Overview
The Niva Bupa GoActive plan is a digitally enabled health insurance policy designed for everyday use, offering holistic coverage for individuals and families. It provides cover amount options up to ₹25 lakhs. Land includes features like OPD consultations, diagnostic services, pre- and post-hospitalization expenses (90-180 days respectively), domiciliary care, day care & AYUSH treatments coverage (up to SI). Unique benefits include the I-Protect add-on (increases sum insured by 10% on every renewal), personalized health coaching with premium discounts, and second medical opinions for critical illnesses. Above all, the plan uses technology to create a seamless wellness ecosystem through its app.
Experts Review
Written by Nikhil Nair
Senior Writer
The Niva Bupa GoActive plan is a standout offering in the health insurance market due to its focus on everyday healthcare needs. Its OPD feature, integrated, ensures convenience for outpatient care—a rare inclusion in health insurance plans. In addition, its I-Protect add-on provides inflation protection by increasing the sum insured by 10% annually, making it future-proof against rising medical costs. The plan also provides personalized health coaching to incentivize healthy living with up to 20% premium discounts.
That said, the plan has limitations. Room rent coverage excludes suites or higher accommodations, which may restrict flexibility for premium policyholders. Additionally, while technologically advanced, reliance on app-based services may not appeal to less tech-savvy users.
Pros
Feature set is satisfactory.
Great pick if you're looking for something affordable.
Insurer has a solid track record with great claim and service metrics.
Cons
Maternity benefits not offered, which is a notable gap.
Niva Bupa (erstwhile Max Bupa)
Key Insights
Founded
2008
Niva Bupa (erstwhile Max Bupa) was established 17 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
91% claims settled in 30 Days
Niva Bupa (erstwhile Max Bupa) settles 91% of all claims it receives demonstrating strong credibility.
Network Hospitals
10,000+
Niva Bupa (erstwhile Max Bupa) maintains a moderate network of 10,000 hospitals, offering reasonable coverage across key locations.
Complaints
43 complaints per 10,000 claims registered
Niva Bupa (erstwhile Max Bupa) has a relatively high volume of complaints, which may point to ongoing issues in customer service or claim handling.
Features
All
Great
Good
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
Shared rooms are okay. Single private rooms are okay. Most rooms are okay unless it’s a suite room — the expensive stuff. Then you’ll have to start splitting the bill.
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for few robotic surgeries, up to 1L and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 90 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.
Add-ons
Personal Accident Cover
Paid out as a lump sum amount for Accidental Death, Total Permanent Disability, Permanent Partial Disability between Rs. 25 lakhs to Rs. 50 lakhs based on the cover chosen.
Health Coach
Get a personalized health coach to meet your health goals and avail of up to 20% renewal discount on the annual premium based on the health score.
Aggregate Deductible
Choose deductible between ₹25,000 and ₹10,00,000 and get a discount on premiums.
I-Protect
Get an increase in sum insured by 10% of the base sum insured for every renewal. This benefit will be provided for every policy year as long as the policy is renewed or until you request for - opting out of this benefit.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Services for terminally ill individuals addressing non-medical needs are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Pancreatitis and stones in biliary and urinary system
Cataract, glaucoma and retinal detachment
Hyperplasia of prostate, hydrocele and spermatocele
Abnormal utero-vaginal bleeding, Prolapse of uterus and cervix, endometriosis, fibroids, PCOD, hysterectomy (unless necessitated by malignancy), abnormal utero-vaginal bleeding
Hemorrhoids, fissure, fistula or abscess of anal and rectal region
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
Maternity benefits not offered.
Customer Reviews
K
Kiaan Mehra
Cashless OPD consultations aur diagnostic services, everyday use ke liye perfect hai.
S
Shanaya Reddy
I-Protect add-on se sum insured har saal 10% badhta hai, inflation se protection.
A
Arjun Verma
Personalized health coaching through their app, up to 20% premium discount bhi!
I
Ishanvi Sharma
Premium thoda higher side pe ho sakta hai because of all digital features.
A
Aanya Agarwal
Room rent suites ya higher accommodations cover nahi karta.
P
Pari Singh
The plan offers decent outpatient benefits, which is useful for regular consultations and check-ups.
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Frequently Asked Questions
Does GoActive have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does GoActive have room rent restrictions?
Does GoActive offer a restoration benefit?
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