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PowerPoint Presentation



COMMON TERMS IN 
HEALTH INSURANCE

W W W . P O L I C I E S 3 6 5 . C O M


PRE-EXISTING ILLNESS
Illnesses that existed prior to the date of purchase of the policy are 
known as pre-existing illnesses. By and large, providers refuse to 
cover illnesses that existed before the policy commencement.

However, some insurers cover this with a waiting period or charge 
an additional premium or put terms and conditions for such 
coverage.


WAITING PERIOD

There is waiting period for all health insurance policies.
The usual waiting period is 30 to 90 days for most health plans. There will be no cover during the waiting period.


MINIMUM HOSPITALIZATION STAY
A minimum hospitalization period of 24 hours (may vary based on the policy) is necessary to claim the benefits 

under hospitalization cover.


CASHLESS FACILITY

Cashless hospitalization, if offered by the policy, will not 
require you to pay at the time of admission to a network 

hospital which has a tie-up with the provider.

An Insurer or a Third Party Administrator on behalf of an 
insurer will be responsible for settling the bills. If admitted to a 

non-network hospital, the insured must settle the bills and 
claim a reimbursement from the insurer.


EXCLUSIONS
Reading your policy document thoroughly and coming to grips with 
what’s not covered will go a long way towards being prepared for 
exclusions under the policy. 

There are some exclusions that are standard across policies such 
as dental treatment, venereal disease, AIDS, congenital diseases, 
intentional self-injury and so on.


GRACE PERIOD
The additional period offered for the payment of premium post the due date is known as the grace period. General insurance 

companies offer a 15-day grace period but you would do well to check how many days your policy allows.


GRIEVANCE REDRESSAL

Any grievance related to your health policy should first be 
taken up with the insurer. The complaint should be 
acknowledged by the insurer within 3 working days.

In case you are unhappy with the resolution of your 
grievance, you can register a complaint with the Integrated 

Grievance Management System portal of IRDAI.


W W W . P O L I C I E S 3 6 5 . C O M

Navnit Insurance Broking Private Limited
172, Solitaire Corporate Park, Building No. 1, 7th Floor, 
Andheri-Ghatkopar
Link Road, Andheri (East), Mumbai, 400093, 
Maharashtra, India

IRDAI Broker License No. CB/446/09

Product information is authentic and solely based on 
the information received from the insurer.

Sales Assistant: (022) 42114211 
Claims/Service: (022) 42114299 
[email protected] 
Toll free number: 18001026234