Insurance Glossary

1 Insurance Glossary A Absolute assignment: Policy assignment under which the assignee (person to whom the policy is assigned) receives full control over the policy and also full rights to its benefits. Generally, when a policy is assigned to secure a debt, the owner retains all rights in the policy in excess of the debt, even though the assignment is absolute in form. (See assignment) Accelerated benefits rider: A life Insurance rider that allows for the early payment of some portion of the policies face amount should the insured suffers from a terminal illness or injury. Acceptance: (See offer and acceptance) Accidental bodily injury provision: Disability income or accident policy provision that requires that the injury be accidental in order for benefits to be payable. Accidental death and dismemberment (AD&D) : Insurance providing payment if the insured's death results from an accident, if the insured accidentally severs a limb above the wrist or ankle joints, or totally and irreversibly loses eyesight.

2 Accidental death and dismemberment (AD&D) : Insurance providing payment if the insured's death results from an accident, if the insured accidentally severs a limb above the wrist or ankle joints, or totally and irreversibly loses eyesight. Accidental death benefit rider: A life Insurance policy rider providing for payment of an additional benefit when death occurs by accidental means. Accidental dismemberment: Often defined as "the severance of limbs at or above the wrists or ankle joints, or the entire irrevocable loss of sight. Loss of use in itself may or not be considered dismemberment. Accidental means provision: Unforeseen, unexpected, unintended cause of an accident. Requirement of an accident-based policy that the cause of the mishap must be accidental for any claim to be payable. Accident and health Insurance : Under which benefits are payable in case of disease, accidental injury, or accidental death.

3 Also called health Insurance , personal health Insurance , and sickness and accident Insurance . Accumulation unit: Premiums an annuitant pays into annuities are credited as accumulation units. At the end of the accumulation period, accumulation units are converted to annuity units. Acquired immune deficiency syndrome (AIDS) : A life-threatening condition brought on by the human immunodeficiency virus; insurers must adhere to strict underwriting and claims guidelines in regard to AIDS risks and AIDS-related conditions. Acute illness: A serious condition, such as pneumonia, from which the body can fully recover with proper medical attention. Adhesion: A life Insurance policy is a contract of adhesion because buyers must adhere to the terms of the contract already in existence. They have no opportunity to negotiate terms, rates, values, and so on. Adjustable life Insurance : Combines features of both term and whole life coverage with the length of coverage and amount of accumulated cash value as the adjustable factors.

4 Premiums may be increased or decreased to fit the specific needs. Such adjustments are not retroactive and apply only to the future. Administrative-services-only (ASO) Plan: Arrangement under which an Insurance company or an independent organization, for a fee, handles the administration of claims, benefits, and other administrative functions for a self-in sured group. Admitted insurer: An Insurance company that has met the legal and financial requirements for operation within a given state. Adult day care: Type of care (usually custodial) designed for individuals who require assistance with various activities of daily living, while their primary caregivers are absent. Offered in care centers. Adverse selection: Selection "against the company." Tendency of less favorable Insurance risks to seek or continue Insurance to a greater extent than others.

5 Also, tendency of policy owners to take advantage of favorable options in Insurance contracts. Advertising Code: Rules established by the National Association of Insurance Commissioners (NAIC) to regulate Insurance advertising. Agency: Situation wherein one party (an agent) has the power to act for another (the principal) in dealing with third parties. Agent: Anyone not a duly licensed broker who solicits Insurance or aids in placing risks, delivering policies, or collecting premiums on behalf of an Insurance company. Agent s report : The section of an Insurance application where the agent reports personal observations about the applicant. Aleatory: Feature of Insurance contracts in that there is an element of chance for both parties and that the dollar given by the policyholder (premiums) and the insurer (benefits) may not be equal. Alien Insurer: Company incorporated or organized under the laws of any foreign nation, providence, or territory.

6 Ambulatory surgery: Surgery performed on an outpatient basis. Amount at risk: Difference between the face amount of the policy and the reserve or policy value at a given time. In other words, the dollar amount over what the policy owner has contributed of cash value toward payment of the policyowner s own claim. Because the cash value increases every year, the net amount at risk naturally decreases until it finally reaches zero when the cash value or reserve become the face amount. Annually renewable term (ART) : A form of renewable term Insurance that provides coverage for one year and allows the policy owner to renew coverage each year without evidence of insurability. Also called yearly renewable term (YRT). Annuitant: One to whom an annuity is payable, or a person upon the continuance of whose life further payment depends.

7 Annuity : A contract that provides a stipulated sum payable at certain regular intervals during the lifetime of one or more persons, or payable for a specified period only. Annuity unit: The number of annuity units denotes the share of the funds an annuitant will receive from a variable annuity account after the accumulation period ends and benefits begin. A formula is used to convert accumulation units to annuity units. Any occupation: A definition of total disability that requires that for disability income benefits to be payable, the insured must be unable to perform any job for which the insured is "reasonably suited by reason of education, training, or experience." Apparent authority: The authority an agent appears to have, based on the principal s (the insurer s) actions, words, deeds, or because of circumstances the principal (the insurer) created.

8 Application: Form supplied by the Insurance company, usually filled in by the agent and medical examiner (if applicable) on the basis of information received from the applicant. It is signed by the applicant and is part of the Insurance policy if it is issued. It gives information to the home office underwriting department, so it may consider whether an Insurance policy will be issued and, if so, in what classification and at what premium rate. Appointment: Authorization or certification of an agent to act for or represent an Insurance company. Approval receipt: Rarely used today, a type of conditional receipt that provides that coverage is effective as of the date the application is approved (before the policy is delivered). Assessment mutual insurer: An Insurance company characterized by member-insureds who are assessed an individual portion of each loss that occurs.

9 No premium payment is payable in advance. Assignee: Person (including corporation, partnership, or other organization) to whom a right or rights under a policy are transferred by means of an assignment. Assignment provision (health contracts) : Commercial health policy provision that allows the policy owner to assign benefit payments from the insurer directly to the health care provider. Assignment: Signed transfer of benefits of a policy by an insured to another party. The company does not guarantee the validity of an assignment. Assignor: Person (including corporation, partnership, or other organization or entity) who transfers a right or rights under an Insurance policy to another by means of an assignment. Attained age: With reference to an insured, the current Insurance age. Authority: The actions and deeds an agent is authorized to conduct on behalf of an Insurance company, as specified in the agent's contract .

10 Authorized company: Company duly authorized by the Insurance department to operate in the state. Automatic premium loan provision: Authorizes insurer to automatically pay any premium in default at the end of the grace period and charge the amount so paid against the life Insurance policy as a policy loan. Average Indexed Monthly Earnings (AIME) : The basis used for calculating the primary Insurance amount (PIA) for Social Security benefits. Average Monthly Wage (AMW) : The average wage base for computing virtually all Social Security benefits prior to. Aviation exclusion: Either attached by rid er or included in standard policy language excepting from coverage certain deaths or disabilities due to aviation, such as "other than a fare-paying passenger." B Backdating: The practice of making a policy effective at an earlier date than the present.