Glossary of Insurance Terms

Cancellation

Done either by the insurer or insured, this discontinues the policy before its normal expiration date

Caregiver

The individual who cares for someone with a disability or illness. The primary caregiver is usually a spouse, child or other relative.

Care Coordinator

An individual employed by the insurance company to handle all matters, financial and otherwise, regarding the welfare of the claimant for cost effective purposes. This includes, but is not limited to, selecting physicians, specialists, care centers, hospitals, etc. as well as coordinating time periods of care

Care Line

An informational service that provides information on where to go for care

Care Manager

A trained professional who is able to work with you and your family and your doctors to assess your situation and determine the appropriate Plan of Care. They will also help with finding the available care resources

Care Plan

This is a written plan formulated by a health care professional after an assessment has been done on the individual with a chronic illness or disability. The plan provides a detailed outline of the person's needs and what health services are required to meet those needs

Case Coordinator Nurse

This is your contact person to discuss claims and benefits

Cede

To transfer all or part of the written risk to an insurer or to a reinsurer

Certificate of Insurance

A statement given to the policyholder stating the insurance benefits and terms

Chronically Ill

A condition that is verified by a physician that the renders the individual unable to perform at least two of the Activities of Daily Living (ADL's) for at least 90 days which requires the individual to have Substantial Supervision to protect themselves from threats to health and safety

Claim

A submitted request to the insurance company by the claimant to receive payment and/or reimbursement for expenses incurred due to disability, illness, etc. which are covered under said policy

Claims Adjuster

This is the person who settles the claim, either an agent, company adjuster, independent adjuster, adjustment bureau, or public adjuster

Cognitive Impairment

Loss of rational comprehensive thought processes due to a degenerative disease or disorder

Commission

A part of the premium that is paid to the policyholder's agent or broker for their services in the insurance policy process

Commissioner

A state officer who handles the state's insurance laws and regulations

Congregate Housing Facilities

Similar to a dormitory setting, individuals have their own private rooms, but often share meals. Care is generally minor supervision to provide safety with emergency medical assistance always available

Contract of Adhesion

A contract written by one party and signed or denied by another with no chance of change to the terms stated within the contract

Compulsory Insurance

Any form of insurance that is required under the law

Concealment

Intentionally withholding information on an insurance application to hide facts from the insurance company

Conservation

An attempt made by the insurance company to prevent of the lapse of a policy

Consideration

Acceptance by the insurance company of the payment of the premium and the statement made by the prospective policyholder in the application

Contingent Beneficiary

The person who will receive the benefits of a policy or plan if the main beneficiary dies while the insured is living

Contract

A binding agreement between two or more parties stating specific terms and agreements. A contract of insurance is a written document known as a policy

Contract Holder

The person, group, or entity, which the contact is issued

Contract Law

The part of civil law that interprets written contracts between parties and resolves any disagreements

Coverage

The amount of protection provided under the contract of insurance

Covered Nursing Care Facility (Confined) Benefits

Policies that provided benefits for all levels of care will pay for benefits in a nursing home that is licensed in the state in which the claim is being made

Custodial Care

Non-medical care in which the patient receives help with their ADL's. Providers of this care do not need to be professionally trained nurses or therapist.