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INSURANCE LEGAL GLOSSARY |
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Glossary of
Insurance Terms
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Educational Fund: One of the uses of Life Insurance. It is designed to provide money for a child's education should the breadwinner of the family die.
Earned Premium: The portion of a premium that has been "used up" during a policy term. With a one-year policy, half of the total premium has been earned after six months.
Effective Date/Inception Date: The date that coverage begins on an insurance policy.
Eligibility Requirements: Requirements imposed for eligibility for coverage, usually in a group insurance or pension plan.
Elimination Period: The number of days of care that you pay before your insurance plan picks up the benefits.
Emergency Fund: One of the uses of Life Insurance which provides money for the emergency expenses of a deceased's family prior to the final settlement of the estate.
Employee Benefit Program: Benefits offered an employee at his place of work by his employer, covering such contingencies as medical expenses, disability, retirement, and death, usually paid for wholly or in part by the employer. These benefits are usually insured.
Employee Certificate of Insurance: The employee's evidence of participation in a group insurance plan, consisting of a brief summary of plan benefits. The employee is provided with a certificate of insurance rather than the actual insurance policy.
Employee Retirement Income Security Act (ERISA): This act prescribes federal standards for funding, participation, vesting, termination, disclosure, fiduciary responsibility, and tax treatment of private pension plans.
Endorsement Split Dollar: A split dollar plan in which the employer owns and controls a life policy on the life of an employee. The employee's rights to certain policy benefits are protected by an employer endorsement.
Endorsement: An addition to a policy that modifies its benefits.
Endowment Insurance: A form of Life Insurance where the face amount is payable to the insured at the end of the contract period or to a beneficiary if the insured dies before that. An example would be an insured purchasing an endowment payable at age 65: If he reaches that age, the proceeds would be payable to him. If he dies prior to that age, the proceeds would be payable to the designated beneficiary as a Life Insurance benefit.
Endowment: A cash value policy payable to the policyholder on the maturity date, if that person is still living, or to a beneficiary at the time of the insured’s
death.
Enrollment Period: The period during which individuals may enroll for an insurance policy, Medicare, HMO benefits.
Entire Contract Clause: A provision in an insurance contract stating that the entire agreement between the insured and the insurer is contained in the contract, including the application if it is attached, declarations, insuring agreements, exclusions, conditions and endorsements.
Entity Agreement: A buy-sell agreement usually used with a partnership in which the partnership agrees to purchase the interest of a deceased or disabled partner.
ERISA: Employee Retirement Income Security Act, a federal law that regulates employer-sponsored pension and insurance plans for employees.
Evidence of Insurability: Statement or proof of a person’s health, finances, lifestyle, habits, or job to the extent that they affect his or her acceptability for insurance.
Evidence of Insurability: The statement of information needed for the underwriting of an insurance policy.
Examination: The medical examination of an applicant for Life or Health insurance.
Examined Business: Coverage written on an applicant who has been examined and who has signed the application but has paid no premium.
Examiner: A physician appointed by the medical director of a Life or Health insurer to examine applicants.
Excess Interest: Interest credited to an insured's contract in excess of the amount guaranteed by the terms of the contract.
Exclusions: Conditions or procedures that are not covered. Every health care plan has its own list of exclusions and limitations. Some of the more common ones are experimental medications/treatments/procedures, sickness or injury as a result of war, attempted suicide, cosmetic surgery, etc.
Expectation of Life: The average number of years of life remaining for persons of a given age according to a particular mortality table. Also called life expectancy.
Expected Mortality: The expected incidence of death within a given group during a given period of time as shown on a mortality table.
Experienced Mortality or Morbidity: The actual mortality or morbidity experienced in a group of insureds as compared to the expected mortality or morbidity.
Experimental and Investigational Procedures: Health insurance coverage generally excludes medical treatments that are deemed to be unproven, ineffective, or non-standard. This includes surgical techniques and medicines not approved by the Food and Drug Administration. Sometimes such treatments may be available by traveling to another country, but these treatments would generally not be covered.
Expiration Date: The date your coverage ends. There is usually a time of day associated with this date, for example, an expiration date of 5/1/2002 at 12:01am. This means your coverage ends one minute after midnight on the date
listed.
Expiry: The termination of a Term Life Insurance policy at the end of its period of coverage.
Explanation of Benefits (EOB): The insurance company’s explanation of its decision regarding your claim.
Extended Death Benefit: A group policy provision which will pay the life benefit when (1) the insured is totally and continuously disabled at the time the policyholder stops paying premium until the insured's death; and (2) if the insured dies within one year of the date the premium payments stopped, or prior to age 65.
Extended Non-Owner Liability: An endorsement that provides broader liability coverage for specifically named people operating any non-owned automobile or trailer. It covers non-owned autos, use of autos to carry people or property for a fee, and individuals driving employer-furnished cars who do not own vehicles themselves.
Extended Term Insurance: A provision in most policies which provides the option of continuing the existing amount of insurance as Term Insurance for as long a period of time as the contract's cash value will purchase. This is one of the non-forfeiture options available to the insured in case a premium is not paid within the grace period.
Extra Percentage Tables: Mortality or morbidity tables showing the extra premium for certain impaired health conditions. Usually this premium is shown as a percentage of the standard premium.
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