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Insurance Glossary
 
   

    Accident Insurance
Provides benefits to the person insured in the event of an accident.

Beneficiary
The person designated to receive proceeds of an insurance policy.

Benefit
A payment or option available under the terms of an insurance policy.

Benefit Year
The consecutive 12 month period following the date a claim is incurred.

Claim
A request for payment of benefits under the terms of an insurance policy.

Coverage
The extent of benefits provided by an insurance policy.

Claimant
An insured making a claim under a policy.

Co-payment
The percentage of charges eligible as benefits which are payable by the insurer.

Death Benefit
The amount of money paid to the beneficiary when the insured person dies.

Deductible
A monetary amount deducted from a benefit paid to a policyholder.

Dentist or Denturist
A practitioner of dentistry lawfully qualified and licensed to practice in the jurisdiction in which he or she has provided the services or supplies for which the charges are incurred.

Dependant
A child of the insured who is listed on an application and who is a natural child, adopted, stepchild or foster child, or a child for whom the insured is by law responsible, who is unmarried, unemployed and dependant on the insured for financial support and is under 21 years of age.

Effective Date
The day on which coverage under a policy takes effect.

Evidence of Insurability
Any statement or proof of a person's physical condition, occupation, etc., affecting acceptance of the applicant for insurance.

Face Amount
The amount of insurance provided by the terms of an insurance contract, usually found on the first page of the policy. In a life insurance policy, the death benefit.

Family Coverage
Benefits are available to the insured, and dependants identified on the application form.

Final Expenses
Expenses incurred at the time of a person's death. These include funeral costs, court expenses associated with probating his or her will, current bills or debt, and taxes. Depending on their circumstances, the survivors may also want to pay the outstanding balances of mortgage and loans.

Funeral Expenses
Expenses incurred for a funeral and burial. These can include casket, vault, grave plot, headstone and funeral director.

Grace Period
Period of time after the due date of a premium during which the policy remains in force without penalty.

Government Health Insurance Plan
Any plan or arrangement provided by, or under the administrative supervision of, any government or agency which provides coverage or reimbursement for any health care service or supply, including but not limited to the health insurance plan of the insured's province or territory of residence, homecare program, assistive devices program and the Workers' Compensation Act or similar legislation in the insured's province or territory of residence.

Guaranteed Issue
An insurance plan for mature Canadians that guarantees insurance coverage regardless of health. Rates are based on age at the time of application.

Health Care Professional
Any licensed, regulated health professional whose occupational duties include the provision of treatment, advice, consultation, diagnosis or hospitalization.

Incontestable Clause
A clause in a policy providing that a policy has been in effect for a given length of time (two or three years), the insurer shall not be able to contest the statements contained in the application. In life policies, if an insured lied as to the condition of his health at the time the policy was taken out, that lie could not be used to contest payment under the policy if death occurred after the time limit stated in the incontestable clause.

Injury
Unforeseeable harm to the body caused by an accident.

Insurance Act
In Canada, a general statute that contains most of the insurance law of a common law province, and regulates the conduct of insurers and insurance agents within the province.

Insurance Policy
The printed form which serves as the contract between an insurer and an insured.

Insured
The person whose life or health is covered by a specific policy.

Insurer
Party that provides insurance coverage, typically through a contract of insurance.

Issue Age
The Age of an insured as at the policy issue date, using "age nearest" next birthday formula.

Lapse
Termination of a policy upon the policy owner's failure to pay the premium within the grace period.

Life Insurance
An agreement that guarantees the payment of a stated amount of monetary benefits upon the death of the insured.

Medical Expenses
Reasonable charges for medical, surgical, x-ray, dental, ambulance, hospital, professional nursing, prosthetic devices, and funeral expenses. (The insurance company defines what is reasonable.)

Nurse
A nurse duly registered in the jurisdiction where the service is provided.

Physician
A duly qualified doctor of medicine (M.D.) entitled under the laws of the province, state or country where the services are rendered, to practice medicine and surgery without restriction.

Policy
The printed document issued to the policyholder by the company stating the terms of the insurance contract.

Policyholder
The person to whom a policy is issued and with whom the insurer has entered into a contract of insurance.

Pre-existing Health Condition
An injury, a sickness, or a condition that existed before the date that an insurance policy takes effect.

Premium
The annual cost of an insurance policy payable by the policyholder. Any policy fee amount is not included in the premium amount.

Premium Mode
The frequency of premium payments for an insurance policy, usually annually, semi-annually, or monthly.

Resident
A person who has a valid provincial health insurance card number, maintains a permanent place of residence in Canada and who has been in the country for a period of not less than 183 days during the past twelve (12) months.

Rider
An optional coverage benefit added to an insurance policy.

Spouse
A person who is covered under a government health insurance plan and to whom the insured is legally married or with whom the insured has cohabited in a conjugal relationship for at least 12 consecutive months.

Supplemental Health & Dental Insurance
Supplemental health and dental insurance can cover day-to-day expenses like dental fillings & cleaning, eyeglasses, prescription drugs and travel insurance. In addition, supplemental health and dental insurance protects against many unpredictable extra costs.

Term Life Insurance
A life insurance plan that provides coverage for a specified number of years.

Underwriter
A person that uses evidence to evaluate the insurance risks of applicants and policyholders.

Waiting Period
The time that must pass before a benefit becomes payable.

Waiver of Premium
A benefit that pays premiums on behalf of the insured.



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