ACCIDENT: An event causing loss, which occurs without being expected or designed, usually specific in time and place. ACCELERATED DEATH BENEFITS: A provision that will pay all or part of the policy death benefits while the policyholder is still alive. Conditions include proof that the policyholder is terminally ill with a life expectancy of less than 12 months, has a specified life-threatening disease or is in a long-term care facility such as a nursing home. By accepting an accelerated benefit payment, a person could be ruled ineligible for Medicaid or other government benefits. The proceeds may also be taxable. ACCIDENTAL DEATH BENEFIT: Provision for payment of an additional amount– usually equal to the face amount of insurance – if the insured is killed in an accident. Popularly known as double indemnity. ACQUISITION COSTS:Expenses incurred in acquiring new business premiums and conservation of renewal business. Broad in scope, it includes cost of soliciting business, issuance of policies, collection of premiums, agents’ compensation, field supervision, advertising, and any other expense reasonably attributable to acquisition and conservation of written premiums. ACTUAL CASH VALUE (ACV): The cost of replacing or restoring property at prices prevailing at the time and place of the loss, less depreciation, however caused. Another definition: the sum of money required to replace property less depreciation, which includes physical wear and tear, and obsolescence. ACTUARY: A person whose principal function is to make the technical calculations required for the pricing of insurance policies. ADDITIONAL EXTENDED COVERAGE: A second endorsement on the fire policy(fire and lightning with extended coverage) which insures the dwelling and/or contents against water damage from plumbing, etc.; boiler explosion; glass breakage; and damage by ice and snow, freezing, fall of trees, collapse, vandalism, vehicles owned by insured or tenants and landslide. ADDITIONAL INSURED: One who is protected by an insurance policy other than the named insured. Examples: In automobile insurance, one who drives the insured’s car with his consent ordinarily is protected. In property insurance, this might be a co-owner, mortgagee, or lien holder. ADJUSTER: A person who investigates and settles losses for an insurance carrier or the insured. ADVANCE PREMIUM: Most companies give the insured the right of making premium payments in advance. AGE CHANGE: An age change occurs on the date, halfway between birth dates, on which the life insurance age changes. Immediately after, the premium for new life insurance will be computed to the age on the next following birth date. The life insurance age is the age at nearest birthday. AGE LIMITS: The ages below and above which the company will not accept applicants. AGENCY: An organization which solicits insurance for one or more carriers and may perform other functions such as issuing policies and adjusting losses. AGENT:1. An individual who solicits insurance for one or more carriers and may perform other functions, such as issuing policies. 2. Agents of a direct writer are sales employees of one company only. AGE OF CAR (age group): A term used to classify cars according to age for rating purposes. ALL PHYSICAL LOSS FORM: This coverage protects against loss from “all risks of physical loss” for dwellings subject to certain exclusions contained in the form. ANNUAL POLICY: Insurance policy written for a term of one year. ANNUITY: A contract in which the buyer deposits money with a life insurance company for investment. The contract provides for specific payments to be made at regular intervals for a fixed period or for life. ANNUITANT: The person during whose life an annuity is payable, usually the person to receive the annuity. APPLICATION: A request to a company for a policy. The application is a conditional offer to buy. If the medical examination and the inspection are in order, the company usually will accept the offer. It may be the policy named in the application or, if the applicant is substandard, it may be on a higher premium or other policy form. APPRAISAL: Determination of the value of property or the extent of damage by impartial experts. Many property insurance policies provide for “appraisals” where the company and the insured cannot agree on the amount or the extent of a loss. APPROVED: In fire insurance, usually means that the construction, equipment, preventive and protective devices meet established requirements for insurance. In many cases,”approved” construction results in reduced insurance premiums. AREA: A territorial subdivision, usually called “rating territory,” within a given state used for rating purposes. ARSON: The willful and malicious burning of property, sometimes with the intent of defrauding an insurance company. ASSETS: All of the property owned by a carrier. ASSIGNEE: One to whom the legal ownership of a policy or a limited interest therein is transferred. ASSIGNMENT: The partial or complete transfer by a person of his right or interest in a policy to another person. The ability of a person to so assign the policy may be limited by law or individual circumstances. An assignment must be written, signed by the owner-policyholder whose interest is being transferred, properly attested, and the original or a certified copy must be filed with the insuring company. A valid assignment so filed is binding on the company. ASSURANCE-INSURANCE: These terms are today generally accepted as synonymous, although not originally so. The term “assurance” is used more commonly in Canada and Great Britain than in the United States.
BENEFICIARY (LIFE): The person named in the policy, to whom the insurance money is paid at the death of the insured. BINDER: A written or oral contract issued temporarily to place insurance in force when it is not possible to issue a new policy or endorse the existing policy immediately. A binder is subject to the premium and all the terms of the policy to be issued. BODILY INJURY BENEFIT COVERAGE: This automobile coverage is designed to protect the insured and any passengers in this car against loss by reason of bodily injury or death caused by the owner or operator of an uninsured automobile (or a “hit-and-run”). Also called uninsured motorist coverage. BODILY INJURY COVERAGE: This coverage, often called “public liability insurance”, protects an insured against legal liability for injury to the person of another arising from an accident. BROAD FORM: A policy affording more liberal benefits, or in fire insurance, an endorsement that grants broader or additional coverages to a basic policy; usually added to a standard fire and extended coverage policy. For example, on a dwelling policy, it usually adds the following: vandalism, glass breakage, falling trees, weight of ice, snow or sleet, collapse. If added to a commercial fire policy, it might include vandalism, falling objects, weight of ice, snow or sleet, and collapse. BROKER: A representative of the insured in placing insurance with companies. He is paid a commission by the company or its agent. Often a broker also is a licensed “agent” for one or more companies. BUILDER’S RISK INSURANCE:Insurance against loss resulting from damage to buildings and to materials incidental to construction, including machinery and equipment, while the buildings are under construction. BURGLARY: Breaking and entering into the premises of another for the purpose of stealing with visible signs of forced entry. BUSINESS INSURANCE (LIFE): Insurance concerned primarily with the protection of an insured’s business or vocation. Business insurance protects a business against the loss of its valuable lives or key men; stabilizes the business through the establishment of better credit relations; and provides a practical plan for the retirement of business interest in the event of the death of one of the owners.
CANCELLABLE POLICY: A policy which may be canceled by the company at any time by giving advance notice to the insured and refunding any unearned premium. CANCELLATION: The discontinuance of an insurance policy before its normal expiration date. CAPITAL SUM: A term in accident insurance to describe the amount payable for death or for loss of hands, feet or sight. Also called principal sum. CARRIER: The insurance company or the one who agrees to pay the losses. The carrier may be organized as a company, either stock, mutual, or reciprocal, or as an association of underwriters such as Lloyds. CASH SURRENDER VALUE: The amount available in cash upon surrender of a life insurance policy before it matures as a death claim or otherwise. CASUALTY INSURANCE: A general class of insurance covering liability resulting from accidents and some types of property insurance. It includes among other coverages:automobile, workers compensation, employers liability, general liability, plate glass, theft and personal liability. It excludes life, fire and marine insurance, but, as ordinarily used, includes health insurance and fidelity and surety bonds. CATASTROPHE REINSURANCE: This is a form of insurance written on an excess of loss basis in order to improve the spread of risk against unknown concentrations of liability subject to one occurrence. A deductible is chosen at the amount necessary to reduce the probable frequency of loss to an acceptable level to the reinsurer, and severity of loss to a level acceptable to the reinsured company. CHARTERED LIFE UNDERWRITER (C.L.U.): A designation conferred in recognition of the attainment of certain standards of education and proficiency in the art and science of life insurance underwriting. CHARTERED PROPERTY AND CASUALTY UNDERWRITER (C.P.C.U.): A designation conferred in recognition of the attainment of certain standards of education and proficiency in the art and science of fire and casualty insurance underwriting. CLAIM: A request for payment of a loss which may come under the terms of an insurance contract. There are two types of claims. First party claim is one made by the policyholder in which the policyholder reports the claim directly to his company. A third party claim is one in which a person makes a claim against a policyholder of another company and payment, if any, is made by that company. CLAIMANT: One who makes a claim. CLAIM SEVERITY: The average cost per claim considering all claims under a certain coverage for a specified period. CLAIMS-MADE COVERAGE: Claims-made insurance is a type of liability protection that covers current legal obligations result for acts of the insured. It provides coverage to the insured for claims reported during the term of the policy. COINSURANCE PROVISION: An insurance provision for property coverage in which the policy holder 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. COLLISION COVERAGE: Covers loss to the insured person’s auto caused by its collision with another vehicle or object. COMBINED SINGLE LIMIT: Bodily Injury and Property Damage coverage expressed as one single amount of coverage. COMMERCIAL FIRE: This coverage insures all property not occupied as a residence, excluding farming and manufacturing, against loss by fire. COMMON DISASTER CLAUSE: In life insurance, this clause is designed to alleviate the hardship that can result if the insured and primary beneficiary die at the same time or within a short period of time of each other. Usually the clause provides that if the primary beneficiary dies either before proof of the insured’s death is submitted to the company, or within a stated period (usually 14 or 30 days after the insured’s death), the proceeds will be paid to the contingent beneficiary. COMPREHENSIVE COVERAGE (physical damage other than collision): Pays for damage to or loss of your automobile from causes other than accidents. These include hail, vandalism, flood, fire, and theft. COMPULSORY INSURANCE: The purpose of compulsory insurance laws is to require all residents to buy liability insurance before auto license plates are issued. The law requires proof of financial responsibility (insurance) when license plates are issued. CONCEALMENT: The withholding of material facts from an insurer, either in applying for a policy or making a claim. CONTENTS: A term used to refer to the personal property contained in a building. It maybe household furniture, personal effects, or other types of personal property, movable in nature and not firmly affixed to the real property. CONTINGENT BENEFICIARY: A beneficiary whose right to receive depends upon the occurrence of a certain contingency – for example, the right to receive certain benefits only in the event that another named beneficiary dies prior to the time of payment. CONTRACT: In most cases, an insurance policy. A policy is considered to be a contract between the insurance company and the policyholder. CONTRIBUTORY NEGLIGENCE:Carelessness of the injured person that helped to cause the accident in which he was injured. COVERAGE: Another term for insurance. Can be used to mean either the dollar amounts of insurance purchased (ex: $500,000 of liability coverage), or the type of loss covered(coverage for theft).
DAMAGES: In a technical sense, damages refer to the money or compensation recoverable in a lawsuit by a party who has been injured in person or property or rights by the negligence of another. DEATH BENEFIT: Amount paid to the beneficiary upon the death of the insured. DEATH CLAIM: When a policy holder dies, the person entitled to the proceeds must complete certain forms giving due proof of the death and establishing the claimant’s right to such proceeds. When filed with the company, the company is said to have received a death claim. DECLARATIONS PAGE: The page in a policy that shows the name and address of the insurer, the period of time a policy is in force, the amount of the premium, and the amount of coverage. DECREASING TERM LIFE INSURANCE: Term 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. DEDUCTIBLE: The amount an insured person must pay before the insurance company pays the remainder of each covered loss, up to the policy limits. DEFERRED ANNUITY: An annuity under which the annuity payment period is scheduled to begin at some future date. DEPRECIATION: A decrease in the value of property over a period of time due to wear and tear or obsolescence. Depreciation is used to determine the actual cash value of property at time of loss. (See ACTUAL CASH VALUE.) DIRECT LOSS: A loss where an insured peril is the proximate cause. If a windstorm blows the roof off a home, the windstorm is the insured peril causing the direct loss or damage. DISABILITY CLAUSE: A benefit provision forming part of a life insurance policy providing for certain benefits in the event of total and permanent disability from accident or sickness. DIVIDENDS: A return to the policyholder of excess premium over losses and expenses at the end of the policy period. Dividends are authorized by the board of directors, and are payable to all participating policyholders of a specified class. DOMESTIC CARRIER: An insurance company organized in a given state is referred to in that state as a domestic carrier. DOUBLE INDEMNITY:Payment of twice the basic benefit in the event of loss resulting from specified causes or under specified circumstances.
EARNED PREMIUM: The portion of the total policy premium that has been “used up” during a policy term. With a one-year policy, half of the total premium has been earned after six months. EFFECTIVE DATE: The date on which an insurance binder or policy goes into effect. ENDORSEMENT: A written agreement attached to a policy expanding or limiting the benefits otherwise payable under the policy. Also called a “rider.” 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: To qualify for a particular policy at a particular price, companies have the right to ask for information about health and lifestyle. An insurance company will use this information – the evidence of insurability – in deciding if your application for insurance is acceptable and at what premium rate. EXCESS AND SURPLUS LINES INSURANCE: Coverage that is provided by insurers not licensed in states where the risk is located. EXCESS LIABILITY POLICY: A policy that provides additional limits in excess of an underlying liability policy. EXCLUSIONS: Items or conditions that are not covered by the general insurance contract. EXPENSE RATIO: The ratio of a company’s operating expenses to premiums. EXPIRATION DATE: The specified date and time at which the policy terminates. EXPOSURE: Measure of vulnerability to loss, usually expressed in dollars or units. EXTENDED COVERAGE:An extension of the fire policy to cover the additional perils of windstorm, hail, explosion, or riot, attending a strike, civil commotion, aircraft, vehicle and smoke. EXTENDED TERM INSURANCE OPTION: A policy provision that provides the option of continuing the existing amount of insurance as term insurance for as long a period of time as the contract’s cash value will purchase.
FACE AMOUNT: The amount covered by the terms of an insurance contract, usually found on the first page of the policy. FAMILY AUTO INSURANCE: The automobile policy (most common in the industry) which provides protection for all members of the family. 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. FIRST PARTY CLAIM: A claim filed by an insured against his or her own insurance policy. FIXED BENEFIT: A death benefit, 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. FLOATER: A type of insurance policy that covers property that is easily movable and provides additional coverage over what normal insurance policies do not. This can cover anything from jewelry to expensive stereo equipment. 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. FRANCHISE INSURANCE: Individual life or health insurance policies issued to a small group of people having a common affiliation or interest. Same as wholesale insurance. FREE LOOK: Trial period required in most states where policy owners have up to 20 days to examine their new policies with no obligation. FULL COVERAGE: Insurance which covers all losses, with no deductions, up to the amount of the insurance.
GAP INSURANCE: Insurance that pays the difference between the actual cash value of a vehicle and the amount still to be paid on the loan. Some gap policies may also cover the amount of the deductible. 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. GENERAL LIABILITY: A broad term meaning liability insurance, other than automobile, written to cover personal, professional and commercial risks. In respect to commercial liability, it protects business owners and operators from exposures such as liability arising from accidents resulting from the insured’s premises or operations; products sold by the insured; operations completed by the insured, and contractual liability. GRACE PERIOD: Period of time after the due date of a premium during which the policy remains in full force without penalty. 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. GROUP OF COMPANIES: Several insurance companies under common ownership and often common
HAZARD: A circumstance that increases the likelihood or probable severity of a loss. For example, the storing of explosives in a home basement is a hazard that increases the probability of an explosion. HEALTH MAINTENANCE ORGANIZATION (HMO): Managed care plans that provides healthcare services to their members through networks of doctors, hospitals, and other healthcare providers. HMOs cover a wide variety of services, usually at a lower cost than traditional health care plans. HOLD HARMLESS AGREEMENT: A contractual agreement that requires one contracting party to assume certain legal liabilities of the other party. HOMEOWNER’S POLICY: A policy in which Fire and extended or Broad coverage for dwelling and contents, residents’ theft insurance, additional living expense, and personal liability insurance are combined
IMPAIRED RISKS: In health insurance, individuals who can reasonably be expected to have an above-average number of claims due to medical history or physical impairment. Most impaired risks can be insured by use of a waiver or waiting period. INDEMNITY: Restoration to the victim of a loss by payment, repair or replacement. INDEPENDENT ADJUSTER: A claims adjuster who provides adjustment services to insurance companies for a fee but is not employed by them. INSURABILITY: The condition of the individual wishing to be insured, including his/her health, susceptibility to injury and life expectancy. INSURANCE POLICY: The printed form which serves as the contract between an insurer and an insured. INSURED: The person or organization covered by an insurance policy. INSURER: The insurance company. The party that provides insurance coverage, typically through a contract of insurance. IRREVOCABLE BENEFICIARY: A named beneficiary whose rights to life insurance policy proceeds are vested and cannot be canceled by the policy owner unless the beneficiary
LAPSE: The termination or discontinuance of a policy due to non-payment of a premium. LIABILITY: Responsibility to another for one’s negligence that results in injury or damage. LIABILITY INSURANCE: An auto insurance coverage that pays for injuries to the other party and damages to the other vehicle resulting from an accident the policyholder caused. It also pays if the accident was caused by someone covered by the policyholder’s policy, including a driver operating the car with their permission. LIABILITY COVERAGE: Covers losses for which an insured is legally liable. For homeowners insurance, for example, liability coverage protects the policyholder against financial loss if they are sued and found legally responsible for someone else’s injury or property damage. LICENSE – AGENT OR BROKER: Certification, issued by the department of insurance, that an individual is qualified to solicit insurance applications for the period covered. LICENSE – COMPANY:Certification, issued by the department of insurance, stating that an insurance company is qualified to do business in the state. 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 a loss. LOSS: The amount an insurance company pays for damages under the terms of the policy. LOSS OF USE: A provision in homeowners and renters insurance policies that reimburses policyholders for the additional costs (housing, food, and other essentials) of having to live elsewhere while the home is being restored following a disaster. LOSS PAYEE/LIEN HOLDER: A person or entity with a legally secured insurable interest in another’s property, usually a financial institution that loaned money to buy a car. The car is the loan collateral. If the auto is damaged in an accident, loss payments will be made to you and to the loss payee on your policy. LOSS PAYABLE CLAUSE: An insurance clause that authorizes loss payments to a person or entity having an insurable interest in the covered property. LOSS RATIO: Percentage of losses incurred against earned premiums for a given period.
MEDICAL PAYMENTS: Optional coverage 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 occurring while they are occupants of the insured auto. MINIMUM PREMIUM: The lowest amount of premium to be charged for providing a particular insurance coverage. 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. MULTI-CAR DISCOUNT: A discount offered by some insurance companies for those with more than one vehicle insured on the same policy. MVR – MOTOR VEHICLE RECORD: A motor vehicle record contains information obtained from an individual’s driver license application, abstracts of convictions and accidents. MORTGAGE INSURANCE: One of the basic uses of life insurance. Family heads buy mortgage insurance for the specific purpose of paying off any mortgage balance outstanding at their death. MULTIPLE LINE: A general term referring to fire and casualty insurance in general. A multiple line company writes auto, fire, health, commercial, boat owners, homeowners, individual fire, theft insurance. MUTUAL INSURANCE COMPANIES: Insurance companies without capital stock, owned by the policyholders for the purpose of sharing in the profits through dividends at the end of the policy year.
NAMED DRIVER EXCLUSION: An endorsement to an auto policy that provides that a policy does not cover accidents when a specifically named person is the driver. NAMED INSURED: Any person, firm or corporation designated by name as the insured person(s) in a policy. Others may be protected by policy definition even though their names aren’t on the policy, such as other drivers operating (with consent) the named insured’s covered auto. NAMED PERILS COVERAGE: A property insurance term referring to exact causes of loss specifically listed as covered. NEGLIGENCE: The failure to use the care that a reasonable and prudent person would have used under the same or similar circumstances. NON-OWNED 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. NON-RENEWAL: a decision by an insurance company not to renew a policy. NONSTANDARD AUTO (HIGH RISK AUTO OR SUBSTANDARD AUTO): Insurance for motorists who have poor driving records or have been canceled or refused insurance. The premium is much higher than standard auto due to the additional risks.
OCCUPANCY: This refers to the use of property. A home, for example, may have a real estate office in it. This dwelling would then have a “business occupancy.” Occupancy plays a very important part in computing rates and determining the acceptance or rejection of risks. OCCUPATIONAL HAZARD: The danger of suffering a sickness or injury due to the hazards of an occupation. OCCURRENCE: An event that results in an insured loss. In some lines of business, such as liability, an occurrence is distinguished from an accident in that the loss doesn’t have to be sudden and fortuitous and can result from continuous or repeated exposure which results in bodily injury or property damage neither expected nor intended by the insured. OCCURRENCE COVERAGE: Occurrence coverage is insurance for incidents of liability alleged to have occurred during the term of the policy, no matter when the claim is reported. OMNIBUS CLAUSE: An automobile policy provision which covers persons driving the named insured’s auto with the named insured’s permission. ORIGINAL AGE: The age you were when you bought an insurance policy. OWNER: The person who can legally exercise all rights and privileges in the life policy. This will usually be the insured, but may be any other party to whom proper transfer of these rights and privileges has been made.
PAID-UP: This event occurs when a life insurance policy will not require any further premiums to keep the coverage in force. PAID-UP ADDITIONS: Additional amounts of life insurance purchased using dividends; these insurance amounts require no further premium payments. PARTIAL DISABILITY: An injury which prevents the insured from performing one or more, but not all, important duties of his job. PERIL: The cause of possible loss, such as fire, windstorm, theft, explosion, or riot. PERSISTENCY: A term used to refer to the length of time insurance remains continuously in force. 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 statues 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: This type of property is usually movable and easily transportable. On the other hand, real property generally is considered to be immovable such as land and things affixed to it. A rule of thumb definition for personal property is “everything other than real property.” PHYSICAL HAZARD: This refers to the material, structural or operational features of the risk itself, apart from the persons owning or managing it. Electrical wiring, building construction, type of heating system, are examples of physical hazards. POLICIES-IN-FORCE: Policies written and recorded on the books of the carrier which are unexpired as of a given date. POLICY: The name generally used to mean the written contract of insurance. POLICY FEE: An amount charged by some companies in addition to the first regular premium. Also called “joiner’s fee.” POLICYHOLDER: One who owns an insurance policy. A mortgagee often is issued a copy of an insurance policy, or a certificate of insurance, at the request of the insured, but he is not a policyholder. POLICY LOAN (LIFE): A loan made by an insurance company to a policyholder on the security of the cash value of his policy. POLICY PERIOD: The period a policy is in force, from the beginning or effective date to the expiration date. PREFERRED RISK: A positive characteristic of someone seeking to be insured. Usually means a better likelihood for long life, and usually means a lower premium. PREMISES: The location where coverage applies. PRE-EXISTING CONDITION: A physical condition which existed prior to the issuance of a health policy. PREMIUM: The amount paid by an insured to an insurance company to obtain or maintain an insurance policy. PREMIUMS-IN-FORCE: Premium dollars which have been written and are unexpired on the books of the insurance carrier. PREMIUM EARNED: The amount of the premium, paid for in advance, that has been“ earned” by virtue of the fact that time has passed without a claim. PREMIUM UNEARNED: The portion of an insurance premium which applies to the unexpired portion of the policy period. 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 is covered by more than one policy. PROCEEDS: The net amount of money payable by the company at the death of an insured or at the maturity of a policy. PROPERTY DAMAGE COVERAGE: An agreement by an insurance carrier to protect an insured against legal liability for damage by his automobile to the property of another. 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. 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. PROVISIONS: Details of an insurance policy which explain the benefits, conditions and other features of the insurance contract. PROXIMATECAUSE: The dominating cause of loss or damage; an unbroken chain of events between the occurrence of an insured peril and damage to property. As an illustration, water damage occurring from fire fighting activities is covered under the fire policy because fire was the proximate cause of the loss.
RATE: A charge per unit in determining insurance premiums. RATED POLICY: A policy issued at a higher premium to cover a person classified as a greater-than-average risk, usually due to impaired health or a dangerous occupation. RATING TERRITORY: A geographical grouping in which like hazards tend to equalize and permit the establishment of an equitable rate for the territory. RENTS OR RENTAL VALUE: Insurance against loss of the rental value of a property; protects against loss of rents resulting from an insured peril. 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. REFUND: An amount of money returned to the policyholder for overpayment of premium or if the policyholder is due unearned premium.. 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. RENTAL REIMBURSEMENT COVERAGE: Optional auto insurance coverage that pays a set daily amount for a rental car if the policyholder’s car is being repaired because of damage covered by the auto policy. RENTERS INSURANCE: A form of property insurance that covers a policyholder’s belongings against perils. It also provides personal liability coverage and additional living expenses. Possessions can be covered for their replacement cost or the actual cash value, which includes depreciation. REPLACEMENT COST: The dollar amount needed to replace damaged personal property or dwelling property without deducting for depreciation but limited by the maximum dollar amount shown on the declarations page of the policy. RESIDUAL BENEFIT: In disability insurance, a benefit paid when you suffer a loss of income due to covered disability or if loss of income persists. The benefit is based on a formula specified in your policy and it is generally a percentage of the full benefit. It may be paid up to the maximum benefit period. RETURN PREMIUM: A portion of the premium returned to a policy owner as a result of cancellation, rate adjustment, or a calculation that an advance premium was in excess of the actual premium. RIDER: Endorsement. Special provision added to an original policy contract. RISK: Chance of loss with respect to person, liability, or the property of the insured. Also used to mean “the insured.
SCHEDULE: A list describing the property or items insured under the policy. 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 INTEREST INSURANCE: Insurance coverage for only one of the parties having an insurable interest in that property. For instance, if a policy holder still owes money on his mortgage, and he does not have homeowners insurance, the lender may take out a single interest insurance policy to protect its own interest in the property. Single interest insurance protects only the policy owner, not the homeowner. SPECIAL CLASS: Policies on which an extra premium rate is charged because an extra risk is presented. STANDARD PROVISIONS: Policy provisions required by law or supervisory regulation –such as provisions relating to grace period and incontestability. STANDARD RISK: A person who, according to a life insurance company’s underwriting standards, is entitled to insurance protection without extra rating or special restrictions. STOCK COMPANY: A company organized and owned by stockholders, as distinguished from the mutual form of company which is owned by its policyholders. SUBROGATION: Assignment of rights of recovery from insured. SUBSTANDARD RISK: A person who is considered an under-average or impaired insurance risk because of his physical condition, family or personal history of disease, occupation, residence in unhealthy climate, or dangerous habits. SURCHARGE: An extra charge added to a premium by an insurance company. For automobile insurance, a surcharge is usually added if a policyholder borrows money on the policy or if the policy lapses for non-payment. SURRENDER CHARGES: Charges that are deducted if a life insurance policy or annuity is cashed in (surrendered). These charges also are deducted if the policyholder borrows money on the policy or if the policy lapses for non-payment.
TERM: The length of time for which a policy or bond is in force. TERMINATION: The recording of a cancellation of an insurance policy. TERM INSURANCE: Life or health insurance protection during a limited number of years but expiring without value if the insured survives the stated period. THIRD PARTY CLAIM: A claim filed against another person’s insurance policy. TORT: A private wrong or harm (other than a breach of contract) committed against another, resulting in legal liability. A tort is either intentional or accidental (negligent). Automobile liability insurance is purchased to protect one from suits arising from unintentional torts. TOTAL DISABILITY: Disability which prevents a person from performing (a) any of his occupational duties, or (b) any duties of any occupation, or ( c) any duties for which he is reasonably qualified. Definitions vary within policies. TOTAL LOSS: A loss of sufficient size about which it can be said there is no value left. The complete destruction of the property. The term also is used to mean a loss requiring the maximum amount a policy will pay. TOWING AND LABOR COVERAGE: Auto insurance coverage that pays for towing charges when a car can’t be driven. Also pays labor charges, such as changing a flat tire, at the place where the car broke down.
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: The person trained in evaluating risks, deciding whether to accept or reject an application for a policy, and determining rates and coverages for risks. UNINSURED MOTORIST COVERAGE: Protects the insured against financial loss resulting from bodily injury carelessly inflicted by an uninsured motorist, including a hit and run driver, who is legally liable. Bodily Injury Benefit. UNEARNED PREMIUM: The amount of a pre-paid premium that has not yet been used to buy coverage. For instance, if a policyholder paid in advance for a six-month premium, but then cancels the policy after two months, the company must refund the remaining four months of “unearned” premium. UNINSURED/UNDERINSURED MOTORIST (UM/UIM) COVERAGE: Auto insurance coverage that pays for the policyholder’s injuries and, in some states, property damage caused by a hit-and-run driver or a motorist without liability insurance. It will also pay when medical and car repair bills are higher than the other driver’s liability coverage. UNIVERSAL LIFE INSURANCE: An interest-sensitive life insurance policy with flexible, adjustable premium payments, that builds cash values. UNREPORTED CLAIMS: Accidents which have occurred but which have not been reported or recorded. UMBRELLA POLICY: Coverage for losses above the limit of an underlying policy or policies such as homeowners and auto insurance. USAGE: Refers to the primary function or purpose in which you intend to operate your vehicle. For example, if you primarily drive your car to and from work, the usage is considered “commute”; if you are self-employed and you primarily drive to see customers, the usage is considered “business.” USUAL AND CUSTOMARY FEES: Charges for medical services that refer to the amount approved by the carrier for payment. These charges may be based on rates usually charged by physicians and providers in your area; rate averages compiled by independent rating services; or rate averages compiled by the insurance company.
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. VARIABLE ANNUITY: A form of annuity policy under which the amount of each benefit payment is not guaranteed or specified in the policy, but which instead fluctuates according to the earnings of a separate account fund. VARIABLE LIFE INSURANCE: A form of life insurance whose face value fluctuates depending upon the value of the dollar, securities or other equity products supporting the policy at the time payment is due. VIN (VEHICLE IDENTIFICATION NUMBER): A 17-digit alpha-numeric code that provides valuable information concerning the vehicle’s serial number, make, model, options, and year in official records (like a Social Security number for your car). VIATOR: A terminally with a life-threatening or terminal illness who sells his or her life insurance policy.
WHOLE LIFE INSURANCE: A plan of insurance that offers protection for a person’s “whole life.” and which pays a benefit upon the person’s death. WORKER’S COMPENSATION: A system (established under state law) which provides payments to employees who are injured in the course of employment, irrespective of fault.