Insurance Resources Glossary
A list of common terms to assist you while shopping or learning about insurance.
A
Replacement cost of property minus depreciation for age and condition.
A person who investigates and settles losses for an insurance carrier.
A person authorized to represent an insurer in negotiating or servicing policies.
A cap on covered expenses an insured pays over a calendar year.
A contract providing periodic payments at regular intervals.
The party applying for an insurance policy.
A form with questions about the prospective insured and the desired coverage.
B
A person or entity designated to receive policy benefits on the death of the policyholder.
A temporary contract placing insurance in force before a policy is issued.
A marketing specialist who arranges coverage between customers and insurers.
C
Health expenses the insured pays before insurance kicks in each year.
Termination of a policy before its normal expiration date.
A request for payment from an insurer for a covered loss.
The percentage of medical costs the insured pays after meeting the deductible.
A flat fee paid for a covered service such as a doctor visit or prescription.
Prior qualifying coverage that can reduce a pre-existing condition exclusion period.
D
The amount the policyholder pays out of pocket before insurance covers the rest.
A person, usually a spouse or child, for whom the insured has legal coverage responsibility.
Reduction in the value of property due to age and use.
E
A hospital visit for sudden, severe symptoms requiring immediate medical care.
An addendum to an insurance policy that changes its original terms.
Conditions and services that aren't covered by a health plan.
G
A length of time (typically 30 days) after a premium is due in which a payment keeps the policy in force.
A health policy the insurer must renew as long as premiums are paid.
H
Federal law that protects health coverage when changing jobs and limits pre-existing condition exclusions.
A health plan that uses managed care and a network of providers, often requiring a primary care physician.
I
Restoring the insured to approximately the same financial position as before a loss.
A person or organization covered by an insurance policy.
The party to the insurance contract that promises to pay losses or benefits.
L
Termination of a policy due to nonpayment of premiums.
A legal obligation to compensate a person harmed by one's acts or omissions.
The maximum amount a plan will pay for an insured's healthcare over their lifetime.
N
A group of providers contracted with a health plan to provide care at agreed rates.
A system where the insured's own insurer pays for losses regardless of fault.
Drugs not on a plan's formulary; often require a higher copay or aren't covered.
O
Care received outside of a health plan's contracted network.
Medical care costs not covered by insurance, paid by the insured.
P
The written contract between an insured and an insurer.
The person who buys insurance.
A network of providers contracted to offer care at discounted rates, usually without referrals.
A condition that existed before the policy was issued.
The price paid for insurance coverage for a specific period.
A doctor who serves as your first point of contact in a managed care plan.
R
The pricing factor used to determine an insurance premium.
Reimbursement of damaged property with new, similar items, subject to policy terms.
An addition to an insurance policy that becomes part of the contract.
The possibility or chance of loss or injury.
S
An agreement on the amount and method of payment for a claim.
A provision under which the insurer pays 100% of eligible expenses after a set out-of-pocket amount is reached.
An insurer's right to seek reimbursement from the party legally responsible for a loss.
T
Life insurance that pays a benefit only if the insured dies within a specified period.
U
The party that decides whether to accept a risk and at what rate.
The process of reviewing and classifying applications for coverage.
Immediate care for a medical urgency that isn't a life-threatening emergency.
W
An agreement attached to a policy that exempts certain disabilities or injuries from coverage.