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Niva Bupa (Max Bupa) Claim Settlement Ratio Online in India
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Niva Bupa (Max Bupa) Health Insurance Claim Settlement

Niva Bupa (earlier known as Max Bupa) Health Insurance has a wide range of network hospitals for cashless treatments & also doctors for cashless OPD treatments. It allows checking the Max Bupa claim ratio to control the stress over financial decisions. Max Bupa Claim Settlement Ratio takes just 30 minutes to process a cashless claim. It offers a direct claim settlement service. Max Bupa Health Insurance provides a home pick service of diagnostics samples and even delivers medicines to customer doorstep. Max Bupa Claim does not involve a third party and makes the claim process simple.

How to Check Niva Bupa (Max Bupa) Claim Status

To view your claim status of Max Bupa, you need to either follow the online method or the offline method. 

1. Niva Bupa (Max Bupa) Online Claim Procedure

To check your claim status, you can easily follow the steps given below:

  • Visit the official website of Max Bupa.
  •  Choose the ‘Claim’ section and go to the claim status portal.
  •  Fill in the details of your username and password to log in to your account. You can easily check your claim status from there.

 

2. Niva Bupa (Max Bupa) Offline Claim Procedure

Even if you can’t check your claim status online, you can use the offline mode also. Simply, you need to call Max Bupa customer care executive at Toll-Free Number, and ask regarding the same. To know regarding your claim status, you can also visit the nearest branch of Max Bupa Insurance company.

Niva Bupa Claim Process for Cashless Treatment

With the help of Max Bupa, you can easily fill the cashless claims. Generally, Max Bupa provides various network hospitals in the country. Here are the steps to filing a Max Bupa cashless claim:

  • Firstly, you need to find a Max Bupa network hospital to get cashless treatment
  • In case of planned hospitalization, Max Bupa provides the emergency hospitalization within 24 hours to 48 hours before admission
  •  You need to carry a Max Bupa Health Card/Policy number and one photo ID proof.
  •  Fill the form of pre-authorization request available at the hospital and submit it to the hospital.
  •  After your identity is verified, the hospital sends your pre-authorization request form to Max Bupa.
  •  Once Max Bupa verifies your documents, it reviews with the hospital and policyholder the claim status within 30 minutes.
  •  As per the terms and conditions of the policy, Max Bupa clears the claim with the hospital once all the forms are complete.

 

Niva Bupa (Max Bupa) Claim Process for Reimbursement Treatment

Reimbursement claims can be entered in case you got treatment at a network or non-network hospital. Here are the step of reimbursement claim process are as follow:

  • Max Bupa Insurance claim informs within 24 hours for emergency hospitalization and 48 hours for planned hospitalization.
  • Either choosing a network hospital or a non-network hospital, inform  Provide discharge documents, invoices, medical reports along with the completely filled and signed reimbursement claim form.
  •  Also, you need to require Max Bupa with valid photo ID proof, and age proof 
  •  After checking the claim request, Max Bupa will either give permission, query or reject your claim on the basis of policy terms and conditions.
  •  Max Bupa clears the claim (as per policy terms and conditions) and reimburses the amount approved.

 

Documents Required For Max Bupa Health Insurance Claim 

Mentioned below is the list of documents required for filing a Max Bupa claim as mentioned below:- 

  • Original investigation reports
  • Provide final hospital discharge summary
  • Report of FIR or post-mortem if happened
  • The prescription of Pharmacy bills 
  • Original bills, receipts, and discharge report
  • Indoor case papers and filled claim form
  • Required original hospital bills and a valid photo ID proof
  • Required doctor’s report, and original consultation notes
  • Bill and receipt of surgeons 
  • Test reports of surgeon’s along with attending doctor’s

 

Also required documents are to be needed In case of a claim for accidental death, claim form other than the original death certificate, FIR copy, proposer’s income proof, copy of Medical-Legal Certificate, employer’s certificate, last 3 month’s salary slip, and audited accounts should be mandatory.

Benefits Of Niva Bupa Health Insurance Claim

  • Max Bupa Health Insurance Claim ratio offers a high claim settlement ratio of 92%.
  • It allows clearing your health insurance claims within 30 minutes
  • Max Bupa Health Insurance Claim has no involvement of the need of TPAs (Third Party Administrators)
  • It also provides international coverage for critical illnesses through its hospital network
  • Max Bupa has been considered to be the ‘Most Trusted Health Insurance Brand’ for three consecutive years
  • It provides cashless claim settlements hospitals in India
  • Max Bupa Health Insurance Claim has no age restriction for enrolment
  • It also provides Maternity and NewBorn Child benefits.

 

What is Covered in Niva Bupa Health Insurance Claim?

  • Purchase online easily and conveniently in use of Max Bupa health insurance policies.
  • Max Bupa Health Insurance Claim allows a sum insured of a maximum up to Rs. 1 crore.
  • It provides coverage for your whole family
  • Pre-existing illnesses covered by Max Bupa Health Insurance Claim 
  • Also cover lifetime renewal options.
  • Provide a good of 12.5% discount on the premium amount during the second policy of renewal
  • Includes all medical expenses like hospital room rent, pre and post-hospitalization, OPD expense cover, organ donation, and daycare.
  • Also provides home hospitalization and domiciliary hospitalization.
  • Includes regular health check-ups once or twice annually.
  • Max Bupa Health Insurance Claim offers cashless facilities on being hospitalized.
  • It also provides international cashless facilities for specific critical illnesses such as cancer, organ transplant, etc.

 

What is not covered in Niva Bupa Health Insurance Claim?

  • AIDS
  • Congenital Disease 
  • Attempted suicide
  • Medical treatments related to pregnancy, miscarriage, childbirth
  • Infertility treatment and in-vitro fertilization
  • Injuries occur due to war, terrorist attacks, etc.
  • Overuse of alcohol or drugs

 

Conclusion

Max Bupa Health Insurance Claim offers various cashless hospitals which allow you to get your claims settled easily. Moreover, it takes cashless claim approvals within 30 minutes making the claim process as easy and customer-friendly. Max Bupa provides claims to their customers to get settled by either cashless treatment or reimbursement facility. It is a quicker resolution process including claims handling. The Max Bupa health insurance is renewed for a long time.

FAQs:

How long does it take for Niva Bupa to approve a claim?

In the health insurance industry, Max Bupa (Now Niva Bupa) has built a unique service concept by promising cashless insurance claims pre-authorization within 30 minutes of admission. While the industry average for cashless claim processing is 2 to 4 hours, Niva Bupa can do it in as little as 30 minutes.

How do I check the Max Bupa claim status?

Here are the simple steps to the status of your Niva Bupa claim as mentioned below:-
1. Go to the official website of Niva Bupa Health Insurance.
2. Visit the claim section and navigate to the claim status portal.
3. Enter your username and password and log in to your Niva Bupa account. You will be able to check the claim status there.

What is Max Bupa (Now Niva Bupa) Health Insurance claim settlement ratio?

Max Bupa Health Insurance Claim Settlement Ratio for FY 2019-20 is 89.46%.

How do I claim my hospital cash benefit in Niva Bupa Hospital cash Policy?

Here is the list of documents you need to submit while filing a claim under the Max Bupa Hospital Cash policy:
1. Max Bupa claim form
2. KYC Documents
3. Consultation notes/investigation reports
4. Hospital Discharge Papers.
5. Copy of FIR or panchnama (in case of an accidental injury)