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Reference guide

Insurance Glossary

Plain-language definitions of common insurance terms across policies, coverage, and claims. Check your policy or plan documents for the terms that apply to you.

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Showing 24 of 65 matching terms

Terms beginning with A

Advance payment

Claims
A partial claim payment issued before the entire claim is resolved to help address immediate covered costs.
Also called: claim advance

Adverse benefit determination

Health insurance
A health plan decision to deny, reduce, end, or decline payment for a requested benefit or service.
Also called: benefit denial

Adverse selection

General insurance
A tendency for people or businesses with above-average loss potential to seek more insurance than average-risk applicants.

Agent

General insurance
A licensed professional who sells or services insurance policies and may represent one or more insurers.
Also called: insurance agent

Aggregate deductible

Business insurance
A deductible structure that limits the total deductible amount the insured pays for covered losses during a policy period.

Aggregate excess of loss reinsurance

General insurance
Reinsurance that responds when an insurer’s aggregate losses exceed a stated retention during a defined period.

Aggregate limit

Business insurance
The maximum a policy will pay for all covered claims during a stated policy period or other defined time.
Also called: policy aggregate

Aggregate limit reinstatement

Business insurance
An endorsement restoring some or all of an aggregate liability limit after it has been reduced by covered losses.

Aggregate stop-loss

General insurance
Coverage that limits an insured’s total retained losses during a policy period after a stated aggregate threshold.

Agreed value

Auto insurance
A vehicle value accepted by the insurer and policyholder that may be used to settle a covered total loss under a specialty policy.
Also called: agreed amount

Allowed amount

Health insurance
The maximum amount a health plan recognizes for a covered service before member cost sharing is calculated.
Also called: allowed charge, negotiated rate

Alternative dispute resolution

Claims
Processes such as mediation or arbitration used to resolve an insurance dispute without a full court trial.
Also called: ADR

Ambulatory surgery center

Health insurance
A facility that provides same-day surgical services without an overnight hospital stay.

Annual benefit limit

Health insurance
A maximum amount a plan will pay for a defined benefit during a plan year, where permitted by law.

Annual dollar limit

Health insurance
A cap on the benefits a health plan will pay in a year; federal rules restrict these limits for essential health benefits in many plans.
Also called: annual benefit limit

Annual notice of change

Health insurance
A yearly notice describing upcoming changes to a Medicare plan’s benefits, costs, service area, or rules.

Annual statement

General insurance
A statutory financial report insurers file with regulators describing financial condition and operations.

Annuitant

Life insurance
The person whose life determines annuity payments, or the person entitled to receive those payments, depending on contract terms.

Annuity

Life insurance
A contract designed to accumulate value or provide a stream of income, subject to its guarantees, charges, and tax treatment.

Annuity accumulation period

Life insurance
The period when money is contributed to or grows inside a deferred annuity before scheduled income payments begin.
Also called: accumulation phase

Annuity beneficiary

Life insurance
The person or entity designated to receive a death benefit or remaining contract value under an annuity.

Annuity certain

Life insurance
An annuity that pays income for a fixed number of years, whether or not the annuitant lives through the full period.
Also called: period-certain annuity

Annuity death benefit

Life insurance
The amount payable to a beneficiary when an annuitant dies before or during the payout phase, subject to contract terms.

Annuity exclusion ratio

Life insurance
A tax calculation that determines what portion of each annuity payment is treated as a return of investment rather than taxable income.