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Michigan life and health insurance
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Accelerated Benefits ✔️ ✔️ Riders attached to life insurance policies which allow death benefits to be used to cover nursing or convalescent home expenses. accident ✔️ ✔️ An unplanned unforeseen event, which occurs suddenly and an unspecific place accident insurance ✔️ ✔️ A type of insurance that protects the insured against loss due to accidental bodily injury. Accidental Bodily Injury ✔️ ✔️ Unplanned, unforeseen traumatic injury to the body. Accidental death and dismemberment AD&D ✔️ ✔️ An insurance policy which pays a specified amount or a specified multiple of the insured's benefit if the insured dies, loses his/her sight, or loses two limbs due to an accident. Accidental death benefits ✔️ ✔️ A policy rider that states that the cause of death will be analyzed to determine if it complies with the policy description of accidental death. Accidental death insurance ✔️ ✔️ An insurance policy that provides payment if the insured's death is the result of an accident. Accumulation Period ✔️ ✔️ The time over which the annuitant makes payments or investments in an annuity And when those payments earn interest tax deferred
Acquired immunodeficiency system (AIDS) ✔️ ✔️ Infectious an incurable disease caused by the human immunodeficiency virus HIV activities of daily living (ADLs) ✔️ ✔️ Activities individuals must do every day such as moving about, getting dressed, eating, bathing, etc. Actual Cash Value (ACV) ✔️ ✔️ The required amount to pay damages or for property loss, which is calculated based on the property's current replacement value minus depreciation. Actual Charge ✔️ ✔️ The amount a physician or supplier actually bills for a particular service or supply. Actuary ✔️ ✔️ Person trained in the technical aspects of insurance and related feels particularly in the mathematics of insurance person who on behalf of the company determines the mathematical probability of loss Adhesion ✔️ ✔️ A contract offered on a take it, or leave it basis by an insurer in which the insured only option is to accept or reject contract. Any ambiguities in the contract will be settled in favor of the insured. Adjustable Life ✔️ ✔️ Life insurance which permits changes in the face amount, premium amount, period of protection, and the duration of the premium payment period. Adjuster ✔️ ✔️ A representative of an insurance company who investigates and acts on the behalf of the company to obtain agreements for the amount of the insurance claim. administrator ✔️ ✔️ An individual appointed by court as a fiduciary to settle the financial affairs and estate of a deceased person
Annual Statement ✔️ ✔️ Detailed financial report, the insurance company must submit every year to the insurance department of state in which it conducts business annuity ✔️ ✔️ A contract that provides income for a specified Period of years or for life Apparent Authority ✔️ ✔️ The appearance or the assumption of authority based on the actions, words, or deeds of the principal or because of circumstances the principal created. applicant ✔️ ✔️ A person making application for, or offering him/herself or another to be insured under an insurance contract application ✔️ ✔️ A document that provides information for underwriting purposes. After the policy is issued, any unanswered questions are considered waived by the insurer. Approved Amount ✔️ ✔️ The amount Medicare determines to be reasonable for a service that is covered under part B of Medicare. Assignment (Life) ✔️ ✔️ The transfer of ownership rights of a life insurance policy from one person to another. Assignment (Health) ✔️ ✔️ A claim to a provider or medical supplier to receive payments directly from Medicare. Attained Age ✔️ ✔️ The age of the insured at a determined date. Attending Physician's Statement (APS) ✔️ ✔️ A statement usually obtained from the applicant's doctor.
Authorized (Admitted) Insurer ✔️ ✔️ An insurance company authorized and licensed to transact business in a particular state. Avoidance ✔️ ✔️ A method of dealing with the risk with deliberately Keeping away from it, (ex ) wanted to avoid the risk of being killed in airplane crash he/she might choose never to fly in a plane back-end load ✔️ ✔️ a fee charged at the time of a sale, transfer or withdrawal from an annuity or a life insurance policy. Basic Hospital Expense Insurance ✔️ ✔️ Coverage that provides benefits for room, board an miscellaneous hospital expenses for a certain number of days during a hospital stay. Basic Illustration ✔️ ✔️ A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements. basic medical insurance ✔️ ✔️ Coverage for doctor visits x-rays left us an emergency room Visits benefits, however, are limited to specific dollar amounts beneficiary ✔️ ✔️ The person who receives the proceeds from the policy when the insured dies Benefit Period ✔️ ✔️ The length of time over which the insurance benefits will be paid for each illness, disability or hospital stay. Binder (Binding Receipt) ✔️ ✔️ A temporary contract that puts an insurance policy into force before the premium has been paid. Blanket Medical Insurance ✔️ ✔️ A policy that provides benefits for all medical costs, including doctor visits, hospitalization, and drugs.
Certificate of Authority ✔️ ✔️ A document that authorizes a company to start conducting business in specifies the kinds of insurance, a company can transact it is illegal for insurance company to transact insurance without the certificate Certificate of Insurance ✔️ ✔️ A legal document that indicates that an insurance policy has been issued, and that states both the amounts and types of insurance provided. claim ✔️ ✔️ A request for payment of the benefits provided by an entire contract coercion ✔️ ✔️ An unfair trade practice, in which insurers use physical or mental, forced to persuade an applicant by insurance Coinsurance ✔️ ✔️ In agreement between insurer and insured in which both parties are expected to pay a certain portion of the potential loss and other expenses Coinsurance Clause ✔️ ✔️ A provision that states that the insurer and the insured will share the losses covered by the policy in a proportion agreed upon in advance. Commingling ✔️ ✔️ A practice in which a person in fiduciary capacity illegally mixes his/her personal funds with funds he/she is holding in trust commission ✔️ ✔️ The payment made by insurers two agents or brokers for the sale in service of policies Commissioner (Superintendent, Director) ✔️ ✔️ The chief executive and administrative officer of a state insurance department. comprehensive policy ✔️ ✔️ A plan that provides a package of health care services, including preventive care, routine physicals, immunization, outpatient services and hospitalization.
Comprehensive major medical ✔️ ✔️ A combination of basic coverage and major medical coverage that features low deductibles, high maximum benefits, and coinsurance. Concealment ✔️ ✔️ The withholding of known facts, which, if material can void a contract Conditional Contract ✔️ ✔️ A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable. Consideration ✔️ ✔️ The binding force in a contract that requires something of value to be exchanged for the transfer risks. The consideration on the part of the insured is the representations made by the application of the payment of the premium. The consideration on the part of the insure is the promise to pay in the event of loss. Consideration Clause ✔️ ✔️ A part of the insurance contract that states that both parties must give something of value for the transfer of risk, and specifies the conditions of the exchange. Consolidated Omnibus Budget Reconciliation Act (COBRA) ✔️ ✔️ The law that provides for the continuation of group healthcare benefits for the insured, for up to 18 months, if he/he terminates employment, or is no longer eligible and for the insured departments for up to 36 months, in case of loss of eligibility to the death of the insured, divorced or attainment of the limiting age Consumer Reports ✔️ ✔️ Written and /or oral statements regarding a consumer's credit, character, reputation, or habits collected by a reporting agency from employment records, credit reports, and other public sources. contract ✔️ ✔️ An agreement between two or more parties that is enforceable by law Contributory ✔️ ✔️ A group insurance plan that requires the employees to pay part of the premium.
Decreasing Term ✔️ ✔️ A type of life insurance that features a level premium and a death benefit that decreases each year over the duration of the policy. Deductible ✔️ ✔️ The portion of the loss that is to be paid by the insured for any claim benefits may be paid by the insurer Defamation ✔️ ✔️ An unfair trade practice, in which one agent or insurers make an injury, a statement about another, with the intention of harming, the person or company's reputation dependent ✔️ ✔️ A person who relies on another for support and maintenance Director (Commissioner, Superintendent) ✔️ ✔️ The head of the state department of insurance. disability ✔️ ✔️ A physical or mental impairment, either congenital or resulting from an injury or sickness. disability income insurance ✔️ ✔️ Health insurance provides periodic payments to replace an insured income when he or she is injured or ill disclosure ✔️ ✔️ An act of identifying the name of the producer, representative or firm, limited insurance representative, or temporary insurance producer on any policy solicitation. Domestic Insurer ✔️ ✔️ An insurance company that conducts business in the state of incorporation. Domicile of Insurer ✔️ ✔️ Insurer's location of incorporation and the legal ability to write business in a state.
Dread (Specified) Disease Policy ✔️ ✔️ A policy with a high maximum limit that covers certain diseases named in the contract (such as polio and meningitis). Dual Choice ✔️ ✔️ A federal requirement that employers who have 25 or more employees, who are within the service area of a qualified HMO, who pay minimum wage, and offer a health plan, must offer HMO coverage as well as an indemnity plan. Earned Premium ✔️ ✔️ The amount of the premium for which the policy protection has been given. Effective Date ✔️ ✔️ The date when an insurance policy begins (also known as the inception date). Eligibility Period ✔️ ✔️ The period of time in which an employee may enroll in a group health care plan without having to provide evidence of insurability. Elimination Period ✔️ ✔️ A waiting period that is imposed on the insured from the onset of disability until benefit payments begin. emergency ✔️ ✔️ An injury or disease, which occurs suddenly and requires treatment within 24 hours Employee Retirement Income Security Act (ERISA) ✔️ ✔️ The act that stipulates federal standards for private pension plans Endodontics ✔️ ✔️ An area of dentistry, that deals with diagnosis, prevention and treatment of the dental pulp within natural teeth at the root canal endorsement ✔️ ✔️ A form of changing the provisions of and attached to a life insurance policy, also known as a rider
Explanation of medical benefits ✔️ ✔️ A statement sent to a Medicare patient indicating how the Medicare claims will be settled exposure ✔️ ✔️ A unit of measure used to determine rates charged for insurance coverage Express Authority ✔️ ✔️ The authority granted to an agent by means of the agent's written contract. extended care facility ✔️ ✔️ Facility, which is license by the state to ride 24 hour nursing care Extension of Benefits ✔️ ✔️ A provision that allows coverage to continue beyond the policy's expiration date for employees who are not actively at work due to disability or who have dependents hospitalized on that date. This coverage continues only until the employee returns to work or the dependent leaves the hospital. face ✔️ ✔️ The first page of a policy Fair Credit Reporting Act ✔️ ✔️ A federal law that established procedures that consumer- reporting agencies must follow in order to ensure that records are confidential, accurate, relevant and properly used. Fidicuary ✔️ ✔️ An agent/broker who handles insurer's funds in a trust capacity. Fixed Annuity ✔️ ✔️ An annuity that offers fixed payments and guarantees a minimum rate of interest to be credited to the purchase payment or payments. Flexible Premium ✔️ ✔️ A policy feature that allows the policyholder to vary premium payments in the amount and/or timing.
Flexible Spending Account (FSA) ✔️ ✔️ A salary reduction cafeteria plan that uses employee funds to provide various types of health care benefits. Foreign Insurer ✔️ ✔️ An insurance company that is incorporated in another state. Fraternal benefit society's ✔️ ✔️ Life or health insurance companies form provide insurance for the members of an affiliated lodge religious organization, or fraternal organization with a representative form of government fraud ✔️ ✔️ Intentional misrepresentation or deceit with the intent to induce a person to part with something of value. Free look ✔️ ✔️ A period of time, usually required by law, during which a policyowner may inspect a newly issued individual life or health insurance policy for a stated number of days and surrender it in exchange for a full refund of premium if not satisfied for any reason. front-end load ✔️ ✔️ A fee or commission charged at the time of purchase of a annuity or security Gatekeeper Model ✔️ ✔️ A model of HMO and PPO organizations that uses the insured's primary care physician (the gatekeeper) as the initial contact for the patient for medical care and for referrals. Grace Period ✔️ ✔️ Period of time after the premium due date, during which premiums may still be paid and the policy and its riders remain in force Group Disability Insurance ✔️ ✔️ A type of insurance that covers a group of individuals against loss of pay due to accident or sickness. Group Health Insurance ✔️ ✔️ Health coverage provided to members of a group.
home health care ✔️ ✔️ Type of care in which part time nursing or home health aid services speech therapy, physical or occupational therapy services are given in the home of the insured Hospice ✔️ ✔️ Facility for the terminally ill that provide supportive care such as pain, relief, and system management To the patient and his/her family. care is covered under part A of Medicare. Medical confinement rider ✔️ ✔️ An optional disability income rider that waves elimination period When an insured is hospitalized as an inpatient. Implied Authority ✔️ ✔️ Authority that is not expressed or written into the contract, but which the agent is assumed to have in order to transact the business of insurance for the principal. Income Replacement Contracts ✔️ ✔️ Policies which replace a certain percentage of the insured's pure loss of income due to a covered accident or sickness. indemnify ✔️ ✔️ To restore the insured to the same condition, as prior to loss with no intent of loss or gain illustration ✔️ ✔️ A ledger or proposal used in the sale of life insurance policy that shows both guaranteed and non-guaranteed elements Insolvent organization ✔️ ✔️ A member organization which is unable to pay its contractual obligations and is placed under a final order of liquidation or rehabilitation by a court of competent jurisdiction. Insurability ✔️ ✔️ The acceptability of an applicant who meets an insurance company's underwriting requirements for insurance.
Insurable Interest ✔️ ✔️ A financial interest in the life of a person, a possibility of losing something of value. If the insured should die in life and health insurance insurable interest must be stated at the time of policy issue. insurance ✔️ ✔️ A contract whereby one party (insurer) agrees to indemnify or guarantee another party (insured) against a loss by a specified future contingency or peril in return for payment of a premium. Insured ✔️ ✔️ The person or organization that is protected by insurance the party to be indemnified Insurer ✔️ ✔️ An entity that indemnifies against losses, provides benefits, or renders services (also known as "company" or "insurance company"). Insuring Clause ✔️ ✔️ A general statement that identifies the basic agreement between the insurance company and the insured, usually located on the first page of the policy. Integrated LTC Rider ✔️ ✔️ A rider that is added to a life insurance policy to pay long-term care benefits. The amount of benefits available for LTC depends upon the life insurance benefits available; however, the benefits paid toward LTC will reduce the life insurance policy's benefits. intentional injury ✔️ ✔️ An act that is intended to cause injury. Self-inflicted injuries are not covered under accident insurance; intentional injuries inflicted on the insured by another are covered. Intermediaries ✔️ ✔️ Organization that processes Inpatient outpatient claims on individuals by hospitals, skilled nursing facilities, home health agencies hospices in certain other providers at of the health insurance
Limited Policies ✔️ ✔️ Health insurance policies that cover only specific accidents or diseases. limiting charge ✔️ ✔️ The maximum amount a physician may charge a Medicare beneficiary for a covered service if the physician does not accept assignment of the Medicare approved amount. liquidation ✔️ ✔️ Selling assets as a method of raising capital Living Benefits Rider ✔️ ✔️ A rider attached to a life insurance policy that provides LTC benefits or benefits for the terminally ill by using available life insurance benefits. Lloyds associations ✔️ ✔️ Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk. Loan value ✔️ ✔️ The amount of money in insured can borrow using the cash value of his/her life insurance policy as collateral long term care ✔️ ✔️ Health and social services provided under the supervision of physical and medical health professionals for persons with chronic disease or disabilities. Care is usually provided in a long-term care facility, which is a state licenses facility to provides services. Long-Term Disability Insurance ✔️ ✔️ A type of individual or group insurance that provides coverage for illness until the insured reaches age 65 and for life in the case of an accident. loss ✔️ ✔️ The reduction decrease or disappearance of value of the person or property insured in a policy by peril insured against Loss of Income Insurance ✔️ ✔️ Insurance that pays benefits for inability to work because of disability resulting from accidental bodily injury or sickness.
lump sum ✔️ ✔️ Settlement method that pays the beneficiary the entire proceeds of a life insurance policy in one payment rather than in installments. Major Medical Insurance ✔️ ✔️ A type of health insurance that usually carries a large deductible and pays covered expenses up to a high limit whether the insured is in or out of the hospital. maturity date ✔️ ✔️ The date, when the face amount of the life insurance becomes payable Medicaid ✔️ ✔️ Medical benefits program jointly administered by the individual states and federal government Medical Expense Insurance ✔️ ✔️ A type of insurance that pays benefits for medical, surgical, and hospital costs. Medical Information Bureau (MIB) ✔️ ✔️ An information database that stores the health histories of individuals who have applied for insurance in the past. Most insurance companies subscribe to this database for underwriting purposes. Medical savings account ✔️ ✔️ An employer-funded account linked to a high deductible medical insurance plan. Medigap ✔️ ✔️ Medicare supplement plans issued by private insurance companies that are designed to fill some of the gaps in Medicare. Misrepresentation ✔️ ✔️ A false statement or lie that can render the contract void. Mode of Payment ✔️ ✔️ The method of premium payment, whether annually, semiannually, quarterly, or monthly.
