Add-on Cover
Extra CoverEk optional extra cover jo aap apni base insurance policy ke saath khareed sakte hain. Add-ons premium badhate hain lekin extra benefits dete hain.
📌 Example:
Zero Depreciation, Engine Protection aur Roadside Assistance car insurance ke popular add-ons hain.
Assignment
TransferPolicyholder (assignor) se dusre vyakti (assignee) ko insurance policy rights ka transfer. Assignment ke baad, assignee policy ka owner ban jaata hai. Usually life insurance pe loan lete waqt use hota hai.
📌 Example:
Aap apni ₹50L life insurance policy bank ko home loan ke collateral ke roop mein assign karte hain.
Bonus
BonusAapki life insurance policy ki sum assured mein judi hui extra amount, insurer dwara surplus profits ke basis pe declared. Sirf participating (with-profit) policies bonus kamati hain.
📌 Example:
Agar aapki policy sum assured ₹10L hai aur bonus ₹3L accumulated hai, toh maturity payout ₹13L hoga.
Cashless Claim
Cashless ClaimClaim jahan insurer directly hospital ya garage ko bill chukata hai — aapko upfront pay nahi karna (except deductibles/co-pay). Sirf insurer ke network hospitals ya garages mein available.
📌 Example:
Aap Star Health network hospital mein ilaj karate hain aur insurer directly hospital ko payment karta hai.
Co-payment (Co-pay)
Co-paymentClaim amount ka fixed percentage jo aapko apni jeb se dena padta hai. Insurer baaki deta hai. Co-pay wali policies ka premium kam hota hai lekin claim mein jeb se zyada kharcha. Senior citizen plans mein aksar 10-20% co-pay mandatory.
📌 Example:
₹2L hospital bill pe 20% co-pay ke saath, aap ₹40,000 denge aur insurer ₹1,60,000.
CSR (Claims Settlement Ratio)
Claim Settlement RatioYear mein received total claims mein se insurer dwara settle kiye gaye claims ka percentage. Formula: (Claims Settled ÷ Total Claims) × 100. Higher CSR = more reliable insurer. Life insurance ke liye 95% se zyada CSR choose karein.
📌 Example:
Agar insurer ko 1,000 claims mile aur 970 settle kiye, toh CSR 97% hai.
Deductible
DeductibleWoh amount jo aapko insurer ke payment shuru karne se pehle jeb se deni hoti hai. Compulsory deductible insurer fix karta hai. Voluntary deductible aap premium kam karne ke liye choose karte hain.
📌 Example:
Agar policy mein ₹5,000 deductible hai aur claim ₹50,000 hai, toh aap ₹5,000 denge aur insurer ₹45,000.
Endorsement
AmendmentInsurance policy mein likhit amendment jo uski terms, conditions ya coverage change karta hai. Endorsements coverage add, remove ya modify kar sakte hain. Insurer dwara issue hone pe legally binding.
📌 Example:
Aap endorsement ke madhyam se apne navjat shishu ko health insurance policy mein add karte hain.
Exclusion
ExclusionSpecific conditions, treatments ya situations jo aapki insurance policy mein covered nahi hain. Excluded items ke claims reject honge. Khareedne se pehle hamesha exclusion list padhein.
📌 Example:
Aapki health insurance policy dental treatment ko exclude kar sakti hai jab tak woh accident ki wajah se na ho.
Free-look Period
Free-look Period15-30 day window policy document receive karne ke baad jismein aap policy return kar full refund paa sakte hain. Yeh mis-selling se bachata hai. India mein sabhi life aur health policies ke liye available.
📌 Example:
Aap online policy khareedte hain, terms padhte hain, aur decide karte hain ki yeh sahi nahi hai. 15 din ke bheetar cancel karein.
Grace Period
Grace PeriodPremium due date ke baad extra time (15-30 din) jismein aap bina policy lapse kiye payment kar sakte hain. Yearly/half-yearly ke liye 30 din. Monthly/quarterly ke liye 15 din.
📌 Example:
Aapka premium 1 January ko due hai. Aapke paas coverage khoye bina 31 January tak payment karne ka time hai.
ICR (Incurred Claims Ratio)
Incurred Claims RatioInsurer dwara paid total claims ka total premium se ratio. ICR 60-90% healthy hai. 60% se kam strict claim handling. 100% se zyada matlab insurer kam se zyada de raha hai.
📌 Example:
Agar insurer ne ₹100Cr premium collect kiya aur ₹75Cr claims pay kiye, toh ICR 75% hai.
IDV (Insured Declared Value)
Insured Declared ValueAapke vehicle ka current market value — theft ya total loss pe insurer dwara max payable amount. IDV = Ex-showroom price minus depreciation based on vehicle age. Higher IDV = higher premium lekin better claim payout.
📌 Example:
Ex-showroom price ₹10L wali car 2 saal baad approx ₹8L IDV (20% depreciation ke baad).
Maturity Benefit
Maturity BenefitLife insurance policy poori term complete karne pe milne wali lump sum amount. Endowment, money-back aur ULIP mein available — term insurance mein nahi.
📌 Example:
Aapki ₹10L endowment policy 20 saal baad mature hoti hai. Aapko ₹10L + ₹4L bonus = ₹14L milte hain.
NCB (No Claim Bonus)
No Claim BonusMotor insurance mein har claim-free year pe Own Damage (OD) premium pe discount. NCB 1 year baad 20% se shuru hoti hai aur 5+ claim-free years baad 50% tak badhti hai. NCB policyholder ka hai, vehicle ka nahi.
📌 Example:
5 claim-free years baad, aapko ₹15,000 ke OD premium pe 50% discount — ₹7,500 ki bachat.
Nomination
NominationEk vyakti (nominee) ko appoint karne ki process jo policyholder ki death ke baad policy proceeds receive karega. Nominee legal heirs ke liye trustee ke roop mein kaam karta hai. Aap policy term mein kabhi bhi nominee badal sakte hain.
📌 Example:
Aap apni wife ko 60% aur bete ko 40% nominee ke roop mein nominate karte hain.
OD (Own Damage)
Own DamageMotor insurance ka component jo accidents, theft, fire, natural calamities aur man-made disasters se aapke vehicle ki damage cover karta hai. OD optional (TP mandatory ke viparit) lekin highly recommended.
📌 Example:
Parked car pe ped girta hai — OD cover repair ke liye payment karta hai. TP isse cover nahi karta.
PED (Pre-existing Disease)
Pre-existing DiseaseKoi bhi health condition jo health insurance policy start hone se pehle mojud thi. Common PED — diabetes, hypertension, thyroid, asthma. Zyadaatar insurers 1-4 years waiting period ke baad PED cover karte hain. PED chhupana claim rejection ka #1 reason.
📌 Example:
Aapko health insurance khareedne se pehle diabetes hai. 2 saal ki waiting period ke baad, diabetes-related treatments covered hain.
Portability
PortabilityEk insurer se dusre mein health insurance badalne ka haq accumulated benefits — waiting period credits aur no-claim bonus retain karte hue. Renewal se 45 din pehle apply karein.
📌 Example:
Aap 3 saal baad Insurer A se B mein switch karte hain. Aapka 3-year waiting period credit transfer hota hai.
Premium
PremiumWoh amount jo aap insurance policy active rakhne ke liye insurer ko dete hain (yearly, half-yearly, quarterly, ya monthly). Premium sum insured, age, health, occupation, policy type pe depend karta hai. Grace period se pehle payment na karne pe policy lapse.
📌 Example:
Aap ₹5 lakh ki health insurance policy ke liye ₹12,000 per year (premium) dete hain.
Reimbursement Claim
Reimbursement ClaimClaim jahan aap pehle hospital ya garage ko payment karte hain, phir insurer ko bills aur documents repayment ke liye submit karte hain. Cashless ke viparit, reimbursement kisi bhi hospital mein kaam karta hai. Processing 7-30 din.
📌 Example:
Aap non-network hospital mein ₹2L payment karte hain. Insurer ko bills submit karein. ₹1.8L reimbursement (co-pay deduction ke baad).
Restore Benefit
Restore BenefitHealth insurance ki feature jo policy year mein sum insured exhaust hone pe automatically reinstate karti hai. Restored amount usually base sum insured ke barabar hota hai. Family floater plans ke liye especially valuable.
📌 Example:
Aapka ₹10L family floater fully use ho gaya. Restore benefit usi year future claims ke liye ₹10L aur add karta hai.
Rider
RiderLife insurance policy ka optional add-on jo base cover se zyada extra benefits deta hai. Common riders — Critical Illness, Accidental Death Benefit, Waiver of Premium. Riders ₹200-2,000/year extra — alag policy se kaafi saste.
📌 Example:
Aap apne ₹1 crore term plan mein sirf ₹1,500/year extra mein ₹25L ka Critical Illness Rider add karte hain.
Room Rent Cap
Room Rent LimitMaximum daily room charge jo aapka health insurance cover karega, usually 1-2% of sum insured. Agar aap is limit se upar ka room choose karte hain, toh aapko proportionally difference pay karna pad sakta hai.
📌 Example:
₹5L policy 1% room rent cap ke saath, insurer room charges ke liye ₹5,000/day tak cover karta hai.
Solvency Ratio
Solvency RatioInsurance company ke financial health aur claim payment capability ka measure. IRDAI minimum 1.5 (150%) solvency ratio mandatory karta hai. Higher solvency = more financially stable insurer.
📌 Example:
Agar insurer ke ₹150Cr assets aur ₹100Cr liabilities hain, toh solvency ratio 1.5 (150%) hai.
Sum Insured
Sum InsuredClaim ki sthiti mein insurer dwara payable maximum amount. Health insurance mein medical expenses ke liye total coverage. Motor insurance mein IDV ke barabar. Life insurance mein isse Sum Assured kehte hain. Under-insurance sabse aam galti hai.
📌 Example:
Aapki ₹10L sum insured wali health policy. Maximum claim payout ₹10L per policy year.
Surrender Value
Surrender ValueAmount jo aapko milta hai agar aap maturity se pehle life insurance policy se bahar nikalte hain. Guaranteed surrender value (3 saal baad) total premium ka 30% minus first year premium. Term insurance mein koi surrender value nahi.
📌 Example:
Aapne ₹10L endowment policy pe ₹50,000/year 5 saal tak diye. Guaranteed surrender value ≈ ₹60,000.
TP (Third-Party Insurance)
Third-Party InsuranceMandatory motor insurance jo aapke vehicle dwara teesre paksh ko chot, maut ya sampatti kshati ke liye aapki legal liability cover karta hai. TP rates IRDAI engine capacity ke basis pe fix karta hai. TP aapke vehicle ki damage cover nahi karta.
📌 Example:
Aapki car pedestrian se takrati hai. TP insurance pedestrian ke medical expenses aur aapki legal liability cover karta hai.
Underwriting
UnderwritingProcess jismein insurer aapki risk profile (age, health, occupation, lifestyle, claims history) evaluate karta hai coverage aur premium decide karne ke liye. Honest disclosure important hai.
📌 Example:
30 saal ka non-smoker preferred rates pata hai. 50 saal ka smoker usi term plan ke liye 50-100% zyada pay karta hai.
Waiting Period
Waiting PeriodWoh time jismein insurance policy ke kuch benefits available nahi hote. Common waiting periods: Initial (30 din), Pre-existing disease (1-4 saal), Specific diseases (1-2 saal), Maternity (9 mahine - 2 saal). Accident ko chodke waiting period mein claims reject.
📌 Example:
Aap 2 saal PED waiting period wali health policy khareedte hain. 2 saal tak diabetes treatment covered nahi.
Zero Depreciation (Zero Dep)
Zero DepreciationMotor insurance mein add-on cover jahan insurer parts replacement ki full cost bina depreciation kaate deta hai. Zero Dep ke bina, aap claim mein plastic, rubber, fiber parts ki 30-50% cost bear karte hain. 5-7 saal tak ke vehicles ke liye available.
📌 Example:
Zero Dep ke bina: ₹30,000 bumper replacement → aap ₹15,000 denge. Zero Dep ke saath → aap ₹0 (sirf compulsory deductible).
Quick Reference – Most Searched Terms
| Abbreviation | Full Form | Hindi | Why It Matters |
|---|---|---|---|
| IDV | Insured Declared Value | बीमित घोषित मूल्य | Aapki car ka claim payout decide karta hai |
| NCB | No Claim Bonus | बिना क्लेम बोनस | OD premium pe 50% tak discount |
| PED | Pre-existing Disease | पूर्व-मौजूदा बीमारी | Declare karna zaroori — warna claim rejection |
| CSR | Claims Settlement Ratio | क्लेम निपटान अनुपात | Higher = more reliable insurer |
| ICR | Incurred Claims Ratio | व्यय क्लेम अनुपात | 60-90% = healthy insurer |
| TP | Third-Party Insurance | थर्ड-पार्टी बीमा | Sabhi vehicles ke liye law dwara mandatory |
| OD | Own Damage | स्वयं की क्षति | Aapke vehicle ki damage cover karta hai |
| Zero Dep | Zero Depreciation | शून्य मूल्यह्रास | Full claim bina depreciation cut ke |