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Guide to understanding the terminologies used in Health Insurance

Purchasing health insurance online is not just about buying a plan for your family. As an insurer, you should be informed and updated on all the terminologies. You can find all the definitions that are commonly used in health insurance within this post.

 

Health Insurance

Health Insurance is a great way to distribute financial risks that are associated with a person’s health care expenditures by pooling out all the costs over a period of time.

Agent

An agent is usually appointed by the person who wants to buy an insurance policy in an insurance organization. They must also hold a valid license that has been issued by the IRDA i.e. Insurance Regulatory Development Authority. Make sure to opt for a trusted and reputed Insurance platform such as One Assure.

Claim

Claims are basically a process where the insurer will apply for reimbursement of any expenses which are incurred during filing claims for treatment. Usually, this process can be handled by someone who is an insurance representative. They are also called “Third Party Administrators”.

Cashless Claims

Just like the term suggests, the person who has bought the insurance can make claim without paying the cash up front. The insurer will have tie-ups with their various hospital networks as well as nursing homes known as network hospitals across India. The insurer could also get admitted to in-network hospitals that are specified, take the right treatment for any contracted disease without taking cash payments from the hospital when they are getting discharged.

Coverage Amount

This is basically the maxim amount that is paid during the claim’s event. It is also called the sum assured or insured. The premiums of this health insurance plan will be dependent on the coverage you selected.

Health Insurance Fraud

This is basically an act where one conceals, deceives, or even misinterprets certain information that causes the benefits being paid in an illegitimate manner to any group or individual.

Group Insurance

An association or firm may require you to buy a policy that ensures group members. For instance, the company you have might require the policy to cover a bigger group of employees.

A Floater Policy

You could also consider having a floating policy which is basically a single sum insured that provides coverage for all your family members. It could also be used by your family member many times. For example: if you have four people in your family along with two kids and a spouse, you could purchase a policy of 500,000 which gives you treatment benefits of 2 lakhs and the rest can be used by your family and yourself.

Once you have a strong understanding of any insurance whether it is term insurance e or heath insurance and how it works, you will definitely be able to find yourself that matches your current budget. So, when you are shopping for health insurance, you will need a trade that’s off between coverage that is high and low in cost. These plans also come with lower deductibles and also provide you with enough flexibility. So, make sure you know these terms well before making the final choice.

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