Insurance Gobbledygook Made Simple
Plain english explanations of insurance terms used by agents, companies and lawyers and found in your insurance policies.
PPaid-up additionsadditional amounts of insurance protection purchased with the dividends from your policy.Paid-up life insuranceinsurance on which no further premiums are due.Participating insuranceinsurance that has the possibility of paying dividends to its policyholders. Also called a par policy.Payout method same as settlement optionPermanent lifea phrase that covers any form of life insurance with the exception of term.Physical examinationphysical examination, as well as information about your medical history, may be required to qualify for health insurance. The requirements will vary for individual or group coverage, for different insurance companies, and for very large or very small groups.PIP (personal injury protection)commonly referred to as “no-fault” insurance. This was designed to pay promptly -- regardless of fault or negligence -- for actual economic losses (e.g., medical expenses, lost earnings, and other reasonable and necessary expenses related to injuries sustained) to a driver or passenger injured in the car and to pedestrians injured by your car, because of its use or operation. It applies to personal injuries only, not for physical damages to the vehicle.Point-of-service (POS) plansthese plans allow members the option of using services outside the HMO network without prior approvalPolicy dividend a partial premium refund on a participating life insurance policyPolicy loan a loan made by a life insurance company to the policyholder on the cash value of the policy.Policy period the amount of time an insurance contract or policy provides coverage.Policy reserves funds held by a life insurance company specifically to fulfill its policy obligations.Policyholder the person or party who owns an individual insurance policy. This person may be the insured, a relative, the beneficiary, a corporation, or another person.Portabilityunder HIPAA, workers with pre-existing medical conditions must receive credit for time in a previous health plan if they join an employer pla.Pre-certificationa requirement that you notify the insurance company for its approval before you check into a hospital, have elective surgery, visit specialists, have expensive tests (e.g., MRI). Pre-certification does not guarantee the insurance company will pay the medical bills. Also called “utilization review”.Pre-existing conditionhealth problem/condition/illness you had prior to applying for insurance and for which you received medical advice, diagnosis, care or treatment. Policies can exclude coverage of any medical condition for a period of time.Pre-need contracta contract with a funeral home that makes it possible to pay your funeral expenses in advance.Preferred Provider Organization (PPO)a network of doctors, hospitals, and suppliers (preferred providers) who agree to provide services to members of a health plan for discounted fees.Preferred risk a person or risk less likely than the average person or risk to make a claim. A preferred risk usually qualifies for a lower premium.Premium the amount you pay for insurance.Premium expense charges an amount deducted from each premium payment that reduces the amount credited to the policy.Premium waiver provision an optional provision that takes effect if the policy owner becomes disabled. The disabled person will not have to pay premiums for the duration of the disability, including lifetime disability.Primary care physician (gatekeeper) the physician selected by HMO members who serves as a personal doctor and provides all medical treatments and any referrals to medical specialists.Primary plan this is the plan that pays first when you are covered by more than one insurance planPrior qualifying coveragehealth plan coverage that was in effect before the effective date of the current or new coveragePro rata cancellation revocation of a policy by an insurance company that returns the unearned premium to the policyholder.Proof of lossdocuments that you give the insurer to support your request for payment of losses.Property damage liability this coverage protects you from claims and lawsuits by people whose property is damaged as a result of an accident you caused.Providera doctor, hospital, x-ray company, pharmacy, etc. that provides medical health care service.