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Benefit Period Defines the period during which a Medicare beneficiary is eligible for Part A benefits. A benefit period is 90 days which begins the day the patient is admitted to a hospital and ends when the individual has not been hospitalized for a period of 60 consecutive days.
Bid Bond A bond intended to guarantee that the bidder on a construction, supply or service contract will enter into the contract if successful as a bidder. Should the bidder fail to enter the contract, the surety on the bid bond may be called upon to pay the difference between the amount of the principl's bid and the bid of the next lowest qualified bidder.
Billed Claims The amounts submitted by a health care provider for services provided to a covered individual.
Binding Authority When one party (usually an agent), has been given the right and commensurate authority to represent another party (usually an insurer), in effecting or creating an insurance contract.
Birthday Rule A contract of Health Insurance that covers all of a class of persons not individually identified in the contract.
Blanket Coverage A single limit of insurance that covers a number of items, such as one amount of insurance to cover two buildings or a single building and its contents. A blanket policy usually contains certain restrictions, which may be absent in "specific" or "itemized" policies, such as the use of a 90% coinsurance clause.
Blanket Crime Policy A blanket crime policy (now obsolete) insuring against employee dishonesty, losses inside and outside the premises, losses from money orders and counterfeit paper currency, and depositor's forgery. The policy covers money, securities and other property with a single limit of insurance applying to all coverages, one of which may be eliminated. Similar to 3-D policy (comprehensive dishonesty, and destruction) wherein the same coverages are afforded, but on an optional basis.
Blanket Insurance A contract of Health Insurance that covers all of a class of persons not individually identified in the contract.
Blanket Medical Expense A policy or provision in a Health Insurance contract that pays all medical costs, including hospitalization, drugs, and treatments, without limitation on any item except possibly for a maximum aggregate benefit under the policy. It is often written with an initial deductible amount.
Blanket Rate A fire insurance rate which applies to blanket insurance.
Blood Bank Professional Liability Insurance Coverage designed for owners and operators of blood banks against negligence, errors, or omissions arising out of alleged malpractice, rendering or failing to render professional services, or mistake in taking, handling, processing, storing, or distributing blood products.
Blue Cross Blue Cross plans are nonprofit hospital expense prepayment plans designed primarily to provide benefits for hospitalization coverage, with certain restrictions on the type of accommodations to be used.
Blue Plan A generic designation for those companies, usually writing a service rather than a reimbursement contract, who are authorized to use the designation Blue Cross or Blue Shield and the insignia of either.
Blue Shield Blue Shield plans are prepayment plans offered by voluntary nonprofit organizations covering medical and surgical expenses.
Board Certified A physician or other professional who has passed an examination which certifies him or her as a specialist in a particular medical area.
Board Eligible A professional person or physician who is eligible to take a specialty examination.
Bobtail Coverage Sometimes called "deadheading," this is an auto coverage for the liability exposure of a trucking operation, which covers tractor-trailer rigs returning empty from a trip and, therefore, not protected by the policy of the client contracting with the trucker.
Bodily Injury (BI) Injury, sickness, or disease sustained by a person, including death at any time resulting therefrom.
Bodily Injury Liability Insurance A form of "third-party" protection covering the insured's legal liability for bodily injury to others caused by the insured's negligence.
Boiler & Machinery Insurance Protection against loss from disruption of boilers and machinery by an insured peril: loss to the boiler and machinery itself, damage to other property, business interruption losses, or all three. Also known as machinery breakdown insurance.
Bond There is more than one type of bond. Insurance bonds are normally three-party contracts in which one party agrees to guarantee the act, performance, or behavior of a second party, to a third party. Two common types of bonds are fidelity and surety.
Brand-name Drug Prescription drug which is marketed with a specific brand name by the company that manufactures it. May cost insured individuals a higher co-pay than generic drugs on some health plans. (see "generic.")
Breach of Warranty Warranties are statements of commitments by the insured on the literal truth of which the insurance contract depends. Warranties may relate to matters existing at or before the time the policy is issued or may be undertakings by the insured that something be done or omitted after the policy takes effect and during its continuance. Breach of warranty exists when a warranty is broken or violated by an insured.
Brick Building A type of construction in which the outer walls are at least the thickness of two bricks in width.
Brick Veneer A building where the outer walls are made of wood faced with a single course of brick. In other words, it is a frame building with a brick outside covering, as distinguished from a brick building in which the supporting walls are brick.
Bridge Policy Special inland marine forms which insure bridges against many hazards.
Broker A licensed, legal representative of the insured who negotiates with underwriters on behalf of the insured; nevertheless, the broker receives a commission from the insurer (underwriter).
Broker of Record A licensed broker who has been designated by the policyholder to represent that policyholder.
Buffer Layer An amount of insurance purchased to satisfy the requirement of an excess carrier with respect to underlying insurance. Also known as gap coverage.
Builders Risk 1) A building or a ship in the course of construction. 2) A special form dealing with the unique loss exposure of property under construction.
Bumpershoot An umbrella or excess liability policy specifically for ocean marine risks.
Burglary Theft by forcible and illegal entry, evidenced by visible signs made by tools, explosives, electricity, or chemicals.
Business Income Insurance A time element 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. Extra expenses incurred to continue operations at another location are included as long as they reduce the total amount of loss.
Business Interruption Insurance A time element coverage which pays for loss of earnings when business operations are curtailed or suspended due to property loss as a result of an insured cause of loss. This coverage is now obsolete and has been replaced by a more comprehensive and generic business income insurance.
Business Overhead Expense A disability income policy which indemnifies the business for certain overhead expenses incurred when the business owner is totally disabled.
By Order of Civil Authority A directive from city officials or other civil authority confirming that a building may be destroyed by the fire department in order to prevent the spread of conflagration.
Calendar Year January 1 through December 31 of the same year. Many deductible amount provisions are on a calendar year basis under major medical plans. Also, benefits under basic hospital surgical and medical plans are usually stated as so much for each calendar year.
Camera Floater An inland marine form designed to insure cameras and their equipment.
Cancel To terminate a contract. Usually applied to the termination of a policy before its natural expiration, but may be used to describe the ending of any contract during its natural life, such as an agent's contract.
Cancelable Policy This type of insurance policy may be canceled by the insured or the insurer at any time, as long as the other party is notified according to the terms and conditions set forth in the policy, and the appropriate time is allowed during the notification process.
Cancellation Notice The notice issued by one party of the policy to the other, informing of the intent and request to cancel. The policy provisions must be followed during the notification process with respect to how the notice must be given (normally in writing), the number of days that must be allowed, and how the notice must be delivered (registered mail, delivery, etc.)
Captive Insurance Company A company which is wholly owned by another organization (generally non-insurance), the main purpose of which is to insure the risks of the parent organization. A pure captive is owned by a single parent, while an association captive is owned by a group of companies usually in the same line of business.
Care, Custody and Control Most liability policies have provisions that exclude coverage for physical damage or loss to property while it is in the care, custody or control of the insured. Two methods are available to buy-back some or all of the care, custody, and control coverage: either endorsements to the liability policy, such as the broad form property damage endorsement or its company-specific equivalent which will provide limited coverage, or the purchase of inland marine coverages such as bailees forms.
Cargo Goods being transported by rail, plane, truck, ship, or other conveyance, excluding the equipment needed to operate the conveyor.
Carrier 1) The insurance company which provides the protection for a particular risk. 2) A transporter of goods, a form of bailee for which insurance is provided. A common carrier is one which is available to the public for the transport of any goods. A private carrier transports only the goods of its owner.
Carrier Usually a commercial insurer contracted by the Department of Health and Human Services to process Part B claims payments.
Carrier Replacement This refers to a situation where one carrier replaces one or more carriers.
Carriers Legal Liability An insurance policy designed to provide coverage for the bailee exposure of cargo carriers that would result from damage to property of others that has been entrusted to the carrier for transport.
Carry Over Provision In major medical policies, allowing an insured who has submitted no claims during the year to apply any medical expenses incurred in the last three months of the year toward the new calendar year's deductible.
Case Management The assessment of a person's long term care needs and the appropriate recommendations for care, monitoring and follow-up as to the extent and quality of services to be provided.


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