Insurance Terms

It’s a long list, but here are the most common insurance terms you may find in a conversation with your agent.

ACT OF GOD – An unpreventable accident or event that is the result of natural causes; for example, floods, earthquakes, or lightning.

ACTUAL CASH VALUE- “Actual Cash Value” is the replacement cost of property that is damaged or destroyed at the time of loss, with deduction for depreciation.

ADVERTISING INJURY LIABILITY- “Advertising Injury” is injury rising out of an offense committed in the course of your advertising activities, such as libel, slander, defamation, violation of privacy, piracy, unfair competition or infringement of copyright, title, or slogan

ANNUITY – contract sold by insurance companies that pays a monthly (or quarterly, semiannual, or annual) income benefit for the life of a person (annuitant), for the lives of two or more persons, or for a specified period of time.

APPRAISAL – A survey by a claims representative or claims appraiser estimating the amount of damage to property and the cost to repair or the determination of a complete loss.

ASSESSED VALUE – The monetary worth of real or personal property as a basis for its taxation. This value, established by a governmental agency, is rarely used by insurers as a means to determine indemnification.

BENEFICIARY – The person or party named by the owner of a life insurance policy to receive the policy benefit.

BINDER – temporary insurance contract providing coverage until a permanent policy is issued.

BROAD FORM INSURANCE – Coverage for numerous perils.

BUILDER’S RISK- Indemnifies for loss of or damage to a building under construction. Normally written for a specified amount on the building and applies only in the course of construction. May contain coverage for items in transit and items stored at the site.

CATASTROPHIC LOSS- Damage resulting from a catastrophe.

CLAIM – A formal request for payment related to an event or situation that is covered under an in-force insurance policy.

COINSURANCE CLAUSE – A clause requiring the insured to maintain insurance on the property at least equal to a stipulated percentage of its value in order to collect partial losses in full.

COMMERCIAL GENERAL LIABILITY- Under this form of insurance and regarding a covered occurrence, the company will pay all sums. The insured becomes legally obligated to pay damages due to:

1. Bodily Injury (Coverage A)

2. Property Damage (Coverage B)

The insurance company has the right to defend any suit against the insured seeking damages on account of such bodily injury or property damage, even if any of the allegations of suit are groundless, false or fraudulent, and make such investigation and settlement of any claim or suit as it deems expedient.

COMMERCIAL LINES – insurance coverage for businesses, commercial institutions, and professional organizations.

COMPLETED OPERATIONS LIABILITY- his form of liability insurance provides coverage for bodily injury and property damage rising from completed or abandoned operations, provided the incident occurs away from the premises owned or rented by the insured.

Operations are deemed completed at the earliest of the following items:

{C}§ {C}When all operations to be performed by or on behalf of the insured under contract have been completed.

{C}§ {C}When all operations to be performed by or on behalf of the insured at the site of the operations have been completed.

{C}§ {C}When the portion of work out of which injury or damage rises has been put to its intended use by a party other than the contractor or subcontractor.

CONTINGENT BENEFICIARY – The party designated to receive proceeds of a life insurance policy following the insured’s death if the primary beneficiary predeceased the insured.

CONVERTIBLE TERM INSURANCE POLICY – A term life insurance policy that gives the policy owner the right to convert the policy to a permanent plan of insurance.

DEBRIS REMOVAL COVERAGE- This pays for the insured’s expenses to remove debris of covered property caused by a covered cause of loss. This does NOT include “pollutants” and must occur during the policy period and be reported within 180 days of the occurrence.

DIRECT INCURRED LOSS – The property loss in which the insured peril is the proximate cause of damage or destruction.

DISASTER – A natural or man-made event that negatively affects life, property, livelihood or industry often resulting in permanent changes to human societies, ecosystems and the environment.

EARNED PREMIUMS – The portion of the total premium amount corresponding to the coverage provided during a given time period.

EARTHQUAKE – A sudden shift or movement in the tectonic plate in the Earth’s crust. On the surface, this is manifested by a moving and shaking of the ground, and can be massively damaging to poorly built structures.

ELECTRONIC DATA PROCESSING COVERAGE- Coverage for electronic data processing equipment and its software

EMPLOYEE DISHONESTY COVERAGE- Employee dishonesty coverage protects an employer from financial loss due to the fraudulent activities of one or more employees. The coverage includes protection for loss of money, securities, and other property of the insured.

Some scheduled policies are still available, but the majority are written on a blanket basis. This provides coverage for all employees, subject to the policy definitions.

The limit of liability is “per loss” and is applied on an “occurrence” basis. All acts involving the same employee or group of employees is considered one occurrence.

EMPLOYMENT PRACTICES LIABILITY INSURANCE (EPLI)- Protects the company and its officers from claims resulting from wrongful termination, discrimination, sexual harassment, wrongful discipline, and failure to employ or promote

ERRORS AND OMISSIONS- Coverage for liability resulting from errors or omissions in the performance of professional duties. Applicable as a general rule to activities such as banking, accounting, law, insurance, and real estate. Also known as professional liability.

EXCLUSIONS, HOMEOWNERS INSURANCE – Part of an insurance contract that excludes coverage of certain perils, persons, property or locations.

EXPERIENCE RATING – A method of calculating group insurance premium rates by which the insurer considers the particular group’s prior claims and expense experience.

FACE AMOUNT – The amount of the death benefit payable under a life insurance policy.

FEMA – Federal Emergency Management Agency – A former independent agency that became part of the new Department of Homeland Security in March 2003 – is tasked with responding to, planning for, recovering from and mitigating against disasters

FLOODPLAIN – A land area adjacent to a river, stream, lake, estuary or other water body that is subject to flooding. These areas, if left undisturbed, act to store excess floodwater.

FREE LOOK PROVISION – An individual life insurance and annuity provision that gives the policy owner a stated time, usually 10 days after the policy is delivered, in which to cancel the policy and receive a full refund on the initial premium payment.

GARAGEKEEPERS LIABILITY COVERAGE- Provides coverage to owners of storage garages, parking lots, etc for liability as bailees with respect to damage to automobiles left in their custody.

GENERAL LIABILITY INSURANCE – coverage for an insured when negligent acts and/or omissions result in bodily injury and/or property damage on the premises of a business, when someone is injured as the result of using the product manufactured or distributed by a business, or when someone is injured in the general operation of a business.

GRACE PERIOD – A specified length of time within which a renewal premium that is due may be paid without penalty.

GROSS NEGLIGENCE – reckless action without regard to life, limb, and/or property.

HAZARD – circumstance that increases the likelihood or probable severity of a loss.

INSURANCE TO VALUE – The amount of insurance written on property is approximately equal to its value. An insured most always wants to insure all property to value.

INCURRED LOSSES – The total dollar amount of losses associated with insured events/situations occurring during a given time period. A portion of incurred claims and losses represent insurers’ estimates of the final costs of pending claims that are still open during the reporting period, as well as estimates of losses associated with claims that have yet to be reported.

IRREVOCABLE BENEFICIARY – A life insurance policy beneficiary who has a vested interest in the policy proceeds even during the insured’s lifetime because the policy owner has the right to change the beneficiary designation only after obtaining the beneficiary’s consent.

INSURABLE INTEREST – The interest an insurance policy owner has in the risk that is insured. The owner of a life insurance policy has an insurable interest in the insured when the policy owner is likely to benefit if the insured continues to live and is likely to suffer some loss or detriment if the insured dies.

LIABILITY INSURANCE – Insurance coverage that offers protection against claims alleging that a property owner’s negligence or inappropriate action resulted in bodily injury or property damage to another party.

LIFE AND HEALTH GUARANTEE ASSOCIATION – An organization that operates under the supervision of a state insurance commissioner to protect policy owners, insured’s, beneficiaries, and specified others against losses that result from the financial impairment or insolvency of a life insurer that operates in the state.

LOSS – The dollar amount associated with a claim.

LOSS OF USE INSURANCE – Compensation for loss caused because the policyholder has lost the use of his property.

MATERIAL MISREPRESENTATION – A misrepresentation that would effect the insurance company’s evaluation of a proposed insured.

MEDIATION – situation in which parties agree to take part in a structured settlement negotiation through the guidance of a neutral expert. By participating in this process, the parties do not agree that they will actually settle and the mediator does not have the authority to impose such a settlement.

MEDICAL PAYMENTS COVERAGE- A general liability coverage in which the insurer reimburses without regard to the insured’s liability. Also known as no-fault medical coverage.

MORTALITY TABLES – Charts that show the death rates an insurer may reasonably anticipate among a particular group of insured lives at certain ages.

MORTGAGE INSURANCE – A contract that insures the lender against loss caused by a mortgagor’s default on a government mortgage or conventional mortgage.

MORTGAGEE CLAUSE – A clause in an insurance policy that makes a claim jointly payable to the policyholder and the party that holds a mortgage on the property.

NAMED PERIL POLICY – The insurance contract under which covered perils are listed. Benefits for a covered loss are paid to the policy-owner. If an unlisted peril strikes, no benefits are paid.

NEGLIGENCE – failure to act within the legally required degree of care for others, resulting in harm to them.

NON-OWNED AND HIRED CAR LIABILITY-Provides coverage for rental or borrowed autos as long as the insured does not own any private passenger vehicles

ORDINANCE OR LAW COVERAGE- 1) Coverage for Loss to the Undamaged Portion of the Building.

Pays for the loss of value of an undamaged portion of the existing building which must be demolished and/or removed to conform with municipal ordinance, code, etc.

(2) Demolition Cost

Pays for the cost of demolition of the undamaged portions of the building necessitated by the enforcement of building, zoning or land use ordinance or law.

(3) Increased Cost of Construction

Pays for any increased expenses incurred to replace the building with one conforming to building laws or ordinances, or to repair the damaged building so that it meets the specifications of current building laws or ordinances.

PERMANENT LIFE INSURANCE – Life insurance that provides coverage throughout the insured’s lifetime and also provides a savings element.

PERSONAL INJURY LIABILITY COVERAGE- Protects against false arrest, detention, or malicious prosecution; libel, slander, defamation, violation of privacy, wrongful eviction, and wrongful entry

POLICY RIDER – An amendment to an insurance policy that becomes part of the insurance contract and either expands or limits the benefits payable under the contract.

PREFERRED RISK – A proposed insured who presents a significantly less than average likelihood of loss and who is charged a lower than standard premium rate.

PREMIUM – The dollar amount paid for an insurance policy.

REINSURANCE – form of insurance that insurance companies buy for their own protection, “a sharing of insurance.” An insurer (the reinsured) reduces its possible maximum loss on either an individual risk or a large number of risks by giving (ceding) a portion of liability to another insurance company (reinsurer).

REPLACEMENT COST – The cost of replacing property without a reduction for depreciation. By this method of determining value, damages for a claim would be the amount needed to replace the property using new materials.

RISK – uncertainty of a financial loss; term used to designate an insured or a peril insured against.

SCHEDULED PROPERTY – Listing specific personal property for a stated insured value. This is usually considered for valuable items that are subject to limited coverage.

SUBROGATION – The circumstance where an insurance company takes the place of an insured in bringing a liability suit against a third party who caused injury to the insured.

TENANTS INSURANCE – Coverage for the contents of renter’s home or apartment and for liability. Tenant policies are similar to homeowners insurance, except that they do not cover the structure.

UMBRELLA POLICY – Umbrella coverage is insurance coverage that extends the terms of a regular insurance policy once coverage limits for the regular policy have been reached. Specifically, umbrella coverage is for people who want protection against a large jury award that is not covered in their standard policy.

UNDERWRITING – The process of identifying and classifying the degree of risk represented by a proposed insured.