Term
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Definition
Riders attached to life insurance policies
allow death benefits to be used to cover nursing or convalescent home expenses |
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Term
| Accidental Death Benefits |
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Definition
| policy rider that states that the cause of death will be analyzed to determine if it complies with the policy description of accidental death |
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Term
| Accidental Death Insurance |
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Definition
insurance policy
provides payment if the insured's death is the result of an accident |
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Term
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Definition
time before an annuitant's retirement
annuitant is making payments or investing in an annuity |
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Term
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Definition
The required amount to pay damages or for property loss.
amount is calculated based on the property's current replacement value minus depreciation. |
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Term
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Definition
A person trained in the technical aspects of insurance and related fields, particularly in the mathematics of insurance.
A person who, on behalf of the company, determines the maximum probability of loss. |
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Term
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Definition
Contract offered on a "take it or leave it" basis by an insurer.
Insured's only option is whether to accept or reject.
Any disambiguities will be settled in favor of the insured, because the insurer draws up the contract. |
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Term
| Adjustable Life Insurance |
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Definition
Life insurance which permits changes in the:
-face amount
-premium amount
-period of protection
-duration of the premium payment period
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Term
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Definition
| representative of insurance company who investigates and acts on behalf of the company to obtain agreements for the amount of the insurance claim. |
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Term
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Definition
| An individual appointed by the courtas a fiduciary to settle the financial affairs and estate of a deceased person. |
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Term
| Admitted (Authorized) Insurer |
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Definition
| insurance company authorized and licensed to contract business in a particular state. |
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Term
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Definition
A program for impaired adults
attempts to meet their health, social, and functional needs in a setting away from their home |
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Term
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Definition
| tendency of risks with a higher probability of loss to purchase and maintain insurance more often than the risks with a lower probability of loss. |
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Term
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Definition
| insurance sales office or company |
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Term
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Definition
| individual who is licensed to sell, negotiate, or effect insurance contracts on behalf of the insurer. |
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Term
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Definition
| special powers granted to an agent by his/her agency contract |
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Term
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Definition
Contract in which participating parties exchange unequal amounts.
Insurance contracts are aleatory in that the amount the insured will pay in premiums is unequal to the amount that the insurer will pay in the event of a loss. |
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Term
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Definition
| insurance company that is incorporated outside of the U.S. |
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Term
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Definition
Additional, miscellaneous services provided by a hospital.
examples: xrays, anesthesia, lab work
is not: hospital room and board expenses |
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Term
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Definition
| detailed financial report that an insurance company must submit every year to the insurance department of state(s) in which it conducts business |
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Term
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Definition
| contract that provides income for a specified period of years, or for life |
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Term
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Definition
appearance or assumption of authority
based on principal's:
-actions
-words
-deeds
-circumstances the principal created |
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Term
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Definition
| a person making application for, or offering him/herself or another to be insured under an insurance contract |
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Term
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Definition
a document that provides information for underwriting purposes.
After the policy is issued, any unanswered questions are considered waived by the insurer |
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Term
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Definition
| the transfer of ownership rights of a life insurance policy from one person to another |
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Term
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Definition
| the age of the insured at a determined date |
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Term
Attending Physician's Statement
(APS) |
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Definition
| a statement usually obtained from the applicants doctor |
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Term
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Definition
a method of dealing with risk by deliberately keeping away from it
example:
avoid crashing in a plane by not flying in planes |
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Term
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Definition
| a fee charged at the time of a sale, transfer, or withdrawal from from an annuity or life insurance policy. |
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Term
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Definition
| A ledger or proposal in the sale of a life insurance policy that shows both guarunteed and non-guarunteed elements. |
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Term
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Definition
| the person who receives the proceeds from the policy when the loss occurs |
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Term
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Definition
| A temporary contract that puts an insurance policy into force before the premium has been paid |
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Term
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Definition
| the method of determining primary coverage for a dependent child, under which the plan of the parent whose birthday occurs first in the calendar year is designated as primary. |
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Term
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Definition
| an individual who represents an insured in the process of purchasing and negotiating a contract of insurance. |
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Term
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Definition
legal contract
determines what will be done with a business in the event that an owner dies or becomes disabled |
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Term
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Definition
booklet that describes insurance policies and concepts,
and provides general information to help an applicant make an informed decision |
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Term
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Definition
| the amount to which a policyholder is entitled if the policy is surrendered before maturity |
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Term
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Definition
| a statement or booklet that confirms that a policy has been written and describes the coverage in general |
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Term
| Basic Medical Expense Insurance |
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Definition
coverage for dr. visits, xrays, lab tests, and emergency room visits,
benefits are limited to specific dollar amounts |
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Term
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Definition
| the length of time over which the insurance benefits will be paid for each illness, disability, or hospital stay |
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Term
| Blanket Medical Insurance |
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Definition
| A policy that provides benefits for all medical costs, including dr. visits, hospitalization, and drugs |
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Term
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Definition
| unfair trade practice in which one person refuses to do business with another until certain conditions are met |
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Term
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Definition
| a selection of health care benefits from which an employee may choose the ones that are necessary. |
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Term
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Definition
| a percentage of the principal amount of a policy paid to the insured if he/she suffered the loss of an appendage. |
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Term
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Definition
| organizations that process claims and pay benefits in an insurance policy |
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Term
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Definition
| a demand of a person to stop commtting an action that is in violation of a provision |
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Term
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Definition
a document that authorizes a company to start conducting business and specifies the kinds of insurance a company can contract.
It is illegal for an insurance company to transact insurance without this certificate |
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Term
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Definition
| a request for payment of the benefits provided by an insurance contract |
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Term
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Definition
| an unfair trade practice in which an insurer uses a physical or mental force to persuade an applicant to buy insurance. |
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Term
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Definition
| an agreement between insurer and insured in which both parties are expected to pay a certain portion of the potential loss and other expenses |
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Term
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Definition
| a provision that states that the insurer and the insured will share the losses covered by the policy in a proportion agreed upon in advance |
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Term
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Definition
| a practice in which a person in a fiduciary capacity illegally mixes his/her personal funds with the funds he/she is holding in trust |
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Term
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Definition
| the payment made by insurers to agents or brokers for the sale and service of policies |
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Term
Commissioner
(Superintendent, Director) |
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Definition
| the chief executive and administrative officer of a state insurance department |
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Term
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Definition
a plan that provides a package of health care services, including:
-preventive care
-routine physicals
-immunization
-outpatient services
-hospitalization |
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Term
| Comprehensive Major Medical |
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Definition
A combination of basic coverage and major medical coverage that features:
-low dedcutibles
-high maximum benefits
-coinsurance |
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Term
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Definition
withholding of known facts
which, if material, can void a contract |
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Term
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Definition
| a type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable |
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Term
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Definition
the binding force in a contract that requires something of value to be exchanged for the transfer of risk.
The consdieration on the part of the insured is the representations in the application and the payment of premiums.
The consideration on the part of the insurer is the promise to pay in the event of loss. |
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Term
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Definition
| part of the insurance contract that states that both parties must give something of value for the transfer of risk, and specifies the conditions of the exchange |
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Term
Consolidated Omnibus Budget Reconciliation Act
(COBRA) of 1986 |
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Definition
The law that provides for the continuation of group health care benefits for the insured for up to 18 mo. if he/she terminates employment or is no longer eligible
and for insured's dependents for up to 36 mo. in cases of loss of eligibility due to death of insured, divorce, or attainment of the limiting age |
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