Review of HeartBeat Health Insurance Policy from Max Bupa

Max Bupa Health Insurance Company Limited is the latest health insurance company to join the ever growing list of health insurance companies in India. It is a joint venture between Max India (promoters of Max New York Life Insurance) and Bupa (UK based Health Insurance Company). Max Bupa has come out with a Family Floater Health Insurance Product by the name of Heartbeat. So is Heartbeat Health Insurance Plan also one of the family floater products offered by other health insurance companies? What is it that makes Heartbeat different from other health insurance plans already available in the market? Let us take a closer look at this product. (Download Brochure)

Three Variants

Heartbeat comes in 3 different variants

  • Heartbeat Silver Plan
  • Heartbeat Gold Plan
  • Heartbeat Platinum Plan

Features of Heartbeat

Life Long Renewal

Yes you read it right. The company assures you life long renewal year after year during your lifetime. This feature of the product makes it stand out among the numerous other family floater products available in the market. Lot of health insurance companies don’t offer renewal of health insurance policies after the age of 65 years or 70 years.

No Maximum Enrolment Age

There is no minimum or maximum age for enrolment. Lot of insurance companies have a maximum entry age of 55 years or 60 years for health insurance. After this age they don’t take new enrolments. Also lot of companies have restrictions on the minimum entry age for enrolment. But in this policy there is no minimum entry age for enrolment. A new born baby can be covered right from day.

Maternity Benefits

The policy provides maternity benefits for upto 2 deliveries. To avail this benefit the individual and spouse should have been covered for 3 years continuously. All new born babies where the company has paid the maternity claim are automatically covered from birth until next renewal. The plan also covers 1st year vaccinations for new born babies where the company has paid the maternity claim.

No TPA’s Involved

The company has not tied up with any Third Party Administrators (TPA) for claim processing and settlement. All the claims are handled by the company personnel inhouse . Read more about TPA’s in How to choose Medical Insurance Policy ?

Dedicated Relationship Manager

The company assigns a Personal Relationship Manager for Gold and Platinum variants of the product. The relationship manager helps at the time of hospitalisation and also at the time of claim settlement.

Online Tracking

The company offers all the details of the policyholders on the website. The policyholder can access his personal details, profile, claim history etc on the company website.

Other Features

Other features of the product include general features which are offered by most of the health insurance companies in their policies. Some of these features are as below:

  • Cashless Treatment: The company has tied up with a number of network hospitals and offers its customers the facility of cashless treatment by providing them health identity cards.
  • Free Look Period: The product comes with a 15 day free look period. Within this period if the policyholder is not satisfied with the terms and conditions of the policy, then he can return the policy. The company will return the premium after deducting few charges.
  • Wide Range of Covers: The product comes in 3 variants offering a wide range of cover from a minimum of Rs 2 Lakhs to 50 Lakhs.
  • Health Check-up on Renewal: The company offers a health check-up on renewal under some of its variants.
  • 24/7 Support: The company offers customer service round the clock even in case of late night emergencies.
  • Pre and Post Hospitalisation Expenses: The policy covers medical expenses incurred upto 30 days prior immediately before admission to the hospital and 60 days after discharge from the hospital.
  • Tax Benefits: The premium paid under the policy is eligible for tax deduction under Section 80D of the Income Tax Act.

Read More on company website

What is not covered ?

  • Benefits will not be available for Pre-existing Conditions until 48 months of continuous coverage have elapsed since the inception of the first Policy with us.
  • No treatment taken during the first 90 days since the commencement of the Policy, unless the treatment needed is a result of an Accident or Emergency.
  • It will not cover some things permanentaly like Addictive conditions and disorders; Ageing and puberty; Artificial life maintenance; Circumcision; Conflict and disaster; Congenital conditions; Convalescence and rehabilitation; Cosmetic surgery; Dental/oral treatment; Drugs and dressings for outpatient or take-home use; Eyesight; Experimental treatment; Health hydros, nature cure, wellness clinics etc.; HIV and AIDS; Hereditary conditions; Items of personal comfort and convenience; Non-allopathic treatment; Obesity; Out Patient Treatment; Neurological and Psychiatric Conditions; Self-inflicted injuries; Sexual problems and gender issues; Sexually transmitted diseases; Sleep disorders; Speech disorders; Treatment for developmental problems; Treatment received outside India; Unrecognised physician or facility.

Read in detail  Here

Conclusion

As we saw above, the policy offers some very good benefits compared to other health insurance products available in the market. But it may just be a matter of time before other companies also follow suit. If that happens the customer will truly be spoilt for choice of good plans available in the market. This will ultimately benefit the customer.

Note: Please check the company website or the product brochure for the latest features of the product carefully before deciding to buy the product. You can also buy it from Coverfox.com

This is a Guest post by Gopal Gidwani , He writes on his blog www.bachatkhata.com

318 CommentsAdd Comment

  1. Ankur

    Hi,

    I am 30 yr old and I went thru angioplasty in November 2014.could you please tell me any other health insurance policy other than start health who covers me.
    Ankur

  2. Mathew B

    Can someone please throw some light on the 59% claim settlement ratio and very bad reviews written in mouth shut. com.
    I do not find max bupa is expensive if you consider cost per lakh, if you consider…it’s a whole sale cover not retail! :)
    But some reviews are like they are literally operating to reject the claims. ..

  3. Dr. Sudhanshu Kumar Sarangi

    PART: II
    Hi Friends,
    Following up on my previous engagement with you all- I received a call from Geetanjali (Gurgaon Office) at 12:37 AM on 12th May, 2015 (today) regarding my email, Facebook & other posts. I was unable to speak with her as there were strong aftershocks in Muzaffarpur area today around the same time. So, I’ve requested her to email me the details. I’ve not received any email response (except the auto emails) since I’ve started writing to Max Bupa from yesterday.
    The reason for the denial cited in the letter and told to me today telephonically today is that the Admission date is within 90 days waiting period. As per policy terms & conditions clause No. 4(b)-90 days initial waiting period since the date of commencement of the policy, unless the treatment needed is the result of an accident.
    In the 38 pages policy kit provided to me after I bought the policy, it’s mentioned on Page No. – 16, Clause B- 90 Days Waiting Period: We will not cover any treatment taken during the first 90 days since the date of commencement of the Policy, unless the treatment needed is the result of an Accident or Emergency. This waiting period does not apply for any subsequent and continuous renewals of Your Policy.
    I myself is a doctor and specialize in Gastro- Most of the doctors who treated me are DM Gastro and are considered to be the best in the country in Gastro- Both the hospitals where I was treated are network hospitals of MaxBupa. Paras HMRI is the most reputed Hospital of Bihar & Sir Gargaram Hospital is the most respected Gastro Hospital in N.Delhi. So, in the treating doctor’s opinion it was an emergency that’s why they admitted me and treated me…… And Emergency is covered in the first 90 days too according to the policy I bought!! So, what’s the problem- I’ll tell you- Selecting Max Bupa as an insurance provider was a mistake. I hope you guys could learn from my mistake and select an honest health insurance provider.
    I hope the wise guys of Max Bapa could wake up from their self-imposed slumber and for a change do what they promise.
    Best,
    Unsatisfied MaxBupa Policy Holder

  4. Dr. Sudhanshu Kumar Sarangi

    Hi Friends,
    I’ve Max Bupa- Individual Gold Policy. When I took the policy I had no pre-existing medical conditions which was established by Max Bupa Medical Tests and by God’s grace I’ve always been in pink of my health. Few weeks back I was diagnosed with intestinal obstruction- I was not able to pass stool or gas for more than 24 hours, severe to moderate pain in my abdomen, vomiting tendency and restlessness. Local doctors tried treating it with medicines when it didn’t resolve permanently I visited a specialty hospital in Patna the doctor there sensing the emergency asked me to get admitted and started me on IV fluids, Parental Antibiotics and few other medications and advised for a battery of diagnostic tests- CECT full abdomen, XRAY Chest & Abdomen, Ultrasound Full Abdomen, Blood Work, Stool Test, TB Tests and few others. Slowly my condition improved and I was diagnosed with obstruction in my Jejunum. Reason could be TB, Infections, Ulcer, Crones Disease, Cancer of Jejunum, Cancer of Lymph Node, etc. I was referred to higher center in New Delhi for further evaluation as appropriate equipment’s are not available in Bihar.
    I went to Gangaram Hospital in N.Delhi as it is excellent for Gastro, while in train same problems started again- At Gangaram Hospital doctors sensed the emergency and admitted me and again started me on IV fluids, Parental Antibiotics and few other medications and advised for a battery of other diagnostic tests- Double Balloon Interoscopy, Colonoscopy, CECT Thorax, Blood Work, Biopsy etc. Slowly my condition improved and I was diagnosed with non-specific stomach ulcer from biopsy sample. The doctors were still confused and they presented my case in a conference so that other doctors could discuss and give their opinion- finally they agreed on the diagnosis and gave me medications for ulcer and I’m recovering now.
    I myself is a doctor and specialize in Gastro- Most of the doctors who treated me are DM Gastro and are considered to be best in the country in Gastro- Both the hospitals where I was treated are network hospitals of MaxBupa. Paras HMRI is the most reputed Hospital of Bihar & Sir Gargaram Hospital is the most respected Gastro Hospital in N.Delhi. But ironically Max Bupa internal team disagree with all of them and they rejected both my Patna & New Delhi claims. Different reasons given:
    1) Excuse 1: First 90 days only accidental claims: Though the policy states Emergency or accidents
    2) Excuse 2: It’s not an emergency- All DM Gastro doctors are wrongs, without seeing the patient MaxBupa team came to this conclusion.
    3) Excuse 3: It’s a chronic condition: Though it has never happened before and the tests reports suggest otherwise.
    4) Excuse 4: Waiting for it!!
    I’ve taken legal counsel they have asked to follow these steps:
    1) Step 1: MaxBupa- Grievance Redressal for Senior Citizen
    2) Step 2: MaxBupa- Grievance Redressal- Gargi Sahu- General Manager – Customer Services
    3) Step 3: MaxBupa- Grievance Redressal- Saurabh Tripathi- Head – Customer Services
    4) Step 4: Insurance Ombudsmen- Bihar- Shri. K. B. Saha
    5) Step 5: IRDA- Grievance Redressal
    6) Legal Notice to MaxBupa
    7) Move to Court

    So, choice is simple, Pay heavy premium to Max-Bupa & get treated like me & run from pillar to post for appropriate compensation or select an honest insurance company!! You know the worst part is how the field & customer representatives treat the patients and their attendants- I bought this policy which is supposedly one of the most expensive policy in the market for just one reason that if anything happens to my health then the insurance company will fulfill its obligation and help me financially in my treatment.
    The customer service rep treats me like an uneducated individual and try to educate me on what is medial emergency, chronic condition and when I asked him/her to connect me to the manager- I was being told that he/she doesn’t see a reason for doing so as what he/she is telling is full & final- It feels like I’m living in a banana republic and MaxBupa is the Judge, Jury & Prosecutor.
    When I was taking treatment in Gangaram hospital, one of MaxBupa Field Rep made a surprise visit to my room which I initially appreciated it, as he could view the documents and resolve the payment issues. But on the contrary instead of helping me out since I was only on IV fluids and medication for quite some time and feeling quite weak with on & off pain and on top of it the mental agony of going through relentless and painful tests with cancer doubts hanging over my head- he was more interested in taking my pictures and asking me twisted questions which could give him reasons to reject my claim. They should have some sensitivity training in Max Bupa- You are selling health insurance not mobiles phones, when people need you then they are in pain so at least have an ounce of humanity.
    As Warren Buffet once said “Price is what you pay & Value is what you get”- I paid an excellent price (38 K PA for 5.0 L Individual Policy) to MaxBupa Health Insurance and in terms of value…. Worst financial decision in the last 35 years of my life.
    Best,
    Unsatisfied MaxBupa Policy Holder

  5. Prosenjit Das

    Fake Cashless Insurance Policy

    It was big mistake for us to select Max-Bupa Insurance. At the time of taking Insurance , they promise for cashless and reimbursement. But, after full filling all conditions, they have denied pre-approval for my mom’s treatment. They can’t even provide proper reason. It is all about advertisement and fake Insurance company. Please get back to me for any evidence, what I am talking.

  6. Vipul Aghera

    BEWARE BEWARE BEWARE from MaxBupa
    Dear friends,
    Please DON’T buy Maxbupa Heartbeat policy. I am regret my decision to buy it.
    I have buy it 2 year ago keeping mind that I may be need maternity benefit after 2 years. Today I don’t need that. So I ask Maxbupa to change my Heartbeat Family Floater Plan to SAME COMPANY’S Health Companion Plan. (Reason : Heartbeat premium = 11500apx. And Health companion premium = 5700apx. Its almost HALF) Now Maxbupa told that if I change plan I have to serve another 2 years waiting period (which they covered for last 2 years).
    Now Mr. Manish and all Maxbupa agents and their well wishers, plz give answers this:
    1. Why another waiting period? I have same company policy and I already serve 2years
    2. When I ask @ health insurance portability from one plan to other plan, they said you have ask to change plan. If u come from another company then its OK. They don’t give me benefit of portability because I am with them for 2 years?
    3. I am asking to change from their Premium/Higher Plan to Lower plan i.e. I am not asking for more benefit, instead I am asking for fewer benefits like no maternity, no bonus, room capping etc. Then why why why? Its India, yaha sab kuchh chalta hai. ** IRDA’s Health Insurance Portability Rules ki 1 2 3?
    If they don’t allow me from lower to higher benefit, its understandable. But in my case only fool can understand…….
    Now for new policy buyers:
    Plz check this things, if you are buying MaxBupa Heartbeat plan,
    1. In maternity benefit policy wording, they said that: THEY WILL COVER PRE AND POST HOSPITALISATION MEDICAL EXPENSES ONLY WHERE SUM INSURED IS MORE THAN Rs. 10 LACS. (so for SI of 2L, 3L, 5L, 7.5L can’t ask for pre and post hospitalization which in general, you may required)
    2. If they charge high premium for service is OK, but why should I pay for benefits which I don’t want like MATERNITY BENEFIT. After certain period you don’t need that, but you pay premium for that whole life.
    3. If they give life long renewal benefit, then ask for very high premium for that as per your age. So why high premium for young age?
    4. Please google for health insurance claim rejection ratio, its 13% with top three. Which said all things.

  7. Salil Save

    Sir,
    I need help in choosing best health insurance policy.(For family)
    I ma diabetic since last 7 years. My age is 43 years, My spouse age:39 yrs, My kids age is 12 years.
    I am looking for sum assured 5 lakhs which would grow upto 10 lakhs in view of no claim
    as my family is insured by my office… and the claim if any would be only after my retirement i.e. after 15 years.
    I need lifelong renewal policy.
    I have heard some companies increase their yearly premium.
    I need guidance from you,
    Thanks

    • Hi Salil

      Every company increase their premium over the years (not every year , but on age slab) . So let us first understand your exact requirement and then you can identify the right policy . I am putting an email to you on this

      Manish

  8. upender

    Hi
    I am planning to take health insurance for my parents , My father age is 58 and mother age is 48 please suggest good health insurance plan and company as well

    Appreciate your response

  9. Abhi

    Friends,

    Do not trust Max Bupa.They apparently seem to be very well versed but in reality do not follow the best practises and is total waste for money when you are in need !
    They bluff things.

  10. Suresh aD

    I want to go for health insurance pplicy fro my parent aged about 58 and 63.

    Please suggest best policy and best insurance company…

    Thank you
    Suresh

  11. ishita

    hi, am looking for a health insurance policy for mysekf where i can include my mother as well, my age is 27 and my mothers age is 57. am looking for accidental as well as hospitalisation and also which will cover major disease. can u suggest which is the best company to go for?

  12. Nisha

    Hi Manish,

    Just wanted to let you know that your blog has been extremely helpful in deciding on the insurance policies to take – be it term plans, CI plan, personal accident plan. Iam in the process of deciding on health insurance. Have read through the entire comments on this page :) and have decided to get in touch with Medimanage as an expert adviser for the same.

    Thanks.

  13. Arun

    Hi Manish,

    First off let me say you have an awesome blog going on here. I have also started reading your books (currently on the second one). Excellent books too. Highly recommended to everyone!!

    I had a question on medical insurance. From your book, i understand that the idea of taking medical insurance early is that premium increases with age and can be costly if taken at later stages of life. Now, I had few months back got Max Bupa family first policy for myself and my wife. But i can’t clearly understand the renewal charges for the future from their policy document. Tried calling the customer care but couldn’t really connect to the renewal department. So i am wondering if the renewal charge next year, will be lesser or will it be about the same if i had started a fresh policy next year?

    Thanks in advance!

      • KALPESH

        Dear Manish / Mahavir Chopra / Dhawal / Javed,

        Very good discussion to understand thoroughly the loopholes to consider while selecting Mediclaim Policy and not to just rely on what agent sells (perhaps he have less knowledge @ what he sells)… Thanks to u guys…

        It takes me 4-5 hrs to read each comment its respective link and make complete understand…

        Now I have question :

        1) If I take the policy(floater/ individual) for particular SA say 5L at some age bracket say at my age 34 (i.e. Below 35 age bracket) and continues policy with no-claim uptil next bracket say upto my age of 42 yrs in particular company. { Pls note that some companies have 36 – 45 age bracket for prm while some has 36 – 40 & 41 – 45 as age brackets for prm table for various ages So in earlier case one bracket while later case second bracket is to be consider for today’s age example} Now my question is : Will there be Renewal Premium for my existing policy will be different than that of as if I am taking same policy with same company for same basic SA at my current age (i.e. 42 yr for our eg) Please forget @ Waiting period, No-claim added SA loyalty benefit, cover of disease that may cover as on today which arise due to increased age etc.

        2) Have the prm table that shows by agent for particular age bracket is valid only at entry time and renewal prm totally depends on company if there is no prm renewal as whole that what happens in previous 3 yrs back where all companies suddenly increased their mediclaim policy prms? (Thanks God !!! Now there is IRDA Of course still many steps to go ahead & can be improved in this field) If there is no loading with claim, we can at least have idea right when we take the policy that what we have to bear over next 10-15 yrs So that in early age we take lesser SA and lateron increases SA as family size, Need as per older age, increased expenses, inflation etc.

        Please comment… Sincere thanks for all contribution.. -Kalpesh

        • Hi Kalpesh

          Truly speaking your question looks a bit complicated for me to understand :( . All I can say to you is that the premium will keep changing as per the slabs irrespective of your old history with them . So if you are a old customer and I am a new one . and we both will be paying the same premium at 40 (suppose i plan to take at 40) . Now the only advantage you have is that your illnesses are covered with them because you are an old customer !

          Manish

          • KALPESH

            Dear Manish,

            Thanks for the reply that clears my doubt.
            So now we can predict on what amount we are going to pay towards mediclaim if family size is same if we choose no loading mediclaim policy – Of course provided there is no market change in basic age bracket premiums – which definitely in coming years may change due to inflation, increased medical treatment cost and % of increasing life mortality. But at least we can have rough idea + 15% here n there…

            God bless you for sharing such nice info…

            Kalpesh

  14. Gaurav

    Hi Manish
    Thank you for your sterling services, I’ve recommended your website to friends.

    Now, my situation is
    I’m a 45 year old IT worker, my wife is 39 years old. My parents and I, as well as my parents are covered by my employer’s health Insurance Plan, which happens to be under Apollo Munich. Having recently paid off my home loan, I have virtually no savings left.

    Now, given the uncertain economy and state of the IT services business, I’ve decided to take another health insurance plan, along with critical illness cover (which may be a rider, or a separate plan from the same or a different insurer) for my wife and myself. Please note that we’re trying to have a baby so coverage for possible pregnancy would be required, should that happen. I also wish to have coverage for any critical illness (about Rs 5L, min). This may come as a rider to a general health insurance policy that I’ll buy, or as a separate policy from the general health insurer or a different insurer. I hope I’ve explained adequately.

    Now in this scenario, which Insurance plan would you recommend? I’ve heard of Apollo’s Optima Restore Policy, but this doesn’t cover pregnancy or doesn’t have a critical illness cover. What If I buy this policy for us (my wife and I) as well as a separate Critical Illness Policy (say from Max Bupa) for additional cover? Or would you suggest a different policy / combination?

    I’m sure there are many other people in the same situation as I and your suggestion would be greatly helpful.

    • Gaurav

      OK, let’s forget pregnancy. Can you please offer your suggestions regarding the other points? I’ll contact medimanage, but I value your opinions as well.

      • A lot of things are not covered in first 2 yrs . Some major illness also have waiting period of 4 yrs . Same with pre-existing illnesses. I suggest you get hold of some policies brochure online , and have a look at them

        Manish

  15. Ravi

    HI

    I am a diabetic and take medicine for diabetics and hypertension. I am of age 40. I have taken insurance for my family with Appllo munich. I wish to have medical insurance for myself. I am thinking of Max bupa. Platinum since paying premium is not an issue for me but I need good service. I am thinking for 15 Lacs cover. I am not sure when appllo will lauch the insurance for diabetics as they have not got the approval from Govt. Please give your opinion for the same.

  16. upendra pandey

    i am confuse bet two plan one is max bupa individual and apolo Munich easy excursive plan i am 34 year old which plan is better for me

  17. Atul Singh

    Hello Expert,

    I have a few queries regarding health insurance, which are as below:

    1. I need a health insurance plan for my family and details of my family members are as under:

    A. Father : DOB is 5.07.1962 (50 years)
    B. Mother : DOB is 15.07.1962 (50 years)
    C. Spouse : DOB is 6.08.1962 (26 years)
    D. Self : DOB is 27.08.1987 (26 Years)

    2. My parents lives in Firozabad city near Agra (U.P) and I with my wife is in Pune.
    3. Should I go for a single plan for all four of us or split it into two between parents and me & spouse ???
    4. Which health insurance plan should I opt for, rather which are the most promising plans available today (Higher premium can also be considered if the benefits are good enough).
    5. Few plans which I’m looking at are : Max Bupa Family First, ICICI Lombard’s complete health plan.

    Kindly advice….

    Thanks
    Atul Singh

  18. Vinay Rawat

    Few major points called Diffrentiater of Max Bupa Heartbeat Policy

    1. No TPA (Applicable for all products)

    2. Assured Renewability Of Life – If something happens in the future where the cust claims for a Disease so for that you can claim again if you require in the future and we will renew your policy to lifetime.

    3. Health Check Up Every Year (Once in two years in Silver Policy & Every year in Gold Policy)

    4. No Capping For Room Rent

    5. Health Relationship Programe 10% Of Your Premium, Next Year At The Time Of Renewal You Will Get Opd Voucher, Dental Voucher Etc ,Irrespectively If You Make A Claim Or Not.

    6. Emergency Ambulance Charges Free In Network Hospital, Emergency Ambulance Charges Upto Rs. 2000 per visit In Non Network Hospital.

    7. No List Of Exclusions Like In The 1st Year & 2nd Year, coverage from the 91st day of the policy. (If we issue a Fresh Policy upto the age of 59)

    8. No Age Restriction For Enrollment/ For Renewability.

    9. We Don’t Do Under Writing (Medical Test) At The Time Of Claim ( We Do Underwriting (Medical Test) At The Time of Application Stage)

    10. Maternity & Child Care Benefits.

    11. Relationship Manager – We May Assign A Relationship Manager Who Will Personally Help You At The Time Of Hospitalization, Attend To Your Claims Settlement, Leaving You Free To Concentrate On Getting yourself Or Your Loved Ones Better.

    12. Covering All Day Care Procedures. (Less Than 24 Hours Treatments Or Operations)

    13. Covering All CRITICAL ILLNESSES From the 91st day Of The Policy(Emergencies from Day 1).

    14. No Loading of premium. (If a Person claims in any year)

    15. No Limitations In terms of Room Rent, Medicines, Operation theatre Charges, Pathology, X-Rays, Therapies and Prosthetic Implants(All Expenses will be covered upto Sum Insured)

    16. In every Plan / Policy we cover All Critical Illnesses.

    17. Pre-Existing Diseases are getting covered after the completion of first initial 48 months.

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