Portability means the right accorded to an individual health insurance policy holder (including family cover) to transfer the credit gained by the insured for pre-existing conditions and time bound exclusions if the policyholder chooses to switch from one insurer to another insurer or from one plan to another plan of the same insurer, provided the previous policy has been maintained without any break. As per HIR 2016 Policy is portable from one Insurer to another, 45 days prior to maturity of policy (including cumulative bonus would also be portable), as per Schedule I, Sec(1) & (18) of HIR 2016. One can transfer the policy from one Insurance company to another and the credits (including cumulative bonus) would also be portable.

Medical Expenses incurred for a period up to 60 days from the date of discharge from the hospital, provided that: Such Medical Expenses are incurred for the same condition for which the Insured Person’s Hospitalization was required, andThe In-patient Hospitalization claim for such Hospitalization is admissible by the Insurance Company.Common Clauses Health Insurance : Pre-existing diseases : Any condition, ailment or injury or related condition for which the insured person had signs or symptoms, and/or were diagnosed and/or received medical advice/treatment within 48 months to prior to the first policy issued by the insured. Generally *exclusions and pre-existing diseases* are not covered by a medical insurance policy (as specified in their policy document). Generally these *could be covered after 2-3-4 years of holding the policy*. Consumer must be honest in disclosing pre-existing ailments, if any.

Medical Expenses incurred during the period up to 30 days prior to the date of admission, provided that: Such Medical Expenses are incurred for the same condition for which the Insured Person’s Hospitalization was required, andThe In-patient Hospitalization claim for such Hospitalization is admissible by the Insurance Company.Common Clauses Health Insurance : Pre-insurance Acceptance Health Check up : Any person beyond 45 years of age desiring to take insurance cover has to submit certain medical reports from authorized Network Diagnostic Centre or any other medical reports required by the company in case of fresh proposal and renewal where there is a break in policy period. The cost of any pre-insurance medical examination shall generally form part of the expenses allowed in arriving at the premium. However in case of products with term of one year and less, if such cost is to be incurred by the insured, not less than 50% of such cost shall be borne by the insurer once the proposal is accepted, except in travel insurance policies. (ii) Insurers shall maintain a list of medical examiners and institutions where such pre-insurance medical examination may be conducted whose reports will be accepted by them. Details of fee payable shall be made available to the prospective policyholder at the time of pre-insurance medical examination on demand.

Qualified nurse is a person who holds a valid registration from the Nursing Council of India or the Nursing Council of any state in India.

Reasonable charges means the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services, taking into account the nature of the illness/injury involved.

Room rent shall mean the amount charged by a hospital for occupying of a bed and associated medical expenses. Generally *bed charges are 1-2%% of the sum assured, depending on Insurance policy. All other charges like doctor visit etc. are often related proportionately to bed charge (Room Rent). It is as such important and helpful for the insured person undergoing hospitalization to be within these limits.

Subrogation shall mean the right of an insurer to assume the rights of the insured person to recover expenses paid out under the policy that may be recovered from any other source.

Surgery or Surgical Procedure means manual and/or operative procedure (s) required for treatment of an illness or injury, correction of deformities and defects, diagnosis and cure of diseases, relief of suffering or prolongation of life, performed in a hospital or day care centre by a medical practitioner.

Unproven/Experimental treatment is treatment including drug experimental therapy which is based on established medical practice in India, is treatment experimental or unproven.

The initial period within which any claims made will not be entertained. Normally, all the new policies come with a minimum 30 days waiting period wherein the insured person cannot make a claim for the disease contracted during the first 30 days. This is to avoid someone taking a policy in order to get a hospitalization claim immediately after purchase of the policy. The waiting period does not usually apply to accidental injuries, or to renewals of policies. Specific waiting periods: 12, 24 or 48 months for named diseases. After 48 months all diseases are covered.