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Reviewed by Finzony Finance TeamLast updated:
Niva Bupa Health Companion is an indemnity health plan that can be issued to an individual, a family floater of up to 6 people (up to 4 of them children), or an extended family under its Family First option, which covers up to 19 types of relationships in one policy. The base sum insured runs from ₹3 lakh to ₹1 crore across three variants, and ₹2 lakh is open only to renewal customers. Adults can join from 18 years, children from 91 days, and there is no maximum entry age and no age at which cover ceases. The policy renews for life. The base cover pays room rent up to the sum insured (except for a suite or above), nursing, doctor fees, ICU, operation theatre, medicines and implants, with 30 days of pre-hospitalisation and 60 days of post-hospitalisation expenses. It also covers day care treatment, domiciliary hospitalisation, a living organ donor, AYUSH treatment, an emergency road ambulance up to ₹3,000 and 12 listed modern treatments, all up to the sum insured. A No Claim Bonus adds 20% of the base sum insured for every claim-free year, up to 100%, and Re-fill restores up to 100% of the base sum insured once in a policy year for a different illness. Re-fill is not offered on Family First. This is an inpatient-focused plan. Pre-existing diseases wait 36 months, 14 groups of conditions such as cataract, hernia and joint disorders wait 24 months, and OPD, maternity, dental and treatment outside India are not covered. Hospital Cash, Personal Accident and an annual deductible are optional.
Room rent up to sum insured (except suites), 12 modern treatments covered up to sum insured, a 20% yearly No Claim Bonus and a once-a-year Re-fill.
Finzony sees Health Companion as a plain, inpatient-first plan whose main strength is that it does not squeeze the big-ticket items. Room rent, modern treatments, day care, ICU and AYUSH treatment are paid up to the sum insured, with no separate sub-limit and no co-payment on the base cover. The Family First option is unusual. Each person gets their own base cover with a shared floater on top, which suits a joint family of parents, children and in-laws better than a single floater. Read the limits before you rely on the headline benefits. Re-fill works once a year, cannot be used again for an illness already claimed in that year, and is not available on Family First. The No Claim Bonus can reach 100% of the base sum insured, but sub-limits such as the ₹3,000 ambulance cover do not grow with it. A suite or above is not covered, and pre- and post-hospitalisation expenses are paid only on reimbursement. Cover also starts late on the conditions that matter most: pre-existing diseases wait 36 months and 14 groups of conditions wait 24 months, with no option listed to shorten either. Premium climbs steeply with age, from about ₹13,700 at age 18 to about ₹75,500 at age 70 for a ₹5 lakh cover at the standard rate. If you want unlimited restoration, an optional Day 1 cover for pre-existing diseases or treatment abroad, compare ReAssure 3.0 before you decide.
Niva Bupa Health Insurance
Key Insights
Founded
2008
Niva Bupa Health Insurance was established 18 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
91.6% CSR, calculated as a 3-year average
Niva Bupa Health Insurance settles 91.6% of all claims it receives.
Network Hospitals
10,000+
Niva Bupa Health Insurance has a network of 10,000+ hospitals, ensuring wide accessibility and convenience for policyholders.
Pays reasonable and customary charges for room rent, nursing (excluding private nursing), doctor fees, physiotherapy, investigations and diagnostics directly related to the admission, medicines and drugs, IV fluids, blood transfusion, consumables, operation theatre charges, internally implanted prosthetics and ICU, up to the sum insured. Room rent is covered up to the sum insured on every variant, with no daily rupee limit.
A suite or above is not covered. If you take a room category higher than you are eligible for, Niva Bupa pays only a pro-rated share of the associated medical expenses. Visiting doctor fees are paid only if the hospital asked for the doctor and the fee is on the hospital bill.
Covers 12 listed modern treatments, as inpatient care or day care, up to the sum insured: uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, monoclonal antibody immunotherapy given by injection, intravitreal injections, robotic surgeries, stereotactic radio surgeries, bronchial thermoplasty, green or holmium laser vaporisation of the prostate, intra-operative neuro monitoring and haematopoietic stem cell therapy for bone marrow transplant.
There is no separate sub-limit. Pre- and post-hospitalisation expenses for these treatments are paid within the same limit.
If you renew without a break and made no claim in the previous policy year, the sum insured goes up by 20% of the base sum insured each year, up to a maximum of 100% of the expiring base sum insured. A claim that Niva Bupa rejected does not stop you getting the bonus.
Sub-limits on individual benefits stay the same and do not grow with the bonus. In a year with a claim, the sum insured is neither increased nor decreased by this benefit. On Family First the bonus applies to each person's base sum insured only, not to the floater.
If the base sum insured and No Claim Bonus are partly or fully used up by claims in a policy year, Niva Bupa adds a re-fill of up to 100% of the base sum insured for later claims in that same year. On a floater, all insured persons share it.
It is available once a policy year and cannot be carried forward. It cannot be used for any illness, including its complications or follow-up, that has already been claimed or accepted in that policy year. It is not offered on Family First.
Pays consultations, medicines, diagnostic tests and physiotherapy (as complementary and alternative medicine) for 30 days before admission and 60 days after discharge, up to the sum insured.
These can be claimed on a reimbursement basis only, and only after Niva Bupa accepts your inpatient care claim. Expenses before the first policy started are not paid.
Pays a fixed amount for each continuous 24 hours of hospitalisation, for up to 30 days in a policy year, once you have been admitted for at least 48 hours continuously. The amount is ₹1,000 a day on Variant 1, ₹2,000 on Variant 2, ₹4,000 on Variant 3, and ₹1,000 or ₹2,000 on Family First.
It is not paid for domiciliary hospitalisation, and it is paid only if an inpatient claim is accepted.
Pays a lump sum for accidental death and disability, with a sum insured of up to 5 times the base sum insured, up to ₹1 crore. Accidental death pays the full sum insured. Permanent total disability pays 125% for loss of two limbs, sight of both eyes, speech and hearing, or a limb and an eye, and 50% for one limb or one eye. Permanent partial disability pays a set share, such as 50% for each hand at the wrist, each eye or each arm below the elbow.
A 30-day wait applies to any illness except accidents, and it does not apply if you have more than 12 months of continuous cover. Cancer is covered after the 30-day wait, and accidents are covered from day 1. Pre-existing diseases wait 36 months, and the prospectus lists no option to shorten the wait. The 14 listed groups of conditions and procedures wait 24 months. Conditions listed against an insured person under a Personal Waiting Period wait 24 months from the first policy and are covered from the third policy year. Waits are reduced to the extent of prior cover if you port or migrate without a break, and start again for any increase in sum insured and for a newly added member. The grace period is 30 days, and the 36-month and 24-month waits apply to each insured person separately.
Initial waiting period
Expenses for any illness in the first 30 days of the policy are excluded, except for accidents. This does not apply if you have more than 12 months of continuous cover.
Cancer
Cancer is not held to the 24-month specified disease wait. It is covered after the initial 30-day wait.
Specified diseases and procedures
The 14 listed groups, such as cataract, hernia, joint and spine disorders, kidney disease, stones and benign tumours, wait 24 months of continuous cover, except accidents. The prospectus lists no option to change this wait.
Conditions or treatments that the policy clearly says it will not cover.
These listed conditions and procedures are excluded for the first 24 months of continuous cover, even if they begin after the policy starts and even if you declared them. The wait does not apply to accidents, and cancer is covered after the 30-day wait. If one of them is also a pre-existing disease, the longer wait applies.
Insurer
Niva Bupa Health Insurance plans and claim process
Health Companion is an inpatient-focused health insurance plan from Niva Bupa for individuals and families. It pays room rent, ICU, modern treatments and day care up to the sum insured, adds a 20% No Claim Bonus for every claim-free year, and renews for life. Its Family First option covers up to 19 types of relationships on one policy.
There are three variants. Variant 1 offers ₹3 lakh and ₹4 lakh, with ₹2 lakh for renewal customers only. Variant 2 offers ₹5 lakh to ₹12.5 lakh, and Variant 3 offers ₹15 lakh to ₹1 crore. Family First offers a base cover of ₹1 lakh to ₹10 lakh per person plus a floater of ₹3 lakh to ₹20 lakh.
Family First covers an extended family of up to 19 types of relationships, such as parents, in-laws, grandparents and siblings, on one policy. Each person gets their own base sum insured, and a shared floater sum insured is used once a person's base cover is used up. Premium is based on each person's own age.
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 Health Insurance website before purchasing.
Contact Details
1860 500 8888
Headquarters: C-98, First Floor, Lajpat Nagar, Part 1, New Delhi – 110024, India.
The aforementioned ratios have been averaged over three years (FY24-FY26)
Death or disability must occur within 365 days of the accident. The benefit ends once accidental death or permanent total disability is paid, and total partial disability payouts cannot exceed the sum insured.
Pick a yearly deductible of ₹1 lakh, ₹2 lakh, ₹3 lakh, ₹4 lakh, ₹5 lakh or ₹10 lakh. Niva Bupa pays the part of your yearly claims that is above the deductible, which lowers your premium.
It does not apply to the health check-up and Hospital Cash. Room rent pro-rating applies first, then the deductible.
Lets you take cashless treatment at network providers in all locations except Delhi (NCR), Mumbai including suburbs, Chennai, Bengaluru, Hyderabad, Kolkata, Pune, Ahmedabad and Surat, where treatment is on a reimbursement basis with a 20% co-payment.
Available only to renewal customers who chose it in the expiring policy. A new customer cannot buy it.
Pre-existing diseases
Declared and accepted pre-existing diseases are covered after 36 months of continuous cover. If a listed disease is also pre-existing, the longer wait applies. The wait is reduced if you port or migrate with prior cover and no break.
Personal waiting period
Conditions listed against an insured person in the policy schedule wait 24 months from the start of the first policy with Niva Bupa, and are covered from the third policy year if cover is continuous.
Higher sum insured or a new member
If you raise your sum insured, the waits start again only for the added amount. A member added later serves the pre-existing disease wait, exclusions and waits afresh.
There is no daily rupee limit. Room rent is paid up to the sum insured on every variant, but a suite or above room category is not covered. If you take a room category higher than your eligibility, Niva Bupa pays only a pro-rated share of the associated medical expenses.
Yes. Twelve listed treatments, such as robotic surgery, immunotherapy by injection, oral chemotherapy and bronchial thermoplasty, are covered up to the sum insured as inpatient care or day care. There is no separate sub-limit.
If you renew without a break and made no claim in the previous year, the sum insured goes up by 20% of the base sum insured each year, up to 100%. Sub-limits on individual benefits stay the same and do not grow with it. On Family First, the bonus applies only to each person's base sum insured.
Once in a policy year, if your base sum insured and bonus are used up, Niva Bupa adds up to 100% of the base sum insured. It cannot be used for an illness, including its complications and follow-up, that has already been claimed in that policy year, and it does not carry forward. Re-fill is not offered on Family First.
Any illness waits 30 days, except accidents. Cancer is covered after the 30 days. Fourteen groups of listed conditions wait 24 months, and pre-existing diseases wait 36 months. The prospectus lists no option to shorten these waits, but they are reduced to the extent of prior continuous cover if you port or migrate.
Yes, after 36 months of continuous cover, if you declared them and Niva Bupa accepted them. Niva Bupa may also add a personal waiting period or a loading based on your health history.
No. Maternity, OPD (except vaccination after an animal bite), dental treatment and treatment outside India are not covered, and claims are paid in India in rupees only.
Hospital Cash, Personal Accident and an annual aggregate deductible can be chosen when you buy the policy or at renewal. Treatment only in the Tiered Network is available only to renewal customers who already chose it. Check your quote to see whether Niva Bupa offers other add-ons.
Adults from 18 years can buy it, with no maximum entry age and no age at which cover ceases. Dependent children can be covered from 91 days to 21 years. You can buy an individual policy, a family floater of up to 6 people, or a Family First policy.
Niva Bupa's prospectus shows a standard premium for a ₹5 lakh individual cover in Zone 3 of about ₹13,733 a year at age 18, ₹18,991 at 39, ₹22,622 at 45, ₹39,309 at 55, ₹52,610 at 63 and ₹75,489 at 70. These are before discounts and loadings and exclude tax. A favourable claim record can lower renewal premium by up to 39%, so get a quote for your age, city and variant.
For cashless treatment, use a network hospital and get pre-authorisation at least 72 hours before planned treatment, or within 48 hours of an emergency admission. For reimbursement, inform Niva Bupa within 48 hours of admission or before discharge, then send the original discharge summary, final bill with receipts, pharmacy bills, lab reports with prescriptions, your KYC and a cancelled cheque. Niva Bupa must settle or reject within 15 days. Call 1860-500-8888.
Yes. Renewal cannot be refused because you claimed, and there is no loading for your own claims. Pay within the 30-day grace period to keep continuity. After 60 continuous months, no claim can be contested except for proven fraud.
A road ambulance is covered up to ₹3,000 for one transfer per hospitalisation, when your inpatient claim is accepted. Vaccination after an animal bite is covered on reimbursement up to ₹2,500 on Variant 1, ₹5,000 on Variant 2, ₹7,500 on Variant 3 and ₹5,000 on Family First.