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We at Max Bupa are very keen to hear about the aspects of your Policy that you believe can be improved. If something does not go well and as expected or promised, here are some simple ways to ensure that your concerns are dealt with as quickly and effectively as possible. Know more
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At Max Bupa, we provide the best services to make claiming as simple and straightforward as it possibly can be. Just follow the simple steps given on the link to claim: Know more
To make a claim against your policy.
Fill and send the claim form with all the original bills at our below mentioned address:
Max Bupa Health Insurance Company Limited,
B-1/I-2, Mohan Cooperative Industrial Estate
Mathura Road, New Delhi-110044
Fax: 1800-3070-3333 Download
To view your claim status, please log on to the customer section. Know more
1860-500-8888 | 011-46096100
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We cover cost of medical treatment when you or your insured family members are hospitalised
We cover cost of ‘Single Private Room’ for Sum Insured Rs. 5 Lac & above. ICU charges
are covered up to Sum Insured.
For Rs. 3 Lac and 4 Lac Sum Insured, room rent limit is covered up to 1% of base
Sum Insured per day or single private room, whichever is lower. ICU charges are
covered up to Up to 2% of base Sum Insured per day.
We reimburse pre & post hospitalisation medical expenses incurred due to illness/injury.
The period of the treatment covered is 30 days before you get admitted to the hospital
and 60 days after you get discharged from the hospital. This is subject to Max Bupa
accepting the In-patient Care hospitalisation, Day Care or Domiciliary hospitalisation
We cover day care treatments under the product. Please refer to Annexure IV of the
policy document to know the day care procedures covered under the product.
In case a bed in the hospital is unavailable or on advice of the attending medical
practitioner, treatment is administered at home; we pay for medical treatment taken
at home, which would otherwise have required hospitalisation. Such treatment should
continue for at least 3 consecutive days and confirmation from treating medical
practitioner/insured that insured person could not be transferred to the hospital
or hospital bed was unavailable, as the case may be.
We will indemnify the medical expenses incurred on the insured person’s hospitalization
for Inpatient Care on treatment taken under Ayurveda, Unani, Siddha and Homeopathy.
Medical expenses for an organ donor’s In-patient treatment for the harvesting of
the organ donated is also covered provided the organ is for the use of the insured
We also cover the ambulance expenses to transfer the insured following an emergency
to the nearest hospital. These expenses are paid up to Rs 1,500 (for Sum Insured
Rs 3 Lac and 4 Lac) and Rs. 2,000 (for Sum Insured Rs. 5 Lac & above) per hospitalisation
only if we have accepted the In-patient claim.
You can avail health checkup for yourself and your spouse (if insured under the
policy) annually from 2nd policy year onwards, so that you live a healthier and
happier life. You can undergo a health checkup through our service provider on cashless
basis. The tests covered under health checkup package are Complete Blood Count,
Urine Routine, ESR, HBA1C, S Cholesterol, Sr. HDL, Sr LDL and Kidney Function Test.
In case you have exhausted your Base Sum Insured and No Claim Bonus (if any) partially
or completely, you are entitled for an additional sum insured equal to the base
sum insured for a subsequent claim in the same year, provided it is for an unrelated
For every claim free year, you will get an increase of 10% of expiring base Sum
Insured at renewal, subject to maximum of 100% of base Sum Insured. There will be
no reduction in No Claim Bonus in case of claim.
You may purchase medicines and diagnostic services from the empanelled service provider
through our mobile application or website. The cost for the purchase of the medicines
or diagnostic services shall be borne by you.
Expenses incurred for inpatient treatment for mental illness are covered under the
policy subject to sub-limit for specific conditions as specified in the policy contract
Expenses incurred for hospitalization (including day care treatment) due to condition
caused by or associated with HIV / AIDS are covered under the policy subject to
sub-limit as specified in the policy contract. This benefit is provided subject
to a waiting period of 48 months from inception of the cover with Us, with HIV /
AIDS covered as a benefit.
Personal Accident coverage against accidental death, permanent total and partial
Critical illness coverage against major illnesses like cancer, CABG, open heart
replacement, kidney failure, stroke, major organ/bone marrow transplant etc.
Unlimited tele / online consultations available under this product.
Daily hospital cash benefit of Rs. 1,000 (for Sum Insured Rs. 5 Lac & below) and
Rs. 2,000 (for Sum Insured above Rs. 5 Lac) in case of hospitalization. Minimum
48 hours of continuous hospitalization required, however claim would be paid from
day one subject to hospitalization claim being admissible. Maximum coverage offered
for 30 days/policy year/insured person.
Enhanced no claim bonus of 20% of expiring base Sum Insured at renewal, subject
to maximum of 200% of base Sum Insured.
Enhanced Re-fill benefit up to 150% of base Sum Insured.
There will be no co-payment under ‘Enhanced’ plan. Under ‘Classic’ plan, a 20% co-payment
will apply for treatment in Mumbai (including Navi Mumbai and Thane), Delhi NCR,
Kolkata & Gujarat state.
The entry age for adults under this policy can be from 18 to 65 years. The entry
age for dependent children is from 91 days to 25 years.
The policy can be taken individually or for the family. The family floater policy
is available in any of the following combinations:
Save tax under Section 80D of the Income Tax Act when you buy a Max Bupa health
insurance policy. Tax benefits are subject to changes in the tax laws, please consult
your tax advisor for more details.
Once insured with us, you will always remain our customers subject to continued
payment of premium. We assure you renewability for life with no extra loadings based
on your claim history.
We believe you should focus on the treatment of your loved ones rather than running
after claim settlement. Therefore, all claims are processed directly by our customer
Cashless Facility can be availed only at our Network Providers or Service Providers.
Please contact us for more details.
We endeavor for transparency and complete satisfaction and therefore, our policies
are transparent and easy to understand. If you are not satisfied, we provide a 15-day
free look period (30 days if the policy has been sold through distance marketing)
within which you can cancel your plan stating the reason.
Get quick and easy access to your claims history, your health information, your
health profile, including records of tests and other details on our website.
• The policy term is one or two or three years.
We shall not be liable to make any payment under any benefits under the Personal
Accident Cover if the claim is attributable to, or based on, or arise out of, or
are directly or indirectly connected to any of the following:
We shall not be liable to make any payment under Critical Illness Cover directly
or indirectly caused by, based on, arising out of or howsoever attributable to any
of the following unless specifically mentioned elsewhere in the Policy.
1. AYUSH Treatment: Any covered Critical Illnesses diagnosed and/or
treated by a Medical Practitioner who practices AYUSH Treatment.
2. Conflict & Disaster: Treatment for any Injury or Illness resulting
directly or indirectly from nuclear, radiological emissions, war or war like situations
(whether war is declared or not), rebellion (act of armed resistance to an established
government or leader), acts of terrorism.
3. External Congenital Anomaly: Screening, counseling or treatment
related to External Congenital Anomaly.
4. Cosmetic and Reconstructive Surgery: Any Critical Illnesses
arising due to treatment undergone purely for cosmetic or psychological reasons
to improve appearance.
5. Experimental/ Investigational or Unproven Treatment:
6. Hazardous Activities: Any claim relating to Hazardous Activities.
7. HIV, AIDS, and related complex: Any condition directly or indirectly
caused by or associated with Human Immunodeficiency Virus (HIV) or Acquired Immune
Deficiency Syndrome (AIDS), including any condition that is related to HIV or AIDS.
8. Reproductive medicine & other Maternity Expenses: Any Critical
Illness arising out of , directly/ indirectly caused by, contributed to or aggravated
9. Sexually transmitted Infections & Diseases: Screening, prevention
and treatment for sexually related infection or disease.
10. Substance related and Addictive Disorders: Treatment and complications
related to disorders of intoxication, dependence, abuse, and withdrawal caused by
drugs and other substances such as alcohol, opiods or nicotine.
11. Traffic Offences & Unlawful Activity: Any condition occurring
as a result of breach of law by the Insured Person with criminal intent.
12. Unrecognized Physician or Hospital:
There are various ways in which you can purchase this policy: Online-
On buying this plan online, your policy will be generated instantly along with your
policy kit and card. This is applicable for cases which do not require further underwriting
or medical checkup.
If you wish to know more about Max Bupa’s Health Insurance Plans, feel free to get
in touch with our trained sales team or your local advisor. Call us on Phone 1860 500 8888 between 9 am and 6 pm India time (Monday to Saturday) or click on ‘Click
to arrange a call’ to buy the policy over the phone or to fix up an appointment.
Branch: Please visit our branch in your city. The complete list of branch locations
is available in the ‘Contact Us’ section of the website
No, co-payment would not be applicable if the treatment is taken in cities other
than Delhi NCR, Mumbai (including Navin Mumbai and Thane), Kolkata and Gujarat state.
Yes, you may avail a tax benefit available under Section 80D of the Income Tax Act
1961 by buying a health insurance policy as per applicable tax laws, which can amend
from time to time. We advise you to consult your tax advisor for further details
A medical checkup may be necessary when you sign up for a new health insurance policy,
depending upon the age of the proposed to be insured and the sum insured opting
for. In case your proposal gets rejected by us, we will deduct the full cost of
medical tests from your premium and the balance premium would be refunded.
Of course, you can cover your family residing in India under one policy. You can
use your health insurance policy across India. For cashless hospitalisation, all
you need to do is check for a Max Bupa network hospital near your place of residence.
You can also present your claim for reimbursement if you get treated at a hospital
which is not a Max Bupa network hospital.