In this chapter, the following terms have the meanings indicated. Terms Defined. “Adverse appeal determination” means a decision made by an insurer on an appeal of an adverse benefit determination to uphold: A denial, reduction, or termination of a disability benefit; A failure to provide or make payment, in whole or in part, for a disability benefit; or Any denial, reduction, termination, or failure to provide or make payment that is based on a determination of a covered individual's eligibility for coverage of a disability benefit. “Adverse benefit determination” means a determination arising from a claim for disability benefits which results in: A denial, reduction, or termination of a disability benefit; A failure to provide or make payment, in whole or in part, for a disability benefit; or Any denial, reduction, termination, or failure to provide or make payment that is based on a determination of a covered individual's eligibility for coverage of a disability benefit. “Authorized representative” means a person, including a health care provider, authorized by the covered individual to act on behalf of the covered individual. “Covered individual” means an individual covered under an insurance policy that provides a disability benefit. Disability benefit. “Disability benefit” means a benefit that is payable based on the disability of a covered individual. “Disability benefit” does not include: Benefits under a long-term care insurance policy; A benefit that is payable based solely on a dismemberment of a covered individual; Benefits in a life insurance policy that operate to safeguard the contract from lapse or to provide a special surrender value, special benefit, or annuity in the event of total and permanent disability; or Benefits in a health insurance policy that operate to safeguard the contract from lapse due to disability.