MEDICAL,USA: 1. Maximum amount of insurance benefits payable under an insurance or managed care contract. 2. Restriction or denial of insurance coverage to certain age groups.
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expressed either on a per occurrence basis (e.g., per accident or event) or on an aggregate basis (e.g., all losses under a single policy, or for all policies during an underwriting period).
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Maximum amount a policy will pay either overall or under a particular coverage.
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Maximum amount for which an Insurer may be liable for any loss, as set forth in the Policy.
Insurance Encyclopedia
Limit of indemnity
Another term for policy limit. It refers to the maximum amount payable under a policy of insurance or reinsurance, either overall or with reference to a particular section of a policy.
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The maximum sum payable under a contract of indemnity. It may be expressed as “per accident”, “per event”, “per occurrence,” or “per annum.”
Limit of indemnity/liability
The maximum sum an insured may collect, or for which an insured is protected, under the policy. It is a ‘sum insured’ under property insurances but a ‘limit of indemnity’ under liability policies. The liability limit may be: per policy, per event, per occurrence, per year, per ‘originating cause’ or, by way of sub-limit, per specified type of loss. See COSTS INCLUSIVE INDEMNITY; COMBINED SINGLE LIMIT.
Limit of liability (Liability Insurance)
The maximum benefit for which the insurer is liable, as established in the contract.
Limit of liability rule (Property Insurance)
A method of apportioning a loss among several insurers that all cover the same property.
Limit reinstatement
Refers to the reinstatement of the limit of liability under an insurance policy that is in effect for two or more years and that contains a single aggregate limit of liability for the entire policy period. Under this provision, insureds may purchase during the policy period an additional limit of liability for future claims, thus allowing additional protection for insureds who believe that prior claims during the policy period may erode the original limit of liability to an unacceptable level. A limit reinstatement provision grants to the insureds the absolute right to purchase the additional limit of liability (upon payment of a specified additional premium), and the insurer has no underwriting discretion at the time the option is exercised by the insureds. If the insureds maintain several layers of insurance coverage within their insurance program, the limit reinstatement provision frequently provides that the additional or reinstated limit of liability affords coverage excess of all other coverage in force at the time the reinstatement option is elected. This type of excess limit reinstatement provision is commonly referred to as an around the clock provision.
Limitation Act 1980
Specifies the maximum periods from the accrual of the cause of action for which claims will be heard before becoming statutebarred. The main periods are: six years for simple contracts and claims for personal property; 12 years for contracts by deed or concerning real property and land; and three years for personal injury (but the court can extend this period (s.11)). If the claimant is unable to take action at the time of accrual because of a disability (e.g. mental incapacity), the time runs from when the disability ends. By s.11 the time runs from the cause of action or when the claimant first had significant knowledge of his right of claim and the identity of the defendant. The Latent Damages Act 1986 deals with latent damage cases.
Limitation for Negligence (Degrees and Defenses available to the Defendant)
An action can be time- barred under the provisions of the Statute of Limitation.
Limitation of liability
1. Statement in an insurance contract that the maximum amount an insurance company agrees to pay in case of loss. 2. In the Medicare program, agreement given to the patient to read and sign before rendering a service if the participating physician thinks that it may be denied for payment because of medical necessity or legal responsibility. The patient agrees to pay for the service; also known as Advance Beneficiary Notice (ABN), waiver of liability, or responsibility statement .
Limitations
Exceptions or reductions to the general coverage.
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Limits and exceptions to the coverage provided in the contract, for example, the limit of liability stated in the contract.
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MEDICAL,USA: Situations or conditions under which the insurance company will not pay or will limit payments. Such exclusions are found in a document called certificate of insurance . If it is a group policy, the employer receives a detailed contract and each employee receives a booklet summarizing and explaining the insurance plan.