I hereby consent and authorise BFL to share my personal details and all information as per BFL records with Niva Bupa Health Insurance Co. Ltd. for the purpose of customer verification and submission and I shall not hold BFL liable for the use/sharing of my application/information as stated above

Statutory Warning (Prohibition of Rebates) (Section 41 of the Insurance Act 1938)

(1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as maybe allowed in accordance with the published prospectus or tables of the insurer

(2) Any person making default in complying with the provisions of this section shall be punishable with fine which may extend to Ten Lakh Rupees

#Conditions apply. These products are offered under the Group Insurance scheme wherein Bajaj Finance Limited is the Master policyholder

Some key features applicable for persons covered by the Policy (“Primary Insured”) are provided herein. Niva Bupa Health Insurance Co. Ltd. (“We/Us/Our”) requests You to refer to the detailed terms and conditions of the Policy provided in Policy Document available with Bajaj Finance. In the event of any conflict between the features mentioned herein and the terms and conditions of the Policy Document, the later shall prevail. Benefits a. In-patient Treatment: Medical Expenses for Doctor’s fees, diagnostic procedures, medicines, drugs and consumables, operation theatre charges, intensive care unit, intravenous fluids, blood transfusion, injection administration charges, the cost of prosthetics and other devices or equipment if implanted internally during a Surgical Procedure. b. Hospital Accommodation: Reasonable charges for Hospital and Intensive Care Unit accommodation. c. Pre & Post Hospitalization Medical Expenses: Medical Expenses incurred due to Illness immediately before Primary Insured’s admission and after an Primary Insured’s discharge from a Hospital. d. Day-Care Procedures: Medical Expenses for Day-Care Procedures where such procedures are undertaken by an Primary Insured in a Hospital requiring stay for a continuous period of less than 24 hours. Any procedure undertaken on an out-patient basis in a Hospital will not be covered e. Organ Donor: Medical Expenses for an organ donor’s treatment for harvesting of the organ. f. Emergency Ground Ambulance: Ambulance expenses incurred to transfer the Primary Insured following an Emergency to the nearest Hospital by surface transport. g. g. Sub-limit on specified illness or conditions: If opted, coverage for specified illness or conditions would be restricted to specified sublimits. Co-payment a. For all Primary Insureds, we will pay only the balanced proportionate percentage of any amount We assess for payment or reimbursement in respect of any claim under the Policy made by a Primary Insured. Waiting Periods a. Pre-Existing Diseases: Benefits will not be available for Pre-Existing Diseases until 48 months of continuous coverage have elapsed from the date of commencement of coverage for the Primary Insured. b. 30 Days Waiting Period: We will not cover any treatment taken during the first 30 days since the date of commencement of coverage for the Primary Insured, unless the treatment needed is the result of an Accident or Cardio or Neurological Emergency. Claims Procedure In respect of any claim a. Cashless Hospitalization Facility for Network Hospitals: 1. The Primary Insured should notify Niva Bupa in writing at least 72 Hours before a planned Hospitalization. In an Emergency the Primary Insured (or person on behalf of the Primary Insured) should notify Us in writing within 48 hours of Hospitalization; and

2. For cashless Hospitalization We will make the payment of the amounts assessed to be due directly to the Network Hospital. In case the Primary Insured is covered under the Co-payment clause, We would pay the final bill as assessed and approved by Us, to the Network Hospital, net of the applicable Co-payment applied to the approved amount. The balance amount and other inadmissible costs will be borne by the Primary Insured and paid directly by the Primary Insured to the Network Hospital. b. Out-Of-Network Hospitals & All Other Claims for Reimbursement: 1. In all Hospitalizations which have not been pre-authorized, We must be notified in writing within 48 hours of the Primary Insured’s admission to the Hospital or before the Primary Insured’s discharge from the Hospital, whichever is earlier. The notification should be provided by the Primary Insured. In the event the Primary Insured is unable to provide the notification due to ill health, then the notification should be provided by an immediate adult member of the Primary Insured’s family. 2. For any Illness or Accident or medical condition that requires Hospitalization, the Primary Insured shall deliver to Niva Bupa the claims documents, at his own expense, within 15 days of the Primary Insured's discharge from Hospital (when the claim is only in respect of post-hospitalization, within 15 days of the completion of the post-hospitalization) 3. For any medical treatment taken from an Out-Of-Network Hospital We will only pay Medical Expenses which are Reasonable Charges. Delayed payments shall attract interest as per applicable regulations. c. In all cases: 1. We reserve the right to call for: i. Any other documentation or information that We believe may be required; and ii. A medical examination by Our doctor or for an investigation as often as We believe this to be necessary. Any expenses related to such examinations or investigations shall be borne by Us. 2. In the event of the Primary Insured's death during Hospitalization, written notice accompanied by a copy of the post mortem report (if any) shall be given to Us within 14 days regardless of whether any other notice has been given to Us. We reserve the right to seek an autopsy. d. All claims are to be notified to Us within timelines as mentioned above. In case where the delay in intimation is proved to be genuine and for reasons beyond the control of the Primary Insured or Nominee specified in the Schedule of Insurance Certificate, We may condone such delay and process the claim, We reserve the right to decline such requests for claim process where there is no merit for a delayed claim. e. If You hold an indemnity policy with Us, a single notification for claim will apply to both the indemnity plan as well as any other Policy. f. For registration of claims You may contact us at: Claims Department Niva Bupa Health Insurance Company Limited, 14th Floor Capital Cyper Space, Golf course extension Road Sec 59, Gurugram, Haryana 122011, Fax No.: 1800-3070-3333 Contact Us at :1860-500-8888 Or at customercare@nivabupa.com

Niva Bupa Health Insurance Company Limited (IRDA Registration Number 145), ‘Niva’, ‘Niva Logo’, ‘Bupa’ and ‘HEARTBEAT’ logo are trademarks of their respective owners and are being used by Niva Bupa Health Insurance Company Limited under license. Registered office:- C-98, First Floor, Lajpat Nagar, Part 1, New Delhi-110024, Corporate Office: 14th Floor Capital Cyper Space, Golf course extension Road Sec 59, Gurugram, Haryana 122011; Fax: +91 11 30902010; helpline no:1860-500- 8888 ; www.nivabupa.com. CIN: U66000DL2008PLC182918. Product Name –Health Plus, Product UIN- NBHHLGP22157V032122