Insurance terms in plain English

57 employee benefits and business insurance terms, from GHS and WICA to claims-made cover, cyber insurance and policy limits.

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57 of 57 terms

A

Aggregate limit: A cap applying across multiple covered claims during a specified period or category of cover.
As-charged: An insurance benefit calculated from eligible actual charges, subject to the policy’s limits and other conditions.
Average clause: A property-insurance condition that can reduce a claim proportionately when the required insured value exceeds the sum insured.

B

Business interruption cover: Insurance for specified financial loss when business operations are interrupted by events defined in the policy.

C

Census: A structured employee list used to prepare an insurance quotation or enrol a group.
Claims notification: Telling the insurer about a claim or relevant incident through the process required by the policy.
Claims-made cover: Cover whose trigger depends on when a claim is first made, with notification and other timing requirements defined by the policy.
Co-insurance: The percentage of an eligible claim that the insured person or policyholder must bear under the policy.
Co-payment: The portion of an eligible healthcare cost that the member pays; a plan may express it as a fixed sum or a percentage.
Commercial motor insurance: Motor insurance arranged for business vehicles and their declared use.
Commercial property insurance: Insurance for specified business property against losses caused by insured events.
Cyber insurance: Insurance addressing specified losses and liabilities from cyber incidents, according to the policy’s triggers and exclusions.

D

Day surgery: A surgical procedure carried out without an overnight hospital stay, subject to the policy’s definition.
Deductible: An amount borne by the insured person or policyholder before a specified insurance benefit starts paying.
Defence costs: Legal and related costs of defending a claim, where covered under the insurance contract.
Dependants’ cover: Insurance extended to eligible family members under an employee’s group arrangement.

E

Excess: The part of a covered loss the insured must bear, according to the policy calculation; sometimes called a deductible.
Exclusions: Conditions, events, losses or treatments that the policy does not cover.

F

Foreign worker security bond: A guarantee required by MOM for specified Work Permit employment obligations; the bond amount is distinct from its purchase cost.
Free cover limit (FCL): The amount of cover available without individual medical underwriting when the group policy’s eligibility conditions are met.
FWMI (Foreign Worker Medical Insurance): Medical insurance that MOM requires employers to buy for every Work Permit and S Pass holder, covering at least S$60,000 a year of hospital stays and day surgery.

G

GHS insurance (group hospital and surgical): GHS stands for group hospital and surgical insurance: employer-arranged cover for eligible hospital and surgical expenses.
GMM (group major medical): Group major medical: additional medical cover whose relationship to the underlying hospital plan is defined by the policy.
GPA insurance (group personal accident): GPA stands for group personal accident insurance: cover for specified consequences of accidental injury.
Group critical illness (GCI): Group insurance that pays a specified benefit when an insured person meets the policy definition of a covered critical illness.
GTL insurance (group term life): GTL stands for group term life insurance: life cover arranged for eligible members of a group during the insured period.

H

Health declaration: Information about health supplied to an insurer for its assessment of an application or change in cover.

I

Inpatient and outpatient: Inpatient treatment involves hospital admission; outpatient treatment is received without that admission, with precise classifications set by the policy.
Integrated Shield Plan (IP): An Integrated Shield Plan combines MediShield Life with an additional private medical insurance component.

L

Letter of guarantee (LOG): A document telling a healthcare provider the amount or payment arrangement an insurer is prepared to support, subject to its terms.
Limit of indemnity: The maximum liability payment specified by a policy, subject to its basis and conditions.
Loss ratio: A measure comparing insurance losses with premiums over a stated period; the reporting basis must be specified.

M

MediShield Life integration: How another medical insurance arrangement coordinates with MediShield Life; the exact mechanism depends on the arrangement.

O

Occupation class: An insurer’s classification of work activities for assessing eligibility, terms or pricing.

P

Panel and non-panel clinics: A panel provider belongs to the arrangement used by the plan; a non-panel provider falls outside that arrangement.
Policy schedule: The part of a policy that records details specific to the insured risk, such as the insured name, period and limits.
Policy wording: The contract text setting out what the insurer covers and the conditions, definitions and exclusions that apply.
Pre- and post-hospitalisation: Eligible care before or after an admission or surgery, covered within the policy’s specified conditions and time windows.
Pre-existing conditions: Conditions that meet a policy’s definition of having existed before the relevant cover start date.
Premium: The price paid to an insurer for the cover agreed in the policy.
Pro-ration: A proportional adjustment used in a claim calculation under the policy’s specified circumstances.
Professional indemnity insurance (PI): Insurance for specified liabilities arising from professional errors, omissions or negligence.
Public liability insurance: Business insurance addressing specified legal liabilities for injury or damage involving third parties.

R

Renewal: The review and continuation of insurance into a new policy period on the terms accepted for that period.
Restructured hospital: A term used in Singapore insurance schedules for the relevant public-hospital category, as defined by the policy.
Retroactive date: A date used in some liability policies to exclude acts or events before that date.
Rider: An addition to an insurance policy that changes or extends the agreed benefits.
Room and board: The hospital accommodation benefit described in the insurance schedule, with its own entitlement and limits.

S

Subrogation: An insurer’s ability, after paying a claim, to pursue recovery using the insured’s rights against another responsible party.
Sum insured: The amount of cover stated for an insured benefit or exposure, subject to the policy’s payment rules.

T

Third-party administrator (TPA): An external organisation that performs agreed administration functions for a benefits or insurance arrangement.
TPD (total and permanent disability): Total and permanent disability: an insured disability benefit whose qualifying definition is set by the policy.

U

Underinsurance: Having less insurance than the value or exposure required by the policy’s basis of cover.
Underwriting: An insurer’s assessment of an application to determine whether, and on what terms, it will provide cover.

W

Waiting period: A period specified by a policy before a particular benefit or type of claim becomes eligible.
Ward class: The hospital accommodation category used to describe an insurance entitlement or a patient’s selected ward.
WICA (Work Injury Compensation Act): Singapore’s work-injury compensation law; WIC insurance is the insurance arranged for the employer’s applicable liabilities.