Any event or circumstance resulting to injury or damages to the insured. It is also a term included in an insurance policy describing possible scenarios where coverage can be triggered.

A package of benefits that can be claimed in the event of an accident clearly under the coverage of the insurance agreement.

The term generally refers to people’s daily self-care activities such as eating, toileting, dressing, bathing, transferring, and maintaining continence.

A person from the insurance company or an independent adjusting bureau who settles claims. An adjuster conducts the investigation of the claim and determines the maximum coverage for the insured.

A person who supports or promotes a cause or policy.

A request made to a higher level of authority for review of a decision

The timeframe in which one can file an appeal.

A term that describes an obvious unfair or unlawful conduct that exceeds mere negligence.

An individual designated to receive something, such as financial compensation or rehabilitation services, as a result of a legal claim or insurance policy.

Compensation or financial assistance for the loss of the insured provided by the insurer based on the terms of contract in an insurance policy.

The degree of proof needed in a proceeding for a claimant to prove a disputed claim.

A written statement outlining the argument of a case. This document often contains objective and legal arguments, as well as references to any laws or cases that are being relied on to support those arguments.

Compensation or financial assistance provided to caregivers (the insured) by their insurance company.

A statement of a legal right. (Ex. Insurance Claims state that you are entitled to a certain support due to injury)

When a statement of a legal right is denied by the designated governing body. (Ex. An Insurance company denies an insurance claim filed by someone who has been in a car accident, and needs financial and medical support post-injury resulting from the accident)

Money claimed by or ordered to be paid to a person as reimbursement for loss or injury

Financial compensation given meant to make amends to the loss or damages sustained.

An agreement or permission granted, voluntarily, by a competent individual, either orally or in writing.

The act of deliberating and discussing matters in order to reach a decision.

Fees payable to a lawyer only if a case is successful. The contingency fee is proposed before the case is pursued, and usually equals to a percentage of what a client recovers.

An oral or written agreement between parties in which there is a mutual promise to each other. (Ex. Your Insurance Company has a contract with you, and outlines what each party will do in the event of filing a claim)

A term that refers to a company as a whole other person or entity.

A set of conditions laid out in an insurance contract to serve as protection to the insured.

Refers to the denial of a Canada Pension Plan claim.

Money claimed by, or ordered to be paid to, a person as compensation for loss or injuries

Financial assistance payable by the insurance company in the event of the death of an insurance policy holder.

An amount deducted from a loss before the insurer pays up the insured his total proceeds.

The event in which a submitted claim has been denied or rejected by the insurer.

A pretrial interview with a witness under oath for the purpose of obtaining evidence related to a lawsuit without the presence of a judge or jury.

A condition that renders a person unable to move or perform his daily living activities normally.

A request for compensation or financial assistance in the event the insured has a disability or impairment.

A disagreement in terms of claim entitlement or coverage due to certain conditions of the disabled insured.

A condition in which the damage has rendered the original object unrecognizable due to extensive damage.

Someone being forced to do something through physical, psychological or emotional pressure (Ex. This can involve pressuring an insurance holder to use their own finances and not their entitled insurance benefits to receive proper care/treatment)

Damages incurred due to unforeseen economic changes.

A person who has a developed skill set and knowledge base on a certain subject and is therefore accepted by the court as being able to form opinions on evidence presented during the case, as well as to assist the judge. An expert may also aid in supporting an insurance claim, such as a Doctor, OT, PT, Social Worker, etc.

Damages for non-financial losses suffered by a claimant. Examples of such include pain, suffering, and disfigurement.

Expenses incurred for paying hospitalization, medical bills, and caregiver aid.

The loss of mental or physical functions, temporary or permanent, due to illness or injury.

Affirmation to be requested by a medical professional from the patient before performing any kind of medical procedure or treatment.

An individual who has incurred physical or mental damage due to an accident.

An agreement between an insurance company and an individual or entity written on paper describing the duty of the company to reimburse the individual for loss or damages with the condition that the individual has provided considerable amount in the form of premiums.

An entitlement to an insured for loss or damage described in the insurance policy.

An assessment conducted to determine the soundness of a claim.

The official power or legal authority to make legal decisions and judgements.

Compensation given to a lawyer for legal services.

The legal responsibility or a financial obligation

The time limit for filing an insurance claim, appeal etc. Limitation period also is a legal term referring to the required timeframe for commencing or filing a legal proceeding.

A Canadian law that governs and explains the allowable limitations imposed on an insurance agreement between the insurance company and the individual or entity.

A condition determined under specific conditions within a policy to be long-term or lifetime. Most policies consider all diseases or conditions that are determined to result in death long-term.

An assistance entitlement to an insured who has lost its ability to care for his/her self.

Any medical or physical assistance required by a person with disability or illness who does not have the capacity to car for his/her self.

Loss of salary due to the insured being unable to work because of a disability or illness.

A person with knowledge or information of a subject matter that has a significant effect to the outcome of a trial.

A negotiation or meeting between two parties to come up with an agreement and resolve the outstanding disputes.

Financial assistance given to the insured for use on medical expenses.

A broad term referring to a condition wherein an individual is considered incapable of understanding or thinking within the lines of a normal or sane person.

A condition in which a person loses the capacity to understand relevant information.

The failure to take reasonable care and responsibility to prevent foreseeable harm to others.

This is a type of insurance in which the insured is reimbursed by the insurer regardless of who caused the fault that resulted to the losses. It is similar to a first-party coverage but is a widely used term in Canada, United States and Australia to refer to automobile insurance wherein the insured and its passengers can be reimbursed without proof of fault.

Skilled workers that treat injured, disabled or ill patients through therapeutic methods.

Additional benefits an insured can add or remove from his policy to increase or decrease his premiums.

An agreement or solution to a dispute without the intervention of the court or a jury. Most agreements are settled by giving an agreed sum of money to the plaintiff so he/she can sign a legal document waiving the rights to pursue the case.

A general term referring to emotional and physical discomfort, or other non-quantifiable illnesses that a claimant can use to collect compensation from the negligent party.

Any individual referred to as the defendant, plaintiff, cross-complainant, or cross-defendant in lawsuits.

Refers to any physical or emotional illness that renders the insured incapable of normal daily function.

Trained and highly educated health care professionals who provide assistance to patients with disabilities for the purpose of lessening the pain and restoring mobile functions.

Trained individuals that help people with disability and injury to practice motor and mental skills, as well as help in managing pain and mental stresses.

A person who brings a case, commences an action, against another in the court of law

The duration in which a policy is in effect or provides the insured cover.

An authority to act on behalf of another person in legal or financial matters. Also may refer to legal document that authorizes a person to make, on the grantor’s behalf, decisions concerning the grantor’s property and personal care. Allowance and boundaries of the Attorney’s power would be outlined and contained within the written document itself.

An assessment or examination conducted by the insurance company or adjuster before approving or releasing claims.

Written statements with a standard format that prove the credibility of an insured’s claim.

Medical doctors that evaluate a patient’s condition to determine whether it is caused by physical, mental, or a combination of both and not psychiatric.

A professional who evaluates the mental condition and capacity of an individual.

Damages awarded to punish a defendant for their “purposely harsh, vindictive, or malicious behavior”. This amount often exceeds simple compensation.

The general well-being of an individual.

A term used to refer to care needs an insured may require that are in line with the limitations outlined in the insurance policy.

Also referred to as claim recovery. It is commonly called as subrogation and is a legal term referring to a situation wherein the insurer assumes the insured’s right to pursue a claim against a wrongdoer.

A compensation given to insured workers that have been injured in a work-related accident.

Also known as judicial relief is the means in which a court imposes its will in the form of penalty, court order or right enforcement.

An individual acting as legal substitute with the full knowledge of the insured.

An agreed amount by both parties paid to the plaintiff to settle a dispute.

A condition in which the insured cannot perform his duties due to disability or illness for a specified period of time.

Compensation given to an insured who cannot perform his duties due to illness or injury and is therefore deemed incapable of earning income for daily life.

A skilled or trained individual that provides assistance to individuals and families to enhance their general well-being.

Damages intended to compensate a plaintiff for aggregated monetary loss. Examples of such include: lost earnings, medical bills, and repair costs.

A written legal notice presented to an individual from someone whom he has a disagreement with. These notices are usually written by a lawyer to present whatever claim the complainant has against the individual.

Compensation provided to accident victims as mandated by the laws of the state or the country.

A person is held liable owing to the fact that an act has occurred. Proof of intent or negligence is required to seek strict liability compensation.

A legal document that compels a person to attend proceedings as a witness in a legal case, in order to give a testimony. Evidence may also be subpoenaed, submitted to a court of law, to help back up a claim made in court.

A legal notice issued to the plaintiff and defendant to commence a civil action or legal proceeding for the purpose of acquiring jurisdiction over a party.

A private or civil wrong doing resulting to legal liability.

A documentation tool detailing the steps provided to a patient for well-rounded health care.

A person with coverage or protection.

The duty or responsibility of the principal resulting from the actions of its subordinates.

Specific lengths of time that must pass before some or all of one’s health care benefits can begin.

An individual with first-hand knowledge or a crime or incident related to an investigation or lawsuit.

A state of mental and physical disturbance resulting from the loss of control of an individual in meeting the demands of his workplace.

A term referring to a situation wherein the death is caused by negligence or intentional harm.