Page 389 - Ebook health insurance IC27

Sashi Publications

charges, medicines, lab tests, surgeon's fees etc) are paid back to the insured who
makes the claim. In other words, the insured pays the (hospital) expenses incurred, but
thereafter gets reimbursed by the insurance company.

Renewal :
General Insurance policies are generally valid for 1 year. After the end of the year it
needs to be renewed again

Rider :
A document that amends the policy or certificate. It may increase or decrease benefits,
waive the condition of coverage, or in any other way amend the original contract.

Surgical Operation :
Surgical Operation means manual and/or operative procedures for correction of
deformities and defects repair of injuries, diagnosis and cure of diseases, relief of suffering
and prolongation of life.

TPA :
"TPA" means a Third Party Administrator who, for the time being, is licensed by the
Authority, and is engaged, for a fee or remuneration, by whatever name called as may
be specified in the agreement with an insurance company, for the provision of health
services;

Qualified Nurse :
Qualified Nurse means a person who holds a certificate of recognized Nursing
Council and is employed on recommendation of the attending Medical
Practitioner.

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