Niva Bupa (Max Bupa legacy plans)
Health Companion
Sum insured options: 3L, 5L, 10L, 15L, 25L
Feature DNA
Coverage Basics
Room Rent Limit
Single private room (SI 7L+); 1% SI/day below 7L
Co-Payment
Nil up to age 55; 10% above 55
Network Hospitals
10,200+
Daycare Procedures
480+ procedures
Waiting Periods
Pre-Existing Waiting
36 months
Maternity Cover
Covered after 36 months, 50,000 limit
Legacy plan maternity limits have not been revised since launch. The 50,000 cap is increasingly inadequate.
Wellness Benefits
Mental Health
Limited coverage; older policy wording
Legacy policy wording predates Mental Healthcare Act 2017 mandate. Coverage may be restricted compared to newer plans.
AYUSH Coverage
Covered up to SI in listed centres
Annual Health Checkup
Included after 2 continuous claim-free years
Domiciliary Treatment
Covered with conditions
Claims Features
No Claim Bonus
Up to 50% (20% per year)
NCB increment is only 20% per year vs 25-50% on newer plans. Takes 3 claim-free years to reach the 50% cap.
Restoration Benefit
No restoration benefit
No restoration benefit on legacy plans. Once SI is exhausted, no further claims can be made for the rest of the policy year.
Ambulance Cover
Up to 2,500 per hospitalisation
Organ Donor
Covered up to SI
Score Breakdown
Premium Estimates
Indicative annual premiums for a 5 lakh sum insured individual policy. Actual premiums vary by age, location, and health status.
| Age Group | Estimated Premium (5L SI) |
|---|---|
| Age 30 | ₹5,800/yr |
| Age 45 | ₹12,400/yr |
| Age 60 | ₹26,800/yr |
Key Exclusions
Gotcha Alerts (4)
No Claim Bonus
NCB increment is only 20% per year vs 25-50% on newer plans. Takes 3 claim-free years to reach the 50% cap.
Source: Health Companion Policy Wording
Maternity Cover
Legacy plan maternity limits have not been revised since launch. The 50,000 cap is increasingly inadequate.
Source: Health Companion Policy Wording
Mental Health
Legacy policy wording predates Mental Healthcare Act 2017 mandate. Coverage may be restricted compared to newer plans.
Source: Health Companion Policy Wording
Restoration Benefit
No restoration benefit on legacy plans. Once SI is exhausted, no further claims can be made for the rest of the policy year.
Source: Health Companion Policy Wording
Compare With Another Plan
Oquilia Analysis: Health Companion
Health Companion from Niva Bupa (Max Bupa legacy plans) is a family floater health insurance plan that has earned an Oquilia Score of 7.4/10, placing it in the “Good” category. This score is derived from our analysis of 14 critical coverage parameters, cross-referenced against industry benchmarks and the actual policy wording filed with the Insurance Regulatory and Development Authority of India (IRDAI).
Starting with the coverage fundamentals, this plan offers room rent limits that buyers should be aware of. Room rent is one of the most consequential features in a health insurance policy because exceeding the limit does not just result in paying the room rent difference — it triggers proportionate deductions across the entire hospital bill, including surgery charges, doctor fees, and medication costs. For co-payment, this plan offers nil up to age 55; 10% above 55, which means the policyholder will need to bear a portion of every claim from their own funds.
The pre-existing disease waiting period stands at 36 months, which is in line with industry standards. Buyers with existing health conditions should factor this waiting period into their purchase decision, as any claim related to a pre-existing condition during this period will be outright rejected.
On the wellness and benefits front, the plan includes coverage for AYUSH treatments (Covered up to SI in listed centres), mental health (Limited coverage; older policy wording), and domiciliary treatment (Covered with conditions). The no-claim bonus structure offers Up to 50% (20% per year), which is reasonable but not the most competitive. Restoration benefit is either absent or severely limited, which is a significant gap in coverage.
We flagged 4 gotcha alerts for this plan. These are fine-print conditions that most buyers overlook during purchase but discover painfully at claim time. Each gotcha is sourced directly from the policy wording and represents a material condition that could affect claim outcomes. We recommend reading each gotcha carefully and factoring them into your purchase decision.
In terms of value for money, the estimated premium for a 30-year-old at 5 lakh sum insured is ₹5,800 per year. When evaluated against the feature depth delivered at this price point, Health Companion offers reasonable value for its price segment, though buyers should weigh the gotcha alerts carefully. We recommend comparing this plan side-by-side with at least one alternative using the Oquilia comparison tool to ensure it aligns with your specific health profile and financial needs.
Frequently Asked Questions
What is the Oquilia Score for Health Companion?+
What are the key gotcha alerts for Health Companion?+
What is the estimated premium for Health Companion?+
Who should buy Health Companion?+
Does Health Companion cover pre-existing diseases?+
Not sure if Health Companion is right for you?
Compare it side-by-side with another plan to see which one wins feature-by-feature.