Mississippi Health and Life Insurance
A % of the principal amount of a policy paid to the insured if he/she suffered the loss of an
appendage - ANS-Capital Amount
A basic, fundamental insurance policy which pays first with respect to other outstanding policies.
- ANS-Primary Policy
A booklet that describes insurance policies and concepts, and provides general information to
help an applicant make an informed decision. - ANS-Buyer's Guide
A circumstance that increases the likelihood of a loss. - ANS-hazard
A claim form that a claimant must submit after a loss occurs. - ANS-Proof of Loss
A claim to a provider or medical supplier to receive payments directly from Medicare -
ANS-Assignment
A clause that defines the insurance company's and the insured's right to cancel or renew
coverage. - ANS-Renewability Clause
A combination of basic coverage and major medical coverage that features low deductibles,
high maximum benefits, and coinsurance. - ANS-Comprehensive Major Medical
A condition which does not allow a person to perform the duties of any occupation for payment
as a result of injury or sickness. - ANS-Total Disability
A contract in which participating parties exhange unequal amounts. Insurance contracts are
aleatory in that the amount the insured will pay in premiums is unequal to the amount the
insurer will pay in the event of a loss - ANS-Aleatory
A contract offereed on a take it or leave it basis by an insurer, in which the insured's only option
is to accept or reject the contract. Any ambiguities in the contract will be settled in favor of the
insured - ANS-Adhesion
A contract that lefally binds only one party to contractual obligations after the premium is paid -
ANS-Unilateral Contract
A covered expense under Part A of Medicare in which a licensed home health agency provides
home health care to an insured. - ANS-home health services
, A demand of a person to stop committing an action that is in violation of a provision. -
ANS-cease and desist order
A facility for the terminally ill that provides supportive care such as pain relief and symptom
management to the patient and his/her family. Hospice care is covered under Part A of
Medicare. - ANS-Hospice
A facility which is licensed by the state to provide 24 hour nursing care. - ANS-extended care
facility
A false statement or lie that can render the contract void. - ANS-Misrepresentation
A federal law that established procedures that consumer-reporting agencies must follow in order
to ensure that records are confidential, accurate, relevant and properly used. - ANS-Fair Credit
Reporting Act
A federal law which extends the minimum COBRA continuation of group health care coverage
from 18 to 29 months for qualified beneficiaries who are disabled at the time of qualification.
reduced limits in qualified retirement programs - ANS-Omnibus Budget Reconciliation Act
(OBRA)
A federal requirement that employers who have 25 or more employees, who are within the
service area of a qualified HMO, who pay minimum wage, and offer a health plan, must offer
HMO coverage as well as an indemnity plan. - ANS-Dual Choice
A form of insurance whereby one insurance company (the reinsurer) in consideration of a
premium paid to it, agrees to indemnify another insurance company (the ceding company) for
part or all of its liabilities from insurance policies it has issued. - ANS-Reinsurance
A form of misrepresentation in which an agent persuades an insured/owner to cancel, lapse, or
switch policies, even when it's to the insured's disadvantage. - ANS-Twisting
A general statement that identifies the basic agreement between the insurance company and
the insured, usually located on the first page of the policy. - ANS-Insuring Clause
A group insurance plan that requires the employees to pay part of the premium. -
ANS-Contributory
A group of small employers who do not qualify for group insurance individually, formed to
establish a group health plan or self-funded plan. - ANS-Multiple Employer Trust (MET)
A group or individual policy that covers disabilities of 13 to 26 weeks, and in some cases for a
period of up to two years. - ANS-Short-Term Disability Insurance
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