Maximum Benefit
The largest total amount the policy will pay, expressed as a lifetime maximum, per-cause maximum, or daily maximum, defining the ceiling of the insurer's obligation.
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Practice This Concept
A health insurance policy is cancelled for nonpayment of premium while the insured is receiving treatment for a covered illness that began while the policy was in force. Under a typical extension-of-benefits provision, what happens?
Benefits for the covered illness continue for a limited period after the policy terminates, usually up to a stated maximum — The extension-of-benefits (extended benefits) provision protects an insured who becomes ill or injured while the policy is in force and is still receiving treatment when the policy terminates. It continues payment for that condition for a limited period after termination — typically a specified number of days or up to a maximum benefit — even though the policy itself is no longer active. The purpose is to avoid cutting off care mid-treatment for a covered condition that arose during the policy period. This is a standard contract provision tested under individual health policy terms (AH-III.A.1d).
National insurance concept
A disability income rider added to a life insurance policy:
Pays the insured a monthly income if the insured becomes totally disabled, separate from the life death benefit — A disability income rider provides monthly income to the insured if total disability occurs, in addition to the base life insurance protection. It typically begins after a waiting period and pays for a defined period. This rider differs from a waiver of premium rider, which only forgives the premium during disability. The disability income rider supplies replacement income, addressing the loss of earnings that total disability causes, and is commonly added to individual life policies for income protection during working years.
National insurance concept
- Medical ExpenseA health insurance policy is cancelled for nonpayment of premium while the insured is r…
- Life InsuranceA disability income rider added to a life insurance policy:
- Accident & Health ConceptsCredit disability insurance is designed primarily to:
- Disability IncomeCredit disability insurance is designed to:
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