Saturday, August 1, 2015

Common Definitions in Health Insurance

Inpatient :
Insured who undergoes treatment after getting admitted in the hospital

Outpatient:
Insured who undergoes treatment without getting admission/staying in the hospital

Day care centre:
Diseases do not require more than a day's stay in the hospital or less than 24 hrs at times Eg.cataract

Third Party Administrator(TPA):
It means any person who is licensed under the IRDA(Third Party Administrators - Health Services) Regulations, 2001 by the Authority, and is engaged for a fee or remuneration by an insurance company, for the purposes of providing health services.

Network Provider:
Hospitals enlisted by an insurer of or by a TPA & Insurer together

Portability:It is the right of the policy holder to transfer the policy with the same conditions from current insurer to the new insurer.

Pre existing Condition(PED): Existing illness before taking the policy with the same conditions from current insurer to the new insurer

Senior citizen:
Who has completed 60 yrs or above


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