Insurance Information
Death and Dismemberment An added benefit rider that can be attached to a life insurance policy that provides monetary payment for the loss of function of vital limbs or organs. Death Benefit A payment made to a designated beneficiary upon the death of the employee annuitant. Debenture A bond that is backed only by the general credit of the issuing corporation. No specific property is pledged as security behind the loan. Declarations Statements in an insurance contract that provide information about the property or life to be insured. Used for underwriting and rating purposes and for identification of the property or life to be insured. Declination The insurer's refusal to insure an individual after careful evaluation of the application for insurance and any other pertinent factors. Deductible An amount which a policyholder agrees to pay, per claim or per accident, toward the total amount of an insured loss. Deferred Annuity An annuity providing for the income payments to begin at some specified future date. Depreciation A decrease in the value of property over a period of time due to wear and tear or obsolescence. Depreciation is used to determine the actual cash value of property at time of loss. (See Actual Cash Value) Direct Loss Financial loss in damages that results directly from an insured peril. Disability A physical or a mental impairment that substantially limits one or more major life activities of an individual. It may be partial or total. (See Partial Disability; Total Disability.) Dismemberment Loss of body members (limbs), or use thereof, or loss of sight due to injury. Disposable Personal Income The personal income less personal tax and other financial obligations or payments. It is the income available to people for spending and saving. Double Indemnity A policy provision usually associated with death, which doubles payment of a designated benefit when certain kinds of accidents occur. Down Payment The premium deposit paid by a prospective policy holder when an application is made for an insurance policy. It is usually equal, at least, to the first month's estimate premium and is applied toward the actual premium when billed.
Insurance Information
Cancellation The discontinuance of an insurance policy before its normal expiration date, either by the insured or the company. Captive Agent A licensed insurance agent who sells insurance for only one company. Captive Insurance Company A company owned solely or in large part by one or more non- insurance entities for the primary purpose of providing insurance coverage to the owner or owners. Casualty Insurance Insurance concerned with the insured's legal liability for injuries to others or damage to other persons' property; also encompasses such forms of insurance as plate glass, burglary, robbery and workers' compensation. Catastrophe Event which causes a loss of extraordinary magnitude, involving a large number of people, such as a hurricane or tornado. Cede To transfer all or part of a risk written by an insurer (the ceding, or primary company) to a reinsurer. Certificate of Insurance A statement of coverage issued to an individual insured under a group insurance contract, outlining the insurance benefits and principal provisions applicable to the member. Cession Amount of the insurance ceded to a reinsurer by the original insuring company in a reinsurance operation. Claim A request for payment of a loss which may come under the terms of an insurance contract. Claimant Vehicle Vehicle owned or driven by another party involved in a loss. Claims Adjuster Person who investigates and/or settles claims - an agent, company adjuster, independent adjuster, adjustment bureau, or public adjuster Class Factor Class factors (also referred to as driver class factors) are based on the age of the driver and the usage of the vehicle. It is one of the main components used in rating auto policies. The factor is applied to the base rate and specific coverages. Collision A form of insurance protecting the insured against loss resulting from any damage to the insured's vehicle caused by collision with any object whether or not it was the insured's fault. Requires comprehensive coverage. Collision for Rental Vehicle Collision coverage, which may be purchased on liability only policies to cover rented vehicles. Coverage only available in state of Alaska. Collision Full Glass No deductible for glass damage resulting from a collision. Deductible applies to all other damage. Collision Liability Buy Back Available in Michigan, this coverage will pay the $500 that a Michigan resident is responsible for if they damage the property of another in an at fault accident. Collision Waiver Deduction Collision deductible would be waived ONLY if vehicle is damaged by an AT-FAULT uninsured motorist. Requires CL and UMBI. Coverage only available in state of California Combined Ratio Basically, a measure of the relationship between dollars spent for claims and expenses and premium dollars taken in; more specifically, the sum of the ratio of losses incurred to premiums earned and the ratio of commissions and expenses incurred to premiums written. A ratio above 100 means that for every premium dollar taken in, more than a dollar went for losses, expenses, and commissions. Combined Single Limit Liability limits that specify a single dollar amount for combined Bodily Injury and Property damage, without showing specific limits for each indiviudal coverage. For instance the combined single limit for the policy is $100,000. The individual coverages are not given specific limits and limited only by the aggregate amount of coverage. Commercial Auto Insurance Provides coverage to a business for losses that arise out of vehicles which are owned or used by the business. Commercial General Liability Policy Commercial liability policy drafted by the Insurance Services Office containing two coverage forms-an occurrence form and a claims-made form. Commercial Lines A general term for any type of insurance (property, casualty, health, life, etc.) purchased by businesses, organizations, institutions, governmental agencies or other commercial establishments to protect risks associated with their operations. Commission The part of an insurance premium paid by the insurer to an agent or broker for his services in procuring and servicing the insurance. Commissioner A state officer who administers the state's insurance laws and regulations. In some states, this regulator is called the director or superintendent of insurance. Comparative Negligence Under this concept a plaintiff (the person bringing suit) may recover damages even though there is contributory negligence. His or her recovery, however, is reduced by the amount or percent of that negligence. Comprehensive Loss caused by factors other than collision: ex. Missiles or falling objects; fire; theft or larceny; explosion or earthquake; windstorm; hail; water or flood; malicious mischief or vandalism; riot or civil commotion; contact with a bird or animal; or breakage of glass. Comprehensive Full Glass Comprehensive with no deductible for glass damage only. Deductible does apply to other comprehensive losses. In FL, CPG applies to windshield ONLY. Coverage not available in every state. Comprehensive Personal Liability Insurance Protection against loss arising out of legal liability to pay money for damage or injury to others for which the insured is responsible. It does not include automobile or business operation liabilities. Refers to the general liability (not auto related) exposures that accompany a person's non-business activities. For example, your dog bites someone or you hit someone with a golf ball. This coverage is generally available to our Fulltimers as a form of coverage to replace their Homeowner's Liability that they lose when they sell their house and RV Fulltime. Comprehensive Rental Vehicle Comprehensive coverage, which may be purchased on a liability-only policy to cover rented vehicles. Available only in AK. Compulsory Auto Liability Insurance Insurance laws in some states require motorists to carry at least certain minimum auto coverages. Concealment Deliberate failure of an applicant for insurance to reveal a material fact to the insurer. Concurrent Causation Legal doctrine that states when a property loss is due to two causes, one that is excluded and one that is covered, the policy provides coverage. Consideration One of the elements for a binding contract. Consideration is acceptance by the insurance company of the payment of the premium and the statement made by the prospective policyholder in the application. Consumer Report A variety of information about the consumer including, prior loss reports (PLR), motor vehicle reports (MVR), and credit score. Contract A binding agreement between two or more parties for the doing or not doing of certain things. A contract of insurance is embodied in a written document called the policy. Contractual Liability Legal liability of another party that the business firm agrees to assume by a written or oral contract to a declared limit. Contribution by Equal Shares Type of other-insurance provision often found in liability insurance contracts that requires each company to share equally in the loss until the share of each insurer equals the lowest limit of liability under any policy or until the full amount of loss is paid. Contributory Negligence Any negligence on the part of the plaintiff which contributed to the cause of the accident may bar the plaintiff from recovery against a negligent defendant, even if the defendant was more negligent than the plaintiff. Coverage The scope of protection provided under a contract of insurance; any of several risks covered by a policy. Credit Score A number that is obtained from a credit bureau vendor. The number, which is also referred to as a score is the result of applying the consumers credit file information against a standard insurance industry model. The score does not enable anyone to determine specifically what information was in the consumer's credit file.
Insurance Information (cont'd)
Salvage Recovery made by an insurance company by the sale of property which has been taken over from the insured as a part of loss settlement. Self- Administered (Trusteed or Directly Invested) Plan A plan funded through a fiduciary, generally a bank, but sometimes a group of individuals, which directly invests the accumulated funds. Retirement payments are made from the fund as they fall due. Self-Administration The procedure where an employer maintains all records regarding the employees covered under a group insurance plan. Self-Insurance A program for providing group insurance with benefits financed entirely through the internal means of the policyholder, in place of purchasing coverage from commercial carriers. Senior Citizen Policies Contracts insuring persons 65 years of age or more. In most cases, these policies supplement the coverage afforded by the government under the Medicare program. Separate Account An asset account established by a life insurance company separate from other funds, used primarily for pension plans and variable life products. This arrangement permits wider latitude in the choice of investments, particularly in equities. Service-Type Plans Plans that provide their benefits in the form of services rendered rather than cash (for example, Blue Cross and Blue Shield). Settlement Options The several ways, other than immediate payment in cash, which a policyholder or beneficiary may choose to have policy benefits paid. Short-Term Disability Income Insurance The provision to pay benefits to a covered disabled person as long as he/she remains disabled up to a specified period not exceeding two years. Sickness Insurance A form of health insurance providing benefits for loss resulting from illness or disease. Skip person a beneficiary who is at least two generations younger than the person making the transfer. Social Security Freeze A long- term disability policy provision which establishes that the offset from benefits paid by Social Security will not be changed regardless of subsequent changes in the Social Security law. Social Security Option An option under which the employee may elect that monthly payments of an annuity before a specified age (62 or 65) be increased, and that payments thereafter be decreased to produce, as nearly as practical, a level total annual annuity to the employee, including Social Security benefits when they become due. Soft Market That part of the insurance sales cycle in which competition is at a maximum as insurance companies use their excess capacity to sell more policies at lower prices (see "Hard market"). Special Damages Compensation awarded for actual economic losses, such as medical expenses and lost wages. (See general damages) Special Risk Insurance Coverage for risks or hazards of a special or unusual nature. Split Funding The use of two or more funding agencies for the same pension plan. An arrangement whereby a portion of the contributions to the pension plan are paid to a life insurance company and the remainder of the contributions invested through a corporate trustee, primarily in equities. Spouse's Benefit Payments to the surviving spouse of a deceased employee, usually in the form of a series of payments upon meeting certain requirements and usually terminating with the survivor's remarriage or death. Standard Insurance Insurance written on the basis of regular morbidity underwriting assumption used by an insurance company and issued at normal rates. Standard Markets insurance companies for which the vast majority of people qualify Standard Provisions A set of policy provisions prescribed by former laws setting forth certain rights and obligations of both the insured and the company under an individual policy of health insurance. These were originally introduced in 1912 and have now been replaced by the Uniform Provisions. Standard Risk A person who, according to a company's underwriting standards, is entitled to purchase insurance protection without extra rating or special restrictions. State-of-the-Art Defense An argument used in product liability cases that the technology needed to avoid the loss in a particular case did not exist at the time of the product's manufacture State Disability Plan A plan for accident and sickness, or disability insurance required by state legislation of those employers doing business in that particular state. State Fund A fund set up by a state government to provide a specific line or lines of insurance. Some state permit private insurers to compete with the state fund. State Insurance Department A department of a state government whose duty is to regulate the business of insurance and give the public information on insurance. Statutory Accounting Special accounting practices for insurance companies required by state law and designed to provide greater protection for the public against potential insolvency of these essential institutions. Statutory Accounting Principles (SAP) Principles required by statute which must be followed by an insurance company when submitting its financial statements to the various state insurance departments. Such principles differ from the Generally Accepted Accounting Principles (GAAP). Statutory Underwriting Profit or Loss Premiums earned less losses and expenses. Step-Rate Premium A rating structure in which the premiums increase periodically at pre-determined times such as policy years or attained ages. Step-up in basis An increase in the tax basis of property to the value claimed in the taxable estate of a decedent. Stock Company A company organized and owned by stockholders, as distinguished from the mutual form of company which is owned by its policyholders. Stock Exchange An organization that provides a facility for buyers and sellers of listed securities to come together to make grades in those securities. Stockholder (or shareholder) A person who owns shares of stock in a corporation. Stock Insurance Company A company in which the legal ownership and control is vested in the stockholders. Stock Life Insurance Company A life insurance company owned by stockholders who elect a board to direct the company's management. Stock companies, in general, issue nonparticipating insurance, but may also issue participating insurance. Stock Redemption Plan An entity purchase form of buy-sell agreement within a corporation that involves the corporation buying back shares from a departing owner. Straight Life Insurance Whole life insurance on which premiums are payable for life. Strict Liability Liability for damages even though fault or negligence cannot be proven. Subrogation Process by which one insurance company seeks reimbursement from another company or person for a claim it has already paid. Substandard (Impaired Risk) A risk that cannot meet the normal health requirements of a standard health insurance policy. Protection is provided in consideration of a waiver, a special policy form, or a higher premium charge. Substandard risks may include those persons who engage in certain sports and persons who are rated because of poor habits or morals. Substandard Insurance Insurance issued with an extra premium or special restriction to those persons who do not qualify for insurance at standard rates. Substandard Risk An individual, who, because of health history or physical limitations, does not measure up to the qualification of a standard risk. Supplementary Contract An agreement between a life insurance company and a policyholder or beneficiary by which the company retains the cash sum payable under an insurance policy and makes payments in accordance with the settlement option chosen. Surety Bond An agreement providing for monetary compensation in the event of a failure to perform specified acts within a stated period. The surety company, for example, becomes responsible for fulfillment of a contract if the contractor defaults. Surgical Expense Insurance Health insurance policies, which provide benefits toward the physician's or surgeon's operating fees. Benefits may consist of scheduled amounts for each surgical procedure. Surgical Schedule A list of cash allowances attached to the policy, which are payable for various types of surgery, with a maximum amount based upon the severity of the operation. Surplus The net worth of a company, i.e. the amount by which assets exceed liabilities. Adequate net worth is necessary for the protection of policyholders against unforeseen losses. Surplus Lines (1) A risk or a part of a risk for which there is no normal insurance market available. (2) Insurance written by non-admitted insurance companies. |
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