Raise a claim

I hereby declare that the benefits paid under this claim shall not be claimed from anywhere else in any form. Further, Niva Bupa Health Insurance Company reserves the right to ask for original claim documents for processing of claims wherever necessary.

I hereby declare that the information furnished by me under this claim is true & correct to the best of my knowledge and belief. If I have made any false or untrue statement, suppression or concealment of any material fact with respect to questions asked in relation to this claim, my right to claim reimbursement shall be forfeited. I give my consent to appointed representative of Niva Bupa Health Insurance Co. Ltd. to verify and collect necessary documents or statements from any hospital or medical practitioner whom I have consulted in past as part of verifying submitted claim authenticity. I hereby declare that I have included all the bills /receipts for the purpose of this claim & that I will not be making any supplementary claim except the pre/post hospitalization claim, if any.