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Healthcare Glosssary

This glossary page covers some of the most widely used terms in the insurance industry. We have organized this page into an easy-to-read format so that new readers would benefit greatly with minimum fuzz here while familiarizing themselves with this new field.

 Beneficiary

This is the party (could either be a person or any legal entity) made to receive the insurance payout as dictated by the insured person, should an event insured come to realization.

 Co-Insurance

Co-insurance measures the difference between the deductible paid and insurance benefits. It is often expressed in terms of percentage. To illustrate, take a 20% (80/20) co-insurance arrangement, 20% of the covered loss is paid by the insured person in the form of deductible while the balance of 80% is attributed to the insurance provider. In order to avoid excessive payment from the insured person, there is usually a cap on this co-insurance fee. To revert back to the example of 20% coinsurance, an extra claim of $10,000 would equate to an additional $2000 from the part of the insured person.

 Chronic condition

This refers to a health condition that has been with a patient for fairly long time. Chronic condition is invariably considered treatable to bring about relief but unfortunately no effective cure has been found, for example asthma.

 Deductible / Excess

This works similarly as excess and it is about the required amount to be paid by the insured person prior to any insurance company steps up to foot the balance in the covered loss, as part of the contract.

 Emergency Reunion and Repatriation Benefits

Emergency reunion refers to a provision by the insurance company to reimburse cost incurred as family member make a trip to be with the insured person who is deemed to be in critical condition. On the other hand, repatriation benefit is an obligation on the part of insurance company to extract without cost the deceased insured person back to his or her country of origin

 Exclusions

These refer to the specified events that would be excluded from any insurance cover. The followings illustrate some events that would fall into this category, i.e.: any cover associated to drug abuse, pre-existing medical conditions, pregnancy, voluntary engagement in hazardous activities, participation in dangerous sports or adventures, circumstances arisen from war, insurrection, riot, etc.

 Hazardous Sports & Activities Coverage

As a rule of thumb, healthcare companies and travel insurance providers tend to turn away from medical bills and/or travel cancellation coverage related to engagement in dangerous sport/activities. However, there exists certain insurance plans which make available riders to customers participate in these sports, so as to at least compensate for these exclusions in part

 Maximum Policy Coverage

This represents the maximum payout an insurance company is willing to fork out as the incurred loss to the policy beneficiary

 Premiums

The amount you invest in exchange of an insurance cover or travel protection plan from the healthcare provider. Medical insurance that is travel-related and trip protection plans are to be paid in full upfront, other variations of medical insurance often compel the customers to either pay the premiums in full, semi-annual, quarterly or monthly

 Pre-existing Conditions

Pre-existing condition describes a medical condition that an insured person (and any covered individuals) has been affected prior to subscription to any insurance plan or policy.

 Underwriting

Underwriting concerns with the assessment of the likelihood of an event to come to realization, the cost side analysis, and attempting to come to a conclusion on the profit / loss impact of the insurance company should it undertake such risk