Page 384 - Ebook health insurance IC27

The Insurance Times

Fraud :
Obtaining an advantageby unfair or wrongful means. Deception or artifice used to deceive
or cheat.

Floater Policy:
A floater policy is issued with a single sum insured covering numberof individuals. Simply
put, it is a one premium and one policy for all members of the family. The cover can be
used any member of the family any number of times. For example, there arethree members
in your family- you, your spouse and your child. You purchase a family floater policy
with a sum insured of Rs 500,000. This means that if you fall sick and utilize Rs 200,000
in treatment- the balance Rs. 300,000 can be utilized by any member of the family
including yourself. Your total expenses across the family would however be capped at
Rs. 500,000.

Grace :
(i) A period of time, during which period a past due premium may be paid without a
penalty (ii) A period of time, usually 30 days following the premium due date during
which a premium may be paid. The policy remains in force throughout this period.

Group insurance :
Insurance covering the members of a group such as the employees of a single employer.
The benefits are not tailormade to the needs of each member. If the group is acceptable
to the insurer, all members are covered.

Good Faith :
It requires both the buyer and seller in a transaction to act honestly toward each other
and to not mislead or refrain from providing wrong information to the other party.

388 Guide for Health Insurance