Niva Bupa Group Health Insurance

Niva Bupa Group Health Insurance

Claim settlement ratio (2019-20)

89.46%

Network hospitals

8600+

TPA

In-house TPA

Total GHI lives insured (2020-21)

21 lakhs

Total GHI claims incurred (2020-21)

₹129 crores

About Niva Bupa group health insurance

Niva Bupa group health insurance is a corporate insurance product of Niva Bupa Health Insurance Company Limited and formerly known as Max Bupa Health Insurance Company Limited is a standalone health insurance company founded in the year 2008. It is a joint venture between Fettle Tone LLP, an Indian private equity firm and Bupa Singapore Holdings Pte. Limited, the UK-based healthcare services expert.

With Pazcare, you can administer your Niva Bupa group health insurance in one place using the Pazcare dashboard. Join the other 500+ HRs who use the Pazcare dashboard to manage the policy, add/delete employees, manage endorsements and many more. The employees can use Pazcare’s employee app to manage their group health insurance plan.

By purchasing Niva Bupa group health insurance from Pazcare you get best-in-class employee insurance services. 

How to buy Niva Bupa group health insurance from Pazcare?

Purchase your Niva Bupa group health insurance from Pazcare using the following process.

Step 1: Visit us at Pazcare and choose group health insurance.

Step 2: After going through the benefits and coverage, click on the get quote button to fill out basic information like your name, company, work email address, phone number and the number of employees in the organisation.

Step 3: Our health insurance consultants will get back to you within 24 hours of submitting the form. Communicate your requirements regarding the Niva Bupa group health insurance. This includes the sum insured, type of policy, add-ons required, etc.

Step4: Our team will get back to you with comprehensive quotes for Niva Bupa group health insurance along with the other group health insurers based on the requirements you communicated.

Step 5: Once you choose the plan, say Niva Bupa group health insurance policy, the next step is to accept the terms and conditions of the plan and pay the premium quoted.

Step 6: Once the payment is done, our team will help you with the onboarding process. Generally, an onboarding process will be done within 24 hours of your policy purchase. We will also assist you in using the Pazcare dashboard to administer your group insurance plan.

For any assistance get in touch with us at support@getpaz.com or call us directly at +91 78291 11300. Alternatively, contact us on Whatsapp using +91 81973 79596.

Why choose Niva Bupa group health insurance as your insurance partner?

These are the reasons why you should choose Niva Bupa group health insurance as your insurance partner.

Process claims in 30 minutes

Niva Bupa group health insurance assures you to process all the health insurance claims queries in 30 minutes.

8600+ network hospitals

The Niva Bupa group health insurance has a strong network of cashless hospitals with 8600+ network hospitals.

70 lakh+ happy customers

The insurer has 70 lakh, happy customers, both in the retail and corporate insurance space.

In-house claim settlement

You do not have to wait for an external TPA to process and settle the group health insurance claims. Niva Bupa group health insurance has an in-house claim settlement team.

Niva Bupa group health insurance claim settlement ratio

The claim settlement ratio (CSR) in insurance is the ratio between the number of claims settled by the insurer to the number of claims requested from the policyholders to the insurer in a financial year.

The claim settlement ratio of Niva Bupa group health insurance is

Financial Year Claim settlement ratio
2019-20 89.46%
2018-19 84.15%

Niva Bupa group health insurance network hospitals

Niva Bupa health insurance company has tie-ups with various hospitals around India. These hospitals are known as network hospitals. These network hospitals are the hospitals where the policyholders can avail cashless treatment as the bills are settled directly to the hospital. Niva Bupa group health insurance has 8600+ cashless network hospitals in India. This makes it easier for the policyholders to avail cashless treatment near their location.

Claim Niva Bupa group health insurance

You can claim your Niva Bupa group health insurance by using a cashless claim process or a reimbursement claim process.

Niva Bupa group health insurance cashless claim 

Use the following steps to make your Niva Bupa group health insurance cashless claim.

  1. Visit your nearest network hospital

Visit your nearest Niva Bupa group health insurance network hospital for treatment. Cashless treatment facilities are only available at a network hospital.

  1. Verification

Confirm your identity using the following documents. A government photo ID (like a voter ID, driving license), the health insurance ID card or policy number, and your company ID at the network hospital. Complete the verification process

  1. Submit your pre-authorisation form

Submit the pre-authorization form to Niva Bupa group health insurance company within 24 hours of hospitalisation in case of emergency. For planned hospitalisation, submit it at least 3 days before the hospitalisation.

  1. Review of request

After submitting the pre-authorisation form, the request for a cashless claim for your cashless claim request will be reviewed by the in-house claim settlement team of Niva Bupa group health insurance. The claim from the network hospital will be responded to within 30 minutes according to the insurer. 

  1. Claim settlement

After Niva Bupa group health insurance company accepts the cashless claim request, the claim is settled directly with the network hospital according to the terms and conditions of the policy.

Niva Bupa group health insurance reimbursement claim

Hospitalisations in a non-network hospital means you will have to opt for Niva Bupa group health insurance reimbursement claim

  1. Intimate the insurance company

Firstly, intimate the Niva Bupa group health insurance company about the hospitalisation within 24 hours in case of emergency and at least 3 days before planned hospitalisation.

  1. Pay the bills

After taking treatment at a non-network hospital, the next step is to pay all the hospital bills and pharmacy bills from your pocket.

  1. Collecting the original documents

Once the bills are paid, collect all the original copies of the required documents to file for a reimbursement claim for your Niva Bupa group health insurance policy.

Documents required to file Niva Bupa group health insurance reimbursement claim

  • Claim form
  • Medical papers, pathology reports, X-ray reports, as applicable
  • Doctor’s prescription and line of treatment suggested
  • Medical bills and cash memos
  • Hospital Discharge Card

  1. Submit the documents

Submit all the original documents collected to Niva Bupa group health insurance company for the reimbursement claim processing.

  1. Claim settlement

Once the claim is verified with the supporting documents, the insurer will settle the reimbursement claim directly to your bank account as per policy terms and conditions.

Contact us at support@pazcare.com for 24X7 claim assistance for your employees. Call us at +91 78291 11300 for all your queries and claim assistance.

Niva Bupa group health insurance renewal process

Renew your Niva Bupa group health insurance with Pazcare using the following steps.

Step 1: Visit us at https://pazcare.com/ and fill out a basic form containing your name, company name, number of employees, work email address and phone number to renew your Niva Bupa group health insurance policy.

Step 2: Our group health insurance consultants will contact you for the following documents to renew your policy. The documents needed are

  • Active data of employees - name, age, gender, details of dependents (as per the type of policy)
  • Claim analysis report
  • Claim dump report from the (existing or previous) insurer/TPA
  • Policy copy

Step 3: You can choose add-ons and riders to your existing Niva Bupa group health insurance plan. The riders include dental insurance riders, maternity insurance riders, and many more. Always communicate your requirements to us for the best tailor-made Niva Bupa group health insurance policy. 

Step 4: We will revert back to you with the competitive quotes from Niva Bupa group health insurance company based on your requirements. Based on the history of claims and the riders opted for, the group health insurance premium may vary.

Step 5: Agree to the terms and conditions of the Niva Bupa group health insurance policy and proceed with the payment. The policy is usually valid for a year after the renewal process.

Step 6: In case, purchasing your Niva Bupa group health insurance for the first time with Pazcare, within 24 hours the onboarding process will be carried out. 

We at Pazcare ensure that your Niva Bupa group health insurance experience is seamless using our Pazcare dashboard for admins/HRs. Your employees can access their Niva Bupa group health insurance plan using Pazcare’s employee app which is available on both the app store and the play store. 

Niva Bupa group health insurance premiums

Niva Bupa group health insurance premium is calculated based on factors like 

Riders and add-ons opted for

When you opt for riders and add-ons like maternity insurance riders, dental insurance riders with the existing Niva Bupa group health insurance policy then your group health insurance premium may increase with respect to the last financial year’s premium.

Sum insured

The maximum amount that a health insurance company will pay in case of any hospitalisation in a financial year is called the sum insured. If the hospitalization expenses cross the sum insured, the policyholder pays the remaining amount from his/her pocket. Hence, the higher the sum insured, the higher the premiums.

Type of plan

The 3 types of Niva Bupa group health insurance plans available are employee only (E), employee+spouse+children (ESC) and employee+spouse+children+parents (ESCP) plans. For instance, the number of people covered in the ESCP plan is more than that of E only plan, hence one has to pay higher premiums.

Claims history

During the Niva Bupa group health insurance policy renewal, the claim history is taken into account to calculate the premium for that financial year. If the number of claims requested by the employees in the previous financial year is higher, then the premium to be paid for the policy will be higher during the renewal process.

What is covered under your Niva Bupa group health insurance?

Your Niva Bupa group health insurance is tailor-made. Hence, you can choose your coverage options. The following will be covered based on the terms and conditions of your Niva Bupa group health insurance plan.

Covid-19 treatments

Cover the treatment expenses for covid-19 using your Niva Bupa group health insurance plan.

Pre-existing conditions

All your pre-existing conditions are covered without any waiting period in your Niva Bupa group health insurance plan with Pazcare.

No disease-wise limits

Generally, a retail health insurance plan has certain limits in covering certain diseases. But with your Niva Bupa group health insurance all your diseases are covered in the plan.

Maternity and newborn coverage

When you opt for a maternity insurance rider in your existing Niva Bupa group health insurance, then all your maternity expenses and newborn baby coverage for up to 90 days are covered in the policy.

What is not covered under your Niva Bupa group health insurance?

Cosmetic treatments

Cosmetic treatments like plastic surgery, liposuction, and botox are not generally covered in your Niva Bupa group health insurance plan.

Gender-changing surgeries

Expenses due to gender-changing treatments or surgeries are excluded from your Niva Bupa group insurance policy.

Self-harm injuries

Injuries due to self-harm, like suicide and hospitalisation expenses for the same are not covered in this Niva Bupa group health insurance policy.

Treatments for substance abuse

Treatment expenses due to substance abuse like drugs or alcohol are exempted from coverage in your Niva Bupa group health insurance.

Niva Bupa group health insurance benefits

No third party involved

The Niva Bupa group health insurance has an in-house claim settlement department to process and settle the claims of their customers without any involvement external third party administrator.

No medical tests needed

Your Niva Bupa group health insurance does not require any medical tests before purchasing your insurance policy.

Huge cashless network hospitals

The Niva Bupa group health insurance has a strong network of cashless hospitals. With around 8600+ cashless network hospitals, the insurer has a pan India presence.

Customise your policy

Your Niva Bupa group health insurance is a highly customisable policy according to the needs of your employees. You can choose your add-ons and riders and create a tailor-made Niva Bupa group health insurance plan.

Niva Bupa group health insurance claim process

1

Intimate the insurer

Inform the Niva Bupa group health insurance company about the hospitalisation within 24 hours, in case of emergency and at least 3 days prior in case of a planned hospitalisation.

2

Verify the identity

Provide the proof of identity - policy number/health insurance ID card, company ID and a valid unique govt. ID card and get it verified at the network hospital.

3

Submit the pre-authorization form

Fill out the Niva Bupa group health insurance pre-authorization form/cashless claim form and submit it to the network hospital.

4

Settlement of claims

After successful verification, the claim will be settled directly to the network hospital. You will be notified about the same.

5

Contact us for assistance

For any claim assistance contact Pazcare at support@getpaz.com or call us at +91 78291 11300. We are available 24X7.

1

Intimate the insurer

Intimate the Niva Bupa group health insurance company within 48 hours, in case of an emergency and at least 3 days prior in case of a planned hospitalisation.

2

Settle the bills

Settle the hospital bills and pharmacy bills and collect the original copies of the essential documents.

3

Submit the documents

Submit these documents along with the claim form to the Niva Bupa group health insurance company

4

Claim settlement

Once verified, the Niva Bupa group health insurance reimbursement claim will be settled in your bank account.

5

Contact us for assistance

For claim assistance and queries contact us at support@getpaz.com or call us at +91 78291 11300.

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Why buy a group health insurance
policy online from Pazcare?

  • Choose the suitable policy with our consulting approach
  • Custom-made plan with health and mental wellness add-ons
  • The tech-enabled Pazcare dashboard to manage endorsements
  • Integrate the dashboard with your HRMS tool

Niva Bupa group health insurance customer care number

For any queries or assistance, reach out to us at any time. We provide 24X7 customer assistance.

Niva Bupa group health insurance

1860-500-8888

Available 24X7

Niva Bupa group health insurance FAQs

What is Niva Bupa group health insurance claim settlement ratio?

The claim settlement ratio of Niva Bupa group health insurance (formerly known as Max Bupa group health insurance) is 89.46% for the financial year 2019-20.

How can I claim my Niva Bupa group health insurance?

Claim the Niva Bupa group health insurance in two ways. Go for a cashless claim at a network hospital and a reimbursement claim at a non-network hospital. In a cashless claim, verify your identity and the bills are settled directly at the network hospital. On the other hand, for a reimbursement claim, the bills are paid by the policyholder and later the insurer settles to the policyholder’s bank account.

How to go about Max Bupa group health insurance renewal?

Max Bupa group health insurance, now known as Niva Bupa group health insurance requires the following documents for the renewal process.

  • Active data of employees which includes name, age, gender, and details of dependents (as per the type of policy)
  • Claim analysis report
  • Claim dump report from the insurer/TPA
  • Policy copy

Once collected, visit us at https://pazcare.com/ and submit a basic form containing your name, phone number, email address, company name and number of employees. Our health insurance consultants will get in touch with you. Communicate your requirements and submit the above-listed documents.

Based on your requirements, the premium for your renewal policy will be calculated.

What is the Max Bupa group health insurance customer care number?

The customer care number of Max Bupa group health insurance, now known as Niva Bupa group health insurance is 1860-500-8888. They provide you with the necessary information and provide claim assistance. Also, you can email them at customercare@nivabupa.com.

What are the benefits of Max Bupa group health insurance for employees?

The benefits of Max Bupa group health insurance for employees, now known as Niva Bupa group health insurance are

  1. No waiting period for pre-existing diseases
  2. No disease-wise sub-limits for health insurance coverage
  3. Maternity cover and newborn baby cover can be added to policy
  4. The company settles the claim using the in-house claim settlement team and not an external TPA, making the process more efficient. 
  5. 8600+ network hospitals pan India, this means the policyholder can make cashless claims at various locations in India.

How to find the Max Bupa group health insurance hospital list?

Find your Max Bupa group health insurance hospital list, now known as Niva Bupa group health insurance here under Network hospitals section.