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  • Glossary

    Health Insurance Terms Made Easy To Understand.


Insurance Fraud refers to an illegal act committed by policyholders or their insurance agents with malicious intent to deceive the insurance provider into issuing an insurance plan. If a policyholder misrepresents facts or actively conceals critical information (not disclosing pre-existing illnesses, for instance), they are said to have committed insurance fraud. In such cases, the insurance provider immediately terminates their insurance policy and black-lists the insured from obtaining insurance in future.

First Diagnosis

Individuals with any illness typically undergo various stages of diagnosis to ascertain their condition. The first diagnosis in health insurance is the first-ever medical diagnosis of an illness, disease or ailment recorded by a medical professional, based on which the individual begins the treatment process.

Family Floater Policy

A family floater policy, also known as a family health insurance plan, is one that covers the medical expenses of various members of a family under a single plan. A family medical insurance plan typically covers the primary policyholder, their spouse, children and, in some cases, parents. Such policies come with a single sum insured amount, jointly shared by all insured members. It enables multiple members to seek treatment simultaneously (if necessary) and covers expenses up to the sum insured.

Free Look Period

A free look period in health insurance is the time insurance providers allow potential customers to cancel their newly purchased health insurance policies. Insurers generally enable policyholders to terminate their policy within 10 to 15 days after its issue date. Policyholders usually use the free-look period to shop around and assess competitors offering better deals.

Fees of Medical Practioner

Medical practitioners like consultants, specialists, anaesthesiologists, surgeons etc., usually levy high fees. A health insurance policy covers these costs when a policyholder needs hospitalisation and treatment. Some of these costs are covered under cashless claims (e.g. surgeon and anaesthesiologist fees) if the policyholder chooses cashless hospitalisation. Policyholders can also claim reimbursement for fees directly paid to medical practitioners like consultants and specialists.


A family is a group comprising more than one member of a family unit. Family members covered under a health insurance plan can be legally wedded spouses, natural or legally adopted dependent children aged between three months and 25 years, and parents. Insurance companies sometimes allow policyholders to include their parents-in-law and dependent siblings under their insurance plans.

Financial Endorsements

A financial endorsement is a written endorsement or request made by a policyholder that generally alters their insurance premiums. A policyholder may wish to add new members, like a spouse or a new-born baby, to the insurance plan, thus increasing the premiums. Conversely, they may want to remove deceased family members or a divorced spouse to reduce their premium. Insurers must submit a written financial endorsement request, as only the insurance provider can incorporate the requested changes.

30 Days Waiting Period

Health insurance providers typically do not offer coverage from day one. They require policyholders to ride out an initial waiting period, also known as the first 30 days waiting period, during which the insurer is not liable to cover medical expenses. A standard health insurance policy typically has a waiting period for the first thirty days. Policyholders cannot file an insurance claim during this period, except in case of an accident.