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Accident: One time event which is unintended, unforeseen and
unexpected. It is something that is definite in time and place.
Accidental Death and Dismemberment Insurance: A form of insurance
providing benefits in the accidental death, or the accidental loss of sight
or members (such as an arm or a leg).
Accidental Death Benefit: A lump sum payment for loss of life due to an
accident that was the direct cause of death. The cause of the mishap must
be accidental for a benefit to be payable under the policy.
Act
of God: An event beyond human origin or control. Lightning, windstorms,
and earthquakes are examples. The damage from which would not be the
responsibility of a bailee, although the bailee might be responsible for
many other calamities. Acts of God are excluded by the usual bill of
landing as well as by some insurance policies, unless specifically
included.
Actual Cash Value: The basis of loss settlement in property insurance
policies which takes into consideration such factors as replacement value
less depreciation, market value, rental value, the use of the building, the
area in which it is located, obsolescence, assessed validation and any
other factor which would have an effect upon the value. A working
rule-of-thumb definition, however, is "replacement cost new at the time of
loss, less depreciation." See Replacement Cost Value.
Actuary: A social mathematician who uses mathematical skills to define,
analyze and solve complex business and social problems involving insurance
and employee benefit programs.
Additional Living Expense Insurance: Insurance for the extra amount it
costs and insured to live until repairs are made to the insured's dwelling
Additional Vehicle:
A vehicle acquired during the policy period in addition to those already
listed in the Declarations
Adjuster: One who determines the amount of loss suffered. A "company"
or "independent" adjuster represents the company. A "public" adjuster
represents the policyholder.
Admitted Company: A foreign or alien insurance company which has been
licensed by the insurance department of the state in question, and thereby
is authorized to conduct business within that state to the extent licensed.
Also know as an authorized company.
Adverse Selection: The insuring of one or more risks with a higher
chance of loss than that contemplated by the applicable insurance rate. The
selection of such risks is adverse because the rate is inadequate.
Age
Change: The halfway point between birthdays when the age of the
applicant changes to the next higher age. In some insurance companies, the
age is based upon the applicant's ate at his nearest birthday. In others,
it is based on the age of his last birthday.
Agent: One who has authority to act for another. The insurance
language, an agent is the person who sells insurance by contacting the
policyholder, and by contract and by law is endowed with many of the powers
of the company itself.
Aggregate Limit: In a policy such an aggregate limit, the maximum
amount the insurer will pay during the policy period, irrespective of the
policy's limit of liability.
Agreed Amount Clause: A condition of a policy stating that he insurer
agrees to waive the coinsurance requirement in consideration of the
insured's maintaining insurance equal to the amount agreed upon at the
inception of the policy.
All-Risk Policy: A policy which covers loss caused by any peril which
is not excluded, as contrasted to "named peril" policies which protect
against certain perils named in the policies.
Annuitant: A person during whose life an annuity is payable. Generally,
an annuitant is the person who receives the monthly income payment.
Annuity: A contract providing periodic income payments for a fixed
period of time or during the lifetime of an annuitant. In may be defined as
the systematic liquidation of an estate.
Annuity, Cash Refund: A life annuity contract which provides that upon
the death of the annuitant, the beneficiary (or his estate) will receive a
lump sum payment which represents the difference between the amount the
annuitant paid to the insurance company and the total income payments
received by the annuitant.
Annuity, Certain: Payable for a minimum specified period and continuing
thereafter throughout the lice time of the annuitant.
Annuity, Deferred: Payments commence more than one year after the
payment of the firs (or single) premium to the insurance company, usually
at a selected retirement age.
Annuity, Installment Refund: Similar to a cash refund annuity, except
that money is refunded in installment payment and the insurance company
makes payments to the designated beneficiary until the total of the
payments made to the annuitant and the beneficiary equals the consideration
paid.
Annuity Joint and Last Survivor: An annuity issued on the lives of two
or more persons, which is payable as long as one of them survives.
Application: A form filled out and signed by a prospective insured
which becomes part of the policy.
Appraisal Clause: The clause in a policy that sets forth the conditions
under which a disputed loss is decided by appraisers.
Appraiser: 1) A person who determines the value of property or 2) A
party who determines the amount of a disputed loss.
Assessment: The charge levied by an insurer writing an assessable
policy (as sold by some mutual insurers), in addition to the policy
premium, in the event the insurer becomes unable to pay its total losses.
Assignee: A person, firm, of corporation to whom the rights under
contract are assigned in their entirety or in part.
Assignment: Transferring property rights to another. Insurance policies
may thus be assigned or transferred to another, but usually this requires
the consent of the insurer.
Assumed Liability: Contractual liability, which arises from agreement
between people as opposed to liability which, arises from common or statute
law.
Assured: The person or party protected by a policy of insurance. Same
as insured.
Attained Age: An age which a person or insured has attained on a given
date. For life insurance purposes, the age is based on either the nearest
birthday or the last birthday, depending on the practices of the insurance
company involved.
Automatic Premium Load (Automatic Premium Advance): A provision in a
life insurance policy which states that if an insured fails to pay a
premium by the end of the grace period, the amount of the premium due will
be loaned to the insured automatically. However, the loan value of the
policy must be sufficient to cover the loan plus interest. Generally, the
insured must request that the clause be made a part of the policy at the
time of application.
Aviation Clause: A clause that limits the liability of the insurance
company if certain types of aviation accidents cause the death of an
insured.
B
Bailee: One who has custody of the property of another to be held and
returned to the owner in good condition. The owner who delivers the
property is called the bailor; the one who receives it is the bailee.
Bailor: A person entrusting goods to another.
Barratry: Willful and illegal sinking, casting away, or damaging a ship
at sea or its cargo.
Beneficiary, Contingent (Secondary): A parson who is entitled to
benefits only after the death of a primary beneficiary.
Beneficiary, Irrevocable: The insured may not change the designated
beneficiary without the beneficiary's consent.
Beneficiary, Primary: A person who is entitled primarily to benefits
upon the death of an insured.
Beneficiary, Revocable: The designated beneficiary may be changed at
the insured request without the consent of the beneficiary.
Beneficiary, Tertiary: The person who entitled to the policy benefits
if the primary and contingent beneficiaries predecease the insured.
Bid
Bond: A bond intended to guarantee that the bidder on a construction,
supply or service contract would enter into the contract if successful as a
bidder.
Binder: An oral or written agreement to insure which serves as evidence
of coverage prior to the issuance of a policy.
Binding Authority: The right on e party (usually an agent) has to
represent another (usually the insurer) in effecting or creating an
insurance contract.
Binding Receipt: Insurance becomes effective on the date of the receipt
and continues for a specified period of time until the company disapproves
the application.
Blanket Insurance: A single amount of insurance covering several items
(e.g. one amount of insurance to cover two buildings, or one building and
its contents)
Blanket Position Bond: A fidelity bond, which insures an employer
against loss from dishonest acts by employees.
Bodily Injury: Injury, sickness, or disease sustained by a person,
including death at any time resulting therefrom.
Bond,
Fidelity: An insurance policy that reimburses an employer for employee
theft, embezzlement, or dishonesty. May be written to cover specific
employees or all employees.
Bond,
Surety: A written agreement wherein on part, called the surety,
obligates itself to a second party, called the obligee or beneficiary, to
answer for the default of a third party, call the principal.
Broker: A licensed, legal representative of the insured who negotiates
with underwriters on behalf of the insured. Nevertheless, the broker
receives a commission from the insurer (underwriter).
Builders Risk: A special form dealing with the unique loss exposure of
property under construction.
Burglary: Theft by forcible and illegal entry, evidenced by visible
signs made by tools, explosives, electricity, or chemicals.
Business: A
trade, profession or occupation.
Business Use: The use of a vehicle for the purposes of the business or
occupation.
By
Order Of Civil Authority: A directive of city officials or other civil
authority that a building may be destroyed by the fire department to
present the spread of conflagration.
C
Cancellation: The termination of a contract before its normal ending.
Captive Agent: An agent who, by contract, represents only one company
and its affiliate. Sometimes called "exclusive or controlled agent".
Cargo: Goods being transported by rail, plane, truck, ship, or other
conveyance, excluding the equipment needed to operate the conveyor.
Cash
Surrender Value: The amount (stated in the policy) which is available
in cash upon the surrender of a policy for cancellation before or after the
policy matures (as in death claim or otherwise). This is one of the three
non-forfeiture options.
Cede:
To pass on to another insurer (the reinsurer) all or part of the insurance
written by an insurer (the ceding insurer) with the object of reducing the
possible liability of the latter.
Certificate of Insurance: A document containing information concerning
the master policy of a group indicating that the individual is covered.
Civil
Commotion: A disturbance among, or a popular uprising of, a large
number of people.
Claim: An amount requested of an insurer, by a policyholder or a
claimant, for an insured loss.
Claims-Made: A liability insurance policy version covering losses from
claims asserted against the insured during the policy period.
Coinsurance Clause: In property insurance, a clause require in the
insured to maintain insurance at least equal to stipulated percentage of
value in order to collect partial losses in full.
Collision: The impact of a vehicle with another object or vehicle, or
the upset of a vehicle.
Collision Coverage: Covers damage to a covered auto caused by collision
with another object or vehicle.
Collision Insurance: Coverage for the loss resulting from the striking
of another object by a moving vehicle.
Commissions: Payments made by the insurance company to the agent for
the sale and servicing of a policy. Commissions are calculated as a
specific percentage of the premium paid and the percentage determined in
accordance with the contract between the agent and his insurance company.
Common Disaster Clause: This clause defines the method of the payment
of the proceeds of the policy by the insurance company if the insured and
the named beneficiary die simultaneously in a common disaster. It protects
the contingent beneficiary since it would consider the primary beneficiary
predeceased the insured.
Comparative Negligence: Under comparative negligence, the damages
collectible in relation to anther person are diminished in proportion to
one's degree of negligence.
Comprehensive Automobile Coverage: "All-Risk" Physical damage
protection for automobiles, except for loss by collision or upset (which
may be added).
Concealment: In insurance, a failure to disclose a material fact, which
may void an insurance policy.
Condition: Something established or agreed upon to be necessary to make
a policy of insurance effective.
Conditional Receipt: A receipt given for the payment of the initial
premium (accompanying the application) which makes coverage effective under
the contract if the risk is approved as applied for, subject to the other
conditions set forth in the receipt.
Consideration: One of the elements of a valid contract. The premium and
the statements made by the prospective insured in the application are
construed as the insurer's consideration. The insurance company's
consideration is its promise to pay a valid claim.
Contract Bond: In general terms, a surety bond guaranteeing the
performance of a contract, usually associated with construction work, but
possible for almost any kind of contract. Sometimes called a performance
bond.
Contributory Negligence: A common law defense in which the plaintiff
must be entirely free from fault in order to recover from a negligent
defendant.
Contributory Plan: A term applied to employees benefit plans (such as
group insurance or group annuities) under which both the employees and the
employer contributes.
Conversion Privilege: The right granted to the insured to change his
coverage from a group policy to an individual policy. If a member of a
group resigns therefrom, his is given an opportunity to secure an
individual policy within a specified period thereafter regardless of
whether or not he is in good health at that time. This term is also applied
to the right of an insured to convert from a convertible term policy to a
permanent form of insurance.
Coverage for Damage to Your Covered Auto (Physical Damage Coverage):
Insures against
damage to an insured auto caused by collision and other than collision
losses.
Coverage Territory: Geographic region where coverage is available under
the Personal Auto Policy. Includes the United States and its territories
and possessions, Canada and Puerto Rico. Coverage is also provided if the
auto is damaged while being transported between these ports.
Credit Life Insurance: Life insurance designed to pay the balance of a
loan (usually payable in installments) if the insured dies before the loan
has been paid in full. Generally, a bank department store, or a finance
company handles credit life insurance. Usually this form of insurance is
written on a group basis, but it may also be written on an individual
basis.
D
Death
Benefit: The amount that is paid to a beneficiary as the result of the
death of an insured.
Death
Claim: Proof of the insured's death and the beneficiary's application
that are filed with the insurance company in a request for payment under
the policy.
Declarations: Section of the Personal Auto Policy that shows who is
insured, what property is covered, when and where coverage is effective,
and how much coverage applies.
Deductible: In a policy providing a deductible clause, the amount which
must first be subtracted from the total damage incurred before determining
the insurance company's liability. Of several types used, the straight
deductible establishes the insurer's liability above the deductible but not
below it; the franchise deductible establishes the insurer's liability for
the entire amount of damage once the deductible amount is exceeded in a
loss; and the disappearing deductible establishes the insurer's liability
for an increasing proportion of the loss, as the total damage rises above
the deductible, until the deductible finally "disappears". The insurer is
liable for the entire amount. The deductible may be in the form of an
amount of dollars, a percent of the loss, a percent of the value of the
insured property, or a period of time, as in health insurance.
Depreciation: The reduction in value of tangible property caused by
physical deterioration, obsolescence, or wear and tear.
Directors & Officers: Coverage for directors and officers.
Direct Writer: A company which sells insurance to the public either
through employees licensed as agents or through licensed agents,
compensated on a commission basis, who represent only one company; but not
through independent agents representing more than one company.
Disability Benefit: A feature added to some life insurance policies
which provides for the waiver of premiums upon the furnishing of proof that
in insured has become totally and permanently disabled and/or for the
payment of monthly income benefits to the insured.
Dividend: A refund of part of the premium under a participating policy
of a share of policyholders surplus funds apportioned for distribution.
They are derived from savings in mortality and expenses and interest earned
in excess of the assumed rate used in the calculation of the premium in the
policy reserves.
Dividend Options: The insured is given the option to apply dividends as
follows: 1) He may receive the dividend in cash. 2) Apply the dividend
toward the payment of any premium due on the policy. 3) Apply the dividend
toward the purchase of paid-up additional insurance. 4) Leave the dividend
with the insurance company to accumulate an interest.
Domestic Company: An insurance company incorporated or organized under
state law is a domestic insurer in that particular state.
Double Indemnity: A clause providing payment of twice the face amount
of the policy if loss of life is due to an accident.
Dwelling: A house in which people live, as distinguished from a store,
a factory, or any other commercial type building.
E
Effective Date: The day upon which a policy first becomes eligible to
pay covered losses.
Endorsement: A document with language attached to and becoming part of
a basic policy for the purpose of amplifying or modifying it, either at its
inception or during its term.
Endowment Insurance: A policy that (after a specified number of years)
pays a stated amount to the insured. If the insured dies during the
endowment period, the face amount of the policy is paid to the designated
beneficiary. An endowment pays at the earlier of death or a specified
period.
Evidence of Insurability: Any statement or proof of a person's physical
condition that may affect acceptance for insurance.
Exceptions: Provisions in a policy that eliminate coverage for
specified causes of death and/or disability). Also know as exclusions.
Excess Insurance: An amount of protection that bears all or a portion
of a loss after the loss exceeds an agreed amount.
Exclusion: 1) That which is not covered by the insurance as stated in
the policy 2) A clause in an insurance policy which specified that which is
excluded from the policy's coverage.
Exclusive Agent: An agent who, by contract, represents only one company
and its affiliates. Sometimes called a "captive agent".
Experience Rating (Group Insurance): The premium is computed on the
basis of past losses and expenses incurred by the insurance company in the
settlement of claims and other expenses involving a particular group of
risk.
Extended Coverage Insurance: Protection against loss or damage caused
by windstorm, hail, smoke, explosion, riot, civil commotion, vehicles, and
aircraft.
Extended Term Insurance: A non-forfeiture option, under which the face
amount of the policy is continued in force for a specified additional
period of time after default in the payment of a premium.
F
Face
Amount: The amount of insurance stated on the face of the policy that
will be paid upon the death of the insured (or in some cases at the
maturity of the policy). It does not include any amount that has been added
through dividend additions or additional insurance payable in the event of
accidental death.
Facility of Payment Clause: A provision in a policy which permits the
insurance company to pay insurance proceeds to persons other than the
insured, the designated beneficiary, or the estate of the insured.
Fair
Plan: A program to provide "Fair Access to Insurance Requirements" for
property owners who experience difficulty in buying insurance on property
located in blighted or deteriorating urban areas.
Family Income Benefits: Under this form of life insurance, on the death
of the insured, a monthly income is paid to the beneficiary (ies) tot he
end of the family income period stipulated in the policy in addition to the
lump sum payment (face amount). For example, it could run for a period of
10 years starting with the inception date of the policy, or it could run
for 15 years, 20 years, or to age 65. Usually m it is a decreasing term
insurance provision that is combined with whole life insurance. If the
insured survives the family income period, the family incomplete protection
ceases. The policy reverts to the face amount (usually, payable in a lump
sum upon the death of the insured).
Family Member: A person related to the named insured or his or her
spouse by blood, marriage or adoption who lives in the named insured's
household.
Familt Maintenance Policy: This type of policy combines ordinary life
insurance and level term insurance. I t affords the payment of a monthly
income during a stated period of 10,15,or 20 years or to age 65 as
pre-selected by the insured. The monthly income is payable from the date of
death to the end of the pre-selected period. The payment of the face amount
of the policy is payable at the end of such pre-selected period.
Farm
Owners - Ranch Owners (FO-RO): A package policy for farming and
ranching risks which can be described as homeowners policy adapted for farm
and ranch properties. Basically the policy provided property and liability
insurance to which may be added appropriate additional coverage such as
animal collision, employers liability, custom farming, etc.
Federal Crime Insurance Program: Administered by the Federal Insurance
Administration to provide limited burglary and robbery coverage for
property owners who experience difficulty in buying insurance on property
located in blighted or deteriorating urban areas.
Fidelity Bond: An insurance policy that reimburses an employer for
employee theft, embezzlement, or dishonesty. May be written to cover
specific employees or all employees.
Fiduciary: A person who occupies a position of trust, especially one
who manages the affairs of another. For example, the guardian of a minor is
a fiduciary.
Financial Responsibility Laws: State laws that require owners or
operators of autos to provide evidence that they have funds to pay for
automobile losses for which they might become liable.
Fire:
Combustion manifested in light, flame and heat for useful purposes
(friendly fire) or destruction purposes (hostile fire). Insurance covers
loss from only the latter.
Floater: A policy that covers property at many locations, even
worldwide and in the course of transit.
Flood: Overflow of water from its natural boundaries. More specifically
defined by the National Flood Act of 19668 as "a general and temporary
condition of partial or complete inundation of normally dry land areas
from: 1) The overflow of inland or tidal waters. 2) The unusual and rapid
accumulation or runoff of surface waters from any source.
Foreign Company: In insurance, a company doing (authorized) business in
one state but incorporated in another.
Form:
A document providing the specifics of the insurance issued, either
separate unto itself or attached to other descriptive language.
Fortuitous Cause: An accidental and unexpected cause of loss. A
happening by chance.
Fraternal Insurance: A cooperative type of insurance provided by a
social organization for its members (e.g., life insurance offered by the
"Knights of Columbus").
Free
of Particular Average (EPA): A clause which exempts the company
insuring cargo from partial losses, usually limited to apply only if the
amount be less than an agreed sum, or if some other described condition
exists.
G
Garage Policy: Protects garage or service station operators from claims
alleging bodily injury or property damage caused by the operator's
negligence in business operations and the use of automobiles.
General Average: In ocean marine insurance, a loss that is common to
all interests (i.e., the hull owners, the cargo owners, and receivers of
the freight and charges, etc.), that may arise due to a peril to the entire
venture, that requires a sacrifice or expenditure for the benefit of all.
Grace
Period: A specified period after a premium payment is due during which
the protection of the policy continues even thought the payment for the
renewal premium has not yet been received.
Group
Certificate: Certificate given to employees participating in a group
insurance plan which sets for the protection to which they are entitled.
Group
Insurance Policy: A policy protecting a group of persons, usually
employees of a firm generally called a "master policy".
H
Hazard: A condition that may lead to a PERIL, thus creating a loss
(e.g., oily rags leading to a fire).
Hold
Harmless Agreement: A contractual arrangement in which one party agrees
to assume certain liability which otherwise would be borne by the other
party.
Homeowners Policy: A "Package" policy for dwelling and contents risks
combining fire and allied line coverage with comprehensive personal
liability and theft insurance for homeowners and tenants.
Hull:
The ship itself as distinguished from its cargo.
I
Implied Warranty: An indirect expression or inference, not in writing,
by the policyholder that certain conditions exist or will be met (e.g.,
that a building is not on fire when insured, or that a vessel is
seaworthy).
Improvements and Betterments: Additions made to real estate enhancing
its value and amounting to more than mere repairs or replacement of waste.
When made by a tenant, such additions are normally included in the tenant's
own property insurance.
Inchmaree: A clause used in ocean marine policies to identify
additional named perils beyond the basic marine perils.
Incontestable Clause: A clause that makes the policy indisputable
(except for non-payment of premium and the operation of the war clause
exclusion) regarding the statements made by the insured in the application
after a specified period of time has elapsed (usually one, two, or three
years).
Increase in Hazard: The standard fire insurance policy is suspended
from liability while the hazard in a risk has been increased beyond what
was contemplated at the time the policy was written.
Indemnify: To pay for loss suffered.
Independent Agent: A property-liability insurance producer who sells
insurance as an independent contractor while representing one or more
insurers of that agent's choosing on a commission basis, owning the
expiration records of customers served.
Indirect Damage: Loss resulting from or as a consequence of, an insured
direct loss.
Individual Insurance: Policies that afford protection to the
policyholder and/or his family (as distinct from group insurance).
Sometimes it is referred to as personal insurance.
Industrial Policy: A Policy with a face amount of $1000 or less for
which the premiums are usually payable weekly or monthly and collected in
person.
Inherent Explosion: Explosion caused by the normal process of a risk
(as opposed to one caused by external causes), e.g., a dust explosion in a
grain elevator
Inherent Vice: The characteristics of any physical property which are
expected to cause deterioration or damage to that property without help,
e.g., milk sours eventually, and wooden houses depreciate over time.
Excluded by most insurance policies.
Injury: An act that damages or destroys a person or property.
Inspection Report: A report that contains general information regarding
the health, habits, finances, and reputation of an applicant made by a firm
that specializes in rendering this type of service.
Insurable Interest: A potential for financial loss from a certain event
that a person must have before acquiring insurance against that event.
Insurance: The transfer of risk from the insured to the insurer. The
insurer promises to pay the insured or beneficiaries an amount of money,
services, or both for economic losses sustained from an unexpected and
accidental event, during a period of time for which the insured makes a
premium payment to the insurer.
Insurance Clause: A clause that defines and describes the scope of the
coverage afforded and the limits of indemnification.
Insurance Company, Alien: One that was organized under the laws of a
country other than the United States.
Insurance Company, Domestic: One conducting business in the state in
which it was organized. A company who has its home office in the state in
which it is conducting business.
Insurance Company, Foreign: One conduction business in a state other
than the state in which it was organized. A company having its home office
in a state other than the one(s) in which it is conducting business.
Insurance Services Office (ISO): A voluntary, nonprofit association of
property and casualty insurance companies providing a great variety of
services on a national basis.
Insured: The person(s) or party(ies) protected by an insurance policy,
synonymous with assured. Some property-liability policies distinguished
between the named insured another insured.
Insuring Clause (Agreement): The portion of a policy that describes the
risk that the insurer has agreed to assume.
Intermediary: One who arranges reinsurance between companies. A
reinsurance broker.
J
Jettison: In ocean marine insurance, the voluntary throwing overboard
of part of the cargo or gear of the vessel to lighten the load and save the
vessel from conditions of stress at sea.
Jewelers Block Insurance: Broad policies insuring jewelers against all
loss to their stock in trade. Generally considered too be a type of inland
marine insurance.
Joint
Life Insurance: Insurance on the lives of two or more persons with the
face amount payable in the event of death of either (or any one) of them.
Joint
Ownership Coverage: The purpose of this coverage is to provide coverage
for individuals, other than husband and wife, residing in the household or
nonresident relatives who jointly own a private passenger auto or a pickup
or van that has a gross vehicle weight of less than 10,000 lbs. and is not
used for the delivery or transportation of goods and materials.
Juvenile Insurance: Life insurance policies written on the lives of
children within specified age limits.
K
Key
Person Insurance: An individual policy designed to reimburse an
employer for the loss of a key person's service due to his or her death.
Usually, the employer pays the premium and is the beneficiary.
L
Lapse: The termination of a policy for nonpayment of premium; used more
commonly in life insurance. If the insurance contract becomes void for
other reasons, it is also said to have lapsed.
Larceny: Theft of personal property. Modern Criminal laws include
obtaining property under false pretense and embezzlement, which common law
did not include in theft.
Law
of Large Numbers: A mathematical concept that postulates that the more
times an even is repeated (in insurance, the large number of homogeneous
exposure units), the more predictable the outcome becomes. In a classic
example, the more times on flips a coin, the more likely the results will
be 50% heads, 50% tails.
Legal
Liability: Liability imposed by laws, as opposed to liability arising
from an agreement or contract.
Legal
Reserve Life Insurance Company: An insurance company that operates
under insurance laws that specify the minimum amount of reserves that he
insurance company must maintain on its policies.
Level
Premium: A premium that remains unchanged throughout the life of the
policy.
Level
Term Insurance: A term Contract whose face amount remains level
throughout the life of the contract but whose premium increase according to
the age of the insured.
Libel: To publish defamatory statement about another. The general
distinction between libel and slander is that the first must be in writing
or similar permanent form, while the later is oral.
Liability Coverage: Covers damage for Bodily Injury (BI) or Property
Damage (PD) for which an insured becomes legally responsible because of an
auto accident.
Life
Expectancy: The average number of anticipated years of life remaining
for individuals who are the same age in accordance with the mortality table
indicated in the policy.
Life
Insurance: Insurance upon the lives of human beings that create an
immediate and guaranteed estate at the death of an insured.
Limited Pay Life Insurance: A plan of permanent life insurance under
which the premiums are payable for a specified number of years (5, 10 years
or to age 65). After which the policy can continue to remain in effect for
life without it being necessary for the insured to make any additional
payments.
Limit
or Limit of Liability: According to the terms of a given policy, the
most an insurer will pay for any one loss.
Lloyd's of London: A collection of individuals who assume policy
obligations as the individual obligation of each.
Loading: An amount that is added to net premiums in order to cover the
insurance companies operating expenses and possible contingencies. The cost
of acquiring new business, collecting expenses, and general management
expenses constitute' loading.
Loan
Value: The amount specified in a policy that the insurance company will
lend to an insured at the rate of interest which the insurance company may
charge for such loans (as indicated in the policy).
Loss:
1) The amount the insurer is required to pay because of a happening
against which it has insured. 2) A happening that causes the company to pay
(e.g., any reduction in quantity, quality, or values of insured property
resulting from an insured peril. 3) The over-all financial result of some
operation, as opposed to "profit." 4) The amount suffered by a person or
property, with or without insurance.
Loss
of Use Insurance: Insurance that compensates the policyholder for
inability to use property destroyed or damaged by an insured peril.
Loss
Payee: Party besides the insured (such as a lending institution) that
has an insurable interest in the vehicle insured. Also called a Lienholder.
M
Malpractice: Improper actions or failure to exercise proper skill by a
professional or others involved with the care of the human body; such as a
physician, dentist, blood bank, etc.
Marine Insurance: One of major divisions of insurance (life, health,
property, marine, casualty, surety), primary written for property in
transit. If my sea, "ocean" marine (or "wet" marine); otherwise, "inland"
marine.
Material Fact: Information having objective reality that influences an
insurer in granting or not granting insurance coverage.
Maturity: The date on which a policy becomes payable due to the death
of the insured, or as a result of an insurer's living to the end of an
endowment period.
Medical Payment Coverage (Med):
Pays medical expenses
incurred in an auto accident for the insured and passengers in the
insured's car.
Mercantile Risk: A property location used for the selling of
merchandise, as distinguished from a habitational risk or a manufacturing
risk in which goods are processed.
Merit
Rating: A system of rating in which the experience of the individual
risk is a factor in determining the rate.
Minimum Premium: The lowest flat or eared policy charge for which a
policy will be issued or for which coverage will be provided.
Misrepresentation: Misleading the company as to material facts
affecting a policy or the settlement of a loss, either by directly or
indirectly lying. Misrepresentation as to material facts voids policies.
Mobile Home Insurance: A special policy has been designed to meet the
needs of mobile home owners or occupants, covering physical damage to the
home, contents and personal liability while the home used as a permanent
residence.
Moral
Hazard: A condition or characteristic by which an insured intends to
profit from an insured loss.
Morale Hazard: The condition that exists when an insured becomes lax in
matters of safety and fire prevention because insurance is in place to pay
for a loss which may occur.
Mortality Table: A statistical table that indicated the probability of
death and survival at each age.
Multi-Peril Insurance: Synonymous with multi-line insurance, a policy
including both property and casualty coverage (e.g., a homeowners policy).
Mutual Insurance: Protection written by an incorporated insurer having
no capital stock and directed by policyholders that are its owners.
Mutual Life Insurance Company: A life insurance company owned and
controlled by its policyholders. Mutual Life Insurance Companies issue
participating policies.
Mysterious Disappearance: The vanishing of insured property in an
unexpected manner.
N
Named
Insured: The person designated in the policy as the insured, as opposed
to someone who may have an interest in a policy by not be shown by name.
Named
Peril Policy: One that specifies the exact cases of loss for which the
insurer will pay, as contrasted with a policy that insures against "all
risks" (and then lists only exclusions, modifications, and conditions).
National Flood Insurance Act of 1968: An act establishing a basis for
flood insurance as a joint venture between the private insurance industry
and the Federal Government. The Federal Government has since taken over the
entire program.
Negligence: The Failure to exercise the care that an ordinary prudent
person would exercise: either doing that which a prudent person would not
do, or failing to do that which a prudent person would do.
Net
Amount at Risk: The difference between the face amount of a policy and
the reserve.
Net
Premium: 1) The gross (paid) premium less any return premium or
dividend. 2) The premium less the commission.
No-Fault Insurance: Form of automobile insurance where each insurance
company pays the damage of its own insureds, regardless of who was at fault
for the accident.
Noncontributory Plan: A group employee benefit under which the employer
pays for the full cost of the benefits for his employees.
Non-forfeiture Values (Options): Benefits required by law to be made
available to the insured (or his beneficiary) in the event that he
discontinues his premium payments. These provide that he does not forfeit
or lose all that he has invested in the policy.
Non-Medical Life Insurance: Insurance that is issued without requiring
the applicant to submit to a medical examination. The insurance company
relies on the applicant's answer to the questions rewarding his physical
condition, personal references, and inspection reports. However, the
insurance company retains the right to require a medical examination, if an
investigation indicates a need for one.
Nonowned Vehicle: An auto that is not furnished or available for the
regular use of the insured or any family member.
Non-Participating Life Insurance: Insurance that does not pay dividends
to the policyholders.
Nonrenewal: Decision made by the insurance company not to extend
coverage for another policy period after the current policy period expires.
O
Obligee: The party in whose favor a bond runs, i.e., the party
protected from loss under the bond.
Obligor: One bound by the obligation covered by a bond. Also called the
"principal".
Occupancy: 1) The use to which a building is put. 2)The type of
contents a building contains.
Occurrence: In insurance, the term may be defined as continual,
gradual, or repeated exposure to an adverse condition which is neither
intended nor expected to result in injury or damage, as contrasted with an
accident, which is a sudden happening.
Omnibus Clause: A part of an automobile or yacht liability policy which
extends coverage to persons and organizations other than the named insured,
such as members of the insured's family, servants and others using the
automobile with the owners permission.
Optional Benefit: An additional benefit that may be included in a
policy at the applicant's request.
Ordinary Life Insurance: Insurance policies of $1,000 or multiples
thereof that provide coverage for the entire life of the policyholder and
for which the premiums are payable until death. It is also referred to as
whole life insurance or straight life insurance, and is different from term
insurance in that it includes a cash value buildup.
Other
Insurance: A Personal Auto Policy provision that describes how much the
insurer will pay when more than one insurance policy or coverage applies to
the same loss.
Other
Than Collision Coverage (OTC): Covers damage to a covered auto caused
by something other than collision coverage, such as hail, glass breakage
and theft. Also called Comprehensive Coverage.
Over
Insurance: Coverage in amounts greater than the value of the property
insured or the amount of loss sustainable by the insured (e.g., several
policies of hospitalization insurance for a total amount in excess of daily
room charges).
P
Package Policy: A combination of property-liability coverages of two or
more separate policies in on contract with one premium.
Paid-Up Additions: An additional amount of insurance purchased through
dividends (single premium insurance) which increase the amount of
protection afforded.
Paid-Up Insurance: Life Insurance on which future premium payments are
not required. Frequently, the term is used to identify a 20-payment life
insurance policy on which 20 annual premiums have been paid. Fractional
paid-up insurance is the term applied to the policy that is issued under
the non-forfeiture option.
Pair-and-Set Clause: An Inland marine policy provision which requires
the insurer, at the insured's option, to restore or pay for the entire pair
or set of jewelry or fine arts when only part has been lost, destroyed, or
damaged.
Partial Loss: Is one involving less than all of the values insured or
calling on the policy to pay less than its maximum amounts.
Participating Insurance: Insurance that entitles the policyholder to
share in the divisible surplus of the insurance company through dividends.
Particular Average: In ocean marine insurance, a loss (partial or
total) which falls on one or more property(ies) or interest(s) being
shipped, as opposed to aGeneral Average.
Payor
Clause: A clause that provides for the waiver of premiums on a child's
policy following the death or the total disability of the adult applicant
for the child's policy.
Penalty of the Bond: In a surety bond, the amount guaranteed or the
limit of the company's liability.
Peril: The cause of loss (e.g., fire, explosion, accident).
Perils of the Sea: Causes of loss unique to the operation of ships and
their cargoes, i.e., sinking, stranding, heavy weather, etc., but not fire
lighting, or theft.
Personal Articles Floater: Worldwide coverage on an "all-risk" basis
for scheduled, valuable personal property.
Personal Auto Policy: Coverage designed to replace both the family auto
policy and the special package auto policy as the "standard" form for
insuring private passenger autos and certain types of non-business trucks.
Personal Effects Floater: An inland marine policy that insures articles
(usually accompanying travelers) against "all-risk" while away from home.
Personal Injury Protection (PIP): Also known as no-fault insurance,
providing insurance for medical costs, loss of earning, additional living
expenses, and funeral costs for occupants of the insured automobile and
pedestrians other than those insured under other policies.
Physical Hazard: Danger of loss or liability arising from the
condition, occupancy, or use of property, as opposed to such danger arising
from the character of the policy holder.
Pilferage: Theft in small quantities, e.g., not limited to the taking
of a whole package or all of the property insured.
Piracy: Robbery on the high seas, typically the seizure of a vessel and
cargo.
Policy: The printed document issued by the insurance company to the
insured that is the insurance contract.
Policy Fee: A small fee charged by some insurance companies for the
first year (or portion thereof) in addition to the regular premium.
Policy Form: Document used to assemble an insurance policy that
describes the policy coverages, exclusions and conditions.
Policy Holder: The party to whom a policy is issued, and who pays a
premium to an insurer in consideration of the patter's promise to provide
insurance protection.
Policy Loan: A loan made by an insurance company to an insured under
his policy (not in excess of its cash value). Policy loans may be assessed
a fixed interest rate or an adjustable rate.
Policy Period: Period of time listed in the Declaration when coverage
under the policy is in effect.
Policy Term: The period of time for which the policy will normally
remain in existence.
Premises: The building (or section of a building) insured or containing
the insured property. Depending on policy conditions, it may also include
an adjacent area.
Premium: The amount of money an insurance company charges to provide
coverage.
Primary Insurance: When two or more coverages or policies apply to the
same loss, the one that pays first, up to its limit of liability or the
amount of the loss, whichever is less.
Principal: in suretyship, the principle is the one whose honesty,
fidelity, or ability to perform is guaranteed.
Private Passenger Auto: A four-wheel motor vehicle, other than a truck,
owned or leased for at least six continuous months.
Proceeds: The net amount of money that is payable by the insurance
company at the death of an insured or when the policy matures.
Product Liability: The liability that a merchant or a manufacturer may
incur as the result of some defect in the product sold or manufactured.
Profits Insurance: Coverage for the loss of profit that the
policyholder could have earned that the merchandise destroyed in a fire (or
by a covered peril) been sold otherwise.
Proof
of Loss: A written statement of a claim giving the pertinent facts and
data that may be in the form of an affidavit.
Property Damage (PD): Physical injury to, destruction of or loss of use
of tangible property.
Pro
Rata Cancellation: Termination of a policy by the insurer, for which
the return premium due the policyholder is the full proportionate part for
the un-expired term.
Proximate Cause: That which brings about a result without the
intervention of any other force. Important in insurance since it
establishes which policy(ies) will pay for a loss; e.g., the one insuring
the perils which was the proximate cause of the loss.
Public Adjuster: One who, for a fee, represents policyholders in the
adjustment of their losses with insurance companies.
Punitive Damages: Damages awarded to a plaintiff that are meant to
punish the defendant for anti-social actions rather than reimburse the
plaintiff for loss.
Q
Quota
Share Reinsurance: A form of pro rata reinsurance (proportional) in
which the reinsurer assumes an agreed percentage of each insurance policy
being insured and shares all premiums and losses accordingly with the
reinsured.
R
Rate:
The price for a unit of insurance; all units in a given policy, multiplied
by the rate per unit, produce the premium. In fire insurance, the price per
$100 of insurance for one year. The basis for pricing other types of
insurance varies greatly i.e., payroll is used in workers compensation
insurance, area of retail floor space or sales volume is used in certain
types of general liability insurance, etc.
Rating: A method under which an insurance company can issue a policy
for a subsequent risk by increasing the premium based on the increased risk
involved.
Rating Factor: Characteristics that differ depending on the individual
risk that is being rated, such as the type of vehicle to be insured and the
age and sex of the insured driver. For most personal auto coverages, they
are used to modify the finished rate.
Rebating: Paying, offering, or giving anything of value (or any
valuable consideration not specified in the policy) to any person as an
inducement to purchase a policy of insurance. Rebating is illegal and both
parties are guilty of it when it is done knowingly.
Reduced Paid-Up Insurance: A non-forfeiture value (option) in a policy
that provides for the continuation of the insurance but at a reduced amount
(sometimes called Fractional Paid-Up Insurance).
Reinstatement: The resumption of coverage under a policy that lapsed.
Reinsurance: 1) The transaction whereby an insurance company (the
reinsurer), for a consideration, agrees to indemnify another insurance
company known as the ceding company (the reinsured) against all or part of
a loss which the latter may sustain under a policy of policies it has
issued. 2) When referred to as "a reinsurance," the term means the
relationship between reinsured and reinsurer.
Removal: The taking of property to some place other than at which it
was insured. The standard fire insurance policy used in most states insures
against damage done in removing the insured property from the path of the
fire.
Renewable Tern Insurance: Insurance that may be renewed at the end of
the term, for another term, without evidence of insurability. The rates
increase at the end of each term and are based on the attained age of the
insured at the time.
Renewal: Continuance of coverage under a policy beyond the initial
period.
Rental Value Insurance: Insurance which reimburses the owner-occupant
of a building for the cost of renting some other place if the building is
rendered unusable by some peril insured against.
Rent
Insurance: Insurance that reimburses a building owner against loss of
rental income if the building is not usable by a tenant because of some
peril insured against.
Replacement Cost Insurance: Protection that pays the cost to restore or
replace damaged or destroyed property without deduction for depreciation.
Automatically included in homeowner's forms.
Replacement Vehicle: A vehicle the insured acquires during the policy
period that replaces one shown in the Declarations.
Representation: Information communicated by the prospective insured to
an insurer that will influence the latter's underwriting decision.
Reserve: A sum (required by law) set aside by an insurance company to
assure the payment of future claims.
Retention Clause: A clause in a policy of reinsurance by which the
ceding company agrees to retain for it own accounts a certain part of the
line.
Rider: Another word for Endorsement.
Risk:
1) Defined variously as uncertainty of loss, chance of loss, or the
variance of actual from expected results. However defined, its existence is
the reason people by insurance. 2) The subject matter of an insurance
contract, e.g., the building, cargo, or liability exposure insured.
Robbery: the taking of property by violence or threat of violence.
Running Down Clause: The clause in an ocean marine hull policy which
covers damage done to another ship by collision, and other property damage
caused by collision.
S
Safe
Burglary Insurance: Protection against loss of property caused by
forcible entry into a safe or vault. Damage to safes, vaults, and other
property on the premises resulting from burglary is also covered unless
caused by fire.
Salvage: Property in a loss saved from further loss.
Schedule: A list of insured properties, and the amount of insurance on
each, which is attached to a "schedule" policy, as distinguished from a
"blanket" policy.
Schedule Bond: A fidelity bond covering a number of named individuals
or positions (irrespective of who occupies them), as contrasted with a
blanket bond, which covers all.
Schedule Policy: A listing of two or more items of property in a
policy, with specified amounts of insurance applying to each item.
Self
Insurance: The retention of sufficient exposure units by an entity to
permit the operation of the Law of Large Numbers. Self insurance is a term
often mistakenly used to describe the situation when an entity decided to
retain its own risks.
Settlement Options: Methods (other than immediate payment in lump sum)
by which an insured (or beneficiary) may choose to have the proceeds of an
insurance policy paid.
Short
Rate Cancellation: Termination of a policy by the policyholder before
its stated expiration. The insurer refunds the policyholder a return
premium in less amount than the pro rata part that is still unearned to
compensate the insurer for expenses incurred to that point, (since the
termination is at the request of the policyholder).
Single Limit of Liability: Policy limit that applies to all bodily
injury and property damage arising from a single accident.
Single Provisions: Certain provisions that must be included in a Life
Insurance Policy.
Social Insurance: Insurance provided by government.
Split
Limit of Liability: Policy that has separate limits per person and per
accident for Bodily Injury and a per accident limit for property damage.
Stated Amount Insurance: Insurance written to cover an item of property
for a specific amount of insurance.
Stock
Life Insurance Company: A Life Insurance Company owned and controlled
by its stockholders who share in its divisible surplus. Generally, Stock
Insurance Companies issue Non-Participating Life Insurance. However, some
of them also issue Participating Life Insurance.
Subrogation: In insurance, the substitution of one party (insurer) for
another party (insured) to pursue any rights the insured may have against a
third party liable for a loss paid by the insurer.
Substandard Risks: Risks that do not met minimum underwriting criteria.
Sue
and Labor Clause: Language in marine and inland marine policies
requiring the policy holder in event of loss to take all necessary means to
save the property from further loss and recover from others who caused the
loss. The insurer agrees to pay the costs, even if they exceed the policies
limit of liability.
Suicide Clause: A provision specifying that in the event the insured
commits suicide within tow years from the date the policy was issued, the
insurance company's liability is limited to the payment of a single sum
equal to the premium(s) actually paid (less any indebtedness due to the
insurance company).
Supplemental Contract: An Agreement between an insurance company and an
insured under which the insurance company retains the lump sum payable
(under a Life Insurance Policy) and makes payments to the insured or the
beneficiary in accordance with the settlement option selected by the
insured.
Surety Bond: A written agreement wherein on part, called the surety,
obligates itself to a second party, called the obligee or beneficiary, to
answer for the default of a third party, call the principal in failing to
perform specified acts within a stated time.
Surplus: The remainder after a company's liabilities are deducted from
its assets.
Systematic Premium Plan (Check-O-Matic Plan): A plan under which the
insured authorizes a ban k to deduct the necessary funds from this account
each month to pay a premium that is forwarded to his insurance company by
the bank.
T
Temporary Substitute Auto: An auto or trailer that the named insured
does not own that is used as a temporary substitute for a vehicle that is
out of normal use because of breakdown, repair, servicing, loss, or
destruction.
Tenants Policy: A form of homeowners policy sold to persons who rent
their living quarters or are co-op apartment owners.
Term
Insurance: Insurance that is generally designed to afford coverage for
a limited number of years. Usually no provision is made for cash values. It
can be described as "Pure Protection".
Theft:
A broad term meaning the wrongful taking of the property of another.
Third
Party: The claimant under a liability policy, so called because the
first two parties are the insured and insurer, who enter into the insurance
contract which pays the third party's claims.
Total
Disability: An illness or injury that prevents an insured continuously
performing every duty pertaining to his occupation or from engaging in any
other type of work for remuneration. (This working varies from one
insurance company to another.)
Total
Loss: 1) Loss of all the insured property. 2) Under a given policy, a
loss involving the maximum amount for which the policy is liable.
Towing and Labor Coverage: Coverage that pays for charges incurred by
the insured for towing and labor charges.
Trailer: Vehicle designed to be pulled by a private passenger auto,
pickup or van.
Treaty, Reinsurance: A reinsurance agreement between an insurance
company and a reinsurer, usually for one year or longer, which may be
divided into two broad classifications: 1) The participating type which
provides for sharing of risks between the ceding company and the reinsurer.
2) The excess type that provides for indemnity by the reinsurer only for
loss which exceeds some specified predetermined amount.
Twisting: Inducing an insured to cancel his present insurance and
replace it with insurance in the same or another insurance company by
misrepresenting the facts or by presenting an incomplete comparison.
U
Umpire: A person selected by two appraisers to help settle disputes in
property insurance claims.
Unauthorized Insurance: Insurance written by an insurer no licensed by
the country or state in which the risk is located (non-admitted company).
Underwriter: One who accepts or rejects risks for an insurer
(originally, by writing the person's name under the contract of insurance
being issues).
Underwriting: The analysis of information pertaining to an applicant
which was obtained from various sources and determination of whether or not
the insurance should be: 1) Insured at request. 2) Offered at higher
premium. 3) Declined.
Unearned Premium: The portion of the premium representing the
un-expired portion of the policy term.
Underinsured Motorists Coverage (UIM): Coverage that reimburses the
insured for the difference between the actual damage sustained for bodily
injury and the amount of liability insurance carried by the at-fault driver
if the at-fault driver's limits are less than the insured's.
Uninsured Motorists Coverage (UM): Pays for bodily injury sustained by
the insured that is caused by an uninsured motorist.
Uninsured Motor Vehicle: A vehicle that: has no Liability coverage; has
Liability coverage that does not meet the state's financial responsibility
requirement; is driven by an unidentified hit-and-run driver; or has
invalid Liability coverage because the insured is insolvent or denies
coverage.
Unoccupied Building: The temporary absence from a building of an
occupant, but with the occupant's furniture and personal effects remaining,
as opposed to a Vacant Building, which has neither occupants nor contents.
V
Vacant Building: A building with nothing in it. If the furniture is in
the building and the owner intends to return, the building is Unoccupied.
Valued Policy: A policy in which the company agrees that the property
insured is worth the amount of insurance, and therefore in the event of
total loss pays the face value of the policy without need of proof of the
value at the time.
Vandalism: Damage done maliciously, included in the extended coverage
endorsement. Also called "malicious mischief".
W
Waiver: The intentional relinquishment of a known right.
Waiver Endorsements: An agreement that waives the liability of the
insurance company for a loss that would normally be covered under the
policy.
Waiver of Premium: A provision included in many policies that waives
the payment of premiums after an insured has been totally disabled for a
specific period of time (usually 6 months)
War
Clause: A clause in a policy that limits an insurance company's
liability if a loss is caused by war.
Warranty: A statement by the insured on the literal truth of which the
insurance contract depends.
Warranties and Representations: Most state laws specify that all
statements by the applicant in the application (or tot he medical examiner)
are considered (in the absence of fraud) to be representations and not
warranties. A warranty must be literally true. A breach of warranty may be
sufficient to void a policy whether the warranty is material or not and
whether or not such breach of warranty had contributed to the loss. A
representation needs only to be substantially true. Generally, a
representation would be material to the risk and that the applicant made
with fraudulent intent.
Whole
Life Insurance: Insurance policies of $1,000 or multiples thereof that
provide coverage for the entire life of the policyholder and for which the
premiums are payable until death. It is also referred to as Ordinary Life
Insurance or straight life insurance, and is different from term insurance
in that it includes a cash value buildup.
Wholesale Insurance: Group insurance written for small groups of
employees, usually less than fifty. Each employee applies for and receives
an individual policy. Usually, this type of insurance is written without a
medical examination and the premiums are on a renewable term basis, but
higher than on regular group insurance.
Windstorm Insurance: Protection against damage done to property by
unusually high winds, cyclones, tornadoes, or hurricanes. Today windstorm
insurance is not available except under an extended coverage endorsement.
Workers Compensation Insurance: Protection which provides benefits to
employees for an injury or contracted disease arising out of and in the
course of employment. All states have laws that require such protection for
workers, and prescribe the length and amount of such benefits provided.
Written Premiums: The premiums on all the policies that a company has
issued in a period of time, as opposed to earned premium.
Y
Your
Covered Auto: Vehicles listed in the policy Declarations and, under
certain circumstances, newly acquired autos and replacement autos.
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