Insurance claim glossary
Plain-English definitions for common claim words. Definitions are general; policy wording controls specific meaning.
ACV
Actual Cash Value; often replacement cost minus depreciation.
RCV
Replacement Cost Value; repair/replacement cost under policy terms, sometimes paid in stages.
Adjudication
Health claim review process that applies plan rules to submitted billing information.
Allowed amount
Amount a health plan uses for claim processing under plan/network rules.
Deductible
Amount assigned to the policyholder before or as part of payment.
Exclusion
Policy language that removes or limits coverage for a category.
First notice of loss
Initial claim report that opens the claim file.
Mitigation
Reasonable steps to prevent additional damage after a loss.
Proof of loss
Formal claim statement requested under some policies.
Subrogation
Recovery process where an insurer may seek repayment from another responsible party.
Supplement
Review of additional repair scope or cost after an initial estimate.
Total loss
When repair is impractical or uneconomical under policy/valuation rules.