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Niva Bupa Health Insurance Claim Settlement

Before you buy a Niva Bupa health insurance plan, it is good to check how many claims they have paid in the past. This is called the Claim Settlement Ratio (CSR). It shows how many people got their claims paid compared to how many applied. If the CSR is high, it means more people get their claims settled. Niva Bupa’s Claim Settlement Ratio is 88.57% for the year 2023-24. A CSR above 85% is usually a good sign. It means Niva Bupa pays most of the claims made by its customers.

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Documents You Need for Niva Bupa Health Insurance Claims

Documents You Need for Niva Bupa Health Insurance Claims

  • A filled and signed claim form is needed.You need your address proof (like an ID or utility bill).The doctor’s prescription and consultation papers should be attached.The hospital will give you a discharge certificate. You need to submit it.All medical reports, bills, and receipts should be included.A copy of your health insurance policy is also required.If it’s an accident, you will need to give the FIR report.In case of death due to an accident, a death certificate or a post-mortem report is needed.You will also need to fill out the KYC form (Know Your Customer form).

    • Step-by-Step Claim Process of Niva Bupa Health Insurance

  • Cashless ClaimsStep 1: Go to a nearby hospital that works with Niva Bupa (network hospital).Step 2: At the hospital reception, talk to the person in charge of insurance (TPA desk).Step 3: The TPA person will help fill out the forms and send them to Niva Bupa.Step 4: Once Niva Bupa checks and approves everything, the hospital will start your treatment.Step 5: After the treatment is finished, Niva Bupa will pay the hospital directly. You don’t have to pay anything (except non-covered costs, if any).Reimbursement ClaimsStep 1: Inform Niva Bupa before going to the hospital - either 48 hours before a planned admission or within 48 hours if it’s an emergency.Step 2: Pay the hospital bills yourself and keep all the papers (bills, reports, etc.).Step 3: Fill out the claim form and send it along with all the documents to Niva Bupa.Step 4: Wait for Niva Bupa to check and approve your claim. If approved, they will transfer the money back to your account.

Health Insurance Plans By Niva Bupa

FAQs

For cashless claims, approval usually happens within 30 minutes to 2 hours. Reimbursement claims take around 7 to 15 working days after you submit all required documents.

You need the filled claim form, hospital bills, doctor’s prescriptions, discharge summary, KYC documents, and your health insurance policy copy. Extra documents, like an FIR, may be needed in accident cases.

You can check your claim status on the Niva Bupa website, call their customer care at 1860-500-8888, or visit their nearest branch office.

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