What Sum Insured options are available under HeartBeat Platinum?

Individual and Family Floater Platinum offers ₹15 lakh, ₹20 lakh, ₹50 lakh and ₹1 crore. Family First Platinum has a separate per-person and floater Sum Insured structure.

Who can be covered under HeartBeat Platinum?

Adults aged 18 to 65 and dependent children aged 91 days to 21 years can be covered under the standard Family Floater structure, subject to eligibility conditions. Family First allows eligible extended family relationships under the policy rules.

Does HeartBeat Platinum cover OPD expenses?

Yes. Platinum covers eligible outpatient treatment, diagnostic tests and prescribed medicines within the applicable limit. The limit varies by Sum Insured, from ₹15,000 for ₹15 lakh SI to ₹50,000 for ₹1 crore SI under Individual/Family Floater Platinum.

Is maternity cover available under HeartBeat Platinum?

Maternity benefits are available under eligible policy structures, subject to the applicable waiting period and limits. The plan also provides newborn cover and first-year vaccination benefits under the policy conditions.

Does HeartBeat Platinum cover international treatment?

The plan includes specified international emergency benefits, including emergency hospitalisation, emergency medical evacuation and specified illness cover, subject to geographical limits and policy conditions. An optional enhanced geographical scope includes the USA and Canada for the specified benefits.

What is the Re-fill benefit under HeartBeat Platinum?

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

What is the pre-existing disease waiting period?

The waiting period for declared pre-existing diseases is 24 months of continuous coverage, subject to the policy terms.

Is there a waiting period for specified illnesses?

A 24-month waiting period applies to listed conditions for insured persons above 45 years at first policy inception. No specific waiting period applies to insured persons aged 45 or below at entry, as described in the policy wording.

Is co-payment mandatory under HeartBeat Platinum?

Zone 1 pricing provides all-India coverage without a mandatory co-payment. Zone 2 pricing applies a 20% co-payment for treatment in specified locations. Voluntary co-payment options of 10% or 20% may also be selected for a premium discount.

Can I get cashless treatment under HeartBeat Platinum?

Yes. Cashless treatment is available at Niva Bupa network hospitals, subject to network participation, pre-authorisation requirements and the policy terms.

Does HeartBeat Platinum include annual health check-ups?

Yes. Annual health check-ups are available from the second policy year through empanelled providers. The test value is ₹3,750 for ₹15 lakh SI and ₹5,000 for ₹20 lakh, ₹50 lakh and ₹1 crore SI under Individual/Family Floater Platinum.

How do Loyalty Additions work?

Base Sum Insured increases by 10% at each renewal up to a maximum of 100% of Base SI, irrespective of claims, subject to the policy terms.

OneAssure

Health Insurance

Niva Bupa

HeartBeat Platinum

Niva Bupa Heartbeat Platinum Plan

Niva Bupa Heartbeat Platinum Plan Health cover from ₹15 lakh to ₹1 crore with OPD benefits, maternity cover, international emergency protection and up to 100% Loyalty Additions.

92.02%

Claim Settlement Ratio

10,000+

Network Hospitals

8/10

Plan Rating

Policy Brochure

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Our Verdict

Expert Review: Niva Bupa HeartBeat Platinum

Final Verdict

Niva Bupa Heart Beat Platinum offers comprehensive coverage with maternity, international treatment, and critical illness benefits. Ideal for individuals and families seeking high sum insured options and global health protection.

About

What Is HeartBeat Platinum?

Niva Bupa Heart Beat Platinum is a comprehensive health insurance plan offering extensive coverage for individuals and families. With sum insured options up to ₹3 crore, it includes in-patient hospitalization, pre- and post-hospitalization expenses, day care procedures, and domiciliary treatment. The plan covers maternity benefits, newborn baby care, and vaccination expenses. It also provides international treatment coverage for specified illnesses. Additional benefits include annual health check-ups, no room rent capping, and a loyalty bonus, ensuring complete financial security for medical needs.

Platinum Ratings

Platinum

Insurer Rating

7.1

out of 10

Insurance Rating

8

out of 10

No Room Rent Limit

Yes

Consumables Covered

No

No Co-payment

Yes

Loyalty Bonus >= 500%

Yes

No Disease Sublimits

Yes

Unlimited Restoration

Yes

Additional Benefits (Informational Only — Not part of score)

PED Waiting <= 2 Years

No

Maternity Available

No

Waiting Period Waiver

No

Testimonials

Real People. Real Relief

These are the moments that show what we really do. We don't sell you a policy. We stand by you when it matters most.

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Mumbai, Maharashtra

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

Mumbai, Maharashtra

My heartfelt thanks to the OneAssure team for making my insurance claim process effortless. Right from the very first interaction, they demonstrated professionalism, clear communication, and an impressive command of the procedures involved. Their swift updates, timely guidance, and persistent follow-through removed all the stress from what could have been a complicated experience.

Anju Renjith

Bengaluru, Karnataka

I am truly grateful for the support and guidance I received in settling my insurance claim. The entire process was handled with great professionalism, clarity, and efficiency. Their prompt response, deep knowledge of the procedures, and consistent follow-ups ensured a smooth and hassle-free experience.Thank you once again for your invaluable help, highly recommended!

Yogesh Meena

Jaipur, Rajasthan

I recently had the pleasure of purchasing health insurance for my parents through this company, and my experience has been exceptional...The team was incredibly patient and took the time to explain every detail to me. No matter how many times I asked questions, they were always calm and thorough in their explanations. Their professionalism and dedication made a significant difference in helping me make an informed decision.

Akash Kumar

West Bengal

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Inclusions and Exclusions

Niva Bupa HeartBeat Platinum Inclusions and Exclusions

Disease-wise sublimits

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.

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.

Modern Treatment

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.

ICU Charges

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

Cumulative Bonus

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

Consumable Cover

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

Initial Waiting Period

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.

Specific Waiting Period

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.

PED Waiting Period

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

Annual Health Checkup

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.

Post-Hospitalisation

Covered for 90 days, up to Sum Insured.

Outpatient Department Cover (OPD Expense)

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.

Deductible Option

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.

Coverage Options

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.

Maternity Cover

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.

AYUSH Treatment

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

Co-payment

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.

Pre-Hospitalisation

Covered for 60 days, up to Sum Insured.

Claim Settlement Ratio

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%.

Room Rent

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

Cashless Healthcare Providers

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.

Daycare Treatment

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

Exclusions

Pre-existing diseases are not covered during the initial waiting period as specified in the policy terms.
Any illness or treatment arising within the first 30 days from policy inception, except for accidental injuries.
Expenses related to self-inflicted injuries, suicide attempts, or harm due to substance abuse.
Treatment for injuries or illnesses resulting from participation in hazardous or adventure sports.
Cosmetic or aesthetic procedures, including plastic surgery unless required due to an accident or medical necessity.

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About the company

About Niva Bupa

Niva Bupa Health Insurance Company Ltd. (formerly Max Bupa) is a standalone health insurer in India, formed through a joint venture between the UK-based Bupa Group and Indian private equity firm True North. Established in 2008, the company offers a comprehensive range of health insurance products for individuals, families, and senior citizens, designed to make quality healthcare more accessible and affordable.The company operates with a nationwide network of over 10,000 hospitals and provides coverage across hospitalization, surgeries, consultations, and post-hospital care. Under the leadership of Managing Director and CEO Krishnan Ramachandran, Niva Bupa has expanded its presence and strengthened its digital and service capabilities to enhance the customer experience. Listed on both the BSE and NSE after its November 2024 IPO, Niva Bupa reflects strong financial performance and market confidence.

FAQs

Frequently Asked Questions

Got questions about health insurance? You're not alone. Here are some of the most commonly asked questions to help you understand plans, coverage, claims, and benefits better.