RakshaPoint Insurance Marketing LLP
Consumer Awareness Portal

Insurance Terms & Definitions Guide

A comprehensive insurance terminology guide to help you understand policy terms, important clauses, and your rights before buying or renewing.

Life & Term

Sum Assured

Sum Assured is the amount specified under a life insurance policy for the applicable insured event, subject to the policy terms and conditions.

Guidance Note: Evaluate your Sum Assured using HLV to cover liabilities and future financial needs.
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Life & Term

Human Life Value (HLV)

An educational mathematical estimation of the financial protection your family would need if earnings stop.

Guidance Note: Accounts for age, income, future expenses, debts, and inflation assumptions.
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Life & Term

Nominee

A nominee is the person designated by the policyholder to receive policy proceeds in the event of the life assured's demise, subject to applicable law and policy terms.

Guidance Note: Keep nominee details updated upon marriage or family milestones; name an appointee if nominee is a minor.
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Life & Term

Rider (Add-on Cover)

Optional supplementary benefits attached to a base policy for extra protection (e.g. Critical Illness, Accidental Death).

Guidance Note: Adding riders is often convenient compared to buying separate standalone policies.
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Life & Term

Surrender Value

The cash amount payable to the policyholder if a traditional life policy is terminated prior to its maturity date.

Guidance Note: Term insurance plans have zero surrender value unless specified in TROP.
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Life & Term

Grace Period

An extra window of 15 to 30 days allowed beyond the premium due date to pay without policy lapsing.

Guidance Note: If death occurs during grace period, claim is payable after deducting due premium.
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Health Insurance

Sum Insured

The maximum annual indemnity limit up to which a health policy will reimburse actual hospital bills.

Guidance Note: Choose a sum insured that accounts for healthcare inflation and metro treatment costs.
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Health Insurance

Pre-Existing Disease (PED)

Any health condition, injury, or medical ailment diagnosed or treated within the timeframe specified in the policy.

Guidance Note: Review disclosure provisions carefully to avoid claim issues under non-disclosure rules.
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Health Insurance

Waiting Period

Mandatory timeframe (initial exclusion, specific illness waiting, and PED duration) before claims become eligible.

Guidance Note: Review specific illness waiting periods in the policy wording before purchasing.
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Health Insurance

Co-Payment (Co-Pay)

A clause requiring the insured to pay a fixed percentage (e.g. 10%-20%) of every claim bill out of pocket.

Guidance Note: Check if co-payment applies by age, city, or hospital zone.
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Health Insurance

Deductible

An initial fixed amount that the policyholder must pay before the insurance policy starts paying benefits.

Guidance Note: Used in Super Top-Up health plans to reduce base premium.
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Health Insurance

Restoration / Reinstatement Benefit

Refills your sum insured if exhausted due to hospitalization during the policy year per terms.

Guidance Note: Check whether restoration applies to the same or different illnesses.
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Health Insurance

Room Rent Sub-Limit

A daily ceiling on hospital room charges. Exceeding this may trigger proportionate deductions on hospital expenses.

Guidance Note: Review room rent limits and consider policies with proportionate deduction waivers.
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Health Insurance

No Claim Bonus (NCB)

A bonus reward (cumulative bonus or discount) earned for every claim-free policy year.

Guidance Note: Review how NCB is reduced or protected in the event of a claim.
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Health Insurance

Cashless Hospitalization

Facility where the network hospital directly coordinates treatment billing with the insurer or TPA.

Guidance Note: Pre-authorization is submitted in advance for planned hospital admissions.
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Health Insurance

Super Top-Up Plan

High-value health cover that activates once cumulative annual medical expenses cross a chosen deductible.

Guidance Note: Cost-effective way to enhance overall health coverage above base sum insured.
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Health Insurance

Day Care Treatment

Medical procedures or surgeries requiring less than 24 hours of hospitalization due to modern technology.

Guidance Note: Ensure the policy covers modern advanced day care procedures.
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Health Insurance

Portability

The statutory right of a health policyholder to transfer their policy to another insurer without losing accrued waiting period credits.

Guidance Note: Must apply for portability within the prescribed regulatory timeframe before renewal.
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Motor Insurance

Insured Declared Value (IDV)

The maximum sum insured for a vehicle, calculated as manufacturer selling price minus standard depreciation based on vehicle age.

Guidance Note: Do not artificially reduce IDV just to lower renewal premium.
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Motor Insurance

Zero Depreciation (Dep Protect)

Add-on cover that minimizes depreciation deductions for plastic, rubber, glass, and metal replacement parts.

Guidance Note: Recommended for vehicles up to 5 years old.
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Motor Insurance

Third-Party Liability Cover

Statutory mandatory insurance protecting against legal financial liabilities arising from injury, death, or property damage to third parties.

Guidance Note: Third party property damage is subject to statutory limits.
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Motor Insurance

Engine Protect Add-on

Covers repair/replacement of engine internal parts damaged due to water ingress or oil leakage.

Guidance Note: Helpful in monsoon-prone cities and flood-risk areas.
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Motor Insurance

Consumables Cover

Covers cost of consumable items like engine oil, nuts, bolts, grease, brake oil, and coolant during accident repair.

Guidance Note: Helps reduce out-of-pocket costs during accident claims.
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Rights & Norms

Free-Look Period

Trial window from policy document receipt allowing policyholders to review terms and cancel subject to applicable rules.

Guidance Note: Applicable statutory and medical expenses may be deducted upon cancellation.
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Rights & Norms

Incurred Claim Ratio (ICR)

The percentage of total claims paid out of total premiums collected by an insurer in a financial year.

Guidance Note: ICR provides insight into the claims underwriting performance of an insurer.
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Rights & Norms

Claim Settlement Ratio (CSR)

The ratio of total claims settled versus total claims received by an insurer within a financial year as per IRDAI annual reports.

Guidance Note: Always verify CSR against official IRDAI published data.
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Rights & Norms

Section 80C & 80D Tax Deductions

Income tax deductions on life insurance (80C) and health insurance (80D), plus applicable tax exemptions under Section 10(10D).

Guidance Note: Subject to the applicable provisions of the Income Tax Act, 1961.
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Health Insurance

Critical Illness Cover & Riders

Fixed benefit insurance paying a lump sum payout upon confirmed diagnosis of specified critical ailments.

Guidance Note: Subject to survival period and specific illness definitions in policy wording.
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Life & Term

Death Benefit in Life Insurance

The financial sum assured paid to the designated nominee upon the unfortunate demise of the policyholder during policy tenure.

Guidance Note: Death benefits are paid in accordance with policy conditions and applicable nomination rules.
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Life & Term

Paid-Up Value

The reduced sum assured that a traditional savings life policy acquires when premium payments are discontinued after a qualifying period.

Guidance Note: Pure term life plans do not acquire paid-up value.
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Rights & Norms

Insurance Marketing Firm (IMF)

An IRDAI-registered insurance intermediary (like RakshaPoint) authorized to solicit and service insurance products through Insurance Sales Persons (ISPs).

Guidance Note: IMFs provide parameter-based multi-insurer options.
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Need Clarification on Any Policy Term?

Our Insurance Sales Persons (ISPs) provide parameter-based guidance on clauses, exclusions, and waiting periods.

Policyholder Query & Assistance

Transparent parameter-based policy guidance from qualified Insurance Sales Persons (ISPs) under IRDAI IMF regulations.

Parameter-Based Policy Evaluation We explain policy features, benefits, terms, and exclusions based on applicable policy wordings.
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