The insurance industry uses quite a number of technical
terms, usually for reasons of precise meaning, which are not
necessarily easily understood by the layman. This section
clarifies what the key words and phrases that you'll find in
insurance documents mean.
A - D |
E - J |
K - M |
N - R |
S - V |
W - Z
ADDENDUM
A document setting out agreed alterations to an
insurance contract. (See also endorsement).
ADDITIONAL PREMIUM
A further premium payable by the insured as a result
of policy amendment that may have increased the risk or changed
the policy conditions or sum insured.
ADJUSTER
One who investigates and assesses claims on behalf of insurers
(claims adjuster or loss adjuster).
ADVANCE PROFITS INSURANCE
Business interruption insurance of the expected
profits of a new enterprise or an extension to an existing
business.
AGGREGATE LIMIT OF INDEMNITY
The maximum amount an insurer will pay under a policy
in respect of all accumulated claims arising within a specified
period of insurance.
ALL RISKS
Term used to describe insurance against loss of or damage to
property arising from any fortuitous cause except those that
are specifically excluded.
ASSURANCE
A term interchangeable with insurance but generally
used in connection with life cover as assurance implies the
certainty of an event and insurance the probability.
AVERAGE
A clause in insurance policies whereby, in the event of
under-insurance, the claim paid out by the insurer is
restricted to the same proportion of the loss as the sum
insured under the policy bears to the total value of the
insured item.
CANCELLATION
Termination of a policy before it is due to expire.
There may be a cancellation clause in a policy setting out the
condition under which the policy may be cancelled by notice.
The period of notice could be anything from 48 hours to 3
months. In most cases this will result in a return premium
being paid by the insurer to the insured.
CLAIMS
Injury or loss to the insured arising so as to cause liability
to the insurer under a policy it has issued.
COMMON LAW
The common law consists of the ancient customs and
usages of the land, which have been recognised by the courts
and given the force of law. It is in itself a complex system of
law, both civil and criminal, although it is greatly modified
and extended by statute law and equity. It is unwritten, and
has come down in the recorded judgements of judges who for
hundreds of years have interpreted it.
COMMUNITY COMPANY
An insurance company whose head office is in a member
State of the European Economic Community.
CONCEALMENT
Deliberate suppression by a proposer for insurance of a
material fact relating to the risk, usually making the contract
null and void.
CONSEQUENTIAL LOSS
Insurance of loss following direct damage e.g. loss
of profits; loss of use insurance.
COVER NOTE
A document issued to the insured confirming details of the
insurance cover placed. Some cover notes are a legal
requirement, e.g. motor.
DEDUCTIBLE
The specified amount a loss must exceed before a
claim is payable. Only the amount, which is in excess of the
deductible, is recoverable.
DEFERRED PREMIUM
The part of a premium which, following agreement with
underwriters, is payable by instalments, usually quarterly or
half yearly.
EMPLOYERS LIABILITY INSURANCE
Insurance by employers in respect of their liability
to employees for injury or disease arising out of and in the
course of their employment. With some exemptions this insurance
is compulsory in Great Britain, and can only be provided by an
authorised insurer.
ENDORSEMENT
Documentary evidence of a change in the wording of or cover
offered by an existing policy or qualification of wording if
the policy is written on restricted terms. (See also Addendum).
EXCESS
The first portion of a loss or claim that is borne by
the insured. An excess can be either voluntary to obtain
premium benefit or imposed for underwriting reasons.
EXCLUSION
A provision in a policy that excludes the insurer's
liability in certain circumstances or for specified types of
loss.
EX-GRATIA PAYMENT
A payment made by an insurer to a policyholder where
there is no legal liability so to pay.
FIRST LOSS INSURANCE
Insurance where the sum insured is accepted to be
less than the value of the property but the insurer undertakes
to pay claims up to the sum insured, without application of
average.
GROSS PREMIUM
A term normally applied to gross written premiums before
deduction of brokerage and discounts.
HAZARD
A physical or moral feature that introduces or
increases the risk.
INCEPTION DATE
The date from which, under the terms of a policy, an
insurer is deemed to be at risk.
INCREASE IN COST OF WORKING
Under a business interruption policy some cover is
provided for additional expenditure incurred by the insured
solely for the purpose of reducing the shortage in production
following an insured event.
INDEMNITY
A principle whereby the insurer seeks to place the insured in
the same position after a loss as he occupied immediately
before the loss (as far as possible).
INDEMNITY PERIOD
Under a business interruption insurance the period
during which cover is proved for disruption to the business
following the occurrence of an insured peril.
INSURABLE INTEREST
For a contract of insurance to be valid the
policyholder must have an interest in the insured item that is
recognised at law whereby he benefits from its safety, well
being or freedom from liability and would be prejudiced by its
damage or the existence of liability. This is called the
insurable interest and must exist at the time the policy is
taken out and at the time of the loss.
INSURABLE VALUE
The value of the insurable interest that the insured has in the
insured occurrence or event. It is the amount to be paid out by
the insurer (assuming full insurance) in the event of total
loss or destruction of the item insured.
INSURANCE BROKER/INTERMEDIARY
An insurance broker/ intermediary advises their
clients and arranges their insurances. Although they act as the
agent of the client, they are normally remunerated by a
commission (brokerage) from the insurer. An insurance broker is
a full-time specialist with professional skills in handling
insurance business.
INSURANCE OMBUDSMAN SERVICE (ISO)
The ISO Scheme provides consumers with the
opportunity of resolving their disputes with a participating
insurance/savings company. It provides an independent and
impartial opinion on disputes and it is free to consumers. The
ISO's decisions are not binding on consumers. If a consumer is
unhappy with a decision of the ISO, he/she can still take the
matter to court or other dispute resolution service. The
companies are bound by the ISO's decisions.
INSURED
The person whose property is insured or in whose favour the
policy is issued.
INSURER
An insurance company or Lloyd's underwriter who, in
return for a consideration (a premium) agrees to make good in a
manner laid down in the policy any loss or damage suffered by
the person paying the premium as a result of some accident or
occurrence.
KNOCK FOR KNOCK
A forbearance agreement between two insurance
companies designed to avoid legal action. This arrangement
applies to motor vehicle policies and under it each company
agrees to pay up to the limits of their respective interests
for the damage to the vehicle of their own insured without
regard as to who was to blame for the accident.
LAPSE
The non-renewal of a policy for any reason.
LATENT DISEASE
An illness that lies dormant for some years before
manifesting itself.
LIMIT
The insurer's maximum liability under an insurance, which may
be expressed 'per accident', 'per event', 'per occurrence',
'per annum', etc
LLOYD'S (OF LONDON)
A Society, incorporated under Act of Parliament of
1871 and known as the Corporation of Lloyd's, which provides
the premises a wide variety of services, administrative staff
and other facilities to enable the Lloyds market to carry on
insurance business efficiently.
LLOYD'S BROKER
A broker approved by the Council of Lloyd's and thereby
entitled to enter the underwriting room at Lloyd's and place
business direct with underwriters. Lloyd's brokers must meet
the Council of Lloyd's stringent requirements as to integrity
and financial stability. They have to file annually with the
Council of Lloyd's a special accountant's report concerning
their financial position.
LOSS
Another term for a claim.
LOSS ADJUSTER
Independent qualified loss adjusters are used by
Insurers for their experience and expertise necessary to carry
out detailed and in some instances prolonged investigations of
complex and large losses. Although the insurers invariably pay
the adjusters fees they are impartial professional people that
make judgement on the amount to be paid in settlement solely on
the basis of established market practice. It is their task to
negotiate a settlement which is within the terms of the policy
and equitable to both insured and insurer. Should the person
appointed not be an expert in a particular discipline that is
necessary or desirable to pursue his negotiations, they will
consult or employ such an expert.
LOSS ASSESSOR
1. In motor insurance, an engineer.
2. In other classes a person who, in return for a fee (usually
a percentage of the amount claimed), acts for the claimant in
negotiating the claim.
MATERIAL DAMAGE WARRANTY
A warranty in a business interruption insurance
policy stipulating that for the interruption insurance to
become effective there must be a policy in force in respect of
the material damage and a claim paid or admitted there under
for such damage caused by an insured peril.
MATERIAL FACT
Any fact that would influence the insurer in accepting or
declining a risk or in fixing the premium or terms and
conditions of the contract is material and must be disclosed by
a proposer, or by the insurer to the insured.
NAME
Another term for an underwriting member of Lloyd's.
NEGLIGENCE
Perhaps the most common form of tort. In Blyth v
Birmingham Waterworks Co. (1856) it was defined as 'the
omission to do something which a reasonable man guided by those
considerations which ordinarily regulate the conduct of human
affairs would do, or doing something which a prudent and
reasonable man would not do'. Gives rise to civil liability.
NET PREMIUMS
Term variously used to mean gross premiums net of
reinsurance premiums payable, or commission, brokerage, taxes,
or any combination of these.
NEW FOR OLD
Where insurers agree to pay the cost of property lost
or destroyed without deduction for depreciation.
NO CLAIMS BONUS (OR DISCOUNT)
A rebate of premium given to an insured person by an
insurer where no claims have been made by that insured. Very
common in motor insurance.
NON-DISCLOSURE
The failure by the insured or his broker to disclose a material
fact or circumstance to the underwriter before acceptance of
the risk.
PASSENGER LIABILITY
The liability of a carrier to passengers.
PERIL
A contingency, of fortuitous happening, which may be covered or
excluded by a policy of insurance.
PERIOD OF RISK
The period during which the insurer can incur
liability under the terms of the policy.
PERMANENT HEALTH INSURANCE
Term used to describe contracts of insurance
providing continuing benefits in the event of prolonged illness
of disability.
PERSONAL ACCIDENT AND SICKNESS INSURANCE
Insurance for fixed benefits in the event of death or
loss of limbs or sight by accident and/or disablement by
accident or sickness. Accident and sickness may be insured
together or separately.
POLICY
A document detailing the terms and conditions applicable to an
insurance contract and constituting legal evidence of the
agreement to insure. An insurer or his representative issues it
for the first period of risk. On renewal a new policy may well
not be issued although the same conditions would apply, and the
current wording would be evidence by the renewal receipt.
POLICY HOLDER
The person in whose name the policy is issued. (See
also insured and assured).
PREMIUM
The consideration paid for a contract of insurance.
PRODUCTS LIABILITY INSURANCE
These policies cover the insured's legal liability
for bodily injury to persons, or loss of or damage to property
caused by defects in goods (including containers) sold,
supplied, erected, installed, repaired, treated, manufactured,
and/or tested by the insured.
PROFESSIONAL INDEMNITY INSURANCE
This policy protects a professional man against his
legal liability towards third parties for injury, loss, or
damage, arising from his own professional negligence or that of
his employees.
PROPOSAL FORM
A form sent by an insurer to a person requiring
insurance so as to obtain sufficient information to allow the
insurer to decide whether or not to accept a risk and what
conditions to apply if it is accepted.
QUOTE
A statement by an insurer of the premium he will require for a
particular insurance.
REINSTATEMENT
Making good. Where insured property is damaged, it is
usual for settlement to be effected through the payment of a
sum of money, but a policy may give either the insured or
insurer the option to restore or rebuild instead.
RENEWAL
The process of continuing an insurance from one
period of risk to a succeeding one.
RISK
The peril insured against or an individual exposure.
RISK MANAGEMENT
The identification, measurement and economic control
of risks that threaten the assets and earnings of a business or
other enterprise.
SALVAGE
A recovery of all or part of the value of an insured
item on which a claim has been paid.
The insurer will normally dispose of the item and apply the
proceeds to reduce the cost of the claim.
SCHEDULE
The part of a policy containing information peculiar to that
particular risk. The greater part of a policy is likely to be
identical for all risks within a class of business covered by
the same insurer.
STATEMENT OF FACT
An alternative to a completed proposal form. A
statement provided by the insurer clarifying the basis on which
insurance is accepted and what conditions apply.
STATUTE LAW
Presently the most important source of law is statute law,
otherwise known as Acts of Parliament; which may create
entirely new law, over-rule, modify, or extend existing
principles of common law and equity, and repeal or modify
existing Statute law.
SUBJECT TO SURVEY
Phrase used by an insurer to signify provisional
acceptance of an insurance pending inspection by a surveyor
whose report is necessary to determine the rate and conditions
applicable.
SUM INSURED
The maximum amount payable in the event of a claim under
contract of insurance.
THIRD PARTY
A person claiming against an insured. In insurance
terminology the first party is the insurer and the second party
is the insured.
THIRD PARTY LIABILITY
Liability of the insured to persons who are not parties to the
contract of insurance and are not employees of the insured.
UNDERLYING INSURANCE
The primary insurance as distinct from excess
insurance.
UNDERWRITER
A person who accepts business on behalf of an insurer. (See
also
Lloyd's underwriter).
UTMOST GOOD FAITH (Uberrima Fides)
Insurance contracts are contracts of utmost good
faith (uberrima fides), which means that both parties to the
contract have a duty to disclose, clearly and accurately, all
material facts relating to the proposed insurance. Any breach
of this duty by the proposer may entitle the insurer to
repudiate liability.
VIS MAJOR (ACT OF GOD)
Nugent v Smith (1876) "Natural causes directly and exclusively
without human intervention and that could not have been
prevented by any amount of foresight and pains and care
reasonably to have been expected".
WARRANTY
A very strict condition in a policy imposed by an insurer. A
breach entitles the insurer to deny liability.
WEAR AND TEAR
This is the amount deducted from claims payments to
allow for any depreciation in the property insured which is
caused by its usage.
WITHOUT PREJUDICE
Term used in discussion and correspondence. Where there is a
dispute or negotiations for a settlement and terms are offered
'without prejudice' an offer so made or a letter so marked and
subsequent correspondence cannot be admitted in evidence
without the consent of both parties concerned.
