Max Bupa Health Insurance India

Max Bupa Health Insurance Company Ltd. (Max Bupa) is a joint venture between True North, a leading Indian private equity firm, and the UK based healthcare services expert, Bupa. Their vision is, “To become India’s most admired Health Insurance Company”. And to make this vision a reality, they have brought together the vast and varied experience of Bupa, global experts in health insurance and the insights and understanding of the Indian healthcare market and transformational business capability of True North. While Bupa has six decades of experience in the healthcare industry and a 29 million customer-base in over 190 countries; True North is a leading Indian private equity firm, with a focus on investing in and transforming mid-sized profitable businesses into world-class industry leaders.

In the last 20 years, True North has invested in more than 50 Indian business, and has successfully guided these companies in making the transition into well-established and large businesses that are valuable, enduring and socially responsible. At Max Bupa, the mission is to help our customers live healthier and more successful lives by providing expertise as their healthcare partners. Max Bupa always believes in adapting to newer lifestyle by promoting healthy habits through rewards, covering new-age treatments and coming up with quick digital solutions like AnyTimeHealth (ATH) Kiosks and Health App. It’s mission is to help customers live healthier and more successful lives by providing expertise as healthcare partners.

For us, it is always about building a long-term relationship with our customers, and providing them the trust they need and expect from the best health insurance company in India.

Unique features

  • Medical treatment abroad for 9 selected diseases (platinum plan only)
  • Buy policy for 2 years and get 12.5% discount on 2nd year premium
  • All day care procedures covered after 90 days (only in Max Bupa)
  • All life threatning medical situations and accidents are covered from day one.
  • Maternity up to Rs. 1Lac and new born baby coverage from day one.
  • Direct claim settlement, no third party involved.
  • Cashless hospitalization across network of quality hospitals.
  • Free health checkups on renewal.

Max Bupa Health Insurance sum insured
2 lacs − 300 lacs options available

Max Bupa Health Insurance tenure options
1 year

List of network hospitals
4,500+ hospitals

Maximum family floater coverage
Self, Spouse + 4 dependent children

Incurred Claims Ratio *
54.00%

Claims Settlement Ratio **
85.96%

Number of policies issued *
696,107

Number of lives covered *
54,33,000

* As per IRDAI report for 2018-19 | ** As per NL25 data published on the Insurance Company website

Max Bupa health insurance – Overview

Some of the awards that the company has won over the years include:

  • In April 2019, the company won ‘The Economic Times Best Brands 2019’ award by The Economic Times and Nielsen
  • In April 2018, Max Bupa’s GoActive Health Insurance Plan recognized as Product of the Year by research agency Nielsen
  • Max Bupa awarded the Golden Peacock Award 2015 for its product Heartbeat Health Insurance Plan
  • Max Bupa Health Insurance awarded the ‘IT Management Best Practices’ at the Celent Model Insurer Asia Awards 2016
  • The company received the Best Product Innovation Award for Heartbeat Family First at Indian Insurance Awards 2011

Max Bupa offers their health insurance customers the option of availing quality treatment at more than 4500+ leading hospitals across the country. With an incurred claims ratio of 54.00%, they also covered 54.33 lac lives during the same year 2018-19, as per the data provided by IRDAI.

Why Should One insure themselves through Max Bupa Health Insurance plans?

  • Max Bupa is one of India’s Fastest growing Standalone Health Insurance Companies operating currently only in the Health Insurance space
  • Cashless Hospitalization Across the Large Network Base With More Than 4500+ Hospitals in India for their Health insurance plans
  • Wide Range Of Health Insurance Products From Individual Plans to Family Floater Schemes with Sum Insureds ranging from ₹2 lacs to ₹300 lacs (₹3 crs)
  • Up to 19 relationships covered in one policy
  • 30 Minute cashless claims processing
  • Health network beyond hospitals
  • No third party assistance provider (TPA). Direct claim settlement through it’s professional and efficient claims team
  • Cashless OPD & Paperless reimbursements – No paper, no hassle. Get online reimbursements
  • Life Time Renewal of all policies + No Upper Entry Age limit for all plans
  • Auto Restoration of Policy Sum Insured upto 100% of Base SI post filing and payment of an admissible claims under the policy during a policy year
  • Additional Features like Tax Benefit under section 80D

Max Bupa Health Insurance benefits

  • Assistance Contact Numbers:

    For Health Claims
    Call at: Toll Free 1860-500-8888
    Call at: 011-66326666
    Fax at: 011-30902010
    Email ID: customercare@maxbupa.com
    Write at: Max Bupa Health Insurance Company Limited,
    B-1/I-2,
    Mohan Cooperative Industrial Estate Mathura Road,
    New Delhi-110044 Website: www.maxbupa.com

    For Health Claims (International Treatment Assistance) – as per plan availability
    Call at: Customer helpline number1860-3010-3333
    Email ID at: customercare@maxbupa.com
    For Emergency Medical Evacuation Call at: +45 7923 2403
    Email id: mergency@ihi.com

Cashless Claims Process

Step 1Get admitted to any one of Max Bupa network hospitals, currently they have 4500+ hospitals across the country…check out the hospital list at Max Bupa
(Note: Cashless Facility is only available at hospitals in the company’s cashless network)
Step 2Use your Max Bupa Health Card or share your Policy number and Passport / PAN card / voter’s ID for identification purposes
Step 3The Network Hospital will check your identity for validation and submit the pre-authorisation request form to Max Bupa as per the defined process / format
Step 4Max Bupa will review and provide our confirmation to the Network Hospital by fax and E-mail and also send a text message and an E-mail confirming the same to you. We will respond to your request within 30 Minutes.
Step 5Max Bupa will settle the claim (as per policy terms & conditions) with the hospital after completion of all formalities of documentation as per submission by the hospital.

Reimbursement Claims Process

Step 1In case of hospitalization notify Max Bupa within 48 hours of your admission in our network or non network hospital. After getting admitted settle bills directly to the hospital.
Step 2On discharge, please ensure you collect all relevant documents, invoices, medical reports and discharge certificate from the Hospital in originals.
Step 3Send these documents and the completely filled and signed claim form to us along with your valid ID proof and age proof. The claim form is available on the company website and in your policy document kit as well.
Step 4We review your claim request and the supporting documents provided along with the claim form. Accordingly based on policy terms & conditions, Max Bupa will approve, query or reject the same.
Step 5Subject to the claim being approved, Max Bupa will settle the claim (as per policy terms & conditions) and reimburse the approved amount to the insured.

Information to be kept ready while intimating the claim:

    • Policy Number
    • Insured/Claimant contact details (phone no. , email id, address, landmark etc.)
    • Name of Insured/ claimant person, who is hospitalised
    • Relationship of insured with the person who is hospitalised.
    • Name of the hospital
    • Health Claims – Nature of ailment
    • Commencement date of the symptom of ailment
    • Accident Claims
      • Nature of accident
      • Date & time of accident
      • Location of accident

Exclusions Under the Policy

Some of the permanent exclusions under the Max Bupa Health Insurance Plans are below, kindly review the policy wordings which are available with your policy kit for the entire list of exclusions under your opted plan. The exclusions include:

  • Suicide or self inflicted Injury, whether the Insured Person is medically sane or insane
  • War (whether declared or not), invasion, act of foreign enemy, hostilities, civil war, martial law, rebellion, revolution, insurrection, military or usurper power, riot or civil commotion
  • Service in the armed forces, or any police organization, of any country at war or at peace or service in any force of an international body or participation in any of the naval, military or air force operation during peace time
  • Any change of profession after inception of the Policy which results in the enhancement of Our risk, if not accepted and endorsed by Us on the Schedule of Insurance Certificate
  • Committing an assault, a criminal offence or any breach of law with criminal intent
  • Taking or absorbing, accidentally or otherwise, any intoxicating liquor, drug, narcotic, medicine, sedative or poison, except as prescribed by a Medicial Practitioner other than the Policyholder or an Insured Person
  • Death or disablement caused by ionizing radiation or contamination by radioactivity from any nuclear fuel
  • Participation in aviation/marine including crew other than as a fare-paying passenger in an aircraft/water craft that is authorized by the relevant regulations to carry such passengers between established airports or ports
  • Including but not limited to engaging in or taking part in professional/adventure sports or any hazardous pursuits, such as speed contest or racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving using hard helmet and breathing apparatus, polo, snow and ice sports, hunting etc
  • Any disability arising out of Pre-existing Diseases if not accepted and endorsed by Us
  • Body or mental infirmity or any disease except where such condition arises directly as a correspondence of an Accident during the Policy Period. However this exclusion is not applicable to claims made under the PPD benefit

Popular Max Bupa health insurance plans

Health Premia

Key Features:

  • Health Premia is a Comprehensive health insurance plan.
  • Comprehensive coverage up to 3 crore.
  • Health Premia International coverage for specified illness and medical emergencies.
Heartbeat

Key Features:

  • Heart Beat health is a simple to buy and easy to understand mediclaim policy.
  • There are two plans under family cover called as Family Floater and Family First.
  • There are two levels of cover to choose for you called as Gold and Platinum.
Health Companion

Key Features:

  • Companion health insurance is a easy to understand and simple to buy policy.
  • Plan is a family oriented health insurance.
  • Provides coverage for sudden medical treatment of your loved ones rather than running after claim settlement.

Popular Max Bupa Health Premia Insurance plans

Individual

Key Features:

  • You can choose a plan for 1 or 2 years between three levels – Silver, Gold and Platimum
  • Comprehensive coverage
  • Cashless facility at quality hospitals
  • Direct settlement of claims
  • Assured renewal for life
Family Floater

Key Features:

  • Health checkup(from day 1) including children
  • New age treatment coverage
  • Trip cancellation & interruption up to Rs.25000/-
Family First

Key Features:

  • 30 Days of initial waiting period
  • Cashless hospitalization
  • No medical test require upto 60
  • Maternity benefit: Plan provides you maternity benefits up to two deliveries.
  • New born baby: Covered up to Sum Insured for one year.

Popular Max Bupa Health Companion Insurance plans

Individual

Key Features:

  • You can choose a plan for 1 or 2 years between three levels – Silver and Gold.
  • Comprehensive coverage.
  • Direct claim settlement.
  • Cashless at quality network hospitals.
  • Assured policy renewal for life
Family Floater

Key Features:

  • The Family Floater plan is available in any of the following combinations.
  • Comprehensive coverage.
  • Cashless facility at quality hospitals.
  • Direct settlement of claims
  • Assured renewal for life

Popular Max Bupa Health Assurance Insurance plans

Personal Accident

Key Features:

  • An accident is not just an irreversible life changing disability it can exhaust your lifetime savings as well.
  • Personal accident health insurance covers and assures coverage for not only accidental death but also Permanent total disability, Permanent partial disability, Child education benefit, etc.

Popular Max Bupa Family Health Insurance plans

Go Active

Key Features:

  • Max Bupa GoActive comprehensive health insurance offers coverage for all the family members. It offers exclusive coverage for outpatient consultations, and other benefits like I-Protect, Health Coach, Personal accident cover.
Health Recharge

Key Features:

  • Max Bupa Health Recharge Insurance covers all the family members against emergency medical expenses. It also offers optional coverage for personal accident and critical illness from which the customers can choose from.
Health Pulse

Key Features:

  • Pre & Post Hospitalisation : Expenses covered up to Sum Insured.
  • Refill Benefit : Sum Insured reinstates (up to 100% or 150% of base sum insured) if subsequent claim is made of a different illness/injury during the same policy year.

Popular Max Bupa Corona Insurance plans for COVID-19

Corona Kavach

Key Features:

  • Max Bupa Health Corona Kavach policy shall be offered with a policy term of 3 ½ months, 6 ½ months and 9 ½ months