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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 92 matching terms

Terms beginning with C

Claim adjustment reason code

Health insurance
A standardized code explaining why a medical claim payment differs from the amount billed.
Also called: CARC

Claim appeal

Health insurance
A request for a health plan to reconsider a denied or reduced claim or coverage decision.
Also called: health insurance appeal

Claim denial

Claims
An insurer’s decision that all or part of a claim is not payable under the policy and available information.
Also called: denied claim

Claim diary

Claims
A claims file system used to schedule follow-up actions, deadlines, and communications during claim handling.

Claim file

Claims
The records and documentation an insurer maintains for a reported claim and its investigation.

Claim number

Claims
The identifier an insurer assigns to a reported loss so the claim can be tracked and referenced.
Also called: claim ID

Claims-made policy

Business insurance
A liability policy designed around claims first made during the policy period, subject to its terms.

Claims-made retroactive date

Business insurance
The earliest date from which an act, error, or omission must occur to be covered by a claims-made policy.

Claim severity

Claims
The average size or cost of claims over a defined period or group of claims.

Claims leakage

Claims
Unnecessary claim cost caused by process errors, missed recovery opportunities, overpayment, or ineffective handling.

Claims trigger

General insurance
The event a liability policy requires before coverage may respond, such as an occurrence or a claim first made.

Classic car insurance

Auto insurance
Specialized auto insurance for qualifying collector vehicles, often using an agreed value and restrictions on vehicle use.
Also called: collector car insurance

Clinical trial coverage

Health insurance
Coverage for qualifying routine patient costs associated with an approved clinical trial, subject to applicable rules.

Closed without payment

Claims
A claim status indicating that the insurer closed the file without issuing a claim payment.
Also called: CWOP

COBRA continuation coverage

Health insurance
Temporary continuation of eligible employer-sponsored health coverage after certain events, usually with the individual paying the required premium.
Also called: COBRA insurance

COBRA qualifying event

Health insurance
An event, such as a job loss or reduced work hours, that may make a person eligible to continue employer health coverage under COBRA.
Also called: qualifying event

Coinsurance

Health insurance
The share of a covered health care cost that a member may pay after the deductible under a plan’s rules.

Coinsurance penalty

General insurance
A reduction in a property loss payment when the insured did not carry the amount of insurance required by a coinsurance clause.

Collateral assignment

Life insurance
An assignment giving a lender rights in a life insurance policy as security for a debt.

Collision coverage

Auto insurance
Optional auto coverage that may pay to repair or replace the insured vehicle after a collision, subject to the policy.

Collision deductible

Auto insurance
The amount a policyholder may pay before collision coverage pays for a covered vehicle loss.

Collision deductible waiver

Auto insurance
A feature that may waive a collision deductible after a qualifying accident, often involving an uninsured driver.

Combined ratio

General insurance
An insurer performance measure combining loss and expense ratios; a ratio above 100 percent indicates an underwriting loss before investment income.

Commercial auto insurance

Business insurance
Insurance for vehicles owned, leased, or used by a business, subject to the vehicles and drivers listed or otherwise covered.
Also called: business auto insurance