Glossary Flashcards
Accident Insurance
Covers expenses associated with a covered accident and can extend to ambulance and emergency room
expenses, intensive care, and hospital costs. Accident insurance also provides for loss of income, and a
death benefit if injuries prove fatal.
Accumulated Depreciation
The total decrease in an item’s value over a period of time. Formula: (annual depreciation x number of
years used). Subtract this number from the item’s replacement cost to get its actual cash value (ACV)
Acreage Reporting Date
In crop insurance, the deadline for providing the insurer with an acreage report, which is used to
determine the amount of coverage needed and the premium charged for a particular crop.
Actual Cash Value (ACV)
A valuation method used by insurers to reflect an item’s current market value right before being damaged
or destroyed. Formula: (replacement cost - accumulated depreciation)
Actual Production History
A history of a farmer’s crop yields over a multi-year period, which is used to determine the normal
production level of a farm.
Adhesion
Characteristic of an insurance contract. Means that one party (the insurer) sets the terms, and the other
(the policyholder) can “take it or leave it.”
Adjusted Gross Revenue
Crop Insurance
Narrowest (and least expensive) form of crop revenue insurance. Insures farm revenue as a whole
instead of individual crops. Guarantees a percentage of the insured farm’s average revenue.
Adjuster
An agent who, for compensation, processes insurance claims. The adjuster investigates the damages,
evaluates the claim, and makes a fair and equitable settlement based on the insurance contract. Can
represent either the insured or the insurer.
Adjuster – Emergency
Adjusters who are temporarily licensed by the insurance commissioner to handle claims during
catastrophes or emergencies that produce an overwhelming number of claims in a short period of time
Adjuster – Independent
Self-employed adjusters who contract with multiple insurers at the same time. Paid on a commission or
fee-plus-expenses basis for each claim. Also called: Fee Adjuster, Bureau Adjuster.
Adjuster – Public
An adjuster who is hired to represent the claimant and help determine a fair indemnification. Usually
specializes in appraisals and negotiation. Paid commission, usually a percentage of final settlement.
Adjuster – Staff
Salaried employee of one insurance company who can work locally, regionally, or nationally. Also called:
Company Adjuster.
Advance Payment
Settlement
A settlement option that lets the insurer offer some financial relief to the claimant before the claim has
been fully settled. The insurer makes advance payments to the claimant, which are then subtracted from
the final settlement amount. Often used when a claimant suffers bodily injury and is unable to work.
Agency Authority
The agent’s authority to act on behalf of someone else (the principal), usually an insurer. This authority is
derived from the agent’s contract with the principal. It can be apparent, express, or implied.
Agency Authority –
Apparent
Indirect authority that the agent can reasonably be assumed to have, based on appearances. If an
adjuster is equipped to represent an insurer (with the insurer’s permission), then an individual can assume
that the adjuster has the authority to act on the insurer’s behalf.
Agency Authority –
Express
Authority that is expressly given to the agent in writing. Allows the agent to act on behalf of the principal.
Agency Authority – Implied
Authority that an agent possesses by implication of her behavior, regardless of whether this authority is
granted in writing. For example, a person portraying herself as a representative for an insurance
company, even though she is not employed by that company.
Agent (Insurance)
Someone who has received authority from an insurer to sell or service insurance policies.
Agreed Value
A valued policy in which the insurer and the insured agree to a specific value for an item, appraised at the
inception of the policy. Often used to insure items whose value is difficult to quantify, such as antiques or
fine art. Also called a Guaranteed Value policy.
Agreement
One of the four requirements of a legally binding contract. All parties involved must agree to the terms of
the contract. Can also refer to a binder, which is the preliminary substance of a contract.
Agricultural Producer
A business that grows, harvests, and sells crops for profit.
Aleatory
A characteristic of an insurance contract. Means “depending on an unknown future event.” An insurance
contract will only pay IF and WHEN covered damages occur. Neither party knows how much the contract
will end up paying when they enter into the contract.
Answer
In liability cases, the defendant’s response to a complaint. There are three possible answers: 1) accept
complaint and pay for damages, 2) deny the complaint, or 3) accept the complaint with a right to insert
evidence into the case.
Annual Depreciation
An item’s replacement cost divided by the number of years in its expected lifespan.
Annual Transit
An uncontrolled inland marine form that covers loss of goods in transit. It applies to all of the insured’s
shipments during the year.
Appraisal
A dispute resolution method which allows the claimant and the insurer each to select an appraiser. The
two appraisers in turn select an umpire. The appraisers then work together to determine a settlement
amount. If they cannot agree, the umpire steps in. Agreement by any two of the three is binding.
Arbitration
A dispute resolution method in which the opposing parties each submit their evidence to a mutually-agreed-upon and neutral third party, called an arbitrator. The arbitrator reviews the positions of each
opposing side and makes a final and legally binding decision.
Arbitrator
The mutually-agreed-upon and neutral third party in an arbitration who reviews the positions of each
opposing side before making a final and legally binding decision.
Artificially Generated
Current
Also called “artificial current.” A peril covered in some property insurance policies. It includes sudden and
accidental damage from any electrical current, except currents that are naturally generated, such as
lightning or static electricity.
Auto Policy
Insurance policy designed to protect the policyholder while owning, occupying, or operating a vehicle.
Usually combines liability coverage and property coverage into one policy.
Automobile
In insurance policies, automobile generally means any vehicle designed for use on public roads.
Automobile No-Fault Laws
Laws in effect in some states that require any owner of a vehicle to purchase no-fault insurance; that is,
insurance that indemnifies the insured, regardless of who was at fault in an accident. No-fault laws also
restrict the insured’s right to sue the at-fault party.
Aviation
Aviation insurance combines hull insurance for the aircraft and liability insurance for any damage to
others’ property or to people who are not passengers.
Average Weekly Wage
AWW
The average amount of income that an employee earns each week while able to perform normal job
duties. When an employee is injured on the job, his workers’ compensation income benefits will depend
on his AWW before the injury.
Bailee
An individual or company that receives the property of someone else for a special purpose and returns
the property after use.
Bailee Coverage
Reimburses a bailee’s customer for damage to the customer’s property while in the bailee’s control.
Binder
A temporary contract provided by an insurer, which ensures coverage until the complete, permanent
policy is issued.
Black Lung Benefits Act
Federal program that provides monthly payments and medical treatments to coal miners who become
totally disabled from black lung disease or pneumoconiosis.
Bodily Injury (BI)
Physical damage to someone’s person. Liability insurance covers bodily injury that the insured might
cause to another person through negligence.
Boiler & Machinery
Insurance coverage designed to indemnify a business for damages to, and damages by, boilers,
machinery, motors, generators, and a variety of other electrical devices and appliances.
Bond
A contract wherein one party guarantees the performance of a third party. Bonds involve three parties:
(1) the surety agrees to pay the second party, (2) the obligee, if the third party, (3) the principal, neglects
to carry out an obligation it has to the obligee.
Breach of Product
Warranty
The failure or falsehood of a stated promise of a product stipulation.
Business Auto Policy
BAP
Provides property damage and liability insurance for automobiles used by a business.
Business Floater
Inland marine coverage form designed for items that are excluded from most property contracts, such as
accounts receivable records, manuscripts, blueprints, etc.
Business Interruption
Coverage
Commercial insurance form designed to indemnify a business if a covered peril leads to lost profits or
revenue. The most common type of Time Element Insurance.
Business Personal
Property
Moveable property used for business.
Cancellation and
Nonrenewal Condition
Establishes when and how the insurer or the insured can terminate an active insurance contract. The
policyholder can cancel at any time by giving a written notice. Typically, the insurer may only cancel the
policy for a few specific reasons, and it must give written notice of the cancellation or non-renewal
anywhere between 10 and 60 days in advance.
Capitation
An arrangement in which an insurer pays a certain healthcare provider up front, and in return, the
healthcare provider agrees to treat all of that insurer’s members.
Catastrophe
An occurrence or a sequence of occurrences that causes enormous property losses. Catastrophes are
normally uninsurable by private insurers.
Cause of Loss
A form included in a commercial package policy or a commercial property policy that lists the causes of
loss against which the insured property is covered.
Certificate of Insurance
An official document that contains the details of an insurance policy. It typically lists the insurance
company, the named insured, what is covered, and the dates of the policy period, among other things.
Policyholders may be required to present their certificate as proof that insurance coverage is in effect.
Commercial General
Liability (CGL)
A policy that protects a business against damages and injuries it may cause to third parties.
Civil Law
Observes court cases of one citizen charging another citizen for damages caused by tort. Differs from
criminal law.
Claim
The request for settlement that the policyholder files with an insurer after she experiences a loss.
Claims-Made Form
A liability policy in which the insurer covers claims that are filed during the policy period, no matter when
the loss occurred. The opposite of an occurrence form.
Claims Management
The practice of the insurance adjuster of managing a claim by processing it in a prompt and effective
manner from the time the claim is filed until a settlement is reached, while adhering to all local and federal
laws.
Claimant
One who files a claim with an insurer for a loss.
Coarse Grains
A provision in crop insurance that covers reduction in crop quality, as well as crop-yield losses. Coarse
grains are corn, grain sorghum, and soybeans
Code of Ethics
A set of governing professional standards of conduct, usually created by regulatory bodies or government
regulatory agencies. These standards may also be formally codified with statutes.
Coercion
The practice of forcing another party to behave in an involuntary manner (whether
through action or inaction) by use of threats, intimidation, or some other form of pressure or force.
Coinsurance
A property insurance provision that requires the policyholder to carry adequate coverage (typically at least 80% of the property’s value). If a property does not meet this requirement (i.e. if it is underinsured), the
insurer applies a penalty on claims for partial losses. The penalty requires the policyholder to pay a
percentage of the claim, depending on how underinsured the property is. To calculate: divide the actual coverage by the coinsurance requirement and then multiply that by the loss. In health insurance,
coinsurance refers to the portion of a covered claim that the insured is responsible for paying out-of-pocket, after the deductible