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Member Certificate Another term for certificate of coverage.
Member Month The total number of participants who are members for each month.
Members Per Year The total number of member months divided by 12.
Mental Health Services and Supplies Items required for treatment of mental illness, including substance abuse and alcoholism.
Minimum Premium The lowest flat or earned policy charge for which a policy will be issued or for which coverage will be provided.
Minimum Premium A cost plus arrangement whereby the employer pays the insurer only a portion of the premium which is to be used for administration costs. The remainder is placed in a "bank account" which is then used by the insurer to pay claims.
Miscellaneous Expenses Ancillary expenses, usually hospital charges other than daily room and board. Examples would be X-rays, drugs, and lab fees. The total amount of such charges that will be reimbursed is limited in most basic hospitalization policies.
Misrepresentation Misleading the company as to material facts affecting a policy or the settlement of a loss, either by directly or indirectly lying. Misrepresentation as to material facts voids policies.
Mistook A mistake.
Mobile Equipment Vehicles not normally designed for use on public roads and not normally required to be licensed.
Modified Arbitration Procedure Rules at Lloyd's of London providing an informal method of resolving disputes between members and agents when the sum involved is unlikely to exceed \j10,000.
Modified Community Rating A method of determining rates for medical services based on data from a given geographic area.
Modified Fee-For-Service A situation where reimbursement is made based on the actual fees subject to maximums for each procedure.
Monoline Policy A policy that covers only one line of insurance.
Monopolistic State Fund A state-controlled workers compensation plan which writes insurance on such risks within the state and prohibits private insurers from doing so.
Moral Hazard A condition or characteristic by which an insured intends to profit from an insured loss.
Morbidity The relative incidence of disease.
Morbidity Rate Rates that have been developed based on the accumulation of statistics and data and that are used to show the percentage or ratio of how often certain types of sickness or illness occur within a given period of time to the classification or a specific group of insureds.
Morbidity Rate The ratio of the incidence of sickness to the number of well persons in a given group of people over a given period of time. It may be the incidence of the number of new cases in the given time or the total number of cases of a given disease or disorder.
Morbidity Table A listing of data showing the accident or sickness rates of persons of each sex at each age.
Morbidity Table A table showing the incidence of sickness at specified ages in the same fashion that a mortality table shows the incidence of death at specified ages.
Multi-Disciplinary Treatment which involves care provided by a wide range of specialists.
Multi-Line Insurance A package of coverages within one policy that provides for more than one line of insurance such as property and liability. Not the same as multi-peril which is a contract that insures more than one peril or cause of loss within the policy. For example, an "all-risk" property policy is multi-peril.
Multiple Employer Trust (MET) A trust consisting of multiple small employers in the same industry, which is formed for the purpose of purchasing group health insurance or establishing a self-funded plan at a lower cost than would be available to the employers individually.
Multiple Employer Welfare Arrangements Employer funds and trusts providing health care benefits to individuals.
Multiple Location Policy A policy covering real or personal property subject to a single common interest (owner, tenant, or one holding a financial interest or title) at a number of different locations. Such policies are rated under a special plan.
Multiple Option Plan Under this plan, employees can optionally choose from an HMO to a PPO to a major medical plan.
Municipal Insurance Commercial Insurance programs designed specifically to cover cities, town, states, or other types of municipalities.
Mysterious Disappearance The vanishing of insured property in an unexplained manner. Previously there were disputes under theft policies as to whether property mysteriously lost had or had not been stolen. To avoid contention, insurers stated in such policies that mysterious disappearance was presumed to be due to theft. Mere disappearance of property, such as an article dropped from a boat, is not covered, since the disappearance is not mysterious.
Named Insured The person designated in the policy as the insured, as opposed to someone who may have an interest in a policy but who is not shown by name.
National Drug Code (NDC) A system for identifying drugs.
National Fraternal Congress of America A federation of fraternal benefit societies.
National Health Insurance Any system of socialized insurance benefits covering all or nearly all of the citizens of a country, established by its federal law, administered by its federal government, and supported or subsidized by taxation.
Negative Film Insurance Pays a producer of commercial films the cost of reshooting should the film suffer damage in the course of production.
Negligence The failure to exercise the care that an ordinary prudent person would exercise: either doing that which a prudent person would not do, or failing to do that which a prudent person would do.
Network A group of doctors, hospitals and other providers contracted to provide services to insured individuals for less than their usual fees. Provider networks can cover large geographic markets and/or a wide range of health care services. If a health plan uses a preferred provider network, insured individuals typically pay less for using a network provider.
New For Old An expression in Marine Insurance which means that when repairs are made, new parts or equipment are supplied in place of old ones that have been lost or damaged. An insurance policy may stipulate that the difference between the old and new costs are either excluded or included in its coverage.
New York Insurance Exchange A newly formed (1980) property-liability underwriting exchange patterned after the syndicate type of operation of Lloyd's of London. The chief differences between the Exchange and Lloyd's are that the New York Exchange permits corporate as well as individual members, and their liability is limited to the amount of funds invested.
Newspaper Policy A form of Limited Health Insurance often sold by newspapers to build or conserve circulation.
No-Fault Automobile Insurance Coverage designed to compensate victims of automobile accidents without the necessity of proving negligence on anyone's part. No-fault laws passed by different states vary greatly in their scope and application. Most provide that a victim's own insurance will allow a victim to sue in tort, once expenses or injuries have passed a stipulated threshold (monetary or otherwise).
Non-disabling Injury An injury that does not qualify the insured for total or partial disability benefits. A Disability Income policy may contain a provision for a small benefit in the case of such an injury, including medical costs of up to 25% or 50% of one month's disability benefit payment.
Non-Occupational Policy A policy or provision of a policy which excludes accidents occurring on the job, when such employment is covered by workers compensation.
Nonadmitted Insurance Protection written by an insurer on a risk located in a state in which the insurer is not licensed. Such an insurer is referred to as a nonadmitted insurer.
Nonadmitted Insurer If an insurer is not licensed to write insurance in a specific state, then the insurer is a nonadmitted insurer for that state.
Noncancellable A provision in some policies (crop-hail insurance and ocean marine insurance) that neither policyholder nor insurer may terminate the contract during its term.
Noncancellable ("Non-Can") A contract of Health Insurance that the insured has a right to continue in force by payment of premiums, as set forth in the contract, for a substantial period of time, also as set forth in the contract. During that period of time, the insurer has no right to make any change in any provision of the contract. The NAIC recommends that the term "noncancellable" not be permitted to be used to designate any form that is not renewable to at least age 50 or for at least five years if issued after age 44. Note that this is in contrast to Guaranteed Renewable, on which the premium may be increased by classes. The premium for noncancellable policies must remain as stated in the policy at the time of issue. Contrast with Guaranteed Renewable.
Noncurrent The condition existing when two or more policies on a risk do not cover identically (a condition to be avoided because of difficulty in adjusting, as well as the possibility that the insured will recover less than anticipated).
Nonduplication of Benefits A provision in some Health Insurance policies specifying that benefits will not be paid for amounts reimbursed by others. In Group Insurance, this is usually called coordination of benefits (COB).
Nonforfeiture Benefit The provision in some life insurance contracts which specifies the benefits that cannot be forfeited even if premium payments are not made. These types of benefits may include the paid-up insurance value, the loan value, or the cash surrender value.
Nonoccupational Insurance See Unemployment Compensation Disability Insurance.


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