Niva Bupa Health Assurance

Accidentcare

An accident can exhaust the savings of a lifetime and even cause irreversible disability and loss of income. Our AccidentCare Insurance Plan provides cover not just in the case of accidental death but also for Permanent Total or Partial Disability, along with a host of other benefits.

Coverage - Individual and Family Coverage

Sum Insured – Rs 5 Lacs to 5 Crore.

If you are claiming your insurance as an individual, you are entitled to 100% of the sum insured promised.

When you are claiming your sum insured on a family plan that covers yourself, a spouse and up to 2 children, you are entitled to 100% of the amount, your spouse is entitled to 50% or Rs. 10 Lacs (whichever is lower), and your children are entitled to 20% of the amount or Rs. 5 Lacs (whichever is lower). 

Maximum Sum Insured will be 12/15 times of annual income for salaried/self-employed respectively.

Features

• Accidental Death
  Accidents cannot be predicted, but they can be prepared for. In the case of accidental death of any insured person, we pay 100% of the sum insured.
• Permanent Total Disability
  In the unfortunate case of permanent total disability due to an accident, we pay 125% of the sum insured.
• Permanent Partial Disability
  If you incur a permanent partial disability through an accident, we pay up to 100% of the sum insured. 
• Child Education Benefit
  Prepare for your child’s future – even when you’re not around. In case of accidental death or permanent total disability, minimum of 5% of your sum insured or Rs. 50,000 (for sum insured up to 25 lacs) / Rs. 500,000 (for sum insured more than 25 lacs) per child, is paid toward your child’s education. This is only applicable for plans where children are covered.
• Funeral Expenses
  Any funeral expenses are covered up to Rs. 5000 (for sum insured up to 25 lacs) / Rs. 50,000 (for sum insured more than 25 lacs), in the case of the accidental death of any insured member.
• Temporary Total Disability (Optional)
  In the unfortunate case of temporary total disability, 1% of Temporary Total Disability sum insured is payable per week. This weekly payout shall be made for a maximum of 100 continuous weeks. 
• Accident Hospitalization (Optional)
  In case of hospitalization due to an accident, medical expenses incurred towards such hospitalization shall be payable up to 2% of AccidentCare sum insured. This benefit shall be available for hospitalization in India only. 
• 2 OR 3 Year Policy Tenure Option
  You can also opt for a 2 or 3 year tenure on your insurance plan and get attractive discounts on your premium.
• Assured Policy Renewal
  Guarantee your policy renewals for life. Your premium is only calculated basis your age and city of residence, and NOT your claim history.
• Free Look Period
  Your complete satisfaction is important to us. If you’re unsatisfied with your policy, you have a 15 day free look period during which you can cancel your policy simply by stating your reason. The free look period will be 30 days if the Policy is purchased through distance marketing mode and Policy Tenure is 3 years.
• Worldwide Coverage
  No matter where you are in the world, or what time it is there, you are covered. However, the optional benefit of Accident Hospitalization shall be available for hospitalization in India only.
  

Click Here to read the policy wording.

Eligibility Criteria

AccidentCare: Coverage available for adults and children. Entry age for adults is 18 years to 65 years and entry age for children is 2 years to 21 years (dependent children)

Permanent Exclusions

• 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 leader), acts of terrorism. 

• Service in the armed forces, or any police organization, 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 which results in the enhancement of Our risk, if not accepted and endorsed by Us on the Schedule of Insurance Certificate.

• 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 including crew other than as a passenger in an aircraft/water craft that is authorized by the relevant regulations to carry such passengers between established airports or ports

• Including but not limited to engaging in or taking part in professional/adventure sports or any hazardous pursuits, such as 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 using hard helmet and breathing apparatus, polo, snow and ice sports, hunting etc; 

• Body or mental infirmity or any disease except where such condition arises directly as a correspondence of an accident during the policy period. However this exclusion is not applicable to claims made under the PPD benefit

• Any costs or expenses specified in the List of Expenses Generally Excluded at Annexure II of policy document. This is applicable only for Accident Hospitalization benefit 
  
  

Criticare

Acquiring critical illness such as cancer, stroke, kidney failure or lung disease is a life changing event which can disrupt dreams and goals for family and wipe out savings. Prepare for any critical illnesses with Niva Bupa, and get the help you need to get back on your feet when your body lets you down

Coverage - individual and family Coverage

Sum Insured – Rs 3 Lacs to 2 Crore

Coverage available for spouse as well. Family combinations – 1 Adult or 2 Adults.

Maximum Sum Insured will be 12/15 times of annual income for salaried/self-employed respectively.

Features

20 Critical Illnesses Covered

• Cancer of Specified Severity 
• Open Chest CABG 
• Myocardial Infarction (First Heart Attack of specific severity)
• Open Heart Replacement or Repair of Heart Valves
• Stroke Resulting in Permanent Symptoms
• Permanent Paralysis of Limbs
• Coma of Specified Severity
•  Kidney Failure Requiring Regular Dialysis
• Major Organ/Bone Marrow Transplant 
• Motor Neurone Disease with Permanent Symptoms
• Multiple Sclerosis with Persisting Symptoms
• End Stage Liver Disease
• End-stage Lung Disease
• Third Degree Burns
• Loss of Speech
• Deafness
• Aplastic Anaemia
• Bacterial Meningitis
• Fulminant Viral Hepatitis
• Muscular Dystrophy 
  
  

Benefit Options

You can choose any of the following benefit options. Option once chosen cannot be changed later during the lifetime of the policy.

• Benefit Option 1: Sum insured payable as lump sum
• Benefit Option 2: Sum insured payable as lump sum plus additional 10% of the sum insured payable each year for subsequent 5 years.  
  
  

2 OR 3 Year Policy Tenure Options
Opt for a 2 or 3 year tenure on your insurance plan and get discounts on your premium.

Assured Policy Renewal
Guarantee your policy renewals for life. Your premium is only calculated basis your age and city of residence, and NOT your claim history.

Tax Benefit
A Niva Bupa health insurance policy can help you save tax under Section 80D of the Income Tax Act. These benefits are subject to change in tax laws. You may consult your tax advisor for more in-depth advice pertaining to your personal finances.

Free Look Period
Your complete satisfaction is important to us. If you’re unsatisfied with your policy, you have a 15 day free look period during which you can cancel your policy simply by stating your reason. The free look period will be 30 days if the Policy is purchased through distance marketing mode and Policy Tenure is 3 years.


Eligibility Criteria
CritiCare: Coverage available only for adults. Entry age is 18 years to 65 years

Permanent Exclusions​​​​​​​

• Acquired Immune Deficiency Syndrome (AIDS), AIDS-related complex or infection by Human Immunodeficiency Virus (HIV)

• The Insured Persons attempted suicide or self-inflicted injuries while  sane or insane 

• Narcotics used by the Insured Person unless taken as prescribed by a Medical Practitioner, or the Insured Person’s abuse of drugs and/or consumption of alcohol 

• The directions, advice and guidance of the treating Medical Practitioner shall be strictly followed. We shall not be obliged to make any payment that arises out of willful failure to comply with such directions, advice or guidance

• 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 leader), acts of terrorism 

• Taking part in any naval, military or air force operation during peace time 

• Participation in aviation/marine activities including crew other than as a passenger in an aircraft/water craft  that is authorized by the relevant regulations to carry such passengers between established airports or ports
  Including but not limited to engaging in or taking part in professional/adventure sports or any hazardous pursuits, such as 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 using hard helmet and breathing apparatus, polo, snow and ice sports, hunting etc.

• Participation by the Insured Person in a criminal or a breach of law with criminal intent