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
Earned Premium That portion of the premium which represents coverage already provided. Each day that an insurance policy is in force represents a day of earned premium. Economic Loss The estimated total cost, both insured and uninsured, of mishaps (such as motor vehicle accidents, work accidents, and fires); includes such factors as property damage, funeral expenses, wage loss, insurance administration costs, and medical, hospital and legal costs. Effective Date The date in which insurance protection begins under a policy. Electronic Funds Transfer A method of collecting policy premium electronically from the policy holder's bank account. Elements of a Negligent Act Four elements an injured person must show to prove negligence - existence of a legal duty to use reasonable care, failure to perform that duty, damages or injury to the claimant, and proximate cause relationship between the negligent act and the infliction of damages. Escheatable Property that has reverted back to the state when no legal heirs or claimants exist. An example is a customer refund check that is undeliverable or unredeemed. Estate The assets and liabilities of a person left at death. Extent and nature of one's interest in land; the assets constituting a descendent's property at the time of death; the assets of a debtor in bankruptcy proceedings. Estoppel Legal doctrine that prevents a person from denyng the truth of a previous representation of fact, especially when such representation has been relied on by the one to whom the statement was made. Exclusion Specified conditions or circumstances, listed in the policy, for which the policy will not provide benefits. Exclusive Agent An agent who is employed by one and only one insurance company and who solicits business exclusively for that company. Expense Ratio The ratio of a company's operating expenses to premiums. Experience A term used to describe the relationship, usually expressed as a percent or ratio, of premium to claims for a plan, coverage, or benefits for a stated time period. Experience Letter Letter requested by an insured that documents their loss history with us. Extended Coverage Insurance Protection for the insured against property damage caused by windstorm, hail, smoke, explosion, riot, riot attending a strike, civil commotion, vehicle and aircraft. This is provided in conjunction with the fire insurance policy and the various "package" policies. External Sources Third Party providers that have personal data on record such as name and address.
Insurance Information (cont'd)
Occupational Hazards Occupations which expose the insured to greater than normal physical danger by the very nature of the work in which the insured is engaged, and the varying periods of absence from the occupation, due to the disability, that can be expected. Occurrence An accident, including continuous or repeated exposure to substantially the same general, harmful conditions, that results in bodily injury or property damage during the period of an insurance policy. Occurrence policy A liability insurance policy that covers claims arising out of occurrences that take place during the policy period, regardless of when the claim is filed. Ocean Marine Insurance Insurance for sea-going vessels, including liabilities connected with them, and their cargoes. Ocean Marine Insurance Coverage on all types of vessels, including liabilities connected with them, and on their cargoes. Operating Ratio The sum of expenses and losses expressed as a percent of earned premium. Optionally Renewable Contract A contract of health insurance in which the insurer reserves the right to terminate the coverage at any anniversary or, in some cases, at any premium due date, but does not have the right to terminate coverage between such dates. Ordinary Life Synonymous With Whole Life and Straight Life - The three terms are applied to the type of policy which continues during the whole of the insured's life and provides for the payment of amount insured at this death. Ordinary Life Insurance Life insurance usually issued in amounts of $1,000 or more with premiums payable on an annual, semi-annual, quarterly or monthly basis. Over-the Counter Market A means of buying and selling securities that are not listed on a stock exchange. Negotiations are carried out by telephone or computer network. Overhead Expense Insurance A special form of health insurance designed to help offset overhead expenses such as office rent, utilities, employees' wages, and auditors' fees, incurred during total disability. The monthly payments during disability is not a fixed amount of indemnity as on regular disability polices, but the amount of overhead expense actually incurred, or a percentage thereof, up to the limit specified in the policy. Overhead Insurance A type of short-term disability income contract that reimburses the insured person for specified, fixed monthly expenses, normal and customary in the operation and conduct of his/her business or office. Overriding Commission (Overwrite) A commission paid to general agents or agency managers in addition to the commission paid the soliciting agent or broker. |
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