Terms Used In Utah Code > Title 17 > Chapter 18a > Part 1 - General Provisions

• Accident and health insurance: means insurance to provide protection against economic losses resulting from:
            (1)(a)(i) a medical condition including:

                 (1)(a)(i)(A) a medical care expense; or

                 (1)(a)(i)(B) the risk of disability;
            (1)(a)(ii) accident; or
            (1)(a)(iii) sickness. See Utah Code 31A-1-301
• Administrator: means the same as that term is defined in Subsection (187). See Utah Code 31A-1-301
• Administrator: includes "executor" when the subject matter justifies the use. See Utah Code 68-3-12.5
• Adult: means an individual who is 18 years old or older. See Utah Code 31A-1-301
• Affected area: means :
       (1)(a) the area that is designated in statute, county ordinance, or municipal ordinance as the area for which public notice must be provided;
       (1)(b) in relation to a statute, if no affected area is designated in the statute, the affected area is the state;
       (1)(c) in relation to a county ordinance, if no affected area is designated in the county ordinance, the affected area is the county; or
       (1)(d) in relation to a municipal ordinance, if no affected area is designated in the municipal ordinance, the affected area is the municipality. See Utah Code 63G-30-101
• Affiliate: means a person who controls, is controlled by, or is under common control with, another person. See Utah Code 31A-1-301
• Agency: means :
       (6)(a) a person other than an individual, including a sole proprietorship by which an individual does business under an assumed name; and
       (6)(b) an insurance organization licensed or required to be licensed under Section 31A-23a-301, 31A-25-207, or 31A-26-209. See Utah Code 31A-1-301
• Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
• Annuity: means an agreement to make periodical payments for a period certain or over the lifetime of one or more individuals if the making or continuance of all or some of the series of the payments, or the amount of the payment, is dependent upon the continuance of human life. See Utah Code 31A-1-301
• Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
• Application: means a document:
       (10)(a)

            (10)(a)(i) completed by an applicant to provide information about the risk to be insured; and

            (10)(a)(ii) that contains information that is used by the insurer to evaluate risk and decide whether to:

                 (10)(a)(ii)(A) insure the risk under:

                      (10)(a)(ii)(A)(I) the coverage as originally offered; or

                      (10)(a)(ii)(A)(II) a modification of the coverage as originally offered; or

                 (10)(a)(ii)(B) decline to insure the risk; or
       (10)(b) used by the insurer to gather information from the applicant before issuance of an annuity contract. See Utah Code 31A-1-301
• Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. ^{Source: OCC}
• Body of water: means any natural or man-made accumulation of water, regardless of whether the accumulation of water is static or subject to a force that causes a hydrological current. See Utah Code 63G-32-101
• Certificate: means evidence of insurance given to:
       (23)(a) an insured under a group insurance policy; or
       (23)(b) a third party. See Utah Code 31A-1-301
• City: includes , depending on population, a metro township as defined in Section 10-3c-102. See Utah Code 68-3-12.5
• Contract: A legal written agreement that becomes binding when signed.
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• Corporation: means an insurance corporation, except when referring to:
            (34)(a)(i) a corporation doing business:

                 (34)(a)(i)(A) as:

                      (34)(a)(i)(A)(I) an insurance producer;

                      (34)(a)(i)(A)(II) a surplus lines producer;

                      (34)(a)(i)(A)(III) a limited line producer;

                      (34)(a)(i)(A)(IV) a consultant;

                      (34)(a)(i)(A)(V) a managing general agent;

                      (34)(a)(i)(A)(VI) a reinsurance intermediary;

                      (34)(a)(i)(A)(VII) a third party administrator; or

                      (34)(a)(i)(A)(VIII) an adjuster; and

                 (34)(a)(i)(B) under:

                      (34)(a)(i)(B)(I) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries;

                      (34)(a)(i)(B)(II) Chapter 25, Third Party Administrators; or

                      (34)(a)(i)(B)(III) Chapter 26, Insurance Adjusters; or
            (34)(a)(ii) a noninsurer that is part of a holding company system under Chapter 16, Insurance Holding Companies. See Utah Code 31A-1-301
• Creditable coverage: includes coverage that is offered through a public health plan such as:
            (35)(b)(i) the Primary Care Network Program under a Medicaid primary care network demonstration waiver obtained subject to Section 26B-3-108;
            (35)(b)(ii) the Children's Health Insurance Program under Section 26B-3-904; or
            (35)(b)(iii) the Ryan White Program Comprehensive AIDS Resources Emergency Act, Pub. See Utah Code 31A-1-301
• Creditor: means a person, including an insured, having a claim, whether:
       (39)(a) matured;
       (39)(b) unmatured;
       (39)(c) liquidated;
       (39)(d) unliquidated;
       (39)(e) secured;
       (39)(f) unsecured;
       (39)(g) absolute;
       (39)(h) fixed; or
       (39)(i) contingent. See Utah Code 31A-1-301
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Department: means the Insurance Department. See Utah Code 31A-1-301
• Dependent: A person dependent for support upon another.
• Direct response insurance policy: means an insurance policy solicited and sold without the policyholder having direct contact with a natural person intermediary. See Utah Code 31A-1-301
• Direct response solicitation: means an offer for life or accident and health insurance coverage that allows the individual to apply for or enroll in the insurance coverage on the basis of the offer. See Utah Code 31A-1-301
• Director: means a member of the board of directors of a corporation. See Utah Code 31A-1-301
• Disability: means a physiological or psychological condition that partially or totally limits an individual's ability to:
       (51)(a) perform the duties of:

            (51)(a)(i) that individual's occupation; or

            (51)(a)(ii) an occupation for which the individual is reasonably suited by education, training, or experience; or
       (51)(b) perform two or more of the following basic activities of daily living:

            (51)(b)(i) eating;

            (51)(b)(ii) toileting;

            (51)(b)(iii) transferring;

            (51)(b)(iv) bathing; or

            (51)(b)(v) dressing. See Utah Code 31A-1-301
• Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
• Donor: The person who makes a gift.
• Eligible employee: includes :
            (55)(b)(i) an owner, sole proprietor, or partner who:

                 (55)(b)(i)(A) works on a full-time basis;

                 (55)(b)(i)(B) has a normal work week of 30 or more hours; and

                 (55)(b)(i)(C) employs at least one common employee; and
            (55)(b)(ii) an independent contractor if the individual is included under a health benefit plan of a small employer. See Utah Code 31A-1-301
• Emergency medical condition: means a medical condition that:
       (56)(a) manifests itself by acute symptoms, including severe pain; and
       (56)(b) would cause a prudent layperson possessing an average knowledge of medicine and health to reasonably expect the absence of immediate medical attention through a hospital emergency department to result in:

            (56)(b)(i) placing the layperson's health or the layperson's unborn child's health in serious jeopardy;

            (56)(b)(ii) serious impairment to bodily functions; or

            (56)(b)(iii) serious dysfunction of any bodily organ or part. See Utah Code 31A-1-301
• Employee: means :
       (57)(a) an individual employed by an employer; or
       (57)(b) an individual who meets the requirements of Subsection (55)(b). See Utah Code 31A-1-301
• Enrollee: includes an insured. See Utah Code 31A-1-301
• Equal: means , with respect to biological sex, of the same value. See Utah Code 68-3-12.5
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• Exclusion: means for the purposes of accident and health insurance that an insurer does not provide insurance coverage, for whatever reason, for one of the following:
       (67)(a) a specific physical condition;
       (67)(b) a specific medical procedure;
       (67)(c) a specific disease or disorder; or
       (67)(d) a specific prescription drug or class of prescription drugs. See Utah Code 31A-1-301
• Fiduciary: A trustee, executor, or administrator.
• Form: means one of the following prepared for general use:
            (74)(a)(i) a policy;
            (74)(a)(ii) a certificate;
            (74)(a)(iii) an application;
            (74)(a)(iv) an outline of coverage; or
            (74)(a)(v) an endorsement. See Utah Code 31A-1-301
• Fraud: Intentional deception resulting in injury to another.
• Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
• Government official: means an individual elected or appointed to a state office, county office, municipal office, school board, school district office, special district office, or special service district office. See Utah Code 63G-30-101
• Governmental entity: means :
       (2)(a) a court;
       (2)(b) the Legislature;
       (2)(c) the legislative body of a political subdivision; or
       (2)(d) another entity of the state or a political subdivision, if the entity has adjudicatory or rulemaking authority. See Utah Code 63G-32-101
• Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. ^{Source: Federal Reserve}
• Group health plan: means an employee welfare benefit plan to the extent that the plan provides medical care:
       (78)(a)

            (78)(a)(i) to an employee; or

            (78)(a)(ii) to a dependent of an employee; and
       (78)(b)

            (78)(b)(i) directly;

            (78)(b)(ii) through insurance reimbursement; or

            (78)(b)(iii) through another method. See Utah Code 31A-1-301
• Group insurance policy: means a policy covering a group of persons that is issued:
            (79)(a)(i) to a policyholder on behalf of the group; and
            (79)(a)(ii) for the benefit of a member of the group who is selected under a procedure defined in:

                 (79)(a)(ii)(A) the policy; or

                 (79)(a)(ii)(B) an agreement that is collateral to the policy. See Utah Code 31A-1-301
• Health benefit plan: means a policy, contract, certificate, or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care, including major medical expense coverage. See Utah Code 31A-1-301
• Health care: means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment:
       (83)(a) a professional service;
       (83)(b) a personal service;
       (83)(c) a facility;
       (83)(d) equipment;
       (83)(e) a device;
       (83)(f) supplies; or
       (83)(g) medicine. See Utah Code 31A-1-301
• Health care provider: means the same as that term is defined in Section 78B-3-403. See Utah Code 31A-1-301
• health insurance: means insurance providing:
            (84)(a)(i) a health care benefit; or
            (84)(a)(ii) payment of an incurred health care expense. See Utah Code 31A-1-301
• Health Insurance Portability and Accountability Act: means the Health Insurance Portability and Accountability Act of 1996, Pub. See Utah Code 31A-1-301
• Human being: means a member of the species classified as Homo sapiens;