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Glossary Terms - C
ExamFX - Texas Life & Health 2011
34
Insurance
Professional
04/07/2011

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Term
Cafeteria Plan
Definition
A selection of health care benefits from which an employee may choose the ones that he/she needs.
Term
Capital Amount
Definition
A percentage of the principle amount of a policy paid to the insured if he/she suffered the loss of an appendage.
Term
Carriers
Definition
Organizations that process claims and pay benefits in an insurance policy.
Term
Cash Value
Definition
The amount to which a policyowner is entitled if the policy is surrendered before maturity.
Term
Cease and Desist Order
Definition
A demand of a person to stop committing an action that is in violation of a provision.
Term
Certificate
Definition
A statement (or booklet) that confirms that a policy has been written and that describes the coverage in general.
Term
Certificate of Authority
Definition
A document that authorizes a company to start conducting business and specifies the kind(s) of insurance a company can transact. It is illegal for an insurance company to transact insurance without this certificate.
Term
Certificate of Insurance
Definition
A legal document that indicates that an insurance policy has been issued, and that states both the amounts and types of insurance provided.
Term
Claim
Definition
A request for payment of the benefits provided by an insurance company.
Term
Coercion
Definition
An unfair trade practice in which an insurer uses physical or mental force to persuade an applicant to buy insurance.
Term
Coinsurance
Definition
An agreement between an insurer and insured in which both parties are expected to pay a certain portion of the potential loss and other expenses.
Term
Coinsurance Clause
Definition
A provision that states that the insurer and the insured will share the losses covered by the policy in a proportion agreed upon in advance.
Term
Commingling
Definition
A practice in which a person in a fiduciary capacity illegally mixes his/her personal funds with funds he/she is holding in trust.
Term
Commission
Definition
The payment made by insurers to agents or brokers for the sale and service of policies.
Term
Commissioner (Superintendent, Director)
Definition
The chief executive and administrative officer of a state insurance department.
Term
Comprehensive Policy
Definition
A plan that provides a package of health care services, including preventive care, routine physicals, immunization, outpatient services and hospitalization.
Term
Comprehensive Major Medical
Definition
A combination of basic coverage and major medical coverage that features low deductibles, high maximum benefits, and coinsurance.
Term
Concealment
Definition
the withholding of known facts which, if material, can void a contract.
Term
Conditional Contract
Definition
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.
Term
Consideration
Definition
The binding force in a contract that requires something of value to be exchanged for the transfer of risk. The consideration on the part of the insured is the representations made in the application and the payment of premium; the consideration on the part of the insurer is the promise to pay in the event of loss.
Term
Consideration Clause
Definition
A part of the insurance contract that states that both parties must give something of value for the transfer of risk, and specifies the conditions of the exchange.
Term
Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986
Definition
The law that provides for the continuation of group health care benefits for the insured for up to 18 months if he/she terminates employment or is no longer eligible, and for the insured's dependents for up to 36 months in cases of loss of eligibility due to death of the insured, divorce, or attainment of the limiting age.
Term
Consumer Reports
Definition
Written and/or oral statements regarding a consumer's credit, character, reputation, or habits collected by a reporting agency from employment records, credit reports, and other public sources.
Term
Contract
Definition
An agreement between two or more parties enforceable by law.
Term
Contributory
Definition
A group insurance plan that requires the employees to pay part of the premium.
Term
Controlled Business
Definition
An entity that obtains and possesses a license solely for the purpose of writing business on the owner, immediate family, relatives, employer and employees.
Term
Convertible
Definition
A policy that may be exchanged for another type of policy by contractual provision, at the option of the policyowner, and without evidence of insurability (i.e. term life changed to a form of permanent life).
Term
Coordination of Benefits
Definition
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy, thus avoiding claims overpayments.
Term
Co-pay
Definition
An arrangement in which an insured must pay a specified amount for services "up front" and the provider pays the remainder of the cost.
Term
Countersignature
Definition
The act of signing an insurance policy by a licensed resident agent.
Term
Coverage
Definition
The inclusion of causes of loss (perils) which are covered within a scope of a policy.
Term
Credit Life Insurance
Definition
A special type of coverage written to pay off the balance of a loan in the event of the death of the debtor.
Term
CSO Table
Definition
(The Commissioner's Standard Ordinary Table) A mortality table used in life insurance that mathematically predicts the likelihood of death.
Term
Custodial Care
Definition
Care that is rendered to help an insured complete his/her activities of daily living.
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