Health insurance, in plain words
The lines in your policy that decide what you pay at the hospital, each explained in a sentence, with an example in rupees.
Co-payment (co-pay)A co-payment is a fixed share of every admissible claim that you pay yourself, such as 10% or 20%.DeductibleA deductible is the part of a claim you, or your base policy, must cover before a policy starts paying.Moratorium periodThe moratorium period is the point after which your insurer can’t refuse a claim or cancel your policy for non-disclosure, except for proven fraud.No-claim bonus (cumulative bonus)A no-claim bonus (or cumulative bonus) adds to your sum insured for each year you don’t make a claim, at no extra premium, often 10% to 50% a year up to a set maximum.Pre-existing disease (PED) waiting periodThe pre-existing disease waiting period is the time before a policy pays for conditions you had when you bought it, such as diabetes or thyroid disease.Proportionate deductionA proportionate deduction is the cut an insurer makes to your whole bill when your hospital room costs more than your room rent limit.Restoration (recharge) benefitA restoration benefit refills your sum insured, once or more in a policy year, after you use it up.Room rent limitA room rent limit is the most your health policy pays for a hospital room per day, often 1% of the sum insured.Specific illness waiting periodA specific illness waiting period is the time before a policy pays for a named list of illnesses and procedures, such as cataract, hernia or joint replacement, even if you didn’t have them before.Sub-limitA sub-limit is a cap on what your policy pays for a particular treatment or item, such as ₹40,000 per eye for cataract, even when your sum insured is much higher.
See these in your own policyUpload your policy PDF. We’ll find each of these lines and show what they mean for you, with the page they’re on.