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Reimbursement Claims Know more
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In case of admission to a non-network hospital, you can settle your bills with the hospital and file for reimbursement of those expenses with us within 30 days of discharge. Your claim will be processed within 7 days of submission.
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Cashless Claims Know more
Cashless Hospitals
Cashless claims are quick, easy & hassle free. You get treated at one of our network hospitals and we pay for the expenses directly to the hospital. Reach out to us at least 48 hours before the treatment in case of planned hospitalization, within 24 hours of admission in case of emergency hospitalization.
Intimate for Cashless everywhere (Non- network)
Pre-auth Intimation (Network hospital)
Please Note: Before choosing a hospital, refer to the list of Unrecognized Hospitals. We will be unable to pay claims-both cashless and reimbursement, for treatment availed for at these hospitals.​​​​​​​ We prioritise and expedite claims for senior citizens ensuring a smooth and hassle free claims experience.
Frequently Asked Questions

Cashless hospitalisation is facility offered under health insurance policy where the insurer directly settles the approved medical expenses with a network hospital. The insured person does not need to pay the treatment cost upfront, except for non-payable or non-covered expenses, deductibles or co-payments.

A network hospital has a formal agreement with the insurance company or a tripartite agreement with a Third-Party Administrator (TPA) to provide cashless treatment to insured patients.

If treatment is taken at a non-network hospital, the insured person must pay the hospital bills upfront and later submit a reimbursement claim to the insurance company.

Niva Bupa processes the initial requests within 30 minutes. Final approval is processed within 3 hours from the receipt of the final discharge request.

To avail the cashless facility, the insured person must seek treatment at a network hospital and present the health insurance card or policy details at the TPA desk.

Step 1: Approach the TPA desk at our network hospital. (Recommended at least 48 hours before the treatment in case of planned hospitalization, and within 24 hours of admission in case of emergency hospitalization).

Step 2: Share your Niva Bupa health card or policy details, and KYC documents along with your medical records.

Step 3: The hospital will verify your identity and submit a pre-authorization request to Niva Bupa.

Step 4: Niva Bupa reviews the details, provides confirmation to the hospital, and notifies the policyholder via SMS and email.

Step 5: Get your treatment done and sign all documents, i.e., discharge summary and final hospital bill with a breakup on discharge.

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

If you want to use cashless services at a hospital that isn't in the Niva Bupa network, please use the link below to intimate us. We will then review your request and confirm if pre-authorization can be arranged.

https://transactions.nivabupa.com/cashlessclaims/pages/intimation-claim.aspx

A reimbursement claim is a process where the insured person pays the medical expenses upfront at the hospital and later submits the bills and required documents to the insurance company to claim the eligible amount as per the policy T&C's.

Policyholders can opt for reimbursement by following these steps:

Step 1: Get your treatment done at any recognized hospital and settle your bills.

Step 2: Collect all original and relevant medical documents, final bill with breakup, invoices, and receipts, etc.

Step 3: Click here to submit your claim. Please ensure that the reimbursement claim is submitted to us within 30 days from the date of discharge.

Step 4: A Claim ID is generated within 24 hours from the date of claim documents submission.

Step 5: Niva Bupa will review and process the claim as per the policy terms and conditions.

Please note: We may request the original physical documents if needed to process your claim.

The documents must be uploaded in JPG, JPEG, GIF, PDF, PNG, and TIFF format, and each file size should not exceed 5 MB.

Yes, you can easily track your claim through the Niva Bupa website or mobile app. Please click here to view your current claim status.

We settle all the reimbursement claims within 15 days from date of claim submission.

Yes, you can submit additional or missing documents via website or mobile app. Please click here to submit additional documents to process your claim.

Please click here to download claim form.

Yes, pre-existing illness is covered after a waiting period of 36 months, or as specified in your policy T&C's. Please refer to your policy document to check the applicable waiting period for the insured person.

Submitting KYC documents is mandatory if the claimed amount is ≥ INR 1,00,000.

Yes, you must select the relevant hospitalization claim ID while submitting a pre/post hospitalization claim.

Click here to view the list of network hospitals. A separate list of unrecognized hospitals is also available in PDF format.

The insurer will pay only the expenses that are covered under the policy terms and conditions. Covered expenses generally include hospital room charges, doctor's fees, diagnostic tests, medicines, and treatment costs, provided they fall within the coverage limits and terms of the insurance policy. Costs such as non-medical items, co-payments, or treatments not included in the policy must be paid by the patient.

In case of emergency hospitalization/treatment for specified illness:

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

Europ Assistance
24*7 Emergency Contact: +91 22 6787 2092
Email address: nivabupa@europ-assistance.in

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

In case of reimbursement claim: (Eligibility as per policy) Please send an email with policy details and all the claim documents to travelclaims@nivabupa.com. Click here to download Travel Claim Form.

Niva Bupa has partnered with a network of trusted hospitals in your city, and you can access a host of special benefits under the Preferred Provider Hospital Network like:

  • Discount on OPD consultation & Diagnostics along with a waiver of up to ₹5,000/- on Non-Medical Expenses.
  • Free pickup & drop Ambulance facility within a radius of up to 10 km for emergency services.
  • Dedicated Representative to guide you during hospitalization & fast track cashless transactions.
To avail these benefits, check out those hospitals under the tag of "additional benefit" by clicking here.
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Cashless:

With a cashless claim, you can receive care at a network hospital without having to pay out of pocket. Instead, the hospital sends the bill directly to Niva Bupa, who then pays it. So, you can go to a hospital that is a part of the Niva Bupa network and present your ID and health e-card to the staff.