HS 352 Ch. 5

An insurer's classification of applicants and their selection for insurance coverage

The tendency for those who know that they are highly vulnerable to loss to be more likely to purchase insurance to cover that loss.

The length of time an insurance contract remains in force.

A premium rate for a policy or policy change that is based on the insured's age at the time the policy is written or the change is made.

Compare issue-age rates.

A premium rate for a policy change that is based on the insured's age at the time a policy was issued rather than at the time the change is made.

The perverse human tendency that increases the frequency and severity of a loss because insurance is in force.

The incidence of sickness and disability

A form that is the basis for an underwriter to make a decision to provide requested coverage. It includes an identification of the insured, coverage and benefit selections, an insurability declaration (if necessary), authorizations and notificaitons, the agent's statement, and the applicant's signature.

A statement that asks the physician to provide information to an insurer about an applicant's dates of treatment, length of treatment, tests ordered, medications prescribed, and the degree of recovery or control achieved for medical conditions.

The results of an investigation of an insurance application conducted by an independent agency that specializes in such investigations.

A not-for-profit association of insurance companies that exchanges information among its members relevant to underwriting life, health, disability income, and long-term care insurance.

The decision to approve an insurance application as applied for. Most insurers approve 70 to 80 percent of their applicaitons on this basis.

The decision to provide insurance with certain modifications to standard coverage, such as an exclusion rider, an extra premium, a change in benefits, or some combination of these options.

A provision in an insurance contract stating that the insurer will not pay for a medical expense resulting from a particular medical problem (such as a back disorder) or an unusually hazardous occupation or avocation (such as automobile racing).

Also known as a waiver

Under HIPPA, portability means that preexisting-conditions limitations for medical insurance are defined and, once satisfied, may not serve to deny, limit, or delay the issuance of a qualified person's group or individual medical coverage or the renewal of that coverage as required by the act.

See also HIPPA

Prior coverage under a group plan.

An insurance benefit program established through an affiliation of independent members with a professional, industry, or other noninsurance relationship or as a construct by insurers (known as a discretionary or trust plan) to provide coverage to individuals who are unaffiliated other than for the purpose of obtaining insurance.

A mechanism, operated as a not-for-profit association, to broadly share the risk of above-standard financial losses for the benefit payments of comprehensive medical insurance offered to individuals whose preexisting conditions denied them standard coverage in the private market.