Insurance Definitions
A-Z Index
- ABANDONMENT: Giving up the proprietary rights in insured property to the Underwriter in
exchange for payment of a constructive total loss.
- ACCIDENT: An unexpected fortuitous event, unforeseen and unintended, not under the
control of an insured and resulting in a loss.
- ACCIDENT FREQUENCY: The number of times an accident occurs. Used in predicting losses
upon which premiums are based.
- ACCIDENT INSURANCE: A form of health insurance against loss by bodily injury.
- ACCIDENTAL DEATH: Coverage in the event of death due to an accident, usually in
combination with dismemberment insurance.
- ACCOUNTS RECEIVABLE POLICY: An inland marine (also burglary) policy written to protect
the insured from financial loss due to his inability to collect amounts owed him because of the
destruction of his records.
- ACT OF GOD: A flood, an earthquake or other accident or event that is without any human
intervention and that could not have been prevented by reasonable care or foresight, but is the result
of natural causes (A snowstorm is an Act of God; driving in one is an act of man).
- ACTUAL CASH VALUE: The sum of money required to pay for damages or lost property,
computed on the basis of replacement value less its depreciation by obsolescence or general wear.
- ACTUAL TOTAL LOSS: Occurs when:
(1) the insured property is completely destroyed or
(2) the Assured is irretrievably deprived of the insured property or
(3) cargo changes in character so that it is no longer the thing that was insured or
(4) a ship is posted "missing" at Lloyd's, in which case both the ship and its cargo are deemed to be an
actual total loss.
- ACTUARY: A professional trained in the mathematics of insurance and risk management.
- ADD-ONS: Additional coverages to your basic policy.
- ADDITIONAL INSURED: A person or firm or corporation other than the named insured on a
policy or mortgage company named in a mortgagee clause, who is protected against loss by the terms of
the policy or mortgage company named in the mortgage clause.
- ADJUSTER: An individual representing the insurance company and acting for the company
in working on agreements as to the amount of a loss and the liability of the company in same.
- ADVERSE SELECTION: Selection against the insurance company; the tendency of more poor
risks to buy and maintain insurance than good risks.
- AGENTS: Two types of agents sell insurance: (1) Independent Agents are self-employed
business people who typically represent more than one insurance company and are paid on a commission
basis; and (2) Exclusive Agents represent only one insurance company and may be salaried or work on a
commission basis.
- ALL RISK: Insurance against loss or damage to property arising from any fortuitous
cause, except such as may be specifically excluded.
- ANNUITY: A life insurance company contract that pays a periodic income benefit for a
specified period of time.
- APPLICATION: A signed statement by a prospective insured client which becomes a part of
the insurance contract.
- APPRAISAL: A survey of property made for determining its insurable value or the amount
of loss sustained.
- ASSIGNMENT: The passing of beneficial rights from one party to another.
- ASSIGNED RISK: A risk which underwriters do not care to insure, but because of state
law or otherwise, the insured must be protected and the insurance is therefore handled through the state
and assigned to companies.
- ASSUMED LIABILITY: Liability which would not rest upon a person except that he has
accepted responsibility by contract expressed or implied. This is also known as contractual liability.
- AUTOMOBILE INSURANCE PREMIUM DISCOUNTS: A discount offered to drivers for such
safeguards as air bags, seat belts, good driving record, anti-theft devices, multiple vehicles, etc.
- AUTOMOBILE FLEET POLICY: A commercial automobile policy covering five or more
automobiles.
- AVERAGE: A marine partial loss. This can be particular average or general average (see
below).
- AVERAGE CLAUSE: A clause in a marine insurance policy, whereby partial losses are
subject to special conditions (e.g. a franchise or deductible is to be applied to claims).
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- BAILEE: A person or concern having possession of property committed in trust from the
owner.
- BAILEE'S CUSTOMERS POLICY: A policy providing for loss or or damages to property of
bailee's customers, payable either to bailees for their account or direct to customers.
- BASIC COVERAGE FORM: Any of the commercial or personal insurance property forms which
provide basic coverages. These forms generally provide the most limited coverage, which is surpassed by
"Broad Forms" and "Special Forms."
- BASIC RATE: The manual rate, from which are taken discounts or to which are added
charges to compensate for the individual circumstances of the risk.
- BENEFICIARY: Designation by the owner of a life insurance policy indicating to whom the
proceeds are to be paid upon the insured's death or when an endowment matures.
- BENEFIT OF INSURANCE CLAUSE: A clause by which the bailee of goods claims the benefit
of any insurance policy effected by the cargo owner on the goods in care of the bailee. Such a clause in
a contract of carriage, issued in accordance with the Carriage of Goods by Sea Act, is void at law.
- BILL OF LADING: Contract of carriage and receipt for goods, issued by carrier.
- BINDER: (Or Binding Receipt): In lines other than life and health, a binder is an
acknowledgement (usually from the agent) that insurance applied for is in force whether or not premium
settlement has yet been made or the policy issued. In life and health insurance, binders are not issued,
but if premium settlement is made with the application, what is often erroneously referred to as a
"binder" is issued. Actually this is a conditional binding receipt.
- BLANKET INSURANCE: (1) Property-liability insurance that covers more than one type of
property in one location in one policy or form instead of under separate items, or one or more types of
property at more than one location; (2) A contract of health insurance that covers all of a class of
persons not individually identified.
- BODILY INJURY LIABILITY: The liability which may arise from injury or death of another
person.
- BOILER AND MACHINERY POLICY: Insurance against loss due to accidents to boilers,
pressure vessels or other machinery including the equipment itself, as well as liability arising out of
the accident.
- BOND: An obligation of the insurance company to protect one against financial loss
caused by acts of another.
- BUILDER'S RISK COVERAGE FORM: A commercial property coverage form specifically designed
for buildings in the course of construction.
- BUILDER'S RISK INSURANCE: Insurance against loss to buildings or structures in the
course of construction.
- BUILDINGS AND PERSONAL PROPERTY COVERAGE FORM: A commercial property coverage form
designed to insure most types of commercial property (buildings or contents or both). It is the most
frequently used commercial property form, and has replaced the General Property Form, Special Building
Form, Special Personal Property Form, and others.
- BUSINESS AUTO COVERAGE FORM: The latest commercial Automobile Insurance coverage form,
which may be written as a monoline policy or as part of a commercial package. This form has largely
replaced the Business Auto Policy.
- BUSINESS INCOME COVERAGE FORM: A commercial property form providing coverage for
"indirect losses" resulting from property damage, such as loss of business income and extra expenses
incurred. It has replaced earlier Business Interruption and Extra Expense forms.
- BUSINESS INTERRUPTION INSURANCE: A type of policy that pays for loss of earnings when
operations are curtailed or suspended because of property loss.
- BUSINESS LIABILITY: The term used to describe the liability coverages provided by the
Businessowners Liability Coverage Form. It includes liability for bodily injury, property damage,
personal injury, advertising injury, and fire damage.
- BUSINESS PERSONAL PROPERTY: Traditionally known as "contents," this term actually
refers to furniture, fixtures, equipment, machinery, merchandise, materials, and all other personal
property owned by the insured and used in the insured's business.
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- C & F: A sale term relating to goods. Cost and Freight. The consignee makes his own
insurance arrangements for the goods throughout the period of transit.
- CANCELABLE POLICY: A policy which may be terminated by the company or the insured by
proper notification sent to the other party according to terms set forth in the policy.
- CARRIER: (1) An insurance company which "carries" the insurance. (The terms "insurance
company" or "insurer" are preferred because of the possible confusion of "carrier" with transportation
terminology). (2) In transportation, the trucker, air carrier, ocean steamship company or other entity
which moves the goods. (See "Contract Carrier)
- CASH SURRENDER VALUE: Money the policyholder is entitled to receive from the insurance
company upon surrendering a life insurance policy containing a cash value clause.
- CASUALTY INSURANCE: That type of insurance that is primarily concerned with losses
caused by injuries to persons and legal liability imposed for such injury or for damage to property of
others. It also includes such diverse forms as Plate Glass, insurance against crime, such as robbery,
burglary or forgery, Boiler and Machinery insurance, and Aviation insurance. Many casualty companies
also write surety business.
- CAUSES OF LOSS: Under the latest commercial property forms, this term replaces the
earlier term "perils" insured against.
- CLAIM: (1) A formal request for payment of a loss under an insurance contract or bond;
(2) The actual amount of the final settlement.
- CLAIMANT: One who seeks reimbursement for loss under the terms and conditions of the
insurance contract.
- CLAIMS-MADE COVERAGE: A policy providing liability coverage only if a written claim is
made during the policy period or any applicable extended reporting period. For example, a claim made in
the current reporting year could be charged against the current policy even if the injury or loss
occurred many years in the past. If the policy has a retroactive date, an occurrence prior to that date
is not covered. (Contrast this with "Occurrence Coverage)
- CLASSIFICATION CLAUSE (CARGO): A clause in a cargo insurance open cover which details
the minimum classification for an overseas carrying vessel that is acceptable to the insurers for
carriage of the insured goods at the premium rate/s agreed in the contract. Goods carried by lower class
vessels are accepted under the open cover, subject to payment of an additional premium.
- CLAUSE: A section or paragraph in an insurance policy that explains, defines or
clarifies the conditions of coverage.
- COBRA (Consolidated Omnibus Budget Reconciliation Act): A federal law under which group
health plans sponsored by employers with 20 or more employees must offer continuation of coverage to
employees who leave their jobs, voluntarily or otherwise, and their dependents; gives individuals and
their dependent families the right to continue their health care coverage for as long as 18 months.
- COINSURANCE: (1) In property insurance, a clause under which the insured shares in
losses to the extent that he is underinsured at the time of loss. (2) In health insurance, a provision
that the insured and insurance company will shared covered losses in agreed proportion. In health
insurance, the preferred term is "percentage participation."
- COLLISION COVERAGE: Physical damage protection for the insured's own automobile(s) for
damage resulting from a collision with another object or upset.
- COMMERCIAL GENERAL LIABILITY (CGL) COVERAGE PART: General liability coverage which may
be written as a monoline policy or part of a commercial package. "CGL" now means commercial general
liability forms which have replaced the earlier "comprehensive" general liability forms. The latest
forms include all sublines, provide very broad coverage, and two variations are available, "Occurrence,"
and "Claims Made," coverage.
- COMPREHENSIVE COVERAGE: Traditional name for physical damage coverage for losses by
fire, theft, vandalism, falling objects and various other perils. On Personal Auto Policies this is now
called "other than collision" coverage. On commercial forms, it continues to be called "comprehensive
coverage."
- COMPREHENSIVE GENERAL LIABILITY POLICY: A policy covering a variety of general
liability exposures, including Premises and Operations (OL&T or M&C), Completed Operations, Products
Liability, and Owners and Contractors Protective. Contractual Liability and Broad Form coverages could
be added. In most jurisdictions the "Comprehensive General Liability Policy" has been replaced by the
newer "Commercial General Liability (CGL) forms which include all the standard and optional coverages of
the earlier forms.
- COMPREHENSIVE PERSONAL LIABILITY POLICY (CPL): A personal liability contract. It
provides personal liability coverage for the individual and family needs arising out of numerous
personal activities and situations, such as the ownership of residential property, ownership of pets,
sports activities, and many other everyday activities.
- CONDITIONALLY RENEWABLE: A contract of health insurance that provides that the insured
may renew the contract to a stated date or an advanced age, subject to the right of the insurance
company to decline renewal only under conditions defined in the contract.
- CONSEQUENTIAL LOSS: A loss arising indirectly from an insured peril.
- CONTRACT CARRIER: A transportation company which carries the goods of only certain
customers and not the public in general as in the case of a common carrier.
- CONTRACTUAL LIABILITY: Liability assumed under any contract or agreement. Coverage is
generally limited in liability policies, but in most cases may be provided for an additional premium.
- CONTRIBUTION: The term relates to circumstances where more than one party covers the
risk. Each party is deemed to be liable for his proportion of the loss. If the Assured recovers in full
from one insurer, that insurer is entitled to recover from the other insurer for that part of the loss
which should have been paid by the latter. The term is used in marine insurance, also, in relation to
contributions paid by the Assured in connection with salvage and/or general average.
- CONTRIBUTORY VALUE: The value on which a contribution to a general average loss or
salvage award is calculated.
- CONVERSION PRIVILEGE: A right granted to group certificate holders, by which they may
obtain an individual policy (upon leaving the group) regardless of physical condition.
- CO-PAYMENT: The portion, either a percentage or a fixed dollar amount, of a medical
bill that a patient pays. The insurer pays the rest.
- COUNTRY DAMAGE: Marine term referring to damage to baled or bagged goods (e.g. cotton)
caused by excessive moisture from damp ground or exposure to weather, or by grit, dust or sand forced
into the insured property by windstorm or inclement weather.
- COVER: (1) A contract of insurance; (2) To effect insurance; (3) To include within the
coverage of a contract of insurance.
- COVERAGE: The scope of protection provided under the contract of insurance.
- COVERAGE PART: Any one of the individual commercial coverage parts that may be
attached to a commercial policy.
- COVERAGE TRIGGER: A mechanism that determines whether a policy covers a particular
claim for loss. For example, the difference between the coverage triggers of liability "occurrence"
forms and "claims made" forms is that the loss must occur during the policy period in the first case and
the claim must be made during the policy period in the second case.
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- DECLARATION PAGE: That page of the insurance policy which lists the insurance company,
its address, name of the policyholder, starting and ending dates of coverage, and the actual coverages
given in the contract, including the locations and amounts.
- DEDUCTIBLE: The amount of loss paid by the policyholder before the insurance policy
benefits become payable.
- DENTAL INSURANCE: Coverage for dental services under a group of individual policy.
- DEPRECIATION: Decrease in the value of any type of tangible property over a period of
time resulting from use, wear, tear, deterioration, and obsolescence.
- DIRECT OR HELD COVERED: A condition requiring that the insured voyage be direct from
one place to another. If the voyage is delayed en route or there is a deviation from the direct route
the insurance cover continues subject to payment of an additional premium, but only if the Assured gives
prompt notice of such delay or deviation immediately on receipt of advices, unless the policy provides
otherwise.
- DISABILITY: A condition that curtails to some degree a person's ability to carry on his
normal pursuits. A disability may be partial or total, and temporary or permanent.
- DISABILITY INSURANCE: A type of health insurance that pays a monthly income to the
policyholder when he or she is unable to work because of illness or accident.
- DISCLOSURE: The duty of the Assured and his broker to tell the Underwriter every
material circumstance before acceptance of the risk.
- DISCOVERY PERIOD: The time allowed the insured after termination of certain bond and
policy provisions to discover that he has sustained a loss which occurred during the period covered by
the contract.
- DUTY OF ASSURED CLAUSE: This appears in the Institute Cargo Clauses published for use
with the MAR form of policy. It directs the attention of the Assured, his agents, etc. to the duty (as
required by the MIA, 1906) to take reasonable measures to avert or minimize any loss which is
recoverable under the policy; also to ensure that all rights against carriers and others are properly
preserved and exercised. Underwriters agree to reimburse the Assured for any reasonable expenditure
incurred by his compliance with the clause; in practice, these expenses are termed "sue and labor"
charges (see Sue & Labor).
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- EARNED PREMIUM: That portion of a premium for which the policy protection has already
been given during the now-expired portion of the policy term.
- EFFECTIVE DATE: The date on which an insurance policy or bond goes into effect, and
from which protection is furnished.
- ELECTRONIC DATA PROCESSING COVERAGE (EDP): Specialized type of insurance designed to
cover computer equipment, data systems, information storage media, and expense or income losses related
to EDP losses.
- ELIMINATION PERIOD: A loosely-used term sometimes designating the waiting period and
sometimes the probationary period.
- EMPLOYERS LIABILITY INSURANCE: Coverage against common law liability of an employer for
accidents to employees, as distinguished from liability imposed by workers compensation law.
- EMPLOYERS NON-OWNERSHIP AUTOMOBILE LIABILITY: (1) Liability arising out of the
operation of an automobile not owned by the insured. This frequently results when an employee uses his
own personal car in the business activities of the insured; (2) Insurance coverage for the liability
exposure mentioned above.
- ENDORSEMENT: A form attached to the policy bearing the language necessary to change the
terms of the policy to fit special circumstances.
- ENGLISH JURISDICTION CLAUSE: OA condition, printed in the MAR form of policy, whereby
Underwriters agree to recognize judgments only from courts convened within English jurisdiction.
Subscribing Underwriters may agree to replace this clause with a foreign jurisdiction clause. Please
note this is not applicable to business emanating from the United States of America which is subject to
the Service of Suit Clause (USA) appearing in the Standard Conditions.
- ENGLISH LAW AND PRACTICE: This clause appears in Institute clauses published for use
with the MAR form or policy. It applies where a foreign jurisdiction clause attaches to the policy and
requires that the foreign court shall base its decisions on English law and practice.
- ERISA (Employment Retirement Income Security Act of 1974): A federal law that
established rules and regulations to govern private pension plans. Most self-insured health plans are
created under this act.
- EVIDENCE OF INSURABILITY: Any statement of a person's physical condition, occupation,
etc., affecting his acceptance for insurance.
- EXCLUSIONS: Specified hazards for which a policy will not provide benefit payments.
(Often called Exceptions)
- EXPERIENCE: The loss record of an insured, class of coverage, or of an insurance
company.
- EXPERIENCE RATING: Determination of the premium rate for an individual risk, made
partially or wholly on the basis of that risk's own past claim experience.
- EXPOSURE: (1) State of being subject to the possibility of loss; (2) extent of risk as
measured by payroll, gate receipts, area, or otherwise; (3) possibility of loss to a risk being caused
by its surroundings.
- EXTENDED COVERAGE ENDORSEMENT: A specific endorsement attached to a Standard Fire
policy, usually providing coverage of windstorm, hail, explosion, riot, riot attending civil strike,
aircraft, vehicular damage, smoke and civil commotion.
- EXTENDED REPORTING PERIOD (ERP): A period allowed for making claims after expiration of
a "claims made" liability policy. Also known as a "tail."
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- FAS: Incoterm meaning Free Alongside Ship"
- FAC: Incoterm meaning "Free Carrier"
- FOB: Incoterm meaning "Free On Board"
- FPA: Free of Particular Average (see Average or Particular Average)
- FIDELITY BOND: A bond which will reimburse an employer for loss up to the amount of the
bond, sustained by an employer (the insured) by reason of any dishonest act of an employee (or
employees) covered by the bond.
- FIRE: Combustion sufficient to product a spark, flame or glow and which is hostile (as
opposed to friendly - i.e. not in the place where it is intended to be as in a furnace or fireplace.)
- FIRE INSURANCE: (1) Insurance contracts that indemnify an insured for loss caused by
the destruction of the insured's property resulting from a fire; (2) The field of insurance that
provides insurance policies on the insured's property for a variety of perils, including fire.
- FIRST NAMED INSURED: The first named insured appearing on a commercial policy. The
latest forms permit the insurer to satisfy contractual duties by giving notice to the "first" named
insured rather than requiring notice to all named insureds.
- FLAT CANCELLATION: Cancellation of an insurance policy as of the date of its start with
no premium charge.
- FRANCHISE: A provision in freight insurance conditions which exempts the insurer from
particular average losses, in any one accident, under 3%. The provision is waived if the loss is caused
by fire, or by the ship stranding, sinking or being in collision.
- FREIGHT: (1) Goods moved for another or, (2) The remuneration earned by a shipowner or
manager for the carriage of goods; including the profit derived from carrying his own goods.
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- GARAGEKEEPERS LEGAL LIABILITY POLICY: Coverage for losses for which the insured is
legally liable, caused by fire or explosion, theft of an entire vehicle, riot and vandalism, collision,
and upset to automobiles in his care, custody and control.
- GARAGE LIABILITY POLICY: A liability contract designed to provide the owner of a garage
operation with the liability protection needed for the special hazards that exist there.
- GENERAL AGGREGATE LIMIT: A Commercial General Liability limit that applies to all
damages paid for bodily injury, property damage, personal injury, advertising injury, and medical
expenses, except damages included in the products-completed operations hazard.
- GENERAL AVERAGE: An Ocean Marine coverage meaning a partial loss which has resulted
from the voluntary and deliberate sacrifice of some cargo for the benefit of all concerned, and which
must be shared by all parties (owners of ship, cargo and freight) in proportion to their interest. For
example, if 100 containers were jettisoned from a 1000 container load in order to protect the ship, the
owners of the remaining 900 containers, the owners of the ship, and the owners of the freight would all
contribute to offset the losses of those whose cargo was jettisoned for the benefit of the whole.
- GENERAL AVERAGE CONTRIBUTION: The proportion paid or payable by a saved interest
involved in a general average act.
- GENERAL AVERAGE DEPOSIT: Paid by a consignee to obtain release of the cargo from the
carrier following a general average act. This may be replaced by an Underwriter's guarantee.
- GENERAL AVERAGE GUARANTEE: Paid by a consignee to obtain release of the cargo from the
carrier following a general average act. This may be replaced by an Underwriter's guarantee.
- GENERAL AVERAGE IN FULL -aka- G-A IN FULL: An agreement in a cargo insurance whereby
Underwriters do not reduce a claim for general average contribution in event of underinsurance.
- GENERAL EXCLUSION CLAUSE: A clause in the Institute Cargo Clauses 1982, which specifies
risks that are excluded, irrespective of the risks covered elsewhere in the wording.
- GLASS COVERAGE FORM: A commercial property form used to insure plate glass, lettering,
frames and ornamentation. It has replaced earlier commercial glass insurance forms.
- GOOD FAITH: A basic principle of insurance. The Assured and his broker must disclose
and truly represent every material circumstance to the Underwriter before acceptance of the risk. A
breach of good faith entitles the Underwriter to avoid the contract. (Proposed changes in law may affect
this definition - also see "Utmost Good Faith".)
- GUARANTEED RENEWABLE POLICY: A policy which the insured has the right to continue in
force by the timely payment of premiums to a specified age, (usually age 50) during which period the
insurer has no right to make unilaterally any change in any provision of the policy while the policy is
in force but make changes in premium rates for the entire policyholder classification. (See also
"Non-Cancelable Policy".)
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- HAZARD: A specific situation that increases the probability of the occurrence of loss
arising from a peril, or that may influence the extent of the loss. For example, accident, sickness,
fire, flood, liability, explosion are perils. Slippery floors, unsanitary conditions, shingled roofs,
congested traffic, unguarded premises, and uninspected boilers are Hazards.
- HEALTH INSURANCE: Protection against the costs of hospital and medical care or lost
income arising from an illness or injury (sometimes called Accident & Sickness Insurance).
- HELD COVERED: A provisional acceptance of risk, subject to confirmation at a later date
that the agreed cover is needed. Where applicable to an existing insurance, cover is conditional, in
practice, on prompt advice to the Underwriter as soon as the Assured is aware of the circumstances to be
held covered coming into effect, and a reasonable additional premium is payable if the risk held covered
comes into effect.
- HIRED AUTOMOBILE:Autos the insured leases, hires, rents or borrows but not autos owned
by employees or members of their households.
- HIT AND RUN: Collision between a motor vehicle with another motor vehicle, object or
pedestrian, where the driver of the vehicle leaves the scene of the accident without identifying
himself.
- HMO (Health Maintenance Organization): An organization that provides health care for a
monthly payment set in advance. In a traditional HMO, doctors and other providers are salaried employees
and the facilities are owned by the organization. In recent years, however, other forms of HMOs have
sprung up that contract with doctors and hospitals to care for members at set, negotiated fees. Many
HMOs are hybrids, offering both kinds of care to members.
- HOLD-HARMLESS AGREEMENT: A contractual arrangement whereby one party assumes the
liability inherent in a situation, thereby relieving the other party of responsibility. Such agreements
are typically found in contracts like leases. A typical lease may provide that the lessee must "hold
harmless' the lessor for any liability from accidents arising out of the premises.
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- ICC CLAUSES: (see Institute Cargo Clauses)
- INDEMNIFY: To restore the victim of a loss, in whole or in part, by payment, repair or
replacement.
- INDEMNITY BOND: A bond which indemnifies the obligee against loss which arises as a
result of failure on the part of a principal to perform.
- INDEPENDENT ADJUSTER:An adjuster who works as an independent contractor, hiring himself
out to insurance companies or other organizations for the investigation and settlement of claims.
- INDEPENDENT CONTRACTOR: One who agrees to perform according to a contract and who is
not an employee.
- INHERENT VICE: A defect or cause of loss arising out of the nature of the goods in
question.
- INLAND MARINE INSURANCE: A branch of the insurance business which developed from the
insuring of shipments which did not involve ocean voyages. Exposures eligible for this form of
protection are described in the nationwide definition of Marine Insurance. Such diverse properties as
bridges, tunnels, jewelry, and furs can now be written under Inland Marine forms.
- INSTITUTE CARGO CLAUSES: Treaty wordings developed by the International Chamber of
Commerce. There are three basic sets of these clauses (A, B and C). The A clauses cover "all risks",
subject to specified exclusions. The B and C clauses cover specified "risks", subject to specified
exclusions. (See actual ICC Clauses treaty wordings via "Ocean Reference" link at left.)
- INSURABLE INTEREST: A direct monetary interest in the insured property sufficient to
result in monetary loss should the property be damaged or destroyed.
- INSURABLE RISK: A risk which meets most of the following requisites: (1) The loss
insured against must be defined; (2) It must be accidental; (3) It must be large enough to cause
hardship to the insured; (4) It must belong to a homogenous group of risks large enough to make losses
predictable; (5) It must not be subject to the same loss at the same time as a large number of other
risks; (6) The insurance company must be able to determine a reasonable cost for the insurance; (7) The
insurance company must be able to calculate the chance of loss.
- INSURANCE: A system to protect persons, groups, or businesses against the risks of
financial loss by transferring the risks to a large group who agree to share the financial losses in
exchange for premium payments.
- INSURED: The person whose risk is transferred and shared; the party to an insurance
agreement whom the insurer agrees to indemnify for losses, provide benefits for, or render services to.
- INSURER: The company or group offering protection through the sale of an insurance
policy to an insured; the party to an insurance agreement who undertakes to indemnify for losses,
provide pecuniary benefits, or render services.
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- JOINT LIFE POLICY: Pays the insurance amount when the first of two or more covered
persons dies.
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- JOINT LIFE POLICY: Pays the insurance amount when the first of two or more covered
persons dies.
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- LEASE: Contract whereby the owner or user of property (the lessor) agrees to let
another party, (the lessee) use the property for a consideration (money or rent).
- LEASEHOLD INSURANCE: Insurance for the tenant of a property leased against the loss of
value of the lease or of profit from a sub-lease through termination of the lease by fire or other peril
insured against.
- LESSEE (Leasee): The party to whom a lease is granted.
- LESSOR:The party who grants a lease to the lessee.
- LIABILITY: Broadly, any legally enforceable obligation; a responsibility of one person
to another, enforceable in law.
- LIABILITY INSURANCE: That insurance that pays and renders service on behalf of an
insured for loss arising out of his responsibility, due to negligence, to others imposed by law or
assumed by contract.
- LIABILITY LIMITS: The sum or sums beyond which a liability insurance company does not
protect the insured on a liability policy.
- LIEN: A word that indicates an encumbrance on property, either for discharge of a duty
or the payment of a debt. When a lien exists, the conditions attaching to the issue of an insurance
contract require that it be disclosed to the insurance company.
- LIFE INSURANCE: Protection against the death of the Insured in the form of payment to a
designated beneficiary, typically a family member or business.
- LONG-TERM CARE INSURANCE: A type of insurance policy that covers the cost of long-term
custodial care in a nursing facility or at home.
- LOCATION CLAUSE: Used in cargo open covers this limits Underwriters' liability in any
one location.
- LOSS OF USE INSURANCE: Insurance against loss due to the inability to use property
because of its damage or destruction.
- LOSS OF HIRE INSURANCE: A type of marine insurance designed to pay for continuing
expenses and loss of profits to vessel owners while unable to work after a claim. It provides the means
to pay loans, insurance premiums, key clerical staff, captain and essential crew, and other expenses.
(Similar to "Business Interruption" or "Loss of Income" policies.)
- LOSS PAYABLE CLAUSE: Clause in an insurance policy to specifically identify interested
parties (the insured, mortgagees, trustees, lienholders, etc.).
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- MALICIOUS DAMAGE CLAUSE: A clause published by the Institute of London Underwriters for
use in a cargo policy that is subject to the Institute Cargo Clauses (1982) B or C. It adds the risks of
malicious acts, vandalism and sabotage to the cargo policy.
- MALPRACTICE INSURANCE: A professional liability coverage that insures physicians,
lawyers and other specialists against suits alleging their negligence.
- MANAGED CARE: A health plan that places limits on which treatments and which doctors,
hospitals and other providers a member can use and still receive full coverage. Generally, under managed
care an insurer negotiates lower fees with doctors, hospitals, or laboratories who join in a network
that members of the plan are encouraged to use. Frequently, members of a managed care plan can use
health care providers outside their network, but they must pay a greater share of the fees.
- MANUAL RATES: Usually the published rate for some unit of insurance. An example is the
Workers Compensation Manual where the rates shown apply to each $100 of the payroll of the insured, $100
being the unit.
- MAR POLICY: A market term for the form of marine policy used by Lloyd's and the London
company market. It is a basic contract form to which the conditions agreed by the insurers subscribing a
marine insurance contract are attached.
- MARINE INSURANCE: Insurance coverage for goods in transit, and for the vehicles that
transport them, over waterways, over land, and in air.
- MARKET VALUE CLAUSE: A provision that may be used in property damage insurance form
covering some risks which obligates the insurance company, in the event of loss, to pay the established
cash selling price of the destroyed or damaged stock, rather than the actual case value as provided in
the Standard Fire Policy.
- MATERIAL FACT: Anything affecting an insurance contract significant enough to change
the agreement between the insurance company and the policyholder.
- MEDICAID: A federal/state program that helps pay for health care for the needy, blind
or disabled and for low-income families with children.
- MEDICARE: A federal health care program for people age 65 and over, and for the
disabled.
- MEDIGAP: Insurance coverage sold by private insurers to supplement federal insurance
benefits and expenses not covered under the federal Medicare program.
- MINIMUM PREMIUM: The smallest premium which an insurance company will accept for
writing a particular policy or bond for a designated period.
- MISREPRESENTATION: An incorrect statement made about a material fact that, if made
deliberately and with intent to deceive, could cause the insurance contract to become null and void.
- MITIGATE: To make less severe; steps to eliminate further damage after a loss occurs.
- MORTGAGE INSURANCE: Life insurance that pays the balance of a mortgage if the mortgagor
(insured) dies.
- MOTOR TRUCK CARGO - OWNER'S FORM: This form insures the owner of a truck against loss
to his own property while being transported. It pays for the loss or damage of cargo for the perils
insured against, regardless of the legal liability.
- MOTOR TRUCK CARGO - TRUCKER'S FORM: This form indemnifies the policyholder, a trucker,
for loss or damage resulting from his legal liability as a carrier while transporting the property of
others. I does not insure against any loss for which he is not legally liable.
- MYSTERIOUS DISAPPEARANCE: The disappearance of insured property in a mysterious,
unexplained manner.
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- NAMED INSURED: Any person, firm, or corporation, or any member thereof, specifically
designated by name as insured(s) in a policy as distinguished from the others who, though unnamed, are
protected under some circumstances.
- NAMED PERIL POLICIES: Named Peril Policies specify what perils are insured against, as
opposed to so-called all-risk policies.
- NEGLIGENCE: Failure to use the degree of care expected from a reasonable and prudent
person.
- NO-FAULT: A system in which each driver's auto insurance coverage pays for injuries and
damage, no matter who caused the accident.
- NON-CANCELABLE POLICY: A policy which the insured has the right to continue in force by
the timely payment of premiums set forth in the policy, during which period the insurer has no right to
make unilaterally any change in any provision of the policy while the policy is in force. (See also
"Guaranteed Renewable Policy".)
- NOTICE OF LOSS: Written notice of a loss to the insurance company as outlined in the
conditions of the insurance policy.
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- OBLIGEE: Broadly, anyone in whose favor an obligation runs. This term is most
frequently used in surety bonds, where it refers to the person, firm or corporation protected by the
bond.
- OBLIGOR: Commonly called principal; one bound by an obligation. Under a bond, strictly
speaking, both the principal and the surety are obligors.
- OCCUPANCY: In insurance, this term refers to the type and character of the use of
property in question.
- OCCURRENCE COVERAGE: A policy providing liability coverage only for injury or loss that
occurs during the policy period, regardless of when the claim is actually made.
- OPEN COVER: An agreement whereby the Assured undertakes to declare every item (e.g.
shipment, vessel, etc. as appropriate) that comes within the scope of the cover in the order in which
the risk attaches. The insurer agrees, at the time of concluding the contract, to accept all valid
declarations up to the agreed limit for each declaration. An open cover may be for a fixed period or
always open; subject to a cancellation clause.
- OVERAGE: An additional premium charged on a cargo open cover declaration because the
carrying vessel is outside the scope of the classification clause.
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- PACKAGE POLICY: An insurance policy including two or more lines or types of coverages
in the same contract.
- PARTIAL LOSS: A loss under an insurance policy which does not either (1) completely
destroy or render worthless the insured property; or (2) exhaust the insurance applying thereto.
- PAYROLL AUDIT: An examination of the insured's payroll records by a representative of
the insurance company to determine the premium due on a policy.
- PERIL: A term used in the Marine Insurance Act (1906) to denote a hazard. The principle
of proximate cause is applied to an insured peril to determine whether or not a loss is recoverable. In
modern practice the term "risk" often replaces "peril".
- PERSONAL ARTICLES FLOATER: Provides all risk coverage for valuable items such as furs,
jewelry, etc. formerly insured under separate contracts.
- PERSONAL EFFECTS FLOATER: An Inland Marine Policy covering worldwide, except in the
insured's domicile, personal effects usually carried by a tourist.
- PERSONAL INJURY: Injury other than bodily injury arising out of false arrest or
detention, malicious prosecution, wrongful entry or eviction, libel or slander, or violation of a
person's right to privacy committed other than in the course of advertising, publishing, broadcasting,
publishing, or telecasting.
- PERSONAL INJURY COVERAGE: Liability insurance coverage for third party claims for
damages which are other than physical such as libel, slander, false arrest, etc.
- PERSONAL INJURY PROTECTION: The formal name usually given to no-fault benefits in
states that have enacted mandatory or optional no-fault Automobile Insurance coverages. PIP usually
includes benefits for medical expenses, loss of work income, essential services, accidental death and
funeral expenses.
- PERSONAL LINES: This term is used to refer to insurance for individuals and families
such as private passenger automobile or homeowner insurance.
- POLICY: The written statement of a contract effecting insurance, or certificates
thereof, by whatever name called and including all causes, riders, endorsements and papers attached
thereto and made part thereof.
- POLICY PERIOD: The period during which the policy contract affords protection.
- PRE-CERTIFICATION AUTHORIZATION: A cost containment technique which requires physicians
to submit a treatment plan and an estimated bill prior to providing treatment. This allows the insurer
to evaluate the appropriateness of the procedures, and lets the insured and the physician know in
advance which procedures are covered and at what rates benefits will be paid.
- PRE-EXISTING CONDITIONS: A physical condition of an insured person which existed prior
to the issuance of the policy.
- PREMISES: The particular location of a property or a portion thereof as designated in a
policy.
- PREMIUM: The payment for an insurance policy, usually paid periodically (annually,
semi-annually, quarterly, or monthly).
- PRIOR DAMAGE: Pre-existing damage that occurred prior to the loss in question.
- PRO-RATA: Cancellation of an insurance contract by the insurance company, allowing a
policyholder a share of the premium relating to the remainder of the time under the contract that bears
to the total contract premium.
- PRODUCTS LIABILITY INSURANCE: Provides protection against claims arising out of the
use, handling or consumption of a product.
- PROFESSIONAL LIABILITY INSURANCE: Liability insurance to indemnify professionals,
doctors, lawyers, architects, etc. for the loss or expense resulting from claim on account of bodily
injuries because of any malpractice, error or mistake committed or alleged to have been committed by the
insured in his profession.
- PROOF OF LOSS: A statement made to the insurance company under oath setting out the
basis of an insured's claim under the insurance policy.
- PROPERTY DAMAGE (LIABILITY) INSURANCE: Protection against liability for damage to the
property of another not in the care, custody and control of the insured, as distinguished from liability
for bodily injury.
- PROPERTY INSURANCE: Insurance which indemnifies a person with an interest in physical
property for its loss or the loss of its income-producing ability.
- PROSCRIPTION: Outside of the time period in which a legal action can be commenced.
- PROXIMATE CAUSE: The immediate and effective cause of loss or damage. It is an unbroken
chain of cause and effect between the occurrence of an insured peril or a negligent act and resulting
injury or damage.
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- QUALIFIED PLAN: A plan under which contributions by the employer are allowed as a
deduction from taxable income, and which provides that the deposits for his employees' future benefits
are not to be considered as taxable income to them in the year in which they are made.
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- RATING BUREAU: An organization that classifies and promulgates and in some cases
compiles data and measures hazards of individual risks in terms of rates in a given territory.
- RECOVERY: Amount recovered from a third party responsible for a loss on which a claim
has been paid.
- REBATE: AA reduction of a premium.
- REIMBURSEMENT: Payment of an amount of money related to the amount of loss to or on
behalf of the insured upon the occurrence of a defined loss.
- REINSTATEMENT: (1) Putting a lapsed policy back in force; (2) The payment of a claim
under some forms of insurance reduces the principal amount of the policy by the amount of the claim.
Provision is usually made for a method of reinstating the policy to its original amount.
- REINSURANCE: (1) A contract of indemnity against liability by which the insurance
company procures another insurance to insure against loss or liability by reason of the original
insurance; (2) Insurance by one insurance company of all or part of a risk accepted by it with another
insurance company which agrees to reimburse the insurance company for the portion of the claim insured.
- REPLACEMENT CLAUSE: A clause limiting Underwriters' liability for damage to machinery
cargo.
- REPLACEMENT COST: The cash value representing what it would cost to replace the
specific property without deduction for depreciation.
- REPORTING FORM: Fire or other direct damage insurance written under a form of policy
that covers fluctuating values of stocks of merchandise, furniture and fixtures and improvements by
means of periodic reports submitted to the insurance company by the insured, with an annual adjustment
of premium on the average value.
- RETROACTIVE DATE: Date on a "claims made" liability policy which triggers the beginning
of insurance coverage. A retroactive date is not required. If one is shown on a policy, any claim made
during the policy period will not be covered if the loss occurred before the retroactive date.
- RIDER: An endorsement to an insurance policy that modifies clauses and provisions of
the policy, adding or excluding coverage(s).
- RISK: A fortuity. A term used to designate an insured of a peril insured against. It
does not embrace inevitable loss. The term is used to define causes of loss covered by a policy.
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- SALVAGE: (1) Property taken over by an insurance company to reduce its loss; (2) Award
recoverable by salvors under maritime law.
- SALVAGE CHARGES: The award due to a salvor for services rendered in saving the insured
property.
- SALVAGE LOSS: Occurs when the Underwriter agrees to settle a cargo claim by paying the
difference between the insured value and the proceeds realized by selling the damaged goods.
- SCHEDULE: (1) A list of specified amounts payable for, usually, surgical procedures,
dismemberments, ancillary expenses or the like in Health Insurance policies; (2) The list of individual
items covered under one policy as the various buildings or animals and other property in property
insurance; (3) In Marine policies, a list attached to a slip, open cover, policy or other document,
usually detailing the rates of premium for various voyages, interests and risks.
- SCHEDULE OF LOSS: Notice completed by the insured documenting loss or damage to
contents, personal property and/or stock.
- SEAWORTHINESS WARRANTY: There is an implied warranty in every voyage policy that the
ship must be seaworthy at the commencement of the insured voyage or, if the voyage is carried out in
stages, at the commencement of each stage of the voyage. To be seaworthy, the ship must be reasonably
fit in all respects to encounter the ordinary perils of the contemplated voyage, property crewed,
fuelled and provisioned, and with all her equipment in proper working order. Cargo policies waive breach
of the warranty, except where the Assured or their servants are privy to the unseaworthiness. Breach of
the warranty is not excused in a hull voyage policy, literal compliance therewith being required.
Although there is no warranty of seaworthiness in a hull time policy, claims arising from
unseaworthiness may be prejudiced if the ship sails in an unseaworthy condition with the knowledge of
the Assured.
- SECURITY: The Underwriters subscribing a risk. The Insurers.
- SHORT-RATE: Cancellation of an insurance contract at the request of the policyholder
with a refund of premiums to the policyholder less than would be given under pro-rata consideration.
- SOLVENCY: Sufficient assets and income. It is the primary responsibility of a state's
insurance department is to monitor insurance companies licensed to transact business within their state
and make certain that they remain solvent and have the ability to pay the claims of their policyholders.
- SPECIFIED DISEASE INSURANCE: A policy which provides stated benefits, usually of large
amounts, toward the expense of treatment of the disease or diseases named in the policy.
- STOP LOSS: (1) Any provision in a policy designed to cut off the insurance company's
loss at a given point. Aggregate benefits and maximum benefits are an example; (2) A type of reinsurance
designed to transfer the loss from the ceding company to the reinsurer at a given point.
- SUBROGATION: The legal process by which an insurance company seeks from a third party
who may have caused the loss, recovery of the amount paid to the insured.
- SUBROGATION WAIVER: A waiver by the named insured giving up any right of recovery
against another party. Normally an insurance policy requires that subrogation (recovery) rights be
preserved.
- SUE AND LABOR: Expenses incurred by the Assured or their representatives with the
intention of preventing or minimizing a loss for which the Underwriter would have been liable. They do
not include expenses incurred in general average or salvage acts; these being recoverable under the
policy only as part of the Underwriters' liability for contribution to general average or salvage, if
any. Sue and labor charges are recoverable under a policy that incorporates a sue and labor clause (SG
policy), or in accordance with the wording of the policy (e.g. under the "duty of the Assured" clause
attached to a MAR policy).
- SURETY: (1) A term loosely used to describe the business or suretyship or bonds.
Suretyship is an arrangement whereby one party becomes answerable to a third party for the acts of
neglect of a second party; (2) The party in a surety arrangement who holds himself responsible to one
person for the acts of another.
- SURETY BOND: A bond in which the surety agrees to answer to the obligee for the
non-performance of the principal (known as the obligor).
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- TAIL: This term has been used to describe both the exposure that exists after
expiration of a policy and the coverage that may be purchased to cover that exposure. On "occurrence"
forms a claims tail may extend for years after policy expiration, and the losses may be covered. On
"claims made" forms tail coverage may be purchased to extend the period for reporting covered claims
beyond the normal policy period.
- TERM INSURANCE: Life insurance issued for a stated temporary period of time.
- TITLE INSURANCE: Indemnifies the owner of real estate in the event clear ownership of
property is challenged by discovery of faults in the title.
- TO PAY AS CARGO: Used in an ancillary insurances relating to the cargo (e.g. increased
value) when the Assured is not required to show evidence of loss or interest and can claim on the policy
if he can show that a corresponding loss has been settled on the main cargo policy.
- TOTAL LOSS: This can be actual total loss or constructive total loss, where the cost of
damage repair exceeds the value of the property insured.
- TRANSIT CLAUSE: A clause in the Institute Cargo Clauses, specifying the attachment and
termination of cover.
- TRUCKMENS LIABILITY FORM: See Motor Truck Cargo Policy
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- UMBRELLA LIABILITY POLICY: A liability policy designed to provide liability protection
above and beyond that provided by standard liability contracts.
- UNDER-INSURANCE: A condition in which not enough insurance is carried to cover the
insurable value, and, especially, to satisfy a coinsurance clause.
- UNDERWRITER: (1) A person trained in evaluating risks and determining the rates and
coverages that will be used for them; (2) An agent, especially a life insurance agent, who might qualify
as a "field underwriter."
- UNDERWRITING: The process of examining, accepting, or rejecting insurance risks, and
classifying those selected in order to charge the proper premium for each.
- UNINSURED MOTORIST COVERAGE: Endorsement to a personal automobile policy that covers an
insured involved in a collision with a driver who does not have liability insurance.
- UNIVERSAL LIFE INSURANCE: A flexible premium policy that combines protection against
premature death with a savings account that typically earns a money market rate of interest.
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- VALUABLE PAPERS AND RECORDS INSURANCE: An Inland Marine or burglary insurance coverage
providing for the replacement of valuable papers, records and forms.
- VOID POLICY: One which is inadmissible as evidence in a court of law (e.g. P.P.I.
policy).
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- WAITING PERIOD: A period of time between the beginning of a disability and the date
benefits begin.
- WAIVE: To forego; to refrain from insisting upon application of an insurance deductible
under specific conditions.
- WAIVER CLAUSE: A clause which entitles both Underwriter and Assured to take measures to
prevent or reduce loss without prejudice to the rights of either party.
- WARRANTY: A statement made on an application for insurance that is warranted to be true
in all respects. If untrue in any respect, even though the untruth may not have been known to the person
giving the warranty, the contract may be voided whether or not the untruth or inexactness is material to
the risk.
- WATERBORNE AGREEMENT: A market understanding whereby Underwriters cover goods against
war risks only whilst they are on the overseas vessel. This rule is relaxed only in the case of goods in
a transshipping port for a short period awaiting onward carriage.
- WHOLE LIFE INSURANCE: Life insurance payable to a beneficiary at the time of death of
the insured, whenever that occurs..
- WITHOUT BENEFIT OF SALVAGE: A term in a marine insurance policy, whereby the
Underwriters forgo their subrogation rights. A policy incorporating such a term is deemed to be a
gambling policy in law, and is therefore invalid in a court of law.
- WITHOUT PREJUDICE: The claim is paid on this occasion, although the Underwriter feels
it does not attach to the policy, but this action must not be treated as a precedent for future similar
claims.
- WORKERS COMPENSATION: (1) A schedule of benefits payable to an employee for injury,
disability, dismemberment, or death as a result of occupational hazard. The payments are a liability of
an employer. (2) Insurance agreeing to pay the Workers Compensation benefits required by law on behalf
of the employer.