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  • Glossary

    Health Insurance Terms Made Easy To Understand.


Renewal is the act of extending the validity period of an existing general insurance policy. Renewal allows policyholders to continue enjoying the benefits and coverage offered by their insurance provider and prevents their policy from expiring or lapsing. Policyholders must pay an annual premium to renew their policy and abide by renewal-specific terms, including paying the premium before the policy expiration date or the grace period. Failure to renew the policy on time can result in the insurer terminating the policy.

Recovery Benefit

A Recovery Benefit is a lump sum amount that an insurance company provides to a policyholder for medically necessary hospitalisation. Policyholders can avail of the recovery benefit in the event that their hospitalisation duration exceeds ten consecutive days. Insurers offer this benefit over and above the sum insured amount, and the benefit does not reduce the applicable sum insured of a given policy. The recovery benefit amount differs from one insurance policy to another.

Renewal Benefit

Insurance companies offer various perks to policyholders for renewing their general insurance plans on time. These perks are collectively called Renewal Benefits. Lucrative renewal benefits offered to policyholders upon renewing a health insurance policy include continuous and uninterrupted coverage, a no-claims bonus that enhances the sum insured, and suspended /reduced waiting periods, especially for critical illness and pre-existing disease policies with longer waiting periods.

Restore/Restoration Benefit

A Reset/Restoration benefit allows policyholders to restore their sum insured upon exhausting it in a policy year. This benefit is offered as an add-on rider with medical insurance plans. The reset benefit is applicable on a partial (restoration after exhausting only a specific portion of the sum insured) and total (restoration after utilising the entire sum insured) exhaustion basis. This add-on rider is ideal for family health insurance policies generally covering several people under a single insured sum.

Road Ambulance Cover

Road Ambulance Cover is an add-on rider offered by health insurance providers. It covers expenses in the event that a policyholder needs to call an ambulance to transport a patient to the hospital. Insurers cover the charges associated with transporting policyholders to the nearest hospital during an emergency, commuting from one hospital to another, and transferring patients from the hospital to their homes. Insurers usually set a limit or cap on the road ambulance cover amount.

Reasonable and Customary Charges

Reasonable and Customary Charges are the charges levied by healthcare facilities for services provided and supplies used while treating an injury or illness. Insurance providers typically cover these "customary" charges so long as they meet the industry standards and are "reasonable". The charges should be consistent with the prevailing expenses in a given geographical area offering similar services, based on the nature of the injury or illness for which the policyholder is seeking treatment.


Reimbursement is a process wherein an insurance provider settles the cash claims submitted by policyholders. Policyholders typically file for reimbursement after seeking treatment in a non-network hospital. Policyholders must submit detailed, itemised bills for all expenses incurred, including costs of diagnostic tests, doctor's fees, hospitalisation charges, etc., to be eligible for reimbursement. The insurance company evaluates the claim and reimburses expenses up to the sum insured limit.

Redressal of Grievances

Insurance companies acknowledge complaints and concerns through a process called Redressal of Grievances. Policyholders can submit this complaints and requests by contacting their insurance company's toll-free number or sending an email ID. They may also contact the Integrated Grievance Management System of the IRDAI or visit the nearest Insurance Ombudsman office for grievance redressal.