Elements of Health Insurance – Terminologies & their Benefits

3 minutes, 21 seconds Read

In India, understanding health insurance planning can often seem like solving a tricky puzzle. Health insurance is like a safety net for your and your family’s well-being, but it comes with a lot of terms and intricacies that can be confusing. To make informed decisions, you need to understand these terms and how they serve you. Health insurance planning isn’t a one-size-fits-all task. It’s about finding the best health insurance plans matching your unique needs. It’s about balancing both your health and your wallet in uncertain times. 


We’ll discover the jargon that leaves people scratching their heads, and see how these essential terminologies can help you pick the best health insurance policy

Key Health Insurance Terminologies and Their Benefits

Steering through various critical illness insurance can be tough, but learning key terminologies is vital to making the right choices. In this section, we’ll uncover critical health insurance terms and their benefits, helping you interpret the complexities of your policy with confidence.


  • Definition: Premium refers to the amount paid to the insurance company in exchange for coverage. 
  • Benefit: Paying a premium ensures financial protection in the event of medical expenses, offering peace of mind.


  • Definition: The policyholder is the individual who owns the health insurance policy. 
  • Benefit: The policyholder wields control over the policy, including the ability to select coverage that aligns with their unique needs.

Sum Insured 

  • Definition: Sum insured denotes the maximum amount the insurer disburses for covered expenses throughout the policy term. 
  • Benefit: It establishes the extent of coverage, guaranteeing that your medical bills are adequately covered.

Pre-existing Condition 

  • Definition: A pre-existing condition signifies a health issue that existed prior to purchasing the policy. 
  • Benefit: Awareness of pre-existing conditions helps policyholders understand which ailments are covered or subject to waiting periods.

Cashless Treatment

  • Definition: Allows policyholders to receive treatment without paying upfront; the insurer settles the bill directly with the hospital.
  • Benefit: Ensures immediate medical care without financial strain during emergencies.


  • Definition: A fixed amount you pay before the insurer covers the rest.
  • Benefit: Choosing a higher deductible can lower premium costs.


  • Definition: A cost-sharing arrangement where you pay a percentage of the medical bills, and the insurer covers the rest.
  • Benefit: Reduces the premium while maintaining coverage.

Network Hospitals

  • Definition: Hospitals and healthcare providers under an agreement with the insurer for cashless treatment.
  • Benefit: Access to quality healthcare without the hassle of reimbursement claims.

Waiting Period

  • Definition: A specific duration after policy issuance when certain benefits aren’t available.
  • Benefit: Prevents policyholders from purchasing coverage only when they need immediate medical attention.

Renewal Grace Period

  • Definition: The additional time provided after policy expiry to renew it without losing continuity benefits.
  • Benefit: Ensures uninterrupted coverage even if you miss the renewal date.

No-Claim Bonus (NCB)

  • Definition: A bonus rewarded for not filing any claims during the policy year.
  • Benefit: Reduces the premium or increases the sum insured for the next year, encouraging a healthy lifestyle.


  • Definition: Exclusions encompass conditions or treatments that the policy does not cover. 
  • Benefit: They clarify the scope of coverage, empowering policyholders to make informed decisions.

Maternity Cover 

  • Definition: Maternity cover provides for expenses related to childbirth, encompassing pre and postnatal care. 
  • Benefit: It aids families planning to have children by alleviating the financial burden of childbirth expenses.


  • Definition: Portability signifies the ability to switch to another insurer while retaining policy benefits. 
  • Benefit: It allows policyholders to explore improved coverage or lower premiums without forfeiting existing benefits.


Understanding these essential health insurance terms is crucial when selecting India’s best health insurance policy. Familiarising yourself with these terminologies will prove invaluable in the long run, enabling you to make informed choices for yourself and your family.


When securing comprehensive health coverage in India, consider exploring Niva Bupa Health Insurance. They offer a range of policies tailored to your needs. Be sure to visit their official website today to discover how Niva Bupa can provide the protection and peace of mind you and your loved ones deserve.

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