Overview
Niva Bupa Heartbeat Platinum is a premium health insurance plan tailored for individuals and families, with sum insured options ranging from ₹15 lakhs to ₹1 crore. Its standout features include global treatment for nine critical illnesses, cashless OPD consultations, and coverage for pre- and post-hospitalization expenses (60 and 90 days). The plan also provides maternity benefits with a short waiting period of 24 months, newborn baby coverage, and loyalty additions that enhance the sum insured annually. With no room rent restrictions and lifetime renewability, it ensures comprehensive protection.
Experts Review
Written by Nikhil Nair
Senior Writer
Niva Bupa Heartbeat Platinum is a top-tier health insurance policy designed for those seeking extensive coverage and global healthcare access. Its unique feature of international treatment for nine critical illnesses, including cancer and organ transplants, sets it apart from the Gold variant, which lacks this global scope. The inclusion of OPD consultations and maternity benefits with a short waiting period makes it ideal for families planning parenthood. Loyalty additions (10% increase up to 100% of Base SI) further enhance the financial security of long-term policyholders.
However, the plan comes with certain drawbacks. While it offers robust coverage, premiums are significantly higher compared to similar plans in its category due to its international treatment benefits. Additionally, while OPD coverage is included, it is capped based on the sum insured (e.g., ₹15,000 for ₹15 lakh coverage), which may not suffice for frequent outpatient needs.
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 - 60 days before you are hospitalized and 90 days after discharge. This includes the cost of medication by the way.
Add-ons
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 2 days, with a maximum payout of ₹1000 for up to 30 days.
Critical Illness
Paid out as a lump sum of 1000000 (as per the sum insured) for null illnesses.
Enhanced International Coverage
Get extended coverage to the USA & Canada for Emergency Medical Evacuation, Emergency Hospitalization & Specified illnesses cover.
Personal Accident Cover
Paid out as a lump sum of 500% of sum insured for Accidental Death, Total Permanent Disability, Permanent Partial Disability up to a limit of ₹10000000.
Tele-OPD Consultation
Each insured member can get unlimited e-consultations.
Aggregate Deductible
Choose deductible between ₹10,000 and ₹10,00,000 and get a discount on premiums.
Premium Waiver
Waives off the premium for 1 year, if the Policyholder dies or is diagnosed or undergoes treatment for the first time for the listed Illnesses.
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 2 years.
Pancreatitis and stones in biliary and urinary system
Cataract, glaucoma and retinal detachment
Hyperplasia of prostate, hydrocele and spermatocele
Prolapse of uterus and cervix, endometriosis, fibroids, PCOD, hysterectomy (unless necessitated by malignancy)
Hemorrhoids, fissure, fistula or abscess of anal and rectal region
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
2 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
After a close look at the waiting periods, we can say that the waiting periods on this policy are excellent. Especially the PED waiting period which is better than usual.
Customer Reviews
R
Rajesh Sharma
Excellent coverage for heart-related conditions. Specialized plan is very helpful.
P
Priya Gupta
The policy includes specific benefits for cardiac treatments and procedures. Very focused.
M
Manoj Verma
The network of hospitals with cardiac facilities is extensive. Easy to find specialized care.
P
Pooja Kumari
Wish there were more options for preventive cardiac check-ups included.
R
Rina Sharma
The waiting period for pre-existing heart conditions is standard but feels long.
S
Shweta Reddy
Customer support team is knowledgeable about cardiac health needs.
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Frequently Asked Questions
Does HeartBeat 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 2-year waiting period for a list of diseases which is a mandate before you can start claiming for persons above the age of 45 years. (Exception - Cancer cover after a 30-day waiting period.)
- 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 HeartBeat Platinum have room rent restrictions?
Does HeartBeat Platinum offer a restoration benefit?
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