Insurance Terminology

Ever wonder what an agent is REALLY saying when reviewing policies with you? Here's a quick guide so you can speak the same language. As always, if you should have any questions, feel free to call our office at 603-225-6677 to speak with one of our trained specialists.

P

Paid-up

This event occurs when a life insurance policy will not require any further premiums to keep the coverage in force.

Paid-up additions

Additional amounts of life insurance purchased using dividends; these insurance amounts require no further premium payments.

Peril

A specific risk or cause of loss covered by a property insurance policy, such as a fire, windstorm, flood, or theft. A named-peril policy covers the policyholder only for the risks named in the policy. An all-risk policy covers all causes of loss except those specifically excluded.

Personal property

All tangible property (other than land) that is either temporary or movable in some way, such as furniture, jewelry, electronics, etc. Special Limits apply to jewelry, furs, some sporting goods and other valuable articles.

Physician Services

Health care services a licensed medical physician (M.D. –Medical Doctor or D.O. – Doctor of Osteopathic Medicine) provides or coordinates.

Plan

A benefit your employer, union or other group sponsor provides to you to pay for your health care services.

Point-of-service (POS) plans

POS plans allow an HMO to contract with an insurance company to give enrollees the option of receiving services outside the HMO´s network. In NH, HMOs must contract with an insurance company to offer POS plans.

Policy

The contract issued by the insurance company to the insured.

Policy loan

An advance made by a life insurance company to a policy owner. The advance is secured by the cash value of the policy.

Policy Limit

The maximum amount a policy will pay, either overall or under a particular coverage.

Policy owner

The person or party who owns an individual insurance policy. This person may be the insured, the beneficiary, or another person. The policy owner usually is the one who pays the premium and is the only person who may make changes to a policy.

Policy period

The period a policy is in force, from the beginning or effective date to the expiration date.

Precertification

A requirement that the health care plan must approve, in advance, certain medical procedures. Precertification means the procedure is approved as medically necessary, not approved for payment.

Pre-existing condition

A medical problem or illness you had before applying for health care coverage.

Preferred provider organization (PPO)

A type of plan in which physicians, hospitals, and other providers agree to discount rates for an insurance company. These providers are part of the PPO´s network. Insurance contracts with PPO provisions reimburse at a higher percentage if you use providers in the network. If you go to providers outside the PPO´s network, you will have to pay more for your care.

Premium

The amount paid by an insured to an insurance company to obtain or maintain an insurance policy.

Premium Financing

A policyholder contracts with a lender to pay the insurance premium on his/her behalf. The policyholder agrees to repay the lender for the cost of the premium, plus interest and fees.

Premium load

An amount deducted from each life insurance premium payment, which reduces the amount credited to the policy.

Prescription Drug Coverage

Health insurance or plan that helps pay for prescription drugs and medications.

Prescription Drugs

Drugs and medications that by law require a prescription.

Preventive care

Health care services such as routine physical examinations and immunizations that are intended to prevent illnesses before they occur.

Primary care physician

The physician selected by HMO members to serve as their personal doctor and provide all basic medical treatments and any referrals to medical specialists. Primary care physicians are prohibited in PPOs and other indemnity health plans. (Also known as a gatekeeper.)

Primary Care Provider

A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine), nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state law, who provides, coordinates or helps a patient access a range of health care services.

Pro-Rata Cancellation

When the policy is terminated midterm by the insurance company, the earned premium is calculated only for the period coverage was provided. For example: an annual policy with premium of $1,000 is canceled after 40 days of coverage at the company's election. The earned premium would be calculated as follows: 40/365 days X $1,000=.110 X $1,000=$110.

Property damage (PD)

Physical damage to property.

Provider

A hospital, pharmacist, registered nurse, organization, institution, or person licensed to provide health care services in your state. A physician also may be referred to as a provider. The term provider is often used collectively to refer to individual or facilities who provide health services.

Provider network

All the doctors, specialists, hospitals, and other providers who agree to provide medical care to HMO or PPO members under terms of a contract with the HMO or insurance company.

Public insurance adjuster

An individual employed by a policyholder to negotiate a claim with the insurance company in exchange for a percentage of the claim settlement. Public insurance adjusters must be licensed by NHID.

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PJ has almost 40 years' experience in the insurance industry, and is very proud to be celebrating Able Insurance Agency’s
20th anniversary this year. From it's humble beginnings in a home office, he has grown Able to its niche as a full service independent agency.  PJ is a community service oriented person, has lived in Concord since 1975, is a dedicated Rotary Club of Concord member and Past- President, and plays more than a little tennis, having held New England rankings as a senior player. He has four children, two grown and on their own, and lives in Concord with his wife Lynn.

Able Insurance offers a range of products and services for both business and personal needs:



 

Business Insurance:

Bond
Commercial Auto
Commercial Liability
Commercial Property Commercial Umbrella
Directors & Officers Liability
Disability
Group Health Group Life
Professional Liability
Workers' Compensation

Personal Insurance:

Homeowner's Insurance
• Automobile Insurance
• Life Insurance
• Health Insurance
• Disability Insurance

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