Glossary Terms N - P Flashcards
Non-admitted (non-authorized)
An insurance company that has not applied for, or has applied and been denied a Certificate of Authority and may not transact insurance in a particular state.
Non-cancelable
An insurance contract that the insured has a right to continue in force by payment of premiums that remain the same for a substantial period of time.
Nonmedical
A life or health insurance policy that is under written based on the insured’s statement of health rather than a medical examination.
Nonrenewal
A termination of a policy by an insurer on the anniversary or renewal date.
Nonresident agent
An agent licensed in the state in which he or she is not a resident.
Notice of claim
A provision that spells out an insured’s duty to provide the insurer with reasonable notice in the event of a loss
Omnibus budget reconciliation act
A federal law which extends the minimum COBRA continuation of group healthcare coverage for 18 to 29 months for qualified beneficiaries who are disabled at the time of qualification.
Oral surgery
Operative treatment of the mouth such as extractions of teeth and related surgical treatment.
Orthodontics
A special field in dentistry which involves treatment of natural teeth to prevent and/or correct dental anomalies with braces or appliances.
Out–of–pocket costs
Amounts an insured must pay for coinsurance and deductible before the insurer will pay its portion.
Over insurance
An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.
Partial disability
Ability to perform some, but not all, of the duties of the insured’s occupation as a result of injury or sickness.
Payment of claims
A provision that specifies to whom claims payments are to be made.
Peril
The cause of a possible loss.
Periodontics
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.
Permanent disability
Disability from which the insured does not recover.
Persistency
The tendency or likelihood of insurance policies not lapsing or being replaced with insurance from another insurer.
Personal contract
An agreement between an insurance company and an individual that states that insurance policies cover the individuals insurable interest.
Physical exam and autopsy
A provision that allows an insurer, at its own expense, to have an insured physically examined when a claim is pending or to have an autopsy performed where not prohibited by law.
Policyholder
The person who has possession of the policy, usually the insured.
Policyowner
The person who is entitled to exercise the rights and privileges in the policy. This person may or may not be the insured.
Preferred provider organization (PPO)
An organization of medical professionals and hospitals who provide services to an insurance company’s clients for a set fee.
Preferred risk
Insurance classification for applicants to have a lower expectation of incurring loss, and who, therefore, are covered at a reduced rate.
Premium
A periodic payment to the insurance company to keep the policy in force.
Presumptive disability
A provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.
Primary policy
A basic, fundamental insurance policy which pays first with respect to other outstanding policies.
Principal amount
The full face value of a policy.
Private insurance
Insurance furnished by non-governmental insuring organizations.
Pro rata cancellation
Termination of an insurance policy, with an adjustment of a premium charge proportion to the exact coverage that has been in force.
Probationary period
The period of time between the effective date of a health insurance policy and the date coverage for all or certain conditions begins.
Producer
Insurance agent or broker.
Proof of loss
A claim form that a claimant must submit after a loss occurs.
Prosthodontics
A special area of dentistry that involves the replacement of missing teeth with artificial devices like bridgework or dentures.
Provider
Any group or individual who provides healthcare services.
Pure risk
The uncertainty or chance of loss occurring in a situation that can only result in a loss or no change.
