Under which health policy feature do the insured and the insurance company share the cost of covered losses?

In health insurance, the feature that allows the insured and the insurance company to share the cost of covered losses is commonly referred to as the deductible provision. A deductible is the amount that the insured must pay out-of-pocket before the insurance policy begins to cover its share of the costs. Once the deductible is met, the insurance company typically pays the majority of the covered expenses, while the insured may be responsible for a percentage of the costs, often known as coinsurance.

The deductible provision encourages responsible use of the insurance by the insured, as they have a financial stake in the initial costs of treatment. It also helps to reduce the overall premiums of the policy, as the insurance company knows that it will not be responsible for the initial costs of smaller claims.

In contrast, the payment of claims provision pertains to the procedure and timelines for claims processing but does not involve cost-sharing between the insured and the insurer. Exclusion provisions specify what is not covered by the policy, and the limit of liability provision defines the maximum amount the insurer will pay for certain covered losses, rather than how costs are shared.