Adjuster – a person who investigates claims and recommends settlement options based on estimates of damage and insurance policies held.
Admission – hospital inpatient care for any medical condition.
Admitted Assets – insurer assets which can be valued and included on the balance sheet to determine financial viability of the company.
Admitted Company – an insurance company licensed to do business in a state(s), domiciled in an alternative state or country.
Advance Premiums – occur when a policy has been processed, and the premium has been paid prior to the effective date. These are a liability to the company and not included in written premium or the unearned premium reserve.
Adverse Selection – the social phenomenon whereby persons with a higher than average probability of loss seek greater insurance coverage than those with less risk.
Advisory Organization – a group supported by member companies whose function is to gather loss statistics and publish trended loss costs.
Affiliate – a person or entity that directly, or indirectly, through one or more other persons or entities, controls, is controlled by or is under common control with the insurer.
Agent – an individual who sells, services, or negotiates insurance policies either on behalf of a company or independently.
Aggregate – the maximum dollar amount or total amount of coverage payable for a single loss, or multiple losses, during a policy period, or on a single project.
Aggregate Cost Payments – method of reimbursement of a health plan with a corporate entity that directly provides care, where the health plan is contractually required to pay the total operating costs of the corporate entity, less any income to the entity from other users of services, and there are mutual unlimited guarantees of solvency between the entity and the health plan that put their respective capital and surplus at risk in guaranteeing each other.