Care Joy vs Niva Bupa HeartBeat Platinum

Covers a Single Private Room with AC. A higher room category means room, boarding, nursing, OT and doctor/surgeon fees are reduced in proportion to the difference in room rent.

Covered up to Sum Insured for eligible room categories, excluding Suite or higher categories.

ICU charges (ICU bed, monitoring devices, critical care nursing and intensivist charges) are payable as part of in-patient hospitalisation up to the sum insured. There is no separate ICU sublimit.

Covered up to Sum Insured as part of inpatient care, subject to policy terms.

20% of each admissible claim applies if the insured's entry age (eldest member for a floater) is 60 years or above. No co-payment applies for entry ages below 60.

No mandatory co-payment with Zone 1 pricing, which offers all-India coverage. Under Zone 2 pricing, a 20% co-payment applies to treatment in Mumbai, including Navi Mumbai and Thane, Delhi NCR, Kolkata and Gujarat. Optional voluntary co-payment of 10% or 20% is available for a premium discount.

No disease-specific caps apply to general hospitalisation, which is payable up to the sum insured. Fixed limits apply to maternity (₹35,000/₹50,000), newborn baby (₹30,000/₹50,000) and ambulance (₹1,000 per claim).

HIV/AIDS: up to ₹50,000 after a 4-year waiting period. Mental disorder treatment: covered up to SI, with a ₹50,000 sublimit for specified conditions after a 3-year waiting period. Maternity limits apply as listed above. Non-network emergency ambulance: up to ₹2,000 per event; network ambulance: up to SI.

Cashless treatment is available at 11,400+ Care network hospitals across India. Pre-authorisation is required, and the network list can change, so check the hospital list before admission.

Cashless treatment is available at Niva Bupa network hospitals. The HeartBeat brochure refers to 10,000+ hospitals, an approximate network figure. Niva Bupa also advertises a 30-minute cashless pre-authorisation commitment, subject to the applicable process and required documents.

Not available. Once the sum insured is used, it is not restored within the same policy year. The optional No Claim Bonanza is a bonus for claim-free years, not a restoration benefit.

Re-fill Benefit: once per policy year, up to 100% of Base SI when Base SI and Loyalty Additions are partly or fully used. It can be used for subsequent claims for the same or a different illness, subject to policy conditions. The benefit is not available under Family First.

Optional "No Claim Bonanza", available for an additional premium. After three consecutive claim-free policy years, the sum insured increases by 100% of the expiring sum insured. The accrued bonus cannot exceed 100% of the sum insured in the renewed policy. If a claim is made, the accrued bonus is not carried to the next renewal, but the base sum insured is never reduced. The bonus is lost if the policy is not renewed within the grace period.

Loyalty Additions increase the expiring Base Sum Insured by 10% at each renewal, up to a maximum of 100% of Base SI, irrespective of claims. The increase does not raise benefit sublimits

Covers a long list of procedures that need less than 24 hours of hospitalisation (for example cataract, dialysis, chemotherapy and radiotherapy, lithotripsy, tonsillectomy and arthroscopy). Cover is up to the sum insured and subject to waiting periods.

All eligible day-care treatments are covered up to Sum Insured, subject to policy terms.

Not covered. Non-medical items (for example gloves, masks, diapers, kits, belts, surcharges and similar items in the policy's non-payable list) are excluded. Some items, such as admission and registration charges, are treated as part of room or procedure charges and are not paid separately.

Allowable consumables during hospitalisation are covered. Items included in the applicable non-payable list are excluded.

Not offered as a standard benefit. Treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, and other non-allopathic treatment, is excluded.

Covers eligible inpatient treatment under Ayurveda, Unani, Siddha and Homeopathy up to Sum Insured, subject to policy terms.

30 days

30 days for illnesses. Accidents are covered from day one. The initial waiting period is waived for insured persons with 12 or more months of continuous coverage, subject to policy terms.

24 months of continuous coverage for listed conditions and procedures. These include arthritis and spinal disorders, joint replacement, benign ENT disorders, benign prostatic hypertrophy, cataract, piles/fissure/fistula, hernia and hydrocele, hysterectomy for fibroids, kidney or gall bladder stones, and varicose veins. Accident-related claims are exempt. Prior continuous coverage can reduce the waiting period. If a listed condition is also pre-existing, the longer waiting period applies.

24 months for listed conditions such as cataract, hernia, joint replacement, piles and stones. This applies only to insured persons above 45 years at first policy inception. No specific waiting period applies to those aged 45 or below at entry.

36 months of continuous coverage from the first policy with Care. Pre-existing conditions must be declared at proposal. If the sum insured is increased, the waiting period applies afresh to the increased amount. Continuous prior coverage with another insurer can reduce the waiting period on porting.

24 months of continuous coverage for declared pre-existing diseases.

Covers 12 listed advanced treatments within the sum insured: uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, monoclonal antibody immunotherapy (injection), intravitreal injections, robotic surgeries, stereotactic radio surgeries, bronchial thermoplasty, laser prostate vaporisation (green laser or holmium laser), intra-operative neuro monitoring (IONM), and hematopoietic stem cell therapy for bone marrow transplant in blood disorders. Advanced methods outside this list are not covered.

Covers 12 listed modern treatments, including robotic surgery, oral chemotherapy, immunotherapy and stem cell therapy, up to Sum Insured. A ₹1 lakh sublimit applies to certain robotic surgeries.

Not available as a benefit. Depending on age and sum insured, Care may ask for pre-policy medical tests at its own cost. If the proposal is declined or the policy is cancelled in the free-look period, the test cost is deducted from the refund.

Annual health check-ups from the second policy year, on a cashless basis through empanelled providers. Test value: ₹3,750 for ₹15 lakh SI and ₹5,000 for ₹20 lakh, ₹50 lakh and ₹1 crore SI. Family First Platinum provides ₹5,000 per insured person.

30 days before admission. Expenses must relate to the same illness or injury and the hospitalisation claim must be admissible.

Covered for 60 days, up to Sum Insured.

60 days after discharge. Expenses must relate to the same illness or injury and the main hospitalisation claim must be admissible.

Covered for 90 days, up to Sum Insured.

Not covered. Routine consultations, tests and pharmacy bills without hospital admission are not payable. Pre- and post-natal expenses are covered only within the maternity limit and as part of the delivery hospitalisation claim.

Covers eligible outpatient treatment, diagnostic tests and prescribed medicines. Limits: ₹15,000 for ₹15 lakh SI; ₹20,000 for ₹20 lakh SI; ₹35,000 for ₹50 lakh SI; ₹50,000 for ₹1 crore SI. Family First Platinum: ₹35,000. Subject to policy terms.

No deductible applies. This is a base indemnity plan, not a top-up.

Optional annual aggregate deductible options are available for eligible Individual/Family Floater policies: ₹10,000, ₹20,000, ₹30,000, ₹50,000, ₹1 lakh, ₹2 lakh, ₹3 lakh, ₹4 lakh, ₹5 lakh or ₹10 lakh.

Sum insured of ₹3 lakh or ₹5 lakh, on an Individual or Family Floater basis. Policy term is 3 years. Entry age is 18 to 65 years for adults, 1 day to 24 years for children, and 1 day to 90 days for newborns. Lifelong renewability. Maternity cover is available only for insured women aged 45 or below.

Individual/Family Floater Platinum offers Base SI of ₹15 lakh, ₹20 lakh, ₹50 lakh and ₹1 crore. Family First Platinum has a separate per-person and floater Sum Insured structure. Policy terms of 1 or 2 years are available, subject to the applicable option.

96.74% for FY 2024-25 (insurer-level, based on IRDAI public disclosures). This reflects Care Health Insurance overall, not Care Joy specifically.

96.0% of HeartBeat claims settled by number in FY 2025-26, according to the insurer's product-level public disclosure. Company-level figure reported in the annual report: 94.4%.

Covers delivery hospitalisation (normal and C-section) including pre-natal and post-natal expenses: up to ₹35,000 on a ₹3 lakh sum insured and up to ₹50,000 on a ₹5 lakh sum insured. Waiting period is 9 months of continuous coverage. Newborn baby cover applies if the maternity claim is admissible. Voluntary termination of pregnancy in the first 12 weeks and miscarriage (unless caused by an accident) are not covered. Ectopic pregnancy is covered under regular hospitalisation, not the maternity limit.

Covers up to two pregnancies or terminations under eligible policy structures after the applicable waiting period. Individual/Family Floater Platinum limits: ₹1.2 lakh for ₹15 lakh SI; ₹1.6 lakh for ₹20 lakh SI; ₹2 lakh for ₹50 lakh and ₹1 crore SI. Newborn cover and first-year vaccinations are included subject to policy conditions.