Back to the top Calendar year Deductible - in health insurance, the amount that must be paid by the insured during a calendar year before the insurer becomes responsible for further loss costs. Capital and Surplus - a company's assets minus its liabilities. Capital and Surplus Requirement - statutory requirement ordering companies to maintain their capital and surplus at an amount equal to or in excess of a specified amount to help assure the solvency of the company by providing a financial cushion against expected loss or misjudgments. Capital gains (Loss) - excess (deficiency) of the sales price of an asset over its book value. Calculated on the basis of original cost adjusted, as appropriate, for accrual of discount or amortization of premium and for depreciation. Capitation Arrangement - a compensation plan used in connection with some managed care contracts where a physician or other medical provider is paid a flat amount, usually on a monthly basis, for each subscriber who has elected to use that physician or medical provider. Capitated payments are sometimes expressed in terms of a "per member/per month" payment.
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Obligations issued by business units, governmental units and certain nonprofit units having a fixed schedule for one or more future payments of money; includes commercial paper, negotiable certificates of deposit, repurchase agreements and equipment trust certificates. Book value - original cost, including capitalized acquisition costs and accumulated depreciation, unamortized premium and discount, deferred origination and commitment fees, direct write-downs, and increase/decrease by adjustment. Broker - an individual who receives commissions from the sale and service of insurance policies. These individuals work on behalf of the customer and are not restricted to selling policies for a specific company but commissions are paid by the company with which the sale was made. Builders' risk policies - typically written on a reporting or completed value form, this coverage insures against loss adoption to buildings in the course of construction. The coverage also includes machinery and equipment used in the course of construction and to materials incidental to construction. Burglary and Theft - coverage for property taken or destroyed by breaking and entering the insured's premises, burglary or theft, forgery or counterfeiting, fraud, kidnap and ransom, and off-premises exposure. Business Auto - coverage for motor vehicles, other than those in the garage business, engaged in commerce. Business auto filings include singularly or in any combination coverage such as the following: Auto liability, pip, mp, uninsured Motorist and/or Underinsured Motorists (UM/uim specified causes of Loss, comprehensive, and Collision. Business Interruption - loss of income as a result of property damage to a business facility. Business owners Policy - business insurance typically for property, liability and business interruption coverage.
Blanket coverage - coverage for property and liability that extends to more than one location, class of property or employee. Boatowners/Personal Watercraft - covers damage to pleasure boats, motors, trailers, boating equipment and personal watercraft as well as bodily injury and property damage liability to others. Bodily Injury - physical injury including sickness or disease to a person. Boiler machinery or Equipment Breakdown machinery - coverage for the failure of boilers, machinery and other electrical equipment. Benefits include (i) property of the insured, which has tnt been directly damaged by the accident; (ii) costs of temporary repairs and expediting expenses; and (iii) liability for damage to the property of others. Coverage also includes inspection of the equipment. Bonds - a form of debt security whereby the debt holder has a creditor stake in the company.
Auto Physical Damage - motor vehicle insurance coverage (including collision, vandalism, fire and theft) that insures against material damage to the insured's vehicle. Commercial is defined as all motor vehicle policies that include vehicles that are used in connection with business, commercial establishments, activity, employment, or activities carried on for gain or profit. Automobile liability Insurance - coverage for bodily injury and property damage incurred through ownership or operation of a vehicle. Back to the top Balance Sheet - accounting statement showing the financial condition of a company at a particular date. Bcegs - building Code Effectiveness Grading Schedule - classification system for assessment of building codes per geographic region with special emphasis on mitigation of losses from natural disasters. Beneficiary - an individual who may become eligible to receive payment due to will, life waiting insurance policy, retirement plan, annuity, trust, or other contract. Benefits (Medical hospital Expenses) - total expenditures for health care services paid to or on behalf of a member.
Assisted living Care - a policy or rider that provides coverage only while a policyholder is confined to an assisted living facility and meets the policy requirements for coverage. Assumed reinsurance - the assumption of risk from another insurance entity within a reinsurance agreement or treaty. Authorized Company - an insurer licensed or admitted to do business in a particular state. Authorized Control level Risk based Capital - theoretical amount of capital plus surplus an insurance company should maintain. Authorized reinsurance - reinsurance placed with a reinsurer who is licensed or otherwise allowed to conduct reinsurance within a state. Auto liability - coverage that protects against financial loss because of legal liability for motor vehicle related injuries (bodily injury and medical payments) or damage to the property of others caused by accidents arising out of ownership, maintenance or use of a motor vehicle (including. Commercial is defined as all motor vehicle policies that include vehicles that are used primarily in connection with business, commercial establishments, activity, employment, or activities carried on for gain or profit. No fault is defined by the state concerned.
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Annuitant - the beneficiary of an annuity payment, or person during whose life and annuity is payable. Annuities Immediate non-variable - an annuity contract that provides for the fixed payment of the annuity at the end of the first interval of payment after purchase. The interval may vary, however the annuity payouts must for begin within 13 months. Annuity - a contract providing income for a specified period of time, or duration of life for a person or persons. Appraisal - an estimate of value.
Arbitration - a binding dispute resolution tactic whereby a conciliator with no interest in the outcome intercedes. Assessed Value - estimated value for real or personal property established by a taxing entity Asset - probable future economic benefits obtained or controlled by a particular entity as a result of past transactions or events. An asset has three essential characteristics: It embodies a probable future benefit that involves a capacity, singly or in combination with other assets, to contribute directly or indirectly to future net cash inflows; A particular entity can obtain the benefit and control others' access. Asset Risk - in the risk-based capital formula, risk assigned to the company's assets. Assigned Risk - a governmental pool established to write business declined by carriers in the standard insurance market.
Aggregate - the maximum dollar amount or total amount of coverage payable for a single loss, or multiple losses, during a policy period, or on a single project. Aggregate cost payments - method of reimbursement of a health plan with a corporate entity that directly provides care, where (1) the health plan is contractually required to pay the total operating costs of the corporate entity, less any income to the entity from other. Aircraft - coverage for aircraft (hull) and their contents; aircraft owners' and aircraft manufacturers liability to passengers, airports and other third parties. Alae - an estimate of the claims settlement associated with a particular claim or claims. Alien Company - an insurance company formed according to the laws of a foreign country. The company must conform to state regulatory standards to legally sell insurance products in that state.
Allied Lines - coverages which are generally written with property insurance,. G., glass, tornado, windstorm and hail; sprinkler and water damage; explosion, riot, and civil commotion; growing crops; flood; rain; and damage from aircraft and vehicle, etc. All-Risk - also known as open peril, this type of policy covers a broad range of losses. The policy covers risks not explicitly excluded in the policy contract. Alternative workers' compensation - other than standard workers' compensation coverage, employer's liability and excess workers' compensation (e.g., large deductible, managed care). Ambulatory services - health services provided to members who are not confined to a health care institution. Ambulatory services are often referred to as "outpatient" services. Annual Statement - an annual report required to be filed with each state in which an insurer does business. This report provides a snapshot of the financial condition of a company and significant events which occurred throughout the reporting year.
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Admitted Assets - insurer assets which can be valued and included on the balance sheet to determine financial viability of the company. Admitted Company - an insurance company licensed to do business in a state(s domiciled in an alternative state or country. Advance Premiums - occur when a policy has been processed, and the premium has been paid prior to the effective date. These are a liability to the company and not included in written premium or the unearned premium reserve. Adverse selection - the social phenomenon whereby persons with a higher than average probability of loss seek greater insurance coverage than those with less risk. Advisory Organization animal - a group supported by member companies whose function is to gather loss statistics and publish trended loss costs. Affiliate - a person or entity that directly, or indirectly, business through one or more other persons or entities, controls, is controlled by or is under common control with the insurer. Agent - an individual who sells, services, or negotiates insurance policies either on behalf of a company or independently.
of time insured must incur eligible medical expenses at least equal to the deductible amount in order to establish a benefit period under a major medical expense or comprehensive medical expense policy. Actual Cash Value - repayment value for indemnification due to loss or damage of property; in most cases it is replacement cost minus depreciation. Actuarial Report - (pc insurance)a document or other presentation, prepared as a formal means of conveying to the state regulatory authority and the board of Directors, or its equivalent, the actuary's professional conclusions and recommendations, of recording and communicating the methods and procedures, of assuring. (In Life and health) this document would be called an "Actuarial Memorandum.". Actuary - business professional who analyzes probabilities of risk and risk management including calculation of premiums, dividends and other applicable insurance industry standards. Adjuster - a person who investigates claims and recommends settlement options based on estimates of damage and insurance policies held. Admission - hospital inpatient care for any medical condition.
These definitions represent a common or general use of the term. Some words and/or phrases may be defined differently by other entities, or used in a context such that the definition shown may not be applicable. (Click on the letter to view terms beginning with that alphabet.). Accident - an unexpected event or circumstance without deliberate intent. Accident Insurance - insurance essay for unforeseen bodily injury. Accident Only - an insurance contract that provides coverage, singly or in combination, for death, dismemberment, disability, or hospital and medical care caused by or necessitated as a result of accident or specified kinds of accident. Accident Only or ad d - policies providing coverage, singly or in combination, for death, dismemberment, disability, or hospital and medical care caused by or necessitated as a result of accident or specified kinds of accidents. Types of coverage include student accident, sports accident, travel accident, blanket accident, specific accident or accidental death and dismemberment (ad d).
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The Associated Press, top health Stories, latest health headlines essay 3h ago. Jun 30, jun 29, jun 29, jun 29, jun 29, jun 29, jun 29, jun 29, jun 29, jun 29, jun 29, jun 29, jun 28, jun 28, jun 28, jun 28, jun 28, jun 28, jun 28, jun 28, jun 28, jun 28, jun. Amy forliti/ap photo, getty Images, apr 11, suggested Interests. This page provides a glossary of insurance terms and definitions that are commonly used in the insurance business. New terms will be added to the glossary over time. The definitions in this glossary are developed by the. Naic research and Actuarial Department staff based on various insurance references.