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A
Actual Cash Value: The value of property based on the cost
of repairing or replacing it with property of the same kind and
quality. Typically, actual cash value equals the current replacement
cost minus depreciation (age, condition, length of time in use,
and obsolescence).
Adjuster: A person who investigates and settles losses
for an insurance carrier.
Agent: In insurance, the person authorized
to represent the insurer in negotiating, servicing, or effecting
insurance policies.
Annuity: A contract that provides
for a series of periodic payments to be made or received at regular
intervals.
Applicant: The party applying for
an insurance policy.
Application: A printed form developed
by an insurer that includes questions about the prospective insured
and the desired insurance coverage and limits.
Assigned Risk: A risk insured through
a pool of insurers and assigned to a specific insurer. These risks
are generally considered undesirable by underwriters, but due
to state law or otherwise, they must be insured.
Auto Collision Coverage: Optional
auto insurance which pays for damage to your car caused by collision
with another car or object, or by rolling the car over. Frequently
required if you have a car loan.
Auto Comprehensive Physical Damage Coverage:
Optional auto insurance which pays for damage to your auto
caused by things other than collision or rolling the car over,
such as fire, theft, vandalism, flood or hail. Frequently required
if you have a car loan.
Automatic Premium Loan: A provision
in some life insurance policies that authorizes a policy loan
using the cash value accumulated by the insurance policy to pay
for past due premiums at the end of the grace period. This prevents
a lapse of coverage.
B
Beneficiary: Any person, persons, or other entity designated
to receive the policy benefits upon the death of the policyholder.
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.
Binding Receipt: A premium receipt
acknowledging temporary insurance coverage immediately until the
insurance company rejects the application or approves it and issues
a policy.
Broker: A marketing specialist who represents insurance
organizations and who deals with either agents or companies in
arranging for the coverage required by the customer.
Buy-Sell Agreements: Agreement that a deceased business
owner's interest will be sold and purchased at a predetermined
price or at a price according to a predetermined formula.
C
Cancellation: The discontinuance of an insurance policy
before its normal expiration date, either by the insured or the
company.
Cash Value (cash surrender value): The cash amount payable
to a life insurance policyowner in the event of termination or
cancellation of the policy before its maturity or the insured
event.
Certificate of Insurance: A statement of coverage issued
to an individual insured under a group insurance contract, outlining
the insurance benefits and principal provisions applicable to
the member.
Claim: A person's request for payment
from an insurer for a loss covered by the insurance policy.
Collision Insurance: Protection against loss resulting
from any damage to the policyholder's car caused by collision
with another vehicle or object, or by upset of the insured car,
whether it was the insured's fault or not.
Comprehensive Automobile Insurance: Protection against
loss resulting from damage to the insured auto, other than loss
by collision or upset.
Compulsory Auto Liability Insurance: Insurance laws in
some states required motorists to carry at least certain minimum
auto coverages. This is called "compulsory" insurance.
Conditions: The part of your insurance
policy that states the obligations of the person insured and those
of the insurance company.
Contingent Beneficiary: In a life
insurance policy, the person designated to receive the policy
benefits if the primary beneficiary dies before the insured.
Contract: A legally enforceable agreement
between two or more parties.
Conversion Privilege: The right to
convert or change insurance coverage from an individual term insurance
policy to an individual whole life insurance policy.
Convertible Term Life Insurance: A
type of term life insurance that offers the policyowner the option
to exchange the term policy for a form of permanent insurance.
D
Declination: The insurer's refusal to insure an individual
after careful evaluation of the application for insurance and
any other pertinent factors.
Deductibles: The portion of the loss that the policyholder
agrees to pay out of pocket, before the insurance company pays
the amount they are obligated to cover. For example, if the covered
claim is $1000 and your deductible is $250, you pay $250 and your
company will pay $750. Deductibles help to keep insurance rates
reasonable. Raising the amount of the deductible lowers the cost
of insurance.
Depreciation: Reduction in the value
of property due to age and use.
Double Indemnity: A provision in a life insurance policy,
subject to specified conditions and exclusions, under the terms
of which double the face amount of the policy is payable if the
death of the insured is the result of an accident. In general,
the conditions are that the insured's death occurs prior to a
specified age and results from bodily injury effected solely through
external, violent and accidental means independently and exclusively
of all other cause, within 60 or 90 days after such injury.
E
Endorsement: Attachment or addendum to an insurance policy;
an endorsement changes the contract's original terms.
Extended Term Life Insurance: A nonforfeiture
benefit under which the net cash value of the policy is used to
purchase term insurance for the amount of coverage available under
the original policy.
F
Face Amount: The amount stated in the life insurance policy
as the death benefit.
G
Grace Period: The specified length of time, after a Life
or Health premium payment is due in which the insured may make
the payment and keep the policy in force. (Usually 30 days.)
Group Health Insurance: An insurance
plan designed for a group, such as employees of a single employer.
Insurance is provided to them under a single policy.
Guaranty Association: Established by each state to support
insurers and protect consumers in the case of insurer insolvency,
guaranty associations are funded by insurers through assessments.
H
I
Indemnification: Compensation to the victim of a loss,
in whole or in part, by payment, repair, or replacement. Indemnity.
Legal principle that specifies an insured should not collect more
than the actual cash value of a loss but should be restored to
approximately the same financial position as existed before the
loss.
Insolvent: Having insufficient financial resources (assets)
to meet financial obligations (liabilities).
Insurable Risk: The conditions that make a risk insurable
are (a) the peril insured against must produce a definite loss
not under the control of the insured, (b) there must be a large
number of homogeneous exposures subject to the same perils, (c)
the loss must be calculable and the cost of insuring it must be
economically feasible, (d) the peril must be unlikely to affect
all insureds simultaneously, and (e) the loss produced by a risk
must be definite and have a potential to be financially serious.
Incontestable Clause: A life insurance
policy wording that provides a time limit (e.g. two years) on
the insurer's right to dispute a policy's validity based on material
misstatements in the application.
Insurable Interest: Any interest a
person has in property that is the subject of insurance, so that
damage to this property would cause the insured a financial loss.
Insurance Company: An organization
that has been chartered by a governmental entity to transact the
business of insurance.
Insured: A person or organization
covered by an insurance policy, including the "named insured"
and any other parties for whom protection is provided under the
policy terms.
Insurer: The party to the insurance contract who promises
to pay losses or benefits. Also, any corporation engaged primarily
in the business of furnishing insurance to the public.
Irrevocable Beneficiary: A named beneficiary
whose rights to life insurance policy proceeds cannot be canceled
or changed by the policyowner unless the beneficiary consents.
J
K
Key Employee: Insurance Protection of a business against
financial loss caused by the death or disablement of a vital member
of the company, usually individuals possessing special managerial
or technical skill or expertise. Also called key executive insurance.
L
Lapse: Termination of a policy due to nonpayment of premiums.
Liability: A legal obligation to compensate
a person harmed by one's acts or omissions.
Liability Coverage: Insurance that
provides compensation for a harm or wrong to a third party for
which an insured is legally obligated to pay.
Life Insurance: Insurance that pays
a specified sum of money to designated beneficiaries if the insured
person dies during the policy term.
Loss: The happening of the event for
which insurance pays.
Loss Expense - Allocated: Handling expenses, such as legal
or independent adjuster fees, paid by an insurance company in
settling a claim which can be definitely charged to that particular
claim.
Loss Expense - Unallocated: Salaries and other expenses
incurred in connection with the operation of a claim department
of an insurance carrier which cannot be charged to individual
claims.
M
Medical Payments Coverage: Medical and funeral expense coverage
for bodily injuries sustained from or while occupying an insured
vehicle, regardless of the insured's negligence.
Misrepresentation: Act of making, issuing, circulating
or causing to be issued or circulated an estimate, an illustration,
a circular or a statement of any kind that does not represent
the correct policy terms, dividends or share of surplus or the
name or title for any policy or class of policies that does not
in fact reflect its true nature.
N
Negligence: Failure to use a generally acceptable level
of care and caution.
No-fault Insurance: A system of compensation
enacted by law in many states under which indemnification is made
by the insured's own insurance company regardless of who is at
fault. Details of this system vary significantly from state to
state.
O
Offer and Acceptance: The offer may be made by the applicant
by signing the application, paying the first premium and, if necessary,
submitting to physical examination. Policy issuance, as applied
for, constitutes acceptance by the company. Or the offer may be
made by the company when no premium payment is submitted with
the application. Premium payment on the offered policy then constitutes
acceptance by the applicant.
P
Paid-up Policy: An in-force life insurance policy for which
no further premium payments are required.
Peril: The cause of loss or damage.
Personal Injury Protection: First-party no-fault coverage
in which an insurer pays, within the specified limits, the wage
loss, medical, hospital and funeral expenses of the insured.
Physical Damage: Damage to or loss of the automobile resulting
from collision, fire, theft or other perils.
Permanent Insurance: A general term
for ordinary life and whole life insurance policies that remain
in effect as long as their premiums are paid.
Personal Property Insurance: Protects
against the loss of, or damage to property other than real property
(real estate) caused by specific perils.
Policy: The written forms that make
up the insurance contract between an insured and insurer. A policy
includes the terms and conditions of the coverage, the perils
insured or excluded, etc.
Policy Declarations: The part of the
insurance contract that lists basic underwriting information,
including the insured's name, address and description of insured
locations as well as policy limits.
Policy Limits: The maximum amount
an insured may collect or for which an insured is protected, under
the terms of the policy.
Policy Loan: A loan from a life insurer
to the owner of a policy that has a cash value.
Policyholder: The person who buys
insurance.
Policyowner: An individual with an
ownership interest in an insurance policy.
Policy Period: The amount of time
an insurance contract or policy lasts.
Preexisting Condition: A physical
illness or disability that existed before the health or life insurance
policy effective date and generally, which was not disclosed on
the application.
Preferred Risk: A risk whose physical condition, occupation,
mode of living and other characteristics indicate a prospect for
longevity superior to that of the average longevity of unimpaired
lives of the same age.
Premium: The price for insurance coverage
as described in the insurance policy for a specific period of
time.
Primary Beneficiary: The person designated
as the first to receive the proceeds of a life insurance policy
upon the death of the insured.
Proof of Loss: A sworn statement that
usually must be furnished by the insured to an insurer before
any loss under a policy may be paid.
Property Damage Coverage: An agreement by an insurance
carrier to protect an insured against legal liability for damage
by an insured automobile to the property of another.
Protection Amount: The face amount
of a life insurance policy, or amount of money that will be paid
to a beneficiary upon the death of an insured. This amount will
be reduced by the amount of any outstanding policy loan.
Q
R
Rate: The pricing factor upon which the insurance buyer's
premium is based.
Rated Policy: Sometimes called an "extra-risk"
policy, an insurance policy issued at a higher-than-standard premium
rate to cover the extra risk where, for example, an insured has
had a DUI or other traffic violations.
Rebating: Giving any valuable consideration, usually all
or part of the commission, to the prospect or insured as an inducement
to buy or renew. Insurance rebating is prohibited by law.
Reimbursement: The payment of an amount of money by an insurance
policy for a covered loss.
Reinstatement: The process by which
a life insurance company puts back in force a policy that has
lapsed or has been canceled for nonpayment of premium.
Renewable Term Life Insurance: A renewable
life policy permits the owner of the policy to automatically renew
the policy beyond its original term by acceptance of a premium
for a new policy term without evidence of insurability.
Revocable Beneficiary: A life insurance
policy whose designation as beneficiary can be revoked or changed
by the policyowner at any time prior to the insured's death.
Riders: An addition to an insurance
policy that becomes a part of the contract.
Risk: The possibility or chance of
loss or injury.
S
Salvage: Recovery made by an insurance company by the sale
of property which has been taken over from the insured as a part
of loss settlement.
Settlement: An agreement between a claimant or beneficiary
to an insurance policy and the insurance company regarding the
amount and method of a claim or benefit payment.
Standard Risk: A person who, according to a company's underwriting
standards, is entitled to purchase insurance protection without
extra rating or special restrictions.
Substandard Risk: A risk that cannot meet the normal requirements
of an auto insurance policy. Protection is provided in consideration
of a waiver, a special policy form, or a higher premium charge.
Substandard risks may include those persons who are rated because
of poor driving habits.
T
Term Insurance: Life insurance under which the benefit is
payable only if the insured dies during a specified period. If
the insured survives beyond that period, coverage ceases. This
type of policy does not build up any cash or nonforfeiture values.
Theft Limit (or Inside Policy Limits):
The highest amount an insurance company will pay on certain items
of personal property. For instance, some policies have a $5,000
limit for computers. If an item would cost more than the limit
to replace.
U
Underwriter: (a) A company that receives the premiums and
accepts responsibility for the fulfillment of the policy contract;
(b) the company employee who decides whether or not the company
should assume a particular risk; (c) the agent who sells the policy.
Underwriting: The process of reviewing applications for
coverage. Applications that are accepted are then classified by
the underwriter according to the type and degree of risk.
Unilateral: A distinguishing characteristic of a life insurance
contract in that it is only the insurance company that pledges
anything. The policyowner does not even promise to pay premiums;
therefore, it is really a one-sided contract favoring the policyowner.
Uninsured (Underinsured) Motorist Coverage: A form of insurance
that pays the policy holder and passengers in his/her car for
bodily injury caused by the owner or operator of an uninsured
or inadequately insured automobile.
Uninsurable Risk: One not acceptable for insurance due
to excessive risk.
Universal Life: Flexible premium, two-part contract containing
renewable term insurance and a cash value account that generally
earns interest at a higher rate than a traditional policy. The
interest rate varies. Premiums are deposited in the cash value
accounts after the company deducts its fee and a monthly cost
for the term coverage.
V
W
Waiver: An agreement attached to a policy which exempts from
coverage certain disabilities or injuries that otherwise would
be covered by the policy.
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