Health insurance requires understanding specific technical terms that differ from life insurance. According to reports from Personal Finance News, the sum insured term is used in health insurance instead of sum assured, representing the maximum cover the insurer pays for eligible medical expenses in a year. Key terms include deductible - the pre-set amount the insured pays out-of-pocket for medical expenses before coverage begins, and co-pay - an agreement to share hospital costs proportionally, available for senior citizens and pre-existing diseases to reduce premiums. A comprehensive health insurance policy is an all-inclusive plan that provides extensive coverage against medical emergencies with lifetime renewability, offering financial support for a wide range of medical expenses including hospitalization, day care treatment, and road ambulance charges.
The waiting period is the time before certain coverage begins, covering general conditions and pre-existing diseases diagnosed before insurance purchase. As reported by Personal Finance News, cashless hospitalisation allows claims approval without upfront payment at network hospitals, eliminating high upfront costs. The incurred claim ratio (ICR) indicates how much money out of total premium collected is deployed towards settling claims, with a 50% ICR meaning ₹50 out of ₹100 collected premium is used for claims settlement. Policybazaar offers 100% claim support in 114 cities with on-ground assistance available, providing comprehensive support for policyholders during claim processes.
A pre-existing disease refers to any medical condition diagnosed by a doctor or for which treatment was received within 48 months before purchasing the health insurance policy. According to recent reports, the waiting period for pre-existing diseases typically ranges from 2 to 4 years, during which claims related to these conditions are not covered. Common pre-existing diseases include diabetes, hypertension, thyroid disorders, asthma, and chronic back pain disorders with varying waiting periods. Some insurers offer immediate coverage for specific diseases such as heart attacks (except those related to pre-existing conditions), cataract caused by accidental injury, and acute asthma attacks.
Exclusions include conditions against which insurers do not extend coverage, such as cosmetic surgery, self-inflicted injuries, and dental treatment. According to the report, no-claim bonus rewards claim-free years by increasing sum insured value or providing discounts on renewal premiums, similar to car insurance benefits. This bonus can range from 10-50% increase in coverage for no-claim years. For pre-existing disease coverage, higher sum insured is recommended to cover long-term treatment costs effectively, while honest disclosure of all medical conditions is vital to avoid claim rejection. Policybazaar provides exclusive benefits including tax benefits and comprehensive support services for policyholders.
