Insurance Information
Mail Order Insurer Type of insurance company that sells policies through the mail or other mass media, eliminating need for agents. Manual Rate A loose-leaf manual, periodically updated or revised, that contains rules, rates and other information prepared by an insurance company or rating bureau to develop premiums for insurance policies. Hard-copy manuals have been supplemented or replaced by electronic data (CD-ROMs, computer disks, electronic networks). Manuscript Policy An insurance policy designed or tailored for a large commercial insured; a unique coverage written at the request of a broker or a risk manager. Marital deduction A reduction of an estate for estate tax purposes, which is available if the decedent is survived by his or her spouse, can be as large as the administrator or executor elects so long as it does not exceed the value of qualifying property passing to the surviving spouse. Market Price The price at which a security can be bought or sold at any particular time. Master Policy An original, complete insurance policy contract that is issued by an insurer with the understanding that certificates of insurance or underlying policies will be issued to others; for example, a master group health policy is issued to an employer while certificates are given to the employees. A master policy and underlying policies may be issued to a property owner to comply with requirements of a mortgage holder. Material Damage Insurance against damage to a vehicle itself. It includes automobile comprehensive, collision, fire and theft. Material damage and physical damage are terms that often are used inter- changeably. Maximum family benefit The largest amount in Social Security benefits that will be paid to any family unit. McCarran-Ferguson Act Federal legislation (U.S. Code Title 15, Chapter 20) enacted in 1945 to permit the states to continue regulating the insurance business after the Supreme Court, in U.S. v. South-Eastern Underwriters Association, overruled the decision in Paul v. Virginia, declaring insurance to be interstate commerce and therefore within Congress's constitutional authority to regulate. Under the Act, insurance is exempt from some federal antitrust statutes to the extent that it is regulated by the states. The exemption primarily applies to gathering data in concert for the purpose of ratemaking. Otherwise, antitrust laws prohibit insurers from boycotting, acting coercively, restraining trade, or violating the Sherman or Clayton Acts. Medicaid A state medical benefit program for persons, regardless of age, whose income and resources are insufficient to pay for health care. As of January 1, 1966, federal matching funds were provided to the states under Title XIX of the Social Security Act. Medical Examination The examination given by a qualified physician to determine to the insurability of an applicant. A medical examination may also be used to determine whether an insured claiming disability is actually disabled. Medical Payments Insurance A coverage, available in various liability insurance policies, in which their insurer agrees to reimburse the insured and others, without regard for the insured's liability, for medical or funeral expenses incurred as the result of bodily injury or death by accident under specified conditions. Medicare A federally administered program of hospital insurance (Part A) and supplementary medical insurance (Part B) primarily for people over 65, created by 1965 amendments to the Social Security Act. It also covers people of any age with permanent kidney failure and certain other disabilities. The Health Care Financing Administration in the U.S. Department of Health and Human Services reimburses hospitals and physicians for services to qualified patients. Part A (hospital insurance) coverage is automatic for all eligible people and is financed by a payroll tax on employers and employees. Part B (supplementary medical insurance) is a voluntary program of government-subsidized insurance requiring participants to make premium payments. Medigap Private insurance purchased by Medicare participants on a voluntary basis that is designed to fill the gaps in Medicare, such as coinsurance, deductibles and noncovered services (e.g., hospital stays beyond a certain length). Minimum Benefits A provision that a minimum amount of annuity will be paid if the regular benefit formula produces less. This minimum is usually payable only if certain service requirements are met at retirement. Minimum Group The minimum number of persons required to form a group insurance program under state law; the minimum number that an insurance company requires to issue a group policy. Miscellaneous Expenses Expenses involving hospital care other than room, board and doctors' fees, such as lab tests, drugs and radiology. Most hospital policies limit coverage for these expenses by scheduling the amounts covered or combining them for a an aggregate limit. Misrepresentation A false, incorrect, improper, or incomplete statement of a material fact, made in the application for a policy. Moral Hazard Circumstances of morals or habits that increase the probability of a loss from an insured peril. Example: An insured previously convicted of arson. Morbidity The frequency of the incidence of disease, illness or sickness. Morbidity Tables A table showing the number of individuals exposed to the risk of illness, sickness, and disease at each age, and the actual number of individuals who incurred an illness, sickness, and disease at each age. Mortality Table A table that indicates the number of individuals within a specified group of individuals (males, females, airline pilots, etc.), starting at a certain age, who are expected to be alive at succeeding ages. It is used to derive the "natural premium" for an individual life policy. Motor Vehicle Records The record maintained by a state motor vehicle department of a driver's accidents and traffic violations. Motor Vehicle Report Report that lists the moving violations and accidents that a driver has had in the past several years. Multi-Peril Policy A package policy which provides protection against a number of separate perils. Multi-peril policies are not necessarily multiple line policies, since the combined perils may be all within one insurance line. Multiple Employer Trust (MET) A legal trust formed by a health benefit plan sponsor to combine a number of small, unrelated employers for the purpose of providing group medical coverage on an insured or group self-insured basis. Mutual Insurance Company An insurance company that has no capital stock, but is owned by its policyholders, who elect a board of directors or trustees through whom business is conducted. Any earnings belong to the policyholders and may be distributed to them as policy dividends or educed premiums.
Insurance Information
Immediate Annuity An annuity that commences benefit payments immediately after a specified interval (one month or one year). This type of annuity is nearly always purchased with a single premium. Imputed Negligence Case in which responsibility for damage can be transferred from the negligent party to another person, such as an employer. Incurred Claims Incurred claims equal the claims paid during the policy year plus the claim reserves as of the end of the policy year, minus the corresponding reserves as of the beginning of the policy year. The difference between the year end and beginning of the year claim reserves is called the increase in reserves and may be added directly to the paid claims to produce the incurred claims. Indemnification Compensation to the victim of a loss, in whole or in part, by payment, repair, or replacement. Indemnity Legal principle that specifies an insured should not collect more than the actual cash value of a loss but should be restored to approximately the same financial position as existed before the loss. Independent Adjuster Claims adjuster who offers his or her services to insurance companies and is compensated by a fee. Independent Agent An independent contractor who sells insurance usually on behalf of more than one insurance company under the independent agency system. Independent agents operate their own business, own the records of the policies sold through them, and are compensated by commissions or fee. Indirect Loss Property loss from a peril that is not the immediate cause of loss; an indirect loss (e.g. a business interruption loss, extra expense, lost rent, etc.) arising out of an insured's inability to use property damaged by another peril. Inheritance tax A tax based on an estate's value at the time of the owner's death. A federal unified tax is assessed on the combined value of the estate and qualifying gifts so that estate taxes cannot be avoided by gifts in anticipation of death. Insolvent Having insufficient financial resources (assets) to meet financial obligations (liabilities). Inspection In property and casualty insurance, the insurer retains the right to make inspections and surveys relating to the insurability of the risk and the premiums charged. The insurer also reserves the right for inspection of property for which a loss arises and claim presented. Installments When a policy is placed on a payment plan, multiple equal installments due in the future are created. Insurability The risk-associated qualities of a person or entity that meet an insurer's underwriting standards and therefore make the insurer willing to offer coverage at a standard premium. Insurable Interest The person who stands to lose financially in the event of a loss. For example, loss to an automobile, home, or contents. Insurable Risk A risk that meets the following criteria: 1. The insured loss must have a definite time and place; 2. The insured event must be accidental; 3. The insured must have an insurable interest in the subject of coverage; 4. The insured risks must belong to a sufficiently large group of homogeneous exposure units to make losses predictable; 5. The risk must not be subject to a catastrophic loss where a large number of exposure units can be damaged or destroyed in a single event; 6. The coverage must be provided at a reasonable cost; 7. The chance of loss must be calculable. Insurance A system under which individuals, businesses, and other organizations or entities, in exchange for payment of a sum of money (a premium), are guaranteed compensation for losses resulting from certain perils under specified conditions. Insurance Adjuster An insurance company employee who is responsible for settling or adjusting claims. Insurance Commissioner The senior official in a state's department of insurance or other insurance regulatory agency. Insurance Company An organization chartered to operate as an insurer. Insurance Examiner The insurance department representative assigned to audit the books or the market conduct of an insurance company. Insurance Exchange An insurance marketplace or organization patterned after Lloyd's of London, formed during the 1980s in New York City, Miami, Florida, and Chicago, Illinois. Exchanges were formed to write large or unique risks, generally on a surplus lines basis, and to write reinsurance business. Both the New York and Florida exchanges have suspended operations. Insurance Guaranty Funds Plans established and administered individually at the state level which assess solvent insurers in order to settle the unpaid claims of a insolvent company and to return unearned premiums to its policyholders. Insurers each pay a proportional share of the losses based on their premium volume in the state. Frequently funds are set up in such a way as to have immediate access to assets of the insolvent insurer (rather than waiting until liquidation proceedings are completed). In many states, funds are given priority before general creditors to obtain assets of insolvent insurers. In some states, solvent insurers are permitted tax offsets against money paid into guarantee funds. Insurance Services Offices Members: Rating bureaus, actuarial associations and other insurance research groups. Objectives: Provides statistical and actuarial information, policy forms and related services to insurers. Functions as an insurance advisory organization and statistical agent. Publishes rate manuals, plans, policy forms and endorsements and other materials. Insured The person whose insurable interest is protected under an insurance policy; the one to whom or at whose direction an insurer reimburses losses, pays benefits, or provides services. The term is generally preferred to policyholder. Insured Loss Ratio The ratio that a reinsurer's percentage of losses incurred bears to premiums earned. Insured Vehicle A vehicle which is covered by an insurance policy or any vehicle which meets the definition of a covered auto according to the language of the insurance policy. Insurer The party to the insurance contract who promises to pay losses or benefits. Also, any corporation engaged primarily in the business of furnishing insurance to the public. Insuring Agreement That part of an insurance contract that states the promises of the insurer. Insuring Clause The clause which sets forth the type of loss being covered by the policy and the parties to the insurance contract. Interest The price for the use of money, expressed as a percentage of the amount borrowed; the charge paid by a borrower to a lender Inter vivos Trust An ordinary trust established by a person while living to manage and distribute assets to other living persons. (Inter vivos is Latin for "between the living.") Intestate Dying without having made a legal will; a person who has died without leaving a will Investment Income An insurance company's earnings from its investment portfolio, including interest, dividends, capital gains, and rent.
Insurance Information (cont'd)
Qualification Period The period during which the insured must be totally disabled before becoming eligible for residual disability benefits. Qualified Impairment Insurance A form of substandard or special class insurance, which restricts benefits for the insured person's particular condition. Qualified Plan A plan which the Internal Revenue Service approves as meeting the requirements of Section 401(a) of the 1954 Internal Revenue Code. Such plans receive tax advantages. Qualified terminable interest property A category of property, created by the Economic Recovery Tax Act, which by a deceased spouse's will entitles the surviving spouse to all income from the property for life, with that income payable at least annually, and precludes anyone including the spouse from appointing the property to anyone else during the spouse's life. |
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