Abandonment Condition
A condition often contained in Property insurance policies that states that
the insured cannot abandon damaged property to the insurer and demand to be
reimbursed for its full value.
Absolute Liability
Type of liability imposed by law on those participating in certain
activities that are considered especially hazardous. A person involved in
such operations may be held liable for the damages of another, even though
the individual was not negligent.
Accident
A loss that occurs at a specific time and place.
Actual Cash Value (ACV)
The cost to replace an item of property at the time of loss, less an
allowance for depreciation. Often used to determine the amount of
reimbursement for a loss.
Additional Coverages
Supplemental insurance coverages that apply only in certain circumstances,
have reduced or separate limits of liability or require the insured to meet
certain requirements before they are applicable. Also called coverage
extensions, other coverages and extended coverages.
Additional Insured
An individual or company, in addition to the insured, who is listed in the
Declarations. An example is a mortgage company that has an insurable
interest in the property insured.
Adhesion Contract
A contract where one party has more power than the other party in drafting
the contract. An insurance policy is an adhesion contract - the insurer is
the one with more power.
Admitted Insurer
See Authorized Insurer
Adverse Selection
The tendency of insureds with a greater-than-average chance of loss to
purchase insurance.
Agency
Principles governing the authority of any agent that represents a principal.
Agent
An individual or organization that legally represents another; a
state-licensed professional who represents the insurance company in the sale
and servicing of insurance; the direct link between the insurance company
and the policyholder.
Aggregate Limit
Type of policy limit found in Liability policies that limits coverage to a
specified total amount for all losses occurring within the policy period.
Agreed Amount Policy
See Valued Policy
Agreed Value Condition
Condition found in some Property insurance policies that stipulates a
certain value that will meet the coinsurance requirement. If the policy
limit equals or exceeds this amount, the insured will not be assessed a
coinsurance penalty. Also called Stated Amount Condition.
Agreement
See Offer And Acceptance
Aleatory Contract
A contract that is contingent on an uncertain event (a loss). An insurance
policy is an aleatory contract.
Alien Company
An insurance company incorporated in a country other than the United States
that is doing business in the United States.
All Risk Policy
See Open Peril Policy
A.M. Best Company
Organization that rates the financial stability of insurance companies doing
business in the United States.
Apparent Authority
Legal doctrine that states that an agent has whatever authority a reasonable
person would assume he or she has.
Application
Questionnaire filled out by an agent and the prospect who is seeking
insurance. The form contains information used to underwrite and rate the
policy.
Appraisal Condition
Policy condition that outlines a procedure for when the insured and insurer
disagree on the amount of a loss. The insured and the insurer each select an
appraiser. The two appraisers select an umpire. If the appraisers cannot
agree on the amount of loss, the umpire is consulted. The amount agreed to
by any two of the three parties is the amount paid for the loss.
Appurtenant Structures
Buildings of lesser value that are on the same premises as the main building
insured under a Property policy. They are usually covered by the policy.
Arbitration Condition
Policy condition that is similar to the Appraisal condition; may be used to
resolve other areas of disagreement besides those regarding the value of a
loss.
Assessment Mutual Company
Mutual insurance company that charges members a pro-rata share of losses at
the end of each policy period. See Mutual Company
Assigned Risk Plan
See Automobile Insurance Plan
Assignment Condition
Condition in insurance policies that specifies that the policy cannot be
transferred to another unless the company consents to the transfer in
writing.
Assumption Of Risk
Defense against liability based on the common law principle that a person
who knowingly exposes himself or herself to danger or injury assumes the
risk of loss and cannot hold another person responsible for the loss.
Audit
See Premium Audit
Authorized Insurer
Company that meets a state insurance department's standards and is
authorized to do business in that state. Also called an admitted insurer.
Automatic Increase In Insurance Endorsement
Dwelling policy endorsement that provides an annual increase in the Coverage
A amount of 4%, 6% or 8%.
Automobile Insurance Plan
A state-sponsored plan that provides Automobile insurance to those who are
uninsurable under standard Auto insurance policies.
Aviation Liability Insurance
Insurance provided for owners of aircraft that covers liability for bodily
injury, injury to passengers and property damage. Also provides Medical
Payments coverage.
Bailee
A person or organization that has temporary possession of someone else's
personal property.
Bailment
Delivery of property by the owner to someone else to be held for some
special purpose and then returned to the owner.
Best's
Organization that rates the financial stability of insurance companies doing
business in the United States.
Bill Of Lading
Standardized contract of carriage issued by common carriers to the business
for which it is shipping goods.
Binder
Oral or written statement that provides immediate insurance protection for a
specified period. Designed to provide temporary coverage until a policy is
issued or denied.
Blanket Insurance
Type of insurance policy that covers more than one item of property at a
single location or one or more items of property at multiple locations.
Boatowners Policy
See Watercraft Package Policy
Bodily Injury (BI)
Defined in most policies to include injury, sickness, disease, and death
resulting from any of these at any time.
Broad Theft Coverage Endorsement
Dwelling policy endorsement that covers theft, attempted theft and vandalism
and malicious mischief resulting from theft. Property is covered while it is
on or off the premises.
Broker
Individual who represents the prospect, instead of the insurance company, in
the insurance transaction.
Builders Risk Reporting Form
Optional form used with the Commercial Property Builders Risk coverage form;
allows insured to purchase a smaller amount of insurance that gradually
increases as the value of the building under construction increases.
Building And Personal Property Coverage Form
Commercial Property coverage form that covers buildings, the insured's
business personal property and the personal property of others located at
the business premises.
Business Pursuits Endorsement
Homeowners policy endorsement that provides Liability coverage for a
business conducted away from the residence premises.
Cancellation
Termination of an insurance policy by the insured or the insurance company
during the policy period.
Capital
The accumulated, permanent resources a company gets from owners and
customers. The value of the portion of assets that a company owns and that
are not restricted by obligations to creditors.
Captive Agent
See Exclusive Agent
Casualty Insurance
Line of insurance that includes a wide variety of unrelated coverages,
including Liability, Auto, Workers Compensation, Aviation, Crime, and Surety
bonds.
Certificate Of Insurance
Written form that verifies a policy has been written. Provides a summary of
the coverage provided under the policy.
Claim Adjuster
Person employed by or acting on behalf of an insurance company to evaluate
and settle insurance claims. The adjuster must determine the cause of loss,
whether the loss is covered by the policy, the value of the loss, and the
amount of loss payable by the policy.
Class Rating
See Manual Rating
Coinsurance
Policy condition that requires an insured to pay part of a loss if the
amount of insurance carried on property is less than a specified percentage
of the value of the property at the time of loss.
Coinsurance Penalty
The amount not paid by the insurance company because the insured failed to
comply with the coinsurance condition.
Collision Coverage
In Auto insurance, a type of Physical Damage coverage that covers loss that
occurs when the insured auto strikes another object or vehicle. May also
include upset or overturn of the insured auto.
Combined Ratio
The sum of the loss ratio and the expense ratio. A ratio of 100% is the
break-even point. A ratio below 100% indicates an underwriting profit; a
ratio above 100% indicates a loss. See Loss Ratio and Expense Ratio
Combined Single Limit
See Single Limit
Commercial Lines
Insurance designed for businesses, institutions or organizations.
Comparative Negligence
Law that allows an injured party to collect from another party for a loss,
even when the injured party contributed to his or her own loss. Damages are
reduced to the extent of the injured party's negligence.
Compensatory Damages
Damages that reimburse an injured party for losses that were actually
sustained. See General Damages and Special Damages
Competent Parties
One of the requirements of a legal contract; states that for a contract to
be valid, it must be made between parties who are considered competent under
the law.
Comprehensive Coverage
In Auto insurance, a broad Physical Damage coverage that covers all property
losses except collision and those perils or property that are specifically
excluded. Also called Other Than Collision Coverage (OTC).
Concealment
The withholding of a material fact involved in the contract on which the
insurer relies.
Concurrent Causation
A situation where two or more perils act concurrently (at the same time or
in sequence) to cause a loss. Some courts ruled that losses from concurrent
causation are covered even when one of the perils that contributed to the
loss is excluded under the policy. These rulings led Property insurers to
revise policy language to clarify the intent of the policy.
Conditional Contract
A contract that contains a number of conditions that both parties must
comply with. An insurance policy is a conditional contract.
Conditions
Portion of an insurance policy that describes the rights and duties of the
insured and the insurance company under the policy.
Consequential Loss
See Indirect Loss
Consideration
A characteristic of a legal contract; the thing of value exchanged for the
performance promised in the contract. With insurance contracts, the
consideration that the insured gives is the premium payment. The
consideration that the insurer gives is the promise to pay for certain
losses suffered by the insured.
Consultant
Insurance professional who, for a fee, offers advice on the benefits,
advantages and disadvantages of various insurance policies. Sells advice,
not insurance.
Contract
A legal agreement between two competent parties that promises a certain
performance in exchange for a certain consideration.
Contribution By Equal Shares
Type of Other Insurance condition found in Liability policies. It calls for
all insurers to contribute equally up to the limit of the policy having the
smallest limit, whereupon that company stops paying. The other companies
share in the remainder of the loss until the loss is paid in full or all
policy limits are exhausted.
Contribution By Limits
See Pro Rata Other Insurance
Contributory Negligence
Common law defense against negligence that states that if an individual
contributes to his or her own loss in any way, then someone else cannot be
held liable for the loss.
Countersignature
Signature of a licensed agent that, in most states, must appear on the
policy to validate the contract.
Coverage Extensions
See Additional Coverages
Coverage Form
Document that contains insuring agreements, coverages, exclusions, and
conditions. Must be attached to a policy jacket to make a complete policy.
Also called a policy form.
Damages
Monetary compensation awarded by a court to an injured party.
Declarations
Section of an insurance contract that shows who is insured, what property or
risk is covered, when and where the coverage is effective, and how much
coverage applies.
Deductible
Dollar amount the insured must pay on each loss to which the deductible
applies. The insurance company pays the remainder of each covered loss, up
to the policy limits.
Defense Costs
Legal expenses incurred by the insurer to defend suits brought against
insureds. Defense costs are paid in addition to payments for BI or PD
claims.
Definitions
Section of an insurance policy that clarifies the meaning of certain terms
used in the policy.
Degree Of Care
Extent of legal duty owed by one person to another. Also called standard of
care.
Deposit Premium
Premium paid at the beginning of the policy period that is based on an
estimate of what the final premium will be. This premium is adjusted based
on reports submitted by the insured to the insurer. Also called an estimated
premium.
Diminution Of Value
An actual or perceived loss of an auto's resale or market value that results
from a direct, accidental loss.
Direct Loss
Financial loss resulting directly from a loss to property.
Direct Response System
Insurance company that sells insurance through the mail or over the phone.
No agents are involved.
Direct Writer
Insurance marketing system where the company's agents are also employees of
the company.
Directors And Officers Liability Insurance (D&O)
Type of Errors And Omissions policy written for directors and officers of
corporations who may be sued as individuals by stockholders.
Disability Insurance
Line of insurance that protects the insured against loss of income resulting
from injury or sickness.
Doctrine Of Reasonable Expectations
Legal principle that provides that an insurance policy includes coverages
that an average person would reasonably expect it to include, regardless of
what the policy actually provides.
Domestic Company
Insurance company doing business in the state in which it is incorporated.
Duties Following Loss
Condition found in property-casualty policies that explains the insured's
responsibilities after a loss occurs.
Dwelling Policy
Policy that provides Property coverage to individuals and families. Covers
dwellings, other structures, personal property, and fair rental value. Some
versions also cover additional living expense. The unendorsed policy does
not provide Liability coverage.
Dwelling Under Construction Endorsement
Dwelling policy endorsement used to provide provisional limits of liability
for dwellings under construction. The limits of liability increase as
construction of the building progresses.
Earned Premium
Premium an insurance company has actually earned by providing insurance
protection for the designated period of time.
Earthquake Insurance
Insurance that covers damage to a structure, its contents or both as the
result of an earthquake. Available as a separate policy and as an
endorsement to the Dwelling, Homeowners, and Commercial Property policies.
Errors And Omissions Insurance (E&O)
Professional Liability coverage that protects the insured against liability
for committing an error or omission in the performance of professional
duties.
Estimated Premium
See Deposit Premium
Estoppel
Principle that states that if one intentionally or unintentionally creates
the impression that a certain fact exists, and an innocent party relies on
that impression and is injured as a result, the guilty party may be legally
prohibited from asserting that the fact does not exist.
Excess Insurance
When two or more policies or coverages apply to the same loss, the one that
applies only after the limits of the primary coverage have been exhausted.
Excess Lines Agent
Agent licensed by the state to handle the placement of business with
nonadmitted insurers. Also called surplus lines agent.
Exclusions
Section of an insurance policy that lists property, perils, persons, or
situations that are not covered under the policy.
Exclusive Agent
An agent who markets insurance for a single company. Also called captive
agent.
Exemplary Damages
See Punitive Damages
Expense Ratio
Ratio that indicates the cost of doing business. It is calculated by
dividing the amount of underwriting expenses by the amount of written
premium.
Experience Modification Factor
In experience rating, the factor applied to reduce the premium when loss
experience is better than expected.
Experience Rating
Type of merit rating that determines premium based on previous loss
experience.
Exposure
A condition or situation that presents a possibility of loss.
Express Authority
Legal doctrine that states that an agent has the authority specifically
given to the agent, either orally or in writing, by the principal.
Extended Coverages
See Additional Coverages
Extended Nonowned Coverage For Named Individual Endorsement
Personal Auto policy endorsement that eliminates most exclusions applicable
to autos that are furnished or available for the regular use of the named
insured or family members.
Fair Credit Reporting Act
Federal law that allows consumers who are denied insurance because of
information contained in a credit report to be notified and allowed to
obtain the information used in the report from the reporting agency.
FAIR Plan
Program established by law that makes Property insurance available to
insureds who might otherwise be uninsurable in the standard market. Stands
for fair access to insurance requirements.
Fiduciary
Person who stands in a special relationship of trust to another person.
Field Underwriting
Selection of clients by the agent in accordance with company standards.
File And Use
Method of rate and form ratification used by some state insurance
departments that allows a company to begin using forms or rates as soon as
they are filed by the department. The department eventually reviews the
filing and officially accepts or rejects it.
Financial Responsibility Laws
State laws that require owners or operators of autos to provide evidence
that they have the funds to pay for automobile losses for which they might
become liable. Insurance is the usual method for providing this evidence to
the state.
First Named Insured
First person listed in the Declarations as an insured. The first named
insured may have a higher level of duties or rights under the policy.
First Party Loss
Property insurance loss.
Flat Cancellation
Cancellation of a policy by the insured or the insurance company on its
effective date.
Floater
Insurance policy that covers property wherever it is located.
Flood Insurance
See National Flood Insurance Program
Foreign Company
An insurance company doing business in a state other than the one in which
it is incorporated.
Fraternal Benefit Society
An incorporated society or order, without capital stock, that is operated on
the lodge system and is conducted solely for the benefit of its members and
their beneficiaries, and not for profit. Fraternal benefit societies offer
insurance that is available only to members.
Fraud
A deliberate misrepresentation that causes harm; an all-out effort by one
party to deceive and cheat the other.
Functional Replacement Cost
Method to determine reimbursement for some losses, particularly those to
antique, ornate or custom construction. The damaged property is repaired or
replaced with less expensive, but functionally equivalent, materials.
General Conditions Form
Separate form that lists the conditions that apply to a policy.
General Damages
Type of compensatory damages that reimburse the injured party for such
things as pain and suffering and disfigurement.
Hazard
Something that increases the chance of loss.
Health Insurance
Line of insurance that protects the insured against financial loss due to
medical bills.
Hold Harmless Agreement
Contractual arrangement where one party assumes the liability of a situation
and relieves the other party of responsibility.
Home Day Care Coverage Endorsement
Homeowners policy endorsement used to provide coverage for home day care
businesses.
Homeowners Policy
Personal multi-line policy for homeowners that includes both Property and
Liability coverages. There are different forms that provide varying degrees
of property coverage. Liability coverage is the same in all forms.
Implied Authority
Authority given by the principal to the agent that is not formally expressed
or communicated.
Imputed Liability
See Vicarious Liability
Incidental Contract
See Insured Contract
Incidental Occupancy
A business conducted in a dwelling used primarily as a residence with no
other businesses operating on the same premises. Individual insurers have
specific guidelines about the types of incidental businesses permitted, but
examples include business or professional offices and private schools or
instructional studios.
Incurred Losses
One of the components used to calculate the loss ratio. It includes paid
losses and certain expenses associated with claim handling.
Indemnity
Principle of insurance that provides that when a loss occurs, the insured
should be restored to the approximate financial condition he or she occupied
before the loss occurred, no better or no worse.
Independent Adjuster
Claim handler who works independently instead of for a particular insurer.
Independent Agent
Agent who represents many insurance companies, rather than a single company.
Also called a nonexclusive agent.
Indirect Loss
Loss that is the result or consequence of a direct loss. Also called a
consequential loss.
Inland Marine Insurance
Form of insurance originally designed as an extension of Ocean Marine
coverage to insure transportation of goods over land. Today it covers a
variety of portable property, in addition to goods in transit. Available as
personal or commercial insurance.
Insurable Interest
Any actual, lawful and substantial economic interest in the safety or
preservation of the subject of the insurance from loss or destruction or
financial damage or impairment.
Insurance
Contract or device for transferring the risk of loss from a person, business
or organization to an insurance company that agrees, in exchange for a
premium, to pay for losses through an accumulation of premiums.
Insurance Commissioner
Head official of a state insurance department. May also be called an
Insurance Director or Insurance Superintendent.
Insurance Department
State department charged with controlling insurance matters within the
state.
Insurance Guaranty Association
State funds created by law that pay claims of insurers domiciled in that
state that become insolvent. Funds are generated by making assessments
against other insurers operating in the state.
Insurance Services Office (ISO)
Organization established for the benefit of its member insurance companies
and other subscriber companies. ISO gathers statistics, provides loss costs,
drafts policy forms and coverage provisions, and conducts inspections for
rate-making purposes.
Insured Contract
Term used in the CGL and Businessowners Liability forms to describe
contracts for which contractual liability coverage is available under the
policy, such as leases, sidetrack agreements and elevator maintenance
agreements. Also called incidental contract.
Insuring Agreement
Section of an insurance policy that describes what is covered and the perils
the policy insures against.
Intervening Cause
An independent action that breaks the chain of causation and sets in motion
a new chain of events. When this occurs, the intervening cause becomes the
proximate cause. Can serve as a common law defense against liability.
Invitee
A person invited onto a premises for some purpose involving potential
benefit to the property owner.
Joint Ownership Coverage Endorsement
Personal Auto policy endorsement that allows the policy to be issued to two
or more persons who live in the same household or two or more individuals
who are related in another way besides husband and wife.
Judgment Rating
Method of rating that establishes premiums based on a careful evaluation of
each individual risk, without the use of manuals or tables.
Law Of Large Numbers
Principle that states that the more examples used to develop any statistic,
the more reliable the statistic will be.
Legal Purpose
One of the characteristics of a legal contract; means that contracts are
only enforceable if they are not obviously illegal, immoral or against the
public good.
Liability Insurance
Type of insurance that protects an insured from financial loss arising out
of liability claims by transferring the burden of financial loss from the
insured to the insurance company.
Liberalization Condition
Condition found in Property insurance contracts that provides that if the
insurer broadens coverage under a policy form or endorsement without
requiring an additional premium, then all existing similar policies or
endorsements will be construed to contain the broadened coverage.
Licensee
Person on the premises with the property owner's consent, but for the sole
benefit of the visitor.
Life Insurance
Insurance that pays a stipulated sum to a designated beneficiary upon the
death of the insured. Protects the insured's beneficiary against the
financial consequences of the insured's premature death.
Limitations
Policy language that eliminates or reduces coverage under certain
circumstances or when specified conditions apply.
Limit Of Coverage
See Policy Limit
Limit Of Insurance
See Policy Limit
Limit Of Liability
See Policy Limit
Livestock Coverage Form
Farm coverage form used to provide separate coverage for livestock.
Lloyd's Association
A voluntary association of individuals or groups of individuals who agree to
share in insurance contracts. Each individual or "syndicate" is individually
responsible for the amounts of insurance they write.
Loss Cost
Factor used in figuring insurance rates that represents how much an
insurance company needs to collect to cover expected losses.
Loss Payable Condition
See Mortgage Condition
Loss Provisions
General term used to describe policy conditions that specify what the
insured and insurer must do after a loss.
Loss Ratio
Method used to determine an insurance company's success in covering current
losses out of current premium income; determined by dividing incurred losses
by earned premium.
Malpractice Insurance
Term used to describe Professional Liability insurance issued to medical
professionals or institutions.
Manual Rating
Method of premium determination that uses rates based on collected
statistics. The rates, which apply per unit of insurance, are published in
manuals. Also called class rating.
Market Value
The amount property could be sold for at the time of loss. May be used to
determine the amount of reimbursement for a loss.
Material Fact
A fact that would cause an insurer to decline a risk, charge a different
premium or change the provisions of the policy that was issued.
Merit Rating
Method of determining premiums where a manual rate is modified to reflect
the risk's unique characteristics. See Experience Rating, Retrospective
Rating and Schedule Rating.
Miscellaneous Type Vehicle Endorsement
Personal Auto policy endorsement that provides coverage for vehicles that
are usually excluded by the policy, such as motorcycles, motor homes, golf
carts, mopeds, and other recreational vehicles.
Misrepresentation
Written or verbal misstatement of a material fact involved in the contract
on which the insurer relies.
Mobile Home Insurance
Coverage that protects both a mobile home structure and its contents. Some
companies have Mobile Home package policies that provide Property and
Liability insurance for owners of mobile homes. In addition, there is a
Mobile Homeowners endorsement that can be attached to an HO-2 or HO-3 to
modify coverage for mobile homeowners.
Mono-Line Company
Insurance company that writes a single line of insurance.
Mono-Line Policy
Insurance policy that provides one type of insurance coverage.
Moral Hazard
Hazard created by an individual who would be willing to create a loss
situation on purpose just to collect from the insurance company.
Morale Hazard
Hazard created by an individual's tendency to contribute to a loss through
his or her own irresponsible actions or carelessness.
Mortgage Condition
Condition found in Property insurance policies that specifies the rights and
duties of the mortgagee under the policy. Also called the Loss Payable
Condition.
Mortgagee Rights
Rights granted to a mortgagee under a Property contract issued to a
mortgagor by virtue of the mortgagee's financial interest in the property.
Multi-Line Company
Insurance company that writes more than one line of insurance.
Multi-Line Policy
See Package Policy
Mutual Company
Insurance company owned by its policyholders. The policyholders share in
profits made by the company through dividends or reductions in future
premiums.
Mysterious Disappearance
Vanishing of property with no explanation.
Named Insured
Person, business or other entity named in the Declarations to whom the
policy is issued.
Named Non-Owner Coverage Endorsement
Personal Auto policy endorsement that provides coverage for the use of
nonowned autos to individuals who do not own a car.
Named Peril Policy
Insurance policy that insures only against perils specifically listed in the
policy. Also called specified peril policy.
National Association Of Insurance Commissioners (NAIC)
Organization made up of individual state insurance commissioners whose
purpose is to promote uniformity in regulation by drafting model laws and
regulations.
National Flood Insurance Program
Program run by the federal government that makes flood insurance available
to eligible communities at subsidized rates. Includes coverage for both
buildings and personal property.
Negligence
The lack of reasonable care that is required to protect others from the
unreasonable chance of harm.
No Benefit To Bailee Condition
Condition found in some Property insurance contracts that states that a
bailee is not covered under an insured's policy while the bailee has
possession of the insured's property.
No-Fault Insurance
Form of Automobile insurance where each insurance company pays the damages
of its own insureds, regardless of who was at fault for the accident.
No-fault insurance has been enacted in several states.
Nonadmitted Insurer
Company that is not authorized to do business in a particular state. Also
called an unauthorized insurer.
Nonconcurrency
Situation that exists when the same property is covered by more than one
policy, but the policies are not identical as to the extent of coverage
provided.
Nonexclusive Agent
See Independent Agent
Nonrenewal
Decision made by an insured or insurance company to not continue coverage
for another policy period after the current policy period expires.
Nonreporting Policy
Type of insurance policy for which a flat premium is charged every time the
policy is renewed.
Occurrence
A loss that occurs at a specific time and place or over a period of time.
Offer And Acceptance
One of the elements of a legal contract; means that a contract must involve
two parties: one who makes an offer and another who accepts the offer. Also
called agreement.
Open Competition
Method of rate and form regulation used by some state insurance departments
that allows insurance companies to compete openly with the forms and rates
they select, subject only to requirements of adequacy and nondiscrimination.
Open Peril Policy
Insurance policy that protects the insured from losses caused by any peril
that is not specifically excluded by the policy. Also called all risk and
special coverage.
Optional Limits
Transportation Expenses Coverage Endorsement Personal Auto policy
endorsement that allows the insured to select the daily and maximum limits
of coverage provided for transportation and loss of use expenses.
Other Coverages
See Additional Coverages
Other Insurance Condition
Policy condition that sets out how any other insurance that applies to the
same loss will affect reimbursement under the policy. See Contribution By
Equal Shares, Excess Insurance, Primary Insurance, and Pro Rata Other
Insurance
Other Than Collision Coverage (OTC)
See Comprehensive Coverage
Outboard Motor And Boat Insurance
Insurance against physical damage to boats. Usually provided by Inland
Marine forms.
Package Policy
Policy that includes more than one type of insurance coverage. Also called a
multi-line policy.
Pair Or Set Condition
Loss settlement condition found in property insurance contracts that states
that when part of a set is damaged or destroyed, the insured will not be
reimbursed for the value of the entire set. Various methods are used to
determine the amount of reimbursement.
Peril
The cause of loss.
Permitted Incidental Occupancies Endorsement
Homeowners policy endorsement that covers the insured's business activities
conducted on the residence premises.
Personal Articles Form
Personal Inland Marine form that provides scheduled coverage for nine
optional classes of personal property: jewelry, furs, cameras, musical
instruments, silverware, golf equipment, fine arts, stamp collections, and
coin collections.
Personal Auto Policy
Auto policy that provides Property and Liability coverage for both owned and
nonowned autos used, maintained or operated by the insured and his or her
family members.
Personal Contract
One of the characteristics of an insurance contract; means that an insurance
contract insures a person, not property.
Personal Effects Form
Personal Inland Marine form that covers an insured's personal belongings,
such as baggage, while traveling.
Personal Injury
Injury other than bodily injury arising out of such things as libel,
slander, false arrest, wrongful entry, violation of privacy, and malicious
prosecution.
Personal Injury Endorsement
Homeowners policy endorsement that modifies the definition of bodily injury
to include personal injury.
Personal Inland Marine Insurance
See Inland Marine Insurance
Personal Liability And Medical Payments To Others Endorsement
Endorsement to the Dwelling policy that provides Liability coverage similar
to that provided by Section II of the Homeowners policy. May also be
purchased as a separate policy.
Personal Lines
Insurance coverages that protect individuals and their families.
Personal Property Form
Personal Inland Marine form that provides open peril coverage for personal
property.
Personal Property Replacement Cost Endorsement
Homeowners policy endorsement that adds replacement cost coverage for
personal property.
Personal Umbrella Policy
See Umbrella Policy
Personal Yacht Insurance
Type of personal watercraft policy written for large pleasure boats.
Physical Hazard
Hazard that arises from the condition, occupancy or use of the property
itself.
Policy
An insurance contract.
Policy Form
See Coverage Form
Policy Jacket
Document used to assemble an insurance policy. Contains general conditions
or the Declarations page, but provides no coverage in and of itself. A
policy form must be attached to make it a complete policy. Also called a
skeleton policy.
Policy Limit
Maximum amount the insurance company will pay for a particular loss, or for
losses sustained during a period of time. Also called limit of coverage,
limit of insurance and limit of liability.
Policy Period
The date and time specified in the Declarations for when coverage begins and
ends.
Policy Territory
Place where coverage under a policy applies.
Postjudgment Interest
Interest accruing on a judgment after an award has been made, but before
payment is made by the insurance company. Usually covered as a supplementary
payment in Liability policies.
Prejudgment Interest
Interest awarded to compensate a third party for interest he or she might
have earned if compensation had been received at the time of injury or
damage, rather than at the time of judgment.
Premium Audit
Survey of the insured's financial records to gather information used to
calculate the premium, such as exposures and limits.
Primary Insurance
When two or more coverages or policies apply to the same loss, the one that
pays first, up to its limit of liability or the amount of the loss,
whichever is less.
Principal
In agency law, the person or company being represented.
Prior Approval
Method of rate and form ratification used by some state insurance
departments that requires a company to obtain official approval before using
new forms or rates.
Producer
General term used to describe someone who sells insurance, such as an agent,
broker or solicitor.
Professional Liability
Liability arising out of rendering or failing to render services of a
professional nature.
Professional Liability Policy
Insurance coverage issued to a professional that covers the rendering or
failing to render services of a professional nature. Policies are tailored
to fit specific occupational needs.
Proof Of Loss
Form completed by an insured after a loss that provides an official
inventory of damages.
Property Damage (PD)
Damage to or destruction of property, including loss of use of the property.
Property Insurance
Line of insurance that includes many types of coverages designed to handle
the risk that a person will suffer financial loss because something he or
she owns is damaged or destroyed.
Pro Rata Other Insurance
Method of handling insurance when more than one coverage applies to a loss.
Each coverage pays a portion of the loss in proportion to the relationship
its limit of liability bears to the total limit of liability under all
applicable insurance. Also called contribution by limits.
Proximate Cause
An action that, in a natural and continuous sequence, produces a loss.
Punitive Damages
Type of damages intended to punish the defendant and make an example out of
him or her to discourage others from behaving the same way. Also called
exemplary damages.
Pure Risk
A risk in which there is no chance of gain, only loss.
Quotation
A summary of coverages and premiums proposed by an agent to a prospective
client.
Rate
The basic charge an insurance company sets for various types of insurance.
Reasonable Person Rule
Principle of law that states that each person must behave like a prudent
person, following those ordinary considerations that guide human affairs.
Rebating
Giving or offering some benefit other than those specified in the policy to
induce a customer to buy insurance. Rebating is illegal in most states.
Reciprocal Company
An unincorporated group of members that share insurance responsibilities
with other members. It is managed by an attorney-in-fact.
Reinsurance
Acceptance by an insurer, called a reinsurer, of all or part of the risk of
loss of another insurer.
Repair Cost
The cost to repair a damaged or destroyed item of property. May be the basis
of reimbursement for a loss.
Replacement Cost
The cost to replace a damaged or destroyed item of property, without
deduction for depreciation. May be the basis of reimbursement for some
losses.
Reporting Policy
Type of policy that does not charge a flat premium. The insured pays a
deposit premium, then submits periodic reports to the insurer showing the
status of the factors on which the premium is based. From these status
reports, premiums are calculated and charged against the deposit.
Representation
Statements on an insurance application that the applicant believes are true.
A representation is not considered a matter to which the parties contract,
so a policy cannot be voided on the basis of a representation.
Residual Market Insurance
Insurance that is not ordinarily available from private insurers and may be
provided by the government. Examples include Flood insurance, which is
provided by the federal government, and Workers Compensation benefits, which
may be provided by state funds.
Retention Limit
In an Umbrella policy, the amount the insured must pay for a loss that is
not covered by an underlying policy before the Umbrella will begin to cover
the loss. Also called the self-insured retention.
Retrospective Rating
Type of merit rating that bases the insured's premium on losses incurred
during the policy period.
Risk
The chance or uncertainty of loss.
Risk Retention Group
Insurance company formed by several organizations to cover those
organizations' liability loss exposures. Risk retention groups are exempt
from most state laws that govern insurance companies.
Salvage
Damaged property that can be retrieved, reconditioned and sold to reduce an
insured loss.
Schedule Rating
Type of merit rating that applies a system of debits or credits to reflect
characteristics of a particular insured.
Scheduled Coverage
Property that is specifically listed in the Declarations and covered for a
specific amount. Also called specific insurance.
Scheduled Personal Property Endorsement
Homeowners policy endorsement that provides open peril, scheduled coverage
for nine optional classes of property.
Self Insurance
Alternative to purchasing insurance where a company or individual assumes
the risk of paying for its losses and sets aside the necessary funds to pay
for such losses.
Self-Insured Retention
See Retention Limit
Service Bureau
Organization that gathers, pools and analyzes statistics from its member
insurance companies to establish loss costs used to determine insurance
rates.
Single Limit
One policy limit that applies to both BI and PD losses. May also be called a
combined single limit.
Skeleton Policy
See Policy Jacket
Solicitor
Insurance professional who sells insurance and collects premiums, but cannot
issue or countersign policies.
Special Coverage
See Open Peril Policy
Special Damages
Type of compensatory damages that reimburse the injured party for direct and
specific expenses involved in the loss, such as medical expenses and lost
wages.
Specific Insurance
See Scheduled Coverage
Specified Causes Of Loss
One of the Physical Damage coverage options in the Commercial Auto coverage
forms; provides more limited coverage than Comprehensive coverage, insuring
only against specified perils such as fire, flood or explosion.
Specified Peril Policy
See Named Peril Policy
Speculative Risk
A risk that may result in a loss or gain.
Split Limits
Policy limit that provides separate limits for BI and PD.
Spread Of Risk
Principle of insurance that states that insurers should spread their insured
risks over a large geographical area, rather than insuring a large number of
people in a small area.
Standard & Poor
Organization that rates the financial stability of insurance companies doing
business in the United States.
Standard Of Care
See Degree Of Care
Stated Amount Condition
See Agreed Value Condition
Statute Of Limitations
Law that provides that certain types of suits must be brought within a
specified time of the occurrence to be valid under the law.
Stock Company
An insurance company owned by its stockholders. Profits are shared by the
stockholders. Policyholders are not entitled to share in company profits.
Subrogation
The transfer to the insurance company of the insured's right to collect
damages from another party.
Supplementary Payments
Provide extra coverage over and above the insured's limit of liability.
Commonly included are defense costs, first aid expenses, bond premiums, and
postjudgment interest.
Surplus
The difference between what a company owns (assets) and what it owes
(liabilities).
Surplus Lines Agent
See Excess Lines Agent
Third Party Loss
A Liability loss.
Tort
A civil wrong for which monetary damages may be provided. Does not include
losses arising out of contracts.
Towing And Labor Costs Endorsement
Personal Auto policy endorsement that covers towing and the costs of labor
performed at the site the car was disabled.
Trespasser
A person who is on the premises without the property owner's express or
implied permission.
Twisting
Illegal activity in which an agent convinces a prospect to cancel existing
insurance and buy another policy from the agent, to the detriment of the
prospect.
Umbrella Policy
Type of policy that provides broad coverage for an insured's liability over
and above liability covered by an underlying contract. May also cover losses
that are excluded by the underlying policy. Available as personal or
commercial insurance.
Unauthorized Insurer
See Nonadmitted Insurer
Underinsured Motorists Coverage
Auto coverage that pays the difference between the insured's actual damages
for bodily injury and the amount of Liability insurance carried by the
at-fault driver. May be added to the Personal or Commercial Auto policy by
endorsement.
Underwriting
Insurance company function that involves researching and evaluating
insurance applicants to decide which ones are acceptable to the company as
insureds.
Underwriting Expenses
One of the components used to calculate the expense ratio. Includes all
costs required to acquire and maintain a book of business, such as expenses
for commissions, salaries, and other administrative and regulatory costs.
Unfair Discrimination
Applying different standards to insureds that have the same risks of loss.
Unilateral Contract
A type of contract that is "one-sided". An insurance policy is one-sided
because only the insurance company is legally bound to perform its part of
the agreement.
Uninsured Motorists Coverage
Automobile coverage designed to provide protection for the insured if he or
she is involved in an accident in which an uninsured motorist is at fault.
Uninsured motorists include those who do not carry insurance, motorists
whose insurance does not meet the state's minimum financial responsibility
laws, drivers whose insurance companies are insolvent, and hit-and-run
drivers who cannot be identified.
Unoccupancy
The absence of people from a premises. Property coverage is often restricted
if there are long periods of unoccupancy.
Use And File
Method of rate and form ratification used by some state insurance
departments that requires insurance companies to file rates and forms within
a certain period of time after they are first used.
Utmost Good Faith
A characteristic of insurance contracts meaning that the insurance company
must be able to rely on the honesty and cooperation of the insured, and the
insured must rely on the company to fulfill its obligations.
Vacancy
The absence of both people and property from a premises. Property coverage
is often restricted when there are long periods of vacancy.
Valuation
Method used by the insurance company to determine the appropriate payment
for a loss.
Valued Policy
Policy written for a specified amount that lists the value of the insured
property as agreed to by both the insured and the insurer. This amount is
used to value losses. Also called an Agreed Amount Policy.
Vandalism And Malicious Mischief (V&MM)
Coverage provided in many Property insurance policies that protects property
against damage caused by vandals.
Vicarious Liability
Liability that a person or business incurs because of the actions of others,
such as family members or employees. Also called imputed liability.
Waiver
The intentional relinquishment of a known right.
Warranty
A specific agreement between the insured and the insurer that becomes a part
of the insurance policy. A breach of warranty can void the policy.
Watercraft Endorsement
Homeowners policy endorsement that provides coverage for BI or PD arising
out of the use of watercraft.
Watercraft Package Policy
Package policy that provides Property, Liability and Medical Payments
coverage for losses arising out of the ownership, maintenance or use of
watercraft.
Written Premium
One of the components used to calculate the expense ratio. It is the gross
amount of premium income on the company's books, which includes both earned
and unearned premium.