Niva Bupa (Formerly known as Max Bupa) Corona Kavach Policy

Key Features and Benefits of Niva Bupa (Formerly known as Max Bupa) Corona Kavach Policy

This policy is designed with unique combination of medical insurance benefits and features to its customers:

• Digital Health Insurance Policy: It is a digital health insurance policy as the policyholder will only receive a digital copy of this policy with all the details, instead of a physical copy.
• Policy Term: Flexibility in policy terms is offered, and the applicant can choose from the following options- Three and half months, Six and half months, Nine and half months including 15 days waiting periods after which the policy coverage kicks in
• Hassle-free Claims: Niva Bupa (Formerly known as Max Bupa) health insurance provides in-house claim settlement and cashless claims processing in 30 minutes

Eligibility Criteria to buy Corona Kavach Policy by Niva Bupa (Formerly known as Max Bupa) Health Insurance

Anyone can purchase this policy if they are minimum 18 years old and maximum 65 years old. Even if the proposer is older than 65 years, he/she can buy this coronavirus health insurance policy for their family members, including:

• Spouse
• Parents and in-laws
• Dependent Children can also be insured till they are 25 years old. If the insured children is above 18 years and is independent, he/she shall not be allowed to get coverage under this Coronavirus health insurance plan

Inclusions of Niva Bupa (Formerly known as Max Bupa) Corona Kavach Policy

Niva Bupa (Formerly known as Max Bupa) health insurance will cover the hospitalization expenses incurred by the insured person on coronavirus treatment upon being diagnosed coronavirus positive as per the reports given by the diagnostic centre, which is government approved. The inclusions under this policy are given below:

• Hospitalisation Coverage up to Rs 5 Lakh
• It includes room rent, nursing and boarding charges to be paid to the hospital or a nursing home
• It also pays for bills charged for treatment in an ICU and ICCU
• Fees charged by a surgeon, treating doctor, anesthetist , consultant, and specialist
• Anesthesia, operation theatre charges, surgical appliances, blood, ventilator charges, oxygen, medicines and drugs, diagnostic tests, masks, PPE Kits, and gloves
• Road Ambulance cover is provided up to Rs 2,000
• Transportation charges from one hospital to another, if required as a part of the treatment

Pre hospitalization Expenses: Pre-hospitalisation medical expenses incurred on COVID treatment 15 days before hospitalisation are covered provided:

• It is only related to coronavirus treatment
• And the homecare treatment and hospitalization is admissible

Post Hospitalization Expenses: Post-hospitalisation medical expenses incurred on COVID treatment 30 days before hospitalisation are covered provided:

• It is only related to COVID-19 treatment
• And the homecare treatment and hospitalization is admissible
• Coverage of Pre-existing Diseases: It covers co-morbid conditions along with pre-existing diseases up to sum insured
• Home Care Treatment Expenses: Medical expenses incurred on treatment taken at home for coronavirus as suggested by the doctor, provided daily monitoring chart is maintained as per the policy schedule
• AYUSH Treatments Coverage: Ayush treatment expenses are also covered including Yoga, Ayurveda, Unani, Naturopathy, Homeopathy, and Siddha as specified in the policy schedule

• Hospital Cash Benefit: The policy also offers option to get additional 0.5% of coverage amount as daily cash benefit for a maximum of 15 days

Permanent Exclusions of Niva Bupa (Formerly known as Max Bupa) Corona Kavach Policy

The policy shall not cover the following medical expenses under any circumstances:

• OPD and Day Care Treatment
• Evaluation and Investigations
• Rehabilitation, Rest Cure and respite care
• Dietary supplements and vitamins unless prescribed under the treatment
• Any coronavirus related claim before the policy commencement
• Diagnosis or medical treatment outside India
• Testing done at a non-government recognized Centre
• Travel history to restricted countries

Other Limitations

Claims are rejected under the following conditions:

• If the insured is found to be undergoing treatment in a medical facility or hospital that is not recognized by the concerned authorities
• Treatment taken in a hospital or advised by a doctor who is not recognized by the Central Council of Indian Medicine/Medical Council of India/ Central council of Homeopathy or by the concerned authorities
• Treatment provided by insured person immediate relative or family member or someone who lives in the same residence as the policyholder
• Treatment received in a healthcare facility/nature care clinics or any other establishment that is not recognized

Niva Bupa (Formerly known as Max Bupa) Corona Kavach Policy Claim Procedure

The claim procedure and turn-around time for corona kavach policy is given below:

Here is the Claim Process:

To initiate the claim process, the policyholder needs to send a notice to the insurer/TPA as mentioned under:

• Within 24-hours of emergency hospitalization or cashless home care treatment
• For planned hospitalization inform 48 hours before hospital admission
• Submit all the documents when filing a claim and submit them within the prescribed time limit

Documents Required for Niva Bupa (Formerly known as Max Bupa) Corona Kavach Policy Claims

• Duly signed and filled claim form/li>
• Payment receipts/li>
• Original hospitals bills with expense break-up/li>
• Copy of the passport of the insured patient ( if available)/li>
• Photo Identity proof of the patient (in case passport is not available)/li>
• Doctor’s prescription advising hospital admission/li>
• Hospital discharge summary with patient’s medical history and other details/li>
• Investigation reports including medical test reports from Authorized COVID diagnostic Centre/li>
• Operation theatre’s notes and Surgeon’s certificate with operation details ( wherever applicable)/li>
• KYC details for claims above Rs 1 Lakh/li>
• NEFT details for claim settlement and a cancelled bank cheque/li>
• Legal heir certificate, as applicable/li>
• Any other documents are required by the TPA/Insurance Company

For homecare treatment following documents are required:

• Claim form ( duly filled and signed)
• Passport copy of the patient ( all pages) passport, if available (All Pages)
• Photo ID Proof (in case passport is not available)
• Medical practitioner’s prescription advising home care treatment
• Discharge Certificate from doctor mentioning date of start and completion of home care treatment
• Daily monitoring chart to be maintained with medical records of treatment and is singed by the treating doctor

Niva Bupa (Formerly known as Max Bupa) Corona Kavach Policy FAQs