|A type of insurance coverage that automatically covers any risk that the contract does not explicitly omit.
|Area of cover
|The geographical region specified in a health insurance policy where you can have medical treatment.
|The health care items or services covered under a health insurance policy.
|The maximum amount that will be paid for a specific benefit under the policy.
|A description of the services and items that an insurance company covers for members of a specific insurance plan.
|A request to an insurance company for payment relating to an accident, illness, damage to property, or any other loss that is covered by the policy.
|A person who settles insurance claims. This typically involves investigation of the loss and a determination of the extent of coverage.
|A fixed amount a health insurance beneficiary pays for medical services with the remaining balance covered by the insurance.
|Insurance coverage helps you financially recover from sudden, unexpected, and accidental things that may happen.
|A pre-agreed amount you pay each year for eligible treatment before your health insurance policy starts to pay any benefit
|The concept of indemnity is based on a contractual agreement made between two parties in which one party (the indemnitor) agrees to pay for potential losses or damages caused by the other party (the indemnitee).
|Any medical service that requires admission into a hospital.
|A pre-agreed amount of money that you need to pay to the insurer in the event of a claim.
|The maximum amount of money an insurer will pay towards a covered claim.
|The person(s) protected under an insurance contract.
|The insurance company that undertakes to provide cover for losses and perform other insurance-related operations.
|Know Your Customer, the process of customer identity and address verification.
|The obligation to pay a monetary award for injury or damage caused by one’s negligent or statutorily prohibited action.
|Any medical service that does not require admission into a hospital.
|Permanent total disability
|This is an individual’s loss of the use of limbs, due to injuries preventing the policyholder from being able to work in the same capacity as they had before the injury.
|A document detailing the terms and conditions of an insurance contract.
|The person who owns the insurance policy.
|A decision by the insurer that a policy benefit can be used.
|Any health condition that a person has, or has had, prior to enrolling for health insurance.
|The amount of money an insurer charges to provide the coverage described in the policy.
|Insurance companies have networks of medical providers (hospitals, clinics, doctors etc.) If you use a network provider the cost of treatment will be settled directly by the insurer. If you don’t use a network provider you have to pay for treatment and submit a claim for reimbursement.
|This is the continuation of coverage. The policyholder extends their contract with the insurance company to continue their current coverage for a specified period.
|The chance something harmful or unexpected could happen.
|The amount of money that the company will pay out to the policyholder or nominated beneficiary in case of the member’s death.
|A professional who evaluates and analyzes the risks involved in insuring a person or asset.
|Work Injury Benefits Act (WIBA) is an employee benefit plan enforced by the Kenya law that guarantees your employees get financial compensation when, by accident, they suffer injury, become disabled or die while at work.