Niva Bupa Health Insurance

Niva Bupa ReAssure 2.0 (with Diabetes / Hypertension rider)

Plain-English breakdown of the plan — every field a shopper actually needs before clicking buy. Compiled from public Niva Bupa brochures and policy wordings. Always confirm against the official PDF below.

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Trust at a glance

Niva Bupa — IRDAI FY 2024-25

Verified

Claim Settlement Ratio: 92.39%
Incurred Claim Ratio: 61.22%
Complaints / 10,000 claims: 43
Network hospitals: 10,000

Source: IRDAI Annual Report FY 2024-25 · UIN 145PolicyPlain earns no commission · numbers shown verbatim

Plan details

Every field, in one place

Sum insured options: ₹5L · ₹10L · ₹15L · ₹25L · ₹50L
Pre-existing disease (PED) waiting: 24 months
Pre-existing covered: Covered after PED waiting period
Co-payment: No copay published
Room rent: No cap
Restoration of sum insured: Unlimited (subject to clauses)
No Claim Bonus (NCB): Variant-specific / not single value
Cashless network: 10,000 hospitals (insurer disclosure)
Free-look cancellation window: 30 days
Premium grace days: 30 days
IRDAI UIN: Not confirmed — verify on irdai.gov.in
Last verified: 2026-06 · third party aggregator

Honesty note: Diabetes rider is an add-on to the base ReAssure 2.0 plan; rider terms vary — confirm against current sales brochure.

Indicative premium

Order-of-magnitude only — NOT a quote

Age	Sum insured	Approx annual premium
45	₹10L	~₹26,000/yr
55	₹10L	~₹38,000/yr

Indicative figures vary by city, family member count, medical loading and policy term. Always confirm on the insurer's premium calculator.

Known exclusions

What this plan typically does NOT cover

Cosmetic surgery (non-reconstructive)
Pregnancy and complications without separate rider
Experimental treatments
Substance abuse
Self-inflicted injury

Known traps

The fine print that decides claim outcomes

Diabetes / HTN rider reduces PED waiting from 36 to 24 months — not day 1.
Rider premium adds ~20-30% over base premium.
Hospital bed-count minimums apply (15 in metro / 10 non-metro).
Restoration unlimited but triggers once per policy year.
Booster+ benefit forfeited on first claim in some variants — confirm renewal mechanics.

How to claim

Cashless vs reimbursement — the steps

1Notify insurer. Within 24 hours of emergency admission or 48-72 hours for planned hospitalisation. Use Niva Bupa's helpline or app — keep the reference number.
2Cashless: Pre-authorisation form filled by hospital, sent to Niva Bupavia the hospital's TPA desk. Approval typically 4-6 hours during business; longer overnight. If your hospital is OUT of network (or PPN-only), you'll be on reimbursement.
3Reimbursement:Pay hospital out-of-pocket, then submit claim form + original bills + discharge summary + investigation reports + KYC. Insurer's IRDAI-mandated turnaround is 30 working days from receipt of complete documents.
4Watch for deductions. Room rent above your eligible category triggers proportionate deduction across the WHOLE bill, not just room rent. Sub-limits on cataract / modern treatment apply even when total SI is far higher.
5If denied: Ask for a written denial citing the exact clause. Internal grievance redressal first, then IRDAI Bima Bharosa or the Insurance Ombudsman.

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