• Glossary-banner
  • Glossary

    Health Insurance Terms Made Easy To Understand.


Injury refers to any accidental physical bodily harm directly caused due to external, visible, or violent means. For a policyholder to file a health insurance claim for an injury, the injury should be evident, and a medical practitioner should verify and certify the injury as accidental. Policyholders can, however, file insurance claims for injuries like cuts, bruises, abrasions, etc., resulting from an illness or a disease.


An illness is a sickness, disease, or pathological condition that disrupts normal physical functions of the body. In health insurance, an illness is defined as a condition that occurs during the policy period. The policyholder can seek medical treatment, while the insurer bears the costs up to the sum insured. An illness can either be an acute condition or a chronic ailment. Acute conditions respond quickly to treatments, whereas chronic diseases need long-term monitoring and control.

In-patient Care/In-patient Treatment

In-patient care or in-patient treatment refers to the treatment covered under a health policy wherein a policyholder is obligated to stay hospitalised for at least 24 hours to file an insurance claim. Insurers generally list the various in-patient treatment courses covered under a health insurance plan in the policy agreement document.

Intensive Care Unit

Intensive care unit is a special section, ward, or wing of a hospital where patients receive specialised treatment for critical conditions. The level of care and supervision provided in the ICU is relatively more sophisticated and intensive than in regular hospital units.

ICU Charges

ICU charges apply for the use of the Intensive Care Unit room. The rooms under this category involve advanced equipment to monitor and care for a patient's condition. The costs to place a patient in the ICU are relatively higher than those associated with standard hospital rooms. The insurance company reimburses the ICU room cost up to the room rent limit applicable in the policy.


IRDAI is short for the Insurance Regulatory and Development Authority of India. It is the national governing body that formulates the rules and regulations concerning insurance in India while regulating and promoting various insurance companies, their agents, and insurance brokers. The IRDAI plays a prominent role in protecting the rights and interests of insurance buyers within the country and supervises the orderly growth of the insurance industry.


An insurer is another term used to refer to an insurance company or an insurance provider. An insurer is an entity that offers insurance plans and covers the cost of medical expenses when a policyholder files a claim. The insurer provides coverage to the insured up to a specific sum insured and charges a premium from the policyholder for the coverage offered.

Insured/Insured Persons/Insured Party

Insured refers to an individual/group named as a beneficiary of health insurance coverage under a health insurance policy schedule. These individuals or entities pay an annual premium to receive medical coverage if/when they need hospitalisation. The insured individuals are obligated to follow due process while filing or raising an insurance claim, which could be a cashless or reimbursement claim.

Individual Health Insurance

Individual health insurance is a type of health insurance plan that covers a single individual registered as the policyholder. Such an individual becomes the sole beneficiary of an insurance plan, which they cannot transfer to anyone else. Policyholders may customise their individual health insurance policies and extend their coverage with the help of various additional riders.