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Frequently Asked Questions
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Georgia Insurance Terms
Glossary brought to you by Georgia Insurance Information Service (GIIS)
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A
ACCIDENT: An event causing loss, which occurs without being expected
or designed, usually specific in time and place.
ACCIDENTAL DEATH BENEFIT: Provision for payment of an additional amount
ñ usually equal to the face amount of insurance ñ if the
insured is killed in an accident. Popularly known as double indemnity.
ACQUISITION COSTS: Expenses incurred in acquiring new business premiums
and conservation of renewal business. Broad in scope, it includes cost
of soliciting business, issuance of policies, collection of premiums,
agentsí compensation, field supervision, advertising, and any other
expense reasonably attributable to acquisition and conservation of written
premiums.
ACTUAL CASH VALUE (ACV): The cost of replacing or restoring property at
prices prevailing at the time and place of the loss, less depreciation,
however caused. Another definition: the sum of money required to replace
property less depreciation, which includes physical wear and tear, and
obsolescence.
ACTUARY: A person whose principal function is to make the technical calculations
required for the pricing of insurance policies.
ADDITIONAL EXTENDED COVERAGE: A second endorsement on the fire policy
(fire and lightning with extended coverage) which insures the dwelling
and/or contents against water damage from plumbing, etc.; boiler explosion;
glass breakage; and damage by ice and snow, freezing, fall of trees, collapse,
vandalism, vehicles owned by insured or tenants and landslide.
ADDITIONAL INSURED: One who is protected by an insurance policy other
than the named insured. Examples: In automobile insurance, one who drives
the insuredís car with his consent ordinarily is protected. In
property insurance, this might be a co-owner, mortgagee, or lien holder.
ADJUSTER: A person who investigates and settles losses for an insurance
carrier or the insured.
ADVANCE PREMIUM: Most companies give the insured the right of making premium
payments in advance.
AGE CHANGE: An age change occurs on the date, halfway between birth dates,
on which the life insurance age changes. Immediately after, the premium
for new life insurance will be computed to the age on the next following
birth date. The life insurance age is the age at nearest birthday.
AGE LIMITS: The ages below and above which the company will not accept
applicants.
AGENCY: An organization which solicits insurance for one or more carriers
and may perform other functions such as issuing policies and adjusting
losses.
AGENT:
1. An individual who solicits insurance for one or more carriers and may
perform other functions, such as issuing policies.
2. Agents of a direct writer are sales employees of one company only.
AGE OF CAR (age group): A term used to classify cars according to age
for rating purposes.
ANNUAL POLICY: Insurance policy written for a term of one year.
ANNUITANT: The person during whose life an annuity is payable, usually
the person to receive the annuity.
APPLICATION: A request to a company for a policy. The application is a
conditional offer to buy. If the medical examination and the inspection
are in order, the company usually will accept the offer. It may be the
policy named in the application or, if the applicant is substandard, it
may be on a higher premium or other policy form.
APPRAISAL: Determination of the value of property or the extent of damage
by impartial experts. Many property insurance policies provide for "appraisals"
where the company and the insured cannot agree on the amount or the extent
of a loss.
APPROVED: In fire insurance, usually means that the construction, equipment,
preventive and protective devices meet established requirements for insurance.
In many cases, "approved" construction results in reduced insurance
premiums.
AREA: A territorial subdivision, usually called "rating territory,"
within a given state used for rating purposes.
ARSON: The willful and malicious burning of property, sometimes with the
intent of defrauding an insurance company.
ASSETS: All of the property owned by a carrier.
ASSIGNEE: One to whom the legal ownership of a policy or a limited interest
therein is transferred.
ASSIGNMENT: The partial or complete transfer by a person of his right
or interest in a policy to another person. The ability of a person to
so assign the policy may be limited by law or individual circumstances.
An assignment must be written, signed by the owner-policyholder whose
interest is being transferred, properly attested, and the original or
a certified copy must be filed with the insuring company. A valid assignment
so filed is binding on the company.
ASSURANCE-INSURANCE: These terms are today generally accepted as synonymous,
although not originally so. The term "assurance" is used more
commonly in Canada and Great Britain than in the United States.BBENEFICIARY
(LIFE): The person named in the policy, to whom the insurance money is
paid at the death of the insured.
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B
BINDER: A written or oral contract issued temporarily to place insurance
in force when it is not possible to issue a new policy or endorse the
existing policy immediately. A binder is subject to the premium and all
the terms of the policy to be issued.
BODILY INJURY BENEFIT COVERAGE: This automobile coverage is designed to
protect the insured and any passengers in this car against loss by reason
of bodily injury or death caused by the owner or operator of an uninsured
automobile (or a "hit-and-run"). Also called uninsured motorist
coverage.
BODILY INJURY COVERAGE: This coverage, often called "public liability
insurance," protects an insured against legal liability for injury
to the person of another arising from an accident.
BROAD FORM: A policy affording more liberal benefits, or in fire insurance,
an endorsement that grants broader or additional coverages to a basic
policy; usually added to a standard fire and extended coverage policy.
For example, on a dwelling policy, it usually adds the following: vandalism,
glass breakage, falling trees, weight of ice, snow or sleet, collapse.
If added to a commercial fire policy, it might include vandalism, falling
objects, weight of ice, snow or sleet, and collapse.
BROKER: A representative of the insured in placing insurance with companies.
He is paid a commission by the company or its agent. Often a broker also
is a licensed "agent" for one or more companies.
BURGLARY: Breaking and entering into the premises of another for the purpose
of stealing with visible signs of forced entry.
BUSINESS INSURANCE (LIFE): Insurance concerned primarily with the protection
of an insuredís business or vocation. Business insurance protects
a business against the loss of its valuable lives or key men; stabilizes
the business through the establishment of better credit relations; and
provides a practical plan for the retirement of business interest in the
event of the death of one of the owners.
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C
CANCELLABLE POLICY: A policy
which may be cancelled by the company at any time by giving advance notice
to the insured and refunding any unearned premium.
CANCELLATION: The discontinuance of an insurance policy before its normal
expiration date.
CAPITAL SUM: A term in accident insurance to describe the amount payable
for death or for loss of hands, feet or sight. Also called principal sum.
CARRIER: The insurance company or the one who agrees to pay the losses.
The carrier may be organized as a company, either stock, mutual, or reciprocal,
or as an association of underwriters such as Lloyds.
CASH SURRENDER VALUE: The amount available in cash upon surrender of a
life insurance policy before it matures as a death claim or otherwise.
CASUALTY INSURANCE: A general class of insurance covering liability resulting
from accidents and some types of property insurance. It includes among
other coverages: automobile, workers compensation, employers liability,
general liability, plate glass, theft and personal liability. It excludes
life, fire and marine insurance, but, as ordinarily used, includes health
insurance and fidelity and surety bonds.
CATASTROPHE REINSURANCE: This is a form of insurance written on an excess
of loss basis in order to improve the spread of risk against unknown concentrations
of liability subject to one occurrence. A deductible is chosen at the
amount necessary to reduce the probable frequency of loss to an acceptable
level to the reinsurer, and severity of loss to a level acceptable to
the reinsured company.
CHARTERED LIFE UNDERWRITER (C.L.U.): A designation conferred in recognition
of the attainment of certain standards of education and proficiency in
the art and science of life insurance underwriting.
CHARTERED PROPERTY AND CASUALTY UNDERWRITER (C.P.C.U.): A designation
conferred in recognition of the attainment of certain standards of education
and proficiency in the art and science of fire and casualty insurance
underwriting.
CLAIM: A request for payment of a loss which may come under the terms
of an insurance contract. There are two types of claims. First party claim
is one made by the policyholder in which the policyholder reports the
claim directly to his company. A third party claim is one in which a person
makes a claim against a policyholder of another company and payment, if
any, is made by that company.
CLAIMANT: One who makes a claim.
CLAIM FREQUENCY: The number of claims of a given coverage reported to
an insurance company divided by the number of policies in force for car
years in force having the given coverage. It is usually expressed as the
number of claim coverages reported per one hundred of such coverages in
force. Example: For bodily injury (BI), the frequency of 2.50 means that
bodily injury accidents were reported at the rate of 2 Ω per year
for each one hundred BI policies in force.
CLAIM SEVERITY: The average cost per claim considering all claims under
a certain coverage for a specified period.
CLAIMS-MADE COVERAGE: Claims-made insurance is a type of liability protection
that covers current legal obligations result for acts of the insured.
It provides coverage to the insured for claims reported during the term
of the policy.
CO-INSURANCE: A provision under which an insured, in consideration of
a reduced premium rate, promises to maintain a certain percentage of insurance
to the value of the property. The co-insurance clause attached to the
policies specifies the percentage, and has no bearing on loss payment
if the insured keeps his promise. If he carries less than the stipulated
percentage of insurance to value, loss payment is limited to the same
ratio which his insurance bears to the amount required. For example, if
the co-insurance clause says he must carry 80% to value but he only carries
60% to value, the company will only pay 60/80 of any loss, up to the policy
limit.
COMMERCIAL FIRE: This coverage insures all property not occupied as a
residence, excluding farming and manufacturing, against loss by fire.
COMMISSIONER OF INSURANCE (INSURANCE COMMISSIONER): Title of the head
of the state insurance department who is responsible for the enforcement
of insurance laws.
COMMON DISASTER CLAUSE: In life insurance, this clause is designed to
alleviate the hardship that can result if the insured and primary beneficiary
die at the same time or within a short period of time of each other. Usually
the clause provides that if the primary beneficiary dies either before
proof of the insuredís death is submitted to the company, or within
a stated period (usually 14 or 30 days after the insuredís death),
the proceeds will be paid to the contingent beneficiary.
COMPULSORY INSURANCE: The purpose of compulsory insurance laws is to require
all residents to buy liability insurance before auto license plates are
issued. The law requires proof of financial responsibility (insurance)
when license plates are issued.
CONCEALMENT: The withholding of material facts from an insurer, either
in applying for a policy or making a claim.
CONTENTS: A term used to refer to the personal property contained in a
building. It may be household furniture, personal effects, or other types
of personal property, movable in nature and not firmly affixed to the
real property.
CONTINGENT BENEFICIARY: A beneficiary whose right to receive depends upon
the occurrence of a certain contingency ñ for example, the right
to receive certain benefits only in the event that another named beneficiary
dies prior to the time of payment.
CONTRACT: The "Law of Contracts" specifies four requirements
for the formation of a single contract: (1) parties of legal capacity;
(2) expression of mutual assent of the parties to a promise or set of
promises; (3) a valid consideration; and (4) the absence of any statute
or other rule declaring such agreement void. A life insurance policy qualifies
as a contract under the above definition.
CONTRACT OF SALE CLAUSE: The clause attached to a fire policy when a dwelling
has been purchased on a "contract" basis. Title to the property
in a "contract sale" remains in the name of the seller; the
buyer gets use and possession of the property.
CONTRIBUTORY NEGLIGENCE: Carelessness of the injured person that helped
to cause the accident in which he was injured.
COVERAGES: Automobile
Bodily Injury Liability: An agreement by a company to protect
an insured against loss from legal liability for injury to another person
arising from an automobile accident. This is usually referred to as
"third party coverage."
Collision or Upset (usually called collision first party coverage:
A form of insurance protecting the insured against loss resulting from
any damage to his car caused by collision with any object, or upset,
whether it was the insuredís fault or not (other than his willful
act). This does not cover other peopleís property.
Comprehensive: An agreement to protect an insured against loss
resulting from damage to his automobile, exclusive of loss by collision
or upset. Broad coverage is provided and includes protection from such
hazards as fire, theft, glass damage, wind hail and malicious mischief
(first party coverage).
Medical Payments: An insurance coverage under which an insurance
company agrees to pay medical, hospital, and the expense of funeral
services resulting from an automobile accident, regardless of the liability
of the insured (first party coverage).
Property Damage Liability: An agreement by an insurance company
to protect an insured against loss from legal liability for damage by
his automobile to the property of another. The term includes damage
to other automobiles, buildings, utility poles and other types of real
and personal property (third party coverage).
Uninsured Motorist Coverage: Protects the insured against financial
loss resulting from bodily injury carelessly inflicted by an uninsured
motorist, including a hit and run driver, who is legally liable. Bodily
Injury Benefit.
COVERAGES: Fire
Additional Living Expense: The purpose of this coverage is
to pay for increased expense of living while the insuredís residence
is being rebuilt or repaired after damage from an insured peril. Examples
are the extra cost of housing the insuredís family in a hotel,
dining in restaurants, etc.
All Physical Loss Form: This coverage protects against loss
from "all risks of physical loss" for dwellings subject to
certain exclusions contained in the form.
Broad Form: Can be written on dwelling and contents. Fire forms
include Extended Coverage perils, plus such additional perils as falling
objects, weight of ice, snow or sleet, collapse of buildings, accidental
discharge, leakage or overflow of water or steam from plumbing, heating,
or air conditioning systems, sudden and accidental tearing asunder,
burning, bulging of appliances for heating water, freezing of plumbing,
heating or air conditioning systems, and domestic appliances, glass
breakage, and breakage of building glass.
Builder's Risk Insurance: Insurance against loss resulting
from damage to buildings and to materials incidental to construction,
including machinery and equipment, while the buildings are under construction.
Extended Coverage: An extension of the fire policy to cover
the additional perils of windstorm, hail, explosion, or riot, attending
a strike, civil commotion, aircraft, vehicle and smoke.
Homeowners Policy: A policy in which Fire and extended or Broad
coverage for dwelling and contents, residentsí theft insurance,
additional living expense, and personal liability insurance are combined.
Rents or Rental Value: Insurance against loss of the rental
value of a property; protects against loss of rents resulting from an
insured peril.
Replacement Cost: Insurance under which the amount payable
is the current replacement cost of the property new, rather than the
depreciated value. Applies only to the building items and covers loss
from all insured perils.
CONVERTIBLE TERM: Some term life insurance policies provide that they
may be converted to permanent forms of insurance without medical examination,
if the conversions are made within a limited period as specified in the
contracts. Usually the conversion may be made as of the original date
of issue, provided the insured pays the difference in reserves, or as
of the attained age of the insured at the time of conversion.
CREDIT LIFE INSURANCE: Life insurance issued by a life insurance company
on the lives of borrowers, payable to the creditors, to cover payment
of loans (usually small loans repayable in installments) in case of death.
It is usually handled through a lending office and is written on either
a group or an individual basis.
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D
DAMAGES: In a technical sense, damages
refer to the money or compensation recoverable in a lawsuit by a party
who has been injured in person or property or rights by the negligence
of another.
DEATH CLAIM: When a policy holder dies, the person entitled to the proceeds
must complete certain forms giving due proof of the death and establishing
the claimantís right to such proceeds. When filed with the company,
the company is said to have received a death claim.
DECREASING TERM LIFE INSURANCE: Term insurance, the face value of which decreases
each year over a slated period. Family income and usually mortgage cancellation are decreasing
term insurance.
DEDUCTIBLE: A provision in an insurance contract stating that the insurer
will pay only that amount of any loss that is in excess of a specified
amount. The specified amount if the deductible.
DEDUCTIBLE COLLISION COVERAGE: A form of collision coverage which specifies
that an insurance carrier will pay the damage less a specified amount.
For example: For $50 deductible collision coverage, the insurance carrier
would deduct $50 from the total damage and be liable for only the amount
in excess of $50.
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; A loss where an insured peril is the proximate cause. If
a windstorm blows the roof off a home, the windstorm is the insured peril
causing the direct loss or damage.
DIRECT MAIL: A form of advertising using letters or other printed material
designed to secure prospects for insurance. Some direct mail is used to
solicit insurance.
DIRECT WRITER: The industry term for a company which uses it own sales
employees to write its policies. Sometimes refers to companies which contract
with exclusive agents.
DISABILITY CLAUSE: A benefit provision forming part of a life insurance
policy providing for certain benefits in the event of total and permanent
disability from accident or sickness. A benefit providing for waiver of
premiums only is called a Waiver of Premium Disability clause. A benefit
providing for waiver of premiums plus payment of monthly income is normally
called a Disability Income clause. Disability is normally considered "permanent"
after it has continued for sic months, while "total" is normally
considered as inability to engage in any gainful occupation. The amount
of monthly income is usually related to the face amount of the life insurance
policy (e.g., $5 or $10 per month per $1,000 of insurance) and current
clauses normally provide for continuation of income to a stated age only.
DIVIDENDS: A return to the policyholder of excess premium over losses
and expenses at the end of the policy period. Dividends are authorized
by the board of directors, and are payable to all participating policyholders
of a specified class.
DOMESTIC CARRIER: An insurance company organized in a given state is referred
to in that state as a domestic carrier.
DOUBLE INDEMNITY: An accidental death benefit providing for an additional
payment equal to the face amount of the policy in case of accidental death
caused solely through external and violent means, and occurring within
a limited period, usually 90 days, after bodily injury. Certain causes
are specifically excluded.
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E
EARNER PREMIUM: The part of the total policy
premium earned by the insurance company which applies to the expired portion
of the policy period.
ENDORSEMENTS: An additional piece of paper, not a part of the original
contract, which cites certain terms and which, when attached to the original
contract, becomes a legal part of that contract. Additions to life insurance
contracts are accomplished through the use of riders, which are similar
to endorsements.
EQUITY: The extent of someoneís interest or ownership of property.
If you purchase a $15,000 home with a $5,000 payment, your equity in the
property is the down payment, of $5.000.
ESCROW FUNDS: Funds set aside with an impartial third party, for a specific
purpose. Mortgage companies quite often include insurance premiums as
a part of the monthly mortgage payment. Each month the mortgage company
collects 1/12 of the fire insurance premium for the house. The total funds
collected for fire premium are placed in an "escrow account"
and cannot be used for any other purpose.
EXPENSE RATIO: The ratio of a companyís operating expenses to premiums.
EXPIRATION DATE: The specified date and time at which the policy terminates.
EXPOSURE: This term in the insurance field may have several meanings:
(1) possibility of loss
(2) a loss potential as measured by type of construction area or values
(3) a possibility of a loss being communicated to an insurance risk from its surroundings.
EXTENDED TERM INSURANCE: The non-forfeiture option which provides that
the case surrender value of a life policy may be used as a net single
premium at the attained age of the insured to purchase term insurance
for the face amount of the policy, less indebtedness and for as long a
period as possible, but not longer that the term of the original policy.
If the cash value of an endowment policy is more than sufficient to purchase
extended term insurance for the remainder of the endowment period, the
excess cash value is used to buy pure endowment payable at the maturity
of the policy.
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F
FACE AMOUNT: The amount of the principal sum, or basic sum, insured
usually stated on the face or first page of the contract. The
actual amount payable by the company may be increased by dividends, decreased
by loans, or increased by supplemental term riders (e.g., Family Income).
FAMILY AUTO INSURANCE: The automobile policy (most common in the industry)
which provides protection for all members of the family.
FAMILY PLAN INSURANCE: Insurance where the head of the household has one
master policy on his life (usually whole life) and term coverage for wife
and children in lesser amounts. New-born children are also included, usually
at no additional premium. The policies have automatic programming devices
that are in the original contract: i.e., the childrenís coverage
terminates at the fatherís age 65, etc. There is usually a savings
over the same coverage provided by separate policies, since one master
policy reduces administrative costs.
FINANCIAL RESPONSIBILITY LAWS: North Carolinaís laws require that
motor vehicle owners maintain financial responsibility through a liability
insurance policy, a financial security bond, or by qualification as a
self-insurer. Any liability policy certified as proof of financial responsibility
must provide coverage of not less than $15,000 for bodily injury to or
death of one person in any one accident and $30,000 for bodily injury
to or death of two or more persons in any one accident, and $5,000 property
damage coverage for injury to or destruction of property of others in
any one accident.
The Vehicle Responsibility Act of 1957 requires that the owner of each
motor vehicle registered in this state shall maintain financial responsibility
continuously throughout the period of registration. The penalty for failure
to do so is loss of the vehicle registration plates for 60 days.
The Motor Vehicle Safety and Financial Responsibility Act of 1953 requires
that the Department of Motor Vehicles suspend the license of each operator
and each owner of the motor vehicle if the person responsible for an accident
does not provide satisfactory evidence of financial responsibility as
required by law. The suspension is effective unless the owner or operator
deposits security in the amount determined by the Commissioner of Motor
Vehicles.
FIRE: Court decisions have held generally that there are three elements
which constitute a fire within the meaning of an insurance policy:
1. Rapid oxidation (combustion).
2. Visible flame or glow.
3. Hostile or unfriendly. (A "hostile" fire is one which escapes
the area in which it was intended to burn. A "friendly" fire
is one which does not exceed its intended purpose.)
FISCAL YEAR: A certain
12-month period selected by an organization for its financial accounting
period. In insurance companies, this always coincides with the calendar
year.
FRANCHISE INSURANCE: Individual life or health insurance policies issued
to a small group of people having a common affiliation or interest. Same
as wholesale insurance.
FRATERNAL INSURANCE: Life insurance protection provided by fraternal benefit
societies, having no capital stock, and not organized for profit, and
maintaining a lodge system. Practically all fraternals operate on a level
rate and legal reserve basis in accordance with special fraternal insurance
regulation, and under supervision of the state insurance authorities.
FULL COVERAGE: Insurance which covers all losses, with no deductions,
up to the amount of the insurance. (See DEDUCTIBLE COLLISION COVERAGE.)
FURNITURE AND FIXTURES: A term used in commercial fire insurance. This
coverage includes: desks, chairs, bookcases, filing cabinets, typewriters,
calculating machines, temporary partitions, etc.
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G
GENERAL LIABILITY: A broad term meaning liability insurance, other than
automobile written to cover personal, professional and commercial risks.
As respects commercial liability, it includes the following hazards and
coverages: premises and operations, elevators, independent contractors,
contractual products, and completed operations.
GRACE PERIOD: Life and health insurance contracts provide that premiums
may be paid at any time within a month or 31 days following the premium
due date, the policy remaining in full force in the meantime. In life
insurance, if death occurs during the grace period, the earned premium
is deducted from the proceeds payable. No interest is charged on overdue
premiums if paid during the grace period.
GUARANTEED RENEWABLE: A health policy which the company guarantees to
renew for life or until the insured reaches a specified age, usually 65.
The company may adjust rates only on a class of risks, not on any individual.
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H
HEALTH INSURANCE: Formerly sickness insurance but now has superseded
the term accident and sickness insurance.
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I
IMPAIRED RISKS: In health insurance, individuals who can reasonably be
expected to have an above-average number
of claims due to medical history or physical impairment. Most impaired
risks can be insured by use of a waiver or waiting period.
IMPROVEMENTS AND BETTERMENTS INSURANCE: Insurance coverage that protects
a tenant against loss of improvements made by him to real property in
which he is a tenant as a result of fire, etc. Some property policies
use the term improvements and additions in describing the coverage.
INCONTESTABILILTY: Life policies provide that, except for non-payment
of premiums of certain other circumstances, the policy shall be incontestable
after the policy has been in force for two years during the lifetime of
the insured. During the contestable period, misrepresentation of facts
material to the risk will permit the company to avoid liability under
the policy and refund the premium. Total and permanent disability and
accidental death provisions usually are excepted from the operation of
the policy incontestable provision, although they may have their own incontestable
provisions.
INDEMNITY: In general, reimbursement for loss, but also a benefit provided
by a policy. In health insurance it sometimes is used to designate a specified
amount paid regardless of actual loss or expense incurred.
INSPECTION REPORT: Filed by an investigator employed by the insurance
company or credit agency, giving general information on the health, habits,
finances and reputation of the applicant.
INSURABLE INTEREST (LIFE): One person has an insurable interest in the
life of another if the death of the latter would cause actual financial
loss to the other person. The purchaser of a life insurance policy must
have an insurable interest in the insured life to make the contract legal.
For example, each person has an unlimited insurable interest in his own
life and the lives of close relatives. This legal requirement arose to
avoid the abuses of wagering types of life insurance contracts in the
earliest days when the insured person frequently was unaware that his
life was the subject of an insurance policy for the benefit of an unknown
third party.
INSURED: A person covered by an insurance policy. In life insurance, the
person upon whose life an insurance policy is issued.
INSURED NAMED: The person with whom an insurance contract is made, and
who is named specifically for protection against loss under the terms
of the policy. Any person or corporation, or any member thereof, such
as the spouse of the specifically mentioned as named insured in a policy,
as distinguished from others who, though unnamed, are protected under
some circumstances. (The most common application of this principle is
in connection with the "omnibus clause" in automobile liability
policies.)
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J
JOINT TENANCY: Ownership of property by two or more in such
a way that when one of the joint owners dies, his share goes to the surviving
joint owners rather than the heirs.
JUVENILE INSURANCE: Life insurance policies written on the lives of children
within specified age limits.
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K
KEY MAN INSURANCE: Insurance used for a business
purpose, usually to reimburse a corporation for the loss it sustains when
an important member of the firm dies.
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L
LAPSE: The termination or discontinuance
of a policy due to non-payment of a premium.
LARCENY: The unlawful taking and carrying away of the personal property
of another without his consent and with intent to deprive him of ownership
or use.
LEGAL LIABILITY: An obligation which can be enforced by law.
LEVEL PREMIUM INSURANCE: Insurance for which the cost is distributed evenly
over the period during which premiums are paid. The premium remains the
same from year to year, and is more than the actual cost of protection
in the earlier years of the policy and less than the actual cost in the
later years. The excess paid in the early years builds up the reserve.
LEGAL RESERVE: In life insurance that sun which, accumulated at an assumed
rate of interest and taken together with future specifications, is defined
by the state insurance code.
LIABILITIES: An insurance companyís liabilities consist of its
immediate or contingent policy obligations and unpaid claims.
LICENSE AGENT OR BROKER: Certification, issued by the department
of insurance, that an individual is qualified to solicit insurance applications
for the period covered.
LICENSE ñ COMPANY: Certification, issued by the department of insurance,
stating that an insurance company is qualified to do business in the state.
LIFE INSURANCE: A contract whereby, for a stipulated premium, the insuring
company agrees to pay the insured, or his beneficiary, a fixed sum or
its equivalent in income, upon the happening of death or some other specified
event.
LOSS EXPENSE, ALLOCATED: Handling expenses, such as legal fees, paid by
an insurance company in settling a claim which can be definitely charged
to that particular claim. This excludes payments to the claimant.
LOSS EXPENSE, UNALLOCATED: Salaries and other expenses incurred in connection
with the operation of a claim department of an insurance carrier which
cannot be charged to individual claims.
LOSS RATIO: The percent which losses bear to premiums for a given period.
LOSS RESERVE: The amount set up as the estimated cost of an accident at
the time the first notice is received.
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M
MATERIAL DAMAGE: Insurance against
damage to a vehicle itself. It includes automobile comprehensive, collision,
fire and theft. Material damage and physical damage are terms that often
are used interchangeably.
MATURITY VALUE: The proceeds are payable on maturity of a policy. An ordinary
life policy matures on the death of the insured and an endowment policy
on a specified date or on the prior death of the insured. The maturity
value is normally the "face amount" of the policy.
MORTGAGE INSURANCE: One of the basic uses of life insurance. Family heads
buy mortgage insurance for the specific purpose of paying off any mortgage
balance outstanding at their death.
MULTIPLE LINE: A general term referring to fire and casualty insurance
in general. A multiple line company writes auto, fire, health, commercial,
boatowners, homeowners individual fire, theft insurance.
MUTUAL INSURANCE COMPANIES: Insurance companies without capital stock,
owned by the policyholders for the purpose of sharing in the profits through
dividends at the end of the policy year.
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NATIONAL ASSOCIATION OF LIFE UNDERWRITERS (N.A.L.U.):
An organization of life insurance men and women
formed for the sole purpose of benefiting the agent in the field. Membership
in the association gives the agent an opportunity to meet others in the
same work, exchange ideas and experience, and listen to successful leaders
in the business.
NEGLIGENCE: The failure to use the care that a reasonable and prudent
person would have used under the same or similar circumstances.
NET COST: This term ordinarily refers to the actual cost of life insurance
in a mutual or participating company after deducting the policy dividends
from the premiums deposited. Since there are no dividends on non-participating
policies, the net cost of such policies is equal to the total premiums
paid. In determining the true net cost of a policy over a period of years,
allowance also should be made for the cash surrender value at the end
of the given period.
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O
OCCUPANCY: This refers to the use of property.
A home, for example, may have a real estate office in it. This dwelling
would then have a "business occupancy." Occupancy plays a very
important part in computing rates and determining the acceptance or rejection
of risks.
OCCUPATIONAL HAZARD: The danger of suffering a sickness or injury due
to the hazards of an occupation.
OCCURRENCE: Any incident or happening. Usually used by insurance carriers
in connection with accidents involving the policyholders. The word "occurrence"
is used because of the precise legal meaning of the word "accident,"
which an "occurrence" may or may not be.
OCCURRENCE COVERAGE: Occurrence coverage is insurance for incidents of
liability alleged to have occurred during the term of the policy, no matter
when the claim is reported.
OMNIBUS CLAUSE: An automobile policy provision which covers persons driving
the named insuredís auto with the named insuredís permission.
OPTIONAL SETTLEMENTS: Most policies offer several optional modes of settlements
of the proceeds in lieu of a single payment at the death of the insured
or at the maturity of a policy, or within certain limits, upon the surrender
of a policy. The usual options are (a) interest only; (b) limited installments
certain; ( c ) equal installments until proceeds are exhausted; (d) life
income with period certain.
ORDINARY LIFE: Synonymous with "whole life" and "straight
life." The three terms are applied to the type of policy which continues
during the whole of the insuredís life and provides for the payment
of amount insured at this death (or at age 96 on the basis of American
Experience Table of Mortality; or at age 100 on the C.S.O. Table, if he
is still living at that age).
OWNER: The person who can legally exercise all rights and privileges in
the life policy. This will usually be the insured, but may be any other
party to whom proper transfer of these rights and privileges has been
made.
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P
PAID-UP ADDITIONS: Additional life insurance purchased by policy
dividends on a net single premium basis at the insuredís attained
insurance age at the time the dividend is allotted.
PARTIAL DISABILITY: An injury which prevents the insured from performing
one or more, but not all, important duties of his job.
PERIL: The cause of possible loss, such as fire, windstorm, theft, explosion,
or riot.
PERSISTENCY: A term used to refer to the length of time insurance remains
continuously in force.
PERSONAL PROPERTY: This type of property is usually movable and easily
transportable. On the other hand, real property generally is considered
to be immovable such as land and things affixed to it. A rule of thumb
definition for personal property is "everything other than real property."
PHYSICAL HAZARD: This refers to the material, structural or operational
features of the risk itself, apart from the persons owning or managing
it. Electrical wiring, building construction, type of heating system,
are examples of physical hazards.
POLICIES-IN-FORCE: Policies written and recorded on the books of the carrier
which are unexpired as of a given date.
POLICY: The name generally used to mean the written contract of insurance.
POLICY FEE: An amount charged by some companies in addition to the first
regular premium. Also called "joinerís fee."
POLICYHOLDER: One who owns an insurance policy. A mortgagee often is issued
a copy of an insurance policy, or a certificate of insurance, at the request
of the insured, but he is not a policyholder.
POLICY LOAN (LIFE): A loan made by an insurance company to a policyholder
on the security of the cash value of his policy.
PRE-EXISTING CONDITION: A physical condition which existed prior to the
issuance of a health policy.
PRELIMINARY CLAIM NOTICE: Notice to the company that the insured wants
to make a claim.
PREMIUMS-IN-FORCE: Premium dollars which have been written and are unexpired
on the books of the insurance carrier.
PREMIUM UNEARNED: The portion of an insurance premium which applies to
the unexpired portion of the policy period.
PRICE-GROUP SYMBOL: Designates the original list price grouping of the
private passenger car covered in the current period.
PROCEEDS: The net amount of money payable by the company at the death
of an insured or at the maturity of a policy.
PROPERTY DAMAGE COVERAGE: An agreement by an insurance carrier to protect
an insured against legal liability for damage by his automobile to the
property of another.
PROXIMATE CAUSE: The dominating cause of loss or damage; an unbroken chain
of events between the occurrence of an insured peril and damage to property.
As an illustration, water damage occurring from fire fighting activities
is covered under the fire policy because fire was the proximate cause
of the loss.
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R
RATE: A charge per unit in determining insurance premiums.
RATING TERRITORY: A geographical grouping in which like hazards tend to
equalize and permit the establishment of an equitable rate for the territory.
REINSURANCE: The insurance by one insurer of liability or another insurance
carrier under its insurance or reinsurance policies.
REPLACEMENT COST: The cost to repair or replace property at construction
costs prevailing at time of loss; the cost to repair or rebuild property
without considering depreciation. (See ACTUAL CASH VALUE.)
RETIREMENT INCOME OR INCOME ENDOWMENT (LIFE): Such a policy provides retirement
income from a stated date and insurance protection in the meantime. On
death, before the first income payment, the death benefit is normally
the stated initial sum assured or the cash surrender value of the policy
at date of death, whichever is greater.
RIDER: Endorsement. Special provision added to an original policy contract.
RISK: Chance of loss with respect to person, liability, or the property
of the insured. Also used to mean "the insured."
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S
SALES EXPENSE:
Compensation of agents, advertising expense, and other costs related to
selling insurance policies.
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.
SCHEDULE: A list describing the property or items insured under the policy.
SETTLEMENT OPTIONS: Nearly all life insurance policies now issued provide
for several optional modes of settlement in lieu of payment in a single
cash sum. The usual options are: (1) interest certain; (2) installments
for a period certain; (3) life income with number of years (usually 10
or 20) payment certain; (4) fixed income as long as proceeds will last.
SPECIAL CLASS: Policies on which an extra premium rate is charged because
an extra risk is presented.
STANDARD PROVISIONS: Policy provisions required by law or supervisory
regulation such as provisions relating to grace period and incontestability.
STANDARD RISK: A person who, according to a life companyís underwriting
standards, is entitled to insurance protection without extra rating or
special restrictions.
STOCK COMPANY: A company organized and owned by stockholders, as distinguished
from the mutual form of company which is owned by its policyholders.
SUBSTANDARD RISK: A person who is considered an under-average or impaired
insurance risk because of his physical condition, family or personal history
of disease, occupation, residence in unhealthy climate, or dangerous habits.
SURPLUS: A stock companyís surplus is the amount by which its admitted
assets exceed its liabilities and capital stock. In both stock and mutual
companies, the term surplus to policyholders means the excess of admitted
assets over liabilities.
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TERMINATION: The recording of a cancellation
of an insurance policy. In some instances, cancellations may not be recorded
for many weeks, due to the pressure of other work. Many policies cancelled
for non-payment are reinstated without either cancellation or being recorded.
(See also CANCELLATION.)
TERM INSURANCE: Life or health insurance protection during a limited number
of years but expiring without value if the insured survives the stated
period.
THEFT: This is a common word for "act of stealing." There is
no precise meaning in law.
TOTAL DISABILITY: Disability which prevents a person from performing (a)
any of his occupational duties, or (b) any duties of any occupation, or
( c) any duties for which he is reasonably qualified. Definitions vary
within policies.
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.
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UNDERWRITER: Originally meant an individual who, together with
other individuals, assumed a proportionate part of the risk, the signatures
of all such individual insurers being written under the basic promise
to pay. In effect, this is still the insurance principle under marine
and certain general types of insurance. In the life insurance industry,
"underwriter" has three different possible meanings:
1. An insurer.
2. an officer, medical adviser or technician who reviews applications
for insurance, selects risks for acceptance, and determines the amount
and the terms of such acceptance.
3. an agent or other field representative who unavoidably "selects
risks" when selecting his prospects for solicitation.
UNDERWRITING PROFIT AND LOSS: The profit or loss experienced after deducting
from earned premiums the incurred losses and expenses of doing business,
but before provision for federal income tax. It excludes investment transactions.
UNREPORTED CLAIMS: Accidents which have occurred but which have not been
reported or recorded.
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V
VALUATION: The process of determining a companyís
liabilities under its policy obligations is known as policy valuation.
The process of determining the value of a companyís investments
is known as asset valuation. Minimum valuation standards are usually prescribed
by state law.
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W
WHOLE LIFE INSURANCE: A plan of insurance for the
whole of life. It includes straight life on which premiums are payable
until death.
WORKER'S COMPENSATION: A system (established under state law) which provides
payments to employees who are injured in the course of employment, irrespective
of fault.
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