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 | |