Exclusions, Medical Benefits
Definition of "Exclusions, medical benefits"
Limiting provision. Exclusions listed in group health plans include: benefits under Workers Compensation; certain dental procedures; convalescent or rest cures; medical expenses resulting from the insured person and/or covered dependents committing a felony or misdemeanor; cosmetic surgery, unless required immediately because of non-occupational disease, illness, accident, injury, or congenital anomaly in an insured newborn infant; expenses incurred by a member of a health maintenance organization (HMO) or other prepaid medical plan; expenses associated with intentional self-inflicted injuries or attempt at suicide; unreasonable charges for services or supplies; convenience items such as telephone and television.
Popular Insurance Terms
LIFE INSURANCE: specification by each state regarding the minimum assumptions that must be used in reserve calculations as theypertain to the maximum interest rate that can be assumed; ...
Situation in which parties agree to take part in a structured settlement negotiation through the guidance of a neutral expert. By participating in this process, the parties do not agree ...
Same as term Final insurance: premiums paid out of funds borrowed from the cash value of a life insurance policy. ...
Same as term Coinsurance: ...
Statement in which a life insurance applicant is charged a higher-than-standard premium to reflect a unique impairment, occupation, or hobby, such as a history of heart disease or a circus ...
Evidence of a temporary contract obliging a life or health insurance company to provide coverage as long as a premium accompanies an acceptable application. This gives the company time to ...
Termination of coverage in insurance. ...
Model state law that stipulates minimum benefits that must be contained in the policy provisions, restrictions on policy illustrations, minimum reserve requirements, and minimum ...
Falsification of birth date by an applicant for a life or health insurance policy. If the company discovers that the wrong age was given, the coverage will be adjusted to reflect the ...
Have a question or comment?
We're here to help.