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    • 1. Cashless Claim


      As the term suggests, the insured can make a claim without paying any cash for the medical assistance at the specified network hospitals.

       

       

    • 2. Coverage Amount/Sum Assured/Sum Insured


      It is the maximum amount payable in the event of a claim. The premium of the health insurance policy is dependent on the coverage amount chosen by you.

       

    • 3. Critical Illness Policy


      A policy for a serious, possibly terminal disease, which is strictly defined by the insurer. Most critical illness policies provide for the payment of a lump sum benefit if the policyholder is diagnosed as suffering from any one of the specified conditions.

    • 4. Cumulative Bonus

       

      Cumulative bonus is similar to no claim discounts, the only difference being that instead of giving an upfront discount, the health insurance company adds more benefits for the same premium paid.

       

    • 5. Disability Insurance


      It is a form of insurance that pays a monthly income to the insured when he suffers from total or partial disability caused due to either illness or injury, that affects his capacity to work and earn

    • 6. Deductible


      It is the amount of loss borne by the insured after which the insurance kicks in. This share of expense can be a certain money amount or a percentage of the claim amount. However, bigger the deductible, lower is the premium.

    • 7. Exclusions


      The diseases, conditions or situations in which medical expenses are not covered by the health insurance policy. Exclusions can be of two types – ‘Permanent’, i.e. the ones never covered and ‘First year’, which are ailments covered from second year.

       

    • 8. Floater Policy


      A policy that is issued with a single sum insured covering number of individuals. The cover can be used by any member of the family any number of times.

    • 9. Sublimit


      It is the limitation in an insurance policy on the amount of coverage available to cover a specific type of expenditure. It can be in amount or percentage.

       

    • 10. Loading

       

      It is the amount a health insurance company adds to you renewal premium if you had made any claims in the previous year.

       

    • 11. No Claim Bonus


      It is a bonus or rather a discount on the Basic Premium if there is a claim-free year in the policy. This bonus gets accumulated with each year you don’t make a claim.

       

    • 12. Overseas Mediclaim Policy (OMP)


      An Overseas Mediclaim Policy is issued to persons who are undertaking trips abroad for business, pleasure or educational purposes.

       

    • 13. Personal Accident Policy


      They are issued as fixed benefit policies whereby specified sums are paid on the occurrence of specified events such as death or disability.





    Some of the definitions may vary from those used in your plan depending on the provisions of your specific plan but you don’t worry about that. Remembering all these terms can be a tough task and you don’t even have to. You can always come back to these the next time you come across an insurance jargon that made you scratch your head.

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