Insurance glossary

Outpatient cover (OPD)

Health insurance for care where the doctor says you can be treated, collect medicine, and go home without staying in hospital—e.g. mild flu, diarrhoea, headache, or conjunctivitis.

Inpatient cover (IPD)

Health insurance when the doctor admits you to hospital. It usually covers room, meals and drugs, visiting doctor fees, nursing, surgery, and other inpatient costs (per policy wording).

Health sum insured

The benefit limit the insurer pays when you are treated for a covered condition, following the doctor’s treatment plan.

Health insurance premium

What you pay the insurer on a schedule—daily, monthly, quarterly, or yearly—in exchange for cover. Looking for cancer cover? Premiums from THB 4/day*, medical benefits up to THB 600,000, travel to treatment, and a lump sum on first diagnosis—see more here

Insurance premium (Premium)

The amount the insured must pay the insurer for the cover to take effect.

Pre-existing conditions

Illnesses or symptoms diagnosed before you bought the policy. Many health plans exclude pre-existing conditions—so if you already had diabetes, kidney disease, etc., claims for that disease may not be paid.

Waiting period

A period after cover starts when you cannot yet claim medical expenses. Cancer may have a waiting period of 14–120 days. Critical illnesses may have a 90-day waiting period, and funeral expenses for death from illness a 180-day period from the policy effective date. (Always check the terms again before deciding to buy.)

Second opinion

A second examination by another doctor to confirm the first diagnosis, often used for serious diseases such as cancer.

The insured (Insured)

The person covered under the policy.

Beneficiary

The person named in the policy to receive the benefit when the insured dies.

Insurance policy (Policy)

The contract document that sets out all the cover, conditions, terms, and exclusions.

Sum assured (Sum Assured)

The maximum amount the insurer pays when a critical illness is found, per the cover conditions stated in the policy.

Critical illness (CI)

A group of serious illnesses that are difficult to treat, require long-term care, can be costly, and may be life-threatening.

Pre-existing condition

An illness or symptom you already had, or showed signs of, before taking out the policy—which is not covered.

No Claim Bonus

Money back when the insured makes no claim under the set conditions—e.g. every 2 years without a claim, the insured gets 15% back, calculated from the first-year premium.

Funeral expenses (Funeral Expense)

All costs of managing the deceased’s funeral—e.g. coffin, shrouding, embalming, dressing the body, bathing and chanting rites, necessary customary merit-making, and crematorium rental.

Body Mass Index (BMI)

A value used to assess the balance between weight and height, to support underwriting decisions.