Glossary

Insurance Terms

Almost everyone needs insurance, but not everyone fully understands it. To help guide your way through the complexities, we have listed below some commonly used terms.

Act of God – An accident or event resulting from natural causes, without human intervention or agency, and one that could not have been prevented by reasonable foresight or care—for example, flood, lightning, tornado, earthquake, or a storm.

Actual Cash Value (ACV) - the cost to replace property minus the allowance for the property's depreciation.

Admitted Insurer - sometimes referred to the "licensed insurer". An insurer authorized by the state insurance department to sell insurance within the state.

Agent/Agency - sells, solicits, or negotiates insurance for compensation and represents or acts on the behalf of another party.

Adjuster – The person who investigates and settles insurance claims. This involves investigating the loss and determining the extent of coverage.

Admitted Insurer – Sometimes referred to the "licensed insurer." An insurer authorized by the state insurance department to sell insurance within the state.

Binder - An oral or written agreement to provide temporary insurance coverage until a form written policy is issued.

Bodily Injury - As defined in many liability policies, any physical injury to a person, including sickness, disease, and death.

Broad Form Coverage - Coverage for causes of loss due to falling objects (trees or other objects that may fall onto a structure), sudden and accidental water damage (sudden leaks, may for example, damage carpets, floors, or ceilings).

Cancellation - Termination of an insurance policy.

Catastrophic Loss - Losses incurred as a result of a hurricane, earthquake, fire, or other major storm.

Claim - A demand by a person or business seeking to recover from an insurer for a loss that may be covered by an insurance policy.

Damages - Money awarded to a party who has suffered bodily injury or property damage for which another party is legally responsible.

Declaration - Insurance policy information page outlining specific details about the insured and the subject of the insurance.

Deductible - A portion of a covered loss that is subtracted from the amount the insurer would otherwise be obligated to pay the insured.

Demotech Rating – One of several financial rating organizations that evaluates life, property, and casualty insurers domiciled in the United States and U.S. branches of foreign property insurer groups active in the United States. The ratings are often used to determine the claims-paying ability, suitability, service record, and financial stability of insurance companies. demotech.com

Depreciation - The allowance for physical wear and tear or technological or economic obsolescence.

Endorsement - A document that amends an insurance policy.

Excess and Surplus Lines (E&S) - Insurance coverages unavailable in the standard market that are written by nonadmitted insurers.

Exclusion - A policy provision that eliminates coverage for a specified exposure.

Exposure - Any condition or situation that presents the possibility of a loss.

Field Claim Representative - An insurer employee who handles claims that cannot be handled easily by phone, mail, or e-mail.

Floater - A policy designed to cover property that floats, or moves, from location to location.

General Damages - Compensatory damages awarded for losses that do not have a specific economic value, such as pain and suffering.

Guaranty fund - A state fund that provides a system to pay the claims of insolvent insurers, generally funded by assessments collected from all insurers licensed in the state.

Hazard - A condition that increases the frequency or severity of a loss.

Incurred Losses - The sum of paid losses and changes in loss reserves for a particular period.

Indeminify - To restore a party who has sustained a loss to the same financial position that party held before the loss occurred.

Independent Agent - A producer who works for an independent agency who can be either owner or an employee of the agency. This agency usually represents several unrelated insurers.

Insurable Interest - A coverage verification criterion that exists when a person or other entity would suffer a financial loss if the subject property were damaged.

Insurance - A form of risk management primarily used to hedge against the risk of a contingent, uncertain loss.

Insurance Agent - A legal representative of one or more insurers for which the representative has a contractual agreement to sell insurance.

Insured - The individual whose property or liability is covered by an insurance policy.

Insurer - An insurance company.

Liability - Financial obligations, or debts, owed by a company to another entity, usually the policyholder in the case of an insurer.

Liability Coverage – The personal liability portion of your homeowners insurance policy covers you against lawsuits for injury or property damage that you or your family members cause to other people. Common types of liability claims are pets/dog bites, slip, fall or trips by guests as well as contractors/workers that are injured on your property. It is important that any contractor you hire to perform work on your property (landscaping included) are properly licensed and insured. The liability coverage in your standard homeowners policy pays both for the cost of defending you and for any damages a court rules you must pay.

Licensed Insurer - An insurer authorized by the state insurance department to sell insurance within that state.

Limit of Liability – The maximum amount for which an insurance company may be held liable, as established in the contract.

Limited Coverage – This states special coverage limit items such as a loss of jewelry resulting from theft, may have a limit of coverage

Loss of Use – Reimbursable living expenses if unable to reside in home

Loss Assessment – Coverage for assessments made against insured resulting from loss of commonly owned property

Managing General Agency (MGA) - An independent business or organization that appoints and supervises independent agents for insurers that use the independent agency system.

Medical Payments Coverage - Coverage that pays necessary medical expenses incurred within a specified period by a claimant (and in certain policies, by an insured) for a covered injury, regardless of whether the insured was at fault.

Named Insured - The policyholder whose name(s) appears on the declarations page of an insurance policy.

Non-Admitted Insurer - Insurers that are not licensed in many of the states in which they operate and that write E&S insurance coverages.

Occurrence Basis Coverage - Coverage for liability claims that occur during the policy period, regardless of when the claim is submitted to the insurer.

Peril - The actual means by which property is damaged or destroyed.

Policy - A complete written contract of insurance.

Personal Liability Insurance - Insurance that provides liability coverage to individuals and families for bodily injury and property damage arising from the insured’s personal premises or activities.

Premium - The price of the insurance coverage provided for a specified period

Rate - The amount per exposure unit for insurance coverage, used to arrive at a premium when multiplied by the number of exposure units.

Reinsurance - A contractual agreement that transfers some or all of the potential costs of insured loss exposures from policies written by one insurer to another insurer.

Replacement Cost - The cost to repair or replace property using new materials of like kind and quality with no deduction for depreciation.

Solvency - The ability of an insurer to meet its financial obligations as they become due, even those resulting from insured losses that may be claimed several years in the future.

Special Form - A policy that provides coverage for any direct loss to property unless the loss is caused by a peril specifically excluded.

Special Provisions – These state additional limits, conditions and exclusions that may apply to a policy.

Subrogation - The insurer’s right, assumed from the insured, to recover payment from a third party that is legally responsible for the loss.

Underwriter - An insurer employee who evaluates applicants for insurance, selects those that are acceptable to the insurer, prices coverage, and determines policy terms and conditions.

Underwriting - The process of selecting insureds, pricing coverage, determining insurance policy terms and conditions, and then monitoring the underwriting decisions made.

Resources:

Luthardt, Constance M. and Wiening, Eric A. and Frappolli, Martin J. Property and Liability Insurance Principles. Pennsylvania: Malvern, 2005. Print.