COPYRIGHTED MATERIAL
WHAT DOES THAT MEAN?
TERM
DEFINITION
beneficiary
the person who receives the pay out on the insurance contract. an accident or disaster as referred to in an insurance policy.
casualty
claim
notification to an insurance company of a loss with request for payment of benefits.
coverage
the dollar amount of insurance provided under an insurance policy.
coinsurance
a percentage of medical expenses the insured is responsible for paying after they meet their deductible.
copay
a fixed amount the insured is required to pay at time of service.
deductible
a fixed amount or fixed percentage of the claim which the insured is responsible for paying before the insurance company has to pay. additions to a homeowner’s insurance policy that alter the policy’s coverage and terms; also called a rider.
endorsement
peril or loss that is not covered by the policy. PRODUCT PREVIEW the potential for loss. a condition that increases the risk that a loss will occur. to compensate for damage or loss. reduction in worth.
exclusion exposure
hazard
Health Maintenance Organization
“HMO”; type of managed care plan where covered healthcare services are provided only through an approved network of providers. a contract between an insurance company and an insured by which the insurer agrees to compensate the insured in the event of loss. a company that by contract assumes the risk of loss in the event of accident, error, illness or death, in exchange for a fee. the person who contracted with the insurance company and is entitled to the benefits of the insurance coverage. the basic information that defines the policy, such as the name of the beneficiary, the policy number, address of the insured property and amount of coverage. the maximum amount an insurance company is obligated to pay out under an insurance policy. “PPO”; type of managed care plan where members may see in-network healthcare providers without a referral and out-of-network providers at reduced benefits. a monthly, quarterly, or annual payment the insured must pay to the insurance company to maintain the coverage under a plan or policy.
insurance policy
insurer
insured
indemnify
loss
policy declarations
policy limits
Preferred Provider Organization
premium
replacement cost
the amount it would cost to repair or replace an item.
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Chapter 15 | Protect What You’ve Earned 284
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