I. Observation period/waiting period clause
The so-called observation period/waiting period can also be called deductible period, which refers to a period of time before the insurance company assumes the liability for compensation in health insurance. Because most of the insured health insurance can be purchased without medical examination now, it is difficult for insurance companies to judge whether the insured suffers from a certain disease before or after insurance only by medical records. In order to prevent the insured from insuring against diseases and ensure the utilization of insurance companies, an observation period is usually stipulated in health insurance, and the longest is 180 days. During this period, the insurance company will not be responsible for the medical expenses or income loss of the insured due to illness, and the policy will only take effect after the observation period expires.
Second, the deductible clause.
Deductible clause is a common clause in health insurance contracts. According to the terms and conditions, the expenses below a certain amount shall be borne by the insured, and the insurance company shall not pay. That is to say, after the insurance accident, before the insurance company pays the insurance money, the insured must pay part of the medical expenses himself, that is, the insurance company is only responsible for compensating the part of its medical expenses that exceeds the deductible.
Third, the liability exemption clause.
The so-called exemption means that the insurance company is not responsible for compensation for losses caused by certain risks. For example: hereditary diseases, external infection, nuclear explosion or nuclear pollution, etc. When the insured suffers from the diseases stipulated in the contract due to the matters in the exemption clause, the insurance company shall not be liable for compensation.