Insurance Terms
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Abandonment | the giving up by an insured to the insurer of damaged property when a total loss is claimed. | |
Acceptance | an absolute and unqualified agreement to the terms of an offer, so creating a contract. | |
Accident | an unforeseen and unintended event or occurrence. | |
Act Of God | an event that is the result of natural forces and which arises without human intervention. | |
Adjuster/Assessor | see LOSS ADJUSTER/ASSESSOR. | |
Agent | a person who acts on behalf of another and in the case of insurance is the intermediary between the proposer and the insurer. | |
Agreed Value | the sum to be paid in the event of a total loss under a valued policy. | |
Arbitration | a means of settling disputes legally without going to court where the issue concerns the amount of a claim and not liability. A qualified person or persons whose appointment has been agreed to by the parties involved, will hear the case and give a decision. | |
Asset | a property or financial commodity which can, if necessary, be converted into cash. | |
Assurance | a term interchangeable with insurance, which is often used in the case of Life and Marine business. | |
Average | in general insurance, this is a policy provision which has the effect of reducing a claim payment where under-insurance is discovered. | |
Balance Of Third Party | the terms used in South Africa for the form of motor insurance which covers the insured's liability' for: | |
i) | injury to passengers not covered in terms of the Road Accident Act 1996; and | |
ii) | damage to the property of third parties caused by the vehicle. | |
Betterment | the value of the improvement in an insured property when it has been repaired or rebuilt following loss or damage. | |
Blanket Policy | a policy covering several items under one sum insured. | |
Bordereaux | the sheets of information prepared by an insurer detailing cessions under reinsurance treaties. | |
Broker | A professional full-time independent agent or intermediary. | |
Brokerage | the commission or fee paid to the brokers by the insurers for placing business with them. | |
Burning Costs | method of calculating the insurance premium (especially in reinsurance) taking account of previous claims. | |
Business Interruption Insurance | the class of insurance which provides cover for consequential loss arising directly from another loss (e.g. loss of profits following fire damage). | |
Cancellation Clause | the clause in a policy which allows one party to cancel the contract following due notice to the other. | |
Captive Insurance Company | an insurance company set up by a parent company, in order to receive that parent's insurance business. | |
Catastrophe Cover | a form of excess of loss reinsurance which protects the insurer against losses arising from major catastrophes. | |
Certificate Of Insurance | a document issued by an insurer which is used mainly in the marine market to certify that cover is in force. | |
Cession | that part of an insurance transferred to a reinsurer. The transfer of rights, title and interest under a contract. | |
Chance | The probability or likelihood that an event occur. | |
Claim | a demand made by the insured for payment after the occurrence of loss or damage covered by the policy. | |
Claim Form | a form supplied by an insurer to enable an insured to lodge a claim in terms of the policy. | |
Claim-Free Group | the term used in motor insurance to indicate into which of the rating groups a policyholder will fall according to his claims record. | |
Claims Ratio | see LOSS RATIO | |
Co-Insurance | the division of a risk between two or more insurers where each is individually liable to the insured for their proportion of claims. | |
Co-Insurer | an insurer who shares with others in co-insurance. | |
Collective Policy | policy issued by the leading insurer on behalf of all the insurers who share a risk by way of co-insurance. | |
Commission | the payment made to intermediaries by insurers for placing business with them. | |
Common Law | the part of a country's legislation built up from customs and usages which have been recognised by its courts and thereby given the force of law. | |
Composite Insurance Company | an insurer undertaking both life and non-life business. | |
Comprehensive Policy | a policy covering a wide variety of perils. | |
Condition | part of a contract which must be complied with by one party or another. | |
Consequential Loss | a loss directly arising from another loss. The term is used to describe the class of business also known as LOSS OF PROFITS or BUSINESS INTERRUPTION INSURANCE. | |
Consideration | the payment or promise of payment for goods or services, this being the premium in the case of insurance. | |
Contingency | an unforeseen occurrence. | |
Contingency Fund | monies put aside by a company in order to pay for unexpected losses. | |
Contract | an agreement made by two or more parties with the intention of creating a legal obligation between them. | |
Contract Of Insurance | an agreement between insurer and insured whereby, in return for the payment of a premium, the insurer undertakes to indemnify the insured upon the happening of a specified event. | |
Contra Proferentum Rule | any ambiguity in contract wordings is construed against the drafter of those wordings. | |
Contribution | the principle whereby two or more insurers covering the same risk contribute proportionately to any losses. | |
Cover | the protection provided by insurance. | |
Cover Note | temporary evidence of the granting of insurance. | |
Damages | an amount of money claimed by or awarded to a third party as compensation for injury or loss. | |
Declaration | the statement on a proposal form signed by the proposer certifying the truthfulness and accuracy of the information supplied. | |
Declaration Policy | a policy requiring the insured to declare periodically the value of fluctuating items, such as stocks or goods-in-transit, to enable the insurer to adjust the premium accordingly. | |
Deductible | an American term, similar in meaning to excess an being the first portion of a loss payable by the insured. | |
Delegated Authority | the authority given to an agent of an insurer to act on its behalf in accepting risks within agreed guidelines. | |
Deposit Premium | an advance payment made by the insured before the actual premium has been decided. | |
Depreciation | the extent to which (insured) property has diminished in value due to factors such as wear and tear. | |
Direct Insurance | an original insurance contract between insurer and insured. | |
Direct Insurer | an insurer in contact with insuring members of the public or corporations. | |
Disclosure | the duty of the parties to a contract of insurance to reveal all material facts to each other before it is concluded and prior to each renewal. | |
Earned Premium | that part of a premium relating to a completed or expired period of risk; the actual premium chargeable under an adjustable policy. | |
Endorsement | documentary evidence of some alteration to a policy of insurance. | |
Escalator Clause | the clause in a policy which allows the sum insured on property to rise throughout the period of insurance in step with the assumed rate of inflation. | |
Ex Gratia Payment | a payment made to an insured where there is no liability under the policy. | |
Exception | a peril specifically excluded from the insurance. | |
Excess | that part of a loss for which the insured is liable | |
Excess Of Loss | a form of insurance where the reinsurer agrees to pay the balance of any losses exceeding a stated monetary amount. | |
Executor | the person named in a will who has agreed to carry out its terms. | |
Expense Loading | that part of the premium which meets the policyholder's share of the insurer's administrative costs | |
Fire | the accidental or fortuitous ignition of something that should not be on fire. | |
First Amount Payable | the amount payable by an insured in the event of a claim | |
First Loss Policy | an insurance policy where the insurer pays all losses up to a given limit. | |
Fleet Insurance | a motor policy covering a group of vehicles with the premiums calculated on an experience basis. | |
Franchise | the amount of a loss at or below which no claim is payable by the insurer. Above that amount, the loss will be met in full. | |
Fund | the common pool into which premiums for each class of insurance are paid and from which the losses are met. | |
General Insurance | insurance which is not long-term business. | |
Good Faith | see under Uberrima fides | |
Hazard | a physical or moral feature that affects the likelihood of a loss occurring or has an influence on the size of the loss. | |
Incurred But Not Reported (IBNR) Claims | claims which have occurred but are not yet reported to the insurers. Many governments require insurers to establish reserves to cover such losses. | |
Indemnity | the placing of the insured in the same financial position after a loss as he was in immediately prior to the occurrence. | |
Indexing | a method of adjusting sums insured to provide for inflationary increases in values. | |
Inspector | a official of an insurance company whose duties involve the selling and servicing of its policies either directly to the public or through intermediaries. | |
Insurable Interest | the principle which requires a person effecting insurance to have a legally recognised relationship to the subject matter of the insurance. | |
Insurance | A risk transfer arrangement whereby the responsibility for meeting losses passes from one party (the insured) to another (the insurer) on payment of a premium. | |
Insurance Policy | a document which is evidence of a contract of insurance. | |
Insured | a person or organisation purchasing insurance. | |
Insurer | a company or society transacting insurance business. | |
Intermediary | a person who arranges insurance on behalf of another. | |
Knock For Knock Agreement | an agreement between motor insurers whereby following a collision, each pays the cost of repairs to its own policyholder's vehicle, regardless of fault, provided that the vehicles involved are all insured for accidental damage. | |
Lapse | the termination of an insurance contract through the non-payment of the s decision not to invite renewal.=premium or by the insurer> | |
Law | the rules enacted or customary in a country ordering or prohibiting certain actions. | |
Leading Case | a legal case where the decision has been widely followed. | |
Leading Insurer | the insurer who accepts a share of risk on a co-insurance agreement - often the one who first signs a broker's slip. | |
Letter Of Acceptance | a letter from an insurer to a proposer indicating that his application for cover has been accepted. | |
Liability | a claim upon one's assets by another person. | |
Limit Of Liability | the maximum amount that an insurer will pay for one loss in terms of a liability policy. | |
Line | a share of an insurance which is divided among two or more insurers | |
Lloyd's | the corporation which organises the market of individual underwriters in London (but accepts business introduced by brokers from all parts of the world) and provides a full range of ancillary services. | |
Loading | Those elements added to a premium to allow for insurer's expenses. | |
Loss Adjuster/Assessor | an independent, qualified person who assesses the size or value of a loss on behalf of an insurer, but who may also be employed by an insured to look after his interests in a loss settlement. | |
Loss Of Profits Insurance | see BUSINESS INTERRUPTION INSURANCE. | |
Loss Prevention | activities undertaken to prevent losses from occurring. | |
Loss Ratio | the ratio of claims to premiums. | |
Market Value | the price at which an investment can be sold or bought at any specific time. | |
Material Damage Warranty | before interruption insurance is effective, a material damage claim under other property insurances must have been admitted. | |
Material Fact | anything which would affect the judgment of a prudent underwriter in accepting or deciding terms for a risk. | |
Misdescription | a false description of a material fact. | |
Misrepresentation | a false statement of a material fact which can be innocent or fraudulent. | |
Mortgage Bond | a loan made for the purpose of purchasing, adding to or improving property | |
Mutual Insurance Company | an insurance company owned by its policyholders i.e. it has no shareholders. | |
Negligence | failing to act in what the law considers to be a reasonable manner. | |
Net Claim | The insurer's own share of claim payments after deduction of the amount payable by the reinsurers. | |
New For Old | insurance where the replacement value of the property which has been lost or damaged is payable without deduction for depreciation. | |
Offer | The communication of the proposed terms of a contract by one party to another | |
Operative Clause | the clause in a policy which sets out the circumstances in which the insurers will make claim payments. | |
Outstanding Claims Reserves | The funds put aside by insurers to cover claims that have been incurred but not yet paid. | |
Outstanding Losses | s=claims not yet paid where estimated figures are used in the insurer accounts | |
Package Policy | a policy into which several different types of insurance have been combined. | |
Peril | A contingency or fortuitous happening which could cause losses. | |
Policy | Written evidence of the terms of an insurance contract. | |
Policyholder | the insured person. | |
Pooling | The basis of insurance whereby premium contributions are funded and used to pay losses. | |
Preamble Clause | the clause in a policy which sets out the essential elements of the contract. | |
Premium | The money paid by the insured to the insurer for cover as provided in the policy. | |
Premium Rate | the price per unit of insurance | |
Principal | A person instructing an agent to act on his behalf. | |
Pro Rata Premium | the premium based on the length of time for which the insurer was actually on risk. | |
Probability | the chance of an event occurring. | |
Professional Reinsurer | a reinsurance company not transacting any direct insurance business. | |
Proportional Reinsurance | s=reinsurance where reinsurers take a given proportion of the direct insurer premiums and losses. | |
Proposal Form | an application for insurance which seeks to obtain from the proposer all the information relating to the risk. | |
Proposer | The individual or organisation seeking insurance. | |
Proprietary Company | a company owned by its shareholders. | |
Proviso | A policy condition whose observance is essential for the enforcement of the contract. | |
Proximate Cause | the direct cause of a loss uninterrupted by any other event. | |
Quota Share | proportional reinsurance where the reinsurer accepts a fixed percentage of every risk written by the ceding company. | |
Rate | The sum charged per unit of exposure by which the premium is calculated. | |
Rated Up | The term applied to insurance where the premium is higher than usual. | |
Reinstatement | the making good of damaged property; the restoration of the sum insured after settlement of a loss on payment of an additional premium. | |
Reinstatement Of Sum Insured | The restoration of the sum insured after it has been reduced through the payment of a claim. | |
Reinsured | An insurer who effects and is entitled to be indemnified under a contract of reinsurance. | |
Reinsurer | An insurer or reinsurance company which accepts contracts of reinsurance. | |
Renewal | The process for continuing an insurance for a further period after the first or current period of cover has ended. | |
Renewal Notice | the notice issued by a short term insurer to remind a policyholder that his contract will shortly terminate. | |
Replacement Cost | the value of property as indicated by the current purchase price of a similar article. | |
Representation | a written or spoken statement made during contract negotiations. | |
Retention Limit | the maximum liability which an insurer wishes to keep for his own account in respect of a particular risk. | |
Risk | a) a situation which cannot be controlled or perfectly foreseen | |
b) the subject matter of an insurance contract. | ||
Risk Management | the business discipline applied by large commercial and industrial organisation to manage those risks which can cause losses. | |
Salvage | whatever is recovered of an insured item or part of it, on which a claim has been paid. | |
Schedule | the list of personal details of the insured and the subject matter of the insurance in a policy. | |
Self-Insurance | insurance which a business organisation finances internally by establishing a fund to meet losses. | |
Short-Period Rate | the rate of premium applied to insurances in force for periods of less than twelve months and which is higher proportionately than the annual rate. | |
Short Term Insurance | insurance that operates on a year to year basis and which may be terminated by the insurer or the insured. | |
Slip | A form submitted by a broker to underwriters containing particulars of the risk proposed for insurance. | |
Solvency Margin | the minimum size of shareholders' funds required by the supervisory authorities. | |
Special Perils | extra risks added to a policy to give cover not provided in terms of the basis wording; the term usually applies to storm, water, wind and impact damage added to a fire policy. | |
Specification | the form on which details of large risks are set out and appended to the policy. | |
Statute Law | laws promulgated by the government of a country. | |
Stop Loss Reinsurance | a form of reinsurance used as a means of limiting aggregate net losses on a particular class of business in any one year of account. | |
Subrogation | the right of one party to stand in a place of another and take up the latter's legal rights against a third party. | |
Sum Insured | the monetary limit of the insurer's liability under a policy. | |
Surplus | That part of the sum insured which the insurer does not retain and consequently reinsures. | |
Target Risk | The main risk where the client has more than one premises. This is the risk which if damaged, will affect the insurer the most. | |
Third Party | a person who is not a party to a contract. | |
Third Party Insurance (Motor) | motor insurance cover providing compensation for injury to third parties and damage to their property. | |
Third Party Fire And Theft Insurance (Motor) | third party insurance plus cover for fire damage to and the theft of the insured's own vehicle. | |
Treaty Reinsurance | a contract between an insurer and a reinsuring company under which the former agrees to give and the reinsurer agrees to accept reinsurance for risks falling within the terms of the agreement. | |
Uberrima Fides | the duty of good faith imposed on both parties to an insurance contract to disclose all material facts. | |
Under Insurance | insurance for a sum insured less than the value at risk. | |
Underwriter | an insurer; a person who makes decisions on whether or not to accept insurance business. | |
Underwriting | the process of assessing a proposal for insurance to decide on its acceptability and if so, on what terms. | |
Utmost Good Faith | see UBERRIMA FIDES ("Utmost" has been ruled to have no particular meaning in South Africa) | |
Valuations | a list of property with values allocated to each item as the basis of insurance. | |
Valued Policy | a contract in which the insurers agree to pay the sum stated in the event of total loss without the usual allowance for depreciation or appreciation. | |
Void Contract | a contract that cannot be enforced by either party. | |
Voidable Contract | a contract which one party can choose not to enforce. | |
Warranty | A condition, which must be complied with literally | |