|
|
Life and Health Glossary A B C D E F G H I J K L M N O P Q R S T U V W X Y Z |
|---|---|
|
A&H,A&S -- Accident & Health or Accident & Sickness. Once commonly used as generic designations for the entire field now more properly designated as Health Insurance.
ACCIDENTALDEATH INSURANCE -- A form of health insurance that provides payment if death of the
insured results from accident. Accidental death insurance is often combined with dismemberment insurance in a form called Accidental Death & Dismemberment.
ACCIDENTAL MEANS -- The unexpected or undersigned cause of an accidental bodily injury. Under an accidental means definition, the mishap itself must be accidental.. . ACCOUNT CURRENT – A monthly premium statement between the company and the agent, showing writings, cancelations, endorsements, commissions.
ACCUMULATION PERIOD – The period of time, prior to retirement, during which an annuitant is making payments or investments in an annuity. Such payments will accumulate on tax-deferred basis.
ACCUMULATION UNITS -- These are issued to owners of variable annuities during the accumulation period, as evidence of the annuitant's participation in the separate account. ACCUMULATIONS -- Percentage additions to policy benefits made upon continuous renewal. ACQUISITION COST -- The immediate cost to an insurer of putting a policy on the books - clerical work, medical examiner's fee, and inspection cost, commission, etc. ACTUARY -- A specialist in the mathematics of insurance who calculates rates, reserves, etc. (Americanism. In most other countries the individual is known as "mathematician.") ADDITIONAL MONTHLY BENEFIT -- Riders added to disability income policies to provide additional benefits during the first year of a claim while the insured is waiting for Social Security benefits to begin. ADJUSTABLE LIFE -- A form of life insurance, which allows changes on the policy face amount, the amount of premium, period of protection, and the length of the premium payment period. ADJUSTABLE PREMIUM -- Usually used in connection with guaranteed renewable health policies in which the premium may be changed by classes of insureds. ADJUSTER -- An individual representing the insurance company and acting for the company in working on agreements as to the amount of a loss and the liability of the company in same. ADJUSTMENT -- Determining the cause and amount of a loss, the indemnity recoverable by the insured and amount to be paid under the terms of the policy. ADMINISTRATIVE SERVICES ONLY -- The services provided by an insurer such as providing claim forms, processing claims, and making payments to health care providers. ADMITTED COMPANY -- An insurance company authorized and licenses to do business in a given state. ADVERSE SELECTION -- Selection against the insurance company: the tendency of more poor risks to buy and maintain insurance than good risks. ADVERSE UNDERWRITING DECISION -- Any decision involving individually underwriting insurance
coverage’s resulting in termination of existing insurance, declination of an application, or writing them coverage only at higher rates. For property and casualty insurance, it also includes placing the coverage with a residual market mechanism or an unauthorized insurer.
AGE CHANGE -- The point in the 12 months between natural birthdays that the individual is considered being of the next higher age for the purposes of insurance rates. Most life insurance companies consider that point as halfway between birthdays. Health insurance companies frequently use age last birthday until the next birthday is actually reached. Age change can be last birthday, nearer birthday, or next birthday, depending on the way the rate was constructed. AGE LIMITS -- The ages below or above which the insurance company will not issue a given policy in force AGENCY -- When one person acts on behalf of another person, an agency is created with the first person being the agent and the second person being the principal. The principal generally can be held responsible for acts of its agents.
AGENT -- The individual appointed by an insurance company to solicit, negotiate, effect or countersign insurance contracts on its behalf.
AGENT'S APPOINTMENT -- Official authorization from an insurance company granting an agent the authority to act as its agent. In most states, agents must be appointed by at least one insurer in addition to being licensed by the state. AGENT'S AUTHORITY OR POWER -- The authority and power granted to an agent by his agency contract, plus "apparent agency." (See also Apparent Agency.) AGGREGATE INDEMNITY -- A maximum dollar amount that may be collected for any disability, period of disability, or under the policy. ALIEN INSURANCE COMPANY (INSURER) -- An insurance company formed under laws of a country other than the United States. ALLOCATED BENEFITS -- Payments for specific purposes up to a maximum specified for each. For example, in some hospital policies the scheduled benefits for X-rays; drugs; dressings; etc. ALL RISK -Insurance against loss or damage to property arising from any fortuitous cause, except such as may be specifically excluded. AMERICAN AGENCY SYSTEM -- The method of sales, service and distribution of insurance through agents who own their "renewals" and are compensated on a commission basis, in contrast to the system of selling insurance through salaried company representatives.
AMERICAN COLLEGE -- American College of Life Underwriters, Bryn Mawr, Pa., which confers the
designation "Chartered Life Underwriter" (CLU).
AMERICAN EXPERIENCE TABLE -- A mortality table widely used until the 1950's ANCILLARY BENEFITS -- Benefits for miscellaneous hospital charges ANNUAL STATEMENT -- The annual report made by an insurance company at the close of the fiscal year. Stating the company's receipts and disbursements, assets and liabilities. ANNUITANT -- The person who is covered by an annuity and who will normally receive the benefits of the annuity. ANNUITY -- (1) An amount of money payable yearly, or by extension, at other regular intervals; (2) An agreement by an insurer to make periodic payments that continue during the survival of the annuitant(s) or for a specified period.
ANNUITY CERTAIN --- An annuity that pays for a fixed number of years. If it pays for life after the certain period, it is called an "annuity certain and for life thereafter."
ANNUITY DLE -- An annuity under which the benefits are paid at the beginning of the benefit period rather than at the end. ANNUITY OPTION -- A method of liquidating and distributing an amluity's principal and interest so that it lasts for the lifetime of the annuitant. ANNUITY PERIOD -- The period of time, usually at retirement, during which the annuitant begins to receive annuity payments or benefits from the insurance company. APP --Trade abbreviation for application. (See Application.) APPARENT AGENCY -- See Presumption Agency. APPARENT AUTHORITY -- Authority of an agent that is created when the agent oversteps actual authority, and when inaction by the insurer does nothing to counter the public impression that such authority exists. APPEAL -- The right of a party who has received an adverse decision to take the case to a higher court for review. APPLICATION (APP) -- A form on which the prospective insured states facts requested by the insurance company and on the basis of which (together with any information from other sources) the insurance company decides whether or not to accept the risk, modify the coverage offered, or decline the risk. APPORTIONMENT -- The division of loss among insurance companies when two or more cover the same loss. APPROVED PENSION PLAN -- A pension plan qualifying for tax exemptions under provisions of the Internal Revenue Code. ASSESSMENT COMPANY-- (or Society or Insurer) - An insurance company that retains the right to assess additional amounts the policy owners must pay if premiums are insufficient for operations. In some cases, an assessment company may not charge a fixed or stipulated premium at all but merely assesses participants in the plan
BENEFICIARY - A person who may become eligible to receive, or is receiving, benefits under an insurance
policy, other than as a participant.
BENEFIT - The amount to be paid to a participant of a retirement plan or his beneficiary at retirement, at death, or at termination of service.
BINDER (or Binding Receipt) - In lines other than life and (usually) health, a binder is an acknowledgement
(usually from the agent) that insurance applied for is in force whether or not premium settlement has yet been made or the policy issued. In life and health insurance, binders are not issued, but if premium settlement is made with the application, what is often erroneously referred to as a binder or "binding receipt" is issued. Actually, this is a conditional binding receipt.
BLANKET A&H POLICY -- An Accident 8( Health Insurance policy that covers all of a class of persons not
individually identified.
BLANKET MEDICAL EXPENSE - A policy or provision in a policy that pays all medical costs (including
hospitalization, drugs, treatments, etc.) without exclusion of any term or maximum on any item save a maximum aggregate benefit under the policy. Often written with a deductible amount.
BLUE PLAN -- Generic term for those insurers (usually on a service rather than reimbursement basis) who are authorized to use the designation "Blue Cross" or "Blue Shield" and the insignia of either. BODILY INJURY LIABILITY - The liability that may arise from injury or death of another person. BOND - An obligation of the insurance company to protect one against financial loss caused by the acts of another. BORDEREAU - Memorandum containing detailed information concerning the passing of reinsurance from one insurance company to another under a reinsurance agreement. BOYCOTT -- An unfair trade practice that occurs when someone in the insurance business refuses to have business dealings with another until he or she complies with certain conditions or concessions. BROKER - One who represents an insured in the solicitation, negotiation or procurement of contracts of insurance, and who may render services incidental to those functions. By law the broker may also be an agent of the insurer for certain purposes such as delivery of the policy or collection of the premium. BROKERAGE DEPARTMENT - A department of an insurance company, the purpose of which is to aid agents in handling insurance outside of their territory and to aid brokers in the placing of insurance throughout the country. BUSINESS - The volume of premiums written. BUSINESS INSURANCE- Life or health insurance written to cover business situations such as key man, sole proprietor, partnership. Corporations, etc. CANCELLABLE - A contract of insurance that may be terminated by the insurance company or insured at any time. Virtually every form of insurance is cancelable except life insurance and those health insurance policies designated as "guaranteed renewable" or "noncancellable and guaranteed renewable."
CANCELLATION - Termination of contract of insurance in force by voluntary act of the insurance company or insured, effected in accordance with provisions in the contract or by mutual agreement.
CAPITAL STOCK INSURANCE COMPANY - An insurance company having, in addition to surplus and
reserve hnds, a capital fund paid in by stockholders.
CAPITAL SUM - The maximum amount payable in one sum in event of accidental dismemberment.
CAPITATION (CAP) -A rate paid, usually monthly, to a health care provider. In return, the provider agrees to deliver health services agreed upon to any covered person.
CARRIER - An insurance company that "carries" the insurance. (The terms "insurance company or "carrier" with transportation terminology.)
CARRY OVER PROVISION - In major medical policies, allowing an insured that has submitted no claims during the year to apply any medical expenses incurred in the last three months of the year toward the new calendar year's deductible.
CASH SURRENDER VALUE - The amount of cash that is due the insured that surrenders cash value life
insurance. Such surrender with termination of all insurance benefits is often called "cashing out."
CEASE AND DESIST ORDER - An order of the state Insurance Commissioner or of a court requiring that a
company or person stop engaging in a particular act or practice, usually involving insurance trade practices.
CERTIFICATE - A statement evidencing that a policy has been written and stating the general coverage.
CESTUI QUE VIE - The person whose life measures the duration of a trust, gift, estate or insurance contract. Thus, in life and health insurance, this refers to the person on whose life or health the policy is written. Such a person is commonly called the "insured," "policyholder," or "policy owner."
CHARTERED PROPERTY AND CASUALTY UNDERWRITER (CPCU) - A designation granted by the
American Institute for Property and Liability Underwriters upon successful completion of a series of examinations and experience requirements in the fields of insurance, plus accounting, financing. economics. management, and law.
CLAIM - The demand for benefits as provided by the policy
CLAIMS-MADE COVERAGE - A policy providing liability coverage only if a written clain~in made during the
policy period or any applicable extended reporting period. For example, a claim made in the current year could be charged against the current policy even if the injury or loss occurred many years in the past.
If the policy has a retroactive date, an occurrence prior to that date is not covered. Contrast with Occurrence Coverage.
CLASS RATE --- A rate for risks of similar hazard. Class rates, for example, apply to dwellings.
CLAUSE - A term used to identify a particular part of a policy or endorsement.
CLOSED ACCESS - A situation where covered insured’s must select one primary care physician. That physician is the only one allowed to refer the patient to other health care providers within the plan. Also called closed Panel or Gatekeeper model.
CLU - Chartered Life Underwriter, a designation granted after examination and experience requirements
by the American College of Life Underwriters.
COINSURANCE - (1) In property insurance, a clause under which the insured shares in losses to the
extent that he is underinsured at the time of loss. (2) In health insurance, a provision that the insured and insurance company will share covered losses in agreed proportion. In health insurance, the preferred tern1 is "percentage participation."
COLLATERAL ASSIGNMENT - Assignment of a life insurance policy as security for a loan, the creditor to
receive the proceeds or values to the extent of his interest.
COLLEGE RETIREMEKT EQUITIES FUND (CREF) - The first variable annuity company in the United
States, established in 1952.
COLLUSION - Cooperation between two or more persons secretly to defraud another.
COMMISSION - That portion of the premium retained by the agent or broker as compensation for sales,
service, and distribution of insurance policies by him.
COMMISSIONER - The title of the head of the department of insurance in most states. (See also Superintendent.)
COMMON CARRIER - An individual or corporation, which offers its services to the public for the carrying of
persons or property from one place to another for payment.
COMPREHENSIVE MAJOR MEDICAL - A plan of insurance that has a low deductible, high maximum
benefits, and a coinsurance feature. It is a combination of basic coverage and major medical coverage
that has virtually replaced separate hospital, surgical and medical policies with each having its own deductible requirements.
COMPULSORY INSURANCE -Any form of insurance that is required by law.
COMPUTER FRAUD -Fraudulent theft or transfer of money, securities or other property resulting from the use
of any computerized equipment or systems.
CONCEALMENT - The withholding of facts by an applicant for insurance that affects an insurance risk or loss.
CONCURRENT REVIEW - A case management technique that allows insurers to monitor an insured's hospital stay and to know In advance if there are any changes in the expected period of confinement
and the planned release date.
CONDITIONAL RECEIPT - The more exact term for what is often called a "binding receipt" in life and health
insurance. It provides that if premium settlement accompanies the application, the coverage shall be in force from the date of application (whether the policy has yet been issued or not) provided the insurance company would have issued the coverage on the basis of facts as revealed by the application and other usual sources of underwriting information.
CONDITIONALLY RENEWABLE - A contract of health insurance that provides that the insured may renew the
contract to a stated date or an advanced age, subject to the right of the insurance company to decline
renewal only under conditions defined in the contract.
CONSIDERATION -The exchange of vaIue on which a contract is based. In life and health insurance, the
Consideration is usually the premium and the statements in the application.
CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA) OF 1986 - Legislation
providing for a continuation of group health care benefits under the group plan for a period of time when benefits would otherwise terminate. Continuation rights apply to enrolled persons and their dependents. Coverage may be continued for up to 18 months if the insured person terminates employment or is no longer eligible. Coverage may be continued for up to 36 months in nearly all other cases, such as loss of dependent eligibility because of death of the enrolled person, divorce, or attainment of the limiting age.
CONSUMER REPORT - A report ordered on an insured or applicant under which information about the persons credit, character, reputation, personal characteristics or lifestyle is obtained primarily through institutional sources. Contrast with Investigative Consumer Report.
CONTINGENT BENEFICIARY - Person or persons named to receive benefits if the primary beneficiary is not
alive.
CONTRACT OF INSURANCE - A contract whereby an insurance company agrees to indemnify an insured for
losses. provide other benefits, or render services to, or on behalf of, an insured. (The contract of insurance
is often called an "insurance policy," but "policy" is merely the evidence of the agreement.)
CONTRIBUTION - (1) The share of a loss payable by an insurer when contracts with two or more insurers cover the same loss. See also Apportionment. (2) The insurer's share of a loss under a coinsurance or similar provision. (3) The amount of the premium for group insurance or a pension plan paid by the employee.
CONTRIBUTION CLUASE - See Coinsurance Clause. Both are similar in effect, but the term Contribution
Clause is identified mostly with Business Interruption forms.
CONTRIBUTORY - A general term used to designate any plan of insurance (usually group or franchise) in which
the insured pays at least part of the premium.
CONVERSION - (1) Wrongful use of property by one in lawful possession of it. (2) The change of one policy
form to another, usually without evidence of insurability.
CONVERTIBLE - A policy that may be changed to another form by contractual provision and without evidence of insurability. Usually, this would be a Term Life Insurance policy that may be changed to a permanent form.
COST BASE - Money that has already been taxed; used in reference to taxation of investment dollars.
COST SHAFUNG - A situation where covered persons pay a portion of the health costs such as deductibles,
coinsurance, or co-payment amounts.
COUNTERSIGNATURE - Signature of licensed agent or representative on a policy necessary to validate the
contract.
COVER - ( 1 ) A contract of insurance. (2) To effect insurance. (3) To include within the coverage of a
contract of Insurance.
COVERAGE - Scope of the protection provided under a contract of insurance.
COVERAGE PART - Any one of the individual commercial coverage parts that may be attached to a commercial policy. Under the latest commercial lines program, a coverage part may be issued as
monoline policy or may be combined with others as part of a package policy.
C.P.C.U. - See Chartered Property and Casualty Underwriters.
CREDIT INSURANCE - Insurance on a debtor in favor of a lender intended to pay off a loan or the balance due
thereon if the insured dies or is disabled (usually Credit Life policy).
CSO TABLE 1958 - Commissioners Standard Ordinary Table. Astandard mortality table used in life insurance premium calculations.
CUSTODIAL CARE - Care that is primarily for meeting personal needs such as help in bathing, dressing, eating or taking medicine. It can be provided by someone without professional medical skills or training but must be according to doctor's orders.
D Return to top of the page
DAILY REPORT - .4n abbreviated statement of pertinent policy information with copies for the insurer, the agent, and others. It is usually the top page of a policy.
DEBIT - The collectable premium accounts assigned to one industrial or combination agent DECLARATIONS (DEC SHEET) - .4 term used in insurance for the portion of the contract which contains
information such as the name and address of the insured, the property insured, its location and
description, the policy period, the amount of insurance coverage, applicable premiums, and supplemental representations by the insured. DECLINATION - Rejection of an application for insurance by the insurer DECREASING TERM - A form of Life Insurance that provides a death benefit which declines throughout the
term of the contract, reaching zero at the end of the term.
DEDUCTIBLE - A provision or clause in an insurance policy that the first given number of dollars or percentage of expense will not be reimbursed. DEFERRED ANNUITY - An annuity contract that provides for the initiation of payments at some designated
future date in contrast to one in which payment begins immediately on purchase.
DEFERRED GROUP ANNCITYI' - A group annuity providing for the purchase each year of a paid-up deferred
annuity for each covered person, the total amount receivable at retirement being the sum of the individual paid-up annuities.
DEFLATION - An economic period characterized by falling prices, high unemployment and a generally sluggish or slow economy.
DEPOSIT ADMINISTRATION (DA) - A group annuity providing for the accumulation of contributions in an
undivided fund out of which annuities are purchased for each individual member of the group when he retires.
DEPSOIT PREMIUM - The premium deposit required by the company on those forms of insurance subject to
periodical premium adjustment.
DIRECT SELLING SYSTEM - Adistribution system within which the insurance company deals with the
insured’s through employees.
DIRECT WRITER - Aninsurance company that sells its policies through salaried employees (licensed agents) who represent it exclusively, rather than through independent local agents, who represent several insurance companies. DISABILITY BENEFIT - The benefit payable for disability under a Disability income policy or provision DISABILITI' INCOME INSURANCE - A form of health insurance that provides periodic payments to replace
income, actually
DISCOUNTED (COMMUTED) VALUE TABLE - Atable showing the discounted or present value, for several
interest rates, of dollars payable at various times in the future.
DISMEMBERMENT - loss, or loss of use of specified members of the body, resulting from accidental bodily injury.
DIVIDENT - The return of part of the premium paid for a participating policy.
DIVIDEND ADDITION - Paid-up life insurance purchased with policy dividends. DIVIDEND OPTION - Any one several ways to take policy dividends other than in cash, as provided in the
policy.
DOMESTIC INSURANCE COMPANY (INSURER) - An insurance company formed under the laws of the state
where the insurance is written.
DOUBLE INDEMNITY (Dl) - Payment of twice the basic benefit in event of loss resulting from specified causes or under specified circumstances. DREAD DISEASE POLICY - A policy, usually offering blanket coverage up to a very high maximum, for certain
specified diseases only, such as scarlet fever, smallpox, polio, tetanus, etc.
DUAL CHOICE - The federal requirement that employers having 25 or more employees who are within the
service area of a federally qualified HMO, who are paying at least minimum wage and offer a health plan to
their employees, must offer HMO coverage as well as an indemnity plan.
EARNED PREMIUM - That portion of a premium for which the policy protection has already been given during
the now-expired portion of the policy term.
ECONOMIC RISK - A risk experienced by those who invest in securities identified as the uncertainty of the
economy.
EFFECTIVE DATE -The date on which an insurance policy or bond goes into effect, and from which protection
is furnished.
ELECTROKIC DATA PROCESSING (EDP) COVERAGE - Specialized type of insurance designed to cover
computer equipment, data systems, information storage media and expenses or income loss related to EDP losses.
ELIMINATION PERIOD - A loosely used term sometimes designating the waiting period and sometimes the
probationary period. (See also Waiting Period and Probationary Period.)
EMBEZZLEMENT - The fraudulent use of money or property that has been entrusted to one's care EMPLOYEE PENSION BENEFIT PLAN OR PENSION PLAN - Any program established and maintained by
an employer or an employee organization providing retirement benefits to employees or deferred income until employment is terminated.
EMPLOYEE RETIREMENT INCOME SECURITW ACT (ERISA) - This act prescribes federal standards for
funding, participation. vesting, termination, disclosure, fiduciary responsibility, and tax treatment of
private pension plans. EMPLOYEE STOCK OWNERSHIP PLAN (ESOP) - A qualified employee plan that provides eligible
employees with part ownership in the corporation for which they work. Stock is issued and held in trust
for the benefit of the employees. EMPLOYEE WELFARE BENEFIT PLAN - Any program established or maintained by An employer or an
employee organization to provide its participants or their beneficiaries with medical, surgical, or hospital care, or benefits in the event of sickness, accident: disability, death or unemployment.
ENDOWMENT INSURANCE - A form of Life Insurance where the face amount is payable to the insured at the
end of the contract period or to a beneficiary if the insured dies before that. An example would be an insured
purchasing an endowment payable at age 65: If he reaches that age, the proceeds would be payable to him. If he dies prior to that age, the proceeds would be payable to the designated beneficiary as a Life Insurance benefit.
EXCESS INTEREST - Interest credited in excess of the minimum guaranteed by the life insurance policy contract.
EXCLLISION RATIO - The relationship or ratio of cost base to total expected return from an annuity: used to
calculate the percentage of each annuity payment which is considered to be a return of cost base.
EXCLUSIONS - Causes, conditions or property listed in the policy which are not covered and for which no
benefits are payable.
EXCLUSIVE AGENCY SYSTEM - A distribution system within which agents function under contracts that limit
representation to one or more insurance companies under common management and that reserve to the insurance company the ownership, use, and control of policy records and expiration data.
EXCLUSIVE PROVIDER ORGANIZATION (EPO) - A type of preferred provider organization where
individual members use particular preferred providers rather than having a choice of a variety of
preferred providers A primary physician who monitors care and makes referrals to a network of providers characterizes EPOs. EXPECTATION OF LIFE - The average number of years of life remaining for persons of a given age according
to a particular mortality table. Also called life expectancy.
EXPENSE CONSTANT - A flat charge added to the premium of small accounts where the premium is so low that the cost of issuing and servicing the policy cannot be recovered. Most often used with Workers' Compensation policies.
EXPENSE GUARANTEE - One of the guarantees of all annuities; that is. the guarantee that expenses, cost of
doing business, will not be increased or exceed a certain percentage of the annuity contributions.
EXPENSE RATIO - The percentage of the premium used to pay all the costs of acquiring, writing and servicing business. EXPERIENCE - The loss record of an insured, a class of coverage, or of an insurance company. EXPERIENCE MODIFICATION - A percentage increase or reduction in rates produced by application of the
experience rating plan, based on the loss history of the insured.
EXPERIENCED MORTALITY - The mortality that actually occurs to a group of insureds of a given insurance
company in contrast to expected mortality. (See Expected Mortality.)
EXPIRATION -The date upon which a policy will cease to cover, unless previously cancelled. EXPIRY - Termination of a Term policy at the end of the term period. EXPLANATION OF BENEFITS (EOB) - The statement sent to a participant in a health plan-listing senfices,
amounts paid by the plan, and total amount billed to the patient.
EXPOSURE - (1) state of being subject to the possibility of loss; (2) extent of risk as measured by payroll, gate receipts, area, or otherwise; (3) possibility of loss to a risk being caused by its surroundings. EXPRESS AUTHORITY - Authority of an agent that is specifically granted by the insurer in the agency contract
or agreement.
EXTENDED CARE FACILITY - A facility such as a nursing home, which is licensed to provide 24-hour,
nursing care service in accordance with state and local laws. Three levels of care may be pro\,ided - skilled,
intermediate, custodial, or any combination.
EXTRA EXPENSE INSCRANCE - Insurance providing extra funds needed to continue a business
uninterruptedly, after damage. It assumes no loss of income.
FACE - The first page of a policy.
FACE AMOUNT - In a Life Insurance policy, the death benefit stated on the first page of the policy.
FACILITY OF PAYMENT - A provision permitting the insurance company to pay a portion of the proceeds of a
policy to any relative or person who has possession of the policy and appears entitled to such payment.
FAIR CREDIT REPORTING ACT - Public Law 91-508 requires that an applicant be advised that a consumer
report may be requested, if such be the case, and the scope of the investigation which may be requested
and the name and address of the reporting agency, should the request for insurance be declined: because of information contained in that report. FAMILY EXPENSE POLICY - A policy that insures the medical expense of all members of a family. FAMILY INCOME POLICY - A life insurance policy that pays an income after the death of the insured for a
stated number of years from date of issue of the policy, and then pays the face amount.
FAMILY MAINTENANCE POLICY - A policy that pays a stated income for a state number of years from the
date of death of the insured and then pays the face amount.
FEDERAL ESTATE TAX - The federal tax that is imposed on the deceased's estate that includes the total assets comprising a person's estate at death. FIDUCIARY - A person who occupies a position of special trust and confidence (for example, in handling or
supervising the affairs or funds of another).
"FIRST" NAMED INSLTRED - The first named insured appearing on a commercial policy. The latest forms
permit the insurer to satisfy contractual duties by giving notice to the "first" named insured rather than requiring notice to all named insured’s.
FIXED-AMOUNT INSTALLMENTS - A settlement option under which fixed: periodic benefits payments are
made until the principal and interest are exhausted.
FIXED DOLLAR ANNUITY - Guarantees a fixed, minimum dollar payout, during each payout period. FIXED-PERIOD INSTALLMENTS - A settlement option under which the proceeds are guaranteed to be paid in equal installments for a specified of time.
FLEXIBLE PREMIUM ANNUITY - An annuity that allows the contract holder to vary the amount of the
premium payment, or stop payments and resume payments at will. A flexible premium annuity is used to find IRA and Keogh retirement plans because it allows the amount of premium to change as wages change.
FLEXIBLE PREMIUM POLICY - A life insurance policy under which the policyholder may vary the amount or timing of premium payments.
FOREIGN INSURER - An insurer formed under the laws of another state other than the state in which the property is written. FORGERY - In general, any false writing with intent to defraud. FORGEREY BOND - A contract of insurance wherein the company agrees to indemnify the insured for loss
sustained by reason of forgery on stated instruments, documents or securities.
FORM - An insurance policy itself or riders and endorsements attached to it. FORTUITOUS EVENT - An unforeseen accident FRANCHISE - In life and health insurance, a plan for covering groups of persons with individual policies uniform in provisions (although they may differ in benefits). Usually used for groups too small to qualify for true group or in association-group cases. In life insurance, the term wholesale is sometimes used instead of franchise. FRATERNAL - An insurance company organized under a special section of the state insurance code, characterized by a lodge or social system, and issuing insurance only to members. Also the insurance is sued by such an insurance company. FREE LOOK - A period of time (usually 10, 20 or 30 days) during which a policyholder may examine a newly
issued individual policy of life or health insurance, and surrender it in exchange for a full refund of
premium if not satisfied for ally reason. |
|
|
GATEKEEPER MODEL - Under this model of HMO and PPO organizations, the primary care physician (the gatekeeper) is the initial contact for the patient for medical care and for referrals.
This is also called a closed access or closed panel GENERAL ACCOUNT -An investment portfolio used by the insurer for investment of premium income. This portfolio generally consists of safe, conservative. Guaranteed investments, such as real estate and mortgages. GRACE PERIOD - A period of time (commonly 30-31 days) after premium-due date during which a policy remains in force without penalty even though the premium due has not been paid. GRADED PREMIUM - A modified Life Insurance policy for which the initial premium is low, and then increases in steps over a period of time (usually 5 years), after which it becomes a level premium. GROUP CONTRACT - A contract of insurance made with an employer or other entity that covers a group of persons identified by reference to their relationship to the entity buying the contract. The group contractual arrangement is generally used to cover employees of a common employer, members of a trade association or trusteeship, members of a welfare or employee benefit association. members of a labor union, or members of a professional or other association not formed only for the purpose of obtaining insurance.
GUARANTEED INSURABILITY - An option in Life or Health Insurance contracts that permits the insured to buy additional prescribed amounts of insurance at prescribed fut
|