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Insurance Terms

Adjuster An individual who assesses and evaluates insurance claims to determine the extent of coverage and the amount of compensation owed.
Deductible The amount of money an insured person must pay out of pocket before the insurance company starts to cover the costs.
Insurer The company that provides insurance coverage and assumes the risk of potential losses in exchange for premium payments.
Policyholder The individual or entity that owns an insurance policy and is entitled to receive the benefits outlined in the policy.
Policy A contract between the insurer and the policyholder that outlines the terms, conditions, coverage limits, and exclusions of the insurance agreement.
Insured The person or property covered by an insurance policy, protected against specified risks in exchange for premium payments.
Peril A specific event or circumstance that may cause loss or damage, such as fire, theft, or natural disasters.
Risk The probability or likelihood of an event causing loss or damage, which insurers assess to determine insurance premiums and coverage.
Premium The amount of money paid by the policyholder to the insurer in exchange for insurance coverage over a specified period.
Replacement Cost The amount of money required to replace or repair damaged property with similar items at current market prices.
Bodily Injury Physical harm or injury to a person resulting from an accident or negligent act, covered under liability insurance policies.
Collision Coverage that compensates for damage to the insured vehicle resulting from a collision with another object or vehicle.
Comprehensive Coverage Insurance protection that covers damage to the insured vehicle caused by perils other than collision, such as theft, vandalism, or natural disasters.
Uninsured Motorist Coverage that provides protection for bodily injury or property damage caused by a motorist who does not have insurance or sufficient coverage.
Property Damage Liability Coverage that pays for damage caused by the insured to another person's property, such as vehicles or buildings.
No-fault Insurance A type of insurance system where each party's insurance company pays for the insured's losses, regardless of who is at fault in an accident.
Liability Insurance Insurance coverage that protects the insured against claims arising from injuries or damage to other people or property.
Claim A formal request by the policyholder to the insurance company for compensation or coverage for a loss or damage covered by the policy.
Co-insurance The percentage of costs shared between the insurance company and the insured after the deductible has been met.
Co-payment A fixed amount paid by the insured for covered services or prescriptions, typically due at the time of service.
HMO (Health Management Organization) A type of health insurance plan that provides coverage through a network of doctors, hospitals, and other healthcare providers, with a primary care physician coordinating care.
Limitations Restrictions or conditions specified in an insurance policy that may limit coverage or benefits under certain circumstances.
POS (Point of Service Plan) A type of health insurance plan that allows members to choose between in-network and out-of-network providers, with different coverage levels for each.
Primary Care Physician A healthcare provider, often a family doctor or internist, who serves as the main point of contact for managing a patient's healthcare needs.
Maximum Out-of-Pocket Expense The most money a policyholder is required to pay for covered services during a specific period, after which the insurance company covers 100% of the remaining costs.
Medical Payments Coverage that pays for medical expenses incurred by the insured or their passengers as a result of injuries sustained in an accident, regardless of fault.
Network A group of healthcare providers, facilities, and suppliers contracted with an insurance company to provide services to its members at discounted rates.
Accidental Death and Dismemberment Benefit Coverage that provides a lump-sum payment to the beneficiary in the event of the insured's accidental death or loss of a limb or sight.
Beneficiary A person or entity designated to receive the proceeds of an insurance policy or financial account upon the death of the insured or account holder.
Cash Value Insurance Life insurance policies that accumulate a cash value over time, which can be accessed by the policyholder through loans or withdrawals.
Medical Examination A physical examination conducted by a healthcare professional to assess an individual's health status, often required for insurance underwriting purposes.
Proceeds The money received from an insurance policy or investment upon the occurrence of a covered event, such as death, disability, or maturity.
Rider An amendment or attachment to an insurance policy that modifies or expands its coverage, often available at an additional cost.
Suicide Clause A provision in life insurance policies that limits or excludes coverage for death by suicide within a specified period after the policy's inception.
Term Life Insurance Life insurance coverage that provides a death benefit for a specified period or term, typically offering lower premiums than permanent life insurance.
Term of Policy The duration or period of coverage provided by an insurance policy, specifying the start and end dates of the insurance contract.
Underwriter An insurance professional responsible for assessing risks, determining premiums, and deciding whether to accept or reject insurance applications.
Whole Life Insurance Life insurance coverage that provides a death benefit for the insured's lifetime, with guaranteed cash value accumulation and fixed premiums.
Act of God An uncontrollable and unforeseeable event caused by natural forces, such as earthquakes, floods, or hurricanes, often excluded from insurance coverage.
Appraisal The process of determining the value of property, assets, or damages for insurance purposes, conducted by an independent appraiser or adjuster.
Declarations The part of an insurance policy that contains basic information about the insured, coverage limits, premiums, and other essential terms and conditions.
Collateral Assets or property pledged as security for a loan or debt, which may be seized by the lender in the event of default.
Hazard A condition or circumstance that increases the likelihood of loss or damage, such as fire hazards or unsafe driving conditions.
Loss The reduction in value or financial detriment resulting from damage, destruction, or disappearance of property, assets, or life.
Homeowner’s Policy An insurance policy that provides coverage for a homeowner's dwelling, personal property, and liability risks, typically including additional endorsements or riders for specific coverage needs.
Renter’s Insurance An insurance policy that provides coverage for tenants' personal property.
Peril An event or circumstance that poses a risk of loss or damage, such as fire, theft, vandalism, or natural disasters, covered under an insurance policy.
Created by: anilec
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