The type of insurance policy you invest in depends on your specific needs and risks. An organization other than the patient (first party) or health care provider (second part) involved in the payment of health care claims. Third-party payers include insurance companies, government agencies and employers. U Subscriber The person whose job it is to determine the acceptance of insurance risks; a person whose job it is to select the risks and determine the amounts and conditions under which the insurance company accepts the risks. Underwriting profit Profit realized by an insurance company after deduction of losses incurred and operating expenses of premiums earned. This amount excludes capital gains and is determined before the federal income tax is established. The purpose of an insurance contract is to create a legally binding contract between the insurance company and the insured. Under this Agreement, the Insured agrees to make small periodic payments in exchange for a payment from the Insurance Company when the covered event specified in the Contract occurs. A disability income program through the SSA for people with disabilities who have not worked enough to contribute much to the social security system and are therefore not eligible for the SSD. The disability rules are the same as for SSDs.
However, SSI has strict income and financial limits. M Malicious violation of someone else`s rights or property with evil or perverse intent. Multi-risk policy, contrary to what its name might suggest, the term “multi-risk policy” does not mean a policy that is insured against two or more dangers. Instead, it is a policy that combines fire and accident and marine coverage into a single contract like the owner`s policy. Multiline policy Package that combines traditional damage insurance. Mutual societies without share capital held by insured persons. The company`s income beyond the payments of operating costs and losses and reserves is the property of the insured. A signed statement from patients or guarantors that allows providers to disclose medical information so that insurance companies can pay claims. Providers can retrieve information about whether you have insurance coverage.
A federal law that protects employees and their families in certain situations by allowing them to keep their existing health insurance for a period of time. COBRA grants certain former employees, retirees, spouses, former spouses and dependent children the right to temporarily pursue health insurance at group rates. The person must pay the cost of the premium to keep their insurance plan, but the cost is usually cheaper than individual health insurance. C Carrier The insurance company that offers or “supports” the insurance. Accident insurance Coverage of losses or liabilities resulting from an accident or accident, excluding certain types of losses that fall under the law or custom exclusively in the context of other types of insurance such as fire or navy. It includes, but is not limited to, employee liability insurance, workers` compensation insurance, commercial liability insurance, automobile liability insurance, glass floor insurance, burglary and theft insurance; also personal liability insurance, counterfeiting, power plant and aviation insurance. Disaster A sudden and severe disaster or disaster. An event that results in the loss of an exceptionally large amount of money. Insurance certificate document used to provide proof of coverage to an interested third party. Chartered Damage Insurance Underwriter (P.O.C.C.U.) Designation given by the American Institute of Property and Liability Underwriters to an individual who has completed a course and passed a series of exams. Right A request for payment under an insurance contract or deposit.
Estimated or actual amount of a loss. Severity of claim Average cost of each claim. Classification A underwriting or rating group in which a particular risk must be classified, determined by the nature of the business, location and other risk factors. Classification of persons, assets or transactions as a basis for tabular presentation of statistical experience and setting premium rates. Co-insurance Agreement by which the insured undertakes, against payment of a reduced rate, to bear an amount of insurance equal to a percentage of the total value of the insured assets. Trading lines The different types of insurance taken out for companies. Multi-line commercial policy A comprehensive policy with a wide range of property and liability insurance for companies. Comparative negligence A rule used in cases of negligence in some states that provides for the calculation of plaintiffs` negligence and defendant`s negligence, reducing the plaintiff`s damages by a percentage equal to the degree of contributory misconduct. If it is established that the plaintiff`s negligence is greater than that of the defendant, the plaintiff receives nothing and is the subject of a counterclaim by the defendant.
Competitive sovereign wealth fund A sovereign wealth fund that underwrites insurance companies in competition with private insurers. Mandatory Auto Liability Insurance A state law that requires motorists to receive minimum coverage for bodily injury and property damage. Concealment The withholding of material facts about the nature of a risk or loss of insurance. Do not disclose important information to the insurer when negotiating an insurance contract or claim. Consequential damage A loss that is not directly caused by property damage, but results from such damage (i.e. loss of rent). Contract An agreement concluded by two or more parties, under which one or more of the parties undertake, for consideration, to perform or refrain from performing an act or act in accordance with the wishes of the other party or parties. A valid and binding contract must be concluded by the competent parties, be bound by a counterparty, have reciprocity, constitute an effective meeting of minds and cover a legal and moral act.
Contributory negligence Lack of care on the part of the person who contributed to the occurrence of the accident. Coverage Guarantee against certain losses provided under an insurance policy. It is used as a synonym for the words “insurance” or “protection” and can also refer to the amount of protection provided under an insurance policy or the insurance contract itself. Risk assessment is an important factor for the party, as it takes a higher risk when considering entering into a random contract. Life insurance policies are considered random contracts because they only benefit the policyholder when the event itself (death) occurs. Only then does the policy allow the agreed amount of money or the services specified in the random contract. The death of a person is an uncertain event, as no one can predict in advance with certainty when the insured will die. However, the amount that the insured`s beneficiary receives is certainly much higher than what the insured paid as a premium.
A number that indicates that your treatment has been approved by your insurance company. Also known as certification number, pre-approval number or processing approval number. Click here to read a detailed definition of insurance contracts. Health Maintenance Organization (HMO) (refers to health insurance) – These health insurance plans require that registered patients receive all of their care from a specific group of providers (with the exception of certain emergency care). The plan may require your GP to make a referral before they can receive special treatment. An HMO may require you to live or work in their service area in order to be eligible for coverage. HMOs often provide integrated care and focus on prevention and well-being. A number that your insurance company gives you to identify your contract. As with any other form of insurance, liability insurance covers the cost of a claim, including but not limited to court costs, fees and settlements. The amount covered by insurance depends on the specific agreement and the cost of insurance depends on many factors, including the history of claims. L Limitations of Liability The amount or amount in excess of which liability insurance does not protect the insured under a particular policy. The majority of policies that cover liability for bodily injury have two limitations: a limitation of liability for a single person; and another, generally higher, limit for each individual accident involving more than one person.
Litigation Act of conduct of a dispute. Loss The basis for a claim for compensation or damage under an insurance policy. Any reduction in the quantity, quality or value of the property. Loss ratio Percentage of premium losses. In 1941, the insurance industry began to move to the current system, in which covered risks are first covered by a “global risk” or “all sums” insurance contract on a general form of insurance (for example.B. “We pay all amounts that the insured is legally required to pay as damages… ), and then by subsequent exclusion clauses (e.B. “This insurance does not apply to… »).  If the insured wants to be covered for a risk taken through an exclusion on the standard form, they can sometimes pay an additional premium for a policy confirmation that outweighs the exclusion. .