INSURANCE TERMS & CONCEPTS
“A” (or Judgment) Rates – Rates that are based on the judgment of the underwriter on an individual risk basis and not supported by loss experience.
Abandonment – A term that applies to property and signifies both a relinquishing of it and the letting go of all legal rights to it, as well, with the intent to claim a total loss. Abandonment of property to an insurance company is something insureds are expressly prohibited from doing in most property polices.
Abandonment clause – A property policy provision that stipulates that the insurer need not accept any damaged property that the insured chooses to relinquish.
Absolute liability – The performance of an act so dangerous as to be sufficient to trigger liability regardless of the degree of negligence. Triggering explosives is often used as an example. Sending workers aloft for construction or repair at elevated heights is another. Strict liability is another term that is sometimes used.
Accident – An unforeseen, unintended, and unexpected event, which occurs suddenly and at a definite place. See Occurrence.
Accident frequency – The rate of occurrence of accidents. Along with accident severity, it is taken into account in ratemaking.
Accident severity – The measure of the seriousness of a claim, measured in, for example, dollars. Along with frequency, it is taken into account in ratemaking.
Accident year experience – Measures premiums and losses relating to accidents which occurred during a 12-month period. Accommodation line – Normally unacceptable risks that are written as an accommodation to an agent or broker who has an overall profitable relationship with the insurer. For example: a personal auto risk with a teenage driver of a sports car might be written if the other lines of insurance that it carries for the customer were profitable; or if the agency has had a good and profitable relationship with the insurer.
ACORD – An organization which develops insurance forms used as a standard by many within the insurance industry. The Acord certificate, application, and loss form are common means of exchanging information. ACORD stands for Agency Company Operations Research and Development.
Account current – A monthly statement provided by an insurer detailing an agent’s premiums, commissions, cancellations, and endorsements.
Account premium modification plan – A rating plan for Fire, Property Damage and Time Element coverages. The maximum credit or surcharge is 25 percent, and it is available to risks which develop a three-year premium of at least $5,000.
Account selling – Trying to handle all of a client’s insurance needs, rather than providing for only a portion of those needs.
Accounts receivable insurance – Pays for the cost of reconstructing accounts receivable records that have been damaged or destroyed by a covered peril. Even more importantly, it covers any payments that cannot be collected because records cannot be reconstructed. Acquisition cost – The expense undertaken to acquire new business. The concept applies to both agents and companies. The largest portion of an insurer’s acquisition cost is agent’s or sales representative’s commission or bonus.
Act of God – Acts of nature—the term was once widely used to distinguish between manmade events, such as, fire, collision, and nature’s rampages in wind and flood.
Active malfunction – In products insurance, a defect or malfunction in a product that damages the property of the user.
Action over claim – In workers compensation, a demand by a third party in a subrogation action suing for damages from the employer. Actual authority – Authority that an insurer intentionally gives to the agent. See express authority and implied authority.
Actual cash value (ACV) – A method for placing value on property as of the time of its loss or damage. ACV may be determined as replacement cost less depreciation. The market value of an item may be used to help determine actual cash value. Contrast with replacement cost.
Actual cash value appraisal – An appraisal to determine the actual cash value of a building and related personal property.
Actual loss sustained – A term used to distinguish from a valued form.
Actuary – A person highly trained in mathematics and statistics who calculates rates and dividends and provides other statistical information for an insurance company.
Additional insured – One who qualifies as insured under the terms of a policy even though not named as insured. Officers of a corporation may be included as insureds under the terms of a policy written in the name of the corporation.
Additional insured endorsement – An endorsement that conveys additional insured status on a party that otherwise is not insured on the policy.
Additional living expense insurance – This coverage, found in homeowners forms, provides payment for extra expenses made necessary by the insured’s inability to reside in the insured dwelling because of a covered loss—for example, restaurant meals and hotel bills. The amount payable is the difference between normal household expenses and the increase.
Additions and alterations – Coverage that protects any additions, alterations, and improvements a condo owner makes to his unit, for up to 10 percent of your contents limit. This coverage can be increased.
Adequate – a criterion of insurance rate regulation that stipulates that an insurer’s premium rates must be adequate to cover the
insurer’s cost of doing business, claims payments, and a reasonable profit to the insurer.
Adhesion contract – A standardized set of agreements offered by one (usually the stronger) party to another on a take it or leave it basis. An insurance policy is an example of such a contract. The insurer offers a personal auto policy, for example, that an individual may adhere to (or not) but in any case the individual may not change any of its terms. Because it has the stronger position, the insurance company has the burden to spell out its terms precisely. Such contracts are interpreted strictly against the author of the contract. Not to be confused with aleatory contract.
Adjuster – A person who may act either on behalf of the insurance company or the insured in the settling of a claim. Employee adjusters work for an insurer, while independent adjusters represent the insurance company on a fee basis; and public adjusters represent the insured on a fee basis.
Adjustment – The process of arriving at an amount of settlement for a claim. It may consist of a series of computations to arrive at the amount of a loss, as in a complicated fire loss. It may involve discussions of liability, quantum, and other such matters as might be the case in a problem liability claim. It may contain both.
Adjustment bureau – Organization for adjusting insurance claims that is supported by insurers using the bureau’s services. Administrative services only (ASO) agreement – Contract between an insurer (or its subsidiary) and a group employer, eligible group, trustee, or other party, in which the insurer provides certain administrative services. These services may include actuarial support, plan design, claims processing, data recovery and analysis, benefits communications, financial advice, medical care conversions, data preparation for governmental reports, and stop-loss coverage.
Administrator – A person legally vested with the right of administration of an estate.
Admiralty courts – Courts of law that deal with matters pertaining to the sea.
Admiralty courts – Courts of law that deal with matters pertaining to the sea.
Admitted assets – The highly liquid assets of an insurer permitted by the state to be taken into account when reporting financial condition.
Admitted company – An insurance company that is licensed (admitted) to conduct business within a given state.
Admitted market – The range of insurance available through admitted companies.
Advance premium – Also called deposit premium, an advance premium is a downpayment on what will be the final premium, in policies where the final premium is subject to audit.
Adverse selection – The tendency of poorer than average risks to buy and maintain insurance. Adverse selection occurs when insureds select only those coverages that are most likely to have losses.
Adverse underwriting decision – Any decision made by an underwriter that is not favorable to the insured. Such decisions involve termination, declination, higher rates, or reduction in coverage. Another example is the placing of a risk in a residual market or with an unauthorized insurer.
Advertising injury – Claim arising out of slander, libel, copyright infringement, or misappropriation of advertising ideas. Coverage is provided as part of coverage B of the commercial general liability policy.
Advisory organization – A rating bureau or other body that may advise but not require its members to adhere to certain practices, in accordance with state insurance laws. Rating organizations or bureaus adopt file rules and rates in the various states, on behalf of their members.
Affinity marketing – Targeting marketing efforts toward one group or category of client. Examples include grocery stores, all the employees of one company, or employees in one industry. Group business is a type of affinity marketing.
Affreightment – A contract to carry merchandise.
After charge – A charge sometimes included in fire rates for commercial buildings. It is usually added for conditions which can be corrected by the insured, such as failure to have the proper types of fire extinguishers.
Agency company – An insurance company that produces business through an agency network. See direct writer.
Agency contract – The legal agreement between an insurance agency and the insurer detailing the terms of representation.
Agency plant – The total force of agents representing an insurer.
Agent – One who solicits, negotiates or effects contracts of insurance on behalf of an insurer. His right to exercise various functions, his authority, and his obligations and the obligations of the insurer to the agent are subject to the terms of the agency contract with the insurer, to statutory law, and to common law.
Agent of record – The agent indicated on and for each insurance policy, binder, or acceptance. The agent on a particular policy or bond. Agent’s appointment – The act by an insurer that grants an agent the authority to act as an agent for the insurer. In most states, agents must be licensed and appointed prior to being allowed to sell insurance.
Agent’s authority – The authority of an insurance agent to act on behalf of the insurer he or she represents. There are several types including express authority (authority to act on specific instructions only), implied authority (actions taken in accordance with prevailing custom), or apparent authority (actions based on appearances created by the agent and acquiesced to by the principal).
Agents errors and omissions insurance – Insurance obtained by the insurance agent to guard against loss caused by an unintentional failure to properly insure (or recommend insurance to) a client.
Agent’s license – A certificate of authority from the state that permits the agent to conduct business.
Aggregate deductible – A deductible provision in some property insurance contracts where all covered losses during a year are figured together and an insurer pays only when the aggregate deductible amount is exceeded.
Aggregate excess reinsurance – A type of excess reinsurance treaty that sometimes is called stop loss or excess of loss ratio reinsurance. The retention in this type of agreement is calculated based on all losses over the period of time that is stated in the treaty. The reinsurer is responsible for the amount of losses between the retention and the limit on the treaty.
Aggregate limit – The maximum amount an insurer will pay under a policy in any one policy period.
Agreed amount clause – An agreement between underwriter and insured whereby, in exchange for the purchase of coverage in an amount specified by the underwriter, the insured is protected from a coinsurance penalty.
Agreed value clause – Though rare, some policies cover for a value agreed upon at the time of writing; if the property is lost because of an insured peril, the amount stated in the policy will be paid. Fine arts insured under a personal articles floater or homeowners scheduled personal property endorsement are examples.
Aircraft coverages – Though aircraft have long been an important element in the lives of most Americans, insurance of aircraft exposures has remained outside the mainstream of property and liability insurance markets. Aircraft hull and liability insurance is the counterpart of personal or commercial auto policies coverage. Aircraft products insurance is the counterpart of products liability cover. Air cargo insurance is mirrored in motor truck cargo. Hangarkeepers liability is akin to garagekeepers coverage. As with any specialty line of insurance, the absence of standardized forms limits practice to specialists in the line.
Alcoholic beverage control (ABC) laws – See Dram shop laws.
Aleatory contract – A contract in which the number of dollars to be given up by each party is not equal. Insurance contracts are of this type, as the policyholder pays a premium and may collect nothing from the insurer or may collect a great deal more than the amount of the premium if a loss occurs. Not to be confused with contract of adhesion.
Allied lines – Lines of insurance that cover for perils other than fire, that are usually sold with fire insurance, for example, fire and allied lines.
Alien insurer – An insurance company formed under the laws of a country other than the one it is doing business in.
Alienated premises – Property that has been sold by an insured.
All risks – A property policy expression now out of fashion. It was used to designate contracts that promised coverage against all risks of direct physical loss in contrast to forms that covered for specific, named perils. The word all came to be perceived as open to broader interpretation than insurers intended and it was dropped in favor of the promise to cover risks of physical loss. See Named perils and also Open perils.
Allocated loss adjustment expenses (ALAE) – Expenses directly attributable to specific claims. Includes payments for defense attorneys, medical evaluation of patients, expert medical reviews and witnesses, investigation, and record copying.
Alternative dispute resolution (ADR) – Methods other than lawsuits that are designed to resolve legal disputes. Examples are arbitration and mediation.
Alternative markets – Mechanisms used to fund self-insurance, including captives, which are insurers owned by one or more non- insurers to provide owners with coverage. Risk-retention groups, formed by members of similar professions or businesses to obtain liability insurance, are also a form of self-insurance.
Ambiguity – A standard policy provision that proves to be ambiguous may be interpreted in the light most favorable to the insured. American Agency System – The system of selling insurance through agents who receive commissions in lieu of salary.
American Association of Insurance Services (AAIS) – An association of insurance companies providing filing and various technical services on behalf of its member companies.
services on behalf of its member companies.
Americans with Disabilities Act (ADA) – Passed by Congress in 1990, this act requires that reasonable accommodation be made in public accommodations, including the workplace, for those with physical or mental disability.
American College, The – An educational institute conferring the Chartered Life Underwriter (CLU) designation.
American Lloyds – Unincorporated associations of individual underwriters who assume specified portions of liability under each policy issued. There is no connection with Lloyd’s of London.
American Municipal Bond Assurance Corporation (AMBAC) – A corporation which offers insurance policies on new municipal bond offerings. An offering with such insurance can command a higher price upon issue, depending on the extent to which the insurance policy guarantees interest and principal.
Amount subject – The maximum amount which underwriters estimate can possibly be lost under the most unfavorable circumstances in any given loss, such as a fire or tornado. Contrast with Probable Maximum Loss.
Anniversary date – The anniversary of the original date of issue of a policy as shown in the declarations.
Annual aggregate deductible – A deductible applied annually to the total amount paid in claims during a policy period. Claims are generally subject to a per-occurrence deductible; the aggregate is the limit beyond which no further deductibles are applied.
Annual bid bond service – An arrangement whereby a contractor pays a premium once a year and in return gets all or a certain number of bid bonds and consents of surety free of charge.
Annual statement – Summary of an insurer’s or reinsurer’s financial operations for a particular year, including a balance sheet. It is filed with the state insurance department of each jurisdiction in which the company is licensed to conduct business.
Anti-coercion laws – Usually contained in a section of the state code entitled Unfair Trade Practices, these provisions define the use of coercion as an unfair practice and, hence, a violation of the state law.
Anti-rebating laws – Laws that prohibit an agent’s refunding part of a commission to an applicant as an inducement for placing
insurance through the agent.
Anti-theft devices – Any of several devices used by the insured to try to prevent the theft of a vehicle; includes The Club, alarms, kills switches, etc.
Anti-theft recovery system – These systems consist of an electronic device that’s installed in a concealed area of a car. If the car gets stolen, the device can be activated, and it will emit a signal that can be used to locate the car. Installation of an anti-theft recovery system may provide eligibility for an auto insurance discount.
Anti-trust laws – Laws that prohibit companies from working as a group to set prices, restrict supplies or stop competition in the marketplace. The insurance industry is subject to state antitrust laws but has a limited exemption from federal antitrust laws. This exemption, set out in the McCarran-Ferguson Act, permits insurers to jointly develop common insurance forms and share loss data to help them price policies.
Apparent authority – The perceived ability of an agent to bind an insurance contract to an insurance company. If an agent or agency holds themselves out as representing a particular company it is reasonable for the public to assume that such authority is established contractually, even if it is not.
Apportionment – The method of dividing a loss between multiple insurers that cover the same loss.
Appraisal – A determination of the value of property for the purposes of determining the proper amount of insurance to be bought or in adjusting a loss.
Appraised value – Value of an object or location as determined by an independent appraiser. This value could be market value, replacement cost value, or utility value.
Approved roof – A roof made of fire resistive materials, e.g., tile or asphalt.
Appurtenant structure – Another structure on the same premises as the principal structure. A detached garage on a dwelling premises is appurtenant to the dwelling. Older homeowners forms refer to the other structures protected under the HO Coverage B as appurtenant structures.
Arbitration clause – The clause in an insurance policy that spells out how disagreements over a claim are settled.
Arson – The intentional setting afire of property.
Assessability – A characteristic of some insurance policies in which policyholders are obliged to pay money, in addition to premiums, if the insurer experiences losses.
Assets – All funds, property, goods, securities, rights of action, or resources of any kind owned by an insurance company. Statutory accounting, however, excludes non-admitted assets, such as deferred or overdue premiums, that would be considered assets under generally accepted accounting principles (GAAP).
Assigned risk – A risk not generally acceptable to any insurance company but for which the law says that insurance must be acquired. Personal auto liability is one such necessary coverage. Insurance companies doing personal auto business in a state can be required to accept assignment of a portion of the state’s unacceptable drivers as insureds.
Assigned risk plan – See Auto insurance plan.
Assignment – The transfer by a policyholder of the legal right or interest in a policy contract to a third party.
Association captive – A captive insurer owned by the members of a sponsoring organization or group, such as a trade association. Assumed liability – Liability assumed under contract or agreement. More commonly known as contractual liability.
Assumed premium – Consideration or payment an insurance company receives for providing reinsurance for another company. Assumption of risk doctrine – Defense against a negligence claim that bars recovery for damages if a person understands and recognizes the danger inherent in a particular activity or occupation.
Assured – A party who is a potential beneficiary of an insurance contract. The synonym insured is more commonly used.
Attachment – The legal process of taking possession of a defendant’s property when the property is in dispute.
Attorney-in-fact – An individual who is given authority to execute legal documents, including bonds; or the manager of a reciprocal exchange, which is an insurance arrangement whereby risk is transferred to other members. The attorney-in-fact need not be a lawyer. Attractive nuisance – Condition that can attract and injure children. The occupants of land on which such a condition exists are liable for injuries to children. Examples of attractive nuisance include swimming pools, earth moving equipment, and playground equipment. Audit – Some policies (such as workers compensation) are written subject to an audit. Since workers compensation premium is based on the insured’s payroll, the insurer is entitled to audit the insured’s records at the end of the policy to verify that it has collected an adequate premium for the amount of payroll to which it was exposed.
Authorized insurer – An insurer granted permission by a state to sell specific lines of insurance within that state.
Auto insurance plan – Program set up by various states to ensure that everyone with a valid drivers license will be able to purchase auto insurance. All auto insurers operating within a state are assigned insureds in proportion to the amount of auto premium written. Automobile liability insurance – Insurance in which the insurer agrees to pay all sums for which the insured is legally obligated because of bodily injury or property damage arising from the ownership, maintenance, or use of an auto.
Automobile medical payments – Insurance applying to the medical, hospital, or funeral expenses of anyone injured while on or in an insured automobile. The coverage is not dependent on liability, being triggered simply by an accident. It may be included in either the
insured automobile. The coverage is not dependent on liability, being triggered simply by an accident. It may be included in either the
Business Auto Policy or the Personal Auto Policy. See also Premises medical payments.
Auto physical damage insurance – Insurance on the vehicle. This coverage usually is broken down into collision and other than
Automobile reinsurance facility – One of several types of shared market mechanisms used to make automobile insurance available to persons who are unable to obtain such insurance in the regular market.
Automobile shared market – A program in which all automobile insurers in each state make coverage available to car owners who are unable to obtain auto insurance in the voluntary market.
Average – Marine insurance term for loss or damage. See also General average and Particular average.
Average adjuster – An adjuster of marine losses.
Avoidance of risk – Taking steps to remove a hazard, engage in an alternative activity, or otherwise end a specific exposure.
Back up of sewers and drains – Condition in which water (possibly plus other materials) enters a premises through a drain or sewer because of blockage or super saturation.
Bad faith – Accusations by policyholders that insurers took steps to deliberately delay, underpay, or deny a claim.
Bail agent – A person who solicits, negotiates, and effects undertakings of bail on behalf of any surety insurer. All bail agents must meet specified bond requirements.
Bail permittee – A person who solicits, negotiates, issues, and delivers bail bonds. All bail permittees must meet specified bond requirements.
Bail solicitor – A person who transacts bail on behalf of, and as the employee of, the holder of a bail license. All bail solicitors must meet specified bond requirements.
Bailee – One who is charged with the care of the property of another. For example, a garage is the bailee of a customer’s (bailor’s) car (the bailment) and a jeweler is a bailee of customers’ jewelry while in its possession for repair or appraisal.
Bailees customers’ insurance – Insurance designed to reimburse a bailee’s customers for loss without regard to liability.
Bailees floater – An inland marine form that covers—on an open perils basis— a bailee’s interest in personal property of others.
Bailees liability insurance – Insurance covering damage negligently caused by a bailee or employee to goods left in their care. Bailment – The act of delivering property in trust to another for a limited time and specific purpose.
Bailor – The person delivering property to another in trust.
Bank depository bonds – Bonds guaranteeing the deposit of public funds.
Bankers blanket bond – A bond designed to indemnify for loss of money or securities caused by dishonesty of employees, robbery or theft from the premises, or robbery or theft while the insured property is in transit.
Bankruptcy trustee bonds – Bonds which provide a guarantee to the beneficiaries of the bankruptcy action that the bonded trustees, appointed in a bankruptcy proceeding, will perform their duties and handle the affairs according to the rulings of the court.
Bare – Without adequate insurance, especially for a business.
Bare walls – This term describes a property policy that insures just the common elements and provides no coverage for the interiors or contents of a unit.
Basic causes of loss – The perils of fire, lightning, and removal of property from premises endangered by those perils as shown in the standard 1943 New York fire policy.
Basic named perils – Covered perils in a property insurance contract: fire, lightning, windstorm, civil commotion, smoke, hail, aircraft, vehicles, explosion, and riot.
Beach plans – Sometimes known as windstorm plans or pools, these are plans devised by coastal states to insure the windstorm exposure of coastal properties. The plans operate in a manner similar to a joint underwriting association with participation by all insurers operating within a state.
Bench error – A mistake in the production process of a product that causes a loss. Such losses are usually covered.
Best’s rating – A rating given to insurance companies by the A.M. Best Company, independent analysts of the insurance industry. The ratings range from A++ (Superior) down to D (below minimum standards). Also, ratings of E and F are given to companies under state supervision or in liquidation. The ratings reflect A.M. Best’s evaluation of an insurance company’s financial strength and operating performance relative to the norms of the property/casualty insurance industry.
Betterment – A term used to express the difference in the value of property before loss and after restoration. If a 20-year roof is damaged by an insured peril and it has to be replaced in its 15th year and the restoration renews the 20-year life expectancy, the owner has obtained a 15-year betterment in the roof. Without replacement cost insurance on the roof, the owner is expected to reimburse the insurance company for the betterment entailed in the restoration. Also see Improvements and betterments.
BI – A shorthand expression for bodily injury.
Bid bond – Guarantees an owner, the obligee, that the accepted contractor will actually undertake the work and that the contractor will furnish performance, payment, and, perhaps, maintenance bonds—or that the contractor will pay the owner the difference between the amount of the contractor’s accepted bid and the bid of another contractor who has to be called in to complete the project.
Bill of lading – A document issued by a carrier which is a receipt for the merchandise or other property to be transported, and which outlines just what the carrier agrees to do and his responsibilities for the property.
Binder – An insurer’s agreement, by way of an agent, to provide nonlife insurance on the spot, pending issuance of the policy contract.
Binding authority – The authority extended to an agent by an insurer to provide insurance, usually on a temporary basis, until a policy can be written.
Blanket bond – An employee dishonesty or fidelity bond covering all persons of a group or class, as opposed to bonds naming specific individuals (name schedule) or positions (position schedule).
Blanket coverage – A means of insuring various items of property under one limit of liability.
Blanket crime policy – An individual policy covering several crime perils on a single amount rather than on individual limits.
Blanket insurance – Insurance covering multiple items of property as a group. Covered property may be at one location or several. Blanket position bonds – Bonds which guarantee the honesty of each of the employees of an entity stated on the bond to the stated amount of the bond.
Blanket position public official bond – The blanket position public official bond covers each public employee of the public entity stated on the bond to the stated amount of the bond.
Blanket public official bond – Blanket public official bonds cover all public employees of the public entity stated on the bond to the stated amount of the bond.
Block policy – A block policy provides a form of inland marine insurance. It covers loss to the property of a merchant, wholesaler, or manufacturer including property of others in the insured’s care, custody, or control; property on consignment; and property sold but not delivered. A block policy covers loss caused by most perils (including transportation), subject to certain limitations as specified in the
delivered. A block policy covers loss caused by most perils (including transportation), subject to certain limitations as specified in the
policy exclusions. Common block policies are jeweler’s block and furrier’s block policies.
Bobtailing – A trucking term that means the driving of the tractor portion of a semi after the trailer has been delivered and removed. A special trucking endorsement, Truckers Insurance for Nontrucking Use, may be necessary when bobtailing.
Bodily injury – A term that refers to physical injury, sickness, or disease, or death resulting therefrom. In some jurisdictions bodily injury includes emotional injury.
Bodily injury liability – Legal obligation that flows from the injury or death of another person. This insurance is commonly limited to bodily injury liability derived by way of negligence, but coverage of liability by way of contract (holding another harmless) is also possible.
Boiler & machinery insurance – Fired vessels, steam generators, mechanical and electrical objects and turbines, are all examples of objects that might be listed for coverage under a boiler and machinery policy. Coverage is for damage to covered property caused by an accident to an object identified in the policy’s schedule. Coverage includes extra expense, automatic 90-day coverage at new locations, defense against liability claims, and supplementary payments like those provided under public liability policies.
Bond – A document for expressing surety. A bond engages three entities: the surety (bonding company) sells the bond to the principal for the purpose of paying the amount the principal will owe to the obligee upon failure of the principal to perform some act or provide some service under agreed terms.
Bond, fidelity – A bond that guarantees the principal’s honesty.
Bond, surety – The financial assumption of responsibility by one or more persons for fulfilling another’s obligations.
Book of business – The accounts written by an agent or company. It can be expressed in a number of ways such as total book of business, book of auto business, or homeowners business.
BOP (Businessowners policy) – See Businessowners policy.
Bordereau – A written schedule of insureds, premiums, and losses submitted to reinsurers under certain types of reinsurance agreements.
Boston plan – This is a plan under which insurers agree that they will not reject property coverage on residential buildings in a run- down part of town. Instead, they will accept the coverage until there has been an inspection and the owner has had an opportunity to correct any faults. Boston was the first city to originate such a plan, and many other cities have followed, including New York, Oakland, Cleveland, and Buffalo.
Boycott – Another practice defined as unfair under most states’ codes. Such a practice occurs when someone in the insurance business refuses to do business with someone else until that person complies with certain conditions or concessions.
Broad form perils – A property insurance designation for coverage that extends beyond the basic named perils.
Broad form property damage endorsement – A commercial general liability endorsement that removes the care, custody, or control exclusion relating to the property of others and replaces it with a less stringent one.
Broadcasters liability coverage – Covers the legal liabilities of broadcasters such as the use of incorrect news stories, libel and slander, invasion of privacy, copyright infringement, and unauthorized use of plot, characters, or music. Defense costs in contesting suits or claims are also covered. Employees are covered as insureds while acting within the scope of their duties as such.
Broker – One who represents the insured in arranging insurance. A broker may also serve as the agent of an insurance company. Typically, a broker does not have binding authority.
Builders risk insurance – A variation of property coverage specifically applicable to construction projects. It is commonly written in an amount to cover the value of the structure when completed. The premium charged takes into account that values at risk increase gradually over the term of the policy.
Building codes – See entry for building ordinance or law.
Building ordinance or law – This coverage pays for additional construction costs incurred as the result of local building laws. It
contains three coverages which may be provided separately or together:
Demolition pays to demolish the parts of the building which were undamaged in the loss but which have to be torn down due to building codes. Similar coverage is provided as Debris Removal for those portions that are damaged by a Covered Cause of Loss.
Increased Cost of Construction pays to bring a building element up to current codes. For example, this could pay to replace aluminum wiring with copper, to add sprinklers, or to upgrade fire rated doors.
Loss of Value or Contingent Liability pays for the cost of replacing that part of the building which was not damaged by the loss but which must be torn down due to code requirements.
Bumbershoot – A form of coverage similar to an umbrella, having to do with ocean marine risks.
Burglary – Unlawful removal of property from premises involving visible forcible entry.
Burning ratio – The ratio of losses to the amount insured.
Business auto policy (BAP) – A standardized contract for writing liability and property coverage on commercial autos.
Business income coverage – Insurance protecting the income derived from an insured’s business activities when curtailed by a covered peril. Coverage includes reasonable extra expense the insured undertakes to expedite return to business operations.
Business income, dependent properties – Covering loss to an insured when the operations of a key supplier, customer, or leader property on which the insured’s operations are dependent, are shut down by a covered peril. Also referred to as contingent business income.
Business personal property – A term relating to contents of a commercial enterprise. It may include furniture, fixtures, machinery and equipment as well as stock, all other chattels owned by the insured, and even use interest in building improvements and betterments. Businessowners policy (BOP) – A package of property and liability insurance for small and medium size businesses, the BOP owes its origin to the success of the homeowners policy.
Business pursuits – Activities that involve at least two elements: continuity and a goal or expectation of monetary gain. Many personal lines policies exclude coverage for loss arising from business pursuits because the primary purpose of such forms is to insure against loss arising from personal activities.
Buy-back deductible – A deductible that may be eliminated for an additional premium in order to provide first-dollar coverage.
Byway – A law or ordinance dealing with matters of local or internal regulation made by a local authority or by a corporation or association.
Byway endorsement – An endorsement explaining how a particular insurance company deals with a claim which is affected by a local byway.
Calendar year experience – Underwriting result based on earned premiums and booked incurred losses for the same calendar year reporting period, regardless of the dates of the loss events. Booked incurred losses include paid losses, beginning of year to end of year changes in case reserves, and IBNR.
Cancellation; flat, pro rata, or short rate – In a flat cancellation the full premium is returned to the insured. A pro rata cancellation means the insurer has charged for the time the coverage was in force. Short rate cancellation entails a penalty in excess of pro rata for
means the insurer has charged for the time the coverage was in force. Short rate cancellation entails a penalty in excess of pro rata for
Capacity – An insurer’s (or reinsurer’s) top limit on the amount of coverage it has available. The term may also refer to the total available in the respective insurance or reinsurance market.
Capital and surplus – The sum of paid up capital, gross paid in and contributed surplus, and unassigned surplus.
Captive agent – A representative of a single insurer. In the case of captive agents, the insurer owns and controls expiration dates and policy records. A captive agent is a member of what may be called an exclusive agency system.
Captive insurer – An enterprise with all the authority to perform as an insurance company but organized by a parent company for the express purpose of providing the parent company’s insurance.
Care, custody, or control – An expression common to liability insurance contracts. It refers to an exclusion in the policy eliminating coverage for damage to property of others that is in the insured’s care, custody, or control. The insured has a bailee relationship to the property, in other words, making the insured liable for the care of the property beyond damage caused by negligence. A bailees floater is often used to cover the insured’s obligation for the care of such property.
Cargo insurance – An inland marine or ocean marine policy covering cargo in the care, custody, or control of the carrier.
Cargo shippers’ agent – One who acts as an agent on behalf of cargo owners or shippers, or both, to procure cargo insurance only on behalf of a cargo owner or shipper for whom the agent is also arranging for the carriage of goods.
Cash-flow underwriting – Name given to an insurer’s practice of nonselectively writing business in order to generate greater amounts of cash for investment purposes.
Casualty Actuarial Society (CAS) – A professional society for actuaries in areas of insurance work other than Life Insurance. This society grants the designation of Associate and Fellow of the Casualty Actuarial Society (ACAS and FCAS).
Casualty insurance – The type of insurance concerned with legal liability for losses caused by bodily injury to others or physical damage to property of others.
Catastrophe (excess) cover – Another term for catastrophe reinsurance, wherein the ceding company is indemnified by the reinsurer
after a specified loss amount is reached for losses caused by catastrophes.
Causes of loss forms – The reference is commonly to property insurance contracts and the form in question details those perils to which the coverage will respond. Though any property insurance contract must name the perils it intends to cover, for example, crop hail, earthquake, or perils of transit, the most commonly used general forms are the basic and broad named perils forms and the special form. In contrast to the named perils forms, that list specific perils for coverage, the special form contract covers simply risk of direct physical loss and relies on exclusions to delimit and define the coverage.
Cede – The transfer of all or part of a risk written by an insurer to a reinsurer.
Cedant – A ceding insurer or reinsurer. See Cede.
Ceding commission – The cedant’s acquisition costs and overhead expenses, taxes, licenses and fees, plus a fee representing a share of expected profits, which often is expressed as a percentage of the gross reinsurance premium.
CERCLA – See Superfund.
Certificate of insurance – A written description of insurance in effect as of the date and time of the certificate. The certificate does not ordinarily confer any rights on the holder, that is, the issuing insurer does not promise to inform the holder of change in or cancellation of coverage.
Certified copy – Reproduction of a document, that authority having custody of original signs and attests as a true, genuine, and authentic copy.
CFP – A designation—Certified Financial Planner. A title conveyed by the International Board of Standards and Practices for Certified Financial Planners. A Certified Financial Planner must pass a series of exams and enroll in ongoing education classes. Knowledge of estate planning, tax preparation, insurance, and investing is required.
CGL (Commercial General Liability) see Commercial general liability.
ChFC – A designation—Chartered Financial Consultant. A financial planning designation for the insurance industry awarded by the American College of Bryn Mawr. ChFCs must meet experience requirements and pass exams covering finance and investing. They must have at least three years of experience in the financial industry and have studied and passed an examination on the fundamentals of financial planning, including income tax, insurance, investment and estate planning.
CIC – A designation—Certified Insurance Counselor.
CLU – A designation—Chartered Life Underwriter — conferred upon successful completers of a series of studies of life insurance and related disciplines designed by the American College.
CPCU – A designation—Chartered Property Casualty Underwriter — conferred upon successful completion of a series of eight exams on insurance and related disciplines designed by the American Institute of Chartered Property Casualty Underwriters.
Civil commotion – One of the extended coverage perils, paired with the peril riot, that refers to a less widespread or generalized event than riot might be thought to encompass.
Claim expense – The expense of adjusting a claim, such as investigation and attorneys’ fees. It does not include the cost of the claim itself.
Claims-made coverage – A type of public liability insurance that responds only to claims for injury or damage that are brought (to the insurer) during the policy period (or during a designated extended reporting period beyond expiration). This development was in response to long tail claims, such as those related to asbestosis injury, carrying over many years and multiple layers of coverage limits. However, most public liability policies are written on an occurrence basis, covering injury or damage occurring during the policy period even if a claim is brought months or even years later.
Clash cover – A type of catastrophe reinsurance for casualty insurance. The retention is equal to the highest limit of any one insurance policy covered by the agreement. Clash cover is written to cover all losses from one source, such as a construction site.
Class action lawsuit – a lawsuit filed by one or more individuals on behalf of themselves and a larger group of people who are in similar situations.
Class rates – When property or people share a certain number of characteristics relevant to the cost of providing them with insurance (such as a male driver under the age of 25 without an accident) underwriters can develop insurance rates that reflect the exposures represented by the class and offer insurance based on a class rate rather than by computing individual rates for each member. Classification – The systematic arrangement of properties, persons, or business operations into groups or categories according to certain criteria. Such classification creates a basis for establishing statistical experience and determining rates, and to avoid unfair discrimination.
Classification code – The identifying number for an occupational classification. It is a four-digit numeric code – based on the nature of the business of the employer – assigned by NCCI or other workers compensation rating bureaus.
Clause – A provision or condition affecting the terms of a contract. Coinsurance, cancellation, and subrogation clauses are typical insurance contract clauses.
Clear space clause – A clause requiring that insured property, such as stacks of lumber, be stored at some particular distance from each
Clear space clause – A clause requiring that insured property, such as stacks of lumber, be stored at some particular distance from each
other or from other property.
Clean-up costs – Generally, those costs associated with the clean-up of pollution.
Close or closely held corporation – A corporation that is owned by a small number of individuals who are related. A close corporation fills its own vacancies.
COBRA – A health insurance plan which allows an employee who leaves a company to continue to be covered under the company’s health plan, for a certain time period and under certain conditions. The name results from the fact that the program was created under the Consolidated Omnibus Reconciliation Act. The system is designed to prevent employees who are between jobs from experiencing a lapse in coverage.
Coercion – Another act defined by most states as an unfair trade practice. Coercion occurs when someone in the insurance business uses physical or mental force to persuade another to transact insurance.
Coinsurance clause – Coinsurance refers to the bargain between commercial property owners and the insurance industry. This clause in property policies encourages the property owner to gauge coverage needs by possible, not probable, maximum loss. With $1 million at risk but a probable maximum loss of $100,000, for example, the property owner would probably buy $100,000 insurance and bank on avoiding the larger disaster. The bargain offered by the insurance industry is a reduced rate per $100 of coverage if the owner agrees to buy coverage at a specified relation (80% commonly) to value (to possible maximum loss in other words). If the insured accepts the bargain but events prove the amount of insurance is inadequate to the stated coinsurance percentage, the insured becomes coinsurer in the same ratio as the amount of insurance bears to the amount that should have been carried.
Collapse – A property insurance peril, subject to its own specific agreement in property policies, that otherwise insure on an open perils basis.
Collision damage waiver – When paired with an auto rental agreement, the rental car company agrees to waive the renter’s responsibility for any physical damage to the rental car in exchange for an additional payment. Sometimes called a loss damage waiver. Collision insurance – A type of physical damage insurance available for automobiles. Coverage is triggered when damage is caused by striking against another object.
Collusion – A secret agreement between persons to defraud another, e.g., an insured driver of an automobile and his passenger may misrepresent the facts of an accident in order to have monies paid to the passenger under the insured’s automobile insurance policy. Combined ratio – The sum of an insurance company’s loss ratio and expense ratio; used as an indicator of profitability for insurance companies.
Combined single limit (CSL) – Liability policies commonly offer separate limits that apply to bodily injury claims and to claims for property damage. 50/100/25 is shorthand under such a policy for $50,000 per person/$100,000 per accident for bodily injury claims and $25,000 for property damage. A combined single limits policy might cover for $100,000 per covered occurrence whether bodily injury or property damage, one person or many.
Commercial blanket bond – A bond that covers the named insured against employee dishonesty. A single coverage amount applies to any one loss, regardless of the number of employees involved.
Commercial general liability (CGL) – The CGL policy is an ISO form, widely used to provide commercial enterprises with premises and operations liability coverage, products and completed operations insurance and personal injury coverage. Premises medical payments coverage is often included as well.
Commercial lines – A distinction marking property and liability coverage written for business or entrepreneurial interests as opposed to personal lines.
Commercial property policy – An alternative title for the commercial building and personal property coverage form.
Commissioner of insurance – The official in a state (or territory) responsible for administering insurance regulation; sometimes called the superintendent or director of insurance.
Common area – The part of a building or premises either owned by or used by all tenants or tenant-owners of the building (e.g., the swimming pool at a condominium).
Common carrier – A carrier (such as a shipping company or railroad) who offers his vessel or other mode of transportation to the public for the purpose of transporting merchandise.
Comparative negligence – A variation of contributory negligence, in which the comparative degree of negligence for each party to an accident is taken into account when awarding damages.
Compensatory damages – The award, usually monetary, that is intended to compensate the claimant for injury sustained. Competitive state fund – A facility established by a state to sell workers compensation in competition with private insurers. Completed operations – See Products and completed operations.
Completed operations insurance – See Products and completed operations.
Completion bond – A bond that guarantees a lending institution or other mortgagee that a building or other construction that they have lent money on will be completed on time so it can used as collateral on the loan.
Comprehensive Loss Underwriting Exchange – Commonly referred to as a CLUE report, this provides accident or loss history of individuals including claim payments and coverages. Used by agents and carriers to determine eligibility and premiums for coverage. Comprehensive personal liability insurance – Provides individuals and family members with protection from legal liability for most accidents caused by them in their personal lives. Note that any legal liability claims submitted while in the course of business activities are not covered.
Comprehensive physical damage (automobile) – 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.
Compulsory auto insurance – The minimum amount of auto liability insurance that meets a state law. Financial responsibility laws in every state require all automobile drivers to show proof, after an accident, of their ability to pay damages up to the state minimum. In compulsory liability states this proof, which is usually in the form of an insurance policy, is required before you can legally drive a car. Computer fraud coverage – Covers loss if money, securities, or other property is stolen or transferred through computer fraud. Computer insurance – Covers computer equipment and peripherals beyond the normal coverage provided in homeowner’s insurance policies, typically between $1,000 and $3,000. Some policies are also designed to cover damage and/or theft of portable equipment, such as laptop computers, and even the costs of data recovery.
Concurrent causation – When two perils contribute concurrently to a property loss, one excluded and the other not, the effect of the exclusion tends to be voided in a policy covering on an open perils basis. A concurrent causation exclusion is found in current forms. Condition – One of the obligations of either the insured or the insurer imposed in the insurance contract.
Conditional sales floater – Covers a store’s property purchased on installment.
Condominium – Type of dwelling where the structure is owned jointly while spaces within the structure are owned individually. Special property and liability forms cover the interests of the condominium association and of unit owners.
Condominium association coverage – A policy that provides coverage for the building, elements of the building, and liability needs for
Condominium association coverage – A policy that provides coverage for the building, elements of the building, and liability needs for
those who collectively own a piece of property.
Condominium unit owners form – A policy that provides coverage for the personal property, owned elements of a unit, and liability for the individual unit owner.
Consequential loss – An indirect consequence of direct loss to property. Business income may be lost when a store burns down, or frozen goods may spoil when windstorm causes an interruption of power. Consequential or indirect loss is not generally insured by policies covering direct damage (i.e., by fire or wind as in these examples), but insurance is readily obtainable separately for most such consequential exposures—business income coverage being among the most common coverage.
Consideration clause – Stipulation that states the basis on which an insurer issues an insurance contract.
Construction bond – A bond that guarantees the owner of a building under construction that it will be completed. If the contractor cannot finish the work, the insurer is obligated to see that the work is performed.
Constructive total loss – This condition is said to exist when the cost of repairs exceeds the actual cash value of damaged property. Contingent business income (interruption) – See Business income, dependent properties.
Contingent liability – Liability imposed on a business entity (individual, partnership, or corporation) for acts of a third party for which the business entity is responsible.
Contract of adhesion – See Adhesion contract.
Contract bonds – A type of bond designed to guarantee the performance of obligations under a contract. These bonds guarantee the obligee that the principal will perform according to the terms of a written contract. Construction contracts constitute most of these bonds. Contract bonds protect a project owner by guaranteeing a contractor’s performance and payment for labor and materials. Because the contractor must meet the surety company’s pre-qualification standards, construction lenders are also indirectly assured that the project will proceed in accordance with the terms of the contract.
Contractors equipment floater – Coverage designed for the special needs of contractors to insure their machinery and other equipment.
Contractual liability – Liability that does not arise by way of negligence but by assumption under contract. For example, in certain leases, a tenant may assume a landlord’s liability to others for unsafe conditions on the premises. Some such assumptions are covered automatically under the Commercial General Liability form.
Contributing location – A location upon which the insured depends as a source of materials or services. One of the four types of dependent properties for which business income coverage may be written.
Contributory negligence – A defense to a negligence action in which it is asserted that the claimant failed to meet the standard required for his or her own protection, which contributed to the loss.
Controlled business – The amount of insurance countersigned, issued, or sold by a producer covering that producer’s interests, immediate family, or employees. Many states limit the amount of controlled business that may be written by placing a maximum percentage of all business that may be controlled.
Convention (or statement) blank – The uniform annual financial statement that must be filed by all insurers as prescribed by the National Association of Insurance Commissioners. The convention blank must be filed annually in an insurer’s home state and every state in which it is licensed to do business.
Corporation – A business whose articles of incorporation have been approved in some state. For insurance purposes, the type of business structure helps to determine who is insured on the policy.
Countersignature – An authorized signature of agent or company representative on an insurance policy. Usually pertains to policies sold by an agent of the insurer located in another state.
Court bonds – See Judicial bonds.
Coverage trigger – In liability insurance, the trigger is the event that brings coverage into play. It may be either an occurrence of bodily injury or property damage; or, in a form with a claims-made trigger, the formal making of a claim.
Covered loss – An accident, including accidental damage by forces of nature, that brings a contract of insurance into play.
Credit card forgery – A criminal act involving the illegitimate use of credit cards to obtain goods or money. Limited coverage for such losses is automatically provided in most homeowners policies.
Credit insurance – Optional coverage that pays off the balance of an outstanding loan in the event the insured becomes disabled, unemployed, or dies. Exact coverage depends on the particular policy. Variations include credit life (pays if the insured dies), credit health or disability (pays if the insured gets sick or becomes disabled) and credit unemployment insurance (pays if the insured involuntarily loses his job). Usually offered with credit cards, auto loans, and mortgages.
Credit score – The number produced by an analysis of an individual’s credit history. Studies have shown that credit history provides an indicator of the likelihood of an auto insurance loss. Some companies use credit scores as an insurance underwriting and rating tool. Crime insurance – A broad category covering loss of property through criminal activity — from employee dishonesty to burglary and robbery, computer fraud, and forgery.
Crop insurance – Insurance covering growing crops against hail, wind, and fire. Protection against a broader range of perils can often be arranged as well.
Cross liability coverage – In the event of a claim by one insured for which another insured covered by the same policy may be held liable, this endorsement covers the insured against whom the claim is made in the same manner as if separate policies had been issued. However, it does not operate to increase the insurance company’s overall limit of liability.
Cross liability exclusion – Excludes coverage for claims by one insured against another insured covered on the same insurance policy.
Daily – The document—now more commonly found in electronic than in paper form — that provides insurer and agent with a quick reference to all pertinent information relative to a contract of insurance such as insured’s identification, location, coverage, term, or premium. Sometimes referred to as a daily report.
Data processing insurance – Coverage for electronic media, computers, and other electronic data processing equipment. Deadheading – A trucking term that means the driving of a tractor-trailer that is empty, usually on the return trip from delivering goods. A special trucking endorsement, Truckers Insurance for Nontrucking Use, may be necessary when deadheading.
Dean schedule – A schedule rating system for property insurance on commercial buildings. It is named for its author, Alfred F. Dean. This system is currently being replaced by a rating plan developed by the Insurance Services Office.
Debris removal clause – A consequential coverage commonly included in direct loss policies. For example, fire policies provide limited recovery for the insured’s cost of removing the debris after a covered fire. Not to be confused with removal.
Declarations page – That part of a property or liability insurance policy that discloses information pertinent to the coverage promised including names, addresses, limits, locations, term, premium, and forms. The who, what, where, and when of the policy. Often referred to as the dec page.
Deductible – The part of the loss that is to be borne by the insured.
Deductible – The part of the loss that is to be borne by the insured.
Defense costs – The portion of the commercial general liability policy that applies whether or not the claim is legitimate and well founded. These costs may be part of the total stated policy limits or may be in addition to the stated policy limits. Auxiliary charges may be included with defense costs.
Demolition insurance – When a building is damaged beyond a certain point, local building codes may direct that the structure be razed. Insurance to cover this exposure (and the lost value of the undamaged but newly razed part) can and clearly should be arranged whenever it exists.
Demutualization – The conversion of an insurance company from a mutual insurance company to a stock insurance company. Dependent properties – See Business income, dependent properties.
Deposit premium – When the price of insurance is tied to fluctuating values or costs that cannot be known until the end of the policy period, inventory or payroll are two common examples, a deposit or provisional premium or estimated premium may be charged at the outset of a policy with final adjustment to come at the end of the term.
Depositor’s forgery insurance – Coverage against loss due to forged instruments. Limited coverage is automatically included in homeowners contracts. Commercial establishments can purchase crime coverage with this feature.
Depreciation – As property ages and becomes worn it often loses value. That loss of value must be taken into account in any adjustment of property insurance that covers loss of actual cash value.
Detached signs – Signs located away from the designated premises. They may or may not be part of the covered property.
Difference in conditions (DIC) – Property insurance obtained through the excess and surplus lines market to supplement and expand on the property coverage available through admitted markets. DIC has been called the property umbrella policy.
Diminution of value – The idea that a vehicle loses value after it has been damaged in an accident and repaired.
Direct billing – A system for the collection of premiums whereby the insurance company directly bills the insured for the premium in lieu of the conventional collection of premiums by the agent or broker. The insurer sends a statement to the agent, usually monthly, recording the premiums collected directly, and credits the agent with the commission on those items.
Direct damage – Physical damage caused to property by a peril such as fire or lightning.
Direct loss – The immediate consequence of the action of an insured peril. A fire damaged structure is a direct loss by fire. In contrast –
See Consequential loss.
Direct premiums – Premiums collected from policyholders before premiums for reinsurance are paid.
Direct writer – An insurer that sells coverage directly via its own employees. Contrast with Independent agent.
Directors and officers liability insurance (D&O) – A form of errors and omissions insurance covering the directors and officers of corporations against suits alleging they committed wrongful act(s).
Disappearing deductible – Deductible in an insurance contract that provides for a decreasing deductible amount as the size of the loss increases, so that small claims are not paid but large losses are paid in full.
Disclosure – The duty of an applicant and his broker to tell the underwriter every material circumstance before acceptance of risk. Discovery period – The period of time, commonly one year, after the termination of a surety bond during which covered loss may be discovered, reported, and covered.
Dishonesty, disappearance, and destruction (3-D) policy – The name once applied to a form used for comprehensive crime coverage.
Divisible contract clause – A clause providing that a violation of the conditions of the policy at one insured location will not void the coverage at other locations.
Dollar threshold – In no-fault auto insurance states with the dollar threshold, the threshold prevents individuals from suing in tort to recover for pain and suffering unless their medical expenses exceed a certain dollar amount.
Domiciled – Refers to the state in which an insurance company receives a license to operate. The company is then regulated by that state’s department of insurance.
Domestic insurance company – Term used by a state to refer to any company incorporated there.
Dram shop laws – State laws pertaining to selling and serving alcoholic beverages and the public liability these activities may entail. Also called alcoholic beverage control (ABC) laws.
Dram shop liability insurance – See Liquor liability insurance.
Drive other car (DOC) endorsement – A business auto or garage policy endorsement providing coverage for named individuals while driving nonowned autos in situations unrelated to the business of the insured.
Driver training credit – To encourage driver education courses at schools and colleges, many insurers grant premium rebates to applicants for private passenger automobile insurance who have successfully completed an approved training program.
Druggists liability insurance – A form of professional liability insurance for druggists.
Duty to defend – Part of the insuring agreement of many policies. The insurer has the duty to defend the insured in event of a covered loss.
Dwelling forms – Forms for coverage of dwellings and personal property that are not eligible for homeowners coverage. Tenant occupied rental properties are commonly insured under these forms.
e-business – The transaction of business by way of electronic media, such as telephones, fax machines, computers, and video- teleconferencing equipment. This generally is broader than e-commerce although some may view e-business and e-commerce as interchangeable terms.
e-commerce – The buying and selling of goods by way of electronic media, such as telephones, fax machines, computers, and video- teleconferencing equipment.
Early warning system – A system of measuring insurers’ financial stability set up by insurance industry regulators. An example is the Insurance Regulatory Information System (IRIS), which uses financial ratios to identify insurers in need of regulatory attention.
Earned premium – Portion of a premium for which protection has already been provided by the insurer.
Earnings insurance – A simplified form of insurance covering business income loss, limited to a set percentage of the policy’s total amount for recovery of proved loss for each 30-day period.
Earth movement – Subject to an exclusion in property policies, this peril includes earthquake, landslide, and mudflow. Easement – An interest in land owned by another that entitles its holder to specific uses.
Economic damages – Out-of-pocket damages, such as incurred medical expenses or lost wages.
EDP – An abbreviation for electronic data processing.
Effective date – The date shown in the declarations of a policy upon which coverage is to take effect.
Elements of a negligent act – Four elements an injured person must show to prove negligence: existence of a legal duty to use reasonable care, failure to perform that duty, damages or injury to the claimant, and proximate cause relationship between the negligent act and the infliction of damages.
act and the infliction of damages.
Elevator collision – Coverage for damage caused by the collision of an elevator, regardless of fault. The damaged property may be personal property, building, or the elevator itself.
Embezzlement – The fraudulent use of money or property which has been entrusted to one’s care.
Employee benefits plan liability coverage protects the insured employer against claims by employees or former employees resulting from negligent acts or omissions in the administration of the insured’s employee benefits programs.
Employee dishonesty coverage – Insurance protecting employers from loss due to theft by their employees.
Employee Retirement Income Security Act of 1974 (ERISA) – Federal law that affects pension and profit-sharing plans. Among other provisions, this law specifies a published summary plan must be distributed to participants within 120 days after adoption of the plan and within 90 days after an employee becomes a participant. The law requires that a summary plan description be issued every 5 years.
Employers liability insurance – A feature of standard workers compensation policies, this coverage applies to liability that may be imposed on an employer outside the provisions of a workers compensation law.
Employers nonownership liability – Employers who buy commercial auto coverage on a basis other than any auto have this exposure whenever an employee uses his or her own auto on the employer’s behalf.
Employment practices liability insurance – Coverage against allegations of illegal or discriminatory hiring and firing practices, sexual harassment of employees, and so on.
Encumbrance – Mortgage, lien, or other charge against a property.
Endorsement – An amendment to a policy form.
Enterprise-wide risk management – An effort to categorize, measure, and treat all types of risk that may adversely affect a business. It includes both traditional hazard risks and other business risks, such as risks posed by competitors, by economic developments, by natural conditions the business cannot control, and by general operations.
Environmental impairment liability insurance – See Pollution liability insurance.
Equipment floater – See Floater.
ERISA – An acronym standing for the 1974 Employee Retirement Income Security Act, which regulates certain employee benefit plans. Errors and omissions coverage (E&O) – A type of professional liability insurance protecting the insured against claims alleging bodily injury or property damage caused by the professional or technical incompetence of the insured.
Estimated premium – See Deposit premium.
Estoppel – The legal doctrine that a party may be precluded from denying that certain rights exist if, by behavior or implication that such rights did, in fact, exist, another party has acted upon this information to his or her detriment.
Ex gratia payment – A payment by an insurer to an insured for which there is no contractual liability. Such payments are sometimes made as a goodwill gesture if there is the possibility of a misunderstanding or a mistake.
Examination under oath – Found in the conditions section of many insurance policies, the insurer’s right to examine an insured under oath following a loss.
Excess insurance – Coverage that applies on top of underlying insurance that is primary—insurance that pays until its coverage limit is exhausted at which point the excess coverage takes over.
Also see Umbrella liability insurance.
Excess or surplus lines market – The range of insurance available through nonadmitted insurers—insurance companies that are not licensed in a particular state or territory. Specific provisions of state or territorial law control placements.
Excluded driver endorsement – An endorsement to an automobile policy offered by a carrier for a driver with violations on his driving record. Some states require carriers to offer such exclusion upon renewal for any new violations. Some carriers allow a voluntary exclusion, where an insured can request an individual to be excluded from the policy. Once an individual is excluded from a policy, there is no coverage of any sort if the individual drives the vehicle and has an accident.
Exclusion – The part of a policy that removes or restricts coverage. Common exclusions to most policies include war, intentional loss, governmental action, etc.
Exclusive agency system – See Captive agent.
Expediting expenses – In business interruption and boiler & machinery policies, expenses to speed up repair or replacement.
Expense ratio – The dollar amount that represents acquisition and service costs, expressed as a percentage of written premium. Experience – A record of losses.
Experience modification – The raising or lowering of premiums under terms of an experience rating plan.
Experience rating – A method of rating that uses past experience to establish current rates.
Expiration date – The date shown in the declarations page of a policy upon which coverage terminates; usually at 12:01 a.m. Explosion – An extended coverage peril and currently a covered peril in nearly every policy of property insurance. The peril remains distinct from steam boiler explosion, which is covered by boiler & machinery insurance.
Exposure – Degree of hazard threatening a risk because of external or internal physical conditions.
Express authority – Authority that is distinctly, plainly expressed, orally or in writing. The express authority of an insurance agent is given to the agent by the insurer in the contract they each sign. See Actual authority and Implied authority.
Extended coverage – An early and indivisible package of property insurance perils said to have been devised to make possible the spread of windstorm insurance beyond the highly exposed coastal and plains states. For those whose exposure to windstorm was less, extended coverage also encompassed smoke damage, hail, riot and civil commotion, aircraft and vehicle damage, and explosion insurance. Included here for historic purposes only since the term, extended coverage, is no longer in general use.
Extended nonowner liability – A personal auto policy endorsement that provides broader liability coverage for specifically named individuals. When attached, it covers nonowned autos furnished for the regular use of an insured, use of vehicles to carry persons or property for a fee, broader coverage for business use of vehicles.
Extended period of indemnity – A time for recovery of proved business income loss after physical property is restored and business reopened. The 30-day extension included in many business income forms may be extended by endorsement.
Extended recovery period – See Extended period of indemnity.
Extended reporting period – See Claims-made coverage.
Extra expense insurance – Coverage that may be purchased as a supplement to business income insurance, applying to expediting expenses that aid in quickly restoring the insured’s operations after a covered loss, or it can be the primary coverage sustaining the extra cost of continuing doing business for those insureds who would find it extremely damaging to fail to meet customer commitments, such as newspapers and dairies.
Face of policy – The front of the policy on which normally the name of the insurance company, the name of the insured, the amount of insurance, and the type of insurance appear among many other items.
insurance, and the type of insurance appear among many other items.
Facility – A pooling mechanism for insureds not able to obtain insurance in the voluntary market. Insurers write and issue policies but cede premium and losses on those policies to a central pool in which all insurers share.
Factory Mutual – A mutual insurance company insuring only properties that meet high underwriting standards. The typical risk is fire- resistive construction with a central station alarm.
Facultative reinsurance – A separate reinsurance agreement that is negotiated for a particular risk or insurance policy.
Fair Credit Reporting Act – Public Law 91-508 requires that an insurer tell an applicant if a consumer report may be requested. The applicant must also be told the scope of the possible investigation. Should the application be declined because of information contained in that report, the applicant must be given the name and address of the reporting agency. The insurer may not reveal the contents of the report. Only the agency that compiled the report may release its contents.
Fair market value – Price at which a buyer and seller, under no compulsion to buy or sell, will trade.
FAIR plan – An acronym for Fair Access to Insurance Requirements, these plans have been established in many states to make fire and extended coverage (and homeowners in some states) available in areas otherwise not addressed by the voluntary market.
Fair rental value – An amount payable to an insured homeowner for loss of rental income due to damage that makes the premises uninhabitable.
Farmowners-ranchowners policy – A homeowners type package policy adapted to include farm and ranch exposures.
Faulty workmanship exclusions – An alternative name for the business risk exclusions, namely damage to your work and damage to your product in the commercial general liability coverage form.
Federal crime insurance – Insurance against burglary, larceny, and robbery losses offered by the federal government where the Federal Insurance Administration has determined that such insurance is not otherwise readily available.
Federal crop insurance – A comprehensive coverage at rates subsidized by the federal government for unavoidable crop losses. Federal Emergency Management Agency – Provides disaster relief in disasters such as floods or earthquakes. See FEMA.
Fee simple basis – A form of ownership in which the owner has full rights to dispose of the property held. Common within homeowner associations.
Fellow employee coverage – Extends bodily injury coverage to one employee when caused by another.
FEMA – Federal Emergency Management Agency. This agency administers the National Flood Insurance Program.
Fidelity bond – See Employee dishonesty coverage.
Fiduciary – A generic term for persons or legal entities such as executors, trustees, and guardians appointed by the court, under a will, or by a trust to manage, control, or dispose of the property of others.
Fiduciary bonds – Bonds which guarantee an honest accounting and faithful performance of duties by administrators, trustees, guardians, executors, and other fiduciaries. Fiduciary bonds, in some cases referred to as probate bonds, are required by statutes, courts, or legal documents for the protection of those on whose behalf a fiduciary acts. They are needed under a variety of circumstances, including the administration of an estate and the management of affairs of a trust or a ward. See Judicial bonds. Fiduciary liability insurance – This insurance covers claims arising from a breach of the responsibilities or duties imposed on a benefit plan administrator; or a negligent act, error, or omission of the administrator.
File and use rating laws – State laws that permit the use of new rates by an insurance company without first obtaining the approval of that state’s insurance department.
Financial responsibility clause – The clause in a auto policy stating that, when the policy is certified as future proof of financial responsibility, the policy will comply with the financial responsibility laws to the extent required.
Financial responsibility law – When applied to automobile operations, this term signifies the minimum statutory limits of an operator’s responsibility for bodily injury and property damage caused by negligent operation of the vehicle.
Fine arts floater – See Floater.
Fire – Combustion evidenced by a flame or glow. Insurance distinguishes between a hostile fire (one out of bounds) and friendly fire (such as that contained within the fire box of a stove).
Fire department service charge – A fee that may be imposed by a fire department for responding to a call. Most fire coverage agreements include indemnification provisions for such eventualities.
Fire legal liability – Public liability policies routinely exclude coverage for damage to property in an insured’s care, custody, or control. This leaves a big gap in a tenant’s coverage, a gap partially filled by an exception in the commercial general liability policy that restores limited coverage for fire damage to the landlord’s building. Perhaps the best benefit of the exception is to call attention to the exposure so arrangements can be made for broader coverage at appropriate limits. Sometimes referred to as fire damage legal liability.
Fire mark – An insignia, attached to the outside of a house that represented the insurer of the house.
Fire resistive construction – A building which has exterior walls, floors, and roof constructed of masonry or other fire-resistive materials.
Fire wall – A A structure (wall) which is designed to prevent fires from spreading within a building. For example townhouses should have a firewall between each unit to prevent the entire row from burning. Regarding computer terminology, a fire wall is hardware or software designed to prevent unauthorized access to data from outside users.
First named insured – An insurance policy may have more than one party named as insured. In such cases, the first named insured attends to policy housekeeping, that is, pays premiums, initiates (or receives notice of) cancellation, or calls for interim changes in the contract. This is spelled out in commercial policies in the common policy conditions.
Fixtures – Generally, something tangible that is fixed or attached, as to a building, so that it becomes an appendage or structural part. Flat cancellation – See Cancellation.
Fleet policy – Written for a risk that has five or more vehicles.
Flesch test – A method to determine the degree of ease or difficulty for reading material. It counts not only the number of words in a sentence, but also the number of syllables in each word. Some states require that insurance contracts be written so that they have a certain readability level (often, 8th grade).
Floater – An inland marine form covering movable property wherever located within territorial limits.
Flood – A general and temporary condition of partial or complete inundation of dry land caused by the overflow of the natural boundaries of a body of water or the unusual and rapid accumulation of surface water runoff. Some insurance policies that include flood as a covered peril only insure against damage caused by overflow of the natural boundaries of a body of water, but other policies also may insure against surface water losses.
Flood insurance – Flood insurance, like earthquake coverage, is usually only of interest to those relatively few whose property is exposed. Consequently, losses among this small group will be high and premiums can be prohibitive. However, in 1968 the federal government stepped in to help property owners in designated flood plains with the National Flood Insurance Act of 1968. Coverage is not only available, but may even be required to obtain financing for exposed properties.
Flood Insurance Rate Map (FIRM) – Provided by FEMA (Federal Emergency Management Agency), this map delineates base flood
elevations and flood risk zones, and is used for rating purposes for flood insurance.
elevations and flood risk zones, and is used for rating purposes for flood insurance.
Floodplain – Any land area susceptible to being inundated by flood waters from any source.
Floorplan insurance – A form of insurance covering merchandise held for sale by a retailer which has been used as collateral for a loan. The lending institution, in effect, is insuring its collateral the merchandise “on the floor” of the retailer.
Following form – A term for a fire or other form written exactly under the same terms and coverages as other insurance on the same property.
Forced place insurance – Insurance purchased by a bank or creditor on an uninsured debtor’s behalf so if the property is damaged, funding is available to repair it.
Foreign insurance company – Name given to an insurance company based in one state by the other states in which it does business. Forgery or alteration coverage – This type of insurance covers loss sustained through forgery or alteration of outgoing negotiable instruments made or drawn by the insured; drawn on the insured’s account(s), or made or drawn by someone acting as the insured’s agent. This includes loss caused by any of the following: checks or drafts made or drawn in the insured’s name, payable to a fictitious entity; checks or drafts, including payroll checks, executed through forged endorsements; and alteration of the amount of a check or draft.
Form – The central document or documents of an insurance contract. Forms may be altered by endorsement.
Four corners of an instrument – A term that refers to studying an entire document for its meaning without reference to information outside of the document, such as negotiations prior to its writing.
Franchise deductible – Deductible in which the insurer has no liability if the loss is under a certain amount, but once this amount is exceeded, the entire loss is paid in full.
Fraud – The intentional perversion of the truth in order to mislead someone into parting with something of value.
Free on board (F.O.B.) – When goods are shipped F.O.B., the shipper is responsible only until the goods have been placed on board the vessel or freight car or truck or other means of transport. After that the risk belongs to the consignee.
Freight – The income of the ship owner from carrying cargo or earned by the employment of his ship.
Freight Forwarder – A specialist in handling overseas shipping details of exports and imports.
Friendly fire – See Fire.
Fronting – The practice, in reinsurance, of the ceding company retaining only a small portion of a risk and ceding the remainder to a reinsurer.
Full reporting clause – Under this clause, an insured is required to report values periodically. The clause provides for a penalty to the insured if true values are not reported.
Functional replacement cost – The cost to repair or replace damaged property with materials that are functionally the equivalent of the damaged or destroyed property, for example, replacing a solid mahogany banister with a pine banister.
Fur floater – See Floater.
Furriers customers insurance – See Bailees floater.
GAAP accounting – Generally Accepted Accounting Principles as promulgated by the Financial Accounting Standards Board (FASB). See Statutory accounting principles.
GAP coverage – Guaranteed Auto Protection. Insurance for a lessee designed to cover the difference in selling price between a vehicle’s actual cash value and the payout left on a lease. This coverage is often available for loan situations as well.
Garage policy – One of the early package policies, it is written for automobile dealers and may include liability insurance for garage operations, automobile operations, physical damage coverage on garage owned autos, bailees coverage on customers cars, and auto and premises medical payments coverage.
Garaging location – The postal code where a vehicle is parked or garaged when not in use. This is usually the insured’s primary residence.
Garagekeepers liability – A bailee coverage applying to automobiles. Commonly included in garage policies, it may be written to provide coverage for limited perils or for comprehensive physical damage, with or without collision damage coverage. Coverage may be expressed as covering the legal liability of the garagekeeper or amended to cover on a direct basis, as primary insurance or excess. General average – A principle of maritime law according to which the owners of ship and cargo share in a loss incurred voluntarily. See also Average and Particular average.
General average contribution – The proportionate shares of the vessel owner and each of the cargo owners in order to make up the expenditure or sacrifice incurred for the common good.
General average sacrifice – The voluntary destruction of part of the vessel or the cargo, or the deliberate expenditure of funds in time of grave peril, which is successful in avoiding total disaster.
General liability insurance – See Commercial general liability.
General partners’ liability coverage – A general partner’s management and fiduciary responsibilities to a limited partnership closely parallel the director’s or officer’s to a corporation. Exposure occurs when general partners become the financial managers of a limited partnership. The directors and officers of corporate general partners share this type of exposure.
Glass insurance – Commercial property form that covers plate glass, glass signs, lettering, etc.
Good faith – Most ordinary contracts are good faith contracts. Insurance contracts are agreements made in the utmost good faith. This implies a standard of honesty greater than that usually required in most ordinary commercial contracts.
Good student discount – The reduction of an automobile premium for a young driver who ranks in the upper percent of his class or maintains a grade point average above a certain level.
Grace period – A period after the premium due date during which an overdue premium may be paid without penalty. The policy remains in force throughout this period.
Grading schedule for cities and towns – A schedule prepared by the National Board of Fire Underwriters for the purpose of determining which of ten grades to assign to a city for fire rating purposes, based on such factors of fire protection as water supply. Graduated driver licenses – Licenses for younger drivers that allow them to improve their skills. Regulations vary by state, but often restrict night time driving. Young drivers receive a learner’s permit, followed by a provisional license, before they can receive a standard drivers license.
Gramm-Leach-Bliley Act – Financial services legislation, passed by Congress in 1999, that removed Depression-era prohibitions against the combination of commercial banking and investment-banking activities. It allows insurance companies, banks, and securities firms to engage in each others’ activities and own one another.
Gross earnings coverage – An outdated term for business income coverage.
Gross negligence – The degree of negligence somewhat greater than ordinary negligence. It may be a reckless wanton and willful misconduct causing bodily injury and/or property damage.
Guaranty funds – State mandated funds collected from licensed insurers and maintained as backup protection for policyholders of
Guaranteed replacement cost – A form of property coverage in which the insurance company agrees to replace damaged property even if the cost to do so exceeds the limit stated in the policy or the underlying rating basis on which the premium is calculated. This extension may be conditional on an approved appraisal and reporting of improvements to the building(s).
Guiding principles – Suggested procedures for establishing primacy of coverage in situations involving loss under a variety of coverage forms and, perhaps, more than one interested party. Last promulgated in the 1960s, the spirit of the principles survives because insurers apparently find that the prescribed procedures commonly lead to equitable settlements for all parties.
HPR – See Highly protected risk.
Hacker insurance – A coverage that protects businesses engaged in electronic commerce from losses caused by hackers. Hail insurance – Form of insurance that protects against loss of crops from hail.
Hangarkeepers legal liability – A bailee coverage for those charged with the care of aircraft owned by their customers. Hard market – A condition of the insurance marketplace in which insurance is difficult to obtain and relatively expensive. Hazard – Generally, a condition which increases the possibility of loss.
Hazardous waste – Term generally used to refer to pollutants or contaminants which result from industrial processing and must be disposed.
Highly protected risk (HPR) – A building meeting certain standards of fire protection, which is therefore eligible for a reduced rate. Highway traffic act – The body or system of laws which govern the obligations of the provincial governments and users of roads. A breach or conviction of any of these laws may be an offense but does not of itself impose legal liability, but it may be relied upon in any proceeding to establish or negate any liability.
Hired auto – A nonowned auto that may be borrowed as well as rented or leased by the insured. Personal auto policy insureds are covered automatically for hired autos, but business auto policy insureds may not be.
Hold back – When a replacement cost policy is triggered due to a loss, most policies pay the actual cash value of the lost or damaged articles immediately and then the full replacement cost once the repair or replacement is done. The differences between these two limits is called a hold back.
Hold harmless agreement – A contractual assumption by one party of the liability exposure of another. Lease agreements, for example, commonly require the tenant to hold the landlord harmless for bodily injury or property damage experienced by others on the premises.
Hole-in-one insurance – Coverage designed for amateur golf tournaments in which there is a substantial cash prize for anyone making a hole-in-one.
Holistic risk management – See Enterprise-wide risk management.
Homeowners insurance – An early and hugely successful example of packaged property and liability insurance. A mid-twentieth century insurance development was the introduction of the so-called multiline era in which insurers became empowered to write both property and liability forms of insurance, making way for the first packaging of these coverages within a single policy.
Host liquor liability – Part of the commercial general liability policy, covers the incidental serving of alcohol by an insured who is not in the business of serving alcohol.
Hostile fire – See Fire.
Housekeeping – A generalized term that refers to the overall care, cleanliness, and maintenance of an insured’s property.
Hull insurance – Ocean marine insurance covering physical damage to the ship or vessel insured. Usually written on an all-risks basis.
Identity theft – The act of assuming another person’s identity in order to gain access to a person’s bank accounts or other personal financial information.
Impaired property – A liability exclusion relating to the insured’s faulty products or work that results in an impairment to the property to which it is attached assuming the insured can salvage the situation by replacing the property or redoing the work.
Implied authority – Authority granted to an agent, even though not stated, that lets the agent perform tasks usual and necessary to exercise the agent’s express authority. See Actual authority and Express authority.
Implied warranty – A warranty is a representation by the policyholder that certain conditions exist or will be met. Even if the warranty is not in writing, it may exist as an “implied” warranty, e.g., that a building is not on fire when insured, or that a vessel is seaworthy. Improvements and betterments – Anything that adds to the value of property. Commonly used to describe a tenant’s use interest in fixtures added to the landlord’s building. May also refer to permanent changes made by a condominium unit owner to his or her unit, such as the addition of new kitchen cabinets.
Imputed negligence – Case in which responsibility for damage can be transferred from the negligent party to another person, such as an employer.
Incendiary – Malicious setting on fire or preparing, providing, and setting the means for fire to start.
Inchmaree clause – Covers losses resulting from latent defect in hull and machinery of vessel and losses resulting from errors in navigation or management of the vessel by master or crew.
Incidental medical malpractice – A portion of the commercial general liability policy that is triggered if a covered party or the association were to be sued because they tried to provide good Samaritan help or other medical first aid type care and were not professionals in the medical field.
Increased cost of construction – A damaged building may have to be upgraded to be repaired under building codes in force at the time of reconstruction. Building owners in such situations need guidance in buying insurance to cover this added exposure.
Increased hazard – Property insurance policies provide that coverage shall be suspended when the hazard in a risk is increased beyond that contemplated when the insurance was written. If a dwelling owner commences manufacturing dynamite in his home, the hazard is extremely increased, and coverage could be denied by the insurer if there were a loss.
Incurred losses – The value of claim payments plus reserves.
Incurred but not reported losses / IBNR – Losses that are not reported to the insurer or reinsurer until years after the policy is sold. Liability claims may be filed long after the event that caused the injury to occur. Asbestos-related diseases, for example, do not show up until decades after the exposure. Also, estimates made about claims already reported but where the full extent of the injury or property damage is not yet known. Insurance companies regularly adjust reserves for such losses as new information becomes available. Indemnity – A fundamental concept governing insurance: compensation for loss or injury sustained.
Independent adjuster – An individual or member of a firm who contracts with insurers to investigate claims and suggest appropriate settlements. Contrast with Public adjuster.
Independent agent – A retailer of insurance who, by contractual arrangement with a number of insurance companies, sells and services property and liability insurance. The independent agent owns the policy information and expiration dates of his client’s coverage and thus
property and liability insurance. The independent agent owns the policy information and expiration dates of his client’s coverage and thus
controls renewals and their placement.
Independent Insurance Agents of America (IIAA) – An association of insurance agents who are independent contractors and represent one or more insurers. Sometimes referred to as the Big I.
Indirect damage – Sometimes referred to as indirect loss, this is loss resulting from a peril but not directly caused by that peril. An example is fire damaging a freezer (direct damage), with resultant food spoilage (indirect damage).
Inflation guard endorsement – An endorsement attached to an insurance policy whereby the limits of liability on a piece of property are increased on a regular basis by a certain percentage in order to offset increasing building costs associated with inflation.
Inherent explosion – A natural explosion like dust in a grain elevator.
Inherent vice – A flaw in an item of property that will, in time, reveal itself and show the property as damaged. Property insurance does not normally cover such damage.
Inland marine insurance – Property insurance signaling broad coverage of properties exposed to the transportation peril and those subject to being used or kept at a location other than the insured’s customary premises. Eligible property is identified in the Nationwide Definition of Marine Insurance.
Innkeepers legal liability – A bailee coverage purchased by innkeepers to cover the property of their guests.
Insolvency – Insurer’s inability to pay debts. Insurance insolvency standards and the regulatory actions taken vary from state to state, but the last resort in the case of insolvency is liquidation.
Insolvency fund – See Guaranty funds.
Inspection report – A report prepared for an insurer by an outside organization. It provides information about an applicant’s or insured’s financial and moral attributes and condition of physical property to be insured.
Institutional property – Schools, churches, and many nonprofit operations are covered under special policies more cheaply if they qualify.
Insurable interest – The potential for financial loss associated with damage or destruction of property.
Insurable risk – The exposure to significant, measurable accidental loss from identifiable perils. The exposure, while not catastrophic, must be shared by a sufficient number of potential insureds so that the cost of loss for one can be measured and affordably shared throughout the market.
Insurance – A mechanism whereby risk of financial loss is transferred from an individual, company, organization, or other entity to an insurance company.
Insurance contract – A legal document defining circumstances under which the insurer will pay, and the amount to be paid. Also see Insurance policy.
Insurance examiner – The representative of a state insurance department assigned to participate in the official audit and examination of the affairs of an insurance company.
Insurance exchange – See Reciprocal exchange.
Insurance Bureau of Canada (IBC) – The trade association of the property/casualty insurance industry in Canada. It concerns itself with such matters as public relations, collection of statistics, and promulgation of forms. It has a substantial permanent staff but also many committees made up of volunteers from the senior ranks of insurance companies.
Insurance Crime Prevention Bureau (I.C.P.B.) – An organization supported by property and casualty insurers which investigates fraudulent insurance claims and provides a deterrent to such losses. Loss prevention information is maintained by the Bureau for use by member insurers, independent claims adjusters, and government authorities across the country.
Insurance exchange – Term used to describe a facility that exists in a few states to provide a market for reinsurance and for the insurance of large and unusual domestic and foreign risks that are difficult to insure in the normal markets. Examples are the New York Insurance Exchange, the Insurance Exchange of the Americas, and the Illinois Insurance Exchange.
Insurance Institute of America (IIA) – An institution offering a variety of insurance diplomas after the successful completion of certain examinations.
Insurance Institute of Canada (I.I.C.) – The educational body of the general insurance industry. It consists of an association of provincial institutes. Among other things, it conducts correspondence courses, holds annual examinations, and grants diplomas. Insurance Institute for Highway Safety – A nonprofit research organization, well-known for its auto crash tests.
Insurance policy – The document containing the contract between the insured and the insurer that defines the rights and duties of the contracting parties.
Insurance pool – A group of insurance companies that pool assets, enabling them to provide an amount of insurance substantially more than can be provided by individual companies to ensure large risks such as nuclear power stations. Pools may be formed voluntarily or mandated by the state to cover risks that can’t obtain coverage in the voluntary market such as coastal properties subject to hurricanes. (See Beach and Windstorm plans; Fair Access to Insurance Requirements Plans / FAIR plans; Joint Underwriting Association / JUA). Insurance Services Office (ISO) – An organization providing statistical information, actuarial analyses, policy language, and related services for the insurance industry.
Insurance to value – The concept of purchasing sufficient insurance coverage so as to closely approximate the value of the property being insured.
Insured – The party or parties whose interests are covered in a nonlife insurance contract. The less common term assured is sometimes used synonymously.
Insuring agreement – In an insurance contract, the insurer’s promise to pay.
Integrated risk financing – A type of risk financing designed to provide integrated protection against catastrophic losses. It may incorporate both traditional and nontraditional types of exposures, or it may include only traditional property and casualty risks. Interline endorsements – Commercial endorsements that apply, or could apply, to more than one coverage part of a package policy. Internet liability insurance – Coverage designed to protect businesses from liabilities that arise from the conducting of business over the Internet, including copyright infringement, defamation, and violation of privacy.
Interstate Commerce Commission endorsement – Issued to trucks which travel from state to state. It guarantees payment of transit losses. Truckers must repay the company for losses not actually covered by the policy.
Investment income – Income generated by the investment of assets. Insurers have two sources of income, underwriting (premiums less claims and expenses) and investment income. The latter can offset underwriting operations, which are frequently unprofitable.
Jacket – The cover of an insurance policy; it usually contains information such as the name and address of the insurer.
Jettison – Act of throwing overboard part of a vessel’s cargo or hull in hopes of saving a ship from sinking.
Jewelers block insurance – A policy especially designed for jewelers, it offers a combination of coverages protecting against risks of physical loss to property at the jeweler’s premises, property in transit, or customers’ property in the insured’s care.
Jewelry floater – See Floater.
Joint and several liability – A legal doctrine whereby a creditor or claimant may demand payment or sue one or more of the parties
Joint and several liability – A legal doctrine whereby a creditor or claimant may demand payment or sue one or more of the parties
separately, or all of them together.
Joint loss agreement – An endorsement that speeds up payment of insurance proceeds when there are two different carriers for the property and the boiler and machinery coverage, and there is a disagreement as to the amount of loss to be paid by each carrier.
Joint tenancy – Ownership of property shared equally by two or more parties under which the survivor assumes complete ownership. This is different from a tenancy in common where the heirs of a deceased party to the tenancy inherit his or her share.
Joint Underwriting Association (JUA) – Insurance pools representing all insurers in a state, usually designed to handle higher risk insureds. A few servicing carriers act on behalf of all the insurers, issuing policies, receiving fees, and handling claims. They are reimbursed for losses and receive fees from the JUA to cover operating costs.
Joint venture – A venture in which two businesses join together to share risk or expertise on a specific project or group of projects. Jones Act – The federal act through which maritime workers are provided workers compensation coverage (which ordinarily responds to the mandates of particular states).
Judgment rating – Rate-making method for which each exposure is individually evaluated, and the rate is determined largely by the underwriter’s judgment.
Judicial bonds – Two types of bonds available to guarantee faithful performance of court appointed duties. Fiduciary bonds guarantee the faithful performance of persons entrusted by the courts in the management, conservation, and disposition of property. Litigation bonds (or court bonds) are required in court actions. Bail bonds and appeals bonds are litigation bonds where the bond amount is forfeited if the bonded person disappears or the appeal is lost.
Jumbo risk – A policy of insurance written with exceptionally high limits.
Keeton-O’Connell – See No fault auto insurance.
Key employee insurance – Life insurance written on the life of an organization’s officers or other key employees, the loss of whom would cause the organization financial hardship.
Kidnap-ransom insurance – A specialty coverage offered in the surplus and excess lines markets that responds to ransom demands for recovery of kidnap victims.
Lapse – Termination of a policy because of failure to pay the premium. If other coverage is not obtained to immediately take effect, there is a gap in coverage during which there is no insurance for any losses. In automobile insurance, this may result in the insured being penalized by the Department of Motor Vehicles for having no insurance coverage, even if the lapse is for only one day.
Larceny – The unlawful taking of personal property of another.
Latent defect – A hidden flaw that will, in time, cause property damage that is uninsurable. Such damage is uninsurable because the element of chance is no longer present.
Law of large numbers – An underlying principle of insurance; the larger the number of participants in a given arrangement, the more accurate the rate is to the exposure.
Leader location – A location which attracts customers to the insured’s business. One of the four types of dependent properties for which Business Income coverage may be written.
Leased worker – A worker leased from another organization on a long-term basis.
Leasehold interest insurance – The insurable interest is that of a tenant who has some years remaining under a favorable lease that is subject to termination upon significant damage to the leased property.
Legal expense insurance – Insurance to reimburse policyholders for legal fees incurred for defense from lawsuits involving areas of civil law not covered by standard liability insurance, such as discrimination, wrongful discharge, contract disputes, and patient disputes. Legal liability – Liability imposed by law, including liability based on negligence, strict liability, or contractual liability.
Lessee – The person to whom a lease is granted, commonly called the tenant.
Lessor – The person granting a lease, also known as the landlord.
Letter of credit – A document issued by the buyer’s bank, through its foreign correspondent bank, establishing a credit against which the seller may draw after complying with specific instructions.
Leverage, or capitalization – Measures the exposure of a company’s surplus to various operating and financial practices. A highly leveraged, or poorly capitalized, company can show a high return on surplus, but may be exposed to a high risk of instability.
Libel – Written defamation of another’s reputation.
Liberalization clause – A feature of property policies that promises that any future change in the company’s form that would broaden coverage with no change in premium will automatically apply under the policy currently in force.
License and permit bonds – Suretyship guaranteeing that the principal will abide by the rules and obligations imposed by licensing laws or ordinances. For example, an electrician may have to post such a bond guaranteeing compliance with building codes before being licensed by a municipality.
Lien – A charge upon real or personal property as security for some debt or duty. Also, the security interest created by a mortgage or automobile loan. The conditions of an insurance policy require the disclosure to the insurer of any existing lien on the insured property. Like kind and quality – Refers to replacement of damaged, destroyed or lost property with used property of similar type and condition. Limited common element – A portion of the common elements of a condominium association which is restricted to the use of one or several unit owners. Normally such elements become the maintenance responsibility of the unit owner and may become the owner’s insurance responsibility too.
Limited partnership – A form of partnership that consists of one or more general partners, who actively engage in the business, and one of more special partners, who are not liable for the debts of the partnership beyond their initial financial contribution. Commercial insurance policies usually differentiate in the Who Is Insured section among corporations, partnerships, and other business models. Therefore, the type of model being insured is important.
Line – A term used to describe a type or class or kind of insurance in relation to the line of insurance appearing in the annual statement (e.g., inland marine, auto liability, fidelity).
Liquor liability insurance – Liability coverage for owners and operators of establishments selling or serving alcoholic beverages. Litigation bonds – See Judicial bonds.
Livery use – An exclusion in automobile liability policies applying to the use of autos to carry persons for hire as in a taxi service. A share-the-ride car pool is not livery use.
Livestock insurance – Life insurance on livestock covering death by named perils.
Lloyd’s of London – An association of individuals, called names, or groups of individuals who write insurance for their own accounts. Lloyd’s had its beginning in 17th century London in Edward Lloyd’s coffeehouse.
Lloyds Register – A catalogue of ships describing each ship— dimensions, age, place of construction, registry, and ownership. A necessary tool for the ocean marine underwriter. Similar information is published by the American Bureau of Shipping.
Lloyds Syndicate – A group of underwriters at London Lloyds who entrust the underwriting of their business to one underwriter.
Lloyds Syndicate – A group of underwriters at London Lloyds who entrust the underwriting of their business to one underwriter.
Loading and unloading exclusion – A feature of commercial general liability (CGL) policies intended to separate that coverage from the automobile exposure. The CGL coverage ends at the point where an item is picked up for loading onto an auto and resumes at the point where the item is deposited upon unloading.
Long tail – Refers to liability under policies written on an occurrence basis. Claims stemming from injury or damage occurring years earlier can be presented for coverage long after the policy has expired. Contrast with Claims-made.
Longshore and Harbor Worker’s Act – A federal law that specifies compensation amounts for injured longshore and harbor workers. Formerly referred to as the Longshoremen’s and Harbor Workers Act.
Loss – An unintentional decline or disappearance in value arising from an event.
Loss adjustment expenses – Payments by an insurer for the investigation and settling of claims. They include the cost of defending a lawsuit in court.
Loss assessment coverage – Insurance responding to property or liability losses of a property owners association that are not covered
by the association’s master policy.
Loss avoidance – A risk management technique whereby a situation or activity that may result in a loss for a firm is avoided or abandoned.
Loss control – Actions to reduce the frequency or severity of losses. Installing locks, burglar or fire alarms, and sprinkler systems are loss control techniques.
Loss control representative – Insurance company employees who perform loss control surveys or inspections and prepare written loss control reports outlining their findings. Also referred to as safety engineers.
Loss costs – Loss data that has been modified by insurance advisory organizations by necessary loss development, trending, and credibility processes in order to arrive at the statistical cost of losses to be used in establishing a premium rate.
Loss development – An actuarial method to detect and correct for consistent errors in estimating the amount of future loss payments or the procedure for adjusting incurred losses to reflect their future development and ultimate value. Loss development factors are developed actuarially and applied to current losses in order to predict what the ultimate cost of losses will be when the claims are closed. Loss expectancy – The underwriter’s calculation of probable maximum loss.
Loss experience – What the loss history has been on a particular line or book of business.
Loss exposure – A set of circumstances presenting the possibility of loss, whether or not the loss actually occurs.
Loss frequency – How often a loss occurs over a given space of time.
Loss history – The historical record of losses for a specific entity or group of entities.
Loss limit – Commonly used in financial institution bonds, a loss limit is the aggregate amount that will be paid out under the coverage during the policy term. Loss limits also may be used when insuring large property risks where the exposures are spread out geographically. In this type of situation, it is unlikely that all property would be damaged by a single occurrence. Therefore, the amount of insurance may be set at a loss limit per each covered occurrence.
Loss of maintenance fees coverage – This coverage protects a condominium association against the loss of maintenance fees when occupancies have been interrupted or impaired by the occurrence of any insured peril. This is a form of business interruption insurance for the association. It assures continuous income while the building is untenantable.
Loss of use insurance – See Additional living expense insurance.
Loss payable clause – A property policy provision that, at the request of the named insured, stipulates that claims tied to losses of certain property will be paid to both the named insured and the party named in the subject clause.
Loss payout pattern – Losses often are paid over a period of years, especially in casualty lines of insurance. The payout pattern illustrates the way that claims are paid out from the time they are filed until they are closed.
Loss prevention – Refers to engineering or inspection activities carried out to prevent losses in the workplace.
Loss ratio – The ratio of incurred losses including loss adjustment expenses to earned premiums.
Loss reserves – The company’s best estimate of what it will pay for claims, which is periodically readjusted. They represent a liability on the insurer’s balance sheet.
Loss runs – A company produced statement of what losses have been filed for a particular insurance policy during a particular time period. Such information may or may not include information on reserves and loss adjustment costs. Typically provision of such information is mandated by state law.
Loss trending – A method to modify developed losses for changes that will occur in the future. Trend factors are used by rate makers to adjust past losses to more accurately reflect the loss experience expected to develop while the rates are being used.
Loss triangle – Used to show how losses develop, a loss triangle is a chart that lists losses by line and by year. It shows the value of each set of annual losses at the end of subsequent 12-month periods.
Lost policy release – A means whereby an insured may cancel a policy by signing a statement to the effect that, since his or her policy has been lost, he cannot return it to the insurer to effect cancellation, but still wishes to cancel the policy.
MCS-90 – This is the Endorsement for Motor Carrier Policies of Insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980. The endorsement assures that the trucker carries insurance to comply with the financial responsibility requirements of the act.
Maintenance bond – Guarantees that faulty work or defective materials charged to the bond principals will be corrected or replaced. A maintenance bond may be included among the terms of a performance bond.
Malicious mischief – See Vandalism.
Malpractice – See Professional liability.
Managing general agent (MGA) – An agent standing between an insurer and other agents. The MGA sells to retail agents, who then sell to the consumer. MGAs often are said to have the pen because they are given the authority to accept, underwrite, and price submissions received from retail agents.
Manual rate – The cost of insurance protection as quoted in the rating manual—the rate listed on the state rate pages in the Basic Manual for a given class code. These rates are usually determined on the basis of per $100 of payroll. The term may also refer to rates developed by the application of a recognized rating plan.
Manufacturers and contractors liability (M&C) – The premises and operations liability exposures of manufacturers and contractors covering third parties for bodily injury or property damage negligently inflicted in the course of daily activities.
Manufacturers output policy (MOP) – Policy originally designed to cover property of a manufacturer being processed at another company; it covers personal property away from the premises on an open perils basis.
Manufacturers selling price clause – Clause stating that finished goods are valued for insurance purposes at their selling price rather than their cost of manufacture.
Manuscript policy – An insurance policy covering property or liability exposures (or both) that is uniquely assembled from standard or
Manuscript policy – An insurance policy covering property or liability exposures (or both) that is uniquely assembled from standard or
specially created forms to suit the needs of an insured.
Marine insurance – Insurance primarily concerned with transportation exposures and property that is commonly moved around from place to place. In the United States, the field is divided between inland marine and ocean marine.
Marine syndicates – Groups of companies acting in common to insure certain ocean marine classes. Also, a term used to describe groups which make inspections and surveys and institute standards for the construction of vessels.
Maritime coverage – Crew members of vessels are subject to admiralty law and may sue their employers for work-related injuries because state workers compensation laws do not apply to them. Therefore, special coverage must be purchased for this exposure. Market value – The price at which insured property could have been sold just prior to its loss or damage. Along with cost new minus use deprecation, market value is but another gauge used to determine the loss settlement to which an insured is entitled. The insured may choose the gauge that produces the most favorable outcome.
Market value appraisal – An appraisal to determine the market value of a building and related personal property.
Mass merchandising – Plan for insuring individual members of a group, such as employees of firms or members of labor unions, under a single program of insurance at reduced premiums. Property and liability insurance is sold to individual members using group insurance marketing methods.
Material circumstances – Any circumstances that would influence the judgment of a prudent underwriter in determining whether to accept a risk and the amount of premium to change.
Material representation – A statement made to the underwriter before acceptance of risk that is material to the decision in accepting and rating the risk.
McCarran-Ferguson Act – Passed by Congress in 1945, this act states that regulation and taxation of insurance by the states is in the public interest and that congressional silence should not be construed as a barrier to state regulation.
Medical malpractice – Type of insurance protecting physicians, surgeons, nurses, and other medical practitioners against claims alleging failure to perform.
Medical payments insurance – A coverage found in auto and liability policies that pays medical expenses to injured persons without regard to liability.
Mercantile risk – A term most often used in Property Insurance meaning a retail or wholesale risk as contrasted with a service risk, a manufacturing risk, or a habitational risk.
Merit rating – A form of auto rating in which an insured’s past experience as well as anticipated experience is taken into account when arriving at a rate.
Messenger robbery – Taking money or property from an employee away from the premises.
Mine subsidence coverage – An endorsement to a homeowners insurance policy, available in some states, for losses to a home caused by the land under a house sinking into a mine shaft. Excluded from standard homeowners policies, as are other forms of earth movement.
Minimum premium – An insurer’s lowest charge for an insurance policy.
Misrepresentation – Generally, misstatement of facts made on an application for insurance. May also be misstatement of coverage made by an agent to an insured.
Mobile equipment – Included for coverage under the commercial general liability form, this term relates to land vehicles used in ways that take them out of an explicit automobile liability exposure (e.g., vehicles used only on the insured premises, to carry certain permanently attached equipment, that are not required to be registered, or are designed for solely for off-road use).
Model bill – A bill drawn up for insurance regulatory purposes by the National Association of Insurance Commissioners with the recommendation that it be implemented by the states.
Money and securities (broad form) rider – A broad form of policy protecting against loss of money or securities. There is no coverage for losses caused by, among other things, employee infidelity.
Monoline policy – An insurance policy covering one subject of insurance, as opposed to a combination or multiline policy.
Monopolistic state fund – Five states have their own system for providing reparations to injured employees eligible under the state’s workers compensation act. Private insurance companies may not compete. The states are North Dakota, Ohio, Washington, West Virginia, and Wyoming.
Moral hazard – As physical hazard relates to susceptibility to fire or wind, the term moral hazard relates to susceptibility to loss through moral lapse of the owner (e.g., burn the house down and collect from the insurance company before losing it in a foreclosure to the finance company).
Morale hazard – Addresses the issue of an apathetic insured (e.g., it’s insured, let it burn).
Mortgage holders clause – A standard property policy provision that creates elements of a separate contract between a mortgage company and an insurance company. Any loss to building or structures will be paid to the mortgage company and insured jointly and any act of the insured voiding coverage will not affect the mortgage holder without it first being given an opportunity to comply with the insurer’s needs.
Motor Carrier Act of 1980 – A federal law that deregulated the United States trucking industry and transferred the enforcement of financial responsibility requirements for truckers to the Bureau of Motor Carrier Safety, U.S. Department of Transportation. Insurance is one method of complying with the financial responsibility requirements.
Motor truck cargo policy – Two forms of inland marine coverage are associated with this title, one for carriers and one for owners. As a carrier, the insured is protected for legal liability relating to property of others in the course of transport. As an owner, the insured is protected for in-transit damage to its own property.
Motor vehicle record (MVR) – An official record of a driver’s accidents and traffic violations kept by the licensing state(s). Often used to determine eligibility and/or premiums for auto insurance.
Multiline era – During the first half of the twentieth century, insurers were licensed to write property insurance or liability insurance but not both. Two insurers were needed to write automobile liability and physical damage insurance, for example, in a contrivance called a combination policy. Not long after World War II, states began licensing insurers to write both forms of insurance introducing what was then called the multiline era.
Municipal bond insurance – Coverage that guarantees bondholders timely payment of interest and principal even if the issuer of the bonds defaults. Offered by insurance companies with high credit ratings, the coverage raises the credit rating of a municipality offering the bond to that of the insurance company. It allows a municipality to raise money at lower interest rates. A form of financial guarantee insurance. See Financial guarantee insurance.
Municipal Bond Insurance Association (MBIA) – A group of insurance companies which insure payment of principal and interest on certain bonds.
Mutual insurance company – A cooperative insurance company organized and owned by its insureds.
Mysterious disappearance – A named peril in some forms. Either theft or unexplained disappearance of covered property from a known location may activate coverage.
known location may activate coverage.
NOC – Underwriter’s shorthand derived from general liability and workers compensation rating tables that stands for not otherwise classified meaning no more specific classification is available—as in Clerical Office Employees NOC.
Name schedule bonds – A type of public official or fidelity bond that lists the specific names and amounts of each named individual bonded. Name schedule bonds use one bond but attach a schedule of individual names of the bonded public officials. Each name will list a specific dollar amount for which that individual is being bonded. These may be used to bond a panel of city council members or similar body of officials.
Named insured – The party or parties specifically named as insured in the insurance contract. Others may have claim on the coverage of a policy by way of internal provisions but any such right is by way of the agreement between the named insured and the insurance company.
Named nonowner policy – Issued to someone who does not own an automobile but who drives borrowed or rented autos.
Named perils – A formal and specific listing of perils covered in a policy providing property insurance. A policy covering for damage by fire is said to cover for the named peril of fire.
Named schedule bond – A fidelity bond that covers persons listed or scheduled on the bond.
National Association of Independent Insurers (NAII) – An advisory organization and statistical agent for insurers with a membership including hundreds of casualty and surety companies of all types throughout the U.S.
National Association of Insurance Commissioners (NAIC) – An association of insurance commissioners and superintendents formed to share information and develop common laws and procedures for insurance regulatory purposes.
National Association of Insurance Women (NAIW) – An international association of women (and men) in the insurance industry. NAIW offers the designations of Certified Professional Insurance Woman (CPIW) or Man (CPIM).
National Association of Professional Surplus Lines Offices (NAPSLO) – Trade association of and providing services to surplus and excess lines agents and brokers.
National Council on Compensation Insurance (NCCI) – National association that collects, tabulates, and provides data used in formulating rates for workers compensation insurance.
National Flood Insurance Program (NFIP) – A federal program through which persons with property located in predefined flood plains can obtain flood coverage. See Flood insurance.
Nationwide Definition of Marine Insurance – A document published by the National Association of Insurance Commissioners that was rooted in an older (1933) definition of Insuring Powers of Marine and Transportation Underwriters. In general, the definition specifies property that may be insured under marine contracts such as property in inland transport and property regularly or routinely in transit, for example, contractors equipment.
Negligence – Action or failure to act that is outside the realm of what would be considered appropriate by ordinary, reasonably prudent
Net income – The total after-tax earnings generated from operations and realized capital gains as reported in the company’s NAIC annual statement page.
Net loss – The amount of a loss, after deductions for salvage, other insurance, and any subrogation, that an insurer is responsible for. Net premium – Premium less expense, such as commission.
New York Standard Fire Policy – Once the benchmark of property policies, it was adopted for use in all but a handful of states. The familiar provisions of its 165-numbered-lines survive in Insurance Service Office property policies as well as in independently produced forms.
Newly constructed or acquired property – An extension of coverage within a multiperil policy to new property purchased or added by the Named Insured. Normally such an extension has a value limit and a time period during which the Named Insured is expected to report the additional property and pay the appropriate premium.
No benefit to bailee – A clause in inland marine forms that prevents a person in the possession of property of others from benefiting from any insurance the owner has on the property.
No-fault auto insurance – A few states have laws that partially exempt drivers from legal liability for auto accidents. In these no fault states car owners buy insurance to protect themselves and their passengers from the economic and medical effects of auto accidents in addition to liability insurance at whatever limit the statute decrees. Professors Robert Keeton and Jeffrey O’Connell gave the no fault notion impetus with the 1967 publication of their study “After Cars Crash.”
Nonadmitted assets – Assets that are not included on the balance sheet, including furniture, fixtures, past-due accounts receivable, and agents’ debt balances. See Assets.
Nonadmitted insurers – See Excess or surplus lines market.
Nonconcurrency – The situation that exists when a number of insurance policies intended to cover the same property against the same hazards are not identical as to the extent of coverage. Nonconcurrency usually results in an insured not being fully covered for a loss. Modern forms have minimized the problem of nonconcurrency.
Noneconomic damages – Pain, suffering, inconvenience, loss of consortium, physical impairment, disfigurement, and other nonpecuniary damages.
Nonowned auto – This term signifies an auto that is neither owned, hired, nor borrowed by the insured under a commercial auto policy. Employees’ cars used in company business are commonly classified this way.
Nonrenewal clause – Provision in a policy that states the circumstances under which an insurer may elect not to renew someone’s policy.
Nonresident agent – An agent who does not reside in the state in which he or she is licensed.
Nonwaiver – An agreement between an insured and an insurer that a claim defense is being undertaken but without agreement that coverage is due. Usually the insured gives up some rights in exchange for the insurer undertaking the defense.
Normal course of transit – The orderly transit of merchandise from the point of origin to the final destination without interruptions or delays resulting from the action or inaction of any party at interest.
Nose coverage – This is the opposite of tail coverage, although it fulfills the same need. Nose coverage most commonly provides prior acts coverage for insureds who are moving from a claims-made coverage form to an occurrence coverage form. It is provided by the replacement policy.
Notice of loss – Notice the insured provides to the insurer that a loss has occurred.
Nuclear energy insurance pools – Any of the insurance pools designed to provide property and/or liability coverage for organizations that handle substantial quantities of nuclear material.
Nuisance value – The amount for which an insurance company will settle a claim—not because it is a valid claim but because the company considers it worth that amount to dispose of it.
Nullification – The act of declaring an insurance contract invalid from its inception so that, from a legal standpoint, the insurance
contract never existed.
contract never existed.
Object – See Boiler & machinery insurance.
Obligee – A term used in surety bonds to refer to the individual or firm that is to benefit from the bond’s protection. A performance bond, for example, provides the obligee property owner with recourse if the bonded contractor, the principal, fails to perform.
Obligor – A term used in surety bonds to refer to the individual or firm bound by an obligation. Also known as the principal.
Occupancy – In general, a condition affecting the desirability of property policies.
Occupational Safety and Health Act – Passed in 1970, this law promulgated strict work-safety regulations, and set up the mechanism to enforce these rules through fines for violations and closure of unsafe plants.
Occurrence – In general, an event that triggers coverage under any policy. Specifically, an event that triggers coverage under an occurrence-based liability policy. Such a policy covers injury or damage that occurs during the policy period even if claim is brought months or even years after the policy has expired. See Claims-made for the alternate arrangement. Also see Accident.
Ocean marine – Insurance coverage for vessels and property in ocean shipping. River marine is the term referring to coverage for
inland shipments on water. Motor truck cargo refers to coverage for property transported over highways.
Off premises cover – Commercial property policies commonly establish a small coverage limit that applies to property temporarily away from the insured’s place of business.
Omnibus clause – An agreement in most automobile liability policies and some others that extends the definition to include others without needing to name them. An example would be a policy that covers the named insured and those residing with him.
Open perils – Property coverage that applies to risks of loss on a general basis, in contrast with policies that cover for specifically identified perils. See Named perils. The old term for open perils was all risks.
Open rating – A state rating system that allows the insurer to use rates without prior approval. Also referred to as open competition. Operating ratio – The sum of the combined ratio plus investment income.
Ordinance or law coverage – This insurance responds to property loss or damage necessitating repair, demolition, or rebuilding in accordance with current building codes.
Ordinary payroll – Payroll allotted to employees whose services could be curtailed in event of a long term shutdown of a business without a harmful effect on reopening. This figure is important in calculating business income insurance exposures.
Other than collision insurance (automobile) – See Comprehensive physical damage (automobile).
Other insurance – When two or more policies cover the same interests for the same exposures, each policy is said to represent other insurance to the other. Most insurance policies contain clauses that specify how or if claims will be paid if other insurance exists for the same exposures.
Outer Continental Shelf Lands Act – This act makes the Longshore and Harbor Workers Compensation Act apply to work involving the development of the natural resources of the outer continental shelf. A special endorsement, the Outer Continental Shelf Lands Act Coverage Endorsement, amends workers compensation policies to provide coverage for this exposure.
Owners and contractors protective (OCP) liability coverage form – Provides coverage for the liability of an owner of land on which a building is being constructed for the acts of the contractor handling the construction.
Owners, landlords, and tenants legal liability (OL&T) – See Premises and operations liability.
Ownership of expirations – Refers to the ability of an independent agent to place a risk with any of the companies that he or she represents. Unless that customer goes to another agent, the current agent owns the policy and the right to place it as he or she sees fit.
PD – A shorthand expression for property damage.
Package policy – Any combination of insuring agreements that combines property and casualty coverages. Homeowners, businessowners, and garage policies are examples.
Paid losses – The losses that have been paid for a claim.
Pair and set clause – Clause that stipulates that partial loss to a pair or set of items will be valued in terms of the lost item, not on the basis of reduced value of the pair or set.
Partial loss – A property loss that is less than a total loss. See Constructive total loss.
Particular average – A loss which falls on the particular property insured, as opposed to a general average, which is a loss for the account of all interests. See also Average and General average.
Partnership – A business model in which two or more individuals join together to conduct business and share profit and losses. Commercial insurance policies usually differentiate in the Who Is Insured section among corporations, partnerships, and other business models. Therefore, the type of model being insured is important.
Pay-at-the-pump – A device for making sure all motorists are insured; the theory being that premiums for basic liability coverage could be collected through taxes at the gasoline pump in a relatively painless manner, thus eliminating the uninsured motorist.
Payment bond – Sometimes also called a labor and materials bond, this bond guarantees that bills owed by the contractor will be paid as they come due. The agreement may be incorporated into the performance bond.
Payroll audit – An examination of the insured’s payroll records by a representative of the insurer to determine the premium due on a policy for which payroll is the basis.
Peak season endorsement – Instead of buying insurance amounts reflecting values at the height of inventory, some enterprises are able to forecast times when values will be at their peak and use this endorsement to increase the amount of insurance during that specific interval.
Pen, The – See Managing General Agent (MGA).
Per diem business interruption – A type of business interruption policy which provides a stated amount to be paid for each day that the business is interrupted due to an insured peril.
Per occurrence/per loss excess reinsurance treaty – An agreement under which losses above a certain dollar amount are ceded to the reinsurer, who is responsible for all losses from any one exposure above this amount up to the reinsurance limit. The retention is expressed as an amount incurred per occurrence. An occurrence may be one hurricane, one flood, or one accident that results in injuries to multiple people.
Per risk excess reinsurance treaty – Similar to a per occurrence/per loss excess treaty except in the matter of the retention. The retention applies separately to each subject of insurance.
Performance bond – A bond that guarantees the property owner (the obligee) that the contractor with the winning bid on a job will perform as promised and on time.
Peril – A potential cause of loss.
Perils of the sea – Somewhat akin to open perils on land, the term refers to any potential cause of loss derived from shipment on a
Period of restoration – The period of time following a loss that is necessary to restore a business or organization to a preloss condition. Permit bond – A bond that guarantees a person who has been issued a permit will comply with any laws and ordinances in which the permit was issued.
Personal articles floater – Before the advent of packaged forms and broad coverages, households commonly had fire insurance on dwelling and personal property with the possible addition of extended coverage. The personal articles floater is an inland marine form that was used by the affluent for scheduling open perils coverage for various articles and classes of valuable personal property. A homeowners endorsement accomplishes the same thing today and the personal articles floater is no longer widely written.
Personal auto policy – The form currently promulgated by Insurance Services Office (ISO) for coverage of personal auto liability and physical damage exposures.
Personal effects – The property of an individual covered by the policy in question. Normally refers to items such as clothing, furniture, and jewelry.
Personal injury – Distinguished from bodily injury, this term relates to injury inflicted by way of false arrest, invasion of privacy, malicious prosecution, and so on. It is written as Coverage B of the commercial general liability forms and as homeowners Coverage E. Personal injury protection (PIP) – The section of an auto policy in a no-fault state that responds to the injuries of the insured such as physical injury or loss of income of the insured regardless of fault.
Personal liability insurance – Insurance for individuals or members of a household offering protection against claims by third parties (outsiders) alleging bodily injury or property damage due to negligence. See also Premises medical payments.
Personal lines – Insurance covering the liability and property damage exposures of private individuals and their households. Contrast with Commercial lines.
Personal property – Term used in insurance to distinguish chattels from real property.
Personal property floater – A broad policy covering all personal property worldwide, including insured’s domicile.
Physical damage – Damage to or loss of the auto resulting from collision, fire, theft, or other perils.
Physical hazard – A hazard that arises from the material, structural, or operational features of the risk itself apart from the persons owning or managing it.
Physicians and surgeons professional liability insurance – See Professional liability.
Pilferage – Petty theft, especially theft of articles in less than package lots.
Plate glass coverage – Provides special protection, except for the perils of war, nuclear reaction, and fire. This coverage is for full replacement cost and covers the expense of repairing frames, installing temporary plates, or boarding up openings.
Policy year – Unique to the insurance business, this is a means of cost accumulation in which the aggregate transactions of all policies becoming effective in a given year determine the financial performance of those policies.
Policyholder – See Insured.
Policyholders’ surplus – The amount of money available to an insurer to meet its obligations to its policyholders, after subtracting liabilities.
Political risk insurance – Coverage for businesses operating abroad against loss due to political upheaval such as war, revolution, or confiscation of property.
Pollutant cleanup and removal – An aggregate first party coverage that applies to the insured’s expense in extracting pollutants from land or water at the insured’s location if the release of the pollutants is caused by or results from a covered loss.
Pollution exclusion – Standard general liability policies include an exclusion for loss arising out of pollution. For certain exposures this exclusion may be modified, e.g., sudden and accidental pollution arising from a fire.
Pollution liability insurance – Coverage for bodily injury or property damage caused by a pollution incident. Insurance Services Office has two forms, one limited to on-site cleanup of pollution spills.
Pool – An organization in which insurers cover certain types of risks as a group and share premiums, expenses, and losses. Pools are often used to underwrite larger risks.
Portfolio – All of an insurer’s in-force policies and outstanding losses, respecting described segments of its business.
Position schedule bonds – A type of fidelity or public official bond, which lists specific positions and their corresponding penalty amounts. Position schedule bonds use one bond but attach a schedule of positions to be bonded. Each name will list a specific dollar amount for which that individual is being bonded. This type of bond may be used to bond certain positions that have a high amount of turnover. Using a position instead of a name will reduce the paperwork involved year-to-year.
Positional risk doctrine – A legal theory related to workers compensation statutory provisions. It infers that an employee’s injury arose out of his employment if the injury would not have occurred but for the fact that the employment placed the employee in a position to be injured by a neutral force, even though the force may not have been distinctly associated with the employment. Power-of-attorney – Commonly used in bonding, this document conveys authority for the individual(s) named on it to execute bonds
and other legal documents.
Premises – Generally, a piece of land with a building or buildings upon it.
Premises and operations liability – Once known as owners, landlords, and tenants legal liability, or as manufacturers and contractors liability, depending on the business’s activity, the term refers to the liability exposure of business entities to third parties (customers, guests, and passers by) who may become injured or have property damaged through the negligent acts of the business persons, their agents, or employees. Coverage of this exposure is by way of the commercial general liability policy. Contrast with Products and completed operations liability.
Premises and operations medical payments – Bodily injury rather than liability is the trigger for this coverage. Sometimes referred to as customer good will insurance, it is a relatively inexpensive addition to the commercial general liability policy and an automatic feature of personal liability protection. Since it responds to injury of customers or guests without regard to fault, it is sometimes effective in heading off a potentially much more serious liability claim against the owner or tenant of the business premises or private residence. Premium – The amount of money the insured pays the insurer to purchase insurance.
Premium auditor – A person who examines a liability insurance policyholder’s insurance records (e.g. sales or payroll) at the end of the policy term to determine if the basis for the premium charge has either increased or decreased.
Premium and dispersion credit – A method of allowing certain credits to large commercial property risks with two or more locations. These credits are based on the fact that there are several locations which are dispersed and, therefore, represent a reduced hazard. Efficiency of management in loss prevention, plus expense savings in handling large amounts of insurance under one policy are also considered.
Premium tax – A tax, imposed by each state, on the premium income of insurers doing business in the state.
Premium to surplus ratio – An insurance company’s surplus, the equivalent of capital and retained earnings or net worth for a manufacturing company, is the amount by which assets exceed liabilities. It provides a cushion for absorbing above-average losses. The premium to surplus ratio is designed to measure the adequacy of this cushion or the company’s financial strength. The ratio is computed
by dividing net premiums written by the surplus. A company that has $2 in net premiums written for every $1 of surplus has a 2-to-1
by dividing net premiums written by the surplus. A company that has $2 in net premiums written for every $1 of surplus has a 2-to-1
premium to surplus ratio. The lower the ratio, the greater the company’s financial strength. State regulators have established as a guideline a premium to surplus ratio no higher than 3 to 1.
Pressure vessel – In boiler and machinery insurance, a type of container designed to hold liquids or gasses under pressure. Types are categorized as fired (such as a boiler) and unfired (such as an oxygen or hydrogen tank).
Price-Anderson Act of 1957 – Federal law that requires evidence of financial responsibility for all privately owned nuclear reactors, spent fuel reprocessing plants, and for fuel fabrication plants licensed to process five or more kilograms of plutonium.
Primary insurance – The first policy or coverage to apply. Contrast with Excess insurance.
Principal – Used in suretyship, it refers to the individual whose performance is guaranteed.
Prior approval – Indicates that an insurer must have rate or form changes formally approved by the state insurance department before it can use them
Private passenger automobile – A four wheeled motor vehicle, subject to state registration laws, designed to carry passengers (such as a car, station wagon, SUV, or van) on public roads.
Pro rata cancellation – See Cancellation.
Probable maximum loss – The maximum amount of loss that one would expect under ordinary circumstances, such as fire departments responding or sprinklers working.
Producer – A term identifying the insurance agent, field rep, or other employee who sells insurance.
Product recall insurance – Coverage for the costs of recalling a product known, or suspected to be, defective.
Products liability – The liability for bodily injury or property damage incurred by a merchant or manufacturer as a consequence of some defect in the product sold or manufactured or the liability incurred by a contractor after he has completed a job as a result of improperly performed work. The latter described part of products liability is called completed operations.
Products and completed operations liability – The liability exposure of the manufacturer whose malfunctioning products may cause injury or property damage or of the contractor whose failed structures or projects may do the same. Coverage of the exposure is a feature of the commercial general liability policy. The insurance does not in any way constitute a guarantee of either the insured’s product or work. Contrast with Premises and operations liability.
Professional Insurance Agents (PIA) – Trade association of insurance agents.
Professional liability – A form of errors and omissions insurance, (sometimes called malpractice coverage for errors alleged against those in the healing and legal professions). Arbitrarily it seems, errors and omissions is the term applied most often to insurance covering liability for mistakes in matters affecting property, for example, coverage for insurance agents E&O, architects E&O—while professional liability is used in reference to coverages such as druggists professional liability, physicians and surgeons professional liability, and lawyers professional liability.
Promulgate – To develop, file, publish, and put into effect insurance rates or forms.
Proof of loss – Following a loss, a formal statement given by an insured to the insurer that includes details of the loss such as the original cost of damaged or destroyed property.
Property damage coverage – An insurance policy which pays for damage caused to the property of others, including cars, as a result
of a motor vehicle accident. Property damage coverage is often mandatory.
Property insurance loss register (PILR) – A computerized record of all fire losses over $500 established by the American Insurance Association (AIA). The PILR enables companies to determine undisclosed duplicate insurance coverage and patterns of losses on submitted risks.
Pro rata or proportional reinsurance – A certain portion of every risk is ceded under a proportional agreement. The insurer and reinsurer agree to share a portion of all insurance, premium, and losses in the same amount. The insurer is paid a commission for ceding the risk portion and premium to the reinsurer.
Prospect – A potential buyer of an insurance policy or program.
Protection and indemnity (P&I) insurance – The nautical equivalent of bodily injury and property damage liability.
Protection class – The grading of fire protection, determined by the Grading Schedule of Cities and Towns, for a given area. This designation is used for all fire rating except for dwellings, in which case the Dwelling Class is used.
Proximate cause – That event which, in an unbroken sequence, results in direct physical loss under an insurance policy. For example, wind is the proximate cause of loss when a windstorm blows out a window that in turn topples a lit candle that sets fire to a structure and burns it down.
Public adjuster – An individual or member of a firm who contracts with private parties to aid with the preparation of loss statements and presentation to insurers. Contrast with Independent adjuster.
Public liability insurance – Any liability coverage for claims brought against the insured by a third party or member of the public. Public official bond – A performance bond for holders of public office.
Punitive damages – An award for damages above and beyond the requirements for compensating third parties for injury or damage. As the word implies, the award is meant to punish the offender. Most states and territories permit punitive damages awards to be covered by liability insurance.
Purchasing group – An entity that offers insurance to groups of similar businesses with similar exposures to risk.
Pure risk – The only consideration is the possibility of loss or no loss but not making a profit. Contrast with Speculative risk.
Quota share reinsurance – A type of pro rata or proportional reinsurance agreement under which the insurer and reinsurer agree to share a predetermined portion of all insurance, premium, and losses. The primary insurer’s retention in a quota share agreement is expressed as a percentage of the amount insured.
Quote – An estimate of the cost of insurance based on information supplied to the insurance company by the applicant.
Railroad protective liability – Liability coverage designed to protect a railroad from liability claims arising out of the operations of others on or adjacent to railroad property.
Rain insurance – A weather coverage that indemnifies a promoter or organizer against loss of income because of the cancellation of an outdoor event due to rainfall that exceeds a specified amount during a specified time period.
Rate filing – Documentation filed by an insurer with the state requesting a change in the existing rates.
Rate regulation – The process by which states monitor insurance companies’ rate changes, done either through prior approval or open competition models.
Rating bureau – A private organization that classifies and promulgates manual rates (or loss costs).
Ratemaking – The statistical process by which insurers determine risks and pricing for the basic classes of insurance.
Real property – Land, buildings, and other structures (such as a swimming pool or tool shed).
Rebate – In insurance, a portion of an agent’s commission returned to a customer as an inducement to place the insurance through the
Rebate – In insurance, a portion of an agent’s commission returned to a customer as an inducement to place the insurance through the
agent. This practice is illegal in most jurisdictions as against public policy.
Receiving room coverage – As described under bailee’s coverage and bailee, this is a form of coverage to protect the insured against claims alleging loss or damage to property belonging to others but temporarily in custody of the insured. Within associations this may be dry cleaning left in a receiving room or a package left with a doorman.
Recipient location – A location which accepts the insured’s products or services. One of the four types of dependent properties for which business income coverage may be written.
Reciprocal exchange – A type of insurance managed by an attorney-in-fact in which members pay premiums and share in losses equally. Membership is required for insurance.
Reclamation bonds – A bond which guarantees that an institution will restore land, that it has mined or otherwise altered, to its original condition.
Redlining – Unfair discrimination based not on the risk’s characteristics but on its location. The term is commonly associated with an insurer’s refusal to consider insuring any home or business within a specific area marked by a line drawn on a map.
Reinsurance – The business of insuring insurance companies. By ceding a portion of its business to a reinsurance company, an insurer spreads the risk of exposure to catastrophic loss.
Reinsurance broker – An organization that places (brokers) reinsurance through a reinsurance underwriter—not to be confused with insurance broker.
Reinsurance facility – An alternative mechanism to service those insureds that cannot obtain insurance in the voluntary market. Premiums and losses for the business that is ceded to the facility are pooled and all insurers share according to their proportion of the voluntary market.
Reinsurer – See Reinsurance.
Removal – A provision of the New York Standard Fire Policy in which the insurer agreed to cover the cost of removing covered property from the path of a fire. Presently, property policies express the agreement in terms of preservation of property from imminent danger of damage from any covered peril. Not to be confused with debris removal.
Renewal – The extension of the term of coverage of an expired policy, commonly by replacement with another policy effective on the date of expiration of the previous policy.
Rent-a-captive – A specialized form of captive insurance company operation designed for businesses that do not want to own a captive but want to obtain some of the advantages offered by captives. A rent-a-captive is formed by a group of investors and operated as an income-producing business. Insureds who wish to participate rent space in the captive instead of setting up and capitalizing their own captive insurance company.
Rent insurance – A form of business income insurance for a landlord. It protects building owners against loss of income when the building cannot be rented because of damage from any of the insured perils. It provides income while an insured’s building is untenantable.
Rental value insurance – Refers to protection of either a landlord’s rental income or an owner-occupant’s economic stake in use of the subject structure. Either interested party can obtain coverage by way of an Insurance Services Office business income form.
Renters insurance – Term for insurance for the nonowner occupant of a dwelling or apartment.
Replacement cost – The cost of replacing property without deduction for depreciation. See Actual cash value.
Replacement cost appraisal – An appraisal that determines the amount required to replace an existing structure and related personal property.
Replacement cost insurance – Covers property—both building and contents—on the basis of full replacement cost without deduction for depreciation on any loss sustained, subject to the terms of the co-insurance clause.
Reporting form – A device for insuring values subject to extensive fluctuation that keeps the premium in line with the actual exposure. A maximum limit is set at policy inception and the insured is charged a deposit premium. Actual values are then reported, usually on a monthly basis, and earned premium is figured on the basis of those reports and laid off against the deposit premium.
Representation – The acceptance or rejection of an insurance risk and the amount of premium that would be required, is determined by information submitted by the person applying for such insurance. Statements which would normally lead the company to decline the acceptance of a risk, or to charge a much higher rate, are material to the risk and are commonly considered warranties. All other statements, such as the insured’s address, are referred to as mere representations to distinguish them from the more important statements considered to be warranties. The penalty for false information on material facts or warranties may be voiding of the policy. Reservation of rights – An arrangement in which an insurer agrees to proceed with the defense of a case without commitment to provide coverage, in the event that the facts disclosed during the trial reveal that the occurrence is not covered.
Reserves or reserved losses – The value of losses that have been estimated and set up for future payment.
Resident agent – A licensed agent who resides in and is licensed in the state in which business is being written.
Residence premises – In homeowners insurance, the dwelling, other structures and grounds, or that part of any other building where the named insured lives.
Residual markets – Insurance markets established outside the normal insurance marketing channels to cover unusually large or poor risks. Such markets include assigned risk plans, aircraft pools, nuclear pools, and certain government insurance programs.
Respondeat superior – A legal term referring to the fact that, under specific circumstances, an employer (or principal) is legally liable for the actions of his or her employees while in the course of their employment.
Retention – Usually used in reinsurance, this is the amount of liability retained by an insurer and not ceded to a reinsurer.
Retroactive date – The date that defines the extent of coverage in time under claims-made liability policies. Claims resulting from occurrences prior to the policy’s stated retroactive date are excluded.
Retrocessionnaire – A reinsurer that contractually accepts a portion of the cedant’s reinsurance risk. The transfer is called a retrocession.
Retrospective rating – A rating arrangement in which the final premium for insurance coverage is not determined until all claims are closed. The final premium is determined by the insured’s actual loss experience during the policy period.
Reunderwriting – The process by which the company reevaluates policyholders and, as necessary, imposes surcharges, deductibles, or nonrenewal in cases where the policyholder’s claims history or other experience presents a consistent pattern that creates an undue liability risk.
Rider – Another term for an endorsement attached to a policy that modifies the coverage.
Riot – One of the extended coverage perils, related to, but broader than, civil commotion.
Risk – Uncertainty concerning loss. Sometimes also used to refer to a piece of business or a submission to an insurer.
Risk and Insurance Management Society, Inc. (RIMS) – Trade association of risk managers and insurance buyers.
Risk-based capital – The need for insurance companies to be capitalized according to the inherent riskiness of the type of insurance
they sell. Higher-risk types of insurance, liability as opposed to property business, generally necessitate higher levels of capital.
Risk management – The process of handling pure risk by way of reduction, elimination, or transfer of risk, with the latter commonly
Risk management – The process of handling pure risk by way of reduction, elimination, or transfer of risk, with the latter commonly
achieved through insurance.
Risk manager – The individual in an organization responsible for evaluation of the organization’s exposures and controlling those exposures through such means as avoidance or transference, as to an insurance company.
Risk purchasing group (RPG) – A group of similarly situated persons or entities that are permitted under federal law to organize across state lines to buy insurance. The carrier that sells insurance to the group must be licensed in at least one state but need not be licensed in every state where a member of the group resides.
Risk retention group (RRG) – An insurance company chartered under the laws of a state or other U.S. jurisdiction, composed of members whose business activities are similar, and controlled by its members.
Robbery – The felonious taking, either by force or by fear of force, of the personal property of another, commonly known as a hold-up. Rolling store – A vehicle out of which goods are sold. An example would be a mobile snack bar at a construction site. Insurance policies may contain wording that may restrict or define available coverage for this type of operation.
Running down clause – Additional coverage which can be added to an ocean marine hull policy to provide protection for damage to another ship caused by collision.
SIG – A self-insured group. A SIG is a group of risks, usually sharing common characteristics or exposures, that join together in order to generate enough premium volume to justify self-insuring themselves. Members of a SIG often are jointly and severally liable for the losses of one another.
Safe depository coverage – Covers property in a safe deposit box on either a legal liability basis or direct basis, regardless of liability. Safe driver plan – Merit rating of automobile insurance. In most states drivers are charged with points for traffic violations and auto accidents. These points translate to surcharges on the drivers’ insurance rates.
Salvage – When an insurer makes a payment for lost or damaged property, the insurer is entitled to the salvage of that property. Schedule – List of items on a policy declaration, sometimes also showing descriptions and values.
Schedule rating – A debit and credit plan that recognizes variations in the hazard-causing features of an individual risk.
Scheduled property floater – An inland marine form of policy specifically insuring various individual items. Articles of unusual value, provided they are movable, may normally be written this way and insured against many hazards, often against all risks.
Seasonal risk – A risk that is present only during certain parts of the year. For example seasonal dwellings such as cottages used for vacations.
Self-insurance – An insurance-like strategy for handling one’s own exposures to loss supported by the financial wherewithal to meet expected losses. Not to be confused with a decision to forego insurance.
Self-insured retention (SIR) – That portion of pure risk an insured undertakes to handle on his or her own. A deductible is a form of self-insured retention.
Selling price clause – Applicable to the value of goods which have been damaged or destroyed by an insured peril. This clause insures the profit that would have been earned if the goods had been sold. It sets the insurable value of the property that has been sold, but not delivered, at the amount at which it was sold, less any charges not incurred.
Severability – A provision that insurance applies separately to each insured under the policy.
Sewer back-up coverage – An optional part of homeowners insurance that covers damage done by sewer back-up.
Shock loss – Name given to any large loss that impacts an otherwise profitable book of business.
Short rate cancellation – See Cancellation.
Short tail – Additional coverage that may be purchased under a claims-made policy that responds to losses that may have occurred during a policy period but are not reported until after the end of the policy period. Usually available for no longer than a year.
Sidetrack agreement – The contract between a business and a railroad wherein a railroad builds a track onto the business’s property to facilitate shipping, and the business agrees to release the railroad from liability.
Sine qua non rule – A legal rule stating that a person’s conduct cannot be held to be the cause of a loss if the loss would have occurred anyway.
Single interest policy – A policy that insures the interest of only one party in property where there are a number of parties having an insurable interest.
Sinkhole peril – Risk of loss by collapse of a sinkhole.
Sistership exclusion – An exclusion in products insurance that eliminates coverage for the withdrawal or recall of products.
Slander – The oral utterance or spreading of falsehood harmful to another’s reputation. Libel is written; slander is spoken.
Sliding scale dividend plan – Often used with workers compensation insurance, dividend plans are established as a means of returning a portion of the premium to the policyholder if losses are better than expected and the insurance company board of directors declares a dividend. In a sliding scale plan, the amount of the potential dividend slides up or down according to the loss experience. Dividends cannot be guaranteed; they are paid upon declaration by the insurer’s board of directors.
Slip – At Lloyd’s of London, a document that identifies which syndicates are participating on a risk and for what percentage.
Smoke damage – An extended coverage peril. See Extended coverage peril.
Society of Chartered Property & Casualty Underwriters – Professional society of those having attained the CPCU designation. See CPCU.
Soft costs and rents – Related to builders risk insurance, these are the necessary expenses that are incurred because a building project is delayed as the result of a covered property loss. Included are expenses such as increases in architectural fees, loss of rents because the project completion date is later than planned, or increased interest expense.
Soft market – A term given to a condition in which insurance is relatively inexpensive and easy to obtain.
Solicitor – An employee of an insurance agent or agency who is empowered to sell insurance on behalf of a licensed agent, generally using only those insurers that the agency represents. A solicitor usually does not have binding authority, and the business that is generated by a solicitor usually is owned by the agent, not the solicitor.
Solvency – Insurers must have sufficient assets (capital, surplus, reserves) in order to satisfy statutory financial requirements (investments, annual reports, examinations) and to meet liabilities.
Special agent – An insurer’s representative in a territory who serves as a liaison between the insurer and the agent. The special agent is responsible for the volume and quality of the business written in that territory. Some states require a special license of special agents. Special form – In contrast to the named perils forms in property insurance, those forms that list specific perils for coverage, the special form contract covers simply risk of direct physical loss, relying on exclusions to limit and define the protection intended. See Open perils. Special risk insurance – Coverage for risks or hazards of a special or unusual nature.
Specific excess reinsurance – Another term for per occurrence/per loss excess reinsurance.
Specific insurance – An insurance policy that covers only property specifically described in the policy, as opposed to blanket insurance which usually covers all property at specified locations.
Specific rate – A rate applying to an individual piece of property.
Specimen policy forms – Forms that are often requested when nonstandard coverage forms are being used. The specimen form may be reviewed to determine the actual policy provisions before coverage is bound.
Speculative risk – Risk that entails a chance of gain as well as a chance of loss. Contrast with Pure risk.
Split limits – As in auto insurance, where rather than one liability amount applying on a per-accident basis, separate amounts apply to bodily injury and property damage liability.
Spread of risk – The selling of insurance in multiple areas to multiple policyholders to minimize the danger that all policyholders will have losses at the same time. Companies are more likely to insure perils that offer a good spread of risk. Flood insurance is an example of a poor spread of risk because the people most likely to buy it are the people close to rivers and other bodies of water that flood. See Adverse selection.
Sprinkler leakage insurance – Insurance that covers damage due to the accidental discharge from an automatic sprinkler system. Sprinklered risk – Property protected against fire by a system of overhead pipes with regularly spaced heads designed to melt at the heat of a fire, thus releasing water for extinguishment.
SR-22 – A form from the motor vehicle department that shows a driver holds auto insurance. Many states require it for high-risk drivers or before a suspended or revoked license can be reinstated.
Stacking of limits – The application of the limits of one or more insurance policies to a claim or loss.
Standard fire policy – See New York Standard Fire Policy.
State of domicile – The state in which the company is incorporated or chartered. The company is also licensed (admitted) under the state’s insurance statutes for those lines of business for which it qualifies.
State fund – A fund set up by a state government to provide a specific line or lines of insurance, such as workers compensation.
State insurance department – An administrative agency that licenses insurers to do business in that state, implements state insurance laws, and supervises (within the scope of these laws) the activities of insurers operating within the state.
Stated amount – Amends the valuation clause on a policy to include an amount that is stated as the value of the item(s) being insured. Usually, these policies pay the lesser of the actual cash value of the damaged property, the cost of repairing or replacing the property, or the stated amount.
Statement of values – The information required when a single rate is to cover more than one item or building. To determine a correct average, the rating bureau requires the policyholder to give the value of each separate risk and its contents.
Statutory accounting principles (SAP) – Statutorily mandated accounting principles and practices that must be followed when an insurance company submits its annual financial statement to the department of insurance. The principal objective of statutory accounting is to provide a framework for a conservative measurement of an insurer’s surplus. In contrast to Generally Accepted Accounting Principles (GAAP), which are followed by most other businesses. See GAAP accounting.
Steam boiler explosion – See Boiler & machinery insurance.
Stock – Merchandise held in storage or for sale, raw materials, and in-process or finished goods, including supplies used in their packing or shipping.
Stock insurance company – An insurance company owned by its stockholders who share in profits through earnings distributions and increases in stock value.
Stop loss – A provision in an insurance policy that cuts off an insurer’s losses at a given point. In effect, a stop loss agreement
guarantees the loss ratio of the insurer.
Stopgap endorsement – Provides employer liability coverage for work-related injury arising out of incidental operations or exposure in the states that have monopolistic state funds.
Strict liability – Liability ascribed to a manufacturer or seller of a defective or dangerous product regardless of any fault or negligence. Subrogation – The right of one party who has paid for the loss of a second party to obtain recompense from the third party who is responsible for the loss. For example, an insurance company becomes subrogated to the rights of its insured to the extent of the insurer’s payment for collision damage caused by the negligence of the other driver.
Subsidence – A form of earth movement, excluded in most property policies.
Substandard risk – A risk falling outside normal underwriting standards. If written at all, it is usually with a substantial premium surcharge.
Sue and labor clause – A marine insurance clause comparable to removal in property insurance.
Summons – A legal document demanding the presence of the named individual at a court hearing.
Superfund – The better-known name for the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) passed by Congress in 1980. Under this law, parties found responsible for polluting a site must clean up the contamination or reimburse the EPA for doing so. Liability is strict, retroactive, joint and several.
Superintendent of insurance – In some states the commissioner of insurance is known as the superintendent.
Superseded suretyship – The acceptance, in a bond, of liability for claims that cannot be recovered from the prior bond because its discovery period has ended. The discovery period is normally one year.
Supplemental extended reporting period – An optional reporting period that allows coverage for liability claims made after the policy period.
Supply bonds – Bonds which guarantee performance of a contract to furnish supplies or materials. In the event of a default by the supplier, the surety indemnifies the purchaser of the supplies against the resulting loss.
Surety – See Bond.
Surety Association of America (SAA) – A voluntary, nonprofit, unincorporated association that is licensed as a rating or advisory organization for surety and fidelity insurance in all states, D.C., and Puerto Rico. The SAA handles statistical information, filings, publications, and surety and fidelity bonds.
Surety bond – A three-party agreement guaranteeing that a principal will carry out the contractual obligations the principal has agreed to perform or, alternatively, to compensate the other parties to the contract for losses resulting from the principal’s failure to perform. Under many surety bonds, the principal is a contractor.
Surface water – Commonly known as water on the surface of the ground usually created by rain or snow that is of a casual or vagrant character, following no definite course and having no substantial or permanent existence. Some insurance policies may include surface water as a covered peril but exclude flood when defined as the overflowing of water from its natural boundaries, such as a lake or river. Surplus – The amount by which an insurer’s assets exceed its liabilities.
Surplus lines – See Excess & surplus lines market.
Surplus share reinsurance – A type of pro rata or proportional reinsurance agreement under which the insurer and reinsurer agree to share a predetermined portion of all insurance, premium, and losses. The primary insurer’s retention in a surplus share agreement is stated as a dollar amount of the amount insured.
Survey – In cargo insurance, an examination of damaged property to determine the cause, extent, and value. In hull insurance, an
inspection of the ship to help determine its insurability or, after a loss, the cause, and extent of damage.
inspection of the ship to help determine its insurability or, after a loss, the cause, and extent of damage.
Syndicate – An association of insurers that work together to insure an especially large or hazardous risk. Also see Pool.
TPA – A third party administrator. A TPA is a contractor who adjusts and administers insurance claims.
Tail coverage – Coverage for claims made after a claims-made liability policy has terminated; the extended reporting or discovery period. See Nose coverage.
Temporary worker – An employee hired on a short term, often seasonal, basis.
Tenancy in common – The form of property ownership in which each owner owns an undivided interest in real property. In a condominium, all owners have tenancy in common interest in common areas.
Tenants improvements and betterments – See Improvements and betterments.
Tenant’s policy – A package policy specially designed to meet the normal insurance requirements of a private tenant covering personal belongings and liabilities.
Territorial rating – A method of classifying risks by geographic location to set a fair price for coverage. The location of the insured may have a considerable impact on the cost of losses. The chance of an accident or theft is much higher in an urban area than in a rural one, for example.
Terrorism Risk Insurance Act (and extension) (TRIA) – A federal law that sets up a temporary program to allow the insurance industry and federal government to share losses according to a specified formula in the event of a major terrorist attack.
Testing exclusion – In boiler and machinery insurance, a provision that excludes coverage for any object while it is being tested.
Theft – Any act of stealing. Theft includes larceny, burglary, and robbery.
Third party – An outsider; a business or personal invitee or a party with absolutely no connection to an insured who may become a claimant under a form of public liability coverage because of injury or property damage alleged to have been caused by the negligence of the insured.
Threshold level – The point at which an injured person may bring tort action under a modified no-fault auto plan. Many no-fault plans allow only tort action for pain and suffering after medical bills exceed some figure, like $1,000, or if disfigurement or death occurs.
Tight market – See Hard market.
Time element coverage – Insurance in which the element of time has heavy bearing on the extent of loss. Business income insurance covers loss of income for the unknown duration of the insured’s business interruption.
Title insurance – Insurance that indemnifies the owner of real estate in the event that someone challenges his or her ownership of property, due to the discovery of faults in the title.
Tort – A wrong for which a civil (as opposed to criminal) action can be brought. Many tort claims arise from negligence.
Total loss – A loss of sufficient size so that it can be said there is nothing left of value. The complete destruction of the property. The term is also used to mean a loss requiring the maximum amount a policy will pay.
Trailer interchange agreement – An arrangement among truckers whereby trailers may be moved along by the tractors of one or more parties to the agreement.
Transfer of risk – A basic underlying principle of insurance, whereby the risk of financial loss is transferred from one party to another. Transit coverage – Coverage of the insured’s property while in transit over land from one location to another. Property insurance policies typically provide coverage only at locations identified in the policy.
Treaty reinsurance – An agreement in which the ceding company agrees in advance to cede certain classes of business or types of insurance to a reinsurance company. The reinsurer agrees to accept all risks or losses that fall within the terms of the agreement.
Trend – A factor applied to indemnity (medical) loss ratio to adjust for future inflation relative to exposure.
Trip transit – Covers goods in transit in a specified way, such as rail or truck.
Tuition fees insurance – Covers school for loss of tuition fees from fire or other peril.
Twisting – The practice of inducing by misrepresentation, or inaccurate or incomplete comparison, a policyholder in one company to lapse, forfeit, or surrender his insurance for the purpose of taking out a policy in another company.
Umbrella liability insurance- A liability contract with high limits covering over top of primary liability coverages and, subject to a self- insured retention (deductible), covering exposures otherwise uninsured.
Unallocated loss adjustment expenses (ULAE) – Claims expenses of a general nature not directly attributable to specific claims. They include the salaries of claims personnel and the other costs of maintaining a claims department.
Underground storage tank (UST) – Tanks sunk in the ground that are used to store or dispose of gasoline or other fuels, hazardous chemicals, or other pollutants or contaminants.
Underinsured motorists coverage – Coverage for the insured and passengers whenever the at-fault driver in an accident has auto liability insurance with lesser limits than the insured’s. This coverage lies atop uninsured motorists coverage or atop the at-fault driver’s low limit automobile liability insurance and provides the insured and passengers with protection equal (usually) to the insured’s own automobile liability cover.
Underlying insurance policy – The policy providing initial coverage for a claim until its limit of liability is reached and an umbrella or excess policy’s coverage is triggered.
Underlying limits – The limits of liability of the policy(ies) underlying an umbrella or excess policy.
Underwriter – One who researches and then accepts, rejects, or limits prospective risks for an insurance company.
Underwriters Laboratories, Inc. (UL) – Originally begun as a cooperative of western fire insurers to test materials, the UL is now an independent organization testing virtually every fabricated device and material. Items are permitted to bear the UL seal of approval only after they have passed stringent testing for safety.
Underwriting income – The insurer’s profit on the insurance sale after all expenses and losses have been paid. When premiums aren’t sufficient to cover claims and expenses, the result is an underwriting loss. Underwriting losses are typically offset by investment income. Unearned premium – That portion of an insurance premium that would have to be returned to the insured if the policy were canceled. Unearned premium reserve – A reserve equal to an amount of net premium written but not yet earned.
Unilateral contract – A contract such as an insurance policy in which only one party to the contract, the insurer, makes any enforceable promise. The insured does not make a promise but pays a premium, which constitutes his part of the consideration.
Uninsurable risk – An uninsurable risk is one that is literally uninsurable because loss is certain rather than possible.
Uninsured motorists coverage – Coverage for the insured and passengers whenever the at-fault driver in an accident has no auto liability insurance. Coverage is usually to the extent of limits required by state auto financial responsibility laws.
Unit owners excess coverage – This type of insurance expands a condo unit owner’s insurance coverage to include damage or loss to alterations, fixtures, and improvements within individual units owned by the unit owner, caused by the insured perils. This includes damage to air conditioners, clothes washers, clothes dryers, cooking ovens, cooking ranges, dishwashers, floor coverings, countertops,
kitchen cabinets, refrigerators, and freezers. This coverage applies only as excess insurance over any other valid and collectible insurance that would apply in the absence of this policy.
United States Longshore and Harbor Workers Compensation Act (USL&H) – A compulsory law administered by the Department of Labor that covers injuries to employees on vessels or drydocks.
Unlimited liability – Requirement that the owner or owners assume full responsibility for all losses or debts of a business.
Unoccupied – Where the premises contain contents but no human beings, such persons being temporarily away from the premises, on vacation for example, the premises are said to be unoccupied. This is distinguishable from vacant in that in vacancy, the contents have been moved out leaving nothing but the building.
Unprotected – A property located in an area not regularly serviced by a fire department.
Unsatisfied judgment fund (UJF) – In some states a person who is injured in an automobile accident and who cannot collect from the person responsible may collect from a special fund.
Utmost good faith – A basic principle of insurance. Mutual trust in negotiating an insurance contract. The insured and the 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.
Vacant property – Once defined as devoid of occupants or contents, a stricter definition is being applied as more and more communities find older buildings of three and four stories that are only one quarter occupied. Property policies impose limitations on coverage of vacant buildings so the (changing) definition of vacant property is quite important.
Valuable papers coverage – Provides all risk coverage on valuable papers, such as written, printed, or otherwise inscribed documents and records, including books, maps, films, drawings, abstracts, deeds, mortgages, and manuscripts. It covers the cost of research to reconstruct damaged records, as well as the cost of new paper and transcription.
Valuation – To estimate the value of a piece of property usually by considering its replacement cost or its actual cash value. Factored into the estimate is any depreciation or wear and tear.
Value reporting form – Commercial form designed for businesses that have fluctuating merchandise values during the year. As values are reported (monthly, quarterly, or annually), the amount of insurance is adjusted. Reporting forms help eliminate problems of over- insurance and under-insurance, as well as the need to continually endorse a policy.
Valued policy – See Agreed amount clause.
Valued policy laws – Laws existing in some states which apply primarily to buildings. The laws differ but, in general, they state that in case of a total loss the amount of insurance is the agreed amount of loss.
Vandalism and malicious mischief – Once treated as a separate peril to be added to a property policy or not, current property forms routinely include the protection.
Verbal threshold – Term in no-fault auto insurance, applicable in some states, that says that victims are allowed to sue in tort only if their injuries meet certain verbal descriptions of the types of injuries that render one eligible to recover for pain and suffering.
Vested commissions – Commissions on renewal business which are paid to the agent whether or not he or she still works for the insurance company with which the business is placed.
Vicarious liability – The condition arising where one person is responsible for the actions of another, as a parent is often held responsible for the vandalism damage a minor child does to a school.
VIN – The vehicle identification number (VIN) on a vehicle. This number is usually found on the dashboard of the vehicle on the driver’s side and is usually listed on the vehicle registration and title. The VIN is a combination of letters and numbers seventeen characters in length that can be used to identify the make, model, and year of a car.
Waiver of subrogation – An insurer has the right of subrogation; however, it may waive that right through this method.
War risk – Special coverage on cargo in overseas ships against the risk of being confiscated by a government in wartime. It is excluded from standard ocean marine insurance and can be purchased separately. It often excludes cargo awaiting shipment on a wharf or on ships after fifteen days of arrival in port.
Warehouse to warehouse – Coverage from a shipment’s point of origin to its destination, even if these points are inland.
Watchman warranty clause – A provision often found in a burglary or fire policy providing for a reduced premium if there is a watchman on duty.
Wear and tear exclusion – A common heading for an all risks exclusion relating to a group of events that do not represent risk at all. Property will become worn out and torn; it will rust, settle, become rotted, infested, marred, or scratched. It is easy to distinguish however between the marring that occurs over time (excluded) and marring that occurs when a concrete block is dropped onto a fine wooden table.
Weather insurance – A type of business interruption insurance that compensates for financial losses caused by adverse weather conditions.
Whole dollar premium – The practice of many insurers to round premiums to the nearest dollar, rather than carrying them out to the nearest cent. An amount of 51 cents or more is usually rounded up to the next dollar, and any cents amount less than that is dropped.
Workers compensation insurance – Coverage that conforms to the workers compensation laws of the states in which it written. See also Employers liability insurance.
Workers compensation self-insurers bond – Workers compensation laws, at the state and federal level, require employers to compensate employees injured on the job. An employer may comply with these laws by purchasing insurance or self insuring by posting a workers compensation bond to guarantee payment of benefits to employees. This is a hazardous class of commercial surety bond because of its long-tail exposure and potential cumulative liability.
Wrap up – A liability coverage specialty focused on contracting risks, attempting to manage in a single contract the broad interplay of exposures and interests among owners, general contractors, and subcontractors.
Write Your Own (WYO) Program – A cooperative undertaking of the insurance industry and the Federal Insurance and Mitigation Administration begun in October 1983. The WYO Program operates within the context of the NFIP and involves private insurance carriers who issue and service National Flood Insurance Program policies.
Written premiums – The entire amount in premiums due in a year for all policies issued by an insurance company.
Wrongful acts – This is the basic covered injury or damage in a directors and officers policy. Such acts include unintentional negligent acts, omissions or breaches of duty, or errors relating to the operation of the community association. What is a wrongful act varies from policy to policy. Some D&O policies add advertising injury and personal injury to wrongful act coverage.
XCU – Short for explosion, collapse, and underground, this acronym is used to denote that certain construction projects carry this
Y2K – An abbreviation for Year 2000. The Y2K problem resulted from the use of two-digit year fields in computer software codes and silicon chip technology. Because of this, the software or chip cannot recognize 00 as the year 2000 instead of 1900 or doesn’t recognize it at all.
Zone system – Developed by the NAIC for the triennial examination of insurers. Under the system, teams of examiners are formed from the staffs of several states in each of the geographical zones. The results of their examinations are then accepted by all states in which an insurer is licensed without the necessity of each state having to conduct its own examinations.
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting or other professional service. If legal advice is required, the services of a competent professional person should be sought.