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  • Glossary

    Health Insurance Terms Made Easy To Understand.


In a health insurance policy, an accident is defined as any sudden event or circumstance that is unplanned, involuntary, or unforeseen. Such an event could be caused by any external, visible or violent means.

Associated Medical Expenses

An Associated Medical Expense is a type of expense that includes various aspects covered under a medical insurance policy, such as room rent costs, RMO and nursing charges costs, operation theatre costs, doctor/surgeon/specialist/anaesthesiologist fees, etc. Expenses such as pharmacy and consumables costs, diagnostic costs and medical devices and implants costs (including artificial limb costs) are not included under Associated Medical Expenses.


An agent is a representative of a health insurance company. Such an individual serves as an intermediary between customers and insurance providers. The insurance company authorises agents to sell, promote, or offer insurance policies on their behalf. Agents also help customers understand the features and coverage provided under various general insurance plans and assist during the claim filing process.

Ambulance Cover

Hospitals typically levy a high charge to transport patients to their facilities in the event of an accident or a medical emergency. Some insurers offer an ambulance cover as an additional rider, which policyholders can purchase by paying a little extra over and above their base insurance premium amount. An ambulance cover if in-built shall cover the expenses of transport of patient from hospital to home, home to hospital or hospital to hospital or as per the medical emergency.

Any one Illness

Any one illness is defined as a continuous period of illness, including the relapse of an illness within a period of 45 days from the date of the last medical consultation at a hospital where the policyholder underwent treatment.


The IRDAI grants policyholders the option to seek alternative forms of treatment or therapy beyond the conventional allopathic treatment course. Treatments like Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) are the recognised alternative treatments policyholders can seek.

AYUSH Hospital/ AYUSH Day Care Centre

An AYUSH Hospital is defined as a healthcare facility wherein medical, surgical, and para-surgical treatment, procedures, and interventions are carried out by Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) medical practitioners. Policyholders who have purchased the AYUSH add-on rider can seek these alternative forms of treatment at central government-recognised AYUSH hospitals and colleges. Such institutions should have more than five in-patient beds, round-the-clock AYUSH practitioners on the premises, and dedicated AYUSH therapy sessions and equipment. An AYUSH Day Care Centre is typically similar to an AYUSH Hospital, but such facilities are not obligated to have in-patient beds.

Annual Renewal Date

The date by which a policyholder is required to renew their general insurance policies is known as the annual renewal date. Failure to renew the policy before the annual renewal date may result in the insurer suspending the policy. Insurers generally offer a one-month grace period during which policyholders can renew their policy. If the policyholder still does not renew the policy, the insurer terminates it altogether.


Insurance companies typically consider the age of policyholders while offering them coverage. For insurers, age is defined as the insured person's age as of their last birthday or age as of the policy commencement date.

Alternative Treatment

Treatment forms beyond conventional allopathic treatments, such as Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH), are known as alternative treatments. Per IRDAI guidelines, insurance companies are obligated to cover the hospitalisation and associated medical costs of these above-mentioned Alternative Treatment courses, so long as the policyholder opts for the AYUSH add-on rider.

Automatic Restoration

Some health insurance policies provide policyholders with a facility that enables them to restore their sum insured after it is exhausted. Policyholders can utilise the restored sums for their next hospitalisation. This benefit, typically offered as an add-on rider and provided under family floater health insurance plans, is known as Automatic Restoration.

Accumulation Period

The period during which a new policyholder is not eligible to file claims (except in case of accidents), is known as the accumulation period. Any expenses incurred by policyholders during the Accumulation Period go towards satisfying the deductible, if applicable. Generally, this period lasts for 30 days from the policy purchase date.


In health insurance policies, an assignee is an individual who receives the benefits of a particular policy.

Acute Care

Acute care is defined as any medical treatment or care a policyholder undergoes or receives at a recognised medical facility (like a hospital or AYUSH centre) under professional nursing care. Acute care treatments are typically temporary and not chronic.