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HI.2 See Health Insurance and Medicare, Part A.
HIAA See Health Insurance Association of America.
Hidden Defect A term used in connection with products liability coverage to designate a product that has a hidden or concelled defect which could cause injury or damage when used.
Highly Protected Risk (HPR) A program for larger commercial properties meeting higher safety standards in order to obtain significantly lower premiums. Protection includes automatic sprinkler systems, better than average construction and occupancy.
HII See Health Insurance Institute.
HIPAA Health Insurance Portability and Accountability Act of 1996, P.L. 104-91. This law relates to underwriting, pre-existing limitations, guaranteed renewal, COBRA and certification requirements in the event someone terminates from the plan. The new law, commonly known as the "Kennedy-Kassebaum Bill," establishes new requirements for self-funded, fully-insured group plans (including church plans) and Individual Health policies. The purpose of the law is to: •Improve portability and continuity of health insurance coverage in the group and individual markets •To combat waste, fraud and abuse in health insurance and health care delivery •To promote the use of medical savings accounts •To improve access to long-term care services and coverage •To simplify the administration of health insurance
HIQA. Health Insurance Quality Award An award granted annually by the International Association of Health Underwriters or the National Association of Life Underwriters for high persistency of Health Insurance policies written by agents. See also Persistency.
HMO See Health Maintenance Organization.
Hold Harmless Agreement A contractural arrangement in which one party agrees to assume certain liability which otherwise would be borne by the other party. For example an insurer may wish to pay a loss when it is uncertain whether it may be called upon a second time to some other party. The payee may be asked to execute an agreement whereby the company will be reimbursed or held harmless by the payee if such request should happen. Another example is when the principal in a large construction project frequently demands hold harmless agreements from all subcontractors in respect to claims made against the principal arising out of the subcontractors' negligence. The principal often stipulates the purchase of a liability policy by the subcontractor to support the hold harmless agreement.
Holdup The taking of property by violence or threat of violence.
Home Health Agency A certified facility approved by a health plan to provide services under contract.
Home Health Care Care received at home as part-time skilled nursing care, speech therapy, physical or occupational therapy, part-time services of home health aides or help from homemakers or choreworkers.
Home Health Services Health care services provided by a licensed home health agency in the patient's home which is a covered expense under Part A of Medicare.
Hospice An organization which is primarily designed to provide pain relief, symptom management and supportive services for the terminally ill and their families. Hospice care is covered under Part A of Medicare.
Hospital Affiliation A contract whereby one or more hospitals agrees to provide benefits to members of a specific health plan.
Hospital Alliances A group of hospitals that work together to share common services and thereby reduce health costs. By grouping together, they are better able to compete with other alliances or chains.
Hospital Benefits Benefits payable for hospital room and board, plus miscellaneous charges resulting from hospitalization.
Hospital Expense Insurance See Hospitalization Insurance.
Hospital Income Insurance A form of insurance that provides a stated weekly or monthly payment while the insured is hospitalized, regardless of expenses incurred and regardless of whether or not other insurance is in force. The insured can use the weekly or monthly benefit as he chooses, for hospital or other expenses.
Hospital Indemnity Coverage that pays based on daily, weekly, or monthly limits regardless of the amount of actual hospital expenses.
Hospital Insurance (HI) Also identified as Part A of Medicare. HI provides inpatient hospital care, skilled nursing care home health and hospice care subject to a benefit period deductible and copayments for certain services.
Hospitalization Expense Policy A policy which covers daily hospital room and board charges and also covers miscellaneous hospital expenses (such as X-ray, etc.). It also often covers emergency treatment charges and many times will also include a surgical benefit.
Hostile Fire A fire occurring where it is not supposed to be, as distinguished from a friendly fire which occurs in its proper place, such as in a stove or a fireplace. Fire insurance policies do not insure losses caused by friendly fires.
House Confinement A provision in some Health Insurance contracts which requires an insured to be confined to the house in order to be eligible for benefits. This provision is most commonly found in policies providing loss of income benefits.
Hull 1)In ocean marine insurance, the frame, body, machinery and equipment of a ship, excluding masts, yards, sails and rigging. 2)In aviation insurance, the fuselage, wings, tail, rudders, and other major structural features of an aircraft, including machinery and equipment.
Human Perils One of three broad categories of perils commonly referred to in the insurance industry which include not only human perils, but also natural perils and economic perils. Human perils are those caused directly by people and include crime, liability, fidelity, and some types of property damage such as vehicle damage or arson. Contrast those with natural perils which include wind, flood, or earthquake, or economic perils such as inflation or obsolesence.
Hurricane A violent cyclonic windstorm covering a large area. It usually originates at sea, with winds circulating at tremendous velocity around a center, which in itself moves fairly slowly. It differs from a tornado, which may be more violent, in that the area of involvement is always extremely large. A typhoon is the Pacific and Indian Ocean version of a hurricane.
ID Card/Identification Card Card given to insured individuals which advises medical providers that a patient is covered by a particular health insurance plan.
Identification of Benefits A provision that the cost of putting a disabled insured in touch with and in the care of relatives will be reimbursed, usually up to a maximum amount.
Impaired Property Property is considered to be impaired when it has not been physically damaged, but either cannot be used for its intended purpose or has lost monetary value because it contains a defective product or the work performed on it is defective or inadequate, or because the insured has not fulfilled a contractual obligation.
Impaired Risk In life and health insurance, when an applicant has a substandard physical condition or a hazardous occupation or hobby, he/she is an impaired risk. Many insurers avoid such risks, while others specialize in them.
In-Area Services Services which are provided within the "authorized" service area as designated in the plan.
In-Force Business Life or Health Insurance for which premiums are being paid or for which premiums have been fully paid. The term refers to the total face amount of a Life insurer's portfolio of business. In Health Insurance it refers to the total premium volume of an insurer's portfolio of business.
In-Network Describes a provider or health care facility which is part of a health plan's network. When applicable, insured individuals usually pay less when using an in-network provider.
Inchmaree Clause A clause used in ocean marine policies to identify additional named perils beyond the basic marine perils. In the more recent hull insurance policies, the clause is now identified as the "additional perils" clause. The original clause grew out of a lawsuit brought in 1887 by the owners of a ship named "Inchmaree".
Incurred Losses 1)Events which have happened and which will cause claims to be made to insurers. 2)The total amount shown in an insurer's operating statement as its obligations for policy claims, whether paid or not, during a given period (usually one year). The composition of incurred losses in such a total is derived by the following formula: losses paid during the year, plus loss reserves existing at the end of the year, minus loss reserves existing at the beginning of the year.
Indemnify To pay for loss suffered, or to reimburse.
Indemnitor In surety bonds, a person or company entering into a written agreement with a surety to hold that surety harmless from any loss or expense it may incur on a bond issued on behalf of another.
Indemnity Indemnity is when the person or party suffering a loss is paid or reimbursed for that loss, the purpose being to restore that party to the condition that was present prior to the loss. In a life insurance contract, the payment made to a beneficiary is called indemnity.
Indemnity Insurance Plans Traditional insurance plans (not HMOs or PPOs) which permit insured individuals to choose their doctors and hospitals. Insured individuals do not have to choose doctors or hospitals from a specific list of providers. Also called "fee-for-service" plans.
Independent Agent A property-casualty insurance producer who sells insurance as an independent contractor while representing one or more insurers of that agent's choosing on a commission basis, and who owns the expiration records of customers served. The independent status is further illustrated by the selling functions performed, which are not directed by the insurer, as would be the case if the agent were an employee. Those functions include contacting prospective insureds, effecting insurance, issuing policies, collecting premiums (in many or most cases), settling some losses of small amounts,and generally representing the insurers in the agent's community as part of the American agency system. By contrast, the direct writing insurer directs the selling functions of its agents, known as exclusive agents, and owns the expiration records.
Indirect Loss A type of loss that does not result from direct damage of a covered cause of loss or peril but is, instead, a consequence of the direct damage loss. To illustrate, if a restaurant burns to the ground from a fire, that is the direct loss; however, the income lost because the restaurant could not operate is the indirect loss.
Individual Contract A contract made with an individual that covers that individual and perhaps also specified members of his family for benefits as described in the policy.
Individual Practice Association (IPA) Model HMO A situation where an individual practice association is contracted with to provide health care services. The individual practice association contracts with individual physicians or groups of physicians for their services.
Inflation Factor A premium loading to provide for future increases in medical costs and loss payments resulting from inflation.
Inflation Guard Endorsement Language which may be added to a homeowners policy for an additional premium to extend the coverage by increasing the limits of liability quarterly (by 1%, 2%, or some fixed amount) to offset inflation.
Inflation Protection Provisions in a health insurance policy that increase benefit levels to account for anticipated increases in the cost of covered services.
Inherent Vice The characteristics of any physical property which are expected to cause deterioration or damage to that property without outside help, e.g., milk sours eventually, and wooden houses depreciate over time, Excluded by most insurance policies.
Initial Eligibility Period The time period during which prospective members can apply for coverage without providing evidence of insurability.
Injury An act which damages or destroys a person or property.

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