IRDAI UIN: IRDAINIV16V012025
✓ Standard CIS Audited
individual
NIVA BUPA Senior Citizen Special
Statutory Customer Information Sheet (CIS) analysis under IRDAI (Protection of Policyholders' Interests) Regulations, 2024.
Entry Age 60 to 99 Years
Sum Insured Range ₹5L to ₹25L
Mandatory Co-Pay 20% Base
TPA Desk Model in house_desk
1. Room Rent & ICU Limits (The Haircut Risk)
⚠️ Haircut Clause Active Room Category Allowed:
percentage of si
Capped at 1.5% of Sum Insured daily. Upgrades trigger proportional deductions.
ICU / ICCU Allowance:
percentage of si
Capped at 2% of Sum Insured daily.
2. Waiting Periods & The 5-Year Moratorium Lock
Initial Waiting Period:
30 Days
Accidental hospitalization covered from Day 1.
Pre-Existing Diseases (PED):
24 Months
Rider available to reduce to 12 months.
Section 45 Moratorium:
5-Year Safety Lock
Claims cannot be rejected on non-disclosure after 5 years.
3. Procedure Sub-limits & Modern Treatments
Cataract Cap (Per Eye):
₹40,000
Joint Replacement Cap:
₹3,00,000
Robotic Surgery Limit:
No Sub-limit
AYUSH Alternative Care:
₹1,00,000