Understanding health insurance jargon to live a healthy life

Important words in health insurance:

Assignee: The individual who receives the policy’s benefits.

Claim: The payment request for medical expenses that the insured party submits to the insurance company.

Co-payment: Under health insurance coverage, a co-payment is a required cost-sharing amount. Under the terms of the insurance, the policyholder consents to pay a portion of the hospital cost; this is known as a co-payment. The insurer then assesses a lower premium. It’s crucial to remember that in these situations, the insured amount is the same and is not lowered. A senior health insurance plan is more likely to provide this provision.

Cumulative Bonus: The NCB (No Claim Bonus) and cumulative bonus are comparable. The amount covered rises by a certain percentage for each year without a claim, subject to the policy’s maximum and acceptable only if the policy is constantly renewed.

Deductible: A higher deductible sum results in a lower premium. A deductible, which may be a set sum of money or a percentage of the claim amount, is a cost-sharing obligation under a health insurance policy. This clause exempts the insurance provider from paying that set or proportionate portion of the insured costs. The policyholder is responsible for paying the hospital the agreed-upon deductible sum.

Dependents: The insured person’s spouse and/or unmarried children (natural, adoptive, or stepchildren).

Exclusions: situations or conditions for which the insurance offers no coverage.

Grace Period: The designated window of fifteen days that opens up just after the premium payment deadline. Payments for insurance renewals or continuations may be made during this time without affecting continuity benefits like waiting periods and pre-existing illness coverage. Coverage won’t be accessible beyond the due date, however. As a result, it’s essential to continue renewing health insurance whenever the payment is due. Depending on the condition, health insurance policies include waiting periods that vary from 12 to 48 months. If the insurance is not renewed, not even during the grace period, the continuity benefits are forfeited.

The insurance provider, or insurer,.

Insurance plans that provide specific services for a certain amount of time are known as long-term care insurance. These services often consist of household care, home health care, and nursing care.

Long-term Disability Insurance: Should the insured become incompetent or disabled, the firm will reimburse him with a portion of his monthly salary.

Premium: The set monthly amount that an insured must pay to get the benefits of their insurance coverage.

Policy: Between the insurer and the insured, there is a binding legal agreement. It includes the insurance’s terms.

Pre-existing disease: Any illness, injury, or associated condition(s) for which the insured experienced symptoms, obtained a diagnosis, or sought medical advice or treatment within 48 months of the insurer’s initial policy issuance is considered a pre-existing disease. Even though pre-existing conditions are covered by the insurance after a certain amount of time, it is still recommended to tell the insurer about any such conditions and any current medications, if any. The insurance company may reject the claim if the information is withheld. These days, a lot of health plans cover pre-existing conditions as long as the policy is constantly renewed with the same insurer and is claim-free for a continuous four-year term.

Network: A collection of medical professionals, hospitals, and other facilities covered by the insurance and required to offer treatments to covered individuals for less than their regular prices.

The amount that the insurance company is required to pay the insured in the event of an occurrence is known as the sum insured. It operates on the indemnification concept. For example, if the hospitalization charges are Rs. 2 lakh and the health insurance amount covered is Rs. 3 lakh, the firm will have to pay Rs. 2 lakh towards the claim.

Waiting period: The time after obtaining a new health insurance policy during which the insured is not eligible for certain benefits of the policy. Usually, there is a certain amount of time from the policy’s start date that passes before some of its unique advantages become operative. For instance, there is often a 4-year waiting time for pre-existing conditions.

Disclaimer: Depending on your needs, Liberty General Insurance offers you health insurance plans. Please carefully read the policy wording before applying, however. For further information, go here.