Most of the insurance
policy terms define the content and coverage included.
There are many
conditions involved in the contracting process of a health insurance
policy, which can be difficult for a person with a little understanding of
the insurance sector to understand.
Below is a list of basic
insurance concepts that you can consult in case of doubt.
Accident
Any kind of injury is
beyond the control or purpose of the insured person, Due to sudden and
accidental events. It is understood that the accident took place while the
policy was in force.
Actuary
Who works in the
company, Through the statistical and mathematical calculations of those and
based on legal and financial knowledge, to give advice about the risk of the
injured person and the costs involved.
Insurance agent
When a person or
organization that mediates an insurance operation is associated with a
particular company, we speak of the party concerned.
Annex
A supplement has been
added to an insurance contract to modify any of its terms and
conditions.
Annual
A period of twelve
calendar months in which a policy is valid with the possibility of automatic
extension.
Cancellation
The termination of a
policy takes into account any of the conditions laid down in the insurance
contract if given prior notice, whether the parties have a bilateral agreement
or a unilateral decision.
Insured person
The person or
organization (in this case, you or your entire family) is covered by an
insurance policy. In the absence of the policyholder, he assumes the
obligations and rights set forth in the agreement. The policyholder is the
person who signs the policy. The concept of the policyholder is further
explained in this glossary.
Insurer
Legal entity (a company)
that estimates third-party risk coverage through an insurance contract that
establishes specific compensation and services in the event of a claim.
Terminology
A survey was conducted
by an actuary based on statistics to determine the cost of premiums paid by the
insured.
Owner
The person nominated by
the Contracting Party as the holder of the right to receive benefits and
benefit from the services mentioned in it in case of risk or loss. The insured
person, the policyholder, and the beneficiary may be the same person or a different
person.
Discount
Discounts are usually
offered on an insurance premium, while the risk covered for a particular policy
is reduced.
Capital insurance
The company decides the
maximum amount to be paid In case of an accident. That value is the property of
the policyholder that they insure.
Grace period
This time the insured
person will not be covered in whole or in part by some of the guarantees
contained in the contract from the date the policy takes effect until the
specified period. It is usually set out in a life, illness, or health insurance
policy for a condition that is concealed by the insured person. This is one of
the most important basic concepts of the f insurance policy.
Section
A contract that is
listed in the terms of an insurance contract sets a standard or condition for
the relationship between the insured and the insured. It changes and adds
information in addition to the information contained in the policy.
Coverage
All health services and
benefits, for which the beneficiary or policyholder is entitled Insurance terms
are a basic concept.
Insurance contract
Formal contract policy
through a document, which establishes the terms of the relationship between the
insured and the insured person. Warrant to cover and cover some of the things
that the insurer may lose by the insured within a specified time and limit, in
exchange for a premium charge.
To be valid, civil law
establishes that an insurance contract must be entered into
freely by a party with legal powers, a specific purpose must be established,
and the reason for its obligation must be legal.
Loss
Damage to goods owned by
the victim of the accident or the insured person.
Intentional misconduct
A civil law term that
applies when someone acts in a fraudulent or deceptive manner to enter into a
contract or to have coverage of an insured provision that has no rights. It is
used in criminal law when a criminal offense is committed intentionally.
Extra
Part of the loss that
the insured party must cover in its own account. This is the total amount or
percentage established in the policy in exchange for a premium discount. If the
cost of a claim is less than the amount discussed in excess, the insured will
pay all costs.
Guarantee
The insurance company's
commitment to cover the cost of the claim in accordance with the maximum limit
established in the policy. Guarantee and coverage are both the same.
Compensation
Compensation or
financial benefits through which an insurance company seeks to recover the
financial loss caused by the insured within the limits established in the
policy. This refers to the payment of the premium by the insured. It can be
specified in two ways: deposit money or replacement of damaged goods by others
for a price that cannot exceed the original cost.
Policy
Documents made between
two parties to establish the terms of an insurance contract.
Premium
The amount is to be paid
by the insured in exchange for covering the prescribed risk. This amount
depends on factors like potential risk or the duration of the insurance. In
premiums, in addition to the portion intended to cover claims, the premium
includes a portion related to the company's administrative expenses (commercial
premium) and taxes.
Finish
Termination of the contract
in case one of the parties to the contract believes that their rights have not
been respected. A basic idea that should always be considered.
Risk
The probability of loss
and the eventual occurrence is covered by an insurance policy for compensation.
Claim facts
An anticipated risk
covered by the terms of an insurance policy that actually occurs and results in
multiple liabilities of the insurer, either by paying compensation or by
replacing the damaged product.
Policyholder
The person who accepts
the insurance contract with the company signs the policy and until it is
indicated that the insured person is another person, acquires the rights and
obligations derived from it.
Insurance policy expires
Termination of the
validity of the insurance contract in the application of some of the conditions
mentioned in it is usually due to the expiration of the established term.
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Validity
The insurance terms and
conditions specified within that period are applicable. In some special
circumstances, such as non-payment, a contract may be temporarily suspended.
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