Health Insurance Glossary (4) - INDIA - continued

Personal Accident Policy

Personal Accident Policies are issued as fixed benefit policies whereby specified sums are paid on the occurrence of specified events. These events could be death or disability.  This payout is not related to the expenses incurred. For Example: Shyam has a personal accident policy. He meets with an accident and is permanently disabled. He would automatically get 100% of the sum insured and this would be in no way linked to the expenses he has incurred in treatment of the same.

Policy

A policy is a stamped document which is evidence of the contract of insurance between the insurer and the insured. The policy encapsulates the benefits and features of the policy.

Pre - existing Disease

A pre - existing disease is any ailment or disease that a person is already suffering from at the time of purchasing health insurance.

Premium

Premium is the amount paid by the insured(the buyer) to the insurer for the policy. Simply put, it is the cost of the insurance policy.

Proposal

Proposal forms are used to give the insurance company full particulars of the risk against which insurance protection is desired. This proposal form is the basis of the health insurance policy. Any misrepresentation or non disclosure of facts would make the insurance null and void.

Proposer

Proposer is the insured who seeks protection against loss he may suffer due to happening of a contingency.

Renewal

Health insurance policies are usually annual contracts.At the end of the policy period, the policy has to be renewed by the insurers. But renewing a contract of insurance is at the discretion of the insurer. There should be continuous renewal of the policies. If there is a break in insurance, the insured would lose the benefits of insurance in the event of any contingency.

Reimbursement

Under a Health Insurance policy, the cost of various hospital charges (such as bed charges, medicines, lab tests, surgeon's fees etc) are paid back to the insured who makes the claim. In other words, the insured pays the (hospital) expenses incurred, but thereafter gets reimbursed by the insurance company.