Overview
The Health Pulse Classic plan by Niva Bupa is a budget-friendly health insurance policy tailored for individuals and families, offering sum insured options from ₹3 lakhs to ₹10 lakhs. Key features include 100% restoration of the sum insured if exhausted, coverage for pre- and post-hospitalization expenses (30 and 60 days), and daycare treatments (up to SI). The plan provides annual health check-ups starting from the second year, AYUSH treatment coverage (up to SI), domiciliary hospitalization benefits (up to SI), and coverage for modern treatments up to SI (However, a limit of maximum INR 1 Lac will apply to all robotic surgeries, except a few).
Experts Review
Written by Nikhil Nair
Senior Writer
The Niva Bupa Health Pulse Classic plan is a solid choice for those seeking economical yet comprehensive health insurance. Its standout feature is the 100% restoration benefit, which ensures financial security during multiple claims within a policy year. The absence of co-payment adds transparency and flexibility, making it appealing for families. Coverage for daycare treatments and domiciliary hospitalization enhances its utility for minor procedures or home-based care. Coverage for HIV/AIDS is included by default, up to 10% of the Base Sum Insured, subject to a maximum limit of ₹50,000. Additionally, optional add-ons such as Hospital Cash and E-consultations are available to enhance coverage for a more comprehensive health plan.
On the downside, the plan’s room rent is capped at 1% of the sum insured or Single Private Room (whichever is lower) for non-ICU rooms (for sums below ₹5 lakhs) & Single Private Room (for sums 5L & above), which may restrict comfort during hospitalization. On the same lines, ICU charges are capped at 2% of the sum insured (for sums below 5L), potentially limiting flexibility in critical care situations.20% co-payment is applicable for treatments undertaken in Delhi NCR, Mumbai (including Navi Mumbai and Thane), Kolkata, and Gujarat under this plan variant. Additionally, while annual health check-ups are included, they begin only from the second policy year, delaying preventive care benefits, and since caps on modern treatments are in place, they are not sufficient in cases where the insured requires advanced medical care and higher coverage is necessary
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
Bad
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
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for null 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 - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Add-ons
Safeguard
Recommended
Increase your cover in line with inflation every year, your bonus amount will not be affected if the claim is less than Rs. 50,000 in the entire year and you also get extended coverage for generally excluded items like syringes, gloves, PPE kits etc as per List I.
Enhanced NCB
Additional bonus of 20% up to a maximum of 200%, irrespective of any claim in the previous year.
Hospital Cash
The insurer pays a lumpsum by adding a fixed sum (daily cash) every day until the day of discharge so you can deal with any potential loss in income during this time. The money will be reimbursed to you after you submit the required documents post-discharge, and while this looks like a neat benefit to have, we don’t recommend it since the benefit doesn’t compensate for the extra premium you pay.
Critical Illness
With this add-on, you get a lump sum payment in the event you are diagnosed with critical illnesses such as like cancer, open heart replacement, kidney failure, stroke, organ transplant, etc.
Personal Accident cover
With this add-on, the insurance company will payout a lumpsum amount based on the cover chosen, in case the proposer of the policy passes away in an accident.
E-consultations
With this add-on, you get unlimited tele/ online consultations under the plan.
Enhanced Refill
With this add-on, the insurer will Re-fill the cover upto 150% of the sum insured, instead of regular 100% of Sum Insured. But remember, this is applicable only if you are hospitalized one more time in a bid to treat a different complication.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
RMO charges
Hormone Replacement Therapy
STD other than HIV
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.
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
Prolapse of uterus and cervix, endometriosis/adenomyosis, 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.
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Frequently Asked Questions
Does Health Pulse Classic 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 Health Pulse Classic have room rent restrictions?
Does Health Pulse Classic offer a restoration benefit?
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