Generally, once you have submitted the proposal form and medical tests if required and made payment, you receive your policy by email within 2 working days and another 2- 3 days for the hard copy through courier. The health cards may take longer as they are sent directly by the TPA and it may take about a month. If you still do not receive the cards, do send us a mail so that we can follow up with the insurance company.
First Premium Receipt is an evidence of adjustment of premium & acceptance of risk but then once the Policy is issued which is the evidence of contract, FPR becomes irrelevant. But then it is always advisable to have FPR also along with Policy document which can be showed as a proof, in case the Policy document is lost.
Yes. But each company will pay its rateable proportion of the loss, liability, compensation, costs or expenses. E.g. If a person has Health Insurance from company X for Rs. 1 Lac and Health Insurance from company Y for RS. 1 Lac, then in case of a claim, each policy will pay in the ratio of 50:50 up to the SI.
The benefit of carrying the Health Card is that you and your family members get access to the cash less facility from the TPA’s network of hospitals. This means you can walk into any of the networked hospitals across the country and get treated without having to pay for your bills first and then claim form us. If you do not get admitted to a networked hospital, your expenses will be reimbursed within 7 days of receipt of complete documents from you. Also in the event of any unforeseen accident a third party can identify your Insurance Company and your family can be intimated.
A. In case you are in an emergency situation, TPA can search your details based on the following: Name, Address, Date of Birth Insurer Underwriting Office Code
You can renew your health policy only within 15 days of expiry of the previous policy(asper IRDA regulation).The company may at its discretion allow renewal within a maximum of 60 days from the expiry of the previous policy. As already four years have passed since the expiry of your policy, you need to purchase a new health insurance plan.
Some insurance companies allow mid term inclusion of infants once they are three months old while the others allow inclusion of members only at the time of renewal.
As per standard norms the insured shall be entitled to reimbursement of medical cost once in every four underwriting years subject to no-claim during this period. The cost shall not exceed 1% of sum insured during the block of four years.
The sum insured is increased by 5% for each claim-free year of insurance subject to a maximum accumulation of 50% during ten years.
In the event of a claim, the increased percentage of the Sum Insured will be reduced by 10% on next renewal but the basic sum insured will remain the same.
Yes, a discount is allowed in the total premium in the total premium to a family comprising the insured and any one or more of the following- ? Spouse ? Dependent children ? Dependent parents
1 Take admission into the hospital. 2 As soon as possible, inform TPA about the hospitalization 3 At the time of discharge, settle the hospital bills in full and collect all the original bills, documents and reports. 4 Lodge the claim with TPA for processing and reimbursement by duly filling in the claim form & enclosing all original bills/vouchers/receipts.
1 Inform TPA about the planned hospitalization. 2 Get admitted into the hospital as planned. 3 At the time of discharge, settle the hospital bills in full and collect all the bills, documents and reports. 4 Lodge the claim with TPA for processing and reimbursement by duly filling in the claim form & enclosing all original bills/vouchers/receipts.
Most of the companies do not cover maternity and related conditions but some companies like Apollo Munich, Max Bupa have specific plans which cover maternity after specified waiting periods generally 2-4 years.For details please visit our health page.
Yes, the insured can cancel the policy at any time. In such a case, the company shall allow a refund of premium at company’s short period rate(given below provided no claim has occurred during the policy period up to cancellation. Period of cover up to Rate of premium to be charged 1 month ¼ of the annual rate 3 months ½ of the annual rate 6 months ¾ of the annual rate  More than 6 months Full annual
1. If there is any doubt in the coverage of treatment of present ailment under the Policy 2. If the information sent to TPA is insufficient to confirm coverage 3. If the ailment/condition is not being covered under the policy 4. If the request for pre-authorization is not received by TPA in time In such a situation, the Insured can take the treatment, pay for the treatment to the hospital and after discharge, send the claim to TPA for processing.
In case of treatment in a non-network hospital, TPA will reimburse you the amount of bills subject to the conditions of the policy taken by the insured. The insured must ensure that the hospital where treatment is taken fulfils the conditions of definition of Hospital in the Mediclaim policy. TPA should be contacted within 7 days from the time of admission with the following documents in original: 1 Claim Form duly filled and signed by the claimant 2 Discharge Certificate from the hospital 3 All documents pertaining to the illness starting from the date it was first detected i.e. Doctor's consultation reports/history 4 Bills, Receipts, Cash Memos from hospital supported by proper prescription 5 Receipt and diagnostic test report supported by a note from the attending medical practitioner/surgeon justifying such diagnostics. 6 Surgeon's certificate stating the nature of the operation performed and surgeon's bill and receipt 7 Attending doctor's / consultant's / specialist's anesthetist's bill and receipt, and certificate regarding diagnosis 8 Certificate from the attending medical practitioner / surgeon that the patient is fully cured 9 Details of previous policies if the details are not already with TPA except in the case of accidents
You can call the helpline number of your TPA or check on their site using your Policy number or member id. Helpline numbers and links for TPA website are available on our website.
Normally, part payments are made due to deficiency of documents or for expenses which are not covered under the policy. In case of the former if the requisite documents are made available, the claim may be considered.
Yes, the claim, which is not covered under the policy conditions, can be rejected. In case you are not satisfied by the reasons for rejection, you can represent to the insurer within 15 days of such denial.
The entire amount of the claim is payable, if it is within the Sum Insured and is related with the in-house treatment as per policy conditions and is supported by proper documents, except the expenses which are excluded.
Kindly check the plan benefits and policy wordings.
The claim has to be submitted directly to the TPA for timely settlement.
Yes it is possible to shift to another hospital for reasons of requirement of better medical procedure.However, this will be evaluated by the TPA on the merits of the case and as per policy terms and conditions.
Following documents are required for processing the claims on reimbursement basis: 1. Claim Form properly filled and signed by the claimant 2. Discharge Certificate from the hospital 3. All documents pertaining to the illness starting from the date it was first detected i. Bills, Receipts ii. Cash Memos from hospital supported by proper prescription iii. Receipt and diagnostic test report supported by a note from the attending medical practitioner/surgeon justifying such diagnostics. Surgeon's certificate stating the nature of the operation performed and surgeon's bill and receipt iv. Attending doctor's / consultant's / specialist's / anesthetist's bill and receipt, and certificate regarding diagnosis v. Certificate from the attending medical practitioner / surgeon that the patient is fully cured 4.  Details of previous policies : if the details are not already with TPA except in the case of accidents
All bills in original and a discharge certificate are to be left with the hospital providing cashless treatment The patient has to countersign all bills and fill the claim form and also leave the same with the hospital at the time of discharge. A copy of the bills & Discharge Summary can be carried by the patient for his records and for submission along with Pre & Post Hospitalization bills.
1 A 24 X 7 assistance to all policy holders through toll free number of the TPA 2 Online assistance during hospitalization and filing of claim documents 3 Assistance in providing Ambulance Services during Emergency 3 Enrollment Card against your policy, which would give you access to TPA services. 4 Cash Less service facilitation at network hospitals up to limit authorized by Mediclaim / Hospitalization Insurance 5 Claims Processing and Reimbursement for non-network hospitals 6 Other services as defined by your Employer / Insurer
For this as per IRDA guidelines, a policyholder should apply to the insurance company at least 45 days before the premium renewal date of the existing policy. And the policyholder has to fill in the portability form (provided by the insurer) along with proposal form and submit it to the insurance company. The insurer shall communicate its decision to the requesting policyholder within 15 days of providing all the details required by the insurer and if the insurer does not communicate its decision within 15 days, it shall not retain the right to reject such proposal.
Yes, with the launch of health insurance portability from 1st October , 2011, you can switch from group health policy to individual or family floater with the same insurer and after one year, you can avail portability as applicable for other individual or family floater policies.
If the primary insured person expires, the other Insured Persons may apply to continue the Policy within 30 days of his/her death provided that they have identified a new adult policyholder who is a member of their immediate family. All relevant particulars in respect of such person (including their relationship) must be given to the company along with the application. If the company accepts such application, then the Policy shall be treated as having been renewed without any break in cover. Migration from family floater to individual may be allowed on acceptance of proposal by the company.
Yes, you can buy health insurance policy from one company and a top up plan from another. Just make sure that your main policy has sum insured equal to the threshold level of top up plan.
During the period of insurance cover, the expenses on treatment of certain diseases such as cataract, hernia,piles, sinusitis, benign Prosthetic Hypertrophy, Hysterectomy for Menorrhegia or Fibromioma etc. for specified periods (Please refer to your policy document for details) are not payable if contracted and/ or manifested during the currency of the policy.
Some general exclusions under this policy are: 1 Pre-existing diseases i.e. Any condition, ailment or injury or related condition(s) for which insured person had signs or symptoms and/or was diagnosed and/or received medical advice/treatment within 48 months prior to his/her health policy with the company. Pre existing diseases will be covered after a maximum of four years since the inception of the policy 2. Any disease contracted during the first 30 days of inception of policy except in case of injury arising out of accident 3. Certain diseases such as cataract, piles, hernia, and sinusitis etc. are excluded for specified periods if contracted or manifested during the currency of the policy. 4. Injury or Diseases directly or indirectly attributable to War, Invasion, Act of Foreign Enemy, War like operations. 5. Cosmetic, aesthetic treatment unless arising out of accident. 6. Cost of spectacles, contact lenses and hearing aids 7. Dental treatment or surgery of any kind unless requiring hospitalization 8. Charges incurred at Hospital or Nursing Home primarily for diagnostic, x-ray or laboratory examinations, without any treatment. 9. Naturopathy or other forms of local medication 10. Pregnancy & childbirth related diseases 11. Intentional self-injury / injury under influence of alcohol, drugs 12. Diseases such as HIV or AIDS 13. Expenses on vitamins and tonics unless forming part of treatment for disease or injury as certified by the attending physician. 14. Convalescence, general debility, run-down condition or test cure, congenital external diseases or defects or anomalies, sterility, venereal disease
You can change the address by giving a request letter to the insurance company on plain paper and the insurance company will pass the endorsement and give a copy of same to you. Kindly remember to send same to your TPA also so that they can incorporate same in their records.
If you are not satisfied with the terms & conditions of the Policy or the benefits which appears in the policy are not the same which was explained to you by the intermediary, you have an option to cancel the policy within 15 days from the date of receipt of Policy document ( free look period) & get back your money less the taxes and medical cost if any, borne by the Insurer in case of Non linked Policy & Fund value less taxes and medical cost in case of Unit linked Policy.
As Policy document is the evidence of contract and it also mention about the beneficiary details, for all kind of benefit payments the policyholder has to submit the original policy document to the Insurer’s office. Moreover it is required for necessary endorsement related to Nomination, Assignment, mortgage etc. In case of lost policy, you have to apply to your Insurer for a duplicate policy.
If you are not satisfied with the terms & conditions of the Policy or the benefits which appears in the policy are not the same which was explained to you by the intermediary, you have an option to cancel the policy within 15 days from the date of receipt of Policy document ( free look period) & get back your money less the taxes and medical cost if any, borne by the Insurer in case of Non linked Policy & Fund value less taxes and medical cost in case of Unit linked Policy.
First Premium Receipt is an evidence of adjustment of premium & acceptance of risk but then once the Policy is issued which is the evidence of contract, FPR becomes irrelevant. But then it is always advisable to have FPR also along with Policy document which can be showed as a proof, in case the Policy document is lost.
As Policy document is the evidence of contract and it also mention about the beneficiary details, for all kind of benefit payments the policyholder has to submit the original policy document to the Insurer’s office. Moreover it is required for necessary endorsement related to Nomination, Assignment, mortgage etc. In case of lost policy, you have to apply to your Insurer for a duplicate policy.
You have to make a FIR with local PS giving reason of loss of Policy, since when it is noticed & simultaneously have to advertise in local Newspaper. Along with the copies of FIR & advertisement, you have to apply to the Insurer’s respective Branch office along with a nominal fees. If the Insurer is satisfied that the reason of loss is a genuine & there is no attempt of fraud, they will issue the Policy.
These requirements depend on the Sum Assured & left out period of the Policy term. Insurer may waive off these requirements. e.g, if SA is small or the duplicate policy request is in the last year of Policy period before maturity.
Age is extremely vital for acceptance of a Proposal. In case the age is not correct, it is immediately to be brought to the notice of Insurer for them to take a corrective action.
They may declare the Policy null & void i.e. Cancel the policy , may ask for medical check up or additional special reports, may revise the premium or alter the terms & conditions of the policy by offering alternate plan/term/SA or restrict the benefits.
See, under Non linked ( traditional ) policies, Insurer do allows grace period of 30 days for Annual/Half yearly/Quarterly mode of premium & 15 days for monthly mode of premium. If the premium is not paid even within grace period, the Policy lapses. Since you have not paid the premium since long it will depend on the current status of your Policy whether payment of back log premium is possible or not.
You can visit to the website of your Insurer for online services or call them on toll free number (IVRS i.e. voice call ) which is mentioned on the Policy document. After verifying your identity, they may share your Policy status.
Alternative is, please check the last premium due date paid. First unpaid premium will be Last due paid + Mode e.g, if Last premium paid is June 2015 & mode is yearly then FUP is June 2016. Since it is more than 1 month & grace period is over, it is a lapsed policy. But then since it is within 6 months, you can pay the arrear premium along with interest & a simple declaration of good health form. The Policy will be brought back to in force provided there is no adverse feature in your DGH. If there is any adverse feature, then Insurer may ask for medical report special report etc & decide accordingly.
Yes it can be revived under different scheme of revivals like Special revival scheme, Loan cum revival, Instalment cum revival & Survival cum revival scheme. But it can not be revived if the Policy is lapsed for more than 5 yrs.
In case of Non-linked ( Endowment) Policy, if the Premium is paid for at least 3 yrs & subsequent premium is not paid , the policy becomes paid up & the paid up value is payable on maturity or on death. The paid up policy will not participate into any further benefits. If it is Term or Risk Policy , the premium paid gets forfeited. In case of Unit linked Policy, the risk premium is adjusted out of fund value. Even though, the premium/contribution not paid, if the fund is sufficient to cover up Risk premium & other charges the Policy remains in force.
The paid up value is calculated as follows; PV = No of Yrs premium paid/No of yrs premium payable (PPT) * Sum Assured. Bonus, if any already vested will be attached is this.
Yes you can do that by surrendering the Policy applying to Insurer along with Original Policy document.
Surrender value will be a certain % of Paid up value. Depending on the time period of surrender from the date of commencement , the % will change. Within 1 st three yrs the % is nil. Higher the duration higher will be the % of SV factor. In case of Unit linked Policy, the surrender value is Fund value less surrender charges. However, surrender charges after 5 yrs of policy period is nil.
Nomination facilitates to receive death claim amount. In absence of nomination, the Insurer will go by the law of succession certificate or Probate of will if any. In case, you have someone who have insurable interest on you ( like wife, son, daughter, parents etc ), you can register nomination immediately to avoid legal complication which is time consuming at the same time cost bearing.
Other than Insurance Policy, you must be leaving behind other properties/assets of yours. In that case, Insurer will go by the Court verdict which will permit simultaneously for other properties/assets of yours.
Yes you can change nomination by sending a request letter to Insurer along with Original Policy document. Insurer will change the Nomination by an endorsement on Policy document.
Yes you can make multiple nomination.
Yes you can assign the policy if you are competent & have rights & title to deal with the policy.
You can assign the policy in favour of Insurer or Bank Against a loan or you can gift it to someone against some consideration which can be love, affection or monetary consideration.
If it is against a Loan favouring Insurer or Bank etc, where assignment is of conditional nature, you have to pay premium but claim benefits will go to the lender to adjust loan amount. If the assignment is absolute, then premium will be paid by the assignee & assignee or his survivor will be eligible for the claim benefits.
This is for information only Endowment type of Policy is eligible for loan. Therefore, TERM/Risk Policy, Unit linked Policy, Annuity Policies & even some endowment policies like Money back are not eligible for loan.
Eligible Loan amount is up to 90% of Paid up value inclusive of Bonus, if any at any point of time.
You can repay the Loan principal along with interest under half yearly mode of payment.
If you do not or can not repay the Loan principal , you can only pay the interest . But then, even if you can not pay interest but you continue paying regular premium, the outstanding Loan amount inclusive of interest will be adjusted out of final claim amount. if neither the regular premium nor the principal & interest are paid & if the outstanding Loan amount exceeds the paid up value, the Policy will be foreclosed ( force-surrendered).
If you see the Policy document date of maturity is mentioned in the schedule. Moreover, as a general practice, Insurer send intimation normally in advance of 2 months prior to maturity date.
Once, you receive the intimation, you need to sign the discharge voucher giving there in details of your Bank account for direct credit of amount. You also need to submit the Original Policy document along with signed discharge voucher to the Insurance office.
In a Money back Policy, there is a provision of instalment benefit payable at regular interval depending on the Term of the Policy. Amount of benefit per instalment is a certain % of Sum Insured which normally varies from 10% to 30%.
You are entitled to get Sum Insured +Bonus less the Instalment benefit already received on maturity date.
In case of your unfortunate death, your beneficiary will be eligible to receive full Sum Insured +Bonus up to the date of death without any adjustment of installment benefits already paid to you.
Normally, if the premium is not paid within grace period, policy lapses. But then, in this case, you will get full death benefit less the due premium amount & interest.
Some Insurer do consider these cases under concession claim. They honour the claim if death happens within 6 months / 1 year from the date of lapse provided the policy has run for atleast 3 yrs / 5 yrs respectively but after adjustment of due premium & interest from the claim amount.
If death happens within 2 yrs from the date of commencement of Policy, Insurer consider the case as Early claim & ask for additional information & investigate the case to justify there was no fraud. If they are satisfied, you can get the death benefit.
The following documents are required to be submitted to Insurer office. 1. Intimation of death from any one. 2. Death certificate in original 3. Original Policy document 4. Discharge form In addition may ask for Last Medical attendants report, hospital report, certificate of cremation or burial etc. if death is due to accident following additional documents will be required: 1. FIR 2. Panchnama of accident site 3. Police Final report 4. Post mortem report 5. Hospital reports
As per Indian Evidence Act, if a person is missing for more than 7 yrs, it is presumed as death. If the beneficiary represent the case to Court, the Judge may award a decree as presumption of death. But to be entitled for death benefit, the Policy premium should have been paid by the nominee/beneficiary till the date of Decree. However, Insurer may waive off the premium & consider the case.
Yes since he has died before maturity date, this will be considered as death claim & if ADB rider is there in the Policy, you will be entitled for twice the Sum Assured.
Death benefit will be Sum Assured + Bonus less O/S Loan amount for In force Policy or Paid up amount + added bonus, if any , less O/S Loan amount in case of Paid up Policy.
Please call the Insurer office & asked them to know the status of your claim stating the Policy No or Claim Acknowledgement No mentioned in Receipt. In case of genuine delay the Insurer will pay you interest @ 2% above Bank Interest Rate.
You can write to the Ombudsman office along with all correspondence & amp; documents. Ombudsman office details are mentioned at the bottom of the Policy document.
In a Unit linked Policy, the balance amount after adjusting Risk premium & amp; different charges out of Total premium paid get unitized & amp; the market value of the same reflects in Account balance.
Under a Unit linked Policy, normally the charges are Risk premium , Policy administration, Fund Switching Charge, Fund management fees. Beside this there are Surrender charges & Service Taxes.
Unit linked Policy is market-linked & the risk is borne by Policy holder. There is no guarantee of return.
It depends on the Policy condition but mostly the amount payable under a Unit linked Policy is Sum Insured or Fund value whichever is higher.
Unlike Traditional Policy where premium has to paid every year, in a Unit linked Policy even you can skip not paying annual premium. If premium is not paid no allocation of unit will be added to the Fund for that period but some units will be deducted for other charges in the policy. This is called Premium Holiday.
There are two type of Pension Policy 1. Deferred Pension Policy 2. Immediate Pension Policy Under a deferred Pension Policy, premium is paid till the term of the Policy & then the Pension payment starts thereafter. In many Policies Pension amount may be mentioned on the Policy itself else the Pension amount will depend on the accumulated value against premium paid & pension rate at that time. Under immediate Pension Plan, the pension amount depends on the purchase amount & type of pension selected.
If Policyholder dies during term of the Policy, the Sum Insured will be used to purchase pension as per pension type that will be selected by the nominee, provided the Policy was in force at the time of death.
Deductible or “excess†is the amount over and above, which the claim will be payable. There is a normal standard/compulsory excess for most vehicles ranging from Rs 50 for two-wheelers to Rs 500 for Private Cars and Commercial Vehicles which increases depending upon the cubic capacity/carrying capacity of the vehicle. However, in some cases the insurer may impose additional excess depending upon the age of the vehicle or if there is high frequency of claims.
Normally there are 6 type of Pension which are mentioned in the Policy document such as; a. Life Pension ceasing on death b. Life Pension with return of capital c. Joint Life Pension with 100% pension to the spouse d. Joint Life Pension with 50% pension to the spouse e. Pension certain for 5 yrs, 10yrs, 15 yrs, 20yrs & 25 yrs & Life thereafter f. Joint Life Pension with return of capital on death of 2 nd life.
See all Pension options are good but then depending on your future requirement, you can decide a particular option. However, the Pension amount will vary according to the choice of the Pension type. e.g. If someone does not have any dependant they normally prefer Life Pension here the Pension amount is highest. Alternately, if someone wants his spouse or dependant may need liquid cash in his absence they normally prefer Life Pension with return of cash. Or if someone thinks, in his absence his spouse should have a regular income during his/her lifetime then option c or d is preferable. Pension quantum is lowest in option “e†but then the Pension is guaranteed for the entire certain period so selected and then even thereafter if alive.
Once the full premium is paid till the Term & the Pension vest, you are entitled to get 1/3 rd of total value as commutation balance 2/3 rd will be used for Pension purchase. Under immediate Pension Plan, once pension starts you can’t withdraw cash.
If you are not satisfied with the terms & conditions of the Policy or the benefits which appears in the policy are not the same which was explained to you by the intermediary, you have an option to cancel the policy within 15 days from the date of receipt of Policy document ( free look period) & get back your money less the taxes and medical cost if any, borne by the Insurer in case of Non linked Policy & Fund value less taxes and medical cost in case of Unit linked Policy.
As Policy document is the evidence of contract and it also mention about the beneficiary details,for all kind of benefit payments the policyholder has to submit the original policy document to the Insurer’s office. Moreover it is required for necessary endorsement related to Nomination, Assignment, mortgage etc. In case of lost policy, you have to apply to your Insurer for a duplicate policy.
You have to make a FIR with local PS giving reason of loss of Policy, since when it is noticed & simultaneously have to advertise in local Newspaper. Along with the copies of FIR & advertisement, you have to apply to the Insurer’s respective Branch office along with a nominal fees. If the Insurer is satisfied that the reason of loss is a genuine & there is no attempt of fraud, they will issue the Policy.
These requirements depend on the Sum Assured & left out period of the Policy term. Insurer may waive off these requirements. e.g, if SA is small or the duplicate policy request is in the last year of Policy period before maturity.
All the information must match with your details in RC book including CC, make model, sub type, fuel type, seating capacity (very important) etc.
Points are: IDV is reduced by a minimum of 10% from last year, Vehicle Registration No. is correct; Premium is less than the last year (If you have not made any claim.) NCB (If applicable) is more than last year’s NCB. (Maximum 50%) Sometimes the Third Party insurance premium may get revised. This is very rare and it may cause the premium to go up.
Ideally the company that has a cashless tie-up with the widest network of service stations that you may visit in case of an accident. Secondly, the company which offers you the best rate without any excess on it. Above all, choose a company that has a good and fastest claim settling ratio and record.
The following information needs to be furnished while intimating a claim:Â 1 Name of Insured person who is sick or injured 2 Nature of Sickness/Accident 3 Contact Numbers 4 Policy Number (as reflecting on the Health Card) 5 Date & Time in case of accident, commencement date of symptom of disease in case of sickness 6 Location of accident
A. All the companies offer 1. Different discounts, 2. Different P.A. cover and 3. Different IDV. It is the reason of difference in premium amounts for all the insurance companies. 1. Different discount: - This mainly depends upon the claims experience of a particular company. If claims experience is good then they will offer higher discount and if claims experience is bad then less discounts are offered. 2. PA (Personal Accident): - PA cover premium will not differ from company to company but it is an optional cover you need to choose the amount how much you want to cover. Eg. One company will offer Rs. 100 as a premium and other company will offer Rs. 250 as a premium. 3. IDV: - Major factor influencing will be IDV. But be very careful, many companies reduce IDV a lot, reduced IDV means your premium will be reduced. Most important point here is at the time of claim insurance company will also have to pay less for your vehicle. (It should be reduced every year by 10% minimum to 20% maximum.) Always keep your IDV on higher side, it helps 1) During claims. 2) At the time of selling car.
If you don’t make any insurance claim on your vehicle then you are eligible for a No Claim Bonus (NCB). This is a discount on your premium for the coming year and is calculates as under: - 1st year – 0% in Own Damage premium amount 2nd year – 20% in Own Damage premium amount 3rd year – 25% in Own Damage premium amount 4th year – 35% in Own Damage premium amount 5th year – 45% in Own Damage premium amount 6th year – 50% in Own Damage premium amount
A Deduction for depreciation on various parts is calculated as under: - For all rubber/nylon/plastic parts/tyres/tubes, batteries & air bags – 50% For fibre glass components – 30% For all parts made of glass – 0% Rate of depreciation for all other parts including wooden parts will be as per age of the vehicle as follows; 7th month to 1st year – 5% 1st year to 2nd year – 10% 2nd year to 3rd year – 15% 3rd year to 4th year – 25% 4th year to 5th year – 35% 5th year to 10th year – 40% More than 10 year – 50%
Excess means the amount that will be deducted by the insurance company before making the payment to insured. There are two types of excesses. First one is compulsory which depends upon the C.C. (cubic capacity)of the vehicle and which cannot be removed from insurance policy. The second is a voluntary excess, which is given to you for reducing the premium in the policy. This is not a recommended option to avail, since it reduces the insurance claim payout if its needed. Never agree for higher excess.
Vehicle replacement cost or Vehicle repairing cost is paid if you have opted for this cover in your policy.
In case of an accident where the repair cost is more than 75% of car value (IDV), then insurance company will scrap the vehicle and pay the insurer the entire value of the vehicle.
If you have not reduced the car value every year minimum by 10% from last year’s IDV, then your insurance company will not pay the IDV. If you have increased the car value without any valid reason than also insurance company will not pay the entire IDV.
In case of an accident, third party property damage and third party life damage is compensated.
Nothing. If you have valid insurance documents then entire loss is paid by insurance company and you don’t have to spend a single penny from your pocket.
No. once you handover the court case and papers to insurance company then they take over the case. You may however need to go once to court.
No, not at all. The premium you pay covers for potential mistakes on your side.
Under third party cover there is a clause called Unnamed Passenger PA (personal accident) cover. If you have opted for this cover (which is available on extra premium of maximum Rs. 100/- per person for a coverage of Rs. 2,00,000/-) then there is compensation payable to the family members in case of death. There is no cost of medical bills or any expenses payable to the injured passengers. Currently there are no options (products) for getting this covered through vehicle insurance.
Yes. The entire expenses are paid under TP(Third Party) policy, if there is a police case, you don’t have to opt for any special policy. Unlimited medical expenses are paid under TP policy.
Entire IDV minus excess is paid.
If you have not reduced the car value every year minimum by 10% from last year’s IDV, then your insurance company will not pay the IDV. If you have increased the car value without any valid reason, then also insurance company will not pay the entire IDV.
Yes. If there is a theft and you make a claim, you lose the NCB.
There are lots of documents which have to be submitted in case of theft insurance. (Approximately number = 18). Post submission of all those documents, you will be required to submit a "Final Investigation Report (FIR)". This is usually issued by/from police station after approx 3 months of the theft. The claim is paid one month after the submission of the FIR.
There is no grace period in Motor insurance. The NCB savings will elapse after 3 months.
For third party it does not matter. But it’s mandatory for comprehensive insurance.
Yes. Your car carries the NCB; every company has to accept it.
When you sell your car, you have to submit Form 29 & 30 to insurance company, which has information about buyer and seller including their signatures. This verifies that you have sold your car. Company then issues a No Claim Bonus Certificate which can be used on your new car.
It depends on a case to case basis. If a tree fell on the car and destroyed it, you can get full IDV back without an FIR.
Yes, you will be eligible for the claim even after the expiry of the policy date. This is because the event took place during the policy period.
In case you file a claim for any kind of damages during the insured period, at renewal, you will loose all the NCB that you have accrued over the years.
Kindly go through the list of garages where you can avail of the cashless service.
In the event of no claims, you would avail of the 'NO CLAIM' bonus, i.e., there would be a reduction of for payment of premium on renewal. If you do not make any claim over a period of time, a No Claim Bonus (NCB) is offered on renewals. This discount can go as high as 50%. However, if there is any claim, the discount (NCB) will be zero for the next renewal.
If there are any changes in the policy like change of address or modifications to the vehicle or its use, it will be done by an Endorsement by the insurance company. Submit a letter to the insurer with proof for the changes and obtain the endorsement. Some endorsements may require you to pay additional premium. Check the correctness of the endorsement.
As per Rule 141 of Central Motor Vehicle Rules 1989, a certificate of Insurance is to be issued only in Form 51. It is only in Motor Vehicle Insurance, apart from the policy, that a separate certificate of insurance is required to be issued by insurers. This document should always be carried in the vehicle. The policy should be preserved separately at home / office.
If a CNG / LPG kit is fitted in the vehicle, the (Road Transport Authority (RTA) office where the vehicle was registered should be informed so that they make a note of the change in the registration certificate (RC) of the vehicle. The insurance company should also be informed so that the kit is covered on payment of extra premium on the value of the kit under “OD†section and also under “LO†section.
Documents are : • Certificate of Insurance • Xerox copy of Registration Certificate • Pollution Under Control Certificate • Photocopy of Driving Licence of person who is driving the vehicle
Yes, the insurance can be transferred to the buyer of the vehicle, provided the seller informs in writing of such transfer to the insurance company. A fresh proposal form needs to be filled in. There is a nominal fee charged for transfer of insurance along with pro-rata recovery of NCB from the date of transfer till policy expiry. It may be noted that transfer of ownership in comprehensive/package policies has to be recorded within 14 days from date of transfer failing which no claim will be payable for own damage to the vehicle.
No. Registration and insurance of the vehicle should always be in the same name with the same address. Otherwise the claim is not payable. A fresh proposal form needs to be filled in. There is a nominal fee charged for transfer of insurance.
Yes, please approach the same office, which had issued the policy, with a written request. A nominal fee is charged for issuing a duplicate policy copy.
A claim under a motor insurance policy could be ? For personal injury or property damage related to someone else. This person is called a third party in this context) or ? For damage to your own, insured, vehicle. This is called an own damage claim and you are eligible for this if you are holding what is known as a package or a comprehensive policy. Third Party Claim In a third party claim, where your vehicle is involved, it is important to ensure that the accident is reported immediately to the police as well as to the insurance company. On the other hand, if you are a victim, that is, if somebody else’s vehicle was involved, you must obtain the insurance details of that vehicle and make an intimation to the insurer of that vehicle. Own Damage Claim In the event of an own damage claim, that is, where your own vehicle is damaged due to an accident, you must immediately inform insurance company and police, wherever required, to enable them to depute a surveyor to assess the loss. Do not attempt to move the vehicle from the accident spot without the permission of police and the insurance company. Once you receive permission for removal of the vehicle and for repairs, you can do so. If your policy provides for cashless service, which means you do not have to pay out of your pocket for covered damages, the insurance company will pay the workshop directly. In either of these situations, you must intimate the insurance company immediately. Theft ClaimIf your vehicle is stolen, you must inform the police and the insurance company immediately. In addition you must keep the transport department also informed. As soon as you receive the policy document, read about the procedures and documentation requirements for claims rather than wait for a claim to arise. If you have to make a claim, ensure that you collect all the required documents and submit them along with the requisite claim form duly filled in, to the insurance company. There may be certain specific documentation requirements for specific types of claims. For instance in respect of a theft claim, there is a special requirement that you should surrender the vehicle keys to the insurance company.
Incidents such as "Third Party Property Damage", "Bodily Injury To Self or Third Party" or "Theft" should be reported to the nearest police station, under whose jurisdiction the incident has occurred.
If the person driving the vehicle is a valid license holder, the vehicle is insured for all the accidents that occurred due to the hazards specified. To insure the person driving the vehicle, who is not the owner, an additional personal accident cover has to be taken for unnamed passengers. For the owner-driver, the policy compulsorily has a personal accident cover, as per tariff.
If you have taken a comprehensive policy for your vehicle you are fully covered against all the hazards mentioned, irrespective of whether the other person has an insurance policy or not.
In case of own damages claim following documents are required: ? Claim form duly signed ? Valid R.C. copy of the vehicle ? Valid driving license copy ? Policy copy (First 2 pages only) ? FIR if required (For Theft, Third party Injury / Damage; Highway accidents-Major only). ? Original repair bill, proof of release and cash receipt.
If you have taken a comprehensive policy for your vehicle you are fully covered against all the hazards mentioned, irrespective of whether the other person has an insurance policy or not.
You can take super top up plan and increase your sum insured to desired level.
To obtain a visa for some countries, overseas travel insurance is compulsory.
Even where it is not, it is prudent to obtain a travel insurance policy when you are travelling on business or holiday or for education, research etc as medical treatment costs in many countries are much higher than what they are in India and are unaffordable.
In most cases it would be. Normally, such policies are meant for travellers who visit other countries on business or holiday or education or other purposes and not for those residing permanently abroad.
To obtain a visa for some countries, overseas travel insurance is compulsory.
Even where it is not, it is prudent to obtain a travel insurance policy when you are travelling on business or holiday or for education, research etc as medical treatment costs in many countries are much higher than what they are in India and are unaffordable.
In most cases it would be. Normally, such policies are meant for travellers who visit other countries on business or holiday or education or other purposes and not for those residing permanently abroad.
The Insurance is valid from the 1 st day of Insurance or date & time of departure from India whichever is later and expires on the last day of the number of days specified in the policy schedule or return to India whichever is earlier.
The Policy will be valid only if the journey commences within 14 days of issuance date of Policy.
There is an automatic extension of 7 days period without any charge, if necessitated by delay of public transport services beyond the control of insured person.
In case your travel doesn’t take off and you show proof of the same, policies would normally provide for premium refund subject to deductions towards administrative costs. Where travel is cut short, policies may or may not allow refund subject to certain conditions.
It covers the following benefits: 1. Medical expenses & repatriation 2. Personal Accident 3. Loss of checked Baggage 4. Delay of checked Baggage 5. Loss of Passport 6. Personal Liability
A. No, certain expenses are not covered as in below; 1. treatment that could reasonably be delayed until return to India 2. cosmetic surgery unless as a result of accident 3. routine physical examination 4. Pregnancy related expenses including childbirth, miscarriage, abortion or any complication.
Air transportation expenses or up to an equivalent amount for a local burial or cremation in the country where the death occurred.
No claim will be paid in cases: 1. Where the insured person is travelling against the advice of the Physician, is travelling to obtain medical treatment, is on waiting list for a medical treatment, has a terminal prognosis of a medical condition. 2. Suicide, attempted suicide, venereal disease, HIV etc 3. Arising due to taking part in Naval, Military, Air force operations, Aviation, Professional sports or hazardous sports.
Formalities for making a travel insurance claim A travel insurance policy is generally a package policy that includes different types of covers like hospitalisaiton, personal accident, loss/ damage to baggage, loss of passport and so on. The procedure and documents required for a claim would vary from cover to cover. All of them would be mentioned in your policy document. For ease of procedure and your convenience, insurers normally attach the claim form with the policy document. This will contain the list of documents required in case of a claim and also the contact details including phone numbers of the claims administrator either in the destination country to which you are travelling or in another country that is designated to receive and process your claim intimation.
Liability for damages even though faults or negligence cannot be proven.
Absolute ownership exists where the interest or explicit right of possession of the insured is so free from limitations, qualifications or restrictions that it cannot be taken from him without his consent.
A brief history of title to land.
Acceptance of Risk is a method of assessment of risk in a Proposal by an underwriter to decide whether to accept the risk or not and if to accept at what terms & condition.
A percentage of the policy’s face amount discounted for interest that can be paid to the insured prior to death, under specified circumstances. This is in lieu of a traditional policy that pays beneficiaries after the insured’s death. Such benefits kick in if the insured becomes terminally ill, needs extreme medical intervention, or must reside in a nursing home. The payments made while the insured is living are deducted from any death benefits paid to beneficiaries.
An event or occurrence causing damage/injury to an entity and is unforeseen and unintended.
Injury to the body as the result of an accident.
Accidental Death or injury arising out of the use of a motor vehicle(s) the identity whereof cannot be ascertained in spite of reasonable efforts for the purpose.
Baggage being taken by someone with his own person whilst travelling.
Percentage addition to policy benefits as a reward to the insured for continuous renewal.
The insurer's cost of putting a new business in force, including the agent's commission, the cost of clerical work, fees for medical examinations and inspection reports, sales promotion expense, etc.
An endorsement that pays the beneficiary an additional benefit if the insured dies from an accident.
Indemnifies for losses that are due to an inability to collect from open commercial account debtors because records have been destroyed by an insured peril.
Perils that cannot reasonably be guarded against, such as floods and earthquakes.
A form of insurance that pays damages equal to the replacement value of damaged property minus depreciation.
The ratio of losses incurred to premiums earned actually experienced in a given line of insurance activity in a previous time period.
Assumptions about rates of investment earnings, mortality, turnover, salary patterns, probable expenses, and distribution or actual ages at which employees are likely to retire.
Methods for computing how much money must be contributed each year to fund pensions.
An insurance professional skilled in the analysis, evaluation, and management of statistical information. Evaluates insurance firms reserves, determines rates and rating methods, and determines other business and financial risks.
Persons who have an insurable interest in the property/person covered in a policy and who are covered against the losses outlined in the policy. They usually receive less coverage than the primary named insured.
Extra charges covered by homeowners policies over and above the policy-holder’s customary living expenses. They kick in when the insured requires temporary shelter due to damage by a covered peril that makes the home temporarily uninhabitable.
An individual employed by a property/casualty insurer to EV adjusters differ from public adjusters, who negotiate with insurers on behalf of policyholders and receive a portion of a claims settlement. Independent adjusters are independent contractors who adjust claims for different insurance companies.
An insurance company licensed and authorized to do business in a particular state or country.
The tendency of those exposed to a higher risk to seek more insurance coverage than those at a lower risk. Insurers react either by charging higher premiums or not insuring at all. In the case of natural disasters, such as earthquakes, adverse selection concentrates risk instead of spreading it. Insurance. works best when risk is shared among large numbers of policyholders.
Selling insurance through groups such as professional and business associations.
An agreement between an insurance company and an agent, granting the agent authority to write insurance from that company. It specifies the duties, rights, and obligations of both parties.
To make the existing risk worse, more troublesome, etc.
The policy which undertakes to pay a specified amount in case of total loss. Under this case, the policy does not take into account the current market value.
Insurance is sold by two types of agents: independent agents, who are self-employed, represent several insurance companies and are paid on commission, and exclusive or captive agents, who represent only one insurance company and are either salaried or work on commission. Insurance companies that use exclusive or captive agents are called direct writers.
A type of deductible that applies for an entire year in which the insured absorbs all losses until the deductible level is reached, at which point the insurer pays for all loses over the specified amount.
A yearly limit, rather than as per occurrence limit. Once an insurance company has paid up to the limit, it will pay no more during that year.
Destruction or damage caused by Aircraft, other aerial or space devices and articles dropped there from excluding those caused by pressure waves.
A legal contract in which the outcome depends on an uncertain event. Insurance contracts are aleatory in nature.
A property or liability insurance contract in which all risks of loss are covered except those specifically excluded; also called open perils policy.
Alternative to going to court to settle disputes. Methods include arbitration, where disputing parties agree to be bound to the decision of an independent third party, and mediation, where a third party tries to arrange a settlement between the two sides.
Mechanisms used to fund self-insurance. This includes captives, which are insurers owned by one or more non-insurers to provide owners with coverage. Risk-retention groups, formed by members of similar professions or businesses to obtain liability insurance, are also a form of self-insurance.
In hospital insurance, covered charges other than room and board.
Summary of an insurer’s or reinsurer’s financial operations for a particular year, including a balance sheet.
An annuity whose purchase price is paid in annual instalments.
An individual receiving benefit under an annuity.
A life insurance company contract that pays periodic income benefits for a specific period of time or over the course of the annuitant’s lifetime. These payments can be made annually, quarterly or monthly. From a life insurer’s viewpoint, an annuity presents the opposite of mortality risk from a life insurance policy. Life insurance pays a benefit when the policyholder dies. An annuity pays benefits as long as the annuitant lives. With both products, the insurer’s profit or loss depends on whether it made correct assumptions about the policyholder’s life expectancy and the company’s future investment returns.
An annuity that is payable for a specified period of time, without regard to the life or death of the annuitant.
A measure used in valuing a variable annuity during the time it is being paid to the annuitant. Each unit’s value fluctuates with the performance of an investment portfolio.
Supplied by the insurance company, usually filled in by the agent and medical examiner (if applicable) on the basis of information received from the applicant. It is signed by the applicant and is part of the insurance policy if it is issued.
The dividing of a loss proportionately among two or more insurers that cover the same loss.
A survey to determine a property’s insurable value, or the amount of a loss.
Procedure in which an insurance company and the insured or a vendor agrees to settle a claim dispute by accepting a decision made by a third party.
The deliberate setting of a fire
A policy subject to additional charges, or assessments, on all policyholders in the company.
Property owned, in this case by an insurance company, including stocks, bonds, and real estate. Insurance accounting is concerned with solvency and the ability to pay claims. Insurance laws, therefore, require a conservative valuation of assets.
To use life insurance policy benefits as collateral for a loan.
The party to whom the rights of the insured under a policy are transferred.
A clause that allows the transfer of rights under a policy from one person to another, usually by means of a written document.
The party granting the transfer of the insured’s rights to the assignee
An insured’s knowledge of likely losses that is unavailable to insurers.
The price an insurance company charges for coverage, based on the frequency and cost of potential accidents, theft and other losses.
An insurer agrees to cover accidents from all machinery of the same type as that specifically listed in the endorsement.
An agreement whereby the ceding company is required to cede some certain amounts of business and the reinsurer is required to accept them.
A name applied to claims adjusters in the field of marine insurance.
Commercial airlines hold property insurance on aeroplanes and liability insurance for negligent acts that result in injury or property damage to passengers or others. Damage is covered on the ground and in the air. The policy limits the geographical area and individual pilots covered.
A right which can be exercised by an underwriter to relieve him of liability under the policy because the assured has been guilty of a breach of good faith or where the risk in voyage policy has failed to attach within a reasonable time after the underwriter wrote the risk.
The decision in arbitration.
Member of Automobile Associations is eligible for a discount. A discount @ 5% of the Own damage premium, subject to a maximum of Rs.200/ - for a Private Car and maximum of Rs.50/-for a Motorized Two Wheeler may be allowed.
the passengers or a hired driver are not covered under personal accident insurance. Third party cover does not include cover for your legal liability towards your paid driver. Therefore, if your car is not self-driven you need to buy a cover for your driver, under the Workmen Compensation Act
This cover can be purchased with an additional premium . This covers the medical expenses of passengers in case of bodily injury due to an accident. Normally the cover is Rs 1 lakh per passenger.
A payable amount is simply another way of describing a balance that is still owed or due.
Ayurveda is an ancient medical science. The word, ayurveda is composed of two words of Sanskrit, ayur (meaning life) and veda (meaning knowledge). Thus Ayurveda is a medical science of Ancient India. It deals with matters relating to health, day-to-day life and longevity (long life).
A rider is an add-on provision to a basic insurance policy that provides additional benefits to the policyholder at an additional cost. Eg ADB,CI, TI, APTD, WOB etc.
Accidental permanent disability rider provides a certain % of Sum assured in case of permanent loss of body parts or functions out of accidents within 180 days from the date of accident.
A situation in which one has entrusted personal property to another.
Provides a snapshot of a company’s financial condition at one point in time.
Hospital insurance, surgical insurance and regular medical expense insurance
Usually, refers to Liability of insurer indicating the lowest amount for which a policy can be written. This amount is either prescribed by law or company policy.
The standard charge for a given type of risk for basic limit.
A person named in a life insurance policy to receive the death proceeds.
It is the bill drawn by exporter against the importer.
Receipt for goods shipped on board a ship signed by the person who contracts to carry them, and stating the terms on which the goods are carried.
In property and liability insurance, the agent customarily is given the authority to accept offers from prospective insureds without consulting the insurer; in such cases, the agent is said to bind the insurer.
Temporary authorization of coverage issued prior to the actual insurance policy.
A fidelity bond that covers all employees of a given class and may also cover perils other than infidelity.
Insurance coverage for more than one item of property at a single location, or two or more items of property in different locations.
A contract of health insurance affording benefits, such as accidental death and dismemberment, for all of a class of persons not individually identified. It is used for such groups as athletic teams, campers, travel policy for employees, etc.
Often called Equipment Breakdown, or Systems Breakdown insurance. Commercial insurance that covers damage caused by the malfunction or breakdown of boilers, and a vast array of other equipment including air conditioners, heating, electrical, telephone, and computer systems. Prevention of loss is emphasized even more than indemnification of loss.
Physical injury, including sickness, disease, mental injury, shock or death.
The Bonus system awards discounts for claim-free driving for a certain continuous period. This goes on increasing up to a certain limit for continuous claim free years. In case of life insurance business, with profit plans are entitled to get a bonus which is generated out of actuarial surplus.
An insurance prospect of doubtful quality from an underwriting point of view to put it in one among two group of risks.
A security that obligates the issuer to pay interest at specified intervals and to repay the principal amount of the loan at maturity. In insurance, a form of surety-ship. Bonds of various types guarantee a payment or a reimbursement for financial losses resulting from dishonesty, failure to perform and other acts.
Total amount of insurance on an insurer’s books at a particular point in time.
When a condition of the insurance contract is broken by the assured, the insurer may avoid the contract from the inception.
An intermediary between a customer and an insurance company. Brokers typically search the market for coverage appropriate to their clients. They work on commission and usually sell commercial, not personal, insurance. In life insurance, agents must be licensed as securities brokers/dealers to sell variable annuities, which are similar to stock market-based investments.
The unlawful taking of property from within premises, entry to which has been obtained by force, leaving visible marks of entry.
Insurance for the loss of property due to burglary, robbery or larceny. It is provided in a standard homeowners policy and in a business multiple peril policy.
The ratio of losses suffered to the amount of insurance in effect.
Coverage for the reduction in revenue in the event of an insured peril.
Commercial coverage that reimburses a business owner for lost profits and continuing fixed expenses during the time that a business must stay closed while the premises are being restored because of physical damage from a covered peril, such as a fire. Business interruption insurance also may cover financial losses that may occur if civil authorities limit access to an area after a disaster and their actions prevent customers from reaching the business premises. Depending on the policy, civil authorities coverage may start after a waiting period and last for two or more weeks.
Continued or regular activity for the purpose of earning a livelihood.
A policy that combines property, liability and business interruption coverage for small to medium sized businesses. Coverage is generally cheaper than if purchased through separate insurance policies.
It covers the expenses incurred for the compulsory baby vaccinations
A health policy that can be cancelled by the insurer at any time for any reason
The supply of insurance available to meet demand. Capacity depends on the industry’s financial ability to accept the risk. For an individual insurer, the maximum amount of risk it can underwrite based on its financial condition. The adequacy of an insurer’s capital relative to its exposure to loss is an important measure of solvency.
It is the sum insured of a Person for which cover is sought under a Personal Accident Policy.
A person who represents only one insurance company and is restricted by agreement from submitting business to any other company, unless it is first rejected by the agent’s captive company.
A type of insurer that is generally formed and owned by potential insured to meet their own distinctive needs
Insurers that are created and wholly-owned by one or more non-insurers, to provide owners with coverage. A form of self-insurance.
Type of insurance that protects the shipper/owner of the goods against financial loss if the goods are damaged or lost while in transit in between place of commencement and destination.
A system of coordinating medical services to treat a patient improves care, and reduce cost. A case manager coordinates health care delivery for patients.
The savings element that accumulates with some life insurance policies.
An option in life insurance policies permitting the insured to take the cash value of the policy on surrender.
It is a health insurance plan for when you get hospitalized within a Health Insurance network hospital and don’t have to pay for the hospital expenses.
Term used for statistical recording purposes to refer to a single incident or a series of closely related incidents causing severe insured property losses totalling more than a given amount.
Risk-based securities that pay high interest rates and provide insurance companies with a form of reinsurance to pay losses from a catastrophe such as those caused by a major hurricane. They allow insurance risk to be sold to institutional investors in the form of bonds, thus spreading the risk.
A percentage or fixed monetary amount that a homeowner must pay before the insurance policy kicks in when a major natural disaster occurs. These large deductibles limit an insurer’s potential losses in such cases, allowing it to insure more property. A property insurer may not be able to buy reinsurance to protect its own bottom line unless it keeps its potential maximum losses under a certain level.
Probability of catastrophic loss, based on the total number of catastrophes in a state (or region) over a 40-year period.
Using computers, a method to mesh long-term disaster information with current demographic, building and other data to determine the potential cost of natural disasters and other catastrophic losses for a given geographic area.
Reinsurance (insurance for insurers) for catastrophic losses. The insurance industry is able to absorb the huge losses caused by natural and man-made disasters such as hurricanes, earthquakes and terrorist attacks because losses are spread among thousands of companies including catastrophe reinsurers who operate on a global basis.
An insurer, also called a primary insurer, that passes on to other insurers some part of its risk under insurance policies it has accepted.
A document issued to a member of a group insurance plan, describing the insurance benefits and principal provisions of the policy in brief.
A reinsurance term meaning that portion of a risk that is passed on to reinsurers by ceding companies.
Professional designation granted to persons in the property and liability insurance field who pass a series of rigorous examinations and meet specified eligibility requirements.
The long-term chance of occurrence or relative frequency of loss. Expressed by the ratio of the number of losses likely to occur compared to the larger number of possible losses in a given group.
New position within some organizations, denoting the responsibility for coordinating an enterprise risk management strategy.
A disease that is long lasting and needs to be managed over a long period of time. Examples of chronic diseases include cardiac diseases, diabetes, and arthritis amongst others.
Legal proceedings directed towards wrongs against individuals and organizations. Breach of contract is an example of a civil wrong.
It is a notification to an insurance company that payment of an amount is due under the terms of a policy by the insured.
It is the amount payable by the insurer under a policy on a claim arising.
They are appointed by insurer in a foreign country abroad for survey/settlement of claims arising out of policy issued in the home country for Overseas medi-claim and marine insurance policies.
A group of claims with a common period of origin. The period is usually a calendar year, but may be shorter. The origin may be defined by the date of the occurrence of claim or alternatively by the date of reporting.
Claims provision, provision for outstanding claims/claims outstanding, claims reserve, total claim liability.
The functions performed in handling loss claims
A form of insurance that pays claims presented to the insurer during the term of the policy or within a specific term after its expiration. It limits liability insurers exposure to unknown future liabilities.
Sentences and paragraphs describing coverage's, exclusions, duties of an insured, and termination of coverage, and other such parts of the insurance policy.
Bill of Lading, which has been endorsed by the ship owner, as the goods described thereon do not conform to what is offered for shipment e.g., package missing, inadequately packed.
A bill of Lading is said to be clean if it has no superimposed clause expressing of any defective condition of the packaging or of goods.
In property insurance, requires the policyholder to carry insurance equal to a specified percentage of the value of property to receive full payment on a loss. For health insurance, it is a percentage of each claim above the deductible paid by the policy-holder. For a 20 percent health insurance coinsurance clause, the policyholder pays for the deductible plus 20 percent of his covered losses. After paying 80 per-cent of losses up to a specified ceiling, the insurer starts paying 100 percent of losses.
Property that is offered to secure a loan or other credit and that becomes subject to seizure on default. (Also called security.)
Portion of an auto insurance policy that covers the damage to the policyholder’s car from a collision.
Percentage of each premium rupee a property/casualty insurer spends on claims and expenses. A decrease in the combined ratio means financial results are improving; an increase means they are deteriorating. When the ratio is over 100, the insurer has an underwriting loss.
A broad commercial policy that covers all liability exposures of a business that are not specifically excluded. Coverage includes product liability, completed operations, premises and operations, and independent contractors.
Products designed for and bought by businesses. Among the major coverages are boiler and machinery, business interruption, commercial auto, comprehensive general liability, directors and officers liability, fire and allied lines, inland marine, medical malpractice liability, product liability, professional liability, surety and fidelity, and workers compensation. Most of these commercial coverages can be purchased separately except business interruption which must be added to a fire insurance (property) policy.
Short-term, unsecured, and usually discounted promissory note issued by commercial firms and financial companies often to finance current business. Commercial paper, which is rated by debt rating agencies, is sold through dealers or directly placed with an investor.
A liability policy designed to cover catastrophic losses.
Fee paid to an agent or insurance sales-person as a percentage of the policy premium. The percentage varies widely depending on coverage, the insurer, and the marketing methods.
A life insurance clause stating what happens to life insurance proceeds if named beneficiaries die in a common accident.
The unwritten law that is based on custom, usage, and court decisions; different from statutory law, which consists of laws passed by legislatures.
Pays for bodily injury or property damage caused by a completed project or job. Protects a business that sells a service against liability claims.
Portion of an auto insurance policy that covers damage to the policyholder’s car not involving a collision with another car (including damage from fire, explosions, earthquakes, floods, and riots), and theft.
The minimum amount of auto liability insurance that is statutorily required.
The failure of an applicant to reveal, before the insurance contract is made, a fact that is material to the risk.
A legal doctrine that says if two perils (one excluded and one not excluded) occur and cause a loss, coverage applies.
Activities that take place at the same time as losses to reduce their severity.
A contract, such as an insurance contract, requiring that certain acts be performed if recovery is to be made.
A document given to an applicant for life insurance stating that the company’s acceptance is contingent upon determination of the applicant’s insurability.
A policy that can be can-celled or have the premiums raised by the insurer on a specific anniversary date, subject to certain reasons written into the policy.
Circumstances under which an insurance contract is in force. Breach of the conditions is grounds for refusal to pay the loss.
Coverage for losses incurred as a result of the failure of an insured object on the insured’s premises.
Losses other than property damage that occur as a result of physical loss to a business for example, the cost of maintaining key employees to help reorganize after a fire.
In an insurance contract, the specified premium and an agreement to the provisions and stipulations that follow.
Right of insurers who have paid a loss under a policy to recover a proportionate amount from other insurers who are liable for the same loss.
Loss occurring when property is not completely destroyed but when it would cost more to restore it than it is worth
A person named in a life insurance contract to receive the benefits of the policy if other named beneficiaries are not living.
Coverage for losses that result from losses to a supplier or customer on whom the firm depends.
Liability of individuals, corporations, or partnerships for accidents caused by people other than employees for whose acts or omissions the corporations or partnerships are responsible.
An agreement embodying a set of promises that are enforceable by law.
A surety bond guaranteeing that the principles will complete their work in accordance with the terms of the construction contracts.
A contract, such as an insurance contract, in which any ambiguities or uncertain-ties in the wording will be construed against the drafter (the insurer).
Insures mobile equipment, such as tractors, steam shovels, drilling equipment, etc., whether it is owned, leased, or borrowed.
Insure losses resulting from fire in which the loss cannot be measured either by direct damage by fire or in terms of elapsed time.
The duty of disclosure of “material information†regarding a proposal & Policy.
Liability arising from contractual agreements in which it is stated that some losses, if they occur, are to be borne by specific parties.
Partial guilt or negligence in a civil lawsuit where both parties are to blame.
A term policy that can be converted to permanent coverage rather than expiring on a specific date.
The sum of (1) outlays to reduce risks, (2) the opportunity cost of activities forgone due to risk considerations, (3) expenses of strategies to finance potential losses, and (4) the cost of reimbursed losses.
An endorsement that automatically increases the amount of coverage by the same percentage the Consumer Price Index has risen since policy issue.
The cost to replace property after a loss but perhaps not with like materials and labor.
Synonym for insurance.
Cover note is a document granted provisionally pending the issue of a regular policy.
The promise to pay in the future in order to buy or borrow in the present. The right to defer pay-ment of debt.
A contract that enables a user, such as a bank, to better manage its credit risk. A way of transferring credit risk to another party.
A technique to lower the interest payments on a bond by raising the issue’s credit rating, often through insurance in the form of a financial guarantee or with standby letters of credit issued by a bank.
Commercial coverage against losses resulting from the failure of business debtors to pay their obligation to the insured, usually due to insolvency. The coverage is geared to manufacturers, wholesalers, and service providers who may be dependent on a few accounts and therefore could lose significant income in the event of an insolvency. Sometimes called bad-debt insurance.
Life insurance coverage on a borrower designed to repay the balance of a loan in the event the borrower dies before the loan is repaid. It may also include disablement and can be offered as an option in connection with credit cards and auto loans.
Legal proceedings directed towards wrongs against society, such as rape, murder, and robbery. Charges are made by a government body, and the guilty party is subject to fine and/or imprisonment.
In simple words, critical illnesses are relatively serious forms of illnesses which are more difficult to treat and require more time to treat.The federation of Indian Chamber of Commerce and Industry (FICCI) lists the following illnesses as critical illnesses: cancer, heart attack, coronary bypass surgery, heart valve repair or replacement, coma, kidney failure requiring regular dialysis, stroke resulting in permanent symptoms, major organ or bone marrow transplants, permanent paralysis of limbs, motor neurone disease and multiple sclerosis with persisting symptoms.
Protection against damage to growing crops as a result of named perils.
The percentage at which the sum insured gets increased annually, without additional premium, e.g. Personal Accident Insurance, Mediclaim Insurance.
It is medical care for permanent or long term illnesses/ chronic diseases. These include a cover for all the related diagnostics, drug expenses and regular consultation expenses that a policy holder incurs.
Compressed natural gas (CNG) (methane stored at high pressure) is a fuel which can be used in place of gasoline (petrol), Diesel fuel and propane/LPG. CNG combustion produces fewer undesirable gases than the fuels mentioned above.
Chassis number is a unique code including a serial used by automotive industry to identify individual motor vehicle.
This number basically is approximately the displacement volume of the engine i.e. the volume covered by the stroke of the piston multiplied by the number of cylinders the engine
No claim bonus (NCB) is a discount, given by an insurer to a policyholder for making no claims during the policy term. NCB can be accumulated over years and the discount ranges from 20% to 50% on the own damage premium.
The compulsory deductible amount is to be paid by the policyholder when clam arises. Deductible varies from Rs.50 for two-wheelers to Rs.500 for four-wheelers or insurer can charge higher deductible basis condition of the vehicle.
Co-payment in a co-payment module, the final claim amount is divided between the policyholder and the insurance company as per the predetermined percentage of co-payment in the insurance policy.
Consumables like oil, nuts, bolts etc. are not covered under the insurance. . This add-on covers expenses towards consumables which are unfit for further use, arising out of damage due to an accident or any such event.
The total sum assured that is payable to policy owner in case of any exigency in a foreign county.
It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.
Insurance coverage is the amount of risk or liability that is covered for an individual or entity by way of insurance services.
It is cost-sharing requirement applicable under a health insurance policy that provides policyholder/insured to bear a specified percentage of the admissible claim amount . A Co-Payment does not reduce the Sum Insured
A benefit which helps cover for treatment of critical illnesses. Such situations entail relatively higher expenses and longer period of absence from work for the affected. While the illnesses covered and the premiums vary among insurers, most insurers cover cancer, coronary artery bypass, heart attack, kidney/renal failure, major organ transplant and paralytic stroke.
A critical illness rider provides payments of sum assured to the insured on diagnosis of certain dreaded diseases like cancer, coronary artery bypass, heart attack, kidney/renal failure, major organ transplant , paralytic stroke etc.
Period of time after the due date of a premium during which the policy remains in force (when both coverage of risk is available and also the premium can be paid without any late fees).
An extension to the standard policy to cover the cost of making a seriously fire-damaged building safe and removing debris.
Part of a property or liability insurance policy that states the name and address of policy-holder, property insured, its location and description, the policy period, premiums, and supplemental information.
Term life insurance in which the amount of coverage declines during the period for which it is issued.
The amount of loss borne or paid by the policyholder. Either a specified rupee amount, a percentage of the claim amount, or a specified amount of time that must elapse before benefits are paid. The bigger the deductible, the lower the premium charged for the same coverage.
The practice of performing extra procedures and tests in addition to those that are probably necessary for a given patient in an attempt to avoid malpractice litigation.
Benefits that begin at some specified time after the annuity is purchased.
Group term life insurance covering an employee’s dependent.
A decrease in the value of property over a period of time due to wear and tear or obsolescence. Depreciation is used to determine the actual cash value of property at time of loss.
Contracts that derive their value from an underlying financial asset, such as publicly-traded securities and foreign currencies. Often used as a hedge against changes in value.
The idea that a vehicle (or any other asset) loses value after it has been damaged in an accident and repaired.
A loss that stems directly from an unbroken chain of events leading from an insured peril to the loss.
Property/casualty premiums collected by the insurer from policyholders, before reinsurance premiums are deducted. Insurers share some direct premiums and the risk involved with their reinsurers.
A system to distribute insurance to customers through direct mail, telephone, television, or other methods without the use of intermediaries.
Method of selling insurance directly to the insured through an insurance company’s own employees, through the mail, or via the Internet. This is in lieu of using captive or exclusive agents.
Insurance companies that sell directly to the public using exclusive agents or their own employees, through the mail, or via Internet. Large insurers, whether predominately direct writers or agency companies are increasingly using many different channels to sell insurance. In reinsurance, denotes reinsurers that deal directly with the insurance companies they reinsure without using a broker.
Covers directors and officers of a company for negligent acts or omissions, and for misleading statements that result in suits against the company, often by shareholders.
Inability to perform all or part of one's occupational duties because of an accident or illness: see Total Disability and Partial Disability.
If the insurance policy is taken from more than one underwriter where period of insurance, subject matter of insurance and sum insured are same, then this is called double insurance
Health insurance that provides periodic payments if the insured becomes disabled as a result of illness or accident.
The inability of a person to work because of an illness or injury.
A deductible used in property insurance in which the size of the deductible decreases as the size of the loss increases. At a given level of loss, the deductible completely disappears.
Process of spreading risk through a firm’s involvement in various businesses or through the location of its operations in different geographic areas.
Money returned to policyholders from an insurance company’s earnings. Considered a partial premium refund rather than a taxable distribution, reflecting the difference between the premium charged and actual losses. Many life insurance policies and some property/casualty policies pay dividends to their owners. Life insurance policies that pay dividends are called participating policies.
It is home based treatment done for a disease, illness or injury. It could because of lack of accommodation at the hospital or because the patient’s condition doesn’t permit them to get admitted in the hospital
Uncertainties, either pure or speculative, that are produced because of societal changes that have national consequences.
Relative variation of actual from expected losses.
A type of health insurance that covers dental care expenses.
Date from which insurance co will give coverage of Sum assured
Date of registration is a date on which the vehicle was registered with regional transport Office.
Occupation-Related Discounts. In many cases, you can actually save money on your car insurance simply by being in a “low-risk profession." Careers considered low-risk by auto insurance companies, statistically show that people in these professions exercise risky driving behaviours less often than those in other jobs
Payment of medical expenses related to acute anaesthetic treatment of a natural tooth or teeth during a trip.
Coverage amount for cost associated with dental treatment overseas.
It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.
Payment of compensation for reasonable expenses incurred for the purchases of toiletries, clothing and medication due to a delay in checked-in baggage caused by a common carrier.
Expense for incurring a duplicate passport will be reimbursed under this cover.
It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.
A daily hospital cash plan would determine coverage based on the daily allowance you choose under the plan. The range of daily cash available is from Rs.500 to Rs.3000. if the insured is admitted in the ICU, the daily cash allowance generally increases twofold or by any other factor as specified in the policy wordings
Dental insurance is a form of health insurance designed to pay a portion of the costs associated with dental care.
Policy start date
Date from which insurance co will give coverage of Sum assured.
Amount payable in case of policyholders death within policy term.
Nature of fund
The amount payable in case death happens due to accident
The portion of premium that applies to the expired part of the policy period. Insurance premiums are payable in advance but the insurance company does not fully earn them until the policy period expires.
A commercial property form without a 50 percent or more coinsurance coverage.
A group life plan in which an employee receives one or two times salary in life insurance coverage.
Covers a building and its contents, but includes a large percentage deductible on each. A special policy or endorsement exists because earthquakes are not covered by standard homeowners or most business policies.
Total financial loss resulting from the death or disability of a wage earner, or from the destruction of property. Includes the loss of earnings, medical expenses, funeral expenses, the cost of restoring or replacing property, and legal expenses. It does not include noneconomic losses, such as pain caused by an injury.
The date upon which the policy is put in force, the inception date
The sale of products such as insurance over the Internet.
The period that must elapse before disability income is payable under a health insurance policy covering disability income loss.
Deferred profit-sharing plans in which investment is usually in stock issued by the employer.
Liability insurance for employers that covers wrongful termination, discrimination, or sexual harassment toward the insured’s employees or former employees.
Legal liability imposed on an employer making him or her responsible to pay damages to an employee injured by the employer's negligence. Generally, replaced by 'workers compensation', which pays the employee whether the employer has been negligent or not.
A written form attached to an insurance policy that alters the policy’s coverage, terms, or conditions. Sometimes called a rider.
Life insurance that pays the face amount at the end of a specified time period if the insured is alive; the face amount is payable in the event of death before the end of the period.
Approach for managing both pure and speculative risks together, another name for integrated risk management.
A life insurance contract stating that the policy and the application form constitute the entire contract between the parties.
A form of insurance designed to cover losses and liabilities arising from damage to property caused by pollution.
A method of apportionment in which insurers covering the same loss share that loss equally, up to their respective limits of liability.
In investments, the ownership interest of shareholders. In a corporation, stocks as opposed to bonds.
A professional liability policy covering the policyholder for negligent acts and omissions that may harm his or her clients.
Provision for automatic increases on some defined basis in premiums and sums insured.
Funds that a lender collects to pay monthly premiums in mortgage and homeowners insurance, and sometimes to pay property taxes.
An expression used in fire, explosion and material damage policies only. An estimate of the monetary loss which could be sustained by insurers on a single risk as a result of a single fire or explosion considered by the underwriter to be within the realms of possibility.
A legal doctrine in which a person may be required to do something or be prevented from doing something that is inconsistent with previous behaviour; may prevent an insurer from denying liability after a loss.
A contract between an insurer and a reinsurer, whereby the insurer agrees to pay a specified portion of a claim and the reinsurer to pay all or a part of the claim above that amount.
A provision in an insurance policy that eliminates coverage for certain risks, people, property classes, or locations.
Restrictions for the coverage provided by an insurance policy
A captive agent, or a person who represents only one insurance company and is restricted by agreement from submitting business to any other company unless it is first rejected by the agent’s company.
Agreed amount up to which no claim is paid under a policy.
A form of reinsurance whereby the reinsuring company reimburses the ceding company for the amount and only the amount of loss the ceding company suffers over and above an agreed aggregate sum in any one loss or in a number of losses arising out of any one event.
A payment made where there is no legal liability
The ratio of losses incurred to premiums earned; anticipated when rates are first formulated.
The insurer agrees to pay reasonable extra cost for expediting the repair of machinery, including overtime and express transportation.
Percentage of each premium rupee that goes to insurers expenses including overhead, marketing, and commissions.
Record of losses.
The system of rating or pricing insurance in which the future premium reflects past loss experience of the insured.
Possibility of loss.
A liability limit that provides coverage when a person is exposed to a product or dangerous substance.
A warranty actually stated in a contract.
An endorsement added to an insurance policy, or clause within a policy, that provides additional coverage for risks other than those in a basic policy.
The consequential prop-erty insurance that covers the extra expense incurred by the interruption of a business; the policy pays if the business does not close down but continues in alternative facilities, with higher than normal costs.
The date after which policy/contract is no longer in effect
Engine number may refer to an identification number marked on the engine of a vehicle. The engine number includes coded information, which can be decoded to reveal information such as year of manufacture, country of manufacture, and engine type
This covers takes care of the expenses incurred in the repair of the engine, gearbox or differential parts that may occur due to such conditions as the leakage of lubricating oils, water ingression etc., conditions that aren’t usually covered by the primary policy.
This cover protects the Emi payable towards your car loan up to a certain months in case of financial disability due to job loss.
Generally, pre-existing diseases (read the policy to understand what a pre-existing disease is defined as) are excluded under a Health Insurance policy. Further, the policy would generally exclude certain diseases from the first year of coverage and also impose a waiting period.
Generally, pre-existing diseases (read the policy to understand what a pre-existing disease is defined as) are excluded under a Health Insurance policy. Further, the policy would generally exclude certain diseases from the first year of coverage and also impose a waiting period.
This signifies the reimbursement of daily expenses of any person who is accompanying a minor insured less than 12 years of age. The maximum payable is for 10 days.
Insurance co normally provides emergency ambulance charges when patient is admitted to a hospital or transferred from one hospital to another hospital
Insurance co pay for cataract operations after a waiting period of 24 to 36 months up to a certain Sum insured.
In a life insurance contract, the stated sum of money to be paid to the beneficiary upon the insured’s death.
A reinsurance policy that provides an insurer with coverage for specific individual risks that are unusual or so large that they aren’t covered in the insurance company’s reinsurance treaties. This can include policies for jumbo jets or oil rigs. Reinsurers have no obligation to take on facultative reinsurance, but can assess each risk individually. By contrast, under treaty reinsurance, the reinsurer agrees to assume a certain percentage of entire classes of business, such as various kinds of auto, up to preset limits.
In a dwelling policy, the rent the building could have earned at the time of the loss whether or not it was actually rented.
A form of protection that covers policyholders for losses that they incur as a result of fraudulent acts by specified individuals. It usually insures a business for losses caused by the dishonest acts of its employees.
A Fidelity guarantee insurance indemnifies the employers against the financial loss suffered by them due to specified dishonest acts of their employees.
A type of surety bond, sometimes called a probate bond, which is required of certain fiduciaries, such as executors and trustees, which guarantees the performance of their responsibilities.
Legal responsibility of a fiduciary to safeguard assets of beneficiaries. A fiduciary, for example a pension fund manager, is required to manage investments held in trust in the best interest of beneficiaries. Fiduciary liability insurance covers breaches of fiduciary duty such as misstatements or misleading statements, errors and omissions.
A process involving the establishment of financial goals, the development and implementation of a plan for achieving those goals, and the periodic review and revision of the overall plan.
Risk involving credit, foreign exchange, commodity trading, and interest rate; may involve chance for gain as well as loss.
A method of risk identification in which each item on a firm’s balance sheet and income statement is analysed regarding potential risks.
The function of planning and controlling the supply of funds.
Combustion in which oxidation takes place so rapidly that a flame or glow is produced.
Coverage protecting property against losses caused by a fire or lightning that is usually included in homeowners or commercial multiple peril policies.
An annuity that pays the annuitant a guaranteed, fixed return every month for a fixed premium. The guarantee is based on the expected return of the underlying investments of the insurance company. (See Annuity)
A life insurance option allowing the beneficiary to take the proceeds in the form of a fixed periodic payment.
Payment of a death benefit in equal instalments over a specified time period.
Attached to a homeowners policy, a floater insures movable property, covering losses wherever they may occur. Among the items often insured with a floater are expensive jewellery, musical instruments, and expensive apparel. It provides broader coverage than a regular homeowners policy for these items.
An inland marine insurance policy that covers property subject to movement from one location to another.
(1) An overflow of inland or tidal waves, (2) unusual and rapid accumulation of runoff of surface waters, (3) landslides or mudslides, (4) excessive erosion along the shore of a lake or any other body of water, or (5) erosion or undermining caused by a body of water exceeding its anticipated cyclical levels.
An underlying principle of social insurance specifying that the goal of social insurance is to provide only limited protection, not one’s entire need.
Abbreviation for free-on-board, used in commerce to describe the value of goods at point of embarkation, excluding transport and insurance costs. Export values are usually expressed f.o.b. for customs and excise purposes, while imports are usually valued cost insurance and freight or charged in full.
Intentional lying or concealment by policy-holders to obtain payment of an insurance claim that would otherwise not be paid, or lying or misrepresentation by the insurance company managers, employees, agents, and brokers for financial gain.
A clause in ocean marine insurance that excludes war as a covered peril.
Money paid for the transportation of goods. Freight insurance is a common coverage in marine insurance, purchased by the owners of transporting vessels.
Number of times a loss occurs. One of the criteria used in calculating premium rates.
Deductible in which the insurer has no liability if the loss is under a certain amount, but once this amount is exceeded; the entire loss is paid in full.
A method of loss control that lessens the chance that a peril will occur.
A fire confined to the area of a boiler, stove, or other place designed to contain it.
A procedure in which a primary insurer acts as the insurer of record by issuing a policy, but then passes the entire risk to a reinsurer in exchange for a commission. Often, the fronting insurer is licensed to do business in a country where the risk is located, but the reinsurer is not. The reinsurer in this scenario is often a captive or an independent insurance company that cannot sell insurance directly in a particular country.
Agreement to buy a security for a set price at a certain date. Futures contracts usually involve commodities, indexes or financial futures.
The type of fuel which is used in vehicle. It could be petrol diesel, CNG
No of times premium to be paid in a year.
A clause in ocean marine insurance that requires ship and freight interests other than the insured to respond to loses suffered by the insured interest when those losses result from voluntary, necessary, and successful sacrifice of the insured’s freight because of shipping peril.
Damages awarded to an injured persons for intangible loss which cannot be measured directly by rupees. Popularly known as "pain and suffering." General damages are distinguished from special damages which are awarded from actual economic loss, such as medical costs, loss of income, etc.
Another term for property insurance.
A clause in life insurance giving the insured an extra 30 days to pay a premium due before lapse takes place.
A reduced commission justified by the size of the premium
Intentional failure to perform a duty, reckless disregard of the consequences as affecting the life or property of another
The premium paid by the policyholder.
The figure calculated by adding turnover to closing stock and work in progress and subtracting from this amount the sum of the opening stock and work in progress and the variables selected by the insured (usually defined as specified working expenses).
The premium charge for insurance that includes anticipated cost of losses, overhead, and profit.
A single policy covering a group of individuals, usually employees of the same company or members of the same association and their dependents. Coverage occurs under a master policy issued to the employer or association.
A policy that cannot be cancelled by the insurer prior to a specified age. Premiums may be increased only for an entire class of insureds.
A coverage that protects businesses engaged in electronic commerce from losses caused by hackers.
Form of insurance that protects against loss of crops from hail
A sellers market in which insurance is expensive and in short supply.
Conditions that introduce or increase the probability of loss stemming from the existence of a given peril.
The transferor of a speculative risk via a hedging contract
A transfer of risk from one party to another; similar to speculation and may be used to handle risks not subject to insurance, such as price fluctuations.
In Motor Insurance, Accident arising out of the use of motor vehicle the identity whereof can not be ascertained in spite of reasonable efforts for the purpose.
The typical home-owners insurance policy covers the house, the garage and other structures on the property, as well as personal possessions inside the house such as furniture, appliances and clothing, against a wide variety of perils including windstorms, fire and theft. The extent of the perils covered depends on the type of policy. An all-risk policy offers the broadest coverage. This covers all perils except those specifically excluded in the policy.
A health care organization that provides humane, dignified care for dying patients.
An insurance contract designed to pay hospital room and board, laboratory fees, nursing care, use of the operating room, and medicines and similar expenses.
It is a health plan that pays a specific amount per day of hospitalization to the policy holder if he/she is hospitalized.
Situation when a policy holder gets admitted into the hospital for either scheduled procedures or accidents/medical emergencies for over 24 hours.Note that some Health Insurance plans also cover day care procedures and treatments i.e., a hospital stay for less than 24 hours
A fire that occurs outside of its normal confines.
When the theft is committed entering into or out of the premises stealthily
The general care, cleanliness and maintenance of an insured property
A package of insurance providing homeowners with a broad range of property and liability coverages Hull insurance (in ocean marine and aviation insurance) Coverage for physical damage to a vessel or aircraft
Property insurance policy covering a sea-going vessel.
The sum of money that when paid in instalments of both principal and interest over the individual’s remaining working life, will produce the same income the person would have earned, minus taxes and personal expenses.
It defines whether there is one person insured or multiple person insured.
Hypothecation is legal term that refers to the granting of a hypothec to a lender by a borrower. In practice, the borrower pledges an asset as collateral for a loan, while retaining ownership of the assets and enjoying the benefits there from
illegally seize (an aircraft, ship, or vehicle) while in transit and force it to go to a different destination or use it for one's own purposes.
Payment of distress allowance in case of hijack of a common carrier for more than certain number of hours whilst on the trip.
It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.
Insurance co provides health checkup reimbursement up to a limit. This facility is available normally after 3-4 renewals with same insurance co.
Coverage for expenses incurred as the result of an identity theft. Can include costs for notarizing fraud affidavits and certified mail, lost income from time taken off from work to meet with law enforcement personnel or credit agencies, fees for reapplying for loans and attorney’s fees to defend against lawsuits and remove criminal or civil judgments.
It is a contract, which is contrary to law and against the interests of public. It can not be sustained and does not have legal effect.
An annuity in which benefits begin soon after the annuity is purchased.
Loss or physical damage or destruction caused to the property due to impact by any Rail/Road vehicle or Animal.
Warranties not stated in a con-tract but assumed by the parties to be true.
Acts committed by one person but for which responsibility has been transferred or imputed to another.
Case in which responsibility for damage can be transferred from the negligent party to another person, such as an employer
A type of watercraft whose motor is a permanent part of it.
A life insurance clause that prevents the insurer, after two years, from denying liability under the policy for misrepresentations or concealments by the insured.
Term life insurance in which the face amount of the policy increases periodically on a predetermined basis.
Losses that are not filed with the insurer or reinsurer until years after the policy is sold. Some liability claims may be filed long after the event that caused the injury to occur. Asbestos related diseases, for example, do not show up until decades after the exposure. IBNR also refers to estimates made about claims already reported but where the full extent of the injury is not yet known, such as a workers compensation claim where the degree to which work related injuries prevents a worker from earning what he or she earned before the injury unfolds over time. Insurance companies regularly adjust reserves for such losses as new information becomes available.
Incurred claims equal the claims paid during the policy year plus the claim reserves as of the end of the policy year, minus the corresponding reserves as of the beginning of the policy year. The difference between the year end and beginning of the year claim reserves is called the increase in reserves and may be added directly to the paid claims to produce the incurred claims
Losses occurring within a fixed period, whether or not adjusted or paid during the same period.
Provide financial compensation for losses.
To restore insured to the situations that existed prior to a loss.
An individual or firm employed by an insurer to settle loss claims.
Agent who is self-employed, is paid on commission, and represents several insurance companies.
A loss that occurs indirectly as a con-sequence of a given peril.
A provision added to a homeowners insurance policy that automatically adjusts the coverage limit on the dwelling each time the policy is renewed to reflect current construction costs.
A cause of loss that stems from the product itself. A loss due to this cause releases the carrier from liability.
A characteristic depreciation such as the fading of ink, a cracking of parchment, the graying of hair
This broad type of cover-age was developed for shipments that do not involve ocean transport. Covers articles in transit by all forms of land and air transportation as well as bridges, tunnels and other means of transportation and communication. Floaters that cover expensive personal items such as fine art and jewellery are included in this category.
A basis contract covering domestic shipments shipped primarily by land transportation systems.
Insurer’s inability to pay debts. Insurance insolvency standards and the regulatory actions taken vary from country to country.
A legal principle in which an insured must demonstrate a personal loss; prevents the insurance from becoming a gambling contract.
Risks for which it is relatively easy to get insurance and that meet certain criteria. These include being definable, accidental in nature, and part of a group of similar risks large enough to make losses predictable. The insurance company also must be able to come up with a reasonable price for the insurance.
In business income coverage, the amount obtained by deducting variable costs and expenses (those that may be discontinued in the event of a shutdown) from the total sales.
A system to make large financial losses more affordable by pooling the risks of many individuals and business entities and transferring them to an insurance company or other large group in return for a premium.
The price of insurance, expressed as a price per unit of coverage.
Employee benefit plans managed by an insurance company.
The transferee; the person or agency providing insurance.
The part of an insurance contract that states what the insurer agrees to do and the conditions under which it so agrees.
Approach for managing both pure and speculative risks together; another name for enterprise risk management.
An insurer that sells exclusively via the Internet.
Coverage designed to protect businesses from liabilities that arise from the conducting of business over the Internet, including copyright infringement, defamation, and violation of privacy.
Laws governing the distribution of an estate not disposed of by a will.
Without a valid will.
Income generated by the investment of assets. Insurers have two sources of income, underwriting (premiums less claims and expenses) and investment income. The latter can offset underwriting operations, which are frequently unprofitable.
Government insurance required to be purchased by certain groups and under certain conditions.
A beneficiary designation that may not be changed without the written consent of the named beneficiary.
A Company that underwrites an insurance risk . The party in an insurance contract undertaking to pay Agreed financial compensation.
Act of throwing overboard part of a vessel's cargo or hull in hopes of saving a ship from sinking.
An all risk insurance contract that provides jewellers with coverage to losses, which they would be exposed.
The legal doctrine that allows a plaintiff to collect in full from one negligent party in an accident where there are two or more negligent parties.
An annuity issued on two lives that guarantees that the annuity in whole or in part will be paid as long as either party shall live.
A joint and survivor annuity in which the payment after the first annuitant dies equals X percent of the benefit while both were alive.
An employee whose services would be difficult to replace if the employee were to die or become disabled.
Insurance on the life or health of a key individual whose services are essential to the continuing success of a business and whose death or disability could cause the firm a substantial financial loss.
Coverage up to specific limits for the cost of ransom or extortion payments and related expenses. Often bought by international corporations to cover employees. Most policies have large deductibles and may exclude certain geographic areas. Some policies require that the policyholder not reveal the coverage existence.
This add on cover takes care of the expenses incurred in the repair or replacement of car keys and locks or related mechanism that are part of insured vehicle.
A defence in product liability cases, alleging that no liability exists because no contractual relationship exists between the manufacturer or vendor and the injured party.
Termination of a policy due to failure by the insured to pay the premium as required
Wrongful or fraudulent taking and carrying away by any person of the personal property of another.
A rule for buying insurance such that serious loss exposures receive priority over less serious loss exposures.
In a case of contributory negligence, the negligent plaintiff may have a cause of action against the defendant if the defendant had a last clear chance to avoid the accident but failed to do so.
The theory of probability on which the business of insurance is based. Simply put, this mathematical premise says that the larger the group of units insured, such as sport utility vehicles, the more accurate the predictions of loss will be.
An interest in real property created by an agreement (a lease) that gives the lessee (the tenant) the right of enjoyment and use of the property or a period of time.
Wrongful violation of a person’s rights.
The costs of defending a claim from a third party and claimant's costs for which an insured is liable, are usually covered by a liability policy.
Any liability imposed on a person by a court of law
The person to whom a lease is granted, commonly called the tenant.
The person granting a lease, also known as the landlord
Within the context of reinsurance, a banking instrument established on a 'standby' basis to secure recoverable from non-admitted reinsurers to enable the ceding company to reduce the provision for unauthorized reinsurance in its statutory statement
Any legally enforceable obligation
Insurance for what the policy-holder is legally obligated to pay because of bodily injury or property damage caused to another person.
Written, printed, or pictorial material that damages a person’s reputation by defaming or ridiculing the person.
The incorporation of a company in the jurisdiction or the approval given to a company to underwrite insurance in the jurisdiction. These are recognized to be separate approvals and may be made in separate jurisdictions
One line is equal to the ceding company 's retention. A proportional treaty may have a total capacity expressed as x lines and a reinsurer's share may be y lines
The general classification of business as utilized in the insurance industry, i.e., fire, allied lines, homeowners, etc
See Ordinary life insurance; Term insurance; Whole life insurance
A limit that applies to all benefits payable under an insurance plan. The maximum can often be restored over time, eventually allowing an insured to collect more than the stated maximum.
Maximum amount of insurance that can be paid for a covered loss.
The ability and speed with which a security can be converted into cash.
A marketplace where underwriting syndicates, or mini-insurers, gather to sell insurance policies and reinsurance. Each syndicate is managed by an underwriter who decides whether or not to accept the risk. The Lloyds market is a major player in the international reinsurance market as well as a primary market for marine insurance and large risks. Originally, Lloyds was a London coffee house in the 1600s patronized by ship owners who insured each others hulls and cargoes. As Lloyds developed, wealthy individuals, called ?Names,? placed their personal assets behind insurance risks as a business venture. Increasingly since the 1990s, most of the capital comes from corporations.
The overhead or administrative expenses of an insurer that is included in the cost of a policy.
Care and service provided to the elderly to assist them with day-to-day living.
Coverage that, under specified conditions, provides skilled nursing, inter-mediate care, or custodial care for a patient (generally over age 65) in a nursing facility or his or her residence following an injury.
An accelerated death benefit specifically for insured’s long-term care needs.
A reduction in the quality or value of a property, or a legal liability.
The sum insurers pay for investigating and settling insurance claims, including the cost of defending a lawsuit in court.
Actions taken to reduce the frequency and/or severity of losses.
The portion of an insurance rate used to cover claims and the costs of adjusting claims. Insurance companies typically determine their rates by estimating their future loss costs and adding a provision for expenses, profit, and contingencies.
A potential loss that may be associated with a specific type of risk.
A risk identification tool used by businesses and individuals that lists many different potential losses. The user can determine which of the potential losses is relevant.
A provision in homeowners and renters insurance policies that reimburses policyholders for any extra living expenses due to having to live else-where while their home is being restored following a disaster.
Percentage of each premium rupee an insurer spends on claims.
The company’s best estimate of what it will pay for claims, which is periodically readjusted. They represent a liability on the insurer’s balance sheet
A provision that helps determine if items will be valued at actual cash value or at replacement cost after a loss.
the passengers or a hired driver are not covered under personal accident insurance. Third party cover does not include cover for your legal liability towards your paid driver. Therefore, if your car is not self-driven you need to buy a cover for your driver, under the Workmen Compensation Act.
It is the cost of replacement of the articles for any amount up to the Total Sum Insured subject to deductible, in case personal documents and/or personal effects have been checked in on the same Common Carrier as a travelling Insured Person, are damaged or lost.
The amount that needs to be paid to claim for baggage insurance.
It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.
Reimbursement of actual expenses incurred in connection with obtaining a duplicate or fresh passport if the passport belonging to the Insured Person is lost.
Amount payable in case of loss of passport
It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.
A book of rates, rules, and coverages usually available for each kind of insurance
The total assets of an insurance company must exceed its liabilities (other than share capital) by a relevant amount, known as the margin of solvency.
Professional liability cover-age for physicians, lawyers, and other specialists against suits alleging negligence or errors and omissions that have harmed clients.
On incurred claim ratio loading is applied to the renewal premium for adverse claim experience
A liability limit that provides coverage when a claimant’s disease or injury is discovered.
A liability limit that provides coverage when a claimant’s disease or injury is discovered.
Coverage for goods in transit, and for the commercial vehicles that transport them, on water and over land. The term may apply to inland marine but more generally applies to ocean marine insurance. Covers damage or destruction of a ship’s hull and cargo and perils include collision, sinking, capsizing, being stranded, fire, piracy, and jettisoning cargo to save other property. Wear and tear, dampness, mould, and war are not usually included.
The price for which something would sell, especially the value of certain types of assets, such as stocks and bonds. It is based on what they would sell for under current market conditions. For example, common stock market value would be the price of the stock as of a specified date
Describes misrepresentations that, had they been known at the time of a contract’s issuance, would have caused it not to be issued at all or issued on different terms.
It is an insurance coverage plan which helps in covering all pregnancy related expenses such as clinical visits, medication and delivery costs.
An estimate of the worst loss that might result from a given occurrence.
Nonbinding procedure in which a third party attempts to resolve a conflict between two other parties.
Reasonable and necessary medical expenses caused by an accident and sustained by the insured. Such expenses must occur within three years of the accident.
A coverage in which the insurer agrees to reimburse the insured and others up to a certain limit for medical or funeral expenses as a result of bodily injury or death by accident. Payments are without regard to fault.
An endorsement to a homeowners insurance policy, available in some states, for losses to a home caused by the land under a house sinking into a mine shaft. Excluded from standard homeowners policies, as are other forms of earth movement.
A practice, usually prohibited by law, in which an insurance agent makes a misleading statement in the sale of insurance.
A clause in life insurance requiring an adjustment of the amount of insurance payable in the event the age of the insured has been misrepresented.
If a person’s sex has been misrepresented, the insurer adjusts the amount of proceeds payable rather than cancelling the policy altogether.
Total supply of money in the economy, composed of currency in circulation and deposits in savings and checking accounts.
A hazard resulting from the indifferent or dishonest attitude of an individual to seek undue advantage in relation to insured property.
A table that shows the number of deaths per thousand and the expectation of life at various ages.
A clause in insurance contracts that gives first right of recovery to the mortgagor of property that is covered.
A form of decreasing term insurance that covers the life of a person taking out a mortgage. Death benefits provide for payment of the outstanding balance of the loan. Coverage is in decreasing term insurance, so the amount of coverage decreases as the debt decreases. A variant, mortgage unemployment insurance pays the mortgage of a policyholder who becomes involuntarily unemployed.
Investment grade securities backed by a pool of mortgages. The issuer uses the cash flow from mortgages to meet interest payments on the bonds.
A person or organization holding a mortgage
The largest loss thought probable under a given insurance policy. Normally applied to material damage risks where the total sum insured is not considered to be at risk from one loss event
A package policy, such as a homeowners or business insurance policy that provides coverage against several different perils. It also refers to the combination of property and liability coverage in one policy.
The date on which the vehicle was manufactured in the car company
Medical Evacuation & Repatriation insurance plans provide you with the protection in case you need to be evacuated or repatriate your mortal remains home.
Coverage amount for Medical Evacuation & Repatriation insurance plans provide you with the protection in case you need to be evacuated or repatriate your mortal remains home.
It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.
Medical Evacuation & Repatriation insurance plans provide you with the protection in case you need to be evacuated or repatriate your mortal remains home.
It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.
Maternity insurance is usually provided as an add-on or additional rider with your main health insurance policy. This insurance covers expenses related to both baby delivery options – caesarean and normal delivery.
Maternity waiting period is the no of months or years when a maternity claim will not be paid by the insurer.
Different Options to pay the premium in the insurance policy. E.g Single/Yearly/Half yearly/Quarterly/Monthly
Maturity amount to be paid to the customer post completion of policy term.
A member of a Lloyd’s association; essentially an investor and underwriter.
An individual in whose name the insurance contract is issued and who is specifically identified as the person being covered.
Peril specifically mentioned as covered in an insurance policy.
An insurance contract that lists perils to be insured; perils not listed are not covered.
A negligent act that consists of a party’s failure to do something he or she should have done.
The failure to exercise the degree of care required by law.
The present value of the cash inflow minus the present value of the cash outflow.
A portion of the premium rate designed to cover benefits of the policy, but not expenses, contingencies, or profit
Net premiums written adjusted for the increase or decrease during the year of the liability for unearned premiums
This item represents gross premiums written (direct and reinsurance assumed) less reinsurance ceded
The final amount of insurance retained by the company after reinsuring such amounts as it did not wish to retain
A reduction in the price of an insurance policy because no claims have been made on it
Auto insurance coverage that pays for each driver’s own injuries, regardless of who caused the accident. It also refers to an auto liability insurance system that restricts lawsuits to serious cases. Such policies are designed to promote faster reimbursement and to reduce litigation.
As per section 39 of the Insurance Act 1938, the holder of a Policy ( Life assured) can nominate a person /s who has insurable interest on the life to receive life insurance benefit on the death of the life assured.
Nominee is the person who is nominated to receive the amount under a policy and to give a valid discharge to the insurer on settlement of claim under a life insurance policy
Insurers licensed in some states or countries, but not others. Countries where an insurer is not licensed call that insurer non-admitted. They sell coverage that is unavailable from licensed insurers within the country or state.
A policy that cannot be cancelled by the insurer prior to a certain age. Premiums may be increased only by the amounts specified at the time the policy is issued.
Any private passenger auto, pickup truck, van, or trailer nor owned by or furnished for the regular use of the insured or any family member while in the custody of or being operated by the insured or any family member.
The idea that people who don’t buy coverage should not receive benefits. Prohibits uninsured drivers from collecting damages from insured drivers.
A written notice required by insurance companies immediately after an accident or other loss. Part of the standard provisions defining a policyholder’s responsibilities after a loss.
Motor Insurance companies offer customers the options of choosing a No Claim Bonus (NCB) retention insurance add-on cover also known as NCB retention add-on. Such add-on covers offer protection for your accumulated NCB up to a certain limit. This cover may not be offered by all insurance providers.
No of days when certain claim is not admissible.
This covers the new born baby from day1 to day 90 for any in patient hospitalization. Many insurance co provide inbuilt insurance cover and may insurance company provide as a rider.
Name of the person as nominated by the Life assured to receive the death claim benefit
The person who is the custodian of the policy till the time nominee is Minor.
Funds offered by Insurer & so selected by the Insured in which Money can be invested.
NAV is market value of investments held under the Unit-Linked Fund plus or minus the expenses incurred in purchase or sale of assets, plus the value of any current assets and any accrued income net of Fund Management Charges less the value of any current liabilities and provisions, if any.
It is arrived by dividing Total fund value with NAV.
The probable variation of actual from expected experience.
In a bond, the party to be reimbursed if he or she suffers a loss because of some failure by the obligor.
A reinsurance contract under which business must be ceded in accordance with contract terms and must be accepted by the reinsurer
Occupations which expose the insured to greater than normal physical danger by the very nature of the work in which the insured is engaged, and the varying periods of absence from the occupation, due to the disability, that can be expected
Abnormal condition or illness caused by factors associated with the workplace. Like occupational injuries, this is covered by workers compensation policies.
Insurance that pays claims arising out of incidents that occur during the policy term, even if they are filed many years later.
Coverage of all types of vessels and watercraft, for property damage to the vessel and cargo, including such risks as piracy and the jettisoning of cargo to save the property of others. Coverage for marine related liabilities. War is excluded from basic policies, but can be bought back.
An authority established either by the company or the Government for the quick redressal of grievances
States that it is the insurer’s intention to cover risks of accidental loss to the described property except due to those perils specifically excluded; also called ?all risks.?
The cost of maintaining a business’s property, includes insurance, property taxes, utilities and rent, but excludes income tax, depreciation and other financing expenses.
Gives to insured automatic insurance protection so that there is no risk of any shipments remaining uninsured through oversight
A continuous policy written on a reporting basis
Defines the class and nature of business covered by a specific reinsurance treaty
The cost of keeping monies liquid in a loss reserve fund rather than using them as working capital.
A policy that can be cancelled by the insurer on the anniversary date. No restrictions, other than the time, are placed on the insurer.
Contracts that allow, but do not oblige, the buying or selling of property or assets at a certain date at a set price.
A life insurance policy that remains in force for the policyholder’s lifetime. It contrasts with term insurance, which only lasts for a specified number of years but is renewable.
Clauses in practically all contracts of indemnity and valued contracts that limit the insurer’s liability in case additional insurance con-tracts also cover the loss.
A person who donates an organ or organs needed for transplantation .
Organ donor value signifies the amount of money to be paid towards the hospitalization expenses for the person who is donating his/her organ. The amount can be as high as Sum insured in the plan.
Any other additional coverage
A single insurance policy that combines several coverages previously sold separately. Examples include homeowners insurance and commercial multiple peril insurance.
Non-economic damages designed to compensate the injured party for the pain endured due to the negligent behaviour of the defendant. Often greater than economic losses, such as loss of income and medical expenses.
Used to determine the loss payment when part of a set or one of a pair is lost. The insurance company will pay only the difference in the actual cash value of the item before and after the loss.
An illness or injury that decreases an individual’s ability to perform some of the major duties of his or her job, but does not cause complete cessation of employment.
A type of life insurance policy in which a dividend (considered a return or a premium overcharge) is payable to the insured.
Programs to provide employees with retirement income after they meet minimum age and service requirements. Life insurers hold some of these funds.
A deductible that is assessed for each new sickness or accidental injury.
Possible occurrences, such as a fire, windstorm, flood, lightning, earthquakes or theft. A named-peril policy covers the policyholder only for the risks named in the policy in contrast to an all-risk policy, which covers all causes of loss except those specifically excluded.
An illness or injury that prevents a person from working for the rest of his or her life.
A fee that is charged for each service or visit to the physician.
A policy or an addition to a policy used to cover personal valuables, like jewellery.
Those lines of insurance designed to cover the risk of perils that may interrupt an individual’s income.
A condition stemming from the material characteristics of an object, e.g., wet or icy street (increasing chance of car collision) and earth faults (hazard for earthquakes)
Petty theft, especially theft of articles in less than package lots.
A conscious and deliberate assumption of recognized risk
A written contract for insurance between an insurance company and policyholder stating details of coverage.
The function of creating a specific insurance policy for a client, usually by the agent.
The insured in an insurance policy.
The amount of money remaining after an insurer’s liabilities is subtracted from its assets. It acts as a financial cushion above and beyond reserves, protecting policyholders against an unexpected or catastrophic situation.
Coverage for businesses operating abroad against loss due to political upheaval such as war, revolution, or confiscation of property
Policies that cover property loss and liability arising from pollution-related damages, for sites that have been inspected and found uncontaminated. It is usually written on a claims-made basis so policies pay only claims presented during the term of the policy or within a specified time frame after the policy expires.
Sharing total losses among a group
A provision by which policy holders can change their insurance provider at their own discretion. This usually happens if the policy holder is not satisfied with the service quality of their current insurance provider, or the coverage is not enough or appropriate for the premiums being paid.
It is treatments and expenses after getting discharged from the hospital which may be follow-up visits to the doctor, medications, etc.
Part of the hospital admission process where a review is done for a policy holder. Physicians or doctors at the hospital examine the policy holder’s health condition and past records before he/she is admitted in the hospital.
Applies in case the policy holder goes for admission to a network hospital. A person from the hospital staff confirms from Health Insurance about details of the policy and assesses what procedures are covered and for what amount. Example scenario: Before getting admitted in the hospital for treatment, the hospital staff will contact insurance companies to confirm if Raj is eligible for insurance. Once pre-authorization is done Raj can get admitted and treatment can begin. Also see a short video explaining the cashless claim process.
A health condition or disability the policy holder has had prior to applying for health insurance. Typically, pre-existing conditions are not covered by insurance policies for a period of several months.
It is the medical expenses taken into account before a policy holder is hospitalized.
Insurance for expecting mothers covering expenses such as tests, checkups, medicines.
Action often leading to legal injury.
Severity-reduction measures such as salvaging damaged property rather than dis-carding it.
A cost-containment measurement requiring that certain non-emergency medical services be authorized prior to delivery of treatment.
A health problem that exists prior to the time when health coverage becomes effective.
Loss control methods implemented before any losses occur. All measures with a frequency-reduction focus, as well as some based on severity reduction, are of this type.
Death that occurs before the stage where it is accepted by society as part of the natural, expected order of life.
The particular location of the property or a portion of it as designated in an insurance policy.
The price of an insurance policy.
The sum of the face amounts, plus dividend additions, of life insurance policies out-standing at a given time.
The total premiums on all policies written by an insurer during a specified period of time, regardless of what portions have been earned. Net premiums written are premiums written after reinsurance transactions.
If a person is reported missing without any information for more than 7 years, as per The Indian Evidence Act, presumption of death is awarded by the Court Authority.
Describes policies that will pay up to their limits before any other coverage becomes payable.
In a reinsurance transaction, the insurance company that is reinsured.
Interest rate that banks charge to their most creditworthy customers. Banks set this rate according to their cost of funds and market forces.
Another name for the obligor, the person bonded, in a fidelity or security bond.
A doctrine that limits the amount that an insured may collect to the actual cash value of the property insured.
Insurance coverage written by firms in the private sector of the economy (as opposed to government insurers).
A court process under which property is distributed and the terms of the will are carried out at the owner’s death.
A section of tort law that determines who may sue and who may be sued for damages when a defective product injures someone.
Protects manufacturers and distributors exposure to lawsuits by people who have sustained bodily injury or property damage through the use of the product.
The selling function in insurer operations.
Liability that arises out of the error of a professional person in performance of his or her duties.
Covers professionals for negligence and errors or omissions that injure their clients.
Coverage for the loss of the profit element in goods already manufactured but destroyed before they could be sold.
An assurance that a certain condition, fact, or circumstance will be true for the entire term of a contract.
Insurance lines designed to cover perils that may destroy property.
Covers damage to or loss of policyholders? property and legal liability for damages caused to other people or their property. Property/casualty insurance, which includes auto, homeowners and commercial insurance, is one segment of the insurance industry. The other sector is life/health. Property/casualty insurance is referred to as non-life or general insurance.
A clause that requires each insurer covering a risk to share pro rata any losses, in the proportion that its particular coverage bears to the total coverage on the risk.
Reinsurance agreements under which premiums and losses are shared in some stated proportion.
Marine liability insurance covering ocean-going vessels.
The direct cause of loss; exists if there is no unbroken chain of events leading from one act to a resulting injury or loss.
An individual or firm hired by the insured to obtain satisfactory settlement of a loss claim.
Insurance coverage written by government bodies or operated by private agencies under government supervision and control.
Assessed when it is deemed that the defendant acted in a grossly negligent manner and deserves to have an example made of his or her behaviour so as to discourage others from acting that way. Usually imposed in addition to other damages.
The portion of an insurance premium that reflects the basic costs of loss, not including over-head or profit.
Uncertainty as to whether a loss will occur.
Name of the insurance policy of the company chosen for cover
Unique serial no assigned to Insured person
Name of the insurance policy of the company chosen for cover
A policy number is a unique identifier that attaches a policy to a specific individual. A policy number is assigned to a policy by an insurance company once you have purchased insurance from them. This number is a reference point for the insurance company.
"Motor insurance policy has an inbuilt Personal accident cover for the vehicle owner and driver at no extra cost, wherein the driver is covered as per the Workmen’s Compensation Act. The driver should have a valid driving license. "
"Personal accident cover for any other person can be obtained by paying an additional premium. The company will pay a fixed amount for the bodily injury or death of the passenger. "
Insurance companies carries a pre sales survey of the car for any damage that is already visible in the car.
Payment of compensation if the Insured sustains accidental bodily injury during a trip resulting in death or Permanent Total Disablement or Permanent Partial Disablement within 12 months of occurrence of such injury.
Pre-hospitalization is additional cover benefits which the insurance company extends the policyholder whereby they provide cover for expenses covered for an illness or injury for a certain period before the treatment for that injury or illness is done in a hospital.
Post hospitalization are additional cover benefits which the insurance company extends the policyholder whereby they provide cover for expenses covered for an illness or injury for a certain period after the treatment for that injury or illness is done
No of Years the policy coverage will be in force if premium is paid as per mode of premium payment so selected.
No of years Premium needs to be paid
Amount to be paid against the coverage amount
Reinsurance arrangements in which each insurer accepts a certain percentage of premiums and losses in a given line of insurance.
An estimate of the cost of insurance, based on information supplied to the insurance company by the applicant
The cost of a unit of insurance. Rates are based on historical loss experience for similar risks and may be regulated.
The process of developing pricing structures for insurance.
A method by which an agent gains authority to write insurance. The agent writes a policy and, after the fact, presents it to the insurance company. If the insurance company approves the policy, the agent?s authority is ratified.
A test used to judge what expenses an insurance policy will pay. The fee is compared to prevailing fees in the area.
An extension of the concept of adhesion, this doctrine makes the proposition that coverage should be interpreted to be what the insured can reasonably expect.
A practice, usually prohibited by law or the regulator, in which a sales agent in insurance returns part of the commission to the purchaser.
Amounts owed to a business for goods or services provided.
A form of insurer owned by policy-holders who exchange coverage with each other; commonly found in the field of automobile insurance.
It is an additional benefit on top of health insurance plans provided by Cigna TTK Health Insurance. As the name suggests, the benefit allows for a reduced waiting time before maternity related claims can be made. Without this, the policy holder might wait up to 48 months before he or she can use the policy for a maternity related claim.
This is an add-on benefit related to pre-existing diseases affecting the policy holder. Typically, those with pre-existing diseases cannot claim if affected by these diseases for several months after enrolling into the insurance plan. However, the ‘reduced pre-existing diseases waiting period’ add-on allows the policy holder to claim expenses faster.
A contract in life insurance that allows a policy that has lapsed to be reinstated.
Insurance bought by insurers. A rein-surer assumes part of the risk and part of the premium originally taken by the insurer, known as the primary company. Reinsurance effectively increases an insurer’s capital and therefore its capacity to sell more coverage. The business is global and the largest reinsurers are based abroad. Reinsurers have their own reinsurers, called retrocessionaires.
The shifting of risk by a primary answer (known as the ceding company) to another insurer (known as the reinsurer).
Provides reinsurance for a specific class of business.
A life insurance policy initially written from a specified number of years and subsequently renewable for similar periods of time.
Rents collected from others who occupy property owned by the insured.
Consequential coverage that insures the loss of rents in the event of the destruction of the insured property.
A form of insurance that covers a policyholder’s belongings against perils such as fire, theft, windstorm, hail, explosion, vandalism, riots, and others. It also provides personal liability coverage for damage the policyholder or dependents cause to third parties. It also provides additional living expenses, known as loss-of-use coverage, if a policy-holder must move while his or her dwelling is repaired.
Insurance that pays the amount needed to replace damaged personal property or dwelling property without deducting for depreciation but limited by the maximum amount shown on the declarations page of the policy.
A statement made by an applicant for insurance, before the contract is made, which affects the willingness of the insurer to accept the risk.
From the view of the insurer, there must be a sufficient number of similar objects, the loss must be accidental and measurable, and the objects must not be subject to simultaneous destruction. From the view of the insured, the potential loss must be large enough to cause financial hard-ship, and the probability of loss must not be too high.
(The thing speaks for itself) - a legal doctrine that enables a plaintiff to collect for losses without proving negligence on the part of the defendant.
A company’s best estimate of what it will pay for claims
A legal doctrine under which a principal is responsible for the acts of his or her agent.
Restoration of sum insured is an added benefit in the health insurance products whereby in the event of claims the basic sum insured gets restored to its original value.
The amount of risk retained by an insurance company that is not reinsured.
The reinsurance bought by reinsurers to protect their financial stability.
A method of permitting the final premium for a risk to be adjusted, subject to an agreed upon maximum and minimum limit based on actual loss experience. It is available to large commercial insurance buyers.
A life insurance beneficiary designation that may be changed by the owner.
An attachment to an insurance policy that alters the policy’s coverage or terms.
Ownership of property automatically transfers to surviving owners when one of the owners dies.
The chance of loss or the person or entity that is insured.
Uncertainty as to economic loss. RISK AVOIDANCE: A conscious decision not to expose oneself or one’s firm to a particular risk of loss.
Management of the varied risks to which a business firm or association might be subject. It includes analysing all exposures to gauge the likelihood of loss and choosing options to better man-age or minimize loss. These options typically include reducing and eliminating the risk with safety measures, buying insurance, and self-insurance.
A plan, procedure, or rule of action followed for the purpose of securing consistent action over a period of time.
(1) Identify risks; (2) evaluate risks as to frequency and severity; (3) select risk management techniques; and (4) implement and review decisions.
An individual charged with minimizing the adverse impact of losses on the achievement of a company’s goals.
Method of risk identification and assessment by arranging all risks in a matrix reflecting frequency, severity, and existing insurance coverage.
A decrease in the total amount of uncertainty present in a particular situation.
Handling risk by bearing the results of risk, rather than employing other methods of handling it, such as transfer or avoidance.
A risk management technique whereby one party (transferor) pays another (transferee) to assume a risk that the transferor desires to escape.
The need for insurance companies to be capitalized according to the inherent riskiness of the type of insurance they sell. Higher-risk types of insurance, liability as opposed to property business generally necessitate higher levels of capital.
Unlawful taking of property from another person by force, threat of force, or violence.
It implies the type of use by the vehicle owner.
A unique series of alpha numeric identifying a motor vehicle, assigned on registration and displayed on a number plate.
RTO location means the Regional transport office location where the vehicle is registered.
Roadside assistance cover provides basic emergency assistance at the time of vehicle breakdown such as towing to nearest service center or arranging for alternate cars.
Any additional comments
The limit imposed on the coverage of boarding expenses or room rent of the hospital is called room rent limit.
Restore benefit feature enables the Sum insured under a policy to be immediately restored when the Sum insured is exhausted. This will be applicable for future claim in a same policy year and cannot be used in the same hospitalization.
Both Restore and Recharge means reinstatement of the complete sum assured in the policy
Relationship between Nominee and insured
Damaged property an insurer takes over to reduce its loss after paying a claim. Insurers receive salvage rights over property on which they have paid claims, such as badly-damaged cars. Insurers that paid claims on cargoes lost at sea now have the right to recover sunken treasures. Salvage charges are the costs associated with recovering that property.
A list of individual items or groups of items that are covered under one policy or a listing of specific benefits, charges, credits, assets or other defined items
The policy holder consults with another healthcare professional to validate the first diagnosis or ‘opinion’.This is typically used to re-confirm that a correct diagnosis has been made.
Services provided by a health care provider or specialist through a referral from another doctor (the one you went to originally).
Life insurance policy covering two insureds, with proceeds payable only after both persons are dead.
Stock held by shareholders.
Using the capital markets to expand and diversify the assumption of insurance risk. The issuance of bonds or notes to third-party investors directly or indirectly by an insurance or reinsurance company or a pooling entity as a means of raising money to cover risks.
The concept of assuming a financial risk oneself, instead of paying an insurance company to take it on. Every policyholder is a self-insurer in terms of paying a deductible and co-payments. Also, a special form of risk retention in which a firm can establish a fund to pay for losses because it has a group of exposure units large enough to reduce risk and thereby predict losses.
Size of a loss. One of the criteria used in calculating premiums rates
A method of loss control that will reduce the seriousness and extent of damage should a loss occur.
When a person suffers a temporary loss of income due to an injury or illness which puts them out of work. The time period may range from 9 to 52 weeks, post which claims can be categorized for long term disability.
An annuity whose purchase price is paid in one lump sum.
A whole life policy paid for with one premium
Spoken words that are defamatory and/or injurious to a person’s reputation.
Insurance plans operated by public agencies, usually on a compulsory basis.
An environment where insurance is plentiful and sold at a lower cost, also known as a buyers market.
Insurance companies ability to pay the claims of policyholders. Regulations to promote solvency include minimum capital and surplus requirements, statutory accounting conventions, limits to insurance company investment and corporate activities, financial ratio tests, and financial data disclosure.
A person who is authorized to perform only a specific act or function and who has no general powers within the insurance company.
The uncertainty of an event that could produce either a profit or a loss, such as a business venture or a gambling transaction.
A third party to which the risk of price fluctuations is transferred during hedging.
The selling of insurance in multiple areas to multiple policyholders to minimize the danger that all policyholders will have losses at the same time. Companies are more likely to insure perils that offer a good spread of risk. Flood insurance is an example of a poor spread of risk because the people most likely to buy it are the people close to rivers and other bodies of water that flood.
A type of reinsurance wherein losses are spread over a five-year period with little or no risk transfer after the five-year period ends.
What an employer would pay at manual rates after adjustment for experience rating but before adjustment for retrospective rating.
Benefits that the state requires be offered to employees by employers.
Uncertainties, either pure or speculative, that stem from an unchanging society that is in stable equilibrium.
A deductible that applies to each loss and is subtracted before any loss payment is made.
A whole life policy in which premiums are payable as long as the insured lives.
A life annuity in which there is no refund to any beneficiary at the death of the annuitant.
Term insurance that covers a specific period of time and which cannot be renewed.
Legal agreement to pay a designated person, usually someone who has been injured, a specified sum of money in periodic payments, usually for his or her lifetime, instead of in a single lump sum payment.
The risk based on the mental state of an individual who experiences uncertainty or doubt as to the outcome of a given event.
The legal process by which an insurance company, after paying a loss, seeks to recover the amount of the loss from another party who is legally liable for it.
A clause in life insurance that requires payment by the insurer, even in the event of suicide, if the suicide occurs after a two-year period from the date the policy was issued.
In a bond, the party who agrees to reimburse the oblige.
A contract guaranteeing the performance of a specific obligation. Simply put, it is a three-party agreement under which one party, the surety company, answers to a second party, the owner, creditor or oblige, for a third party’s debts, default or non-performance. Contractors are often required to purchase surety bonds if they are working on public projects. The surety company becomes responsible for carrying out the work or paying for the loss up to the bond (penalty) if the contractor fails to perform.
The remainder after an insurer’s liabilities are subtracted from its assets. The financial cushion that protects policyholders in case of unexpectedly high claims.
That amount of money that becomes available for distribution to living annuitants as a result of the death of other annuitants.
The calendar day on which a policy cover initiates. It includes the day, month and year.
Seating capacity is the number of people who can be legally seated in a specific space.
Amount of Insurance coverage
Money back amount paid at regular interval to the customer as a percentage of Sum insured within policy term.
Illnesses or injuries that prevent a person from working for a limited time.
An annuity that pays benefits until the expiration of a specified period of years or until the annuitant dies.
A health policy that expires at the end of a specified time and which cannot be renewed.
A form of life insurance that covers the insured person for a certain period of time, the ?term? that is specified in the policy. It pays a benefit to a designated beneficiary only when the insured dies within that specified period which can be one, five, 10 or even 20 years. Term life policies are renewable but premiums increase with age.
Healthcare provided at specialty or super specialty hospitals.
Any act of stealing.
Coverage against loss through stealing by individuals not in a position of trust.
An administrator hired by an employer to handle claims and other administrative functions associated with employee benefits. May also refer to and outside group that performs clerical functions for an insurance company.
Insurance companies such as Cigna TTK Health Insurance. When insurance companies like Health Insurance pay for the medical expenses to the hospital on behalf of the policy holder.
Insurance that indemnifies the owner of real estate in the event that his or her clear ownership of property is challenged by the discovery of faults in the title.
A legal term denoting a wrongful act resulting in injury or damage on which a civil court action, or legal proceeding, may be based.
The body of law governing negligence, intentional interference, and other wrongful acts for which civil action can be brought, except for breach of contract, which is covered by contract law.
A wrongdoer; one who commits a tort.
An illness or injury that renders a person completely incapable of gainful employment during the period of disability.
The condition of an automobile or other property when damage is so extensive that repair costs would exceed the value of the vehicle or property.
Reinsurance contracts.
A standing agreement between insurers and reinsurers. Under a treaty each party automatically accepts specific percentages of the insurer’s business.
The person having legal ownership of the trust property; required by law to manage and distribute it in accordance with the instructions specified in the trust agreement.
The acts of a life insurance agent to persuade a client to drop one life policy and accept another, by misrepresenting the terms of either the present policy or the new policy, or both, to the detriment of the insured.
An insurance premium is the amount of money that an individual or business must pay for an insurance policy.
the premium paid for an accidental claim for damaged parts. An own damage cover in your motor insurance policy compensates you for expenses incurred to repair /replace parts damaged in the road accident
The amount payable for third party damages in an insurance policy.It covers the insured's legal liability for death/disability of third-party loss or damage to the third-party property.
a compulsory contribution to state revenue, levied by the government on workers' income and business profits, or added to the cost of some goods, services, and transactions.
Total IDV is the current market value payable to vehicle owner in case of total loss of vehicle.
Return to invoice cover will ensure that in case of total loss or theft of your car, you will get the original invoice value, including registration charges and road tax paid, of the car and not just the insured declared value (IDV).
It is the sum of all funds at their market value. Total Fund Value = (Number of equity fund units x NAV of equity fund) + (Number of bond fund units x NAV of bond fund) etc
Accidental permanent disability rider provides a certain % of Sum assured in case of permanent loss of body parts or functions out of accidents within 180 days from the date of accident.
Coverage for losses above the limit of an underlying policy or policies such as homeowners and auto insurance. While it applies to losses over the amount stated in the underlying policies, terms of coverage are sometimes broader than those of under-lying policies.
The result of the policyholder’s failure to buy sufficient insurance. An underinsured policyholder may only receive part of the cost of replacing or repairing damaged items covered in the policy.
Examining, accepting, or rejecting insurance risks and classifying the ones that are accepted, in order to charge appropriate premiums for them.
The insurer’s profit on the insurance sale after all expenses and losses have been paid. When premiums aren’t sufficient to cover claims and expenses, the result is an underwriting loss. Underwriting losses are typically offset by investment income.
The portion of a premium already received by the insurer under which protection has not yet been provided. The entire premium is not earned until the policy period expires, even though premiums are typically paid in advance.
Absorbing the expense of losses as they occur, rather than making any special advance arrangements to pay for them.
A contract, such as an insurance contract, in which only one of the parties makes promises that are legally enforceable.
Risks for which it is difficult for someone to get insurance.
The implicit assumption of risk by a firm or individual that does not recognize that a risk is acknowledge to exist but the maximum possible loss associated with it is significantly underestimated.
A legal doctrine in which a higher standard of honesty is imposed on parties to an insurance agreement than is imposed through ordinary commercial contracts.
A policy under which the insurer pays a specified amount of money to or on behalf of the insured upon the occurrence of a defined loss. The money amount is not related to the extent of the loss. Life insurance policies are an example.
The malicious and often random destruction or spoilage of another person’s property.
An annuity whose value may fluctuate according to the value of underlying securities in which the funds are invested.
The purchase of a life insurance policy from a terminally ill individual by an unrelated third party.
Legal responsibility for the wrong committed by another person.
Laws requiring that parents assume liability for the acts of their children and that bar owners assume liability for the acts of their patrons. Also makes car owners liable for acts of drivers of their cars.
A policy contract that for some reason specified in the policy becomes free of all legal effect. One example under which a policy could be voided is when information a policyholder provided is proven untrue.
A characteristic of a negligent act- the person committing the act chose to do so and could have chosen not to.
Insurance coverage purchased at the discretion of the buyer.
You need to pay a certain portion of the claim amount and we will pay the rest. This option helps lower the insurance premium amount.
It implies the name of Vehicle manufacturer.
An automobile model (or car model or model of car, and typically abbreviated to just "model") is a particular brand of vehicle sold under a marquee by a manufacturer, usually within a range of models, usually of different sizes or capabilities.
A ‘variant’ within a vehicle type shall group the vehicles which have all of the construction features in common.
Insured Declared Value is the maximum Sum Assured fixed by the insurer which is provided on theft or total loss of vehicle. Basically, IDV is the current market value payable to vehicle owner in case of total loss of vehicle.
Voluntary deductible or excess is that portion of any claim, which is not covered by the insurance company. It is usually a standard amount specified in the policy document which the insured is willing to pay out of his pocket
It is the time period before which a policy holder cannot make a claim after enrolling into a medical insurance plan. Typically this waiting period is for a few days.
The surrender of a right or privilege. In life insurance, a provision that sets certain conditions, such as disablement, which allow coverage to remain in force without payment of premiums.
Eliminates insurance coverage for death that is a direct result of war or other hostile action.
Special coverage on cargo in overseas ships against the risk of being confiscated by a government in wartime. It is excluded from standard ocean marine insurance and can be purchased separately. It often excludes cargo awaiting shipment on a wharf or on ships after 15 days of arrival in port.
A clause in an insurance contract that requires certain conditions, circumstances, or facts to be true before or after the contract is in force.
A type of business interruption insurance that compensates for financial losses caused by adverse weather conditions, such as constant rain on the day scheduled for a major outdoor concert.
Being in good physical and mental health. Health Insurance emphasizes wellness for all its policy holders, as it ultimately reduces the chances of ill health (and in turn claims).
The oldest kind of cash value life insurance that combines protection against premature death with a savings account. Premiums are fixed and guaranteed and remain level throughout the policy's lifetime.
A way to transfer ownership of property at death.
Policies entitled to bonus, which is paid at the time of claim-death or maturity one with-profit policies.
These policies are not entitled to participate in bonuses.
Insurance that pays for medical care and physical rehabilitation of injured workers and helps to replace lost wages while they are unable to work.
To insure, underwrite, or accept an application for insurance.
provide foreign travel emergency health care coverage when you travel outside your home country
A waiver of premium rider is a clause in an insurance policy that waives the policyholder's obligation to pay any further premiums to keep the policy in force, should he become seriously ill or disabled or on his death in certain policies.
Zero depreciation cover promises comprehensive coverage without factoring in for depreciation. If the cover is opted, then the vehicle market price does not depreciate with years. The owner gets full amount of insurance in subsequent years.
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