Which clause in a health policy determines the benefits payout amount?

The insuring clause is crucial in a health insurance policy as it outlines the terms under which the insurer agrees to pay benefits. This clause specifies the types of coverage provided, the scope of the payout, and the conditions under which claims can be made. It essentially serves as the foundation of the policy, detailing what exactly is covered and the limit of benefits that can be expected, which directly determines the benefits payout amount in the event of a valid claim.

In contrast, the exclusion clause identifies circumstances or conditions under which the insurer will not provide coverage, thus limiting potential payouts. The renewal clause pertains to the process of extending the insurance coverage after the policy term ends and does not specify payout amounts. Similarly, the termination clause states the conditions that may lead to the cancellation or non-renewal of the policy, which is also not related to determining the benefits payout. Therefore, the insuring clause stands as the definitive guideline for determining benefits within the policy.