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Cashless Health Insurance

Your health doesn’t take a backseat just because you’re abroad, nor should your protection. Niva Bupa NRI Health Insurance is designed specifically for Non-Resident Indians, offering you and your loved ones in India seamless access to quality healthcare, minus the financial stress.You're never far from reliable medical support.

checkicon 10,400+ cashless hospitals

checkicon A swift 30-minute cashless claim process

checkicon Trust of over 1.4 crore satisfied customers

Why Choose Niva Bupa?

Still Need Reasons? Here They are:

Trusted by over 1.4 crore Indians, we combine reliability with innovation to keep your health safeguarded, always. With 10,400+ cashless hospitals and a 30-minute claim process, quality healthcare is truly accessible and stress-free.

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30 min

Cashless Claim Processing 1

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15 Lakh+

Claims paid since inception 2

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1.4 Crore+

Happy customers served till date

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Custom Health Insurance Plans designed for You

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How does Our Claim Process work?

Get to know the steps involved in the claim Process, Whether it is a planned or emergency hospitalisation. Filling a claim is made easy by choosing any of the following ways:

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1

Hospital Admission:

Get admitted to a Niva Bupa network hospital.

2

Identification:

Present your Niva Bupa Health Card or policy number along with valid ID (Passport/PAN card/Voter’s ID) to the hospital staff.

3

Pre-authorisation:

The hospital will verify your details and submit a pre-authorisation request to Niva Bupa.

4

Niva Bupa Confirmation:

After verification, Niva Bupa will confirm coverage to the hospital via fax and email, and notify you by text and email, typically within 30 minutes of the request.

5

Final Settlement:

Upon completion of treatment and necessary formalities, the hospital will settle the claim with Niva Bupa according to your policy terms.

Medical emergencies can occur anytime in people’s lives. They can be emotionally straining and can significantly impact your savings too. To combat this uncertainty, it is important to consider health insurance policies that save you from burning a hole in your pocket. Investing in health insurance is one of the best decisions one can take. It comes to your rescue, especially during emergency or unplanned hospitalisation.

Most insurance companies in India offer two types of health insurance plans - reimbursement and cashless. While there are several benefits and features that your medical insurance plan should provide, Cashless Health Insurance is one of the most important benefits.

What is Cashless Health Insurance?

Cashless health insurance is the best health insurance policy that comes with a cashless mediclaim facility. As the name implies, in a cashless health insurance policy, you don’t have to face the hassles of paying cash during medical emergencies and then getting reimbursed from the insurance company. Instead, the insurance company directly settles the payments with the hospital. However, the critical thing to know about this plan is that you can avail of the cashless facility only if you seek treatment at the network of hospitals that have a contract with the insurance company. Therefore, knowing the list of network hospitals in your locality will help you save last-minute hassles in an emergency.

 

Types of Cashless Health Insurance Plans in India
 

What is Cashless Hospitalisation?

Cashless hospitalisation is a service provided by some insurance providers, allowing the policyholder to avail of hospital facilities without worrying about paying hospital bills. The insurance company coordinates directly with the hospital with which it has a tie-up to pay bills specified in the insurance policy.

 

Points to Remember Before Buying Cashless Health Insurance in India

Before purchasing a cashless insurance plan, consider the points below to make the right decision:

  • It would be best if you bought a policy that offers adequate coverage without compromising on the benefits and at an affordable premium. The best practice is to look for the causes behind a reduced premium. It should not be at the cost of insurance coverage. Check if there is any clause of co-payment, deductibles, and sub-limits; if there is, you would actually end up paying more at the time of claim.

  • This waiting period shall apply to pre-existing illnesses like blood pressure, diabetes, thyroid, etc., that one may have before buying the policy. Additionally, it applies to specific treatments and illnesses like arthritis, varicose veins, cataracts, etc. So, you can compare and choose a plan with a minimum waiting period to claim the benefits in case of a health emergency.

  • No-Claim Bonus (NCB) refers to the discount offered by the insurance company for all the years that you have not filed a claim. Basically, your coverage amount is increased during subsequent policy renewals for all claim-free years. However, most health insurance providers specify the NCB limit. And the increase in the sum insured would depend on the limit specified by the insurer.

  • It will be helpful to check with your insurer for the list of hospitals and know which network hospitals are in your vicinity. It saves you from the tiresome paperwork that is required at the time of admission and claim. Moreover, the insurance company pays the sum insured directly to the hospital.

Importance of Cashless Health Insurance


Cashless health insurance is necessary during unforeseen health emergencies when you might be cash-strapped or not have immediate access to cash. It is designed to eliminate the need to worry about documents and cash in hand when genuinely being with the family. It also allows people to avail the best quality medical treatment without stressing about arranging money to pay the bills.

Features of Cashless Health Insurance

Health insurance policies have a wide array of features covering every aspect of healthcare emergencies. In addition, almost every insurer today is offering cashless health insurance policies. Let's take a look at some of the features offered by cashless health insurance plans:

  • Domiciliary treatments

  • Daily hospital cash allowance

  • Emergency ambulance cost cover

  • Value added services

  • Pre-existing illness cover

  • Free health check-ups

  • No claim bonus

  • Organ donor cover
     

Advantages/Benefits of Cashless Health Insurance in India

Provides Extensive Coverage for Medical Emergencies

Whether unforeseen or not, medical emergencies burn a hole in our pockets when we don't financially plan for them in advance. Cashless claims are more beneficial as they save critical time that a patient's family requires to arrange for medical expenses. Instead, they can start the necessary procedures by showing their cashless health insurance policy card to the relevant hospital authorities.

Peace of Mind

Instead of worrying about how to organise money during hospitalisation, cashless treatment offers to pay the bills, thereby delivering peace of mind. In addition, you also get to avail yourself of quality healthcare at one of the network hospitals.

Tax Savings

Along with all the financial protection and convenience benefits, cashless medical insurance also offers tax benefits. Premiums paid towards health insurance plans taken for self, spouse, children, and parents can be claimed under Section 80D of the Income Tax Act for a tax deduction.

Safeguards Health During Travel

The uncertainties of a new location often prevent you from accessing the proper treatment in case a medical emergency arises while travelling. However, being the holder of cashless health insurance or cashless mediclaim assures you of reliable medical services at a network hospital, and that too, without the hassle of arranging for hospitalisation and medical expenses.

 

How Does Cashless Health Insurance Work in India?

Cashless insurance removes the hassles of having to pay cash at the hospitals at the time of need. For cashless medical insurance, insurance providers enter into direct negotiations with hospitals in their network to pay for the treatment availed by the insured person. They tie up with some specific hospitals, known as the network hospitals of the insurance company.

When the insured gets hospitalised in a network hospital, they do not have to settle the bill with the hospital at the time of discharge. Instead, the TPA (third party administrator) or the insurance company will coordinate and settle the bill directly at the hospital.

 

What is Covered & Not Covered Under Cashless Health Insurance?

Inclusions

  • Pre and post hospitalisation expenses

  • Coverage of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy treatments (AYUSH Treatment)

  • OPD expense cover

  • Free annual health check-ups as a loyalty benefits

  • Costs related to in-patient care

  • Daycare procedures like chemotherapy, cataract surgery, etc.
     

Exclusions

  • Pre-existing illnesses

  • Medical expenses incurred within 30 days from the policy's start date are excluded, except for accidents.

  • Medical treatments related to congenital diseases.

  • Expenses that can be traced to consumption or misuse of drugs or alcohol

  • Non-medical expenses incurred during hospitalisation, like toiletries, attendance fees, service charges, etc.

 

Claim Cashless Health Insurance During Emergencies


Medical emergencies come unannounced. To avail of cashless hospitalisation during such circumstances, follow the steps below:

  • Once the insured is admitted to the hospital, they must show a health card issued by the insurance company. The Health card will have all the vital details such as the insurer's name, policy number, plan type, etc.

  • Insured needs to contact the TPA/insurance desk and initiate the cashless claim by filling up a pre-authorisation request, usually within 24 hours of hospitalisation.

  • A third-party administrator/insurance company will review all the initial documents submitted.

  • Once the insurance company approves the cashless request, further documents are to be produced by the hospital to expedite the claim process.

  • Once the final set of documents submitted by the hospital is verified, the claim amount will be directly settled with the network hospital.

  • If admission to the specified list of network hospitals is not feasible, there is an option of a reimbursement claim. In this case, the insured would pay the bill in full, and they can file a claim with relevant documents and medical bills later on with the insurance provider.

 

Documents Required for Cashless Health Insurance

The requirement of documents may vary on a claim-to-claim basis. However, certain standard documents are needed for cashless health claims. Following are the documents required:

  • Claim form duly filled and signed

  • Doctor's advice for hospitalisation

  • Discharge summary of the hospital

  • Doctors' prescriptions, treatment details along with original medical bills and receipts given by hospitals, diagnostic centres, doctors, and pharmacies

  • Diagnosis reports (ECG/Scan/X-ray, Lab test reports, etc.)

  • Health card copy

 

Difference Between Cashless Claim & Reimbursement Claim

 

Niva Bupa provides the best cashless health insurance. We have truly understood what makes health insurance ideal for the people and created products that cater to all those needs and much more.

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