benefit trigger


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benefit trigger

A term used in health insurance policies which describe when and how payments for benefits begin.

benefit trigger

, trigger
A set of conditions or self-care deficits used by a health insurer as criteria for the initiation of insurance payouts. In the care of elderly patients, benefits for certain residential services may be linked to the documentation of new deficits in self-care, e.g., the inability to perform two or more activities of daily living.
References in periodicals archive ?
criteria for benefit triggers. (147) Elimination periods, also referred
LTC insurance policy benefits are limited by benefit triggers,
Current use of benefit triggers, elimination periods, and benefit
An initial claim and periodic claim update requests should be coordinated with an applicant's broker, possibly with a geriatric caregiver, and reviewed with a primary or specialist doctor who understands the policy's benefit triggers and may reasonably support any claim paid.
* Coverage at home; nursing home; state-licensed assisted living facility (if insured meets benefit triggers); respite care; nursing home; alternative care
This clause is especially helpful to the insured because it allows access to benefits based on certification by the insured's doctor that LTC assistance is medically necessary, even if the other benefit triggers have not been activated.
Most policies have two benefit triggers: proof of the inability to perform a certain number of activities of daily living, or proof the insured is cognitively impaired.
The benefit triggers are the same as LTCi -- 2 of 6 activities of daily living (ADL's) or severe cognitive impairment.
Assuming the annuity designers working behind the scenes create policies that make it easy for the insured to access benefits in a multitude of settings with realistic benefit triggers, then insurance agents will have yet another tool that provides multiple solutions for their clients.
The rider provides a lump-sum benefit triggered by some serious contractually defined illnesses, including strokes, cancer and heart attacks.
Chart 2 shows the most common benefit triggers. What of marketing?
Earlier in that decade, companies greatly expanded coverage (e.g., providing meaningful home care and other alternatives to institutional care) and redesigned products based on objective benefit triggers. As a result, these improved products helped the industry increase consumer confidence, market appeal and subsequently sales.