| Product
Feature |
Explanation |
| Product
Name |
Name of
the Product / Plan offered
in the market. |
| Coverage |
The period
from commencement of insurance
cover to the end of the insurance
cover. |
| Sum Insured |
The maximum
amount that an insurance company
will pay out in the event
of a claim. |
| Family
Floater Benefit |
Floater
Benefit means the Sum Insured
as specified for a particular
Insured and the members of
his/her family as covered
under the policy, is available
for any or all the members
of his/her family for one
or more claims during the
tenure of the policy. |
| Entry
Age |
The permissible
age of the insured at the
commencement of the policy. |
| Renewal
Age |
The permissible
age of the insured up to which
the policy can be renewed. |
| Cumulative
Bonus |
Bonus
that you received as a percentage
discount on your premium after
a year with no claims or An
increase in the Sum insured
by a specified percentage
for every claim free year,
subject to a certain maximum
limit |
| Pre Hospitalization
Expenses |
Actual
medical expenses incurred
during a period up to a particular
number of days, prior to hospitalization
for treatment of disease,
illness or injury sustained
and considered a part of a
claim admissible under the
Policy |
| Post Hospitalization
Expenses |
Actual
medical expenses incurred
during a period up to a particular
number of days after hospitalization
for treatment of disease,
illness or injury sustained
and considered a part of a
claim admissible under the
Policy. |
| Medical
Examination |
Requirement
of a mandatory medical examination
for issuance of the policy
to persons beyond a certain
years of age as mentioned
in the Policy. |
| Domiciliary
Hospitalization |
Expenses
for medical treatment for
an illness/injury upon the
written advice of a Medical
Practitioner, for a period
exceeding three consecutive
days for such illness or injury
which in the normal course
would require care and treatment
at a hospital/nursing home
but is actually undertaken
whilst confined at home in
India under certain circumstances
namely:
a. The condition of the patient
is such that he/she cannot
be moved to the hospital/;
or
b. The patient cannot be moved
to hospital for lack of accommodation
therein.
|
| Pre existing
Disease |
Any condition,
ailment or injury or related
condition(s) for which you
had signs or symptoms, and
/ or were diagnosed, and /
or received medical advice/
treatment, within 48 months
prior to your first policy
with a given insurer. |
| Day care
treatment/Named surgical procedure |
Treatment
undertaken in a Hospital/Nursing
Home on the recommendation
of a Medical Practitioner
for diseases, illness or injury
which require hospitalization
for less than 24 hours (but
not in outpatient department
of Hospital) |
| Network
Hospitals |
Hospitals
or other institutions which
have been empanelled by the
Company or the appointed TPA
for provision of medical treatment.
|
| Cashless
hospitalization |
Hospitalization
expenses made directly to
the hospital by the company
in case the hospital is a
Network Hospital. |
| Free Health
Check up |
Provision
for a free medical check-up
for the Insured Person (s)
covered under the policy on
renewal. |
| Family
Discount |
Discount
offered on the premium paid
when more than one person
of the same family is covered
in the same policy, individually. |
| Ambulance |
Eligilbility
for reimbursement to the Insured/
Insured Person of expenses
incurred for his/her transportation
by ambulance to the nearest
Hospital/Nursing Home for
treatment of the disease/illness/injury
necessitating his/her admission
to Hospital/Nursing Home. |
| Co-payment
|
A certain
percentage of the claim amount
which has to be borne by the
insured person. |
| Tax Benefit |
Medical
insurance premium paid qualify
for deduction under section
80D from your income up to
a defined limit. |
| In House
claim settlement |
The claim
is settled directly by the
company without the invovlement
of a Third Party Administrator. |
| Terror
Attacks |
Hospitalization
on account of injury sustained
due to act of terrorism. |
| Donor
Expense |
The Medical
Expenses incurred in respect
of donor for organ transplant
surgery, provided the organ
is donated for use of insured
person. |
| Maternity
Expenses |
The Medical
Expenses incurred for a delivery
(including caesarean section)
while Hospitalized or the
lawful medical termination
of pregnancy during the Policy
Period. |
| New born
babies coverage |
Coverage
to the baby born to the insured
person during the policy period
aged between ___ day and ____
days. |
| Expenses
for Vaccination of children |
The Medical
Expenses of First year vaccinations
for all new borns. |
| Critical
illness |
Critical
illness includes illnesses
such as Cancer, First heart
attack, Coronary artery diseases
etc. These are specifically
defined in the given policy. |
| Hospitalization |
Admission
in a Hospital / Nursing Home
upon the written advice of
a Medical Practitioner, for
a minimum period of 24 consecutive
hours. |
| Nursing
at home |
Medical
services of a nurse at the
Insured / Insured Person’s
residence provided such services
are confirmed as being necessary
by the attending Medical Practitioner. |
| Accompanying
persons Allowance |
Payment
to Insured/Insured Person
of an allowance towards expenses
incurred by the accompanying
person at the Hospital/Nursing
Home during treatment of Insured/Insured
Person for a disease, illness,
injury necessitating his/her
Hospitalization. |
| Ayush
Treatments Expenses |
The Medical
Expenses for In-patient treatment
taken under Ayurveda, Unani,
Sidha or Homeopathy. |
| Opinion/Consultation
Expenses |
Reimbursement
for seeking professional opinions
or consultation up to a certain
limit. |
| Spectacles,
Contact Lenses, Hearing Aid
Expenses |
Reimbursement
for expenses of Spectacles,
Contact Lenses, Hearing Aid
up to a certain limit. |
