What is an out-of-pocket maximum in private health insurance?

The out-of-pocket maximum is the highest amount you have to pay for covered services in a year. Once you reach this limit, the insurance company covers 100% of eligible expenses for the rest of the policy year. This includes deductibles, copays, and coinsurance.

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How does liability insurance protect businesses?

It shields businesses from financial risks by covering legal fees, court settlements, and damages arising from accidents, negligence, or product defects that harm third parties.

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Does ACV apply to all types of insurance policies?

ACV is commonly used in property insurance policies, especially for personal property or vehicles. However, policies may vary, and some use replacement cost instead.

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What is stop-loss reinsurance?

Stop-loss reinsurance is a type of non-proportional reinsurance where the reinsurer covers losses exceeding a pre-set limit. It helps insurers manage unpredictable claims by setting a cap on total losses within a specified period.

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What is marine cargo insurance?

Marine cargo insurance is a policy that covers goods in transit against risks like damage, loss, or theft during shipment via sea, air, or land transport.

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What is the deductible for earthquake insurance?

Earthquake insurance typically has a high deductible, often ranging from 10% to 25% of the home's insured value. This means if your home is insured for $300,000 and you have a 15% deductible, you would need to cover the first $45,000 in damages before insurance pays out.

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Are there any exclusions to what I can be reimbursed for?

Yes, insurance policies often have exclusions, such as reimbursement for damages caused by certain activities, unapproved medical procedures, or non-covered services. It’s important to read the policy to understand what is and isn’t covered.

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Is Claim Settlement Ratio the same as Claim Rejection Ratio?

No, Claim Rejection Ratio is the percentage of claims denied, whereas CSR represents the percentage of claims approved out of total claims received.

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