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A
Abandonment: As used in property insurance,
prohibits the insured from abandoning damaged
property to the insurance company for repair or
disposal
Accelerated Benefits Rider: An adjustment (rider) to
a life insurance policy that allows for the early
payment of some portion of the policy's face amount
should the insured suffer from a terminal illness or
injury.
Accidental Death Benefit Rider: An adjustment
(rider) to a life insurance policy that provides for
payment of an additional cash benefit when death
occurs by accidental means. This amount depends on
the value of the policy.
Accidental Death Insurance: An insurance policy that
provides payment if the insured's death
results from an accident.
Accounts Receivable Coverage: Covers loss of sums
owed to the insured by its customers that are
uncollectible due to damage by an insured peril to
accounts receivable records
Actual Cash Value (ACV): Cost to repair or replace
damaged property with materials of like kind and
quality, less depreciation
Additional Insured: A person or organization for
whom insured status is arranged by endorsement
Advertising Injury: General liability coverage that
insures against libel, slander, invasion of privacy,
copyright infringement and misappropriation of
advertising in connection with the insured's
advertising of its goods or services
Agent: An authorized representative of an insurance
company.
Aggregate: The maximum amount an insurance company
will pay during the policy
All Risk Coverage: Property insurance covering loss
arising from all causes of loss except those that
are specifically excluded
Annually Renewable Term: Term insurance that
provides coverage for one year and allows the policy
owner to renew his or her coverage each year.
Application: A form with the information needed for
an insurance company to underwrite and rate a
specific policy
Assignment: The transfer of ownership of a Life
Insurance policy from one person to another.
Attained Age: Your current age. Your attained age is
a factor life insurance companies use to determine
premiums.
Audit: A verification of the financial records,
usually payroll or receipts, of an organization to
determine exposures and premiums
Automobile: A land motor vehicle, trailer or
semi-trailer designed for travel on public roads,
not including 'mobile equipment'
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B
Backdating: Making the effective date of a policy
earlier than the date of application. Backdating is
often used to make the age of the applicant lower
than it actually was at the time of application so
that he/she can get a lower premium. State laws
often set limits to this.
Bailee Coverage: Coverage on property left in the
care of the insured for storage, repair or servicing
Basic Cause of Loss Form: Property coverage for
named perils: Fire, Lightening, Explosion, Smoke,
Windstorm, Hail, Riot, Civil Commotion, Aircraft,
Vehicles, Vandalism, Sprinkler Leakage, Sinkhole
Collapse and Volcanic Action
Basic Limits: The minimum limits of liability that
can be carried by an insured
Beneficiary: The designated person set to receive
the death benefit if the insured should die.
Best's Rating: A rating system by A.M. Best Company
giving the financial condition of insurance
companies
Bind: The act of effecting coverage
Binder: A temporary insurance policy that expires at
the end of a specific time period or when a
permanent policy is written. A binder is given to an
applicant for insurance during the time it takes an
insurance company to complete the policy paperwork.
Binder Date: The date and time that coverage is
bound or put into effect.
Bodily Injury by Accident Limit: The most an insurer
will pay under Part Two of a Workers' Compensation
Policy for claims arising out of any one accident,
regardless of how many employee claims arise out of
the accident
Bodily Injury by Disease, Each Employee: The most
an insurer will pay under Part Two of a Workers'
Compensation Policy for damages due to bodily injury
by disease to any one employee
Bodily Injury by Disease-Policy Limit: The most an
insurer will pay under Part Two of a Workers'
Compensation Policy employee bodily injury by
disease claims during the policy period regardless
of the number of employees who make such claims
Bodily Injury Liability Limit: The insured is
legally liable for damages due to bodily injury,
sickness, or disease, including resulting death
Boiler & Machinery Insurance: Coverage for loss
caused by mechanical or electrical equipment
breakdown, including damage to the equipment
Bond: A written agreement in which one party, the
surety, guarantees the performance or honesty of a
second party, the principal (obligor), to the third
party (obligee) to whom the performance or debt is
owed
Brands and Labels Endorsement: Property insurance
coverage that allows the insured to remove labels
from damaged goods or mark the items as 'salvage,'
provided the goods are not damaged in the process
Broad Causes of Loss Form: Property coverage for the
named perils: Fire, Lightening, Explosion, Smoke,
Windstorm, Hail, Riot, Civil Commotion, Aircraft,
Vehicles, Vandalism, Sprinkler Leakage, Sinkhole
Collapse, Volcanic Action, Breakage of Building
Glass, Falling Objects, Weight of Snow, Ice or
Sleet, Water Damage (in the form of leakage from
appliances) and Collapse from Specified Causes
Broker: A licensed transactor of insurance who
represents the client
Broker Fee: The fee for services rendered that is
charged by a Broker
Building Ordinance Coverage: Covers against loss
caused by enforcement or ordinances or laws
regulating construction and repair of damaged
buildings
Burglary: Theft of property by forcible entry, which
is evidenced by visible signs, in premises, by a
person
Business Auto Policy: Auto Policy for businesses
that includes auto liability and auto physical
damage coverages
Business Income Coverage: Insurance covering loss of
income by a business when operations are interrupted
due to property loss that is a covered cause of loss
Business Interruption Coverage: See Business Income
Coverage
Business Owners Policy (BOP): A policy that combines
property and liability coverages for special types
of small businesses
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C
Cancellation: The termination of an insurance policy
usually before its expiration
Care, Custody or Control: An exclusion of liability
insurance which eliminates coverage for damage to
property in the insured's care, custody or control
Carrier: The insurance company which provides
coverage
Cash Benefits: The money that is paid to the policy
holder upon settlement of a covered claim.
Cash Value: The equity amount or "savings"
accumulation in a whole life insurance policy.
Casualty Insurance: Insurance that covers loss
caused by injuries to persons and the legal
liability imposed on the insured for injury or for
damage to property of others
Catastrophe: A severe loss causing sizable financial
loss
Causes of Loss Forms: The commercial property forms
that define the covered causes of loss for which
coverage is provided. Commonly, there are 3 Cause of
Loss Forms: Basic, Broad and Special
Certificate of Insurance: A document providing
evidence that insurance has been purchased
Claim: A request by a policyholder or a claimant for
payment under a policy of insurance
Claim Expense: Expenses of settling or investigating
a claim
Claimant: The person presenting a claim
Claims Reserve: An amount of money set aside to meet
claims reported but not paid
Class: A group of businesses who have common or
similar exposures and are grouped together for
rating purposes
Classification: The arranging or establishing of
business groups or categories for rating purposes
Coinsurance Provision: An insurance provision for
property coverages in which the policyholder must
carry an amount of insurance that is at least equal
to a set percentage of the value of the property in
order to receive full payment of a loss
Collapse: Collapse of a building and collapse of
personal property within a building due to specified
causes (such as weight of snow, ice or rain). Does
not include collapse due to design error or due to
faulty workmanship or materials if the collapse
occurs after construction is complete
Collision Deductible Waiver (CDW): That coverage
which, in the event our insured's car is damaged in
an accident which is the fault of an identified
Uninsured Motorist, waives (or eliminates) the
deductible requirement under the collision coverage
when repairing the auto.
Collision Insurance: Provides for payment to a
covered automobile resulting from the striking of
another object by a moving vehicle
Combined Single Limit (CSL): A limits structure for
Bodily injury and Property Damage Liability or
Uninsured Motorist Bodily injury coverage which
provides one single limit, which is the maximum
payable for all damages in any one occurrence. Most
commercial auto insurance is written CSL
Commercial General Liability Policy (CGL): A
coverage which protects business organizations
against liability claims for bodily injury and
property damage. Those claims may be the result of
events at your place of business, from your business
operations, the products or services you make or do,
communications or advertisements your business
broadcasts
Competitive State Funds: State-owned and operated
facilities that write Workers' Compensation
Insurance solely for that state
Completed Operations: A General Liability coverage
for the work of the insured that has been completed
away from the business premises
Comprehensive Auto Coverage: Covers an automobile
for loss or damage for all causes except for those
specifically excluded
Compulsory Insurance: Insurance that is required by
law
Concealment: Failure to disclose facts which may
void an insurance policy
Conditional Receipt: Given to policy owners when
they pay a premium at the time of the application.
These receipts bind the insurance company, provided
your policy is approved, but are subject to any
other conditions stated on the receipt.
Conditions: Things agreed upon in an insurance
policy that state the rights and the requirements of
the insured and the insurer
Consequential Loss: An indirect loss such as the
reduction in value of property that is the result of
a direct damage loss
Constructive Total Loss: Term used when damage to
property is more than the value of the property
*Contestable Clause: A provision in an insurance
policy setting forth the conditions or time period
under which the insurance company may contest or
void the policy. After this time has lapsed,
typically two years, the policy cannot be contested.
Example: Suicide.
Contingent Beneficiary: Person or persons designated
to receive the value of an insurance policy in case
the original beneficiary is not alive.
Contract: An agreement between two or more parties
with characteristics of mutual assent, competent
parties, a valid consideration and legal subject
*Coverage: Coverage is just another term for
Insurance. It can be used to mean either the dollar
amounts of insurance purchased ($500,000 of
liability coverage), or the type of loss covered
(coverage for theft).
Convertible Term: A policy that may be changed to
another form by contractual provision and without
evidence of insurability. Most term policies are
convertible into permanent insurance.
Countersignature: The signature of a licensed agent
or representative on a policy that is required to
validate the policy
Cross-Purchase Plan: An agreement that provides that
upon a business owner's death, surviving owners will
purchase the deceased's interest, often with funds
from life insurance.
Cumulative Injury: A type of injury which occurs
from the repetition of tasks over an extended length
of time
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D
Data Processing or EDP Coverage: All risk property
insurance for electronic data processing equipment
(computers), computer programs and data including
mechanical breakdown, electrical injury and changes
in temperature and humidity
Death Benefit: The amount of money paid to the
beneficiary when the insured person dies.
Decreasing Term Insurance: Term life insurance on
which the face value slowly decreases in scheduled
steps from the date the policy comes into force to
the date the policy expires, while the premium
remains level. The intervals between decreases are
usually monthly or annually.
Debris Removal: The cost of removal of debris from
covered property damaged by an insured peril
Deductible: The amount of loss which is paid or
absorbed by the insured prior to determining the
insurance company's liability
Defense: Coverage provided in most liability
policies, which pays for the cost of defending the
insured in the event of lawsuit regarding a covered
loss. Defense cost, in the auto policy, is said to
be "unlimited," in that the policy requires the
insurer to pay whatever is necessary, however it is
actually limited in that the insurer can pay policy
limits in damages and thereby avoid the defense
requirement entirely.
Deposit Premium: The amount of premium required at
the beginning of a policy prior to the actual
premium being determined
Depreciation: The reduction in value of property
over a period of time. Usually as a result of age,
wear and tear, or economic obsolescence
Direct Damage: Causes of loss that produce direct
and straightforward property damage (without
interruption in time or deviation in space) from the
cause of the event to the damaged property
Double Indemnity: Payment of twice the basic benefit
in the event of loss resulting from specified causes
or under specified circumstances.
Down Payment: An amount of money (usually a
percentage of the premium plus any fees) which the
insured must pay in order for the coverage to be
bound
Driver Other Car Endorsement: An endorsement that
can be added to an automobile policy that gives
protection while the insured designated in the
endorsement is driving a car other than the one
named in the policy
Drop Down Provision: A clause used in Umbrella
policies providing that the Umbrella will
'drop-down' over underlying policy aggregate limits
when they have been reduced or exhausted
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E
Earned Premium: The amount of premium that has been
used for certain periods of time
Earth Movement or Earthquake Exclusion: An exclusion
found in most property insurance policies
eliminating coverage for earth movement or
earthquake, except ensuing fire
Effective Date: The date on which an insurance
binder or policy goes into effect
Electrical Damage or Injury Exclusion: An exclusion
usually contained in property insurance policies
eliminating coverage for damage to electrical
appliances caused by artificially generated
currents, except for ensuing fire or explosion
Employee Dishonesty Coverage: Coverage for theft of
money, securities or property by an employee
Employee Leasing: A staffing method which an
employee leasing company provides all or most of its
client's employees
Employers Excess Indemnity Insurance: Insurance
coverage purchased by employers that do not
subscribe to the Texas Workers' Compensation law
Employers Liability Coverage: Part 2 of the Workers'
Compensation policy which pays on behalf of the
employer all sums that the employer becomes legally
obligated to pay because of bodily injury by
accident or disease sustained by any employee of the
insured arising out of and in the course of his
employment by the insured
Employment Practices Liability Insurance: A form of
liability insurance covering wrongful acts arising
from employment practices such as wrongful
termination, discrimination and sexual harassment
Endorsement: A document attached to an insurance
policy that changes the original policy provisions
Equipment Floater: A property insurance coverage for
equipment that is often moved from place to place
Estimated Premium: A preliminary premium amount that
could be adjusted based on a variance in exposures
Evidence of Insurability: Any statement or proof of
a person's physical condition, occupation, etc.,
affecting acceptance of the applicant for insurance.
Excess and Surplus Lines Insurance: Coverage that is
provided by insurers not licensed in the states
where the risk is located
Excess Liability Policy: A policy that provides
additional limits in excess of an underlying
liability policy
Exclusions: Specified hazards listed in a policy for
which benefits will not be paid.
Expected or Intended: An exclusion for injury or
damage that is expected or intended
Expediting Expense Coverage: Coverage providing
reimbursement of expenses for temporary repairs and
costs incurred to speed up the permanent repair or
replacement of covered property or equipment
Expense Constant: A small flat expense charged to
Workers' Compensation policies
Experience Modifier: A debit or credit factor
developed by measuring the difference between the
insured's actual past experience and the expected or
actual experience of the class of business
Expiration: The ending date of an insurance policy
Exposure Base: The basis of rates that are applied
to determine premium. Some exposures may be measured
by payroll, receipts, sales, square footage, area,
man-hours or per unit
Extra Expense Coverage: Coverage for reimbursement
of expenses in excess of normal operating expenses
that are incurred to continue operations after a
direct damage loss
Extraterritorial Coverage: The coverage for
extending workers' compensation law to provide
benefits for workers hired in one state but injured
while working in another state
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F
Face Amount: The amount covered by the terms of an
insurance contract, usually found on the first page
of the policy.
Fiduciary Liability: The liability placed on
trustees, employers, fiduciaries and professional
administrators with respect to errors and omissions
in the administration of employee benefit programs
Final Expenses: Expenses incurred at the time of a
person's death. These include but are not limited
to: funeral costs, court expenses, current bills or
debt, mortgages, loans and taxes.
Fine Arts Coverage: Property insurance for works of
art
Fire Department Service Charge Coverage: Coverage in
a property insurance policy for charges incurred by
the insured from a fire department for their
services in fighting a fire
Fire Legal Liability Coverage: Liability coverage
for the insured's legal liability for fire damage to
premises rented by the insured
Fire Wall: A wall designed to prevent the spread of
fire from one part of a building to another
Firewall: A computer that protects a company's
private network from outside internet users
First Party: The Insured. A first party loss is a
loss that involves injury and /or damage to the
property of our insured
Fixed Benefit: A death benefit in which the dollar
amount of which does not vary.
Flat Cancellation: The full cancellation of a policy
as of the effective date of coverage which requires
the return of paid premium in full
Flood Coverage: Coverage for damage to property
caused by flood
Flood Exclusion: A provision in most all property
insurance policies eliminating coverage for damage
by flood and possibly other types of water damage,
such as seepage and sewer backup
Follow Form: An umbrella policy provision that
follows the underlying policy for coverages and
policy provisions
Forgery or Alteration Coverage: Covers loss due to
the dishonesty of writing, signing or altering of
checks and bank drafts
Fortuitous Event: An event that is subject to chance
without the implication of suddenness
Free Look: Trial period required in most states
where policy owners have up to 20 days to examine
their new policies with no obligation.
Frequency: The number of times that a loss will
occur within any given period of time
Full Coverage: Any form of insurance that provides
payment in full of all losses caused by the perils
insured against without applying a deductible or
depreciation
Funeral Expenses: Expenses including casket, vault,
grave plot, headstone and funeral director.
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G
Garage Liability Insurance: Insurance coverage for
the legal liability of automobile dealers, garages,
repair shops and service stations for bodily injury
and property damage arising out of their business
operations
Garagekeepers Coverage: Provides coverage to owners
of storage garages, parking lots and body and repair
shops for their liability of damage to automobiles
left in their custody for safekeeping or repair
General Aggregate Limit: The maximum amount of
insurance payable during the policy period for
losses (other than those arising from the products -
completed operations hazards as covered under the
standard commercial general liability policy)
General Liability Insurance: Insurance protecting
businesses from most liability exposures other than
automobile and professional liability
Glass Insurance: A property insurance policy
covering breakage of building glass regardless of
cause
Governing Classification: In Workers' Compensation
Insurance, the classification that best describes
the workers' compensation exposure of an employer's
business
Grace Period: Period of time after the due date of a
premium during which the policy remains in force
without penalty.
Graded Premium Policy: A type of whole life policy
designed for people who want more life coverage than
they can currently afford. They pay a lower premium
rate that increases gradually over the first three
to five years and then remains constant over the
life of the policy.
Gray Market: A vehicle which was built for sale
outside the U.S. These vehicles (usually built by
Porsche, Mercedes, or BMW) do not meet U.S.
standards regarding emission control, safety glass,
lighting, etc.
Gross Negligence: Willful and wanton misconduct
Gross Vehicle Weight (GVW): The weight specified by
a manufacturer for the maximum total loaded weight
of a single vehicle
Guaranteed Term: A form of renewable term insurance
that remains in force as long as the premiums are
paid on time. With guaranteed term insurance, the
insurance company cannot terminate the policy during
the term.
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H
Hired Automobile: An automobile whose exclusive use
has been temporarily given to another for a monetary
sum or other consideration. The business auto
definition of 'hired autos,' however, includes autos
borrowed except those borrowed from employees or
partners
Hold Harmless Agreement: A contractual agreement
that requires one contracting party to assume
certain legal liabilities of the other party
Host Liquor Liability: Liability coverage for hosts
of business or social functions arising out of the
serving or distribution of alcoholic beverages by a
party not engaged in this activity as a business
enterprise
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I
Impound Account: Your mortgage company/financial
institution that you financed your home with will
pay for the insurance and taxes on the home in full
and you pay them back monthly. Monthly payments get
added onto your normal monthly payments of you loan.
Even though your mortgage company pays your
insurance, you still get to choose the insurance
company and the price.
Improvements and Betterments: Additions or changes
made by a lessee at his own expense to property that
may not legally be removed. Usually covered under
the tenants property coverage
Incontestable Clause: A clause in a policy providing
that a policy has been in effect for a given length
of time (two or three years), the insurer shall not
be able to contest the statements contained in the
application. In life policies, if an insured lied as
to the condition of his health at the time the
policy was taken out, that lie could not be used to
contest payment under the policy if death occurred
after the time limit stated in the incontestable
clause.
Incurred Losses: The amount of paid claims and loss
reserves within a particular period of time, usually
a policy year. Customarily computed as losses
incurred during the period, plus outstanding losses
at the end of the period, less outstanding losses at
the beginning of the period
Independent Adjuster: A claims adjuster who provides
adjustment services to insurance companies but is
not employed by them
Independent Contractor: An individual or company who
has agreed, in writing, with another party to
perform a job or function on behalf of that party
Inflation Guard Provision: A provision that
increases the limit of insurance by a specified
percentage over a specified period of time to offset
inflation costs
Insurability: The condition of the individual
wishing to be insured, including their health,
susceptibility to injury and life expectancy.
Insurance: A formal social device for reducing risk
by transferring the risks of several individual
entities to an insurer. The insurer agrees, for a
consideration, to pay for the loss in the amount
specified in the contract.
Insurance Policy: The printed form which serves as
the contract between an insurer and an insured.
Insurance to Value: Insurance written in an amount
equal to the value of the property or which meets
coinsurance requirements
Insured: The party who is being insured. In life
insurance, it is the person because of his or her
death the insurance company would pay out a death
benefit to a designated beneficiary.
Insured Agreement: Promise made by the insurance
company, which outlines its duties. Exclusions,
conditions and definitions that appear later in the
policy modify this promise.
Insurer: The insurance company; Party that provides
insurance coverage, typically through a contract of
insurance.
Irrevocable Beneficiary: A beneficiary that cannot
be changed without that beneficiary's consent.
Increasing Term Insurance: Term life insurance in
which the death benefit increases periodically over
the policy's term. Usually purchased as a cost of
living rider to a whole life policy.
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J
Joint Venture: A business relationship when two or
more persons join their labor or property for a
business undertaking and share profits
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K
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L
Lapse: Termination of a policy due to the policy
owner's failure to pay the premium within the grace
period.
Leasehold Interest: Property insurance covering the
loss suffered by a tenant due to termination of a
lease because of damage to the leased premises by a
covered loss
Lessee: The person to whom a lease is granted
Lessor: The person granting the lease
Liability: The legal obligation to pay a monetary
award for injury or damage caused by one's negligent
or statutorily prohibited action
Liberalization Clause: A provision within an
insurance policy that broadens the coverage if the
insurance company offers a broader coverage form
within the first 45 days of coverage
Lien: An obligation that can be held by an
individual who has an interest in a particular
matter or property
Life Expectancy: The average number of years a
person is expected to live based on a national
average per age group, and other factors.
Life Insurance: Insurance coverage that pays out a
set amount of money to specified beneficiaries upon
the death of the individual who is insured.
Limit of Liability: The most an insurance company
agrees to pay in the case of loss
Limited Pay Policy: A type of whole life insurance
designed to let the policyholder pay higher premiums
over a specific time period such as 10 or 20 years
so that they won't have to pay any premiums for the
rest of his or her life.
Limits: Maximum amounts payable under a given
coverage. May be per person, per occurrence, per
day, or per year.
Longshore and Harbor Workers' Compensation Act: A
federal law that provides workers' compensation
benefits to employees of a vessel injured in
maritime employment - usually in loading, unloading,
repairing or building a vessel - but not applicable
to crew members
Loss: The amount an insurance company pays for
damages under the terms of a policy
Loss Adjustment Expense: The cost assessed to a
particular claim for investigating and adjusting
that claim
Loss Constant: A flat charge added to the premium of
small workers' compensation policies to offset
higher loss ratios
Loss Control: A technique that is put in place to
reduce the possibility that a loss will occur or
reduce the severity of those that do occur
Loss Payable Clause: An insurance clause that
authorizes loss payments to a person or entity
having an insurable interest in the covered property
Loss Payee: Typically the finance company holding
title to the owned auto
Loss Ratio: Percentage of losses incurred against
earned premiums
Loss Report: A form showing reported claims which
provides information such as the date of occurrence,
type of claim, amount paid and amount reserved for
each loss
Loss Reserve: An estimated amount set aside for a
particular claim that has not yet been paid
Lost Policy Release: A signed statement by the named
when the insured wishes to cancel the policy, but
has lost or mislaid the policy, which releases the
insurance company from all liability or losses
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M
Medical: A document completed by a physician or
another approved examiner and submitted to an
insurer (insurance company) in order to provide
medical information. This is usually done to
determine insurability (or lack of insurability) or
is sometimes done in relation to a claim.
Medical Expenses: Reasonable charges for medical,
surgical, x-ray, dental, ambulance, hospital,
professional nursing, prosthetic devices, and
funeral expenses. What is considered reasonable is
outlined in a policy.
Medical Payments, Auto: Coverage, which is optional,
under an auto policy to pay for medical expenses for
bodily injury caused by an auto accident, regardless
of fault. Coverage for persons other than the named
insured and his or her family members is typically
restricted to circumstances when they are occupants
of the insured auto
Medical Payments, General Liability: A general
liability coverage that reimburses others,
regardless of fault, for medical or funeral expenses
incurred as a result of bodily injury or death
sustained by an accident
Mexico Coverage: Coverage which is sometimes
provided under automobile policies for the operation
of an insured motor vehicle within Mexico, usually
limited to a stated number of miles from the U.S.
border
Minimum Premium: The lowest amount of premium to be
charged for providing a particular insurance
coverage
Misrepresentation: The act of knowingly presenting
false information.
Mobile Equipment: Equipment such as earthmovers,
tractors, diggers, farm machinery, forklifts, etc.,
that even when self-propelled, are not considered as
automobiles for insurance purposes
Monopolistic State Funds: States or Jurisdictions
where an employer must obtain workers' compensation
insurance from a state fund or qualify as a
self-insurer, as is allowed in five of the states:
North Dakota, Ohio, Washington, West Virginia,
Wyoming, Puerto Rico and the U.S. Virgin Islands
Mortality Rate: The number of deaths in a group of
people, usually expressed as deaths per thousand.
Mortality Table: A table showing the incidence of
death at specified age groups.
Mortgage Clause: Property insurance provisions
granting protection for the mortgagee named in the
policy. It establishes that loss to mortgaged
property is payable to the insured and to the
mortgagee named in the policy
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N
Named Insured: That person so listed on the
Declarations and his/her spouse if a resident of the
same household
Named Perils Coverage: A property insurance term
referring to exact causes of loss specifically
listed as covered
National Flood Insurance Program: A federally funded
program established to make flood insurance
available to properties located in participating
communities
Nonadmitted Insurer: An insurance company that is
not licensed to do business in a specific state. The
insurers may write coverage through an excess and
surplus lines broker that is licensed in these
jurisdictions
Nonowned Automobile: In commercial auto policies,
coverage for autos that are used in connection with
the named insured's business but are neither owned,
leased, hired, rented or borrowed by the named
insured. The term specifically applies to vehicles
owned by employees and used for company business
Nonsubscription: A Workers' Compensation term used
in Texas that refers to employers who choose to be
out of the workers' compensation system. Firms that
are proven negligent in causing a worker's injury,
can be held liable in tort, since nonsubscribing
employers waive the traditional common law defenses
available to employers subject to workers'
compensation laws
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O
Operator: In auto insurance, that person seated
immediately behind the steering controls of the
automobile and no other person
Original Age: The age you were when you bought an
insurance policy.
Other Insured Rider: The temporary addition to an
insurance policy, usually a member of the direct
family.
Ownership: All rights, benefits and privileges under
life insurance policies are controlled by their
owners. Policy owners may or may not be the insured.
Ownership may be assigned or transferred by written
request of current owner.
Occupational Hazard: A condition in the workplace
that increases the chances of an accident, sickness,
or death. It usually will mean higher premiums.
Occurrence: A continual, gradual or repeated
exposure to substantially the same general harmful
conditions. General liability policies insure
liability for bodily injury or property damage that
is caused by an occurrence
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P
Package Policy: A policy providing several different
coverages combined into one policy. Refers to a
policy providing both general liability insurance
and property insurance
Payroll Limitation: A limit on the amount of payroll
for certain classifications used for the development
of premium
Peril: Cause of loss such as fire, windstorm,
collision, etc.
Permissive User: An entity not listed on the policy,
using the insured's vehicle with permission.
Depending on the particular policy, certain
individuals may not be covered, even if given
permission by the insured
Personal Auto Policy (PAP): A policy insuring
private-passenger autos owned by individuals
Personal Injury: A General Liability coverage for
insurable offenses that cause harm, other than
bodily injury, such as false arrest, detention or
imprisonment, malicious prosecution, wrongful
eviction, slander, libel and invasion of privacy
Personal Injury Protection (PIP): An automobile
insurance coverage mandated by law in some states.
The statutes typically require insurers to provide
or offer to provide first-party benefits for medical
expenses, loss of income, funeral expenses and
similar expenses without regard to fault
Personal Property: All tangible property not
classified as real property such as contents
Policy: The printed document given to the insured,
outlining the terms and conditions of the Insurance
coverage.
Policy Fee: A one-time charge per policy that does
not change with the size of the premium
Policy Holder: The person who owns a life insurance
policy. This is usually the insured person, but it
may also be a relative of the insured, a partnership
or a corporation.
Policy Jacket: A preprinted brochure which contains
all policy language except that contained in the
Declarations Page and Endorsements. In the Policy
Jacket you will find the Insuring Agreement(s),
Exclusions, Conditions and Definitions
Policy Period: The term or duration of a policy
including the effective and expiration dates
Pollutant: An irritant or contaminant, whether in
solid, liquid, or gaseous form, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
waste
Preferred Risk: A positive characteristic of someone
seeking to be insured. Usually means a better likely
hood for long life, and usually means a lower
premium.
Premises: The location where coverage applies
Premises-Operations: A category of hazard ordinarily
insured by a general liability policy which is
composed of those exposures to loss that fall
outside the defined 'products-completed operations
hazard,' including liability for injury or damage
arising out of the insured's premises or out of the
insured's business operations while such operations
are in progress
Premium: The agreed upon, payment made to keep an
insurance policy in force, usually a monthly
payment.
Premium Flexibility: The policy holder's right to
vary the amount of premium paid each month.
Primary Beneficiary: In life insurance, the
beneficiary designated by the insured as the first
to receive policy benefits.
Primary Policy: The insurance policy that pays first
when you have a loss that's covered by more than one
policy.
Private Passenger Auto: A self-propelled motor
vehicle, with neither more nor less than four
wheels, designed for use upon streets and highways
and subject to motor vehicle registration under the
law
Pro Rata Cancellation: The cancellation of an
insurance policy with the return premium being the
full proportion of premium for the unexpired term of
the policy, without penalty for early cancellation
Producer: A fire and casualty licensee who, for
compensation, acts or aids in any manner of
soliciting, negotiating, or procuring the making of
any insurance contract on behalf of the insured
Producer Fee: The fee charged by the producer for
services, which is in addition to the premium
Product: Items manufactured, sold, handled,
distributed or disposed of by the named insured or
others involved with the named insured in the course
of their business. Includes containers, parts and
equipment, product warranties and provision of or
failure to provide instructions and warnings
Product Liability: The liability for bodily injury
or property damage a merchant or manufacturer may
incur as a consequence of some defect in the product
sold or manufactured
Products-Completed Operations: General Liability
coverage for liability arising out of the insured's
products or business operations conducted away from
the insured's premises once those operations have
been completed
Professional Liability: Coverage designed to protect
professionals such as physicians and real estate
brokers, against liability incurred as a result of
errors and omissions in performing professional
services
Property Damage: In the general liability policy, a
physical injury to property, resulting in the loss
of use
Property Insurance: First-party insurance for real
and personal property against physical loss or
damage
Provisions: Details of an insurance policy which
explain the benefits, conditions and other features
of the insurance contract.
Proof of Non-Fault/ No B/I: Documentation required
by the insurer to support not charging for an
accident or not assigning points for bodily injury
in an accident. Acceptable forms are limited to a
police report, a letter from the previous insurer or
a letter from the carrier of the other party in the
accident. The insurer may accept a copy of the
claims check stub if it contains sufficient
information
Punitive and Exemplary Damage: That form of damages,
awarded by the court, which is intended to punish
the wrong-doer, not to compensate the injured party.
This form of damages is generally not covered by a
liability policy
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Q
Quote: An estimate of the cost of insurance given to
a prospective client. This estimate does not
constitute an offer and therefore is not
enforceable. It is literally an invitation to the
insured to make an offer. The offer, which may be
accepted or rejected, is the policy application
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R
Real Property: Real estate including buildings and
vegetation
Re-entry Option: An option in a renewable term life
policy under which the policy owner is guaranteed,
at the end of the term, to be able to renew his or
her coverage without evidence of insurability, at a
premium rate specified in the policy.
Reinstate with Lapse: The act of re-activating a
policy which has ceased to be valid due to
expiration or cancellation. There is a period
between the cessation of coverage and its
reinstatement during which the carrier provided no
coverage
Reinstatement: Putting a lapsed policy back in force
by producing satisfactory evidence of insurability
and paying any past-due premiums required.
Renewal Policy: A policy issued to replace an
expiring policy
Rents or Rental Value Insurance: Insurance that
reimburses a building owner for loss of rental
income due to damage by an insured peril
Replacement: A new policy written to take the place
of one currently in force.
Replacement Cost: The cost of replacing the damaged
property with new property of like kind and quality
without deduction for depreciation
Representation: Statements made by applicants on
their applications for insurance that they represent
as being substantially true to the best of their
knowledge and belief but that are not warranted as
exact in every detail.
Return Premium: The amount of premium due the
insured should the actual cost of a policy be less
than the insured previously paid
Rider: An attachment to a policy that modifies its
conditions by expanding or restricting benefits or
excluding certain conditions from coverage.
Risk: The chance of injury, damage, or loss.
Robbery: Theft of property while force is used or
threatened
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S
Secondary Beneficiary: An alternate beneficiary
designated to receive payment, usually in the event
the original beneficiary predeceases the insured.
Short-Term Cancellation: Cancellation of an
insurance policy prior to the expiration date in
which a penalty in the form of a less than full
pro-rata premium refund is allowed
Single Premium Policy: A whole life policy for
people who want to buy a policy for a one-time lump
sum, and then be covered for the rest of their lives
without paying any additional premiums.
Special Causes of Loss Form: A cause of loss form
providing coverage from all causes of loss unless
specifically excluded or limited
Specified Causes of Loss Coverage: Auto physical
damage coverage only for losses caused by the perils
listed in the policy
Split Limits: A limits structure for Bodily Injury
and Property Damage Liability or Uninsured Motorist
coverage which provides, for Bodily Injury, one
limit per person, which is the maximum payable for
all damages payable to any one injured person, a
separate limit per Occurrence, which is the maximum
payable for all Bodily Injury in any one occurrence,
and a third limit which is the maximum payable for
Property Damage in any one Occurrence. Most personal
lines auto insurance is written Split Limits
Sprinkler Leakage Coverage: Coverage for property
damage caused by the accidental discharge or leakage
of water from automatic sprinkler systems or other
fire prevention devices
Subrogation: The transfer of the insured's legal
right against an injuring Third Party to the
insurance carrier
Surplus Lines Insurance: Insurance written by
insurers not licensed in the states where the risks
are located and placed with such insurers under the
surplus line laws of the various states. Before such
placements can be made through specially licensed
surplus line agents and brokers, state laws
generally require evidence reported before some
predetermined future date ('sunset')
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T
Time Element Insurance: A term referring to property
coverage for loss of earnings or income resulting
from the inability to put damaged property to its
normal use
Term Insurance: Protection during limited number of
years; expiring without value if the insured
survives the stated period, which may be one or more
years but usually is five to twenty years, because
such periods usually cover the needs for temporary
protection.
Term: Period for which the policy runs. In life
insurance, this is to the end of the term period for
term insurance.
Third-Party Owner: A policy owner who is not the
prospective insured. The policy owner and the
insured may be, and often are the same person. If
for example, you apply for and are issued an
insurance policy on your life, then you are both the
policy owner and the insured and may be known as the
policy owner-insured. If, however, your mother
applies for and is issued a policy on your life,
then she is the policy owner and you are the
insured.
Towing: The optional auto insurance coverage which
will reimburse the insured for the expenses of
towing or repairs at the place of disablement in the
event the vehicle becomes disabled. Coverage is
written with a per Occurrence Limit
Trailer Liability: Trailer Liability is always
provided by the towing vehicle
Transit Coverage: Coverage on the insured's property
while in transit from one location to another, over
land
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U
Umbrella Liability Policy: A policy designed to
provide additional protection against catastrophic
losses covered under liability policies, such as the
business auto policy, commercial general liability
policy, watercraft and aircraft liability policies
and employers liability coverage. It provides excess
limits when the limits of the underlying liability
policies are used up by the payment of claims and it
drops down and picks up where the underlying policy
leaves off when the aggregate limit of the
underlying policy in question is exhausted by the
payment of claims. It also provides protection
against some claims not covered by the underlying
policies, subject to a self-insured retention
Underinsured Motorists Coverage: Provides coverage
for bodily injury, and in some states property
damage, for losses incurred by an insured when an
accident is caused by a motorist who does not have
sufficient insurance limits
Underlying Coverage: The insurance or coverage in
place on the same risk that will respond to loss
before the excess policy is called on to pay any
portion of the claim
Underwriter: Company receiving premiums and
accepting responsibility for fulfilling the policy
contract. Also, company employee who decides whether
the company should assume a particular risk; or the
agent who sells the policy
Uninsurable Risk: A person who is not acceptable for
insurance due to excessive risk.
Universal Life: An interest-sensitive life insurance
policy that builds cash values. The premium payer
has control over how the policy is structured. He
has the flexibility to eliminate the premiums
(essentially pay up the policy and pay no more
premiums) or have the premiums continue for life. It
is a matter of juggling three variables: the assumed
interest rate, the cash value and the premium
payment plan. The policy is interest-sensitive, and
if interest rates change from the assumed interest,
it will affect the other two variables. In the past,
many Universal Life Policies were structured
assuming a higher interest rate then was actually
received, therefore, most of them have under
performed. If you have a Universal Life Policy, you
should have it evaluated to see if it needs to have
the premiums adjusted to get it back on track. A
fourth variable that has not been a factor but could
be in the future, and the owner should be aware of,
is the Mortality variable. Universal Life policies
are usually structured assuming current mortality
rates. The insurance companies reserve the right to
change those rates.
Unearned Premium: That portion of the policy premium
that represents the unexpired policy term
Uninsured Motorist Bodily Injury (UMBI): That
coverage which, in the event our insured is injured
in an accident which is the fault of an Uninsured
Motorist, covers the Bodily Injury expenses of the
Named Insured, Relatives and passengers in his/her
auto. The coverage is generally written with a per
person and per Occurrence limit
Uninsured Motorist Coverage: Provides coverage for
bodily injury, and in some states property damage,
for losses incurred by an insured when an accident
is caused by a motorist who is not insured
Uninsured Motorist Property Damage (UMPD): That
coverage, which, in the event out insured's car is
damaged in an accident which is the fault of an
Uninsured Motorist, pays the cost of repairing the
auto. This coverage is only written when the policy
does not cover collision and has a variable maximum
Occurrence Limit
Uninsured Motorist Waiver of Deductible (UMWD): Only
pays if you do not have full coverage and you have
uninsured motorist coverage up to $3,500 to fix your
vehicle if you get hit by an uninsured motorist and
it is their fault
Utility Service Interruption Coverage: Coverage for
the loss to an insured due to lack of incoming
electricity which was caused by damage from a
covered cause of loss, such as a fire or windstorm,
to property away from the insured's premises -
usually the utility generating station. Also
referred to as 'off-premises power coverage'
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V
Vacancy Provision: Property insurance provision
found in commercial property policies that restrict
coverage in connection with buildings that have been
vacant for a specified number of days, usually 60
days
Valuable Papers and Records Coverage: Coverage that
pays the cost to reconstruct damaged or destroyed
valuable papers and records and usually includes
almost all forms of printed documents or records
except money or securities; data processing
programs, data and media are usually excluded
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W
Waiver of Premium: Rider or provision included in
most life insurance policies exempting the insured
from paying premiums after he or she has been
disabled for a specified period of time, usually six
months.
Waiver of Subrogation: Also known as 'transfer of
rights of recovery,' the relinquishment by an
insurer of the right to collect from another party
for damages paid on behalf of the insured
Whole Life Insurance: Life insurance that is kept in
force for a person's whole life as long as the
scheduled premiums are maintained. All Whole Life
policies build up cash values. Most Whole Life
policies are guaranteed as long as the scheduled
premiums are maintained. The variable in a Whole
life Policy is the dividend which could vary
depending on how well the insurance is doing. If the
company is doing well and the policies are not
experiencing a higher mortality than projected,
premiums are paid back to the policy holder in the
form of dividends. Policyholders can use the cash
from dividends in many ways. The three main uses
are: it can be used to lower or vanish premiums, it
can be used to purchase more insurance or it can be
used to pay for term insurance.
Workers' Compensation: Protection which provides
benefits to employees for injury or contracted
disease arising out of and in the course of
employment. Most states have laws which require such
protection for workers and prescribe the length and
amount of such benefits provided
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