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Term Policy A policy written for longer than one year. If for less than a year, it is a short-term policy.
Terminally Ill A term which refers to the status of a person who will normally die within 6 months of a specific illness or sickness. Often refers to the terminally ill requirement for hospice care
Terrorist Insurance Property insurance coverages or policies designed to protect an insured against physical damage caused by terrorist acts.
Tertiary Care Services provided by such providers as thoracic surgeons, intensive care units, neurosurgeons, etc.
Theatrical Floater An inland marine policy covering loss or damage to the scenery, costumes, and other properties of a theatrical production.
Theft A broad term meaning the wrongful taking of the property of another.
Therapeutic Alternatives Alternate drug products which may be different in chemical content, but provide the same effect when administered to patients.
Therapeutic Equivalence Different drugs which will control a symptom or illness exactly the same as other drugs used to control that illness.
Third Party The claimant under a liability policy, so called because the first two parties are the insured and insurer, who enter into the insurance contract, which pays the third party's claim.
Third Party Administrator (TPA) A firm which provides administrative services for employers and other associations having group insurance policies. The TPA in addition to being the liaison between the employer and the insurer is also involved with certifying eligibility, preparing reports required by the state and processing claims. TPA's are being used more and more with the increase in employer self-funded plans.
Third Party Insurance Protection against liability to a third party. The first two parties are the insured and the insurer.
Third-Party Payor This refers to any organization such as Blue Cross/ Blue Shield, Medicare, Medicaid, or commercial insurance companies which is the payor for coverages provided by a health plan.
Ticket Policy See Transportation Ticket Policy
Tight Market In the property and liability insurance business, underwriting philosophies fluctuate between periods called the tight or hard market and the soft market. The tight or hard market is the period when underwriting standards are very tight and the rates are high. Normally the hard market closely follows a soft market period where the underwriting standards had been soft and the price or rates are very low, resulting in substantial underwriting losses. The cycle swings back and forth between soft underwriting with low rates and heavy losses, to the hard market with subsequent tightening of standards and dramatic increases in price.
Time Element Insurance A coverage which pays for loss of earnings or income when business operations are interrupted, curtailed or suspended due to property loss as a result of an insured cause of loss. Also covered are loss of rents and rental value. The current commercial time element coverage forms are business income and extra expense. Extra expense covers costs incurred to continue operations at another location.
Time Limit on Certain Defenses One of the uniform individual accident and sickness provisions required by state law to be included in every Individual Health Policy. It sets a limit on the number of years after a policy has been in force that an insurer can use as a defense against a claim the fact that a physical condition of the insured existed before the policy was issued, but was not declared at that time.
Title XIX Benefits See Medicaid.
Tornado A destructive and whirling wind of extreme violence which is accompanied by a funnel-shaped cloud moving rapidly over land in a narrow path. The barometric pressure may drop so severly and rapidly that buildings actually explode from within.
Tornado Insurance Protection against damage done to property by usually high winds, cyclones, tornadoes, or hurricanes.
Tort A legal wrong arising from a breach of duty fixed by law, except under contract, causing injury to persons or property and redressible by legal action for damages.
Tort Law The area of civil law that involves tort actions, which are defined as: a legal wrong arising from a breach of duty fixed by law, except under contact, causing injury to persons or property and redressible by legal action for damages.
Total Disability Inability to perform any functions of any occupation, caused by a covered illness or injury.
Total Loss 1)Loss of all the insured property. 2)Under a given policy, a loss involving the maximum amount for which that policy is liable.
Transfer of Risk When the hazards of, exposures, or financial responsibility for loss is transferred or shifted from the risk to another entity. Various types of risk transfer or risk management methods are available and may include insurance policies, hold harmless and other contractual agreements, leasing mechanisms, or other alternate financing.
Transportation Ticket Policy An accidental Death and Dismemberment and Disability Benefit policy issued with a common carrier ticket and limited to the risks or travel and the duration of the trip for which the ticket has been purchased. The name is derived from the fact that it was originally issued in the form of an extra stub on a travel ticket.
Treatment Facility Any facility, either residential or nonresidential, which is authorized to provide treatment for mental illness or substance abuse.
Trend Factor The factor applied to rates which allows for such changes as increased cost of medical providers, the cost of new and expensive medical technology, etc.
Triage A method of ranking sick or injured people according to the severity of their sickness or injury in order to ensure that medical and nursing staff facilities are used most efficiently.
Triple Option A plan where employees have their choice, among different types of provides such as HMO, PPO, or basic indemnity plan. Usually, their choice depends on how much they want to pay for the coverage.
Twenty-Four Hour Coverage An emerging theory aimed at providing medical and health insurance protection in one format for both work-related and non-work related coverage. In theory, this would eliminate the need for workers compensation coverage and would evolve the current traditional medical or health insurance program into 24-hour or around-the-clock protection, and would possibly set the venue for national health insurance coverage.
Typhoon A hurricane-type storm originating in the Pacific Ocean, China Sea and the Philippines.
Uberrimae Fidie Literally, of the utmost good faith. The basis of all insurance and reinsurance contracts. Both parties to the contract are bound to exercise good faith and do so by fully disclosing all information material to the proposed contract.
UCD See Unemployment Compensation Disability Insurance.
Ultralight Aircraft A gasoline powered aircraft weighing 160 pounds or less resembling in appearance its motorless cousin, the hang glider. Humorously referred to as an airborne lawnmower.
Umpire 1)A person selected by two appraisers to help settle disputes in property insurance claims. The appraisers are chosen by the disputing company and claimant, and a decision of any two of the three is binding. For example, if a company and claimant fail to agree on actual cash value of property destroyed or the amount of the loss, many policies provide that these be determined by appraisal. 2)A similar person in an arbitration proceeding under a reinsurance contract.
Unallocated Benefit A benefit providing reimbursement of expenses up to a maximum but without any schedule of benefits as such.
Underground Storage Tank (UST) The EPA had developed financial responsibility requirements with respect to owners and users of specific types of underground storage tanks that contain pretroleum products or other hazardous chemicals.
Underinsurance Insurance which is insufficient in amount to cover a loss which the policyholder may suffer.
Underinsured Motorist Coverage Coverage an insured may purchase to protect his or her own self from damage or injury caused by a negligent party who does not have adequate limits of insurance to cover the loss.
Underlying Insurance Policy The basic or primary layer of coverage, the initial policy that will respond to the covered loss. Only when the limits of the underlying policy have been exhausted, will the other respective layers of insurance respond, as with the case of an excess or umbrella policy in liability insurance.
Underlying Limits 1)In the case of liability excess or umbrella policies, it refers to the limits of the primary (underlying) policy below the excess or umbrella policy which will respond first to loss. Many excess or umbrella policies have established minimum limits for underlying policies. Should the underlying policy not meet the minimum limit requirements, the excess or umbrella will not be offered. 2)With respect to reinsurance, it is the amount that must be exhaused on the underlying coverages or policies before the reinsurance coverage will go into effect.
Underwriter One who accepts or rejects risks for an insurer (originally, by writing the person's name under the contract of insurance being issued).
Unearned Premium The portion of the premium representing the unexpired portion of the policy term.
Unemployment Compensation Disability Insurance (UCD) Health Insurance that covers off-the-job accidents and sickness. It does not cover disability resulting from an injury or sickness covered by Workers Compensation Insurance. See also Disability Benefits Law.
Uniform Billing Code of 1992 (UB-92) This code is scheduled to be implemented on October 1, 1993. It's a federal directive which states how a hospital must provide their patients with bills, itemizing all services included and billed on each invoice.
Uniform Premium A rating system that is used to calculate premiums for all insureds with no distinctions as to age, sex or occupation.
Uniform Provisions A set of provisions regarding the operating conditions of individual Health policies developed in a model law recommended by the National Association of Insurance Commissioners and required, with minor variations by almost all jurisdictions, and permitted in all jurisdictions.
Universal Life Insurance A combination of monthly term life insurance plus possible savings in an arrangement that provides limited flexibility as to death benefits and premium payment.
Unscheduled Property Floater A primarily personal inland marine insurance designed to provide blanket special or "all-risk" property coverage on all related property of a certain type.
Urgi-Center An emergency medical service center which is separate from any other hospital or medical facility.


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