Super Saver – Individual Health Insurance Plan | Niva Bupa (2023)

Investigation & Evaluation

Rest Cure, rehabilitation and respite care

Obesity/ Weight Control

Change-of-Gender treatments

Cosmetic or Plastic Surgery

Hazardous or Adventure sports

Breach of law

Excluded Providers

Refractive Error

Unproven Treatments

Birth control, Sterility and Infertility

Maternity Expenses

Circumcision

Conflict & Disaster

External Congenital Anomaly

Unrecognized Physician or Hospital

(Note: the above is a partial listing of the policy exclusions. Please refer to the policy contract for the full list of exclusions.)

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:

• Suicide or self-inflicted injury, whether the insured person is medically sane or insane.

• 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 (the act of armed resistance to an established government or leader), acts of terrorism.

• 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 peacetime.

• Any change of profession after the inception of the policy which results in the enhancement of our risk, if not accepted and endorsed by us on the policy schedule.

• Committing an assault, a criminal offense, 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 medical practitioner other than the policyholder or an insured person.

•Participation in aviation/marine including crew other than as a passenger in an aircraft/watercraft that is authorized by the relevant regulations to carry such passengers between established airports or ports.

• 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, ice sports, hunting, etc.

• 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 Permanent Partial Disability benefit.

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.

• AYUSH Treatment:Any covered Critical Illnesses diagnosed and/or treated by a Medical Practitioner who practices AYUSH Treatment.

• 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 (the act of armed resistance to an established government or leader), acts of terrorism.

•External Congenital Anomaly:Screening, counseling, or treatment related to External Congenital Anomaly.

•Cosmetic and Reconstructive Surgery:Any Critical Illnesses arising due to treatment undergone purely for cosmetic or psychological reasons to improve appearance.

a. Services including device, treatment, procedure, or pharmacological regimens are considered as investigative or Unproven / Experimental Treatment.

b. Biodegradable (bioresorbable, bioabsorbable) polymer drug-eluting stents will be considered as experimental and investigational for all-purpose.

Hazardous Activities:Any claim relating to Hazardous Activities

a. Pregnancy or Child BirthPregnancy (including voluntary termination), miscarriage, maternity or childbirth (including through cesarean section)

b. Birth ControlAny type of contraception, sterilization, abortions, voluntary termination of pregnancy or family planning;

c. Assisted ReproductionInfertility services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy;

d. Sexual disorder and Erectile Dysfunction.Treatment of any sexual disorder including impotence (irrespective of the cause) and sex changes or gender reassignments or erectile dysfunction;

• 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 or nicotine.

•Traffic Offences & Unlawful Activity:Any condition occurring as a result of a breach of law by the Insured Person with criminal intent.

a. Treatment or Medical Advice provided by a Medical Practitioner not recognized by the Medical Council of India or by Central Council of Indian Medicine or by the Central council of Homeopathy or by relevant authorities in the area or country where the treatment is taken.

b. Treatment or Medical Advice related to one system of medicine provided by a Medical Practitioner of another system of medicine.

c. Treatment provided by anyone with the same residence as an Insured Person or who is a member of the Insured Person’s immediate family or relatives.

d. Treatment provided by the Hospital or health facility that is not recognized by the relevant authorities in India or any other country where treatment takes place.

e. Treatment or services received in health hydros, nature cure clinics or any establishment that is not a recognized Hospital or healthcare facility