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Ins 21
Definitions
288
Other
Not Applicable
03/29/2005

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Cards

Term
insured
Definition
"a person, a business, or an organization whose property, life, or legal liability is covered by an insurance policy"
Term
insurer
Definition
an insurance company
Term
covered loss
Definition
the events for which insurance pays
Term
loss exposure (exposure)
Definition
any condition or situation that presents the possibility of a loss
Term
law of large numbers
Definition
"a mathematical principle stating that as the number of similar but independent exposure units increases, the relative accuracy of predictions about future outcomes (losses) based on these exposure units also increases"
Term
exposure unit
Definition
"a measure of loss potential and used in pricing insurance, i.e., in homeowners insurance, each home insured is an exposure unit"
Term
property loss exposure
Definition
any condition or situation that presents the possibility that a property loss will happen
Term
real property
Definition
consists of land as well as buildings and other structures attached to the land or embedded in it
Term
personal property
Definition
consists of all tangible or intangible property that is not real property
Term
net income
Definition
income (or revenue) minus expenses during a given period
Term
liability loss exposure
Definition
any condition or situation that presents the possibility that a liability loss will happen
Term
liability loss
Definition
a claim for monetary damages because of injury to another party of damage to another party's property
Term
human loss exposure (personal loss exposure)
Definition
"any condition or situation that presents the possibility of a financial loss to an individual or a family by such causes as death, sickness, injury, or unemployment"
Term
personnel loss exposure
Definition
"the possibility of a financial loss to a business because of the death, disability, retirement, or resignation of key employees"
Term
indemnify
Definition
to restore a party who has had a covered loss to the same financial position that party held before the loss occurred
Term
fire and allied lines insurance
Definition
covers direct damage to or loss of insured property
Term
business income insurance
Definition
covers the loss of net income or additional expenses incurred by a business as the result of a covered loss to its property
Term
crime insurance
Definition
"protects the insured against loss to covered property from various causes of loss such as burglary, robbery, theft, and employee dishonesty"
Term
ocean marine insurance
Definition
includes hull insurance (which covers ships) and cargo insurance (which covers the goods transported by ships)
Term
inland marine insurance
Definition
"covers miscellaneous types of property, such as movable property, goods in domestic transit, and property used in transportation and communication"
Term
auto physical damage insurance
Definition
covers loss of or damage to specified vehicles owned by the insured and sometimes covers vehicles borrowed or rented by the insured
Term
auto liability insurance
Definition
covers an insured's liability for bodily injury to others and damage to the property of others resulting from automobile accidents
Term
commercial general liability insurance
Definition
"covers businesses for their liability for bodily injury and property damage; it can also include liability coverage for various other offenses that might give rise to claims, such as libel, slander, false arrest, and advertising injury"
Term
personal liability insurance
Definition
provides liability coverage to individuals and families for bodily injury and property damage arising from the insured's personal premises or activities
Term
professional liability insurance
Definition
"protects physicians, accountants, architects, engineers, attorneys, insurance agents and brokers, and other professionals against liability arising out of their professional acts or omissions"
Term
whole life insurance
Definition
provides life-time protection (to age 100); policies accrue cash value and have premiums that remain unchanged during the insured's lifetime
Term
cash value (of life insurance)
Definition
"a savings fund that accumulates in a whole life insurance policy and that the policyholder can access in several ways, including borrowing, purchasing paid-up life insurance, and surrendering the policy in exchange for the cash value"
Term
term insurance
Definition
a type of life insurance that provides temporary protection (for a certain period) with no cash value
Term
universal life insurance
Definition
"combines life insurance protection with savings; the policy is a flexible-premium policy that separates the protection, savings, and expense components"
Term
medical insurance
Definition
"covers the cost of medical care, including doctors' bills, hospital charges (including room and board), laboratory charges, and related expenses"
Term
disability income insurance
Definition
a type of health insurance that provides periodic income payments to an insured who is unable to work because of sickness or injury
Term
stock insurance company
Definition
an insurer that is owned by its stockholders and formed as a corporation for the purpose of earning a profit for these stockholders
Term
mutual insurance company
Definition
an insurer that is owned by its policyholders and formed as a corporation for the purpose of providing insurance to its policyholder-owners
Term
demutualization
Definition
"the process by which a mutual insurer, which is owned by its policyholders, becomes a stock company, which is then owned by its stockholders"
Term
reciprocal insurance exchange (interinsurance exchange)
Definition
an unincorporated association formed to provide insurance coverage to its members; one of the distinguishing features of a reciprocal is that the subscribers empower an attorney-in-fact to manage it
Term
subscriber
Definition
"also known as members, these are the policyholders of a reciprocal insurance exchange who agree to insure each other"
Term
attorney-in-fact
Definition
the contractually authorized manager of a reciprocal insurance exchange who administers its affairs and carries out its insurance transactions
Term
captive (insurance company)
Definition
"an insurer that is formed as a subsidiary of its parent company, organization, or group, for the purpose of writing all or part of the insurance on the parent company or companies"
Term
reinsurance
Definition
a type of insurance in which one insurer transfers some of all of the loss exposures from policies written for its insureds to another insurer
Term
primary insurer
Definition
the insurance company that transfers its loss exposures to another insurer in a contractual reinsurance arrangement
Term
reinsurer
Definition
the insurance company that accepts the loss exposures of the primary insurer
Term
monopolistic state fund
Definition
a state workers compensation insurance plan that is the only source of workers compensation insurance allowed in that state
Term
competitive state fund
Definition
a state workers compensation insurance plan that competes with private insurers to provide workers compensation insurance
Term
residual market plan (shared market plan)
Definition
a program that makes insurance available to those who cannot obtain coverage because private insurers will not voluntarily provide such coverage for various reasons
Term
guaranty fund
Definition
a state fund that provides a system to pay the claims of insolvent insurers; the money comes from assessments collected from all insurers licensed in the state
Term
National Association of Insurance Commissioners (NAIC)
Definition
"an association consisting of the commissioners of the insurance departments of each state, the District of Columbia, and US territories and possessions; it coordinates insurance regulation activities among the various insurance departments"
Term
model law
Definition
"a document drafted by the NAIC, in a style similar to a state statute, that reflects the NAIC's proposed solution to a given problem and provides a common basis to the states for drafting laws that affect the insurance industry"
Term
ratemaking
Definition
the process insurers used to calculate the rates that determine the premium for insurance coverage
Term
rate
Definition
the price of insurance for each unit of exposure; it's multiplied by the number of exposure units to arrive at a premium
Term
premium
Definition
a periodic payment by an insured to an insurance company in exchange to insurance coverage
Term
actuary
Definition
a person who uses complex mathematical methods and technology to analyze loss data and other statistics and to develop systems for determining insurance rates
Term
actuarial equity
Definition
a ratemaking concept through which actuaries base rates on actuarially calculated loss experience and place insureds with similar characteristics in the same rating class
Term
social equity
Definition
a rating concept that considers rates to be unfairly discriminatory if they penalize an insured for characteristics (such as age or gender) that are beyond the insured's control
Term
unfair discrimination
Definition
involves applying different standards or methods of treatment to insureds who have the same basic characteristics and loss potential
Term
prior-approval law
Definition
rates must be approved by the state insurance department before they can be used
Term
flex rating law
Definition
prior approval is required only if the new rates are a specified percentage above or below previously filed rates
Term
file-and-use law
Definition
rates must be filed by do not have to be approved before use
Term
use-and-file law
Definition
rates must be filed within a specified period after they are first used in the state
Term
open competition
Definition
(also called no-file) rates do not have to be filed with the state
Term
state-mandated rate
Definition
state-specified rates must be used by all insurers of a particular type of insurance in the state
Term
solvency
Definition
"the ability of an insurance company to meet its financial obligations as they become due, even those resulting from insured losses that might be claimed several years in the future"
Term
solvency surveillance
Definition
"the process, conducted by state insurance regulators, of verifying the solvency of insurance companies and determining whether the financial condition of insurers enables them to meet their obligations and to remain in business in the long term"
Term
Insurance Regulatory Information System (IRIS)
Definition
begun in the early 1970s as the Early Warning System; it is an analytical system designed by the NAIC to monitor an insurer's overall financial condition
Term
licensed (admitted) insurer
Definition
is authorized by the state insurance department to transact business within that state
Term
domestic insurer
Definition
is incorporated in the same state in which it is transacting business
Term
foreign insurer
Definition
licensed to operated in a state but is incorporated in another state
Term
alien insurer
Definition
is licensed in a US state but incorporated in another country
Term
market conduct regulation
Definition
"consists of state laws that regulate the practices of insurers in regard to four areas of operation: sales and advertising, underwriting, ratemaking, and claim handling"
Term
standard market
Definition
refers collectively to insurers who voluntarily offer insurance coverages at rates designed for customers with average or better-than-average loss exposures
Term
excess and surplus lines (E&S insurance)
Definition
"consists of insurance coverages, usually unavailable in the standard market, that are written by unlicensed insurers"
Term
nonadmitted (unlicensed) insurer
Definition
insurers that are not licensed in many of the states in which they operate and that write E&S insurance coverages
Term
written premium
Definition
premiums on policies put into effect during a given period
Term
earned premium
Definition
the portion of the written premium that applies to the part of the policy period that has already occurred
Term
unearned premium
Definition
the portion of the written premium that applies to the part of the policy period that has not yet occurred
Term
paid loss
Definition
claim payment that an insurer has made
Term
incurred loss
Definition
the sum of paid losses and changes in loss reserves
Term
loss reserve
Definition
amounts designated by insurance companies to pay claims for losses that have already occurred but are not yet settled; it is the insurer's best estimate of the total amount that it will pay in the future for a loss that has already occurred
Term
net underwriting gain or loss
Definition
earned premiums minus losses and underwriting expenses for a specific period
Term
overall gain or loss from operations
Definition
net underwriting gain or loss plus net investment gain results (or minus investment loss results)
Term
asset (in financial statements)
Definition
property (both tangible and intangible) owned by an entity (the insurance company)
Term
admitted asset
Definition
"types of property, such as cash and stocks, that regulators allow insurers to show as assets on their financial statements; such assets are easily convertible to cash at or near the property's market value"
Term
nonadmitted asset
Definition
"types of property, such as office furniture and equipment, that insurance regulators do not allow insurers to show as assets on financial statements because these assets cannot readily be converted to cash at or near their market value"
Term
liabilities (in financial statements)
Definition
"financial obligations, or debts, owed by a company to another entity, usually the policyholder in the case of an insurance company"
Term
unearned premium reserve
Definition
the total of an insurer's unearned premiums on all policies at a particular time
Term
policyholders' surplus
Definition
equal to total admitted assets minus total liabilities
Term
balance sheet
Definition
"a type of financial statement that shows a company's financial position at a particular point in time and includes the company's admitted assets, liabilities and policyholders' surplus"
Term
income statement
Definition
"a type of financial statement that shows a company's revenues, expenses, and net income for a particular period, usually one year"
Term
loss ratio
Definition
calculated by dividing an insurer's incurred losses (including loss expenses) for a given period by its earned premiums for the same period
Term
expense ratio
Definition
calculated by dividing an insurer's incurred underwriting expenses for a given period by its written premiums for the same period
Term
combined ratio
Definition
the sum of the loss ratio and the expense ratio
Term
investment income ratio
Definition
calculated by dividing net investment income by earning premiums for a particular period
Term
overall operating ratio
Definition
calculated by subtracting the investment income ratio from the combined ratio
Term
capacity ratio or premium-to-surplus ratio
Definition
calculated by dividing written premiums by policyholders' surplus
Term
marketing
Definition
"the process of identifying customers and their needs and then creating, pricing, promoting, selling, and distributing products or services to meet those needs"
Term
producer
Definition
any person who sells insurance products for an insurance company or companies
Term
agency
Definition
"a legal relationship that is formed when one party, the principal, authorizes another party, the agent, to act as a legal representative of the principal"
Term
principal
Definition
the party that authorizes the agent to act on its behalf in an agency relationship
Term
agent
Definition
the party that is authorized by the principal to act on the principal's behalf in an agency relationship
Term
insurance agent
Definition
legal representatives of the insurance company for which they have contractual agreements to sell insurance
Term
agency contract (agency agreement)
Definition
"a written agreement between an insurance company and an agent that specifies, among other things, the scope of the agent's authority to conduct business for the insurer"
Term
errors and omissions (E&O)
Definition
negligent acts committed by a person in the conduct of the insurance business that give rise to legal liability for damages; these claims can also arise from a failure to act that creates legal liability
Term
express authority
Definition
authority that the principal specifically grants to the agent
Term
binding authority
Definition
"usually granted in the agency contract, this is the authority of an insurance agent to effect coverage on behalf of an particular insurer"
Term
binder
Definition
a temporary contract of insurance that can be either written or oral
Term
implied authority
Definition
"authority that arises from actions of the agent that are in accord with accepted custom and are considered to be within the scope of authority granted by the principal, even though such authority is not expressly granted orally or in an agency contract"
Term
apparent authority
Definition
authority based on a third party's reasonable belief that an agent has authority to act on behalf of the principal
Term
independent agency
Definition
"an independent firm that sells insurance, usually as a representative of several unrelated insurance companies"
Term
independent agent
Definition
a producer who works for an independent agency
Term
agency expiration list
Definition
the record of an insurance agency's present policyholders and the dates their policies expire
Term
(insurance) broker
Definition
an independent business owner or firm that sells insurance by representing customers rather than insurers
Term
managing general agency (MGA)
Definition
an independent business organization that appoints and supervises independent agents for insurance companies that use the independent agency system; it functions almost as a branch office for one or more insurance companies
Term
exclusive agent
Definition
an agent that has a contract to sell insurance exclusively for one insurance company (or a group of related companies)
Term
direct writing system
Definition
uses sales representatives who are employees of an insurance company
Term
direct writer
Definition
uses the direct writing system to market insurance
Term
direct response system
Definition
"includes any insurance marketing system that does not depend primarily on individual producers to locate customers and sell insurance but relies primarily on mail, phone, and/or internet sales"
Term
mixed marketing system
Definition
refers to the use by an insurer of more than one marketing system
Term
(sales) commission
Definition
a percentage of the premium that the insurer pays to the agency or producer for new policies sold or existing policies renewed
Term
contingent commission
Definition
"a commission that an insurer pays, usually annually, to an independent agency and that is based on the premium volume and profitability level of the agency's business with that insurer"
Term
marketing representative
Definition
"insurance company employees whose role is to visit agents representing the insurer, to develop and maintain sound working relationships with those agents, and to motivate the agents to produce a satisfactory volume of profitable business for the insurer"
Term
production underwriter
Definition
insurance company employees who work in an insurer's office in an underwriting position but who also travel to visit and maintain rapport with agents and sometimes clients
Term
unfair trade practices laws
Definition
state laws that specify certain prohibited business practices
Term
rebating
Definition
"offering anything of value, other than the insurance itself, to an applicant as an inducement to buy or maintain insurance"
Term
underwriting
Definition
"the process of selecting insureds, pricing coverage, determining insurance policy terms and conditions, and then monitoring the underwriting decisions made"
Term
underwriter
Definition
"an insurance company employee who evaluates applicants for insurance, selects those that are acceptable to the insurer, prices coverage, and determines policy terms an conditions"
Term
adverse selection
Definition
a situation that occurs because people with the greatest probability of loss are the ones most likely to purchase insurance; it normally occurs if the premium is low relative to the loss exposure
Term
capacity
Definition
"refers to the amount of business an insurer is able to write, usually based on a comparison of the insurer's written premiums to the size of its policyholders' surplus; an insurer must have adequate policyholders' surplus to be able to increase the volume of insurance it writes"
Term
commensurate with the exposure
Definition
a relationship between the premium and the exposure where the size of the premium is appropriate for the exposure assumed by the insurer
Term
class rate or manual rate
Definition
"rates that apply to all insureds in the same rating category, or rating class; insureds with similar loss exposures are grouped into rating classes"
Term
merit rating plan
Definition
rating plans that modify class rates to reflect loss characteristics of a particular insured
Term
individual rate or specific rate
Definition
used to assign a specific insurance rate that reflects the unique characteristics of an insured or the insured's property
Term
judgment rate
Definition
a type of individual rate used to develop a premium for a unique exposure for which there is no established rate; the underwriter relies heavily on his experience
Term
standard form
Definition
"insurance forms that contain standardized policy wording; they are developed by insurance advisory organizations, although some insurers develop their own"
Term
book of business (portfolio)
Definition
"a group of policies with a common characteristic, such as territory or type of coverage; it can also refer to all policies written by a particular insurer or agency"
Term
treaty reinsurance
Definition
an arrangement whereby a reinsurer agrees to reinsure automatically a portion of all eligible insurance of the primary insurer
Term
facultative reinsurance
Definition
involves a separate transaction for each reinsured policy; each policy is evaluated individually
Term
underwriting authority
Definition
the limit on decisions that an underwriter can make without receiving approval from someone at a higher level
Term
decentralized
Definition
"activities are moved away from a central location; processes and decision-making authority are moved geographically closer to the insured, usually to a field office"
Term
centralized
Definition
activities are in a central location; many decisions are made in the home office
Term
underwriting audit
Definition
a process in which members of the home office underwriting department examine files to see whether underwriters are following underwriting guidelines
Term
expert system (knowledge based system)
Definition
"computer software programs that supplement the underwriting decision-making process; it asks for information necessary to make an underwriting decision, ensuring that no necessary information is overlooked"
Term
hazard
Definition
conditions that increase the chance of a loss occurring
Term
physical hazard
Definition
"tangible characteristics of property, persons, or operations that tend to increase the probably frequency or severity of loss"
Term
moral hazard
Definition
dishonest tendencies in the character of the insured (or applicant) that increase the probability of a loss occurring
Term
morale hazard (attitudinal hazard)
Definition
"involve carelessness about, or indifference to, potential loss on the part of an insured or applicant"
Term
legal hazard
Definition
characteristic of the legal/regulatory environment that affect an insurer's ability to collect a premium commensurate with the exposure to loss
Term
claim
Definition
a demand by a person or business seeking to recover from an insurance company for a loss that might be covered by an insurance policy
Term
claim representative (adjuster)
Definition
"a person responsible for investigating, evaluating and settling claims"
Term
claimant
Definition
anyone who submits a claim to an insurance company; can be a first party or a third party
Term
reservation of rights letter
Definition
a notice sent by the insurer to an insured advising that the insurer is proceeding with investigation of a claim but that the insurer retains the right to deny coverage later
Term
staff claim representative
Definition
an insurance company employee who performs some or all of the insurer's claim handling activities
Term
inside claim representative
Definition
"an insurance company employee who handles claims that can be settled, usually by telephone or letter, from inside the insurer's office"
Term
outside claim representative (field claim representative)
Definition
an insurance company employee who handles claims that cannot be handled easily by phone or mail
Term
independent adjuster
Definition
independent claim representatives who offer claim handling services to insurance companies for a fee
Term
draft authority
Definition
authority expressly given to an agent by an insurer to settle and pay certain types of claims by writing a claim draft up to a specified limit
Term
public adjuster
Definition
a person hired by an insured to represent the insured in handling a claim
Term
self-insurance plan
Definition
"an arrangement in which an organization pays for its losses with its own resources rather than purchasing insurance, however, the organization may choose to buy insurance for losses exceeding a certain limit"
Term
third-party administrator (TPA)
Definition
business firms that contract to provide administrative services to other businesses (often contracted by business with self-insurance plans)
Term
insurable interest
Definition
exists if a person or other entity has any right to or interest in the property such that a loss to that property would cause a direct monetary loss to that person or entity
Term
actual cash value (ACV)
Definition
the replacement cost of property minus depreciation
Term
replacement cost
Definition
the cost to repair or replace property using new materials of like kind and quality with no deduction for depreciation
Term
depreciation
Definition
an allowance for physical wear and tear or technological or economic obsolescence
Term
agreed value
Definition
"a method of valuing property in which the insurer and the insured agree on the value of the property at the time the policy is written, and that amount is stated in the policy declarations and is the amount the insurer will pay in the event of a total loss to the property"
Term
subrogation
Definition
the insurer's right to recover payment from a negligent third party
Term
salvage rights
Definition
the rights of the insurer to recover and sell or otherwise dispose of insured property on which the insurer has paid a total loss or a constructive total loss
Term
constructive total loss
Definition
exists when a vehicle (or other property) cannot be repaired for less than its actual cash value minus the anticipated salvage value
Term
damages
Definition
refer to a monetary award that one party is required to pay to another who has suffered loss or injury for which the first party is legally responsible
Term
compensatory damages
Definition
"damages, which include both special and general damages, that are intended to compensate a victim for harm actually suffered"
Term
special damages
Definition
"compensatory damages allowed for specific, out-of-pocket expenses, such as doctor and hospital bills"
Term
general damages
Definition
"compensatory damages awarded for losses, such as pain and suffering, that do not have a specific economic value"
Term
punitive damages
Definition
"damages awarded by a court to punish wrong-doers who, through malicious or outrageous actions, cause injury or damage to others"
Term
unfair claim practices laws
Definition
state laws that specify claim practices that are illegal
Term
contract
Definition
a complete written contract of insurance
Term
policy
Definition
a legally enforceable agreement between two or more parties
Term
agreement
Definition
offer and acceptance
Term
consideration
Definition
an exchange of something of value that is required in any valid contract
Term
conditional contract
Definition
a contract in which one or more parties must perform only under certain conditions
Term
utmost good faith
Definition
an obligation to act in complete honesty
Term
concealment
Definition
an intentional failure to disclose a material fact
Term
material fact
Definition
any information that would affect the insurer's underwriting decision to provide or maintain insurance or that would affect a claim settlement
Term
misrepresentation
Definition
a false statement of a material fact
Term
contract of adhesion
Definition
a contract in which one party (the insured) must adhere to the agreement as written by the other party (the insurer)
Term
contract of indemnity
Definition
"the insurer agrees, in the event of a covered loss, to pay an amount directly related to the amount of the loss"
Term
principle of indemnity
Definition
states that the insured should not be better off financially after a loss than before
Term
valued policy
Definition
"a policy in which the insurer pays a stated amount in the event of a specified loss, regardless of the actual value of the loss"
Term
"declarations page (declarations, dec)"
Definition
an information page that provides specific details about the insured and the subject of the insurance
Term
insuring agreement
Definition
"a statement that the insurer will, under certain circumstances, make a payment or provide a service"
Term
exclusion
Definition
policy provisions that eliminate coverage for specified exposures
Term
manuscript policy
Definition
an insurance policy that is specifically drafted according to terms negotiated between a specific insured (or group of insureds) and an insurer
Term
self-contained policy
Definition
a single document that contains all the agreements between the insurer and the insured and that forms a complete policy by itself
Term
endorsement
Definition
a document that amends an insurance policy in some way
Term
modular policy
Definition
"consists of several different documents, non of which by itself forms a complete contract"
Term
cancellation
Definition
"refers to the termination of a policy, by either the insurer or the insured, during the policy period"
Term
pro rata refund
Definition
the unused premium (based on the portion of the premium for the number of days remaining in the policy) returned to the insured when a policy is canceled
Term
short rate refund
Definition
"sometimes used when the insured cancels midterm, this is a return of premium less than the pro rata refund would be"
Term
liberalization clause
Definition
"a policy condition that provides that if a policy form is broadened at not additional premium, the broadened coverage automatically applies to all existing policies of the same type"
Term
assignment
Definition
the transfer of rights or interest in a policy to another party by the insured
Term
money
Definition
"currency, coins and bank notes; can also include traveler's checks, credit card slips and money orders held for sale in some cases"
Term
securities
Definition
"written instruments representing either money or other property (i.e., stocks and bonds)"
Term
auto (automobile)
Definition
"a broad term that includes cars, trucks, buses and other motorized vehicles designed for use on public roads"
Term
mobile equipment
Definition
includes many types of land vehicles -- usually designed for use principally off public roads -- including equipment attached to them (this is specifically defined in most commercial insurance policies)
Term
recreational vehicles
Definition
vehicles used for sports and recreational activities
Term
cause of loss (peril)
Definition
the actual means by which property is damaged or destroyed
Term
named perils
Definition
listed and described in the policy; represent the only covered causes of loss
Term
open perils (special form coverage) (all-risks)
Definition
provides coverage for 'risk of direct loss' to property; any direct loss to property is covered unless the cause of loss is specifically excluded in the policy
Term
mortgagee (mortgage holder)
Definition
"a lender that loans money on a home, building or other real property"
Term
mortgagor
Definition
the person or organization that borrows money from a mortgagee to finance the purchase of real property
Term
bailee
Definition
a person or business that holds the property of others for some specific purpose
Term
property insurance
Definition
"any type of insurance that indemnifies an insured who suffers a financial loss because property has been lost, stolen, damaged or destroyed"
Term
floater
Definition
policies that are designed to cover property that moves from location to location
Term
friendly fire
Definition
"a fire that stays in its intended place (i.e., a fireplace)"
Term
hostile fire
Definition
a fire that leaves its intended place
Term
proximate cause
Definition
the event that sets in motion an uninterrupted chain of events contributing to the loss
Term
vehicle damage (peril)
Definition
damage done by a motor vehicle to some other kind of property
Term
vandalism
Definition
willful and malicious damage to or destruction of property
Term
sprinkler leakage
Definition
the accidental leakage or discharge of water or other substance from an automatic sprinkler system
Term
sinkhole collapse
Definition
a cause of loss involving damage by the sudden sinking or collapse of land into underground empty spaces created by the action of water on limestone or dolomite
Term
mine subsidence
Definition
"a cause of loss involving the sinking of ground surface when underground open spaces, resulting from the extraction of coal or other minerals, are gradually filled in by rock and earth from above"
Term
volcanic action
Definition
"a cause of loss by lava flow, ash, dust, particulate matter, airborne volcanic blast, or airborne shock waves resulting from a volcanic eruption"
Term
burglary
Definition
the taking of property from inside a building by someone who unlawfully enters or exits the building
Term
robbery
Definition
the taking of property from a person by someone who has caused or threatened to cause the person harm
Term
theft
Definition
a broad term that means any act of stealing; theft includes burglary and robbery
Term
collision
Definition
covers damage to an insured motor vehicle caused by its impact with another vehicle or object or by its upset or overturn
Term
other than collision (comprehensive)
Definition
"covers losses to a covered auto by fire, theft, vandalism, falling objects, flood and various other perils"
Term
specified causes of loss
Definition
"a less expensive alternative to comprehensive coverage in commercial auto policies; it is a named perils coverage that covers loss to a covered vehicle caused by fire, lightning, theft, windstorm, hail, earthquake, flood, vandalism and other specifically listed perils"
Term
direct loss
Definition
a reduction in the value of property that results directly and often immediately from damage to that property
Term
time element loss (indirect loss)
Definition
includes loss of income or extra expenses resulting from direct loss to property
Term
extra expenses
Definition
expenses that reduce the length of a business interruption or enable a business to continue some operations when the property has been damaged by a covered cause of loss
Term
additional living expense
Definition
a coverage in homeowners policies that indemnifies the insured for the additional expenses that are incurred following a covered property loss so that the household can maintain its normal standard of living while the dwelling is uninhabitable
Term
named insured
Definition
the policyholder whose name(s) appear on the declarations page of an insurance policy
Term
first named insured
Definition
"the person or organization whose name appears first as the named insured on a commercial insurance policy and who, depending on the policy conditions, might be the one responsible for paying premiums and the one who has the right to receive any return premiums, to cancel the policy, and to receive the notice of cancellation or nonrenewal"
Term
mortgage clause (mortgage holders clause)
Definition
"protects the insurable interest of the mortgagee by giving it certain rights, such as the right to be named on claim drafts for losses to insured property and the right to be notified of policy cancellation"
Term
loss payee
Definition
"a lender, named on an insurance policy, who has loaned money on personal property, such as a car"
Term
loss payable clause
Definition
"provides that a loss will be paid to both the insured and the loss payee as their interests appear and gives the loss payee certain rights; however, not as many rights are extended to the lender as the mortgage clause extends"
Term
deductible
Definition
a portion of a covered loss that is not paid by the insurer; it is subtracted from the amount the insurer would otherwise be obligated to pay the insured
Term
insurance-to-value provisions
Definition
"provisions in property insurance policies that encourage insureds to purchase an amount of insurance that is equal to, or close to, the value of the covered property"
Term
coinsurance
Definition
"an insurance-to-value provision in many property insurance policies; if the property is underinsured, this provision reduces the amount than an insurer will pay for a covered loss"
Term
legal liability
Definition
means that a person or organization is legally responsible for injury or damage suffered by another person or organization
Term
constitutional law
Definition
consists of the Constitution itself and all the decisions of the Supreme Court that involve the Constitution
Term
statutory law
Definition
"consists of the formal laws, or statutes, enacted by federal, state, or local legislative bodies"
Term
common law (case law)
Definition
consists of a body of principles and rules established over time by courts on a case-by-case basis
Term
criminal law
Definition
the category of law that applies to wrongful acts that society deems so harmful to the public welfare that government takes the responsibility for prosecuting and punishing the wrongdoers
Term
civil law
Definition
the category of law that deals with the rights and responsibilities of citizens with respect to one another; applies to legal matters not governed by criminal law
Term
contract law
Definition
the branch of civil law that deals with contracts and settles contract disputes
Term
tort
Definition
"a wrongful act, other than a crime or breach of contract, committed by one party against another"
Term
tort law
Definition
the branch of civil law that deals with civil wrongs other than breaches of contract
Term
negligence
Definition
failure to act in a manner that is reasonably prudent; occurs when a person or organization fails to exercise the appropriate degree of care under given circumstances
Term
tortfeasor
Definition
"a person, a business, or another party who has committed a tort"
Term
vicarious liability
Definition
legal responsibility that occurs when one party is held liable for the actions of another party
Term
intentional tort
Definition
a deliberate act (other than a breach of contract) that causes harm to another person
Term
assault
Definition
the intentional threat of bodily harm
Term
battery
Definition
the unlawful physical contact with another person
Term
libel
Definition
a written or printed untrue statement that damages a person's reputation
Term
slander
Definition
an oral untrue statement that damages a person's reputation
Term
false arrest
Definition
an unlawful physical restraint of another's freedom
Term
invasion of privacy
Definition
an encroachment on another person's right to be left alone
Term
absolute liability (strict liability)
Definition
"a legal liability that arises from inherently dangerous activities or dangerously defective products that result in injury or harm to another, regardless of how much care was used in the activity; does not require proof of negligence"
Term
hold harmless agreement
Definition
a contractual provision that obligates one party to assume the legal liability of another party
Term
warranty
Definition
"a promise, either written or implied, such as a promise by a seller to a buyer that a product is fit for a particular purpose"
Term
statutory liability
Definition
legal liability imposed by a specific statute or law
Term
compensatory damages
Definition
damages intended to compensate a victim for harm actually suffered; include special (specific out-of-pocket) and general (losses w/o specific economic value) damages
Term
liability insurance
Definition
covers losses resulting from bodily injury to others or damage to the property of others for which the insured is legally liable and to which the coverage applies
Term
bodily injury
Definition
"any physical injury to a person, including sickness, disease and death"
Term
property damage
Definition
"physical injury to, destruction of, or loss of use of tangible property"
Term
personal injury (as used in insurance policies)
Definition
"injury, other than bodily injury, arising from intentional torts such as libel, slander, or invasion of privacy"
Term
litigation expenses
Definition
"the expenses incurred for legal defense, such as attorneys' fees, expert witness fees, and the cost of legal research"
Term
supplementary payments
Definition
"amounts the insurer agrees to pay (in addition to the liability limits) for items such as premiums on bail bonds and appeal bonds, loss of the insured's earnings because of attendance at trials, and other reasonable expenses incurred by the insured at the insurer's request"
Term
prejudgment interest
Definition
interest that might accrue on damages before a judgment has been rendered
Term
postjudgment interest
Definition
interest that might accrue on damages after a judgment has been entered in a court and before the money is paid
Term
medical payments coverage
Definition
"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"
Term
occurrence basis coverage
Definition
"covers liability claims that occur during the policy period, regardless of when the claim is submitted to the insurer"
Term
claims-made coverage
Definition
covers liability claims that are made (submitted) during the policy period for covered events that occur on or after the retroactive date and before the end of the policy period
Term
retroactive date
Definition
the date on or after which injury or damage must occur in order to be covered under a claims-made policy
Term
each person limit
Definition
the maximum amount an insurer will pay for injury to any one person for a covered loss
Term
each occurrence limit
Definition
"the maximum amount an insurer will pay for all covered losses from a single occurrence, regardless of the number of persons injured or the number of parties claiming property damage"
Term
aggregate limit
Definition
the maximum amount an insurer will pay for all covered losses during the covered policy period
Term
split limits
Definition
separate limits that an insurer will pay for bodily injury and for property damage
Term
single limit
Definition
the maximum amount and insurer will pay fro the insured's liability for both bodily injury and property damage that arise from a single occurrence
Term
risk management
Definition
"the process of making and implementing decisions to deal with loss exposures; involves identifying loss exposures and then applying various techniques to eliminate, control, finance or transfer those exposures"
Term
loss exposure survey
Definition
a risk management tool in the form of a checklist of questionnaire listing potential loss exposures that a household or an organization might face
Term
flowchart
Definition
a diagram that depicts the flow of a particular operation or set of related operations within an organization
Term
loss frequency
Definition
a term used to indicate how often losses occur or are expected to occur; it is used to predict the likelihood of similar losses in the future
Term
loss severity
Definition
refers to the dollar amount of damage that results or might result from loss exposures; used to predict how costly future losses are likely to be
Term
avoidance
Definition
a risk management technique that eliminates a loss exposure and reduces the chance of loss to zero
Term
loss control
Definition
a risk management technique that attempts to decrease the frequency or severity of losses; includes loss prevention and loss reduction
Term
loss prevention
Definition
seeks to lower the frequency of losses; to decrease the number of losses
Term
loss reduction
Definition
seeks to lower the severity of losses that do occur; to decrease the dollar amount of losses
Term
retention
Definition
a risk management technique that involves retaining all or part of a particular loss exposure
Term
noninsurance transfer
Definition
a risk management technique in which one party transfers the potential financial consequences of a particular loss exposure to another party that is not an insurance company
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