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Niva Bupa Health Assurance CritiCare is a critical illness benefit available under the Health Assurance product. It pays a benefit when an insured person is diagnosed for the first time with one of the specified critical illnesses and satisfies the policy conditions. The product lists 20 critical illnesses, including specified cancer, heart, neurological and organ-related conditions. Customers can select between a lump-sum payout and a lump sum followed by staged annual payments. This is a defined-benefit product and should not be presented as reimbursement of all hospital bills. CritiCare is a benefit under Health Assurance, not a separately verified standalone policy.
20 specified critical illnesses; two benefit payout options
CritiCare may help provide financial support following an eligible critical illness diagnosis. Benefit Option 1 pays a lump sum equal to the applicable sum insured. Benefit Option 2 pays a lump sum and a further 10% of the sum insured annually for five subsequent years, subject to the policy terms. The policy has a 90-day initial waiting period and a 30-day survival requirement after diagnosis. Pre-existing disease rules and the exact definitions of covered illnesses are important when assessing suitability. Confirm the available sum insured, current product wording and premium directly with Niva Bupa before purchase.
Niva Bupa
Key Insights
Founded
2008
Niva Bupa was established 18 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
96.1% CSR, calculated as a 3-year average
Niva Bupa settles 96.1% of all claims it receives, demonstrating strong credibility.
Contact Details
1860 500 8888
Headquarters: 3rd Floor, Capital Cyberscape, Sector 59, Gurugram, Haryana
Benefit Option 1 pays a lump sum equal to 100% of the applicable sum insured for an admissible first diagnosis of a covered illness.
Subject to policy terms and claim eligibility.
Benefit Option 2 pays the applicable lump sum plus 10% of the sum insured annually for five subsequent years.
The staged payments are subject to the selected option and policy conditions.
Includes Cancer of Specified Severity as listed in the product illness schedule.
The policy definition of specified severity applies.
Includes listed conditions such as first heart attack of specified severity, Open Chest CABG and specified heart valve surgery.
Medical definitions and claim conditions apply.
Includes listed conditions such as stroke resulting in permanent symptoms, permanent paralysis of limbs and multiple sclerosis with persisting symptoms.
Only conditions meeting the policy definition qualify.
Initial waiting period: 90 days from commencement of CritiCare cover. Survival period: 30 days from diagnosis. Pre-existing disease waiting period: 36 months of continuous coverage under the applicable Health Assurance prospectus. Confirm the current policy wording before purchase.
Initial waiting period
Benefit is not payable if signs or symptoms of a listed critical illness commence within 90 days from commencement of CritiCare cover.
Survival period
The insured person must survive for at least 30 days from the diagnosis of the covered critical illness.
Pre-existing disease waiting rule
The Health Assurance prospectus states that pre-existing diseases are subject to 36 months of continuous coverage for the respective benefit.
Conditions or treatments that the policy clearly says it will not cover.
The official Health Assurance CritiCare brochure lists 20 specified critical illnesses. A diagnosis must meet the exact policy definition and claim conditions; the names below are not a substitute for the detailed medical definitions.
Insurer
Niva Bupa plans and claim process
CritiCare is a critical illness benefit available under the Health Assurance product. It pays according to the selected benefit option for an admissible first diagnosis of a listed illness.
The official Health Assurance CritiCare brochure lists 20 specified critical illnesses.
Option 1 pays a lump sum equal to the applicable sum insured. Option 2 pays the lump sum plus 10% of the sum insured annually for five subsequent years, subject to the policy wording.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official Niva Bupa website before purchasing.
Official Website
nivabupa.com
Visit the official Niva Bupa website for plan brochures, premium quotes and policy services.
The aforementioned ratios have been averaged over three years (FY24-FY26)
The official product benefit table states an entry age of 18 to 65 years for adults.
The stated initial waiting period is 90 days from commencement of CritiCare cover.
Yes. The official customer information sheet states that the insured person must survive for at least 30 days from diagnosis.
The cited official documents describe CritiCare as a benefit under the Health Assurance product. They do not establish it as a separate standalone policy.
Premium depends on the selected sum insured, age, benefit options and other applicable factors. Obtain a current official quotation.