Category: General

A time period after the payment due date, during which insurance coverage remains in force and the policyholder may make a payment without penalty.

Inpatient care means hospitalised treatment. As per insurance terms, inpatient treatment includes hospitalisation for a minimum of 24 hours.

The automatic termination of insurance coverage due to lack of payment on or before the renewal due date or after a specific period of time called grace period. In case of Life Insurance and Health Insurance, a grace period after the renewal date is allowed as per the regulatory guidelines within which if the renewal premium is not paid, the policy will lapse.

The period of time for which an insurance policy provides coverage and remains in effect.

It is a legal document, which acts as a contract between the insurer and insured. It contains conditions of the insurance.

The process by which an insurer determines whether it will accept an application for insurance based upon risks and projections, and through which a determination on monthly premium is made.

Proposer is the person seeking insurance cover against loss he/she may suffer due to an undesired event or contingency.

Sum insured is the maximum pay-out amount that the Insurer is liable to pay to the insured in case of a claim and/or for the whole policy period. It works on the principle of indemnity. For e.g. the sum insured is ₹2 Lakh under health insurance, and if the insured gets hospitalised and his/her expenses turn out to be ₹3 Lakh, then the Insurer is liable to pay him/her ₹2 Lakh only.

Domiciliary Hospitalisation (also known as home care treatment) is a treatment of an illness, where hospitalisation of the patient is normally required, but he/she is treated at home.

There are specific conditions under which health insurers will agree for domiciliary hospitalisation.

• Due to non-availability of accommodation in nearby hospitals/nursing homes (or )
• The patient’s condition being such that, he/she cannot be moved to the hospital. The decision for home care treatment needs to be as per doctor’s recommendation and all the required treatment facilities are made available at home.
• In both the above cases, for the claim to be applicable, the treatment should be for a period of more than 3 days.
• Domiciliary hospitalisation will not be applicable for certain listed diseases as specified in the policy document of the respective insurers. The list of diseases excluded for domiciliary hospitalisation varies from insurer to insurer.
• And, last but not the least, you also need to watch out for any sub-limit imposed for domiciliary hospitalisation as a percentage of Sum Insured (SI) in your health insurance policy. For example, if the overall SI is Rs.5,00,000/- and the sub-limit is 50% of the SI, then the claims related to domiciliary hospitalisation will be limited to Rs.2,50,000/-.

Add-ons are additional benefits that can be opted by the policyholder, and added to the basic policy in exchange for extra premiums.

In Life Insurance, add-ons are usually referred to as Riders.