Network hospitals often referred as cashless hospitals are hospitals which have tied up with your insurance company for providing cashless hospitalization benefit.

If you get admitted at a non-network hospital, you have to pay the bills first and later claim for reimbursement.

Step 1: Approach TPA desk of our Network Hospital (recommended at least 72 hours before the treatment in case of planned hospitalization, within 24 hours of admission in case of emergency hospitalization)

Step 2: Share Niva Bupa Health Card or your policy number, and Passport size photo, PAN card or Aadhar card along with your medical records.

Step 3: Network Hospital would check your identity for validation and submit preauthorization form to us.

Step 4: We review and provide our confirmation to the network Hospital by e-mail and send a text message and e-mail to you.

Step 5: Get your treatment done and sign all documents, forms and invoices on discharge.

Step 6: We make payment to the hospital for preapproved treatment as per policy terms and conditions.

Step 1: Get admitted to any recognized hospital for treatment.

Step 2: Settle your bills with the hospital.

Step 3: Collect all relevant documents, invoices, medical reports, discharge summary from Hospital in original and receipts of the payment made to the hospital.

Step 4: Upload documents here. Please ensure that claim is submitted to us within 30 days from date of discharge.

Step 5: We will review and process the claim as per Policy terms and conditions .

In case of emergency hospitalization/treatment for specified illness.

Step 1: Please contact us or our global TPA before admission.
Contact details for registering claim:

Europ Assistance

24*7 Emergency Contact: +91 22 6787 2092

Email address: nivabupa@europ-assistance.in

Step 2: Our TPA will coordinate with hospital and process your cashless request.

In case of reimbursement claim(eligibility as per policy), please send a mail with policy details and all the documents to travelclaims@nivabupa.com.

Step 1: Collect all the relevant documents mentioned in the policy.

Step 2: Upload documents here .

Step 3: While we start your claim processing, send all original documents to Claims Department at below address:
Niva Bupa Health Insurance, 2nd Floor, Plot No D-5, E Block, Sector 59, Noida, Uttar Pradesh 201301.

Step 4: We will review and process the claim as per Policy terms and conditions.

Step 1: Select Network Hospital (recommended at least 72 hours before the treatment in case of planned hospitalization) Click here.

Step 2: Share your Policy Number and Passport photo/ PAN card/ Voter's card along with your medical records, if any.

Step 3: Network Hospital will check your identity for validation and submit pre authorization form to us.

Step 4: We will review and provide our confirmation to the network Hospital by e-mail / Provider portal and send an SMS/ e-mail to you.

Step 5: Get admitted for treatment and sign all documents, forms and invoices on discharge.

Step 6: You will have to pay for non-payable items ( As per IRDA list ) to the hospital.

Step 7: Sign all documents at the time of discharge.

Step 8: Hospital will send us the documents and pre-approved amount will be settled with Hospital as per the tariff and policy guidelines Click here

Step 1: Approach the nearest hospital and take the first aid.

Step 2: Approach TPA desk in hospital or Niva Bupa website www.nivabupa.com , if it is a network hospital (within 48 hours after admission) Click here.

Step 3: Share your Policy Number and Passport, PAN card or Voter's Card for identification purposes.

Step 4: Network Hospital will check your identity for validation and submit pre authorization form to us.

Step 5: We will review and provide our confirmation to the network Hospital by e-mail / Provider portal and send an SMS/e-mail to you within 30Minutes.

Step 6: You will have to pay for non-payable items ( As per IRDA list ) to the hospital.

Step 7: Sign all documents at the time of discharge.

Step 8: Hospital will send us the documents and pre-approved amount will be settled with Hospital as per the tariff and policy guidelines.(Anywhere Cashless Intimation Link: Click here)
Note: Anywhere Cashless Intimation Link is not eligible for blacklisted hospitals.

If you are hospitalized in an non-network hospital, you can pay for treatment and request for reimbursement later.
Here is how:

Step 1: Get admitted to any recognized Hospital for treatment or meet a doctor for OPD consultation (as per eligibility).

Step 2: Pay directly to the hospital or to the doctor (as applicable).

Step 3: Collect all relevant documents (invoices, medical reports, discharge certificate, payment receipt) from Hospital in original.

Step 4: Upload documents on https://transactions.nivabupa.com/claims/pages/claimdocupload.aspx

Step 5: We will review and make payment to you as per Policy terms and conditions Click here

The standard time frame for processing the claim is indicated below.

Turn around time as per IRDAI	Death Claims	Health Claims
Settlement or rejection of claims wherein investigation is not required	Within 10 Days from the date of receipt of last necessary document	Within 10 Days from the date of receipt of last necessary document
Settlement or rejection of claims wherein investigation is required	Investigation should be completed not later than 30 days from the date of receipt of claim intimation and the claim shall be settled within 10 days thereafter	Investigation should be completed not later than 30 days from the date of receipt of last necessary document and the claim shall be settled within 10 days thereafter

Yes, please Click here for query reply submission.

Please Click here to submit claim.

In case of the claims for which cashless facility has not been pre-authorized or for which treatment has not been taken at a network hospital, please intimate us on below link https://transactions.nivabupa.com/cashlessclaims/pages/intimation-claim.aspx

Yes, you can submit your reimbursement claim by clicking here

• Faster claim submission and processing
• Instant acknowledgement
• Claim document checklist available to guide what specific documents need to be submitted
• Paperless claim submission, no need to fill claim form

No, Please submit copy of original documents only

Yes, there is an option to delete & re-upload documents before final submission.Click here

No, please choose one from the drop down shown to you while submitting.

Yes, you can choose the member from drop down
https://transactions.nivabupa.com/claims/pages/claimdocupload.aspx

Not necessary, you can also raise a claim without login.

Yes, you can raise a claim by choosing "Others" from hospital list & you will be asked to mention hospital name and address.

Yes, the size of every document file is limited and should not be more than 5-6MB. The document format should be in PDF.

The allowed file formats are jpg, jpeg, gif, pdf & tiff.

KYC document is needed in case the claimed amount is ≥ INR 1,00,000.

Yes, you should keep the original documents safe till the time claim is settled. These documents can be asked in case of any dispute, unclear images etc.

For a pre or post claim, all the claims will be displayed, and you can choose the desired claim number under which you want to tag the pre-post.

• Original copy of Discharge summary (Discharge summary should contain: Reason for hospitalization, significant findings, procedures and treatment provided, patient's discharge condition, patient and family instructions, and attending physician's signature)
• Original copy of Hospital bill & Payment details(Copy of original receipts of payment made to the Hospital against final bill and other charges like medicines, investigations, implant etc.)
• Original copy of Relevant Investigation & lab report
• Original copy of Canceled Cheque (Personalized Canceled cheque or front page of passbook with account holder name and account details
• KYC document: Applicable in case of claimed amount is ≥ INR 1,00,000
1. PAN card
2. Aadhaar card / Voter ID / Driving License
3. Latest passport-size photo
Click Here

Be it for cashless treatment or reimbursement mode, policyholders are required to inform Niva Bupa within 24 hours (emergency hospitalization) and within 48 hours prior to admission (planned hospitalization).

A claim is rejected if 'non-disclosure' or 'misstatement' of facts is discovered during an investigation. When a fact that affects the policy issuance decision is not disclosed in the proposal, it is 'non-disclosure'. Similarly, withholding information or providing incorrect information while answering questions in the proposal form is 'misstatement'. For example, when an applicant suffering from kidney failure does not inform the insurer about the same in the proposal form, it is a non-disclosure. Similarly, when an applicant overstates his or her income, then it is a misstatement.

Pre-existing illness are excluded for a certain tenure at the beginning of the policy. It's important to be aware of the waiting period for your pre-existing illness and whether it is temporarily not covered or completely excluded.

1. The reimbursement claims ID & status are communicated via SMS & email at registered email mobile number & registered email ID within 72 hours of submitting claims document online.
2. Cashless claim ID & status is also communicated via SMS & email at registered email mobile number & registered email ID within 30 minutes of submitting details at hospitals TPA desk. If you do not receive cashless ID kindly contact TPA desk.

Should you need to check the status of the claims anytime, we can visit claims section of "Insta Assist" at https://rules.nivabupa.com/customer-service
Claims status are also available on Niva Bupa Health App Click here to download app

1. Should you need to check the status of the claims anytime, we can visit claims section of  "Insta Assist" at https://rules.nivabupa.com/customer-service/
2. Claims status are also available on Niva Bupa Health App Click here to download app

Network hospitals often referred as cashless hospitals are hospitals which have tie up with insurance companies for providing cashless hospitalization benefit. Click here to view the list of cashless hospitals tied up with Niva Bupa health Insurance.