Accelerated Death Benefit—a benefit offered as part of a life insurance policy which pays a portion of the policy's death benefit before death to an insured person who has been diagnosed as terminally ill.

Accident—an event or occurrence which is unforeseen and unintended.

Accidental Bodily Injury—injury to the body of the insured as the result of an accident.

Accidental Death Benefit—a lump sum payment upon the loss of life of an insured person due to the direct cause of an accident.

Accidental Means—appearing in some policies, the unexpected or undesigned cause of an accident. The "means" which caused the mishap must be accidental in order to claim policy benefits.

Accumulations—increased policy benefits as a result of continuous policy renewal.

Actuary—a mathematically trained person in the insurance field who calculates policy rates, reserves, and dividends, and makes various other statistical studies and reports.

Acquisition Cost—the charge made for the placing of a new policy on the books of a company (includes cost of clerical work, agent's commissions, etc.).

Adjustable Premium—the agreed right of a company to modify the insured person's premium payments under certain specified conditions.

Age Limits—set ages contained in a policy for the insuring of new applicants or for the renewal of the policy.

Aggregate Indemnity—a maximum dollar amount which may be collected for any disability, period of disability, or under the policy.

Allocated Benefits—payments in some policies for specified hospital services (x-rays, drugs, dressings, etc.) up to a maximum amount.

Application—a signed statement by a prospective insured person which becomes part of the health insurance contract.

Assignment—the signed transfer by an insured person of his policy benefits to a third party.

Association Group—group insurance provided to a trade or business association by which all members are protected under one master contract.

Beneficiary—a person or entity designated to receive a specified cash payment of a policy upon the policyholder's accidental death.

Binding Receipt—a receipt given by a company upon a policy applicant's first premium payment. The policy, if approved as applied for, is effective from the date of receipt.

Blanket Medical Expense—a policy provision for the payment of hospital and medical expenses up to a maximum amount.

Blanket Policy—a health insurance contract which protects all members of a certain group against a specific hazard.

Blue Cross—an independent, non-profit membership corporation providing protection against the cost of hospital care in a limited geographical area.

Blue Shield—an independent, non-profit membership corporation providing protection against the costs of surgery and other items of medical care in a limited geographical area.

Business Insurance—a policy which primarily provides reimbursement against the work time lost by a key employee who is disabled.

Capital Sum—a specified payment for accidental dismemberment or loss of sight.

COBRA Continuation Coverage—a federally-mandated requirement that states that an employer-sponsored medical care plan must provide that if, as a result of a qualifying event, any employee (or in some cases the spouse or dependent children of an employee) would lose health insurance coverage under the plan, the employee must be entitled to elect to continue his or her coverage under the plan. Qualifying events include termination of employment, divorce, death, and a dependent child ceasing to be a dependent.

Coinsurance—a policy provision, frequently found in major medical insurance, by which both the insured person and insurance company in a specific ratio share the hospital and medical expenses resulting from an illness or injury.

Comprehensive Major Medical Insurance—a policy designed to give the protection offered by both a basic and major medical health insurance policy. It is characterized by a low "deductible" amount, coinsurance feature, and comparatively high maximum benefits.

Deductible—in major medical or hospital insurance, that portion of covered hospital and medical charges which an insured person must pay before his policy benefits begin.

Dental Expense Insurance—insurance against the expense of treatment and care of dental disease and injury to teeth.

Disability—a physical condition which makes an insured person incapable of doing one or more duties of his occupation.

Dismemberment—the accidental loss of limb or sight.

Dividend—a refund of part of the premium on a participating policy; a share of policyholder surplus funds apportioned for distribution.

Double Indemnity—a policy provision which doubles payment of designated benefits when certain types of accidents occur.

Elective Benefits—lump sum payments for certain injuries which a policyholder can choose instead of receiving loss-of-income benefits.

Elimination Period—the duration of time between the beginning of an insured person's disability and the start of a policy's benefits. Also called waiting period.

Evidence of Insurability—any statement or proof of a person's physical condition, occupation, etc., affecting his acceptance for insurance.

Family Expense Policy—a policy which insures both the policyholder and his immediate dependents (usually spouse and children).

Franchise Insurance—uniform individual health insurance protection provided to groups of persons, usually in the same occupation or profession.

Fraternal Insurance—a cooperative-type of insurance provided by social organizations for their members.

Grace Period—a specified time granted for payment of each premium falling due after the first premium, and during which the policy continues in force.

Group Insurance—a policy protecting a group of persons—usually employees of a firm.

Guaranteed Renewable Policy—a policy which the insured has the right to continue in force by the timely payment of premiums to a specified age, during which period the insurer has no right to make unilaterally any change in any provision of the policy while the policy is in force, but may change premium rates by policyholder class.

Health Insurance—protection against the costs of lost income and hospital and medical care arising from illness or injury, also accidental loss of life, limb, or sight. Also called accident and sickness, accident and health, sickness and accident, or disability insurance.

Health Maintenance Organization (HMO)—an alternative system to the one traditionally used to provide health care, an HMO is a group of doctors and other health care providers that offers a full range of health care services on a prepaid basis.

Hospital Benefits—benefits provided under a policy for hospital charges incurred by an insured person because of an illness or injury.

Hospital Expense Insurance—health insurance protection against the costs of hospital care resulting from the illness or injury of an insured person.

Indemnity—a benefit for injury or sickness which is payable as provided in a health insurance policy.

Individual Insurance—policies which provide protection to the policyholder and his family (as distinguished from group and blanket insurance). Sometimes called "personal" insurance.

Injury Independent of All Other Means—an injury resulting from an accident that is not the result of an illness.

Key-Person Health Insurance—a policy which provides reimbursement to a business against the work time lost by a key employee who is disabled.

Lapse—termination of a policy upon the policyholder's failure to pay the premium within the time required.

Level Premium—a premium which remains unchanged throughout the life of a policy.

Lifetime Disability Benefit—a payment to help replace income lost by an insured person for as long as he is totally disabled, even for lifetime.

Limited Policies—contracts which cover only certain specified diseases or accidents.

Long-Term Care Insurance—a policy which provides payment for a portion or all of the cost of certain long-term care facilities such as skilled or intermediate nursing homes.

Loss-of-Income Benefits—payments made to the insured person to help replace income lost through disability.

Loss-of-Income Insurance—policies which provide benefits to help replace an insured person's income stopped by an illness or accident.

Major Medical Expense Insurance—policies especially designed to help offset the heavy medical expenses resulting from catastrophic or prolonged illness or injury. They provide benefit payments for 75-80 percent of all types of medical treatment by a physician above a certain amount first paid by the insured person and up to the maximum amount provided by the policy.

Medical Expense Reimbursement Plan—a plan under which an employer reimburses employees for certain medical expenses; may be used in conjunction with other types of health insurance plans or policies.

Miscellaneous Expenses—in connection with hospital insurance, hospital charges other than room and board; i.e., x-rays, drugs, laboratory fees, etc.

Morbidity—term used for sickness. A morbidity table shows the average number of illnesses befalling a large group of persons.

Non-Cancelable or Non-Cancelable and Guaranteed Renewable Policy—a policy which the insured has the right to continue in force by the timely payment of premiums set forth in the policy to a specified age, during which period the insurer has no right to make unilaterally any change in any provision of the policy while the policy is in force.

Non-Disabling Injury—an injury which does not hamper the insured person from performing his occupational duties.

Non-Occupational Policy—a contract which insures a person against off-the-job accident or sickness.

Non-Profit Insurers—corporations organized under special state laws to provide hospital, medical, or dental insurance on a non-profit basis.

Older Age or Senior Citizen Policies—contracts which are issued beyond the normal insuring age of sixty or over.

Optionally-Renewable Policies—policies which are renewable at the option of the company.

Partial Disability—an illness or injury which prevents an insured person from performing one or more of his occupational duties.

Pre-Existing Condition—a physical condition of an insured person which existed prior to the issuance of his policy.

Preferred Provider Organization (PPO)—an organization of health care providers and/or facilities that offers a discount on services to members of the PPO.

Principal Sum—a lump sum payment under a policy upon the insured person's accidental death, dismemberment, or loss of sight.

Proration—the modification of policy benefits because of a change in the insured person's occupation or the existence of other insurance.

Recurring Clause—a period of time during which the recurrence of a condition is considered as being a continuation of a prior period of disability or hospital confinement.

Regular Medical Expense Insurance—policies which provide benefits toward doctor fees for non-surgical care, commonly in the hospital, but also at home, or at the physician's office. These benefits are sometimes in hospital and surgical expense policies.

Reinstatement—the resumption of a policy which has lapsed.

Renewal—an acceptance of a premium for a new policy term.

Reserve—a sum set aside by a company to fulfill future claims.

Rider—an amendment which modifies the protection of a policy, either expanding or decreasing its benefits or excluding certain conditions from the policy's coverage.

Risk (Impaired or Substandard)—an insurance applicant whose physical condition does not meet the standards for normal health.

Service Benefit—a contract benefit which is paid directly to the provider of hospital or medical care for services rendered.

Specified Disease Insurance—insurance which provides stated benefits, usually large amounts, for expenses of the treatment of the disease or diseases named in the policy.

Substandard Health Insurance—insurance issued to persons who cannot meet normal health requirements for issuance of standard health insurance policies. Protection is provided in consideration of additional premium for benefits which are sometimes provided under a special qualified impairment policy.

Surgical Expense Insurance—insurance benefits that pay the cost of operations.

Surgical Schedule—a list of cash allowances to a maximum amount according to the severity of the operation.

Time Limit—that period of time in which a notice of claim or proof of a loss must be filed.

Total Disability—an illness or injury which prevents an insured person from performing any duty of his occupation or any other profitable work.

Travel Accident Policies—limited contracts covering only accidents while an insured person is traveling.

Unallocated Benefit—a policy provision providing reimbursement up to a maximum amount for the costs of extra hospital services but not specifying the exact amount to be paid for each charge.

Waiting Period—the duration of time between the beginning of an insured person's disability and the start of the policy's benefits. Also called elimination period.

Waiver—an agreement attached to a policy which exempts from coverage certain disabilities normally covered by the policy.

Waiver of Premium—a provision included in some policies which exempts the insured person from paying premiums under loss-of-income policies while the insured is collecting loss-of-income benefits or during a period of total disability, and under some hospital and surgical expense policies while the insured (or spouse) is totally disabled.