Category
Claims & Settlement
15 terms explained in plain English, with Indian context.
- Cashless ClaimA cashless claim is a health insurance claim processed directly between the hospital and the insurer (through its Third Party Administrat...
- Claim FormA claim form is the standard document an insurer requires the policyholder (or the nominee, in a death claim) to fill out and submit, alo...
- Claim IntimationClaim intimation is the formal notice you give the insurer that a claim-triggering event has occurred.
- Claim InvestigatorA claim investigator is a person or empanelled agency the insurer commissions to verify the facts of a claim independently, typically whe...
- Claim RepudiationClaim repudiation is the formal rejection of an insurance claim by the insurer, accompanied by a written statement of the grounds for rej...
- Claim Settlement RatioClaim Settlement Ratio (CSR) is the percentage of death or hospitalisation claims that an insurer settled out of the total claims it rece...
- Cumulative Bonus (Health)Cumulative Bonus (CB) — sometimes called No-Claim Bonus on health policies — is an automatic increase in the sum insured at renewal of an...
- Discharge SummaryA discharge summary is the hospital's narrative medical document, prepared by the treating doctor at the time the patient is released fro...
- Final Non-Traceable Report (FNTR)A Final Non-Traceable Report (FNTR), often called a 'non-traceable certificate', is a formal document issued by the police after they hav...
- Free Look PeriodThe free look period is a statutory window, defined by IRDAI, during which a new policyholder can review the policy document after receiv...
- Pre-authorisationPre-authorisation is the formal approval that a health insurer (through its TPA) gives to a network hospital before treatment begins or s...
- Reimbursement ClaimA reimbursement claim is a health insurance claim where the policyholder pays the hospital bill upfront and then recovers the admissible ...
- Salvage ValueSalvage value is the residual market value of a damaged vehicle (or other insured property) after a total-loss claim has been settled.
- SubrogationSubrogation is a legal principle under which an insurer, after paying a claim to its policyholder, steps into the policyholder's shoes to...
- Surveyor (Motor Insurance)A surveyor (in the context of motor and general insurance) is an IRDAI-licensed independent professional who inspects the loss scene, ass...