Quick Overview

When comparing Niva Bupa vs ICICI Lombard, both are top health insurers, but they serve different needs. Niva Bupa is a standalone health insurer with a higher claim settlement ratio of 91.62% (FY 2022-25). ICICI Lombard is a general insurer with stronger financial backing, fewer complaints, and a highly customizable flagship plan called Elevate, despite a lower CSR of 84.50%. While both insurers are reliable, the choice depends on whether you prefer built-in benefits or flexible customization. 

Choosing between Niva Bupa vs ICICI Lombard health insurance isn’t as straightforward as it looks. Factors like claim settlement ratio, complaint volumes, network hospitals, annual business, and plan flexibility can make a difference in the long run.

In this detailed comparison of Niva Bupa vs ICICI Lombard, we break down their performance metrics, flagship plans, pricing, and key differences, so you can clearly understand which insurer aligns better with your needs.

Not sure which policy is the right choice for you? Book a call or WhatsApp us for further guidance.   

Niva Bupa vs ICICI Lombard: Company Overview

About Niva Bupa Health Insurance

    • Founded: 2008 (originally Max Bupa, rebranded as Niva Bupa in 2021).
    • Ownership: Joint venture between the private equity firm True North and the UK-based healthcare giant Bupa. 
    • Hospital Network: 10,000+ cashless hospitals across India.

About ICICI Lombard Health Insurance

    • Founded: 2001
    • Ownership: Joint venture between ICICI Bank (64%) and Fairfax Financial Holdings, Canada (36%). 
    • Hospital Network: 10,200+ cashless hospitals across India.

Niva Bupa vs ICICI Lombard: Performance Metrics

MetricsNiva BupaICICI LombardIndustry Average
Claim Settlement Ratio (CSR) 91.62%84.50%91.22%
Incurred Claim Ratio (ICR) 58.10%79.47%81.88%
Complaints Received per 10,000 Claims 42.8510.6727.06
GWP/ Annual Business-Total Health (In Crores) ₹5,481₹6,794₹3,969

Note: 

    • The complaint numbers shown above reflect all of ICICI Lombard’s products (health, motor, and others), as the insurer does not publish product-wise complaint data separately.
    • All the data is sourced from IRDAI Annual reports, along with Niva Bupa and ICICI Lombard’s public disclosures.

Key Insights:

    • CSR: The ICICI Lombard claim settlement ratio is below the industry average. Niva Bupa, on the other hand, performs better than ICICI Lombard on this metric. This means the chances of your claim being settled by Niva Bupa are higher than those of ICICI Lombard.
    • ICR: Both the insurers perform decently across this metric as they fall within the healthy range of 50%-80%, implying financial stability.
    • Complaint Volume: ICICI Lombard has a lower number of complaints, indicating smoother service. 
    • Gross Written Premium (GWP): Both insurers are above the industry average, which signals broad market reach and customer trust.
CTA

Niva Bupa vs ICICI Lombard: Plan Comparison

Niva Bupa health insurance plans include ReAssure 2.0, Aspire, and Health Recharge super top-up. 

ICICI Lombard’s portfolio also includes comprehensive health policies like Elevate, Health AdvantEdge, and Max Protect Premium. 

Let’s compare their flagship plans to see where each one stands out.

FeaturesNiva Bupa ReAssure 2.0ICICI Lombard Elevate
Sum Insured Options₹5 lakh-₹1 crore ₹5 lakh-unlimited 
Waiting PeriodsInitial: 30 days (except accidents), specific illness: 2 years, pre-existing disease (PED): 3 yearsInitial: 30 days (except accidents), specific illness: 2 years (90 days for diabetes, hypertension, and cardiac conditions if not diagnosed as PEDs), pre-existing disease: 3 years
Copayment Not applicable Not applicable 
Room Rent Limits No limitSingle private room (upgradable via add-on)
Disease-Wise Sub-Limits Not applicable Not applicable 
Consumables Covered with an add-on: safeguard/safeguard+Covered with an add-on: claim protector
Bonus Booster+ benefit, coverage depends on variants, Bronze+: 3x, Platinum+: 5x, Titanium+: 10x20% up to 100% of the base sum insured, irrespective of claims made
Restoration100%, unlimited times, partial exhaustion, same/different illness100%, unlimited times for any illness, partial exhaustion
Daycare, Domiciliary, and AYUSH TreatmentsCovered up to the sum insured Covered up to the sum insured 
Pre- and Post- Hospitalization 60/180 days 90/180 days
Add-ons Available Disease management rider, hospital cash, acute care, and personal accident25+ add-ons, including power booster, annual health check, worldwide cover, and maternity

Quick Take: Niva Bupa ReAssure 2.0 offers more built-in benefits, with no room rent cap, unlimited restoration, and no copayment, making it the better pick for buyers who want comprehensive protection. 

Conversely, ICICI Lombard Elevate offers a higher sum insured (up to unlimited) and a variety of add-ons, which suit buyers looking for long-term coverage and flexibility.

Niva Bupa vs ICICI Lombard: Premium Comparison

ProfilesNiva Bupa ReAssure 2.0 Titanium+ICICI Lombard Elevate
Individual Plan, Age 25₹11,443₹11,433
Family Floater (2A), Ages (31, 32)₹26,302₹17,155
Family Floater (2A 1C), Ages (35, 34, 5)₹34,167₹22,258
Family Floater (2A), Ages (62, 63)₹69,579₹66,253

Note: A denotes adult and C implies child. Premiums are indicative and vary by age, city, sum insured, and chosen add-ons. The premiums are calculated for a ₹15 lakh sum insured with recommended add-ons for healthy individuals living in Delhi (pin code - 110010).

The add-ons taken into account for the ICICI Lombard Elevate plan are annual health checkup, room rent modifier, and claim protector (consumables). For Niva Bupa, we’ve considered Safeguard+.

Premium Analysis:  The base premiums for ICICI Lombard are comparatively lower than Niva Bupa. However, the premiums can go higher based on the add-ons selected.

Top 10 Health Insurance Companies in India

RankInsurerCSRComplaints Volume (Per 10,000 Claims)Annual Business Volume (in Crore)
1HDFC ERGO96.71%9.28₹6,118
2Bajaj General96.78%3.07₹6,119
3Aditya Birla95.81%18.67₹3,290
4Care Health93.13%42₹6,775
5Niva Bupa91.62%42.85₹5,481
6SBI General96.14%20.51₹3,329
7Go Digit98.66%16.88₹1,388
8Generali Central 91.78%11.02₹3,989
9ICICI Lombard84.50%10.67₹6,794
10TATA AIG88.72%10.65₹3,165

Note: Both Niva Bupa and ICICI make it to the list of top 10 health insurance companies in India. Niva Bupa ranks higher based on metrics like CSR, GWP, and complaint volume.

Should You Choose Niva Bupa or ICICI Lombard?

Consider Niva Bupa If You Want: 

    • Better claim settlement ratio
    • More built-in benefits without needing multiple add-ons
    • Comprehensive maternity coverage, including IVF, surrogacy, and adoption
    • Digital-first experiences and wellness rewards

Consider ICICI Lombard If You Want: 

    • A plan you can fully customize with optional add-ons 
    • Fewer service complaints and a smoother resolution experience
    • Global coverage 
    • Unique features like surrogate and oocyte cover, and bariatric surgery cover

Why Choose Ditto for Health Insurance?

At Ditto, we’ve assisted over 8,00,000 customers with choosing the right insurance policy. Why customers like Pallavi below love us:

Niva Bupa vs ICICI Lombard
    • No-Spam & No Salesmen
    • Rated 4.9/5 on Google Reviews by 15,000+ happy customers
    • Backed by Zerodha
    • Dedicated Claim Support Team
    • 100% Free Consultation

Confused about the right insurance? Speak to Ditto’s certified advisors for free, unbiased guidance. Book your call or chat on WhatsApp with us now!

Conclusion

Niva Bupa and ICICI Lombard are both credible insurers. Niva Bupa leads in claim settlement, and backs it up with a set of built-in plan features. ICICI Lombard stands out with lower complaint volumes, solid financial backing, and the highly flexible Elevate plan for buyers who want to build their own coverage.

That said, insurers like HDFC ERGO outperform both across key metrics like CSR, ICR, and complaint volumes. If you are looking for a good health policy, you can also check our detailed guide on the best health insurance in India as a starting point. 

Frequently Asked Questions

Does ICICI Lombard health insurance cover pre-existing diseases?

ICICI Lombard plans cover pre-existing diseases after a 3-year waiting period. The Jumpstart add-on in Elevate can reduce this to 30 days for conditions such as diabetes and hypertension. 

Can I switch my existing policy to Niva Bupa or ICICI Lombard?

Yes, you can port your policy to either insurer at renewal without losing your accumulated waiting period. Apply at least 45-60 days before your renewal date to avoid a coverage gap. This will be subject to medical underwriting. 

Do both Niva Bupa and ICICI Lombard use third-party administrators (TPAs) for claims?

For individual retail policies, both insurers use in-house claims teams, not TPAs. This means faster, more direct communication when you file a claim on a personal or family floater policy with either insurer.

Is Niva Bupa a standalone health insurer or a general insurer?

Niva Bupa is a standalone health insurer (SAHI), meaning it exclusively sells health insurance products. ICICI Lombard is a general insurer covering motor, travel, home, and health. SAHIs have better health-specific expertise, which may reflect in Niva Bupa's higher claim settlement ratio.

Does Niva Bupa offer maternity coverage?

Niva Bupa's Aspire plan provides maternity coverage, including surrogacy, adoption, C-section, and normal deliveries, and vaccinations for the expecting mother. 

Last updated on: