Insurance Terminologies – III

In this 3rd installment of Insurance Terminologies series, let’s look at couple of the jargons which comes across during health insurance purchase or claims.

  • Cumulative Bonus: Cumulative Bonus, as the name suggests, is an increase in the sum insured for the claim free year. This terminology is used in health insurance. This means if the customer has not made any claim for an year, there will be a percentage increase in sum insured which is generally 5% to 10% and can also range from 10% to 50% which varies from insurer to insurer. The maximum bonus given is 50%. One important thing to be noted is that the cumulative bonus is provided on the basic sum insured. For example, if the basic sum insured is INR 100000 and there is no claim made by the customer, the sum insured will be increased by 10% at the time of renewal and hence the new sum insured becomes INR 110000 for the next year. If no claim is reported again in the subsequent year, the cumulative bonus of 10% (10% of 100000=10000) will be provided and the total sum insured will become INR 120000 ( 110000+10000= 120000). As you can see cumulative bonus is calculated on basic sum insured which is INR 100000 in the given example and it is accumulated for every claim free year. The cumulative bonus is added to the sum insured of preceding year which becomes the new sum insured for subsequent year (110000+10000= 120000).
  • Waiting period: Waiting period is the duration for which the coverage is not provided. Health insurance policies have waiting period of 30-60 days. This means any claim made during this period is not payable even though if the loss occurred due to the risks covered in the policy. Any claim made post waiting period is payable provided the loss would have occurred due to the perils covered in the policy. One important point to be noted is that for pre-existing disease, waiting period is 48 months (4 years). Pre-existing diseases are covered after 4 years from the inception of the policy.

Ashish Kumar