Glossary of Visitor Health Insurance terms
AD&D (Accidental Death & Dismemberment): Provides insurance protection if insured death has occurred due to an accident. AD&D also provides benefits for the accidental loss of hands, feet, eyesight, speech or hearing.
Beneficiary: is the person or persons nominated by the insured to earn the benefits of an insurance policy after the death of the insured.
Co-Insurance: The percentage or amount of covered expenses that the insurance company pays after the deductible. For Example: "Co-Insurance = 10% or 90/10" means that insurer pays 90% of the charges, the insured pays 10%. Generally in many insurance policies there is a maximum co-pay amount, i.e., a limit after which the insurance company pays 100%. Example: "Deductible = $500 and 90/10 co-pay up to $4000, then 100% up to policy maximum." This means the insured is required to pay the deductible of $500 plus 10% of expenses up to $4,000, and the insurance provider pays 100% of covered expenses that exceed $4000 up to the maximum policy coverage limit.
Deductible: is that portion of a covered loss that is subtracted (deducted) from the amount of the insurer would otherwise be obligated to pay the insured. This encourages insured to try to prevent losses because the insured will bear a part of any loss. This reduces the premium and enables people to purchase coverage at reasonable price without involving the insurer in small losses. For example, if an Insured purchase a plan with a $400 deductible and incur $3000 of expenses, the insurer will reimburse $2600 (3000-400) only, and the insured bears $400.
Exclusions: This can be defined as the provisions which eliminate coverage for specific exposures wherein the insurance company/policy will not pay. For example: intentionally causing losses to collect the insurance proceeds, expenditure that is incurred from illegal drug use, conditions that occurred before or which were performed former to the effective date of insurance policy (pre-existing conditions), involvement in different dangerous activities. Understand coverage precisely for these exclusions in your Insurance policy.
Hazardous Activity Coverage: amateur racing, piloting any aircraft, bungee jumping motorcycling, scuba diving, jet, snow, water skiing, mountain climbing, sky diving, spelunking, parasailing , surfing, and whitewater rafting etc related coverage.
Indemnify: means to restore the insured who has sustained a loss to the same financial position that the insured held before the loss occurred.
Inpatient: Medical treatment that involves/requires to stay overnight at a hospital.
Insured: is the end customer who buys the insurance policy; a person who contracts for an insurance policy that indemnifies him against loss of property or life or health etc.
Insurer: company who sells Insurance and contracts to indemnify another in the event of loss or damage..
Intensive Care: or critical care that provides more than general medical care and continuous monitoring and observation to patients in a critical or unstable condition. The arrangement of intensive care is normally supervised in a specialized unit of a hospital called the Intensive Care Unit (ICU) or Critical Care Unit (CCU).
Maximum Coverage: The maximum limit/amount of money that the insurance company will pay for covered expenses. This may be an overall maximum or an amount for each accident/illness. Suppose total policy limit is $10000 and each accident/illness limit is $1000, this means the insurer will pay a maximum up to $1000 per accident/illness. The amount paid by the insurer per accident is deducted from total policy limit. This implies that after reimbursement of $900 in an accident, the policy limit is now reduced to $9100 for that policy term.
Outpatient: Medical attention that does not include to stay overnight at a hospital.
Pre-existing conditions: Normally, pre-existing conditions are termed as, any sort of medical illness, medical consultation; medication problems, or any treatment or surgery that occurred before or which were performed former to the effective date of insurance policy.
Premium: The amount that the insured pays to buy an insurance policy for a specified period. Premiums can be paid by the insured as a full amount in advance or monthly, quarterly, half yearly or annually depending on the policy.
Renewable: If a policy is renewable, it means the particular plan/policy can be continued and not be treated as a new policy. This feature has an importance in the manner that if something occurs in previous months, that will not be considered as pre-existing condition where as the new policy will consider it as a pre-existing condition. So if insured extends his stay and like to renew the policy the same policy can be renewed.
Repatriation: Coverage to send insured back to his home country, if the insured are unwell or injured overseas.
Return of Mortal Remains: coverage to send remains of the insured back home in the event of death.
Underwriter/Carrier: The insurer who evaluates applicants for insurance, select those who are acceptable to be insured, prices coverage, premiums, and decides policy terms and conditions and it is the Underwriter that actually carries the risk associated with the plans. Example: Lloyd's is underwriter for INBOUND plan.
URC (Usual, Reasonable, and Customary): URC charge is the maximum amount that an insurance provider will reimburse for a medical expense covered under insured health insurance policy. URC charges are normally decided based on charges that are actually billed by health providers for each medical procedure or service in a geographical area.
