Category
Health Insurance
15 terms explained in plain English, with Indian context.
- AYUSH CoverAYUSH cover is the part of an Indian health insurance policy that pays for in-patient treatment under recognised non-allopathic systems o...
- CashlessCashless hospitalisation is a claim-settlement mode where the insurer pays the hospital directly for your treatment and you do not have t...
- Co-payCo-pay (short for co-payment) is the fixed percentage of an admissible claim that the policyholder agrees to pay out of pocket, with the ...
- Cumulative Bonus BoosterA cumulative bonus booster is an enhanced no-claim bonus structure on a health policy that adds a higher percentage to the sum insured ea...
- Day Care ProcedureA day care procedure is a medical or surgical treatment that requires hospital admission but, due to advances in technology, is completed...
- Deductible (Health)A deductible in health insurance is the fixed amount of an admissible claim that the policyholder must absorb before the insurer's paymen...
- Domiciliary TreatmentDomiciliary treatment is medical treatment administered at the patient's home rather than in a hospital, but treated by the insurer as if...
- Family FloaterA family floater is a single health insurance policy that covers multiple members of the same family under a shared sum insured.
- Network HospitalA network hospital is a hospital that has signed a tariff agreement with an insurer (or its TPA) to provide cashless treatment to that in...
- Pre-Existing Disease (PED)A Pre-Existing Disease (PED) is any condition, illness, injury, or related diagnosis that the insured person had — or had received treatm...
- Restoration BenefitA restoration benefit (also called 'reinstatement of sum insured' on some policies) is a feature of indemnity health insurance that autom...
- Room Rent LimitA room rent limit caps the amount the insurer will reimburse for your hospital room per day.
- Sub-limitA sub-limit is a cap, smaller than the overall sum insured, that a health insurance policy applies to a specific category of expense or t...
- TPA (Third Party Administrator)A Third Party Administrator (TPA) is an IRDAI-licensed company that processes health insurance claims on behalf of one or more insurers.
- Waiting PeriodA waiting period is a time window at the start of a health insurance policy during which certain claims are not payable, even if all othe...