IC 38 IMPORTANT BITS

LLOYDS :Origin of Modern Insurance

IRDAI :Insurance Regulatory and Development Authority of India.

IGMS :Integrated Grievance Management System

Process of Insurance : Sharing the losses of a few my many (200)

OMBUDSMAN : Is the appropriate option for the customer to lodge a policy related complaint.
Approach Ombudsman with in one year from the date of rejection of the complaint by the insurer.
Insurance Ombudsman operates only with in specified territorial limits.
No fees or charges need to be paid. The complaint is to be made in writing.
Complaints can be lodged against private insurers. Deals up to 20 lakh.

Consumer Courts : District forum deals up to 20 lakh. State Commission deals between 20 lakh to 100 lakh.
National Commission deals above 100 lakh.

FPR & RPR : First Premium Receipt (Risk cover starts), Renewal Premium Receipt

Free Look Period : Can cancel the policy with in 15 days from the date of receipt of policy bond.

Grace Period : Can renew the policy with in 30 days from the due date.

Standard Age Proofs : Birth Certificate, Pan Card, Passport, Driving License, School Certificate, Baptism Certificate,
Defence ID Card, Govt. Employees Service Record.

Non-Standard Age Proofs: Voter ID, Ration Card, Village Panchayat Certificate, Horoscope.

Section (39) : Described about Nomination in Insurance Act of 1938.

Jan Arogya : Insurance Scheme run by Insurers and not sponsored by the Government.

Hospitalization expenses : Room, boarding and nursing expenses, ICU charges, Medicines and drugs, Doctors fees.

Inpatient : Hospitalization for a period of 24 hours or more.

Day Care Procedures : Hospitalization for a period of less that 24 hours. Ex. Eye Surgery, Chemotherapy

Pre hospitalization : Expenses incurred before admitting in hospital. Normally 30 days.

Example: Tests, Medicines, Doctor fees etc.,

Post hospitalization : Expenses incurred after discharge from hospital. Normally 60 days.
Example: Recovery and follow up expenses.

Domiciliary hospitalization: Expenses incurred for treatment taken at home without being admitted to a hospital.

Waiting period : Initial waiting period is 30 days (except accident related hospitalization)
and for Pre-existing diseases 48 months.

Top up Plans : Coverage for high sums insured over and above a specified amount (called threshold).

Hospital Daily Cash : Fixed amount is paid per day based on the number of days stayed in hospital.

Critical illness policy : Lump sum amount will be paid on diagnosis of certain named critical illness.

Morbidity :Health Insurance is designed to handle the risk of Morbidity ( means chance of falling ill).

TPA : Third Party Administrators process health claims and remunerated by Insurance companies.

Underwriting : The process of risk selection and risk pricing.

Insurable Interest : Financial interest of the person in the asset to be insured.

Portability : An option to port the policy to another insurance company at least 45 days before the premium
renewal date of the existing policy.
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