Exclusions, Medical Benefits
Definition of "Exclusions, medical benefits"
Limiting provision. Exclusions listed in group health plans include: benefits under Workers Compensation; certain dental procedures; convalescent or rest cures; medical expenses resulting from the insured person and/or covered dependents committing a felony or misdemeanor; cosmetic surgery, unless required immediately because of non-occupational disease, illness, accident, injury, or congenital anomaly in an insured newborn infant; expenses incurred by a member of a health maintenance organization (HMO) or other prepaid medical plan; expenses associated with intentional self-inflicted injuries or attempt at suicide; unreasonable charges for services or supplies; convenience items such as telephone and television.
Popular Insurance Terms
Portion of reinsurance premium received by the reinsurer that relates to the unexpired part of the reinsured policy. ...
Income (premiums + investment earnings) minus disbursements (dividends + death claims + policies surrendered for benefits + general expenses). ...
Present value of future benefits. This type of reserve would be applicable for single premium life insurance, paid-up insurance, single premium annuity, and a paid-up annuity. ...
Legislation passed in 1988 by the U.S. Congress to facilitate movement of checks through the collection system. As the result of this Act, the Federal Reserve has established rules for the ...
Property damage coverage for a vehicle under the collision insurance and comprehensive insurance sections of the business automobile policy (BAP) and the personal AUTOMOBILE POLICY (PAP). ...
Assumption that an employer is liable for negligent acts or omissions of employees that result in bodily injury and/or property damage to third parties if those acts are in the course of ...
Model state statute that governs terms for surrender of individual deferred annuities and cash value life insurance. This model, adopted by most states in the late 1970s and early 1980s, ...
Amendment that modifies the federal flood insurance program by providing relocation and acquisition coverage for structures in imminent danger from an encroaching shoreline. This amendment ...
Federal agency that collects and analyzes numerous U.S. demographics used by government and industry. Insurance companies use the demographics to predict areas of high demand for their ...
Have a question or comment?
We're here to help.