|
NOTE:
This glossary provides a comprehensive list of some of the most
commonly used terms in the property/casualty, life and health
insurance industries. However, it should not be viewed as
all-conclusive.
| A | B |
C
| D | E | F |
G | H | I |
J | K | L |
M | N | O |
P | R | S |
T | U | V |
W |
A
Accidental Death Benefit (Auto or Health Insurance):
Provision for payment of a dollar amount—usually equal to the
face amount of insurance—if the insured is killed in an
accident. This coverage is available either as a health
insurance policy, or as an auto insurance option with some
companies. (Also see
Accidental Death Benefit [Life Insurance].)
Accidental Death Benefit (Life Insurance):
Provision under a life insurance policy for payment of an
additional amount—usually equal to the face amount of
insurance—if the insured is killed in an accident. Popularly
known as “double indemnity.” (Also see
Accidental Death Benefit
[Auto or Health Insurance].)
Accident and Health Insurance:
See Health Insurance.
Act of God (Act of Nature):
Perils that occur naturally such as tornadoes, earthquakes and
hurricanes.
Actual Cash Value:
Insurance under which the amount payable is the current
replacement cost of the property new; reduced by an allowance
for depreciation, wear and obsolescence.
Actuary:
A highly specialized mathematician professionally trained in the
risk aspects of insurance, whose functions include the
calculations involved in determining proper insurance rates,
evaluating reserves, and in various aspects of insurance
research.
Additional Living Expense:
A property coverage which pays for the increased expense of
living while the insured’s residence is being rebuilt or
repaired after damage from an insured peril. Examples are the
extra cost of housing the insured’s family in a hotel, dining in
restaurants, etc.
Adjuster:
A person who investigates and settles losses for an insurance
carrier
Admitted Company (Carrier):
An insurance company licensed and authorized to do business in a
particular state.
Agent:
Laws of all states require all insurance agents to be licensed
by the state to sell insurance. Agents may be categorized as:
(1) An Exclusive Agent, who is a sales employee or sales
representative of one and only one insurance company or its
affiliated group of insurance companies, and seeks and services
business exclusively for that company or group. (See
Direct Writer.) (2) An Independent
Agent, who usually represents two or more insurance companies or
groups in a sales and service capacity as an independent
business person.
Alien Insurance Company:
An insurance company incorporated under the laws of a foreign
country.
Allied Lines:
Types of insurance associated with property insurance, which may
include earthquake, sprinkler leakage, and income and extra
expense coverages.
Annual Policy:
Insurance policy written for a term of one year or renewed one
year at a time.
Annual Statement:
A report made by a company at the close of its fiscal year. It
is the primary financial report required by state insurance
departments to be submitted by insurers annually.
Annuitant:
The person during whose life an annuity is payable, usually the
person to receive the annuity.
Annuity:
A contract that provides an income for life, a specified number
of years, or a combination of the two.
Application:
The statement of information that a prospective insured gives
when applying for an insurance policy and that an insurance
company uses to help decide if it will issue the policy and what
premium rate will be charged.
Apportionment:
The dividing of a loss proportionately among two or more
insurers which cover the same loss.
Appraiser:
In insurance, a specialist that evaluates the size and cost of
an object, such as jewelry or art; or the extent of damage based
on a claim. Often works with a claims adjuster.
Appurtenant Structures:
Buildings on the same premises as the main building insured
under a property insurance policy.
Arbitration:
Determination by impartial experts of the value of property or
the extent of damage. Many insurance policies provide for
appraisals where the company and the insured cannot agree on the
amount or the extent of a loss. Arbitration also may be used to
resolve liability and policy-coverage issues in certain
situations.
Arson:
The willful and malicious burning of, or attempt to burn any
structure or other property, often with criminal or fraudulent
intent.
Assessment:
The extra premium a mutual or reciprocal insurer’s policyholder
may be required to pay in the event the insurer’s losses are
greater than anticipated.
Assets:
(1) All of the property owned by a carrier. (2) The items on the
balance sheet of the insurer that show the book value of
property owned. Under state regulations, not all property or
other resources can be admitted on the statement of the insurer.
This gives rise to the term “non-admitted assets.” (Examples
would be furniture, fixtures, agents’ debt balances and accounts
receivable that are over 90 days old.)
Assigned Risk Plan (Automobile Insurance Plans):
A mechanism used in some states to insure people who cannot
obtain insurance in the voluntary market. There is one rate
level and the individual policies are assigned to specific
companies according to the percentage of the market they insure.
Assurance–Insurance:
These terms are today generally accepted as synonymous, although
not originally so. The term “assurance” is used more commonly in
Canada and Great Britain than in the United States.
Assured:
Synonymous with “insured.” One who has an insurance policy with
an insurance carrier. “Insured” is preferred.
Audit:
An examination of the books of accounts, vouchers or other
records of a person, corporation, firm or other organization for
the purpose of ascertaining the accuracy or inaccuracy of the
record.
Automobile Death Indemnity Coverage:
Provides limited life insurance protection to insured persons
specifically named in the policy in the event of a death that is
a direct result of a vehicle accident. Payment is not contingent
upon the establishment of negligence, but death by an
intentional act of the insured is not covered.
Automobile Disability Income Coverage:
Provides persons specifically named in the policy with the
weekly benefit shown in the policy in the event of continuous
total disability as a direct result of bodily injury, sickness,
or infection caused by an auto accident.
Automobile Insurance (Coverages):
For definitions of specific types available, see following auto
insurance coverages listed alphabetically throughout the
Glossary—Automobile Death Indemnity Coverage, Automobile
Disability Income Coverage, Automobile Liability Insurance,
Automobile Physical Damage Insurance, Bodily Injury Liability
Insurance, Collision Insurance, Comprehensive Automobile
Insurance, Deductible Collision and Deductible Comprehensive
Coverages, Medical Payments Automobile Insurance, Personal
Injury Protection Automobile Insurance (PIP), Property Damage
Liability Insurance, Towing Coverage, Underinsured Motorists
Coverage, Uninsured Motorists Coverage and Uninsured Motorists
Property Damage Coverage.
Automobile Liability Insurance:
Protection for the insured against loss arising out of legal
liability when his or her car injures others or damages their
property. (Includes Bodily Injury Liability and Property Damage
Liability Coverages.)
Automobile Physical Damage Insurance:
The Collision and Comprehensive coverages in the automobile
insurance policy.
Aviation Insurance:
Coverage against aviation perils, primarily involving operation
of aircraft and characterized by a constant exposure to
potential catastrophe loss. Types of coverages include insurance
for damage to the aircraft or contents, aircraft owner’s
liability insurance on passenger bodily injury or death, Airport
Liability, Hangarkeeper’s Liability, and Aviation Products
Liability insurance.
B
Bailee:
One who has temporary possession of property belonging to
another.
Basic Form:
A package insurance policy providing coverage against a limited
number of specified perils.
Beneficiary:
Any person, institution, trust, etc., named in a life policy to
receive the policy benefits upon the death of the insured.
Binder:
A written or oral contract issued temporarily to place insurance
in force immediately prior to issuance of a new policy or
endorsement of an existing one. A binder is subject to payment
of the premium and provides coverage under the terms of the
policy to be issued, unless otherwise specified.
Blanket Coverage:
A blanket form is one under which property is insured under a
single amount applying to several different pieces of property
rather than a specific amount of insurance on each property.
Block Policy:
An inland marine policy covering all property on or off a
merchant’s premises, including property of others in the care,
custody or control of the policyholder
Bodily Injury Liability Insurance:
This coverage protects an insured against legal liability for
injury to another person arising from an accident.
Boiler and Machinery Insurance:
A form of property coverage for loss arising out of the
operation of pressure, mechanical and electrical equipment. It
may, among other things, cover loss to the boiler and machinery
itself and business interruption losses.
Broad Form:
A package policy providing coverage for the same perils covered
in the basic form, plus specified additional perils.
Broker:
A representative of the buyer of property and liability
insurance who deals with either agents or companies in arranging
for the coverage required by the customer. A broker is paid a
commission by the company or its agent.
Burglary:
The loss of property due to theft when there is visible evidence
of forcible entry to the exterior of the building.
Business Income Insurance:
See Business
Interruption Insurance.
Business Interruption Insurance:
Coverage for loss of earnings in case the policyholder’s
business is shut down by fire, windstorm, explosion or other
insured peril. It’s often added as a rider to a standard
business policy and pays for such expenses as the rebuilding of
an accounts receivable data base, cleaning computers, leasing
temporary office space, and similar losses associated with a
disaster.
Buy-Out Policy:
A professional liability policy covering future claims resulting
from incidents which occurred during the period that an expired
claims-made policy was in force.
C
Cancellable Policy:
A policy which may be cancelled by the company at any time by
giving advance notice in compliance with state requirements to
the insured citing the reasons such insurance is being cancelled
and refunding any unearned premium. (Term is not usually
applicable to life or health insurance.)
Cancellation:
The discontinuance of an insurance policy before its normal
expiration date
Capacity:
A measure of the amount of insurance which an insurer is able or
prepared to assume on particular risks.
Capital Stock Insurance Company:
An insurance company which is owned and controlled by
stockholders or investors.
Captive Insurer:
An insurance company set up by a company or group of companies
to insure their own risks or risks common to the group.
Cargo Insurance:
A broad classification of marine insurance providing coverage on
cargo, as opposed to hulls, to protect shippers by sea from loss
or damage to goods for which they would be unlikely to collect
from the carriers themselves. Whether cargoes are insured for a
particular voyage or under open policies which are in the nature
of reporting-form policies depends upon the volume and
regularity with which a shipper uses ocean transit. Cargo
insurance also can cover goods transported by train or truck.
Carrier:
The insurance company or the one who agrees to pay the losses.
The carrier may be organized as a stock or mutual company, a
reciprocal exchange, as an association of underwriters or as a
state fund.
Cash Value:
The cash fund which a life policy develops usually after the
first or second year the policy has been in force. It is
available when the policy is surrendered or may be borrowed
earlier as a policy loan.
Casualty Insurance:
Insurance primarily concerned with the legal liability for
losses caused by injury to persons or damage to property of
others. Also includes, among other coverages: automobile,
workers’ compensation, employers’ liability, general liability,
plate glass, theft and personal liability. It excludes life,
fire and marine insurance
Catastrophe:
A sudden event causing an extraordinary level of loss; most
often associated with natural disasters such as tornadoes,
hurricanes, floods or earthquakes. In insurance, it is applied
to an incident or series of related incidents involving an
insured loss in excess of $5 million.
Catastrophe Reinsurance:
This is a form of insurance written in order to improve the
spread of risk against unknown concentrations of liability
subject to one occurrence. This type of reinsurance reimburses
an insurer when its losses due to a single catastrophe exceed a
specified large amount (the retention).
Cede:
To transfer all or part of a risk written by an insurer (the
ceding, or primary company) to a reinsurer.
Cession:
The unit of insurance passed to the reinsurer by the ceding
company. The unit (cession) may accordingly be the whole or a
portion of (a) single risks, (b) defined type or class of
policies or (c) defined divisions of a policy as agreed.
Chartered Life Underwriter (CLU):
A designation conferred in recognition of the attainment of
certain standards of education and proficiency in the uses of
life insurance to satisfy the financial needs of the insured in
light of current tax and other laws. A Chartered Life
Underwriter is normally an agent or someone responsible for
sales or marketing activities.
Chartered Property Casualty Underwriter (CPCU):
A designation conferred in recognition of the attainment of
certain standards of education and proficiency in the art and
science of property and casualty insurance underwriting.
Claim:
A request for payment for a loss which may come under the terms
of an insurance contract. There are two types of claims. A
first-party claim is one made by the policyholder for
reimbursement by his or her company. A third-party claim is one
by a person against a policyholder of another company and the
payment, if any, will be made by that company.
Claim Frequency:
The number of claims occurring under a given coverage divided by
the number of earned exposures for the given coverage. It is
usually expressed as the number of claims paid per 100 of such
exposures. Example: For auto bodily injury (BI), the frequency
of 2.50% means that bodily injury accidents were incurred at the
rate of 2-1/2 for every 100 cars insured for BI for one year.
Claim Severity:
The average cost per claim.
Claims-Made Form:
A type of liability policy which covers claims which occur and
are reported while the policy is in effect.
Classification:
The combining of policyholders or properties into groups with
the same general characteristics so that the various groups’
inherent differences in exposure to loss can be recognized for
rating or underwriting purposes.
Coinsurance (Health Insurance):
A provision in a medical-expense insurance policy which requires
that the insured person pay part of the expense and the
insurance company will pay the remaining part. (Also see
Coinsurance [Property Insurance].)
Coinsurance (Property Insurance):
A provision in a property insurance policy which requires the
insured to carry insurance equal to a certain specified
percentage of the value of the property for the insured to
receive full payment on a loss up to the amount of the policy.
Otherwise, payment would be only a percentage of the actual
loss, that percentage determined by the amount of insurance
carried relative to the amount that is required to be carried by
the policy for full protection up to policy limits. (Also see
Coinsurance [Health Insurance].)
Collision Insurance:
Protection against loss resulting from any damage to the
policyholder’s car caused by collision with another vehicle or
object, or by upset of the insured car, whether it was the
insured’s fault or not (other than his/her own willful act).
This does not cover other people’s property. (See
Deductible Collision.)
Combined Ratio:
The sum of the ratio of losses incurred to premiums earned and
the ratio of commissions and expenses incurred to premiums
written.
Combined Single Limit:
A liability coverage limit that combines both bodily injury and
property damage into one aggregate amount.
Commercial Blanket Bond:
A fidelity bond for operators of commercial establishments, etc.
(See Fidelity Bond.)
Commercial Credit Insurance:
A guarantee to manufacturers, wholesalers and service
organizations that they will be paid for goods shipped or
services rendered. It is a guarantee of that part of their
working capital that is represented by accounts receivable.
Commercial General Liability Policy:
Often referred to as the CGL, this policy provides broad
protection against situations in which a business must defend
itself against lawsuits or pay damages for personal injury or
property damage to third parties
Commercial Insurance (Coverages):
Definitions of many commercial coverages are listed
alphabetically throughout the Glossary. Among these coverages
are Aviation Insurance, Cargo Insurance, Commercial Credit
Insurance, Commercial Multiple-Line Policy, Crop-Hail Insurance,
Employers’ Liability Insurance, General Liability Insurance,
Kidnap and Ransom Insurance, Marine Insurance, Products
Liability Insurance, Professional Liability Insurance, Public
Liability Insurance, Rain Insurance, Surplus Lines, Title
Insurance and Workers’ Compensation
Commercial Lines:
The various kinds of insurance which are written for businesses.
(Also see Commercial Insurance
[Coverages].)
Commercial Multiple-Line Policy:
Package type of policy that includes a wide range of essential
property and liability coverages for businesses
Commission:
A percentage of an insurance premium paid to an agent or broker
for producing and servicing the business
Commissioner of Insurance:
Title of the head of the state insurance department who is
responsible for the enforcement of insurance laws and for
promulgating regulations dealing with the insurance industry
Comparative Negligence:
Under this concept a plaintiff (the person bringing suit) may
recover damages even though guilty of some negligence. His or
her recovery, however, is reduced by the amount or percent of
that negligence. There are various forms of comparative
negligence, such as: “Pure Comparative,” in which the plaintiff
recovers so long as he or she is not solely at fault; “Less
Than,” in which the plaintiff recovers so long as his or her
negligence is less than that of the defendant; and “Not Greater
Than,” in which the plaintiff recovers so long as his or her
negligence is not greater than the defendant’s
Competitive State Fund:
State-operated workers’ compensation insurer which competes with
private insurers for employers’ workers’ compensation business
in certain states
Comprehensive Automobile Insurance:
Protection against loss resulting from damage to the insured
auto, commonly referred to as ”other than collision” coverage.
Broad coverage is provided and includes protection from such
hazards as fire, theft, glass damage, wind, hail and malicious
mischief. This is a first-party coverage
Comprehensive Personal Liability Insurance:
Protection for an insured against loss arising out of his or her
legal liability to pay money for damage or injury he or she has
caused to others. This does not include automobile liability,
but includes almost every activity of the insured except
“personal injury” and his or her business operations. (See
“Personal Injury” Liability Insurance.)
Compulsory Auto Liability Insurance:
Insurance laws in some states require motorists to carry at
least certain minimum auto liability coverages for bodily injury
and property damage
Concealment:
Normally means the willful withholding of material fact which
could affect an insurer’s issuance of a policy or processing of
a claim
Conditions:
Provisions of an insurance policy which state the rights and
duties of the insured and insurer
Condominium Insurance:
A policy designed for the special needs of condominium unit
owner-occupants to cover personal property and liability, to
complement the insurance normally purchased by the condominium
association for the building, structures and liability.
Additional coverages are offered unit owners by many insurers
Consequential Loss:
A loss resulting from, but not caused directly by, another
insured loss. A “consequential loss” (spoilage of meat stored in
a refrigerated building, for example) usually arises out of a
change in temperature resulting from damage to the building (but
not directly to the meat) by a covered peril such as fire.
“Consequential Loss” coverages are available to protect the
insured against this specific indirect loss
Contingent Liability Insurance:
Covers the insured individual or business in cases of indirect
or “contingent” liability, where direct liability for an
accident, for example, falls on another, but because of the
relationship between the insured and the other party, the
insured might still be held indirectly liable. (Example: A
business being responsible for the work performed by an
independent contractor.)
Contract:
The “Law of Contracts” specifies four requirements for the
formation of a single contract: (1) parties of legal capacity;
(2) expression of mutual consent of the parties to a promise, or
set of promises; (3) a valid consideration; and (4) the absence
of any statute or other rule declaring such agreement void. An
insurance policy qualifies as a contract under the above
definition
Contract Bond:
A bond which guarantees faithful performance of a construction
contract and payment of all material and labor bills related to
that contract. A Performance Bond covers faithful performance
only; a Payment Bond guarantees payment of material and labor
expenses
Contractual Liability Insurance:
Provides coverage for claims arising out of liability that has
been assumed by the insured under a written or oral contract
Contributory Negligence:
Carelessness of the injured person that helped cause the
accident in which he or she was injured. Some states bar
recovery to the plaintiff if the plaintiff was contributorily
negligent
Coverage:
The scope of the protection provided under a contract of
insurance; any of several risks covered by a policy
Covered/Insured Peril:
The perils of loss you are protected against by an insurance
policy. Examples of perils include fire, lightning, theft,
vandalism and the threat of a lawsuit
Credit Disability Insurance:
Disability insurance on the borrower, payable to the creditor
while the borrower is disabled, to cover the loan payment
(usually small loans repayable in installments). This insurance
is usually issued through the creditor (a lender or lending
agency) and is provided by an insurance company under a group
credit disability policy. Credit disability insurance also can
be purchased by an individual directly from an insurance
company. (Also see Credit Life
Insurance.)
Credit Insurance (Commercial):
See Commercial Credit
Insurance
Credit Life Insurance:
Term life insurance on the life of a borrower, payable to the
creditor, to repay a loan (usually small loans repayable in
installments) in case of death. This insurance is usually issued
through the creditor (a lender or lending agency) and is
provided by a life insurance company under a group credit life
insurance policy to insure the lives of those who borrow from
the creditor. Credit life insurance also can be purchased by an
individual directly from a life insurance company. (Also see
Credit Disability
Insurance.)
Crop-Hail Insurance:
Protection against hail damage to growing crops. Coverage is
often afforded under such policies for crop damage due to fire,
windstorm, drought, frost, snow, etc
Customer Service Representative:
The assistant that supports the sales efforts of the sales agent
or producer. Other titles include administrative assistant,
agency underwriter and marketing specialist. CSR is also a
designation for a certified customer service representative
D
Declarations:
That part of the policy describing the named insured, address,
effective date, term of the policy, applicable coverages, the
amount of insurance and the premium
Decreasing Term Life Insurance:
Term insurance, the face value of which decreases each year over
a stated period. Family income and mortgage cancellation are
common types of decreasing term insurance
Deductible:
A provision in an insurance contract stating that the insurer
will pay that amount of any insured loss that is in excess of a
specified amount. The specified amount is the deductible
Deductible Collision and Deductible Comprehensive
Coverages:
Forms of collision or comprehensive auto insurance coverages
which specify that an insurance company will pay the damage less
a specified amount under the particular coverage. For example:
For $100 Deductible Collision Coverage, the company would deduct
$100 from the total damage under the collision coverage and be
liable for the amount in excess of $100. Rates are reduced as
the amount of the deductible is increased
Depreciation:
A decrease in the value of property due to age, wear and tear
Directors and Officers Liability Insurance:
Coverage for directors and officers of firms or organizations
against liability claims arising out of alleged errors in
judgment, breaches of duty, and wrongful acts related to their
organizational activities
Direct Premiums Written:
Property and casualty insurance premiums written (less return
premiums), without any allowance for premiums for assumed or
ceded reinsurance
Direct Writer:
An insurer whose distribution mechanism is either the direct
selling system or the exclusive agent system. (See
Agent.)
Disability Threshold:
In no-fault insurance states with the disability threshold, it
provides that a victim may not sue in tort unless he/she has
been disabled (defined differently in various state plans) from
an accident for a specific period of time
Dividends:
(1) Policyholder Dividend—The return of part of the premium paid
for a policy issued on a participating basis by an insurer. Any
such dividend is dependent upon premiums collected in excess of
losses and expenses for the particular class of business at the
end of the policy period. (2) Stockholder Dividend—A portion of
the surplus paid to the stockholders of a corporation
Dollar Threshold:
In no-fault auto insurance states with the dollar threshold, it
prevents individuals from suing in tort to recover for pain and
suffering unless their medical expenses exceed a certain dollar
amount
Domestic Insurance Company:
An insurance company organized or domiciled in a given state is
referred to in that state as a domestic carrier
Double Indemnity:
See Accidental Death
Benefit (Life Insurance)
E
Earned Premium:
The part of the total property/casualty policy premium earned by
the insurance company which applies to the expired portion of
the policy period
Employers’ Liability Insurance:
Provides protection for the employer for those injuries arising
out of and in the course of employment which were not covered
under the workers’ compensation law
Endorsement:
An additional piece of paper, not a part of the original
contract, which cites certain terms and which becomes a legal
part of that insurance contract. Additions to life insurance
contracts are accomplished through the use of riders, which are
similar to endorsements
Environmental Impairment Insurance:
A form of insurance designed to cover losses and liabilities
arising from damages to property by pollution
Equipment Breakdown Insurance:
See Boiler and Machinery
Insurance
Errors and Omissions Insurance:
A type of professional liability insurance which indemnifies
insured professionals—who include, but are not limited to,
lawyers, insurance agents and brokers, accountants, real estate
agents, appraisers, abstracters, title insurance agents,
architects and engineers, advertising agents, adjusters,
directors and trustees, fiduciaries, travel agents and data
processing firms—for losses sustained because of their errors or
oversights
Excess Limits:
Coverage against losses in excess of a specified dollar limit
Exclusion:
A provision in an insurance policy which denies coverage for
certain perils, persons, property or location
Expense Ratio:
The ratio of a company’s operating expenses to premiums written.
(Expenses include losses and loss adjustment expenses.)
Experience:
The loss record of an insured or of a particular class of
coverage
Expiration Date:
The date shown on the declarations page of the policy when
coverage will stop. It may be a specific date or a statement
that coverage is continuous until cancelled
Exposure:
This term in the insurance field may have several meanings: (1)
possibility of loss; (2) a loss potential as measured by type of
construction, area or values; (3) a possibility of a loss being
communicated to an insurance risk from its surroundings; or (4)
a unit of measure of the amount of risk a company assumes (for
example, one car insured for one year)
Extended Coverage Property Insurance:
An extension of the fire insurance policy to protect the insured
against property damage caused by the additional perils of
windstorm, hail, explosion, or riot, civil commotion, aircraft,
vehicle and smoke
F
Face Amount:
See Protection Amount
Facultative Reinsurance:
Reinsurance on an individual policy basis wherein each risk
which an insurance company wishes to reinsure is reviewed by the
reinsurer, which has the “faculty” or option to accept or
decline all or part of each risk offered to it
FAIR (Fair Access to Insurance Requirements) Plan:
A facility, operating under a government-insurance industry
cooperative program, to make fire insurance and other forms of
property insurance readily available to persons who have
difficulty obtaining such coverage
Family Auto Insurance:
The automobile policy (most common in the industry) which
provides protection for the insured and resident relatives in
the same household
Family Plan Insurance:
This is insurance in which the head of the household has one
master policy on his/her life (usually whole life) and term
coverage for wife/husband and children in lesser amounts
Federal Crime Insurance:
Insurance against burglary, larceny and robbery losses offered
by the federal government where the Federal Insurance
Administration has determined that such insurance is not
otherwise readily available
Fee For Service (FFS):
Formerly a standard health insurance policy. Now a form of
health insurance that allows the insured to go to any doctor,
hospital or other provider which would bill for each service
given, and the insurer and the patient share in the cost of the
services provided
Fidelity Bond:
Protection guaranteed by the surety which reimburses an employer
for losses due to dishonest acts of employees
Financial Responsibility Law:
A state law which may require motorists to furnish evidence,
either before or after involvement in an auto accident
(depending on the individual state’s law), of ability to pay for
damages up to certain minimum dollar limits. These requirements
commonly are met by carrying auto liability insurance with
specified minimum limits or more
Fire Insurance:
Coverage is provided to protect the insured property from the
perils of fire and lightning
Fleet Policy:
An auto policy covering a number of vehicles owned by a single
insured
Floater:
A form of insurance that applies to movable property, whatever
its location, within the territorial limits imposed by the
contract. The coverage “floats” with the property
Flood Insurance:
Coverage against loss resulting from the flood peril, widely
available under a program developed in 1968 by the private
insurance industry and the federal government
Foreign Insurance Company:
In a given state, an insurer domiciled in another state
Fraud:
Intentional concealment or misrepresentation with the objective
of forcing an insurer to provide a benefit (such as paying a
claim) which otherwise would not be provided
Funded Reserve:
Bookkeeping account of sums set aside periodically by a business
for the purpose of paying for losses as they occur. Usually, the
sums are invested conservatively
G
General Average:
In ocean marine insurance, a concept which provides that, where
a portion of a vessel or cargo is jettisoned to save the entire
venture from peril at sea, the resulting loss is shared by all
parties involved. The owners of property that is saved
contribute in proportion to the interests suffering loss,
provided the latter are free of fault in the danger and the
venture ultimately is successful. (Distinct from Particular
Average.)
General Damages:
In auto insurance, typically refers to awards for pain and
suffering
General Liability Insurance:
A broad term meaning liability insurance, other than automobile
liability or employers’ liability, written to cover professional
and commercial risks. In respect to commercial liability,
various available coverages could cover such risks as premises
and operations, contractual liability, products and completed
operations
Generally Accepted Accounting Principles (GAAP):
A method of accounting used by insurance companies to produce
results consistent with those of other industries. This is the
method of reporting financial results required by the Securities
and Exchange Commission of all industries under its jurisdiction
and by the stock exchanges
Glass Insurance:
Protection for loss of or damage to glass and its appurtenances
Good Driver Plan:
An auto insurance rating program that reflects the insured’s
accident and traffic violation record as a factor in determining
the premium
Grace Period:
The number of days (31 in most cases) a life insurance policy
will remain in force when a payment is overdue
Group Insurance:
Insurance written on a group of people under a single master
policy, issued to their employer or to an association with which
they are affiliated
Guaranteed Cost Insurance:
The life insurance sold by some companies, with all cost factors
guaranteed at the time of issue. Policies of this type usually
have lower premiums than the pre-dividend premiums of comparable
participating policies
Guaranteed Renewable:
A health policy which the company guarantees to renew until the
insured reaches a specified age, usually 65. The company may
adjust rates only on a class of risks, not on any individual
Guaranty Fund:
A fund, derived from assessment against solvent insurance
companies, to absorb losses of claimants against insolvent
insurers
H
Hail Insurance:
See Crop-Hail Insurance
Hard Insurance Market:
A condition caused by insurance companies lacking sufficient
capital to accept new business, sometimes causing a sharp rise
in pricing and the diminishing of coverage availability
Hazard:
The presence of a condition that could cause loss or injury to
property or persons. For example, smoking in bed increases the
chance for loss of property and life resulting from fire
Health Insurance:
There are two major types: Disability income insurance pays for
loss of income due to disability; medical expense insurance pays
for hospital, doctor and other medical expenses. Both of these
generally pay for losses arising from sickness or accidents.
Some policies, referred to as “accident policies,” do not cover
sickness
Health Maintenance Organization (HMO):
The oldest form of managed health care. In exchange for a
monthly fee, HMOs offer members a comprehensive range of health
services, usually including preventive medical care
Hold Harmless Agreement:
A contract under which one party’s legal liability for damages
is assumed by the other party to the contract
Homeowners Policy:
A package policy for the homeowner that combines “named peril”
(including theft coverage) protection on contents, coverage on
the dwelling ranging from “named peril” to physical loss,
additional living expense protection and personal liability
insurance
Hull Policy:
An ocean marine or aviation insurance contract covering damage
to or loss of a ship or plane, but not the contents
Hurricane:
A tropical storm with sustained winds of 75 or more miles an
hour that is usually accompanied by rain and abnormally high
tides
I
Improvements and Betterments Insurance:
Insurance coverage that protects a tenant or condominium unit
owner against loss as a result of fire, etc., of improvements
made by him/her to the real property in which he/she resides.
Some property policies use the term “improvements and additions”
in describing the coverage
Incontestable Clause:
The provision of a policy that prevents a life insurance company
from calling the policy invalid after the policy has been in
effect a certain length of time (usually two years)
Indemnity:
In general, means reimbursement for loss, but also is used to
mean a benefit provided by a policy. In health insurance it
sometimes is used to designate an amount paid regardless of
actual loss or expense incurred
Individual Practice Association (IPA):
A type of HMO that contracts with a type of physician entity.
Patients (policyholders) then visit individual doctors at their
private offices
Industrial Life Insurance:
A class of life insurance that is usually issued with a
protection amount of less than $1,000 and premiums usually
payable weekly or at most monthly
Inland Marine Insurance:
A broad type of insurance, generally covering articles that may
be transported from one place to another as well as bridges,
tunnels and other instrumentalities of transportation and
communication. It includes goods in transit (generally excepting
transoceanic) as well as numerous “floater” policies such as
personal effects, personal property, jewelry, furs, fine arts
and others
Inspection Report:
A report filed by an investigator employed by the insurance
company or a credit agency, giving general information on the
health and finances of the applicant and the physical condition
of the property (if property is to be insured)
Insurance to Value:
Insurance written in an amount approximating the value of the
property insured
Insured:
A person covered by an insurance policy
Internal Fraud:
An act of deception or strategy used to deceive or cheat an
insurer by an employee, including misrepresentation or
concealment
Investment Income:
The income generated by a company’s portfolio of investments
(such as bonds, stocks or other financial ventures)
J
Joint Underwriting Association (JUA):
A device used to provide insurance to those who cannot obtain
insurance in the voluntary market. Certain companies issue
policies at one rate level and handle claims, but the ultimate
costs are borne by all companies writing insurance in that state
K
Kidnap and Ransom Insurance:
Written for financial institutions and other corporations, this
insurance covers named employees for individual or aggregate
amounts paid as ransom, with deductibles requiring the insured
to participate in approximately 10% of any loss
L
Lapsed Policy:
A life or health insurance policy terminated as a result of
nonpayment of a premium before the end of the grace period
Legal Expense Insurance:
Insurance to reimburse policyholders for legal fees incurred for
defense from lawsuits involving areas of civil law not covered
by standard liability insurance. Examples include:
discrimination, wrongful discharge, contract disputes and patent
disputes
Level Premium Life Insurance:
Insurance for which the cost is distributed evenly over the
period during which premiums are paid. The premium remains the
same from year to year and is more than the actual cost of
protection in the earlier years of the policy and less than the
actual cost in the later years. The excess paid in the early
years builds up a reserve which helps meet the costs in later
years
Liabilities:
An insurance company’s liabilities consist of its immediate or
contingent policy obligations and unpaid claims, as well as the
usual obligations arising out of doing business such as taxes,
payroll, etc
Liability Insurance:
Provides protection for the insured against loss arising out of
his/her legal liability to third parties
Liability Limits:
The stipulated sum or sums beyond which an insurance company is
not liable to protect the insured
License—Agent or Broker:
Certification issued by a state’s department of insurance that
an individual is qualified to solicit insurance applications in
the state for the period covered
License—Company:
Certification issued by a state’s department of insurance that
an insurance company is qualified to do business in the state
Life Insurance Cost Indexes:
The measurements used to determine the cost of life insurance
protection
Limit:
The maximum amount of benefits that an insurer agrees to pay in
the event of a loss
Line:
A type or kind of insurance
Litigation:
The process of a lawsuit
Loss:
An occurrence that is the basis for submission and/or payment of
a claim. Losses can be covered, limited or excluded from
coverage, depending on the terms of the policy
Loss Control Representative:
Insurance company employees, also called safety engineers, that
perform loss control surveys or inspections, and prepare written
loss control reports that outline their findings
Loss Control Service:
Engineering or inspection service which assists the insured in
reducing its exposure to loss
Loss Expense—Unallocated:
Salaries and other expenses incurred in connection with the
operation of a claims department of a property and liability
insurance carrier which cannot be charged to individual claims
Loss Exposure:
The possibility that a loss may occur
Loss Ratio:
In property and liability insurance, the percent that losses
bear to premiums for a given period
Loss Reserve:
The estimated liability on an insurer’s balance sheet for unpaid
insurance claims or losses that have occurred as of a given
reporting date. On an individual claim, the loss reserve is the
estimate of what will ultimately be paid out on that case
M
Malicious Mischief:
The willful or intentional damage to or destruction of another’s
property. Coverage for malicious mischief is usually combined
with the vandalism peril in insurance policies
Malpractice Insurance:
Coverage afforded to a professional practitioner, such as a
doctor or a lawyer, against liability claims for damages
resulting from alleged negligence in the performance of the
insured’s services
Manual:
A book published by an insurance company, rating association or
bureau, containing its rates, classifications and rules for
rating a policy
Marine Insurance:
See Inland Marine Insurance
and Ocean Marine Insurance
Material Damage:
Insurance against damage to a vehicle or boat itself. It
includes automobile comprehensive, collision, fire and theft.
Material damage and physical damage are terms that are often
used interchangeably
Maturity:
The date at which the endowment amount of a life policy becomes
payable
Medical Payments Automobile Insurance:
Coverage in non-no-fault states, which pays medical and hospital
expenses and the expense of funeral services resulting from an
automobile accident, regardless of the liability of the insured.
This is a first-party coverage
Mortgage Insurance:
(1) A basic type of life insurance or disability insurance
purchased for the specific purpose of paying off any mortgage
balance outstanding at death or paying mortgage payments while
the insured is disabled. (2) ”Private mortgage insurance“ offers
a method of providing minimum down payment residential mortgages
by insuring mortgage lenders against losses in the event of
borrower default
Multi-Peril Policy:
A package policy that provides protection against a number of
separate perils. Multi-peril policies are not necessarily
multiple-line policies, since the combined perils may be all
within one insurance line, such as property. (See
Multiple-Line Policy.)
Multiple-Line Company:
A company that writes a variety of basic or traditional lines of
insurance known as property and casualty (liability) insurance,
such as auto, boat owners, homeowners, commercial, etc
Multiple-Line Policy:
A package policy which combines coverages from both the
traditional property and liability insurance lines
Mutual Insurance Companies:
Insurance companies without capital stock, owned by the
policyholders
N
Named Perils:
Coverage in a property policy that provides protection against
loss from only the perils specifically listed in the policy
rather than protection from physical loss. Examples of named
perils are fire, windstorm, theft, smoke, etc
Negligence:
The failure of a person to exercise the care that a prudent
person would exercise under similar circumstances
Net Cost:
This term ordinarily refers to the cost of life insurance after
deducting the policy dividends from the premiums paid. A variant
is the net surrendered cost, which is the premiums minus both
dividends and the cash surrender value at the end of the given
period
Net Premiums Written:
Property and casualty gross premiums written less returned
premiums, plus reinsurance assumed premiums less reinsurance
ceded premiums
No-Fault Automobile Insurance:
A form of insurance by which a person’s financial losses
resulting from an automobile accident, such as medical and
hospital expenses and loss of income, are paid by his/her own
insurance company without concern for who was at fault. The
right to sue may be restricted in some cases
Non-admitted Company (Carrier):
An insurance company not licensed to do business in the state in
question
Non-Forfeiture Options:
The choices available to an insured as to how the cost value of
a life insurance policy will be received—as a lump-sum payment,
as extended term insurance, or as reduced paid-up life
insurance. These options guarantee that the cash value will not
be forfeited by the insured
Non-Participating Insurance:
See Guaranteed Cost
Insurance
Notice of Loss:
Notification to an insurance company by an insured or claimant
that a loss has occurred. Written notice may be required,
although many companies accept notice by telephone
O
Obligee:
A person, firm, corporation or government agency protected by a
surety bond
Occupational Hazard:
Dangers inherent in an occupation which increase the risk of
sickness or injury
Ocean Marine Insurance:
Coverage on all types of vessels, including liabilities
connected with them, and coverages on their cargoes
Omnibus Clause:
An automobile policy provision that covers persons driving the
named insured’s auto with the named insured’s permission
Ordinary Life Insurance:
The class of life insurance that usually refers to whole life,
term and endowment insurance
Other Than Collision Coverage:
See Comprehensive
Automobile Insurance
P
Package Policy:
A combination of two or more individual policies or coverages
into a single policy. A homeowners policy, for example, is a
package combining property, liability and theft coverages for
the homeowner
Paid Losses:
The actual dollar total that has been paid on incurred losses by
issuing checks or drafts to claimants
Partial Disability:
An impairment that prevents the insured from performing one or
more, but not all, important duties of his/her job
Participating Insurance:
The life insurance, sold by some life companies, on which
dividends may be payable to policy owners. The amount and timing
of the dividend payments are determined by the company board of
directors
Particular Average:
In ocean marine insurance, a concept providing that, where a
portion of vessel or cargo is jettisoned to save the entire
venture from peril at sea, the resulting loss is borne entirely
by that individual owning the property that is damaged or
sacrificed. No other interests contribute to payment of the
loss. (Distinct from General Average.)
Peril:
The cause of a possible loss, such as fire, windstorm, theft,
explosion or riot
Permanent Insurance:
The type of life insurance that develops cash value and includes
whole life, endowment, universal life and variable life
insurance
Persistency:
An insurance term used to refer to the probability of insurance
remaining in force
Personal Articles Floater:
A form of coverage designed to meet the needs for insurance on
property of a movable nature. The coverage usually protects
against all physical loss, subject to special exclusions and
conditions. Examples of property covered include jewelry, furs,
silverware and fine arts
“Personal Injury” Liability Insurance:
Protects against liability for damages other than physical
injury arising out of false arrest, detention or imprisonment,
or malicious prosecution; libel, slander or defamation of
character; invasion of privacy, wrongful eviction or wrongful
entry
Personal Injury Protection Automobile Insurance (PIP):
First-party coverage in no-fault states that usually pays for
medical expenses, loss of income and certain other expenses
resulting from an auto accident. Coverage’s scope varies widely
by state law so no two states have identical coverages. (See
No-Fault Automobile
Insurance.)
Personal Lines:
Types of insurance written for individuals or families, rather
than for businesses
Personal Property:
This type of property is usually movable and easily
transportable. On the other hand, real property generally is
considered to be immovable, such as land and things affixed to
it. A rule of thumb definition for personal property is
“everything other than real property.”
Physical Hazard:
This refers to the material, structural or operational features
of the risk itself, apart from the persons owning or managing
it. Electrical wiring, building construction and type of heating
system are examples of physical hazards
Physical Loss Form:
This property coverage protects against loss from risk of
physical loss to buildings except as limited or excluded in the
form
Point of Service (POS) Plan:
An HMO that offers an indemnity-type option. The primary care
doctors in a POS plan make referrals to other providers in the
plan. However, members can refer themselves outside the plan and
still get some coverage as well
Policies-in-Force:
Policies written and recorded on the books of the carrier which
are unexpired as of a given date. Usually applies to property
and liability insurance
Policy:
The name generally used to mean the written contract of
insurance
Policyholder:
One who owns an insurance policy. A mortgagee often is issued a
copy of an insurance policy or certificate of insurance at the
request of the insured, but it is not a policyholder
Policyholders’ Surplus:
The sum an insurance company has remaining after all liabilities
are deducted from all assets. Sums such as paid-in capital and
special voluntary reserves are also included in this term. This
surplus is one form of financial protection to policyholders in
the event a company suffers unexpected or catastrophic losses
Policy Loan:
The borrowing against a life insurance policy’s cash value
Pool:
An organization of insurers or reinsurers through which
particular types of risks are underwritten with premiums, losses
and expenses shared in agreed ratios
Pre-Existing Condition:
A physical condition that existed prior to the issuance of an
insurance policy
Preferred Provider Organization (PPO):
Health plan through which a sponsoring group negotiates price
discounts with providers in exchange for patients. The sponsor
may be an insurer, employer or third-party administrator
Premises:
The building, other structures and land where the insurance
protection is applicable. It is usually described and defined in
the property and casualty policy
Premium:
The amount of money charged a policyholder for an insurance
policy. (Also see Direct
Premiums Written, Earned Premium,
Net Premiums Written,
Unearned Premium.)
Premium Auditor:
A person who examines a liability insurance policyholder’s
insurance records (sales, payroll, etc.) at the end of the
policy term to determine if the basis for the premium charge has
either increased or decreased. If the audited premium is less
than originally estimated and paid, the policyholder will
receive a refund; if greater, the policyholder will receive a
statement for the balance
Principal:
In suretyship, the party whose honesty or performance is
guaranteed
Producer:
Any person directly involved in the sale of insurance
Product Liability Insurance:
Protection against financial loss arising out of the legal
liability incurred by a manufacturer, merchant or distributor
because of injury or damage resulting from the use of a covered
product
Professional Liability Insurance:
See Directors and Officers
Liability Insurance, Errors
and Omissions Insurance, and
Malpractice Insurance
Proof of Loss:
Documentation presented to the insurance company by the insured
in support of a claim so that the insurer can determine its
liability under the policy
Property Damage Liability Insurance:
Protection against loss from legal liability for damage to the
property of another
Property Insurance:
Provides financial protection against loss or damage to the
insured’s property, other than automobile, caused by specified
perils, such as fire, windstorm, hail, explosion, riot,
aircraft, motor vehicles, vandalism, malicious mischief, riot
and civil commotion, and smoke. (See
Property Insurance [Coverages].)
Property Insurance (Coverages):
For definitions of specific types available, see following
property insurance coverages and terms listed alphabetically
throughout the Glossary—Actual Cash
Value, Additional
Living Expense, Blanket Coverage,
Condominium Insurance,
Extended Coverage Property
Insurance, Fire Insurance,
Homeowners Policy,
Property Insurance,
Renter’s Policy,
Rents or Rental Value
Coverages,
Replacement Cost Property Coverage,
Tenant‘s Policy and
Theft Insurance
Protection Amount:
The face amount of a life insurance policy, or amount of money
that will be paid to a beneficiary upon the death of an
insured—depending upon the policy. This amount will be reduced
by the amount of any outstanding policy loan
Proximate Cause:
The dominating cause of loss or damage; an unbroken chain of
events between the occurrence of an insured peril and damage to
property. As an illustration, weather damage occurring from
fire-fighting activities is covered under the fire policy
because fire was the proximate cause of the loss
Public Liability Insurance:
A broad term meaning insurance to cover professional and
commercial risks against liability exposures other than those
involving employees or arising out of ownership or use of autos
or airplanes
R
Rain Insurance:
Insurance protection against loss due to rain, hail, snow or
sleet, which causes cancellation or reduced earnings of an
outdoor event
Rate:
A charge per unit in determining insurance premiums
Rating Bureau:
An organization that gathers statistics, makes rates and/or
creates policy forms and provides other services for the
property and casualty insurers affiliated with the bureau
Rating Territory:
In various property and casualty lines, a geographical grouping
within which insureds are likely to share an exposure to similar
risks. Grouping of insureds within a territory helps establish
equitable rates for the territory
Redlining:
An illegal act to refuse to lend money or issue insurance based
only on geographic area
Reinstatement:
The restoration of a lapsed life or health insurance policy to
its original premium-paying status—usually after evidence of
good health has been submitted and past-due premiums have been
paid
Reinsurance:
An arrangement by which one insurer transfers all or a portion
of its risk under a policy or group of policies to another
insurer (reinsurer). Thus reinsurance is insurance purchased by
an insurance company from another insurer, to reduce risk for
the original insurer
Reinsurance Facility:
An alternative mechanism to service those insureds who cannot
obtain insurance in the voluntary market. Premiums and losses
for the business that is ceded to the facility are pooled and
all insurers share according to their proportion of the
voluntary market
Renters Policy:
A package type of insurance that includes coverage similar to a
homeowners policy to cover the personal property of a renter or
tenant in a building
Rents or Rental Value Coverages:
Insurance against loss of the rental value of a property;
protects against loss of rents resulting from an insured peril
Replacement Cost Property Coverage:
Insurance under which the amount payable is the current
replacement cost of the property new, rather than the
depreciated value. Applies to the building structures (in most
cases) and can apply to contents in some policies
Reserve:
(1) An amount representing actual or potential liabilities kept
by an insurer to cover obligations to policyholders and
third-party claimants. (2) An amount allocated for a special
purpose. Note that a reserve is usually a liability and not an
extra fund. On occasion, a reserve may be an asset, such as a
reserve for taxes not yet due
Residual Market:
A general term describing the total of all consumers who have
had difficulty purchasing insurance through normal channels.
Automobile Insurance Plans, FAIR Plans, Reinsurance Facilities
and Joint Underwriting Associations all service this market
Retention:
The net amount of risk retained by an insurance company for its
own account or that of specified others, and not reinsured
Retrospective Rating:
Rating procedure that allows adjustment of an insured’s final
rate on the basis of the insured’s own loss experience
Rider:
Additional provision added to a policy by issuance of an
amending document (See Endorsement.)
Risk:
Chance of loss with respect to person, liability or the property
of the insured. Also is used to mean “the insured.”
Risk Management:
The management of the various risks that might affect a business
firm. Its purpose is to identify potential loss situations and
control or reduce them through insurance, elimination of risk,
or improved or additional safety practices
Robbery:
The loss of property due to theft when a person is threatened
with physical harm or injury
S
Sales Expense:
Compensation of agents, advertising expense and other costs
related to selling insurance policies
Salvage:
Property damaged to the extent that it is not economical to
perform repairs, taken over by an insurer after it has paid a
claim, to reduce its loss by “salvaging” the remaining value of
the property
Schedule:
A list describing the property or items insured under the policy
and the extent to which they are insured
Self-Insurance:
A form of risk financing through which a firm assumes all or a
part of its own losses. Self-insurers may purchase insurance to
cover excess losses
Soft Market:
A condition where insurance premiums are lowered and the
availability of insurance is high. Opposite of a hard insurance
market
Solicitor:
A person authorized by an agent to solicit and receive
applications for insurance
Special Multi-Peril Policy (SMP):
A business policy which combines in one contract the coverages
normally purchased under several policies. Many options and
endorsements are available to tailor it to the policyholder’s
needs
Specified Perils:
See Named Perils
Speculative Risk:
A type of risk with three possible outcomes: gain, loss or no
change
Standard Provisions:
Policy provisions required by law
Standard Risk:
A person who according to a company’s underwriting standards is
entitled to insurance without extra rating or special
restrictions
Statutory Accounting Principles (SAP):
Those principles required by statute that must be followed by an
insurance company when submitting its financial statements to
the various state insurance departments. Such principles differ
from Generally Accepted Accounting Principles (GAAP) in some
important respects. For example, SAP requires that expenses must
be recorded immediately and cannot be deferred to track with
premiums as they are earned and taken into revenue
Statutory Underwriting Profit or Loss:
Earnings or losses as shown by an insurer on its Statutory
Income Statement (convention blank) as required by state
insurance departments. More specifically: (1) the profit or loss
realized from insurance operations as distinct from that
realized from investments; (2) the excess of premiums over
losses and expenses (profit), or the excess of losses and
expenses over premiums (loss)
Stock Company:
A company organized and owned by stockholders, as distinguished
from the mutual form of company, which is owned by its
policyholders
Stopgap Endorsement:
Provides employer liability coverage for work-related injury
arising out of incidental operations or exposure in the
monopolistic fund states
Subrogation:
A principle of law incorporated in insurance policies that
enables an insurance company, after paying a loss to its
insured, to recover the amount of the loss from another who is
legally liable for it
Substandard or Extra Risk:
An individual who, because of health history or physical
limitations, does not measure up to the qualifications of a
standard life or health insurance risk
Surety Bond:
An agreement providing for monetary compensation should there be
a failure to perform specified acts within a stated period. The
surety company, for example, becomes responsible for fulfillment
of a contract if the contractor defaults
Suretyship:
Contractual relationship in which one party (surety) guarantees
another party (obligee) against the default or misperformance of
a third party (principal). (See
Fidelity Bond and Surety Bond.)
Surplus:
A stock company’s surplus is the amount by which its admitted
assets exceed its liabilities and capital stock. In both stock
and mutual companies, the term surplus-to-policyholders means
the excess of admitted assets over liabilities
Surplus Lines:
A term originating in property/casualty insurance, used to
describe any risk or part thereof for which insurance is not
available through a company licensed in the applicant’s state
(an “admitted” insurer). The business, therefore, is placed with
“non-admitted” insurers (insurers not licensed in the state) in
accordance with surplus or excess lines provisions of state
insurance laws. These provisions generally allow operations on a
relatively unregulated basis; that is, the non-admitted insurer
is not subject to the same rate or coverage requirements that
apply to an admitted insurer
Syndicate:
A group of insurers or underwriters that join to insure certain
property that may be of such value or high hazard or so
expensive to underwrite that it can be covered more safely or
efficiently on a cooperative basis
T
Tenants Policy:
See Renters Policy
Term:
A period of time for which a policy is issued
Term Insurance:
Life insurance protection during a limited number of years but
expiring without value if the insured survives the stated period
Theft Insurance:
Protection for loss of property due to stealing, including
burglary, robbery and larceny
Third Party:
A person who files a liability insurance claim
Threshold:
Used in no-fault auto insurance to remove non-serious cases from
the tort system by establishing a point of “threshold” that must
be met or exceeded to sue in tort. Of those states and the
District of Columbia that have no-fault auto insurance, many,
including the District of Columbia, have a threshold in their
plan. There are three types of thresholds: the dollar threshold,
the disability threshold and the verbal threshold
Title Insurance:
An insurance contract relating to real estate described in the
policy which protects the insured landowner against loss or
damage by reason of defects, liens or encumbrances in the
insured title, if these faults exist at the date of the policy
and are not expressly excluded from its terms
Tort:
Any wrongful act, damage or injury done willfully, negligently
or in circumstances involving strict liability, but not
involving breach of contract, for which a civil lawsuit can be
brought
Total Disability:
Disability that prevents a person from performing (a) any of
his/her occupational duties, or (b) any duties for which he/she
is reasonably qualified. Definitions vary within policies
Towing Coverage:
Insures against charges for towing and road service at the place
of disablement, with a maximum amount stipulated for each
occurrence
Treaty Reinsurance:
A general reinsurance agreement between the ceding or primary
company and the reinsurer containing the contractual terms under
which a portion or all of the primary company’s business or a
particular class is passed on to the reinsurer
U
Umbrella Liability Policy:
A form of insurance protection against losses in excess of
amounts covered by other liability insurance policies; also
protects the insured in many situations not covered by the usual
liability policies. This policy is available for both personal
and commercial lines coverage
Underinsured Motorists Coverage:
Coverage is intended to cover you and passengers in your car for
losses unpaid because sufficient bodily injury liability limits
are not available from the policy of an at-fault driver. How and
under what circumstances the coverage becomes operative varies
in different states
Underwriter:
An employee of an insurance company who is a selector of risks.
The underwriter is expected to select business that will produce
an average risk of loss no greater than anticipated for the
class of business. In the life insurance industry, “underwriter”
may also mean an agent or other field representative who is
referred to as a “field underwriter.”
Underwriting:
The process of selecting risks for insurance and determining in
what amounts and on what terms the insurance company accepts the
risk
Underwriting Profit or Loss:
The profit or loss experienced by a property/casualty insurance
company after deducting from earned premiums the incurred losses
and expenses of doing business, but before provision of federal
income tax. It excludes investment income
Unearned Premium:
The portion of a property/casualty insurance premium that
applies to the unexpired portion of the policy period
Uninsured Motorists Coverage (UM):
Pays the policyholder and passengers in his/her car for losses
sustained by reason of bodily injury, sickness, disease or death
caused by the owner or operator of an uninsured automobile or a
“hit-and-run” driver
Uninsured Motorists Property Damage Coverage (UMPD):
Provides coverage to a vehicle involved in an accident with an
uninsured motorist. UMPD is similar to “collision coverage,” and
is not available to those who purchase collision coverage
Universal Life:
A type of permanent life insurance under which the policyowner
is allowed to vary the timing and amount of premium payments,
plus increase or decrease the death benefit (subject to
underwriting for an increase)
V
Valuation:
The process of determining a company’s liabilities under its
policy obligations is known as policy valuation. The process of
determining the value of a company’s investments is known as
asset valuation. Minimum valuation standards are usually
prescribed by state laws
Valued Policy:
An insurance policy under which the insurance company is
obligated to pay the full amount of the policy written to insure
real property against loss by fire (and, sometimes, other
perils) when the property insured is totally destroyed. Several
states have laws that are known as Valued Policy Laws
Vandalism:
Willful, intentional, often random, destruction or defacement of
private or public property. Insurance against the vandalism
peril is usually combined with the malicious mischief peril
Variable Life Insurance:
A type of permanent life insurance in which the death benefit
and the policy value vary in relation to the investment
experience of a selected fund in which the policy values are
invested
Verbal Threshold:
In no-fault auto insurance states with the verbal threshold,
victims are allowed to sue in tort only if their injuries meet
certain verbal descriptions of the types of injuries that
should, as a matter of policy, render one eligible to seek to
recover for pain and suffering in a cause of action in tort
Voluntary Market:
The market where a person seeking insurance obtains it with no
help from the state, through an insurer of his or her own
selection
W
Workers’ Compensation:
A system (established under state laws) under which employers
provide insurance for benefit payments to employees for their
work-related injury, death and disease regardless of fault. Not
to be mistaken as health insurance
Write:
To insure, underwrite or accept an application for insurance.
Sources: Original glossary reprinted, with
permission, Allstate Insurance Company, Northbrook, IL, with all
rights. Excerpts also from Insuring Your Business, by
Sean Mooney, Chief Economist, Director of Research, and Senior
Vice President at Guy Carpenter & Company in New York, and
former economist, Insurance Information Institute; Ensuring
Availability: Residual Property Insurance Plans, Property
Insurance Plans Service Office and The Buyers’ Guide to
Business Insurance, PSI Research. |