Co-insurance

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In insurance, co-insurance or coinsurance is the splitting or spreading of risk among multiple parties.

Contents

In the United States

In the U.S. insurance market, co-insurance is the joint assumption of risk between the insurer and the insured. In title insurance, it also means the sharing of risks between two or more title insurance companies.

In health insurance

In health insurance, copayment is fixed while co-insurance is the percentage that the insured pays after the insurance policy's deductible is exceeded, up to the policy's stop loss. [1] It can be expressed as a pair of percentages with the insurer's portion stated first, [2] or just a single percentage showing what the insured pays. [3] Once the insured's out-of-pocket expenses equal the stop loss, the insurer will assume responsibility for 100% of any additional costs. 70–30, 80–20, and 90–10 insurer-insured co-insurance schemes are common, with stop loss limits of $1,000 to $3,000 after which the insurer covers all expenses. [4]

In property insurance

Co-insurance is a penalty imposed on the insured by the insurance carrier for underinsuring the value of the tangible property. The penalty is based on a percentage stated within the policy and the amount underreported. [5]

In title insurance

Owner's title insurance policy forms of the American Land Title Association created between 1987 and late 2006, contain co-insurance clauses. For partial losses, they require the insured carry a percentage of the risk of loss in two circumstances. The first is if the insured did not insure its title for at least 80% of its market value at the time the policy was issued. In that case, the insurer will pay only 80% of the loss. The second is if improvements constructed on the property after the policy is issued increase the property's value by at least 20% above the amount of the policy. In that case, the insurer will pay a percentage of the claim equal to the ratio of 120% of the amount of insurance purchased divided by the sum of the amount of insurance and the cost of the improvements. [6]

Co-insurance is also used among U.S. domestic title insurers in a manner similar to that described below for the international insurance market.

In other insurance

In some cases, including employer's liability insurance, co-insurance percent denotes a function analogous to the copay function that it has in health insurance, in which the insured covers a certain percentage of the losses up to a certain level. [7]

In business income interruption insurance, a type of time-element insurance, [8] the co-insurance percent indicates how long the coverage will last, and can range from 50% to 125%. The former co-insurance allows for 6 months of coverage, compared to 15 months for 125%. [9]

See also

Related Research Articles

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<span class="mw-page-title-main">Reinsurance</span> Insurance purchased by an insurance company

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Stop-loss insurance is insurance that protects insurers against large claims. Stop-loss policies take effect after a certain threshold has been exceeded in claims.

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Accident insurance is a type of insurance where the policy holder is paid directly in the event of an accident resulting in injury of the insured. The insured can spend the benefit payment however they choose. Accident insurance is complementary to, not a replacement for, health insurance.

Vehicle insurance in the United States is designed to cover the risk of financial liability or the loss of a motor vehicle that the owner may face if their vehicle is involved in a collision that results in property or physical damage. Most states require a motor vehicle owner to carry some minimum level of liability insurance. States that do not require the vehicle owner to carry car insurance include Virginia, where an uninsured motor vehicle fee may be paid to the state, New Hampshire, and Mississippi, which offers vehicle owners the option to post cash bonds. The privileges and immunities clause of Article IV of the U.S. Constitution protects the rights of citizens in each respective state when traveling to another. A motor vehicle owner typically pays insurers a monthly fee, often called an insurance premium. The insurance premium a motor vehicle owner pays is usually determined by a variety of factors including the type of covered vehicle, marital status, credit score, whether the driver rents or owns a home, the age and gender of any covered drivers, their driving history, and the location where the vehicle is primarily driven and stored. Most insurance companies will increase insurance premium rates based on these factors, and less frequently, offer discounts.

References

  1. "2006 Medical Plan Frequently Asked Questions". UPS.edu. University of Puget Sound. What is the difference between co-payments, coinsurance, and deductibles? (entry). Retrieved 2020-01-29.
  2. "Health Plan Explained".
  3. glossary. coinsurance
  4. What Is Coinsurance? Archived 2009-02-27 at the Wayback Machine . Insurancelane.
  5. "What Are Coinsurance Clauses and Do Courts Enforce Them? | Property Insurance Coverage Law Blog | Merlin Law Group". Property Insurance Coverage Law Blog. 2011-09-29. Retrieved 2020-08-31.
  6. See, for example, Conditions and Stipulations No. 7(b) of the 1992 ALTA Owner's Policy.
  7. StudentCover. What is Coinsurance? Know more about Copayment/Copay.
  8. Miller M, Garko M. (2008). Time Element Coverage.
  9. Taking time out for time-element insurance. American Agent & Broker.