Overview
Niva Bupa’s Health Premia Platinum plan offers comprehensive coverage with sum insured options ranging from ₹1 crore to ₹3 crores. Its standout features include worldwide coverage for medical emergencies and critical illnesses, maternity benefits (up to 2L depending on SI opted for), newborn baby coverage, and annual health check-ups from day one. The plan also comes with a 200% enhanced loyalty addition to the sum insured (as an add-on), restoration benefits, and OPD consultations up to ₹50,000. With no room rent restrictions, advanced treatments like robotic surgeries (sub-limits of 1L on a few robotic surgeries), and travel insurance benefits, it caters to diverse healthcare needs.
Experts Review
Written by Nikhil Nair
Senior Writer
Niva Bupa’s Health Premia Platinum plan is a flagship offering that combines domestic and international healthcare coverage with advanced features. Its emergency global coverage for critical illnesses and medical emergencies makes it ideal for frequent travelers or those seeking treatment abroad. The 200% loyalty addition optional add-on ensures long-term financial security, while restoration benefits provide robust protection against multiple claims in a policy year. Maternity benefits and newborn baby coverage add significant value for families planning parenthood. OPD consultations up to ₹50,000 further enhance the plan’s utility for outpatient care.
Compared to the Silver and Gold variants, the Platinum plan offers significantly higher sum insured options (up to ₹3 crores vs. ₹7.5 lakhs and ₹50 lakhs) and broader international coverage, excluding the USA and Canada. It also provides OPD coverage not available in lower variants.
However, the plan’s high premiums may deter budget-conscious buyers. Additionally, reliance on app-based services for certain benefits may not appeal to less tech-savvy users.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Premiums are relatively high.
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
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
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
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 just 2 years. It’s probably the best deal you can get to be honest.
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 - 90 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.
Add-ons
Enhanced NCB
Additional bonus of 20% up to a maximum of 200%, irrespective of any claim in the previous year.
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 2 days, with a maximum payout of ₹7500 for up to 30 days.
Critical Illness
Paid out as a lump sum amount for Critical illnesses between Rs. 25 lakhs to Rs. 1 crore based on the cover chosen.
Personal Accident Cover
Paid out as a lump sum amount of Rs. 1 crore for Accidental Death, Total Permanent Disability, Permanent Partial Disability
International coverage extension
Double the sum insured available under international coverage.
Enhanced Geographical Scope For International Coverage
Extend the international cover to USA & Canada.
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 1 years.
Pancreatitis and stones in biliary and urinary system
Cataract, glaucoma and other disorders of lens, disorders of retina
Hyperplasia of prostate, hydrocele and spermatocele
Abnormal utero-vaginal bleeding, female genital prolapse, endometriosis/adenomyosis, fibroids, PCOD, or any condition requiring dilation and curettage or hysterectomy
Hemorrhoids, fissure or fistula or abscess of anal and rectal region
Waiting Period
30 days Initial waiting period
1 years Specific illness waiting period
2 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. The specific illness waiting period is better than usual.
Customer Reviews
R
Rajesh Sharma
Global coverage for critical illnesses and medical emergencies is perfect for international needs.
R
Rajkumar Verma
200% loyalty addition ensures fantastic long-term financial security.
R
Ritu Gupta
Restoration benefits provide robust protection against multiple claims.
S
Sanjana Joshi
Compared to Silver/Gold, this Platinum is much more expensive, so must need the extra features.
S
Sameera Khan
Premiums are very high, definitely a top-tier plan for those who can afford it.
S
Sagar Patel
Sum insured options up to ₹3 crores is very high, offering extensive coverage.
V
Vikram Jain
Global coverage for critical illnesses is fantastic! Perfect for frequent travellers like my husband.
S
Sneha Khanna
200% loyalty addition is a huge long-term benefit! Rewards for staying with them.
A
Aditya Kapoor
Unlimited restoration benefits mean no stress about multiple claims in a year. Solid protection.
T
Tanvi Gupta
Loyalty addition takes time to build up, so immediate high value might not be there for new users.
D
Diya Sharma
Premium is definitely on the higher side, only for those who can afford it.
I
Isha Saxena
Domestic and international coverage dono milta hai, truly premium plan.
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Frequently Asked Questions
Does Health Premia Platinum 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 1-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 2-year waiting period for any pre-existing disease you may have while buying the policy.
- Maternity and Newborn Waiting Period: There’s a 2-year waiting period before you can make claims related to pregnancy and childbirth.
Does Health Premia Platinum have room rent restrictions?
Does Health Premia Platinum offer a restoration benefit?
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