Health Insurance

Understand Health Insurance Terms in Detail

A lot of talks go about productivity. To be productive, one must keep the mind and body healthy. You require financial support to safeguard your health, and health insurance offers this backup. That…

A lot of talks go about productivity. To be productive, one must keep the mind and body healthy. You require financial support to safeguard your health, and health insurance offers this backup. That is the reason that every individual must have a health insurance policy.

But there are terminologies that a person may not be familiar with regarding health insurance. But do not worry! In this post, we've clarified the meaning of specific terms you might have read about health insurance but weren't exactly sure what they meant.

Top 17 Health Insurance Terms in Detail

Here are a few important terms to know that will help you understand the best health insurance plans in India:

1. Riders/Add-ons

Health insurance policies have riders that can be added to the standard health insurance coverage. These add-ons riders can be added by paying an extra premium, as it is an additional feature that enhances your coverage. Most health plans have critical illness coverage, hospital cash benefits, accidental death, etc.

2. Sum Insured

The highest amount for a given year that the insurance company will cover if you need hospitalization is known as the sum insured. Any amounts above the insured amount will be your responsibility to pay. It solely works on the concept of indemnity.

3. Nominee

A nominee is someone you may name on your health insurance policy as the beneficiary of your account in the event of your untimely death. Any person you consider your first relation may be nominated, including your parents, spouse, children, siblings, etc.

4. Waiting Period

The waiting period is when the health insurance company will not cover any of the insurer's medical costs. This implies that even if you bought a health plan, you could not be compensated if you filed a claim within that time.

5. Pre-existing Disease

Any illness or medical condition a person has before buying health insurance is referred to as a pre-existing condition or disease. Pre-existing illnesses can range in severity from mild ones like high blood pressure, allergies, and asthma to serious ones like cancer, diabetes, and Alzheimer's disease.

6. Deductible

The amount you would be responsible for paying in the case of a claim is known as a deductible in health insurance. Your insurance will begin to pay the remaining costs if your policy covers the loss. A deductible is used to discourage filing claims for less serious incidents.

7. Co-payment

The percentage of the claim amount that an insured individual covers under a health insurance policy is known as the copay. However, the insurance will cover the remaining balance. Since both the insurer and the insured pay according to their respective percentages on a sharing basis, you may conclude that the amount is an acceptable claim amount.

8. Cashless Claims

With cashless health insurance, the insurance company pays the hospital immediately, and the patient is not responsible for the inconvenience. For patients and their family members, this is undoubtedly beneficial.

9. Claim Settlement Ratio

The percentage of paid claims to all claims received by an insurance company in a given fiscal year is known as the health insurance claim settlement ratio. It is one of the most trustworthy variables that show if an insurance business manages the claims of the consumers properly or not.

10. Maternity Benefit

Maternity benefits refer to pregnancy-related costs, including the cost of the pregnancy, the delivery, and the baby's medical insurance. It is ideal to buy maternity health insurance to get all the benefits mentioned above.

11. Inclusions

The circumstances under which a policyholder may make a claim are described in the inclusions. Insurance should be purchased with the availability of coverages in mind. Regarding health insurance, popular coverages include bed costs, doctor visits, nurse fees, etc.

12. Exclusions

Exclusions are scenarios that your health insurance does not cover. The opposite of inclusion is exclusion. Plans for health insurance specifically highlight these circumstances. The insurance company will most certainly deny a claim if the situation comes under exclusions.

13. Premium

The regular payment required for your health plan. Typically, you can pay it monthly, quarterly, or annually.

14. No-Claim Bonus

Under specific terms and conditions, the insurer will provide the policyholder with a no-claims bonus for their health insurance. The primary requirement for obtaining a No Claim Bonus is that the policyholder should have made no claims during the prior policy period.

15. Comprehensive Health Insurance

You don't need to purchase a variety of separate health insurance policies to cover a range of medical bills since a comprehensive health insurance plan offers all-inclusive coverage under a single policy. You get most of the benefits.

16. Family Floater Plan

Family members linked by blood or law can purchase this family floater plan. The family splits the insurance payout as these plans are not particularly comprehensive in scope.

17. Group Health Insurance

Group insurance aims to protect members of the same group against risk. The best example of a group health insurance plan is employee medical insurance. The insured amount may not always be divided among the members. Each participant in group health insurance may get a specific sum insured.


Now that you have read all the important terms that are used in health insurance, you can easily buy the plans. This will allow you to make good decisions. It is ideal to buy health insurance online these days as the process is simple and hassle-free.



Health insurance policies come in various forms in India, including individual plans, family floater plans, group health insurance plans, etc.

Age, gender, medical history, way of life, and many other factors can impact a health insurance policy. There are several different plans that you can purchase. Also, you can buy health insurance online.

There is no ideal age to purchase health insurance. However, the cost of the premium decreases over time. Though, there is a lower chance of sickness while you are young.

You can indeed have multiple medical insurance policies. You can buy a group health insurance plan, an individual and a family floater plan.

The hospitals on the insurance company's panel are referred to as network hospitals. Non-network hospitals are general hospitals where you can receive care and then submit a claim for payment.


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