insurance.wa.gov

Website:https://www.insurance.wa.gov/
Upvotes received3
Downvotes received2
Karma:0 (upvotes-downvotes)



0 earned Badges

No badges were found



Definitions (234)

1

2   1

policy owner


The person who may exercise the rights and privileges in the insurance policy. This person may or may not be the insured.
Source: insurance.wa.gov

2

1   1

risk sharing


A financial arrangement between a managed-care organization and a contracted health care provider to allocate the risk and rewards of providing health care services. Risk sharing motivates the provider to operate more efficiently.
Source: insurance.wa.gov

3

0   0

actual cash value


The cost to replace damaged or lost property with comparable or like property, minus depreciation.
Source: insurance.wa.gov

4

0   0

actuary


An insurance professional who analyzes and calculates rates and reserves. Evaluates and manages statistical information.
Source: insurance.wa.gov

5

0   0

actuarial


Statistical calculations insurance companies use to decide insurance rates and premiums based on usage projections and costs for a defined risk in a specific insurance market.
Source: insurance.wa.gov

6

0   0

adjuster


Someone who is paid by the insurance company or the insured person to investigate or negotiate insurance claims on their behalf.
Source: insurance.wa.gov

7

0   0

administrative costs


Costs associated with running an insurance business, such as utilization review, marketing, medical underwriting, commissions, premium collection, claims processing, insurer profit, quality assurance programs, and risk management.
Source: insurance.wa.gov

8

0   0

administrative services only


When a third-party administrator (see “Third-party administrator”) provides services such as processing and paying health benefit claims for an employer.
Source: insurance.wa.gov

9

0   0

admitted company


An insurance company the Office of the Insurance Commissioner authorizes and licenses to do business in Washington state.
Source: insurance.wa.gov

10

0   0

adverse benefit determination


This means that for some reason, the health plan has decided that it’s not going to pay a claim, or it’s not going to pay the dollar amount that the consumer wanted. The denial can be for many reasons. For example:
Source: insurance.wa.gov


To view all 234 definitions, please sign in.