Mail Order Insurer: Type of insurance company that
sells policies through the mail or other mass media, eliminating
need for agents.
Major Medical Insurance: Health insurance to finance
the expense of major illness and injury. Characterized by
large benefit maximums ranging up to $250,000 or no limit,
the insurance, above an initial deductible, reimburses the
major part of all charges for hospital, doctor, private nurses,
medical appliances, prescribed out-of-hospital treatment,
drugs, and medicines. The insured person as coinsurer pays
the remainder.
Malingering: The practice of feigning illness or inability
to work in order to collect insurance benefits.
Malpractice: Improper care or treatment by a physician,
hospital, or other provider of health care.
Malpractice Insurance: Coverage for a professional
practitioner, such as a doctor or a lawyer, against liability
claims resulting from alleged malpractice in the performance
of professional services.
Managed Care: Health care systems that integrate the
financing and delivery of appropriate health care services
to covered individuals by arrangements with selected providers
to furnish a comprehensive set of health care services, explicit
standards for selection of health care providers, formal programs
for ongoing quality assurance and utilization review, and
significant financial incentives for members to use providers
and procedures associated with the plan.
Manual Rate: The premium rate developed for a group
insurance coverage from the company's standard rate tables
normally referred to as its rate manual or underwriting manual.
Manuscript Policy: Policy designed for a firm's specific
needs and requirements.
Marine Insurance: A form of insurance primarily concerned
with means of transportation and communication, and with goods
in transit (see "Inland Marine Insurance" and "Ocean Marine
Insurance").
Marital deduction: A reduction of an estate for estate
tax purposes, which is available if the decedent is survived
by his or her spouse, can be as large as the administrator
or executor elects so long as it does not exceed the value
of qualifying property passing to the surviving spouse.
Market Price (or Market Value): The price at which
a security can be bought or sold at any particular time.
Mass Merchandising: Plan for insuring individual members
of a group, such as employees of firms or members of labor
unions, under a single program of insurance at reduced premiums.
Property and liability insurance is sold to individual members
using group insurance marketing methods.
Master Policy: A policy that is issued to an employer
or trustee, establishing a group insurance plan for designated
members of an eligible group.
Master Policy (or Master Contract): The policy issued
to a group policyholder setting forth the provisions of the
group insurance plan. The individuals insure under the policy
are then issued certificates of insurance.
Material Damage: Insurance against damage to a vehicle
itself. It includes automobile comprehensive, collision, fire
and theft.
Material damage and physical damage are terms that often are
used inter- changeably.
Maximum family benefit: The largest amount in Social
Security benefits that will be paid to any family unit.
McCarran-Ferguson Act: Federal law passed in 1945
stating that continued regulation of the insurance industry
by the states is in the public interest and that federal antitrust
laws apply to insurance only to the extent that the industry
is not regulated by state law.
Medicaid: State programs of public assistance to persons
whose income and resources are insufficient to pay for health
care. Title XIX of the federal Social Security Act provides
matching federal funds for financing state Medicaid programs,
effective January 1, 1966.
Medical Examination: The examination given by a qualified
physician to determine to the insurability of an applicant.
A medical examination may also be used to determine whether
an insured claiming disability is actually disabled.
Medical malpractice: Improper care or treatment by
a physician, hospital, or other provider of health care.
Medical Payments Insurance: A coverage, available
in various liability insurance policies, in which their insurer
agrees to reimburse the insured and others, without regard
for the insured's liability, for medical or funeral expenses
incurred as the result of bodily injury or death by accident
under specified conditions.
Medicare: A program of Hospital Insurance (Part A)
and Supplementary Medical Insurance (Part B) protection provided
under the Social Security Act.
Medigap: A term sometimes applied to private insurance
products that supplement Medicare insurance benefits.
Minimum Group: The least number of employees permitted
under a state law to effect a group for insurance purposes;
the purpose is to maintain some sort of proper division between
individual policy insurance and the group forms.
Minimum Premium Plan (MPP): An arrangement under which
an insurance carrier will, for a fee, handle the administration
of claims and insure against large claims for a self- insured
group.
Miscellaneous Expenses: Expenses in connection with
hospital insurance, hospital charges other than room and board,
such as X-rays, drugs, laboratory fees, and other ancillary
charges. (Sometimes referred to as ancillary charges.)
Misrepresentation: A false, incorrect, improper, or
incomplete statement of a material fact, made in the application
for a policy.
Mode of Premium Payment: The frequency with which
premiums are paid monthly, quarterly, semiannually, or annually.
Moral Hazard: Hazard arising from any nonphysical,
personal characteristic of a risk that increases the possibility
of loss or may intensify the severity of loss for instance,
bad habits, low integrity, poor financial standing.
Morbidity: The incidence and severity of sicknesses
and accidents in a well-defined class or classes or persons.
Morbidity Tables: Actuarial statistics showing the
frequency and duration of disability.
Mortality Table: A table showing how many members
of a group, starting at a certain age, will be alive at each
succeeding age. It is used to calculate the probability of
dying in, or surviving through, any period, and for the valuation
of an annuity. To be appropriate for a specific group, it
should be based on the experience of individuals having common
characteristics, such as sex or occupation.
Mortality Table: A statistical table showing the death
rate at each age, usually expressed as so many per thousand.
Multi-Employer Plan: A plan maintained according to
a collective bargaining agreement, to which more than one
employer contributes. Under ERISA, at the beginning of the
plan, no single employer may contribute as much as 50% of
the total, and thereafter as much as 75%. An employee may
change employers within the group without losing retirement
benefits unless a break in service (under the plan) cancels
credits earned before the break.
Multi-Peril Policy: A package policy which provides
protection against a number of separate perils. Multi-peril
policies are not necessarily multiple line policies, since
the combined perils may be all within one insurance line.
Multiple Employer Trust (MET): A legal trust established
by a plan sponsor that brings together a number of small,
unrelated employers for the purpose of providing group medical
coverage on an insured or self-funded basis.
Mutual Insurance Company: An insurance company in
which the ownership and control is vested in the policyholders
and a portion of surplus earnings may return to policyholders
in the form of dividends. No capital stock exists.
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