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10 Must-Know Insurance Terminologies In India

Updated On Jul 30, 2021

When you buy a health insurance policy for yourself or your family, you have to go through some paperwork. The insurance company usually gives a period of 15 days as a free-look period to the customers, to go through the policy-related documents. However, sometimes you might not get the policy papers due to the terms used in the policy. Therefore, you must have a simple understanding of some of the commonly used terminologies in health insurance policies. Not knowing the meaning of certain terms can cause serious problems and confusion at the time of making a claim for your purchased health insurance cover. In this article, we shall come across around 10 widely used terms in health insurance policies in India. 

10 Must-Know Insurance Terminologies In India

10 Must-Know Insurance Terminologies In India 

Let us look at some of the important and commonly used terms in the Insurance documents in India: 

1. Automatic Restoration 

Restoration benefit is offered by various insurance firms, under which the amount of sum assured is restored completely in case of exhaustion. The restoration can be either complete or partial based on the choice of the policyholder. Therefore, you must always make sure that restoration benefit is a part of your policy cover, especially in the case of a family floater plan. 

2. Add-On Cover 

Add-on covers are health insurance policies that can be purchased to extend the benefits and coverage of the existing health insurance policy. These covers are affordable and come with additional features to meet the demands of the policyholders. Such additional financial covers are helpful against the expensive medical treatments that are not sufficed by the existing health insurance policy. 

3. Waiting Period

It is the time period for which the policyholder cannot avail of the benefits of the health insurance policy purchased. The waiting period usually ranges from 2 to 4 years and is applicable to pre-existing diseases. People are usually advised to invest in a health insurance cover as early as possible to overcome the waiting period of the policy. The waiting period can differ from one insurer to the other and therefore, you must read about the same in the policy-related documents carefully. 

4. Co-Payment 

The co-payment clause states that the policyholder has to pay a fixed percentage of the amount to the insurance company before availing of the health care services from the insurer.  The co-pay amount is specified by the insurer within the policy and can differ according to the age group of the applicant. 

5. Cashless Claims 

Cashless claim settlements can be made at the network hospital of the insurance company. Under this claim settlement process, the policyholder does not have to pay any amount from the pocket. The insurer pays for the medical dues to the hospital directly without involving any third party. This makes the whole claim settlement process quick and hassle-free for the customers and gives them peace regarding the medical bills of the treatment received. 

6. Deductibles 

Deductibles are the fixed amount of sum that the policyholder has to pay at the time of claim. With the increase in the deductible amount, the premium payment decreases. You can go for voluntary deductible and pay for it only if you are financially capable.

7. Exclusions  

These are the limitations of the policy purchased by the customer. It includes the list of expenses that are off-limits or excluded from the health insurance policy coverage. If a claim request is made for an expense that comes under the exclusions of the policy, then the claim request will be canceled by the insurer. Therefore, you must carefully read the fine print of the policy and be aware of the exclusions in your policy. 

8. No Claim Bonus

A no-claim bonus is awarded to the policyholder for each claim-free year within the policy tenure. You can get a discount on your premiums under this benefit. The no-claim bonus discount can vary from one insurer to the other. 

9. Top-Up Plans

These plans are bought along with the base plans as a backup in case of the exhaustion of the sum assured under the base health insurance policy. 

10. Premium 

It refers to the amount of sum that is to be paid by the policyholder to the insurance company to make the purchase of the health insurance policy. The premium paid for a policy depends on a lot of factors like age, medical history, deductibles chosen, etc. 


You must be aware of some of these above-mentioned basic terminologies, as they can help you understand the policy purchased better. You can also make sure that your demands and requirements are met in the purchased insurance policy by the insurer. 

Also Read: Best Health Insurance Plans In India

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Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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