Niva Bupa Aspire Diamond+
Overview
Niva Bupa’s (formerly known as Max Bupa) latest offering, Aspire, is a feature-rich plan that comes in multiple variants. Niva Bupa Aspire Diamond+ is a mid variant in Aspire lineup. It offers unlimited restoration, bonus up to 5X of base cover, maternity expense coverage after a waiting period of 24 months and much more. You also get multiple add-ons to customise your cover. The plan is also reasonably priced.
The rich and innovative features in the plan may pose challenges for the insurer to service effectively in the future. Also, aggressive pricing can push the insurer to keep the cost of claims tightly under control. Niva Bupa already faces a lot of service and claim-related issues that reflect in its high volume of claim complaints. Will the insurer be able to resolve service issues and be a customer champion? Only time will tell.
Pros and Cons
- Lock the Clock – The premiums you pay at renewals get locked as per your entry age.
- 2+ hour hospitalisation – Covers all hospitalisation expenses if you are hospitalised for 2 hours or more. Includes all day care treatment too.
- Modern treatments – Listed modern treatments are covered up to sum insured.
- Booster+ accumulates unutilised sum insured up to 5X.
- Maternity coverage with a waiting period of 24 months.
- Disease Management Rider – Get day 1 coverage on diabetes and hypertension with this add-on.
- Get treatment anywhere in the world with Borderless add-on.
- OPD benefits available with an add-on.
- Room rent limit – Room category coverage limited to standard single room. If you pick a higher category room, a 15% copay applies.
- Higher waiting period on PEDs of 36 months.
- Benefits like Safeguard+ (covers non-medical items) come at extra cost.
Plan Benefits
Pay premiums as per entry age till 1st claim
The plan offers Lock the Clock feature which locks your age at entry until you make your first claim under the policy. Until then, there is no age-related increase in the premium at each renewal.
2+ hour hospitalisation covered
The plan covers your in-patient hospitalisation expenses if you are hospitalised for 2 hours or more. A minimum 24 hour hospitalisation is not mandatory. It includes coverage for all day care treatments too.
Room rent limit
You can choose either a single standard room or a shared room at policy purchase. Your room coverage is restricted to the room type you choose. In case you pick a higher category room during hospitalisation, a copay applies as per the terms of the policy. ICU charges are covered at actuals.
Alternative treatments covered
Want to consider an alternative line of treatment like Ayurveda or Homeopathy? Your insurer covers the cost of treatment provided you are hospitalised for more than 24 hours.
Modern treatments covered at actuals
Expenses related to modern treatments are covered at actuals up to sum insured. A list of modern treatments covered is provided in the policy document.
Cover available for pre and post-hospitalisation expenses
You get cover for treatment-related expenses up to 60 days before hospitalisation and 180 days after hospitalisation. These include diagnostic tests, follow-up consultations, medications and other related expenses.
Carry forward your unutilised sum insured with Booster+
Carry forward your unutilised base sum insured into the future with Booster+ feature. Aspire Diamond+ variant allows up to 5X carry forward, depending on your entry age.
Cover available even if you are forced to be hospitalised at home
Are you forced to be hospitalised at home when hospitalisation is medically necessary? Your insurer covers the treatment cost if hospitalisation happens under the supervision of a medical practitioner.
Organ donor cover available
Your insurer pays for the medical expenses related to organ harvesting when you are the organ recipient. Your insurer also covers the cost of organ harvesting when you are the donor.
ReAssure+ provides unlimited restorations after 1st claim
After you make the first claim in your policy, you unlock unlimited restorations forever. There is no requirement of the first claim to re-trigger unlimited restorations after each renewal.
Get free health check-up every year
Annual health check-ups are available for all insured lives once every policy year. Only listed tests are included which can be taken on a cashless basis with pre-booking via the insurer’s mobile app.
Get maternity expenses covered after a 2 year wait period
The plan covers maternity and related expenses after a waiting period of 2 years. This is an inbuilt benefit available at no extra cost. Also, this benefit has a separate limit over and above the base coverage.
Ambulance charges covered
The plan covers road and air ambulance charges up to sum insured. Air ambulance charges are covered only in case of emergencies.
Opt for Safeguard+ to get cover on non-medical items
The base plan does not cover non-medical items such as syringes, gloves, masks etc. These usually form 10% to 20% of every hospital bill. Opt for Safeguard+ add-on to ensure that your insurer covers this cost.
Combine multi-tenure sum insured with Fast Forward
With Fast Forward add-on, combine muti-tenure sum insured if you opt for a 2 or 3 year tenure. Use this combined coverage anytime during the policy tenure.
Disease management rider provides day 1 coverage for diabetes and hypertension
Want immediate coverage for pre-existing illnesses such as diabetes or hypertension? Opt for the disease management rider and get day 1 cover on these conditions. Extra premium applies.
Get your future spouse covered with Future Ready
With this add-on, you get guaranteed coverage for your future spouse. Spouse coverage starts when you marry and add your spouse to your policy. Your spouse also gets continuity benefits on waiting periods served by you.
Worldwide coverage with Borderless add-on
With borderless add-on, you can get emergency or planned treatment anywhere in the world. Your insurer covers the cost of hospitalisation.
Get OPD and wellness benefits with WellConsult add-on
With this add-on, you get tele and physical OPD consultations with specialists and general practitioners within the insurer’s network. Prescribed diagnostic tests, medicines and other wellness benefits are also included.
Get daily hospital cash benefit with an add-on
With this add-on, the insurer pays you a daily fixed cash benefit for each day of hospitalisation. You can utilise the amount received any way you want.
Rewards for every claim-free year with CashBag add-on
If you purchase this add-on, you get some rewards for each claim-free year in the policy. Utilise these rewards points to get discounts on renewal premiums, avail of OPD benefits, and pay for copayments or non-payable items.
Opt for a deductible
If you find the plan expensive, choose a small deductible to lower the premium. But choose your deductible carefully. In case of a claim, you have to pay upfront an amount equal to your deductible for policy benefits to get triggered.
Opt for tiered network to get discount on premium
If you opt for the tiered network, you get a straight discount of 15% on your premium. If you take treatment in a non-tiered network hospital, a 20% copay on the claim applies.
Live healthy discounts
Walk daily and stay healthy to get up to a 30% discount on your renewal premium. Step tracking is through the insurer’s official health app.
e-Consultations
Unlimited online doctor consultations are available within network centres.
Policy Conditions
| Sum Insured Range | Rs. 3 Lakh – Rs. 1 Crore |
| Entry Age | 30 Years for dependent children; 18 Years onwards for adults |
| Policy Tenure Options | 1, 2 or 3 Years |
| Coverage Types | Individual, Multi-individual and Family Floater |
| Family Coverage | Up to 2 adults and 4 children under the family floater option, up to 4 adults and 5 children under multi-individual option |
| Premium Payment | Annual. EMI options are available. |
Exclusions
Waiting Periods
- Initial Waiting Period: 30 days (except accidents)
- Specific Illness Waiting Period: 24 months
- Waiting Period on Pre-Existing Diseases: 36 months
- Maternity Benefit Waiting Period: 24 months
Medical Exclusions
- Cosmetic surgeries (unless due to accident, cancer, etc.)
- Unproven therapies
- Obesity treatments (unless certain conditions met)
- OPD expenses
- Dental treatments
Non-Medical Exclusions
- Investigation and evaluation
- Self-injury or attempt to suicide
- Alcoholism, drug or substance abuse
- Expenses for treatment necessitated by committing breach of law with criminal intent
- Expenses for treatment taken by a medical practitioner outside his discipline.
- War, terrorism, nuclear events
About the Insurer
Niva Bupa Health Insurance (formerly known as Max Bupa) is a leading stand-alone health insurance company in India known for innovative plans. It was founded in 2008. It is a joint venture between Bupa Singapore Holdings Pte Limited, a UK based healthcare services provider and Fettle Tone LLP, an affiliate of private equity firm True North.
Niva Bupa offers a wide range of feature-rich health insurance plans for young adults, families and senior citizens.
Performance Highlights (FY24)
Turnover – Rs. 5,608 Crore
Claim Settlement Ratio – 91.93%
Incurred Claim Ratio – 59%
Volume of Claim Complaints – 38.76 / 10,000 claims
Network Hospitals – 10,000+
Get In Touch
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Frequently Asked Questions
What is the Niva Bupa Aspire Diamond+ plan?
Niva Bupa Aspire Diamond+ is a comprehensive health insurance variant under Niva Bupa’s Aspire series. It offers extensive coverage with features like entry age lock, unlimited restorations, maternity benefits, and global treatment options.
What is the sum insured range for this plan?
The plan offers a sum insured ranging from Rs. 3 Lakh to Rs. 1 Crore.
Does the plan have any co-payment or disease-wise sub-limits?
No, Niva Bupa Aspire Diamond+ plan does not have co-payment requirements or disease-wise sub-limits.
What is the ReAssure Forever benefit?
ReAssure Forever feature allows unlimited restorations of the base sum insured under the policy after the 1st claim. There is no requirement of the first claim to re-trigger restoration benefit after each renewal.
Can unused sum insured be carried forward?
Yes, Booster+ feature allows carry forward of unused base sum insured up to 5 times under Niva Bupa Aspire Diamond+ variant. However, the carry forward limit depends on your age at entry.
Is there any room rent limit?
Yes, room coverage is limited to a single standard room. If you pick a higher category room during hospitalisation, a copay on the claim applies as per the terms of your policy. However, ICU charges are covered at actuals.
What is the minimum hospitalisation duration for claim eligibility?
Hospitalisations of 2 hours or more are covered, except for AYUSH treatments, which require a minimum of 24 hour hospitalisation.
What is the waiting period for maternity benefits?
For Niva Bupa Aspire Diamond+ variant, the waiting period for maternity benefits is 24 months.
Does the plan cover newborn care?
Yes, it includes coverage for newborn care, including vaccinations and treatment for certain genetic conditions.
Are modern treatments like robotic surgeries covered?
Yes, modern treatments such as robotic surgeries, stem cell therapy, and oral chemotherapy are covered up to the base sum insured. A list of all the modern treatments covered is included in the policy document.
Is domiciliary (home) treatment covered?
Yes, the plan covers home-based treatments that would otherwise require hospitalisation, up to the sum insured.
Does the plan offer cover for global treatment?
Yes, with Borderless add-on, treatments can be availed anywhere in the world, up to the sum insured. It includes planned hospitalisation as well as medical emergencies.
Are e-consultations included?
Yes, unlimited e-consultations with network doctors are available under this plan.
How does 'Lock the Clock' feature work?
This feature allows you to lock your entry age, ensuring there is no age-related increase in the premium at renewals until a claim is made.
Are pre and post-hospitalisation expenses covered?
Yes, hospitalisation-related expenses incurred 60 days before and 180 days after hospitalisation are covered under the plan.
Does the plan cover organ donor expenses?
Yes, Niva Bupa Aspire Diamond+ covers hospitalisation expenses of the donor for harvesting the organ when you undergo an organ transplant. The plan also includes the cost of organ harvesting when you are the donor.
Are non-medical expenses like consumables covered?
Yes, with the Safeguard+ add-on, non-payable items such as gloves, oxygen masks, and nebulisation kits are covered.
What is the policy tenure available?
The policy can be purchased for 1, 2, or 3 years.
How many members can be covered under a single policy?
The plan allows coverage for up to 6 family members under a single policy.
What is the Cash-Bag benefit and how does it work?
The ‘Cash Bag’ feature rewards you for maintaining a healthy lifestyle. You accumulate reward points for every claim-free year that can be used to pay renewal premiums, deductibles, or even outpatient expenses.
What is Fast Forward feature in the Aspire Diamond+ plan?
Fast Forward add-on allows you to combine multi-tenure sum insured amounts and you can use the combined coverage anytime during the policy period.
What is the Future Ready benefit and how does it work?
Future Ready benefit ensures guaranteed issuance of coverage to your future spouse. Cover for the spouse starts when you marry and add your spouse to your existing policy. Your spouse also gets continuity benefits on waiting periods served by you under the policy. for their future spouse.
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