See: disabled enrollee .
Insurance Encyclopedia
Disabled enrollee
Individual younger than age 65 who has been entitled to disability benefits under Title II of the Social Security Act or the Railroad Retirement system for at least 2 years and who is enrolled in the supplemental medical insurance (SMI) program.
Disabled life annuity
Series of payments, each of which is conditional on a person being alive and still disabled.
Disabled life reserve
Funds set aside for payment of currently recognized or future claims on lives of disabled insureds.
Disablement
Physical or mental condition preventing a person from undertaking ‘normal’ work duties or the ‘activities of daily life’. ‘Disablement’ or ‘disability’ is invariably defined in the policy. See DISABILITY 2.
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In the case of injuries different kinds leading to different effects on the person could exist. The net result in these cases will be that the person is not in a position to attend to his normal occupation.
Disablement benefit
The benefit payable under a personal accident or income protection insurance when the insured is either permanently or temporarily disabled. See PERMANENT DISABLEMENT; TEMPORARY DISABLEMENT.
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Benefits payable in respect of disablement sustained due to accident, sickness etc. whether temporary partial, temporary total, permanent partial and permanent total under workmen’s compensation, health and accident Insurance. These benefits are payable either as a fixed percentage of capital sum insured on weekly basis or a fixed sum as per the provisions of the relevant policies.
Disallowance
Provider’s fee that is above an insurance plan’s fee ceiling (maximum allowable) and which the insurance company does not recognize for payment. Also referred to as disallowed amount, nonallowed amount , or contractual disallowance .
Disallowed amount
See: disallowance .
Disallowed Claim Frequency
The claim frequency calculated using only the number of claims disallowed under an NCD scheme (as opposed to the claims that are allowed not to be counted as claims for the purpose of scheme).
Disappearance and Destruction Insurance (DDD) (3-D) for Dishonesty
An insurance Policy providing broad coverage, in various amounts selected by the insured, against employee dishonesty, disappearance or destruction of money and securities and depositors, ‘forgery’ together with a great number of additional optional crime coverage.