports
• Breach of law
• Excluded Providers
• Refractive Error
• Unproven Treatments
• Birth control, Sterility and Infertility
• Maternity Expenses
• Circumcision
• Conflict & Disaster
• External Congenital Anomaly
• Unrecognized Physician or Hospital

(Note: the above is a partial listing of the policy exclusions. Please refer to the policy contract for the full list of exclusions.)

We shall not be liable to make any payment under any benefits under the Personal Accident Cover if the claim is attributable to, or based on, or arise out of, or are directly or indirectly connected to any of the following:

• Suicide or self inflicted injury, whether the insured person is medically sane or insane.
• Treatment for any injury or illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations (whether war is declared or not), rebellion (act of armed resistance to an established government or a leader), acts of terrorism.
• Service in the armed forces, or any police organisation of any country at war or at peace or service in any force of an international body or participation in any of the naval, military or air force operation during peace time.
• Any change of profession after inception of the policy or any renewal which results in the enhancement of our risk, if not accepted and endorsed by us on the policy schedule.
• Committing an assault, a criminal offence or any breach of law with criminal intent.
• Taking or absorbing, accidentally or otherwise, any intoxicating liquor, drug, narcotic, medicine, sedative or poison, except as prescribed by a medical practitioner other than the policyholder or an insured person.
• Participation in aviation/marine activities (including crew) other than as a passenger in an aircraft/water craft that is authorised by the relevant regulations to carry such passengers between established airports or ports.
• Engaging in or taking part in professional/adventure sports or any hazardous pursuits, speed contest or racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving, polo, snow and ice sports, hunting.
• Body or mental infirmity or any illness except where such condition arises directly as a result of an accident during the policy period. However, this exclusion is not applicable to claims made under Permanent Partial Disability.

• Select and approach insurance/corporate/TPA helpdesk of our network hospital [recommended at least 72 hours before treatment].
• For identification purpose use passport, voter card, PAN card or driver's license along with your Niva Bupa health card or policy number.
• Network hospital will check your identity for validation and submit a pre-authorisation form to us.
• We provide our decision to the hospital within 4 hours, when no further document is required.
• We may assign a relationship manager to make the hospitalisation simple for you.
• Get admitted for treatment and sign all documents, forms and invoices on discharge.
• We make payments to the hospital for pre-approved treatment and as per policy terms and conditions.

• What is top-up with an Annual Aggregate Deductible?
• It becomes really difficult to decide how much cover is adequate. A cover which we find sufficient today becomes irrelevant tomorrow due to the rising medical inflation. At the same time buying a large insurance cover in the current policy may not be affordable or available. Our Niva Bupa Health Recharge’s deductible acts like a spare tire to your health insurance plan. It’s an additional coverage offered to you with a threshold limit. It comes into effect only when your total claim in the same year surpasses the threshold limit.

• Why is top-up important?
• Top-up is important as it takes care of the gap between your existing coverage and the actual cost incurred during the year.

• When does it make sense to opt for a top-up?
• It makes sense when you want to increase your total coverage without paying much. While anybody can buy our top-up option at any time, however, it is not advisable unless you have bought a base health insurance cover or the coverage offered by your employer is at least equal to the chosen deductible (threshold limit) amount of our top-up.

• How does the plan work?

Let us understand with an example:

• How can I buy this policy?
• There are various ways in which you can purchase this policy:

• You can buy this plan online. On buying this plan online, your policy will be generated instantly along with your policy kit and card. This is applicable for cases which do not require further underwriting or medical check-up.
• If you wish to buy or know more aboutNiva Bupa’s health insurance plans, feel free to get in touch with our trained sales team or your local advisor. Call us on: 1860 500 1000 (Toll Free) between 9 am and 6 pm India time (Monday to Saturday) or click on ‘Click to arrange a call’ to buy the policy over the phone or to fix up an appointment. Branch: Please visit our branch in your city. The complete list of branch locations is available in the ‘Contact Us’ section of the website

• Is there any tax benefit that one can avail while purchasing health insurance?
• Yes, you can avail a tax benefit available under Section 80D of the Income Tax Act 1961 by buying a health insurance policy. Every taxpayer can avail an annual deduction of Rs. 25,000 from his/her taxable income for health insurance premium for self and dependants. For senior citizens, this amount is Rs. 30,000. Please note: You will have to show the proof of payment of premium. (Section 80D benefit is different from the exemption of Rs. 1,50,000 under Section 80C). These benefits are as per applicable tax laws which can amend from time to time. We advise you to consult your tax advisor for further details or clarifications.

• Is a medical check-up necessary before buying a policy?
• A medical check-up may be necessary when you sign up for a new health insurance policy, depending upon the age of the person to be insured and the Sum Insured opting for. In case your proposal gets rejected by us, we will deduct the full cost of medical tests from your premium and the balance premium would be refunded.

• My wife and children are residing at Chandigarh while I am here in Delhi. Can I cover all of us in one policy?
• Of course, you can cover your family residing in India under one policy. You can use your health insurance policy across India. For cashless hospitalisation, all you need to do is check for a Niva Bupa network hospital near your place of residence. You can also present your claim for reimbursement if you get treated at a hospital which is not a Niva Bupa network hospital.