With the high costs of hospitalisation, treatments, and medicine, it only makes sense to protect yourself in any way you can by purchasing comprehensive health insurance. Understanding key health insurance terms and conditions, on the other hand, is critical to ensuring that you get the ideal value for money and the ideal coverage.
You should be acquainted with the terminology used in health insurance policies. The following is a detailed explanation of five health insurance terms.
Waiting time –
This is the period during which you cannot file a claim under your health insurance coverage in india. The length of the waiting period varies depending on the insurance policy. In general, there are two types of waiting periods.
The first is the initial waiting period. If you need hospitalisation within the first 30-90 days of purchasing the insurance, your claim will be denied unless it results from an accident. This period, however, may differ between insurance companies. The second factor is the waiting period for a pre-existing illness.
Before purchasing a health insurance policy, you must disclose any diseases for which you have been treated or are currently being treated. There is a waiting period for pre-existing illnesses before your insurance will accept a claim. A premedical condition may require a one- to four-year wait.
Specific plans include a co-payment provision. When you file a claim, this health insurance jargon implies that you will be responsible for a portion of the claim amount. Your out-of-pocket expense is typically a percentage of the total claim cost.
For example, if you submit a claim for 20,000 and the co-payment condition is 10%, you will be required to pay 2,000 out of pocket. When the risk is significant, such as in a senior citizen’s health insurance policy, insurers typically include a co-payment provision.
The deductible is a predetermined amount of money that can be deducted from the claim amount, and only claims that exceed this amount are considered due. The deductible is the portion of your claim that is not covered by individual plans or health insurance plans for family. You must pay this amount as a policyholder before your insurer covers losses.
The amount of this health insurance jargon is usually determined at the time of insurance purchase. The primary purpose of deductibles is to keep people from filing frivolous claims or seeking unnecessary treatment and hospitalisation simply because they have insurance.
Cumulative Bonus* –
These health insurance terms mean that if you don’t make any claims, insurers will give you a cumulative bonus*. Most insurance policies increase your coverage, or sum insured, by 5-10% for each year you go without filing a claim, up to a maximum of 50%.
Each insurer offers a different type of bonus and a different rewards rate. Several insurers, for example, may increase your coverage by 100% rather than 50%. However, it’s critical to understand the impact of a claim on your collected incentives, so talk to your insurer about it.
Free trial period –
Someone may have purchased health insurance on the recommendation of a friend, only to discover later that the benefits and terms and conditions do not meet their requirements. It is at this point that the free-look period comes in handy.
If you are thinking about purchasing health insurance, you should be aware of the these policy terms to make the ideal choice.
‘Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.‘
All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply
(* Standard T&C Apply )