Glossary

Accidental death results directly and solely from (1) an accidental injury visible on the body or disclosed by an autopsy; (2) a disease or infection resulting directly from an accidental injury as described, beginning within 30 days after the date of the injury; or (3) an accidental drowning.

Accidental death and dismemberment (AD&D) is a type of coverage often written in conjunction with group life insurance plans. It essentially provides for (1) "double indemnity" when death is caused by an accident and (2) defined dismemberment benefits. It will generally pay the full principal sum when death occurs or more than one member (e.g., hand, eye, or foot) is lost in an accident. One-half of the principal sum is generally paid when one member is lost.

The accidental death benefit (ADB) is a supplementary life insurance policy provision that pays an additional death benefit if the insured is killed in an accident. Usually, an additional premium is charged for this provision to be added to the policy.

Accidental death insurance refers to a life insurance policy that pays its benefit when the insured dies in an accident. Most commonly, this coverage is combined with dismemberment insurance and offered as accidental death and dismemberment (AD&D) insurance.

Accidental means is a condition precedent to recovery under some insurance policies requiring that the covered loss be the result of an accident rather than merely the accidental result of a nonaccidental event.

Accident and health insurance refers to a class or type of insurance that pays benefits for losses caused by disease, accidental injury, accidental death, and related health expenses.

Accident year data refers to a method of arranging loss and exposure data of an insurer or group of insurers or within a book of business, so that all losses associated with accidents occurring within a given calendar year and all premium earned during that same calendar year are compared. Thus, regardless of individual policy periods and regardless of when a loss is reported or is paid, accident year data 2025 will include all premiums earned during 2025 and will include all losses occurring in 2025. Rate-making organizations use both accident year data and policy year data in their analyses of rate adequacy. For example, workers compensation loss development factors (LDFs) promulgated by the National Council on Compensation Insurance (NCCI) are developed from accident year data.

The accident year experience or accident year is any 12-month period for which losses from incidents taking place during that 12-month period are tracked. Accident year experience is calculated by adding the total losses from any incidents occurring in that 12-month period. Two other cost accounting terms used in sorting loss experience are calendar year and policy (underwriting) year.

An accommodation line is a line of coverage an insurer accepts from an agent, broker, or the insured that would ordinarily be declined if considered strictly on the merits of the individual risk. The practice occurs only when the account is desirable to the underwriter.

An accountable care organization (ACO) is one created by the Patient Protection and Affordable Care Act (PPACA). ACOs offer financial incentives for healthcare providers to band together to better coordinate services for groups of patients and thereby improve the quality of care, all while lowering costs. Another focus of ACOs is to promote a reduction in hospital readmission rates for certain conditions, such as heart attack/heart failure and pneumonia. ACOs can include primary care physicians, specialist physicians, hospitals, or other types of healthcare providers. Under the provisions of the PPACA that created ACOs, if an ACO achieves certain quality targets, the resulting savings are divided between the various providers who are part of the ACO.