Glossary Terms N - P

Question 1

Non-admitted (non-authorized)

Answer 1

An insurance company that has not applied for, or has applied and been denied a Certificate of Authority and may not transact insurance in a particular state.

Question 2

Non-cancelable

Answer 2

An insurance contract that the insured has a right to continue in force by payment of premiums that remain the same for a substantial period of time.

Question 3

Nonmedical

Answer 3

A life or health insurance policy that is under written based on the insured’s statement of health rather than a medical examination.

Question 4

Nonrenewal

Answer 4

A termination of a policy by an insurer on the anniversary or renewal date.

Question 5

Nonresident agent

Answer 5

An agent licensed in the state in which he or she is not a resident.

Question 6

Notice of claim

Answer 6

A provision that spells out an insured’s duty to provide the insurer with reasonable notice in the event of a loss

Question 7

Omnibus budget reconciliation act

Answer 7

A federal law which extends the minimum COBRA continuation of group healthcare coverage for 18 to 29 months for qualified beneficiaries who are disabled at the time of qualification.

Question 8

Oral surgery

Answer 8

Operative treatment of the mouth such as extractions of teeth and related surgical treatment.

Question 9

Orthodontics

Answer 9

A special field in dentistry which involves treatment of natural teeth to prevent and/or correct dental anomalies with braces or appliances.

Question 10

Out–of–pocket costs

Answer 10

Amounts an insured must pay for coinsurance and deductible before the insurer will pay its portion.

Question 11

Over insurance

Answer 11

An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.

Question 12

Partial disability

Answer 12

Ability to perform some, but not all, of the duties of the insured’s occupation as a result of injury or sickness.

Question 13

Payment of claims

Answer 13

A provision that specifies to whom claims payments are to be made.

Question 14

Peril

Answer 14

The cause of a possible loss.

Question 15

Periodontics

Answer 15

A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.

Question 16

Permanent disability

Answer 16

Disability from which the insured does not recover.

Question 17

Persistency

Answer 17

The tendency or likelihood of insurance policies not lapsing or being replaced with insurance from another insurer.

Question 18

Personal contract

Answer 18

An agreement between an insurance company and an individual that states that insurance policies cover the individuals insurable interest.

Question 19

Physical exam and autopsy

Answer 19

A provision that allows an insurer, at its own expense, to have an insured physically examined when a claim is pending or to have an autopsy performed where not prohibited by law.

Question 20

Policyholder

Answer 20

The person who has possession of the policy, usually the insured.

Question 21

Policyowner

Answer 21

The person who is entitled to exercise the rights and privileges in the policy. This person may or may not be the insured.

Question 22

Preferred provider organization (PPO)

Answer 22

An organization of medical professionals and hospitals who provide services to an insurance company’s clients for a set fee.

Question 23

Preferred risk

Answer 23

Insurance classification for applicants to have a lower expectation of incurring loss, and who, therefore, are covered at a reduced rate.

Question 24

Premium

Answer 24

A periodic payment to the insurance company to keep the policy in force.

Question 25

Presumptive disability

Answer 25

A provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.

Question 26

Primary policy

Answer 26

A basic, fundamental insurance policy which pays first with respect to other outstanding policies.

Question 27

Principal amount

Answer 27

The full face value of a policy.

Question 28

Private insurance

Answer 28

Insurance furnished by non-governmental insuring organizations.

Question 29

Pro rata cancellation

Answer 29

Termination of an insurance policy, with an adjustment of a premium charge proportion to the exact coverage that has been in force.

Question 30

Probationary period

Answer 30

The period of time between the effective date of a health insurance policy and the date coverage for all or certain conditions begins.

Question 31

Producer

Answer 31

Insurance agent or broker.

Question 32

Proof of loss

Answer 32

A claim form that a claimant must submit after a loss occurs.

Question 33

Prosthodontics

Answer 33

A special area of dentistry that involves the replacement of missing teeth with artificial devices like bridgework or dentures.

Question 34

Provider

Answer 34

Any group or individual who provides healthcare services.

Question 35

Pure risk

Answer 35

The uncertainty or chance of loss occurring in a situation that can only result in a loss or no change.