Page: 2 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20


Peer Review Review of health care provided by a medical staff with training equal to the staff which provided the treatment.
Peer Review Organization (PRO) Groups of physicians who are paid by the federal government to conduct pre-admission, continued stay and services reviews provided to Medicare patients by Medicare approved hospitals.
Percentage Participation A provision in a Health Insurance contract which states that the insurer will share losses in an agreed proportion with the insured. An example would be an 80-20 participation where the insurer pays 80% and the insured pays the 20% of losses covered under the contract. Often erroneously referred to as coinsurance.
Performance Bond In general terms, surety bond guaranteeing the performance of a contract, usually associated with construction work, but possible for almost any kind of contract.
Peril The cause of loss; for example, fire, wind, vandalism, or accident.
Perils of The Sea Causes of loss unique to the operation of ships and their cargoes, such as sinking, stranding, heavy weather, etc., but not fire, lightening or theft.
Permanent and Total Disability Total disability from which the insured does not recover. When used as a definition in a policy (usually a life insurance policy rider), "permanent" is presumed after a stated period of time, commonly six months.
Permanent Partial Disability A condition where the injured party's earning capacity is impaired for life, but he is able to work at reduced efficiency.
Permanent Total Disability A condition where the injured party is not able to work at any gainful employment for the remaining lifetime.
Personal Injury Protection (PIP) Also known as a no-fault insurance, PIP provides insurance for medical costs, loss of earnings, additional living expenses, and funeral costs for occupants of the insured automobile and pedestrians, other than those insured under other policies.
Personal Effects Floater An inland marine policy which insures articles, usually accompanying travelers, against "all-risks" while away from home.
Personal Injury Injury, other than bodily injury, resulting from false arrest, false detention, false imprisonment, malicious prosecution, wrongful eviction, wrongful entry, or the invasion of privacy of a premises. It also includes injury caused by oral or written material that slanders a person, goods, products, services, or which violates the right of privacy.
Personal Property Property other than real property; chattels.
Personal Property of Others Contents, business personal property, and any other property excluding real property, that is not owned by the insured.
Pharmacy and Therapeutics (P&T) Committee A panel of physicians _ usually from different specialties _ who advise the health plan regarding the proper use of prescription drugs.
Physical Damage 1)As used in property or liability insurance, physical injury to tangible property. 2)As used in automobile insurance, actual damage or loss of the vehicle itself caused by collision, overturn, fire, theft, vandalism, or malicious mischief.
Physical Hazard Danger of loss or liability arising from the condition, occupancy or use of property, as opposed to such danger arising from the character of the policyholder.
Physical Therapist A trained medical person who provides rehabilitative services and therapy to help restore bodily functions such as walking, speech, the use of limbs, etc.
Physician Contingency Reserve (PCR) A portion of the claim which is deducted and withheld by the health plan before payment is made to the physician. It serves as an incentive for proper quality and utilization of health care. A portion of this reserve may be returned to the physician or to pay claims where the plan needs additional funds. It is also sometimes called "withhold."
Physician's Current Procedural Terminology (CPT) This terminology includes medical services and procedures performed by physicians and other providers of health care. The health care industry uses it as a standard for describing services and procedures.
Pilferage Theft in small quantities, for example,not limited to the taking of a whole package or all of the property insured.
Piracy Robbery on the high seas; typically, the seizure of a vessel and cargo.
Place of Service This designates where the actual health services are being performed, whether it be home, hospital, office, clinic, etc.
Plan Administration Overseeing the details and routine activities of installing and running a health plan, such as answering questions, enrolling new individuals for coverage, billing and collecting premiums, etc.
Pleasure Use A rating classification term used in auto insurance that indicates the vehicle is not used for business and does not have commercial exposures, other than to drive back and forth from work.
point-of-service (POS) Health plan which allows the enrollee to choose HMO, PPO or indemnity coverage at the point of service (time the services are received).
Policy The formal written contract of insurance.
Policy Fee A charge made by an agent on small premium policies, in addition to the premium set forth in the policy, which is kept by the agent. The practice is made illegal under the insurance laws of most states.
Policy Loan A life insurance policy nonforfeiture benefit, whereby the insured may borrow from or take a loan from the insurer based on the cash surrender value of the policy.
Policy Reserve The percent of premium that an insurer must set aside in a reserve to pay claims and fulfill the obligations of insurance contracts. On an individual policy basis, each policy has its own pro rata share of the total accumulated policy reserve covering the insured's entire book of business.
Policy Year The year commencing with the effective date of a policy or with the renewal date of that policy, to be distinguished from the calendar year, which always starts from January 1. A term of particular importance in the collection of loss statistics.
Policyholder Surplus As reported on a statutory basis, the sum of all unassigned surplus of a mutual insurer, or for a stock insurer, the sum of all unassigned surplus and capital.
Pool (Risk Pool) A separate account which includes entries for income and expenses. It is used when a number of groups are put together for the purposes of combining their premium and paying their losses.
Port Risk Insurance An ocean marine insurance designed to protect a vessel that is portside for a lenghty period of time. Coverage terminates as soon as the vessel leaves port.
Power Interruption Insurance Property and time element endorsements designed to cover the insured for losses that result from the interruption of services by an insured cause of loss. The current endorsements allow the insured to select coverage for off-premises services, whether supplied by a private or public utility. Protection may be purchased for the following options: water suppliers, communication suppliers, or power supplies.
Power of Attorney A document which authorizes a person to act for another within the limitations it contains. A subscriber to an interinsurance exchange executes such a document in favor of the person who operates the exchange.
Practical Nurse A licensed individual who provides custodial type care such as help in walking, bathing, feeding, etc. Practical nurses do not administer medication or perform other medically related services.
Pre-Admission Authorization A cost containment feature of many group medical policies whereby the insured must contact the insurer prior to a hospitalization and receive authorization for the admission.
Pre-Admission Certification Before being admitted as an inpatient in a hospital, certain criteria are used to determine whether the inpatient care is necessary.
Preexisting Condition An illness, injury or condition for which the insured individual received medical advice, treatment, services or supplies; had diagnostic tests done or recommended; had medicines prescribed or recommended; or had symptoms of typically within 12 months (time periods may vary depending on state laws) prior to the effective date of insurance coverage.
Preferred Provider Organization (PPO) An organization of hospitals and physicans who provide, for a set fee, services to insurance company clients. These providers are listed as preferred and the insured may select from any number of hospitals and physicians without being limited as with an HMO. Coverage is 100%, with a minimal copayment for each office visit or hospital stay. Contrast with Health Maintenance Organization.
Premises The building or section of a building, insured or containing the insured property. Depending on policy conditions,it may also include an adjacent area.
Premium The amount of money an insurance company charges to provide coverage.
Premium Adjustment Provision Policies for which a deposit or estimated premium is charged at inception but recalculated at expiration, based on the acutual exposure covered during the policy period.
Prescription Medication A drug which can be dispensed only by prescription and which has been approved by the Food and Drug Administration.
Pressure Vessel Something designed to contain gas or vapor, such as steam, under pressure. A steam boiler is an excellent example.
Presumptive Disability When an insurer is able to presume that a disability is permanent or for the life of the insured, based upon the type of injury experienced, such as loss of sight or limb.
Presumptive Disability A disability involving loss of sight, hearing, speech, or any two limbs, which is presumed to be a permanent and total disability. In such cases, the insurer does not require the insured to submit to periodic medical examinations to prove continuing disability.
Preventive Care This type of care is best exemplified by routine physical examinations and immunizations. The emphasis is on preventing illnesses before they occur.
Primary Beneficiary In a life insurance policy, the individual named to be first to receive the policy benefits and proceeds. If any others should be listed, they are considered contingent or secondary and will collect only if the primary is deceased.


↑ Top