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Material Fact
A material fact is the critical information essential to evaluating the risk associated with an insurance policy. Material facts help the insurance company assess the risk and determine the terms and conditions of the policy coverage.
An applicant seeking an insurance policy should declare or disclose all the material facts that can impact the terms of the contract in the policy application stage. The insurer uses this information to assess the level of risk and determine the terms of the coverage it can offer.
If material information is not disclosed at the application stage, it may lead to claim issues or outright termination of the policy.
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A
- Accident
- Acute Care
- Acute Condition
- Age Limit
- Agent
- Ambulance Cover
- Annual Health Checkup
- Any One Illness
- AYUSH Treatment
B
C
- Cancer Insurance
- Cashless Facility
- Chronic Condition
- Claim
- Claim Settlement
- Claim Settlement Ratio
- Comorbidity
- Congenital Anomaly
- Consumables
- Contract
- Copayment
- Critical Illness
- Cumulative Bonus / No-Claim Bonus (NCB)
D
- Daily Hospital Cash / Daily Cash
- Day Care Treatment
- Deductible
- Discharge Summary
- Domiciliary Hospitalisation
E
F
G
H
I
- Illness
- Indemnity
- Injury
- Inpatient Care / Inpatient Hospitalisation
- Insurance Ombudsman
- Insured Person
- Insurer
- Intensive Care Unit (ICU)
- IRDAI
L
M
N
O
P
- Personal Accident Cover
- Policy Document
- Policyholder
- Portability
- Post-Hospitalisation Expenses
- Pre-Existing Disease (PED) / Pre-Existing Condition
- Pre-Hospitalisation Expenses
- Premium
R
- Reasonable and Customary Charges
- Reimbursement
- Renewal
- Restoration Benefit / Automatic Restoration
- Rider / Add-on Cover
- Room Rent Limit
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