Key Terms
Co-pay
It is the fixed percentage or amount of the medical bill that you, the insured, have to pay out of your own pocket when making a claim under your health insurance policy.
Waiting period
It is a specified time duration from the start of your health insurance policy during which certain illnesses, treatments, or conditions are not covered.
Pre-Existing Diseases (PED)
These are any medical conditions, illnesses, or ailments that you had before buying a health insurance policy.
Restoration of Coverage
- It is a feature in some health insurance policies that replenishes your sum insured if it gets exhausted during the policy year due to claims.
- Restoration can be one-time or unlimited during the policy year, depending on the plan.
- The sum insured is reloaded either fully or partially if it gets exhausted due to claims during the policy year.
Day Care Treatment
- These are medical procedures or surgeries where you don’t need to stay overnight in the hospital and can be discharged the same day.
- These treatments are covered by your health insurance.
Pre-Hospitalization
Medical expenses you incur before you are admitted to the hospital for treatment. This includes tests, consultations, and medicines related to the illness.
Post-Hospitalization
Medical expenses you incur after being discharged from the hospital for follow-ups, medicines, or tests related to the hospitalization.
Life/Term Insurance
- It is a type of life insurance that provides coverage for a specified period of time/term (e.g., 10, 20, 30 years).
- If the policyholder passes away during this term, the beneficiary (usually a family member) receives the sum assured (death benefit).
- However, if the policyholder survives the term, there is no payout (as opposed to permanent life insurance policies)
Riders
These are optional add-ons that can enhance the coverage of a term insurance policy.
- Accidental Death Benefit Rider (ADB)
- Critical Illness Rider
- Waiver of Premium Rider (WOP)
- Disability Benefit Rider
- Return of Premium Rider (ROP)
Health Insurance
- It is a type of insurance that covers medical and surgical expenses incurred by the insured person.
- It helps protect you financially when you're sick, injured, or need medical care.
Deductible
- It is a fixed amount that you (or your base policy) must cover before the top-up policy pays anything.
Top-up Plan
- It is an additional health cover that provides benefits only when a single medical claim exceeds the deductible.
Super Top-up Plan
- It is an enhanced version of a top-up plan.
- It provides additional coverage after the total of all medical claims in a policy year exceeds the deductible.
Endowment Policy
- It is a life insurance plan that combines insurance coverage with savings. It provides a lump-sum payout to the policyholder:
- If you survive the policy term (maturity benefit)
- To your nominee if you die during the term (death benefit)
- If the policyholder dies before the term ends, the nominee receives the full sum assured along with any bonuses.
Money Back Policy
A type of life insurance that offers:
- Regular payouts during the policy term (survival benefits)
- Lump sum at maturity
- Full death benefit if the policyholder passes away during the term
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