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Health Insurance Terminology and Definations - Greyfont


Common Health Insurance Jargons Decoded

Insurance terms are confusing. However, with a good knowledge of them, you can make the best deal.Here’re some health insurance jargons decoded to make your insurance journey pleasant!

Some insurance jargons decoded:

  • Insurance Agent: He/she is the person appointed by the insurer to help you with the insurance related formalities and provide the information about a policy.

 

  • Assignee: The person to whom the policy benefits are confirmed.

 

  • Health Insurance ClaimA written request made by the insured to avail the insurance benefits from the insurer’s end. 

 

  • Insurance Certificate: The document stating the benefits and coverage offered under a policy. It also contains the list of exclusions and the contract between the two parties.

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  • Co-payment: A portion of the total claim that is paid by the insured is called Co-payment. One can reduce the premium rate by opting for co-payment, where Sum Insured remains the same.

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  • Cumulative Bonus: Similar to No Claim Bonus, it is a type of bonus you can earn for not claiming your insurance. The percentage of bonus can be ranged from 5% to a maximum of 50%, depending on the number of claim-free years

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  • Deductible: The only difference between co-payment and deductible is while the former means a portion of the total hospital bill, while the later is a fixed amount to be paid by the insured before the insurer releases the claim amount. 

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  • Dependents: People that are dependent on you like your spouse, children, and elderly parents; the policy benefits are extended to them as well. 

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  • Exclusions: The conditions that are just not feasible to cover. 

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  • Insurer: The insurance service provider that assures you to cover the risk mentioned in the policy, against a premium received. 

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  • Long-Term Care Policy: Policies that serve for a specific period of time, which may come with varied policy benefits and premiums. 

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  • Disability Insurance: Acts as a source of income in case of an accident leading to the permanent or temporary disability of the insured. 

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  • Premium: The amount you are liable to pay towards availing the policy benefits. 

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  • Pre-existing Illness: A health condition that exists before you own a health insurance policy. While most of the insurers cover such conditions after a pre-decided waiting period, some others can permanently exclude them. 

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  • Network Hospital: A group of hospitals that is associated with the insurer, where the insured can avail cashless treatments. It is recommended to look for an insurer with an extensive network hospital list. 

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  • Sum Insured: The actual coverage amount offered under a policy, up to which the insured can claim. 

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  • Waiting Period: Every health insurance comes with waiting period- initial waiting period, waiting period for pre-existing illness, waiting period for specific illness etc. Within such duration, you can’t claim your insurance. 

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  • Free-look Period: A pre-defined period during which you can cancel your insurance policy in case you  find it unsuitable. Usually, it is 15 days from the date of policy issuance; however, it may differ from insurer to insurer.

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In a Nutshell!

Knowing your insurance policy aptly helps you enjoy the most out of it. These jargons may put you in a state of confusion, where a little awareness can go a long way!




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