Health Insurance Jargons

Health Insurance Article

decrypting the language in Health Insurance for a healthy life

KEY TERMS IN MEDICAL INSURANCE

Assignee The person who get the benefits of the policy.

Claim The payment request filed by the insured person to the Insurance company, for payment of Medical Charges.

Co-paymentCo-payment is a cost– sharing demand under a health insurance policy. In certain cases, the policyholder agrees to bear a certain chance of the sanitarium bill, as per the conditions of the policy it’s calledco-payment. In doing so, insurer charges a lower decoration. It’s important to note that the sum ensured in similar cases remains the same and isn’t reduced. This point is more likely to figure in a elderly citizen health insurance plan.

Accretive perk Accretive perk is analogous to NCB( No Claim perk). For every claim free time, the sum ensured increases by a fixed chance as per policy, but can not exceed 50 per cent of the Main Sum Insured and is permissible only if the policy was renewed continuously.

Deductible further the deductible quantumlower the decoration. A deductible is a cost– sharing demand under a health insurance policy, which can be a fixed quantum or a chance of the claim quantum. Under this provision, the insurance company won’t be liable to pay for that fixed or chance quantum of the covered charges. It’s the liability of policyholder to pay the contracted deductible quantum to the sanitarium.

Dependents partner and/ or unattached children( whether naturalespoused or step) of an ensured.

Rejections Conditions or circumstances for which there will be no benefit in the policy.

Grace Period The specified period of 15 days incontinently after expiry of the due date of decoration payment. During this period the payment can be made to renew or continue a policy without loss of durability benefits similar as staying ages and content ofPre-existing conditionsstillcontent won’t available for the delayed period from the due datethus, it’s veritably important to keep renewing the health insurance as and when the decoration is due. The staying ages in health insurance policy range from 12- 48 months depending on affections. The durability benefits are lost, where policy isn’t renewed indeed within the grace period.

Insurer The insurance company.

Long– Term Care Policy Insurance programs that give specified services for a specified period of timesimilar services generally include nursing carehome health care services, and custodial care.

Long– term Disability Insurance Under this the company pays the ensured a chance of his yearly income, if he’s incapacitated/ impaired.

Premiumfixed journal quantum an insured is needed to pay to mileage the insurance content benefit.

Policy It’s a legal contract between the insurer and ensured. It contains conditions of the insurance.

Pre-existing complaintPre-existing complaint is, any conditiondisease or injury or affiliated condition( s) for which insured had symptoms, and/ or was diagnosed, and/ or entered medical advice/ treatment within 48 months to previous to the first policy issued by the insurer. Although thepre-existing affections get covered by the policy after a certain period, it’s judicious to expose any similar being disease and ongoing drug, if any to the insurer. Non-disclosure may affect in rejection of the claim by the insurer. Nownumerous health plans have started covering indeedpre-existing affections handed the policy is continuously renewed with the same insurer and that too without any claims for a nonstop period of four times.

Networkgroup of croakers , hospitals and other health care providers, who are part of the contract under the policy and who are obliged to give services to ensured persons at lower charges than their normal freights.

Sum Insured Sum ensured is the pay– eschewal quantum that the Insurance Company is liable to pay to the ensured in case of an eventuality. It works on the principle of reprisal. For case, where the sum ensured is Rs 3 Lakh under health insurance and the hospitalization charges areRs. 2 Lakh, the company is liable to pay Rs 2 Lakh, towards the claim.

Waiting period The period during which certain benefits of the policy won’t be available to the ensured, when a new health insurance policy is taken. This is generally a fixed period of time from the date of inception of policy, after the completion of which, certain specific benefits of the policy take effect. For illustration, the usual waiting period forpre-existing conditions is 4 times.

Disclaimer Liberty General Insurance provides you health insurance programs depending on your conditionsstill, before you apply, please read the policy wordings precisely. You can click then to know more

here is link for you 

Leave a Comment

error: Content is protected !!