Page 195 - IC38 GENERAL INSURANCE

Summary

a) A health insurance policy provides financial protection to the insured person
in the event of an unforeseen and sudden accident / illness leading to
hospitalization.

b) Health insurance products can be classified on the basis of number of people
covered under the policy: individual policy, family floater policy, group
policy.

c) A hospitalization expenses policy or Mediclaim reimburses the cost of
hospitalization expenses incurred on account of illness / accident.

d) Pre hospitalization expenses would be relevant medical expenses incurred
during period up to the defined number of days (generally 30 days) prior to
hospitalization and will be considered as part of claim.

e) Post hospitalization expenses would be relevant medical expenses incurred
during period up to the defined number of days (generally 60 days) after
hospitalization and will be considered as part of claim.

f) In a family floater policy, the family consisting of spouse, dependent
children and dependent parents are offered a single sum insured which
floats over the entire family.

g) A hospital daily cash policy provides a fixed sum to the insured person for
each day of hospitalization.

h) Critical illness policy is a benefit policy with a provision to pay a lump sum
amount on diagnosis of certain named critical illness.

i) High Deductible or Top-up Covers offer cover for higher sum insured over
and above a specified chosen amount (called threshold or deductible).

j) The fixed benefits cover provides adequate cover to the insured person and
also helps the insurer to effectively price his policy

k) A Personal Accident (PA) Cover provides compensation in the form of death
and disability benefits due to unforeseen accidents.

l) Out-patient covers provide for medical expenses like dental treatments,
vision care expenses, routine medical examinations and tests etc. that do
not require hospitalization.

m) A group policy is taken by a group owner who could be an employer, an
association, a bank‟s credit card division, where a single policy covers the
entire group of individuals.

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