Insurance Definitions

M Return To Alpha Index     Mail Order Insurer: Type of insurance company that sells policies through the mail or other mass media, eliminating need for agents. Major Medical Expense Insurance: A form of health insurance that provides benefits for most types of medical expense up to a high maximum benefit, such as $250,000 or higher after a substantial deductible, such as $500 or more. Such contracts may contain internal limits and are normally subject to coinsurance. Major Medical Insurance: Health insurance to finance the expense of major illness and injury. Characterized by large benefit maximums ranging up to $250,000 or no limit, the insurance, above an initial deductible, reimburses the major part of all charges for hospital, doctor, private nurses, medical appliances, prescribed out-of-hospital treatment, drugs, and medicines. The insured person as coinsurer pays the remainder. Malingering: The practice of feigning illness or inability to work in order to collect insurance benefits. Malpractice: Improper care or treatment by a physician, hospital, or other provider of health care. Malpractice Insurance: Coverage for a professional practitioner, such as a doctor or a lawyer, against liability claims resulting from alleged malpractice in the performance of professional services. Managed Care: Health care systems that integrate the financing and delivery of appropriate health care services to covered individuals by arrangements with selected providers to furnish a comprehensive set of health care services, explicit standards for selection of health care providers, formal programs for ongoing quality assurance and utilization review, and significant financial incentives for members to use providers and procedures associated with the plan. Manual Rate: The premium rate developed for a group insurance coverage from the company's standard rate tables normally referred to as its rate manual or underwriting manual. Manuscript Policy: Policy designed for a firm's specific needs and requirements. Marine Insurance: A form of insurance primarily concerned with means of transportation and communication, and with goods in transit. Marital deduction: A reduction of an estate for estate tax purposes, which is available if the decedent is survived by his or her spouse, can be as large as the administrator or executor elects so long as it does not exceed the value of qualifying property passing to the surviving spouse. Market Price (or Market Value): The price at which a security can be bought or sold at any particular time. Mass Merchandising: Plan for insuring individual members of a group, such as employees of firms or members of labor unions, under a single program of insurance at reduced premiums. Property and liability insurance is sold to individual members using group insurance marketing methods. Master Policy: A policy that is issued to an employer or trustee, establishing a group insurance plan for designated members of an eligible group. Master Policy (or Master Contract): The policy issued to a group policyholder setting forth the provisions of the group insurance plan. The individuals insured under the policy are then issued certificates of insurance. Material Damage: Insurance against damage to a vehicle itself. It includes automobile comprehensive, collision, fire and theft. Material damage and physical damage are terms that often are used inter- changeably. Maximum family benefit: The largest amount in Social Security benefits that will be paid to any family unit. McCarran-Ferguson Act: Federal law passed in 1945 stating that continued regulation of the insurance industry by the states is in the public interest and that federal antitrust laws apply to insurance only to the extent that the industry is not regulated by state law. Medicaid: State programs of public assistance to persons whose income and resources are insufficient to pay for health care. Title XIX of the federal Social Security Act provides matching federal funds for financing state Medicaid programs, effective January 1, 1966. Medical Examination: The examination given by a qualified physician to determine the insurability of an applicant. A medical examination may also be used to determine whether an insured claiming disability is actually disabled. Medical Expense Insurance: A form of health insurance that provides benefits for expenses incurred for medical care. This form of health insurance provides benefits for expenses of physicians, hospital, nursing, and related health services, and supplies. These benefits may be related to actual expense, specified sums, or services rendered. Such insurance sometimes includes benefits for prevention and diagnosis as well as treatment. Medical malpractice: Improper care or treatment by a physician, hospital, or other provider of health care. Medical Payments Insurance: A coverage, available in various liability insurance policies, in which their insurer agrees to reimburse the insured and others, without regard for the insured's liability, for medical or funeral expenses incurred as the result of bodily injury or death by accident under specified conditions. Medicare: A program of Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B) protection provided under the Social Security Act. Medigap: A term sometimes applied to private insurance products that supplement Medicare insurance benefits. Minimum Benefits: A provision that a minimum amount of annuity will be paid if the regular benefit formula produces less. This minimum is usually payable only if certain service requirements are met at retirement. Minimum Group: The least number of employees permitted under a state law to effect a group for insurance purposes; the purpose is to maintain some sort of proper division between individual policy insurance and the group forms. Minimum Premium Plan (MPP): An arrangement under which an insurance carrier will, for a fee, handle the administration of claims and insure against large claims for a self- insured group. Miscellaneous Expenses: Expenses in connection with hospital insurance, hospital charges other than room and board, such as X-rays, drugs, laboratory fees, and other ancillary charges. (Sometimes referred to as ancillary charges.) Miscellaneous Hospital Expense Benefit: A provision in a hospital expense policy providing for the payment of a benefit for expenses for necessary hospital services and supplies during a period of hospital confinement. Expenses commonly covered under this benefit include those for x-ray examinations, laboratory tests, medicines, surgical dressings, anesthetics (including administration thereof), and use of operating room. Misrepresentation: A false, incorrect, improper, or incomplete statement of a material fact, made in the application for a policy. Mode of Premium Payment: The frequency with which premiums are paid: monthly, quarterly, semiannually, or annually. Moral Hazard: Hazard arising from any nonphysical, personal characteristic of a risk that increases the possibility of loss or may intensify the severity of loss: for instance, bad habits, low integrity, poor financial standing. Morbidity: The incidence and severity of sicknesses and accidents in a well-defined class or classes or persons. Morbidity Tables: Actuarial statistics showing the frequency and duration of disability. Mortality Table: A table showing how many members of a group, starting at a certain age, will be alive at each succeeding age. It is used to calculate the probability of dying in, or surviving through, any period, and for the valuation of an annuity. To be appropriate for a specific group, it should be based on the experience of individuals having common characteristics, such as sex or occupation. Mortality Table: A statistical table showing the death rate at each age, usually expressed as so many per thousand. Multi-Employer Plan: A plan maintained according to a collective bargaining agreement, to which more than one employer contributes. Under ERISA, at the beginning of the plan, no single employer may contribute as much as 50% of the total, and thereafter as much as 75%. An employee may change employers within the group without losing retirement benefits unless a break in service (under the plan) cancels credits earned before the break. Multi-Peril Policy: A package policy which provides protection against a number of separate perils. Multi-peril policies are not necessarily multiple line policies, since the combined perils may be all within one insurance line. Multiple Employer Trust (MET): A legal trust established by a plan sponsor that brings together a number of small, unrelated employers for the purpose of providing group medical coverage on an insured or self-funded basis. Mutual Insurance Company: An insurance company in which the ownership and control is vested in the policyholders and a portion of surplus earnings may return to policyholders in the form of dividends. No capital stock exists.

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