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 mutuallyagreed-
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-ofpocket,
after the deductible has been paid.
Coinsurance Payment
(Health Insurance)
A percentage of the total health care expenses that the insured must pay.
Commerce
The exchange or transport of goods or property
Commercial
Having to do with commerce or business activity in general
Commercial Crime
Insurance
Commercial insurance that covers employee dishonesty and theft by employees or others.
Commercial Lines
A variety of insurance coverages that protect those involved in the business of creating, selling,
displaying, evaluating, or shipping, etc. Examples include: business owner’s policy (BOP); commercial
property; commercial general liability (CGL); workers’ compensation (WC); professional liability, errors
and omissions (E&O); and employment-related practices liability.
Commercial Property
Floater
A means of protecting a business’ property that is not in one fixed location. Includes domestic shipments,
instrumentalities of transportation and communication, and commercial property floater risks.
Common Crop Insurance
Policy
A single uniform policy that combines crop revenue coverage, revenue assurance, income protection, and
indexed income protection
Common Law
Based on court decisions and customs when statutory law does not provide an answer; creates
precedent.
Compensatory Damages
Money awarded in civil court for tangible and intangible damages caused by a policyholder. There are two
types: general and special
Compensatory Damages –
General
Money awarded for the emotional losses of the plaintiff that will continue after the trial date. These are a
subjective value and are determined by the court.
Compensatory Damages –
Special
Money awarded for the exact value of the physical damage caused to the plaintiff up to the trial date. This
is an objective value determined by receipts and medical bills
Competence
One of the four qualifications of a legally binding contract. All parties must be competent, with the
necessary legal and mental capacity.
Complaint
A complaint initiates a civil lawsuit by one person (the plaintiff) requesting financial relief from damages
caused by someone else (the defendant).
Concealment
The act of withholding relevant material facts from an insurer
Conditionally Renewable
Policy
A policy that gives the insurer the option to cancel coverage only if certain stated conditions are met.
Conditions
The section of a policy that qualifies or limits an insurer’s promise to pay or perform.
Consideration
One of the four qualifications of a legally binding contract. All parties must bring something of value to the
contract.
Contract
An agreement entered into voluntarily by two parties or more with the intention of creating a legal
obligation.
Contribution by Equal
Shares
Each policy pays an equal share of the loss up to the lowest policy limit. If the loss is not fully covered, the
process is repeated among the remaining insurers with available coverage. As each policy limit is
reached, the remaining portion of the loss is split equally between the insurers with available coverage
until the loss is either fully covered or all of the policy limits have been reached.
Controlled Line Floaters
Standardized forms provided by a bureau and filed with the state. These forms disclose the rates being
charged and can be used as both general property floaters (such as “personal effects” or “personal
property”) and specific property floaters that break down covered property by type.
Copayment
The amount a policyholder must pay each time she accesses the benefits of a health insurance policy.
Coverages
The amount and extent of protection provided by an insurance policy.
Crime
An offense against the state or federal government, or a breach of law, for which the offender must make
satisfaction to the public
Criminal
Someone who has been convicted of a criminal act in a court of law.
Crop Hail Insurance
A form of crop yield insurance that is usually provided by private insurers without government subsidy. It
offers named-peril protection on an acreage basis
Crop Insurance
Insurance coverage designed to protect a farmer’s financial investment in his crops. Covers losses to a
crop’s profitability.
Crop Revenue Insurance
Crop insurance that combines crop-yield insurance and price insurance to protect against losses to crop
value.
Crop Yield Insurance
Crop insurance that covers physical losses to actual crops.
Damages – General
Intangible losses, such as pain and suffering or mental anguish. See also: “Punitive Damages.”
Damages – Special
Tangible, financial losses that can be documented
Dangerous Instrumentality
Doctrine
States that anyone involved in the use of inherently dangerous products or machines is held 100% liable
for their own damages
Declaratory Judgement
Action
As an alternative dispute resolution before litigation, the court can clarify the legal relationship and the
rights of both parties: the claimant and the principal. Does NOT decide how to resolve the case.
Declarations Page
Also called the Dec page. First page of a policy, which provides a summary of the contract; includes
names of insured, addresses, coverage limits, policy period, etc.
Declined Coverage
Takes place when an insurance company rejects an application for coverage
Deductible
The amount the policyholder must pay out-of-pocket before the insurance company will pay the remaining
costs. There are three types: fixed, franchise, and percentage
Deductible – Fixed
One specific, predetermined amount that a policyholder must pay out-of-pocket before his policy
coverage kicks in
Deductible – Franchise
The policyholder only pays if the total damages come out to less than his deductible. If the cost of
damages equals or exceeds the deductible, the insurer pays the full amount and the policyholder pays
nothing
Deductible – Percentage
A deductible that is calculated as a percentage of the value of the insured risk
Defamation
Damage to another’s name or reputation, whether by libel (which is in print) or by slander (which is in
speech).
Default Judgement
A judgment entered by the court against a party who fails to present his case or defense in a civil action.
Most commonly, this applies when the defendant fails to show up and answer the claim brought against
him, so the court decides in favor of the plaintiff.
Definitions
Page in policy that gives specific limited meaning to terms used in policy
Depreciation
A decline in value of property caused by wear or loss of usefulness, usually measured by a specific
formula.
Diligence and Dispatch
An adjuster should act with speed and care in completing the adjusting process. Failure to settle a claim
in a timely manner can result in disciplinary action by the insurance commissioner, including a fine or loss
of license
Disclosure
An adjuster must disclose all financial interests in any direct or indirect aspect of an adjusting transaction.
For example, an adjuster cannot refer a claimant to his brother’s auto repair business without first telling
the claimant that the business is owned by a relative
Discoverable
Capable of being demanded and handed over as evidence in a court of law; during litigation proceedings,
the adjuster’s claims file is discoverable
DP-1
“Basic Form” of Dwelling Policy. Covers direct physical loss to property caused by only three perils: fire,
lightning, and internal explosion (coverage for other perils can be added by endorsement).
DP-2
“Broad Form” of Dwelling Policy. A named peril policy that covers everything on the DP-1 Basic from, as
well as 9 Extended Form perils and the Broad Form perils.
DP-3
“Special Form” of Dwelling Policy. Unlike DP-1 and DP-2, DP-3 offers open-peril coverage for the
property’s structures (but named peril for personal property).
Dwelling Policy (DP)
Property coverage for people and businesses who are not eligible for homeowners insurance or do not
need the extensive coverage of the homeowners policies.
Electronic Data Processing
(EDP)
An endorsement that covers the loss of computer equipment, data systems, information storage media,
and expenses or lost income related to EDP losses.
Eligibility
Eligibility Requirements are found in some insurance policies. They identify the conditions that must be
met by the policyholder in order to qualify for coverage under a policy.
End of Insurance Date
The date that crop insurance coverage will end. It is the earliest of the following: total crop destruction,
harvest of the crop, final adjustment of a loss, abandonment of a crop, or a date predesignated by crop
type.
Endorsement(s)
An optional provision that can be added to a policy to increase, reduce, or modify coverage for specific
property types or perils
Errors and Omissions
(E&O)
Liability insurance that indemnifies professionals for errors or oversights on the part of the insured that
caused harm to their clients
Estoppel
A legal principle that bars a party from asserting something contrary to what has been implied by his
previous actions or statements. This is a form of “implied waiver”; for example, if the insurer regularly
accepts late payments, it waives its right to deny coverage due to late payment
Ethical
Adhering to moral laws and to principles of fairness
Equipment Floater
An uncontrolled form that covers heavy machinery and equipment needed to conduct business.
Protection on this form includes loss by fire, landslide, theft, and other perils to equipment that is being
stored, on its way to the job site, or at the job site itself. Coverage is available on an open peril or named
peril basis for all equipment, whether rented, owned, or borrowed.
Evaluation
The process of determining the approximate value of damages relevant to a claim (i.e. total of medical
bills, costs of repair & replacement of damaged property) and considering the financial provisions of the
insurance policy to decide on a fair settlement amount.
Excess Policy
Pays for a loss only after the primary policy’s limits have been exhausted. See also: “Primary Policy.”
Exclusions
A section of an insurance policy that reduces coverage by listing specific individuals, property, or perils
that the policy does NOT cover
Exposure
The extent to which an item is open to damage or loss. More exposure means a loss is more likely, so
this is a determining factor in an insurer’s underwriting decisions
Fair Credit Reporting Act
(FCRA)
This act regulates how companies collect, share, and use consumers’ personal and financial information.
It is enforced by the US Federal Trade Commission and civil lawsuits.
False Advertising
Presenting something to the public in a deceptive or untrue manner; misrepresentations in
advertisements
Farm
A property where a farmer or rancher both resides and conducts commercial business.
Farm Liability Coverage
Form
A form added to a farm insurance policy that provides coverage for injury and damage to a third party.
Farm Property Coverage
Form
A form added to a farm insurance policy that provides coverage for the dwelling, other structures, farm
structures, and both household and farm personal property.
Farmer
Someone in the business of growing, harvesting, and selling crops for profit. In farm insurance, a farmer
must reside and do business on the same premises.
Federal Crop Insurance
Act
Legislation passed by Congress that established the federal crop insurance program.
Federal Crop Insurance
Corporation (FCIC)
A government-owned corporation that manages the federal crop insurance program.
Federal Emergency
Management Agency
(FEMA)
A branch of homeland security that coordinates relief programs when disaster strikes an entire
community.
Federal Employees
Compensation Act (FECA)
Federal program that provides insurance for civilian employees of the federal government. As a workers’
compensation program, FECA covers disability or death sustained while the employee is on the job. Pays
medical expenses and two-thirds of normal monthly salary while the employee is unable to work.
Additional payments may be made for permanent injuries or to dependents.
Federal Employers
Liability Act (FELA)
Federal program enacted in 1908 before most state workers’ compensation laws. FELA protects only
interstate railroad workers and their families, by allowing workers who are not covered by regular WC
laws to sue their employer
Fiduciary
One of the terms that describes the adjuster’s relationship with the principal (the insurer). As fiduciary
agent, the adjuster acts for the benefit of the principal, rather than for his own benefit.
Fiduciary Duty
A legal relationship in which one party represents the best interests of another. As the insurer’s fiduciary
agent, the adjuster makes financial decisions on behalf of the insurer and must uphold the insurer’s
financial interests in all transactions,while ensuring that claims are settled fairly according to their
insurance contracts. This means the adjuster must perform her job with honesty and “utmost good faith”
at all times.
Final Planting Date
In crop insurance, the last day to plant crops in order to receive the full insurance yield and/or revenue
guarantee selected.
First Named Insured
The first person or entity named as insured on the declarations page of a policy
First Party Claim
A claim that a policyholder files with her own insurer (as opposed to a third party claim, which the claimant
files with someone else’s insurer).
Floater
A term for inland marine policies that cover mobile property. See also: “Controlled Lines Floater” and
“Uncontrolled Lines Floater.”
Flood
An overflow of inland or tidal waters; an unusual or rapid accumulation of runoff or surface waters from
any source; mud flows; collapse or subsidence of land along the shore of a lake or other body of water.
Flood Insurance
Provides relief following flood damage to communities who participate in the NFIP floodplain management
system; covers damages to the building and its contents
Floodplain Management
Maps out areas with high risk of flood, so that communities will avoid building in these areas
Fraternal Benefit Societies
Non-profit, mutual aid organizations that engage primarily in charitable or benevolent activities. They offer
their members insurance against death, disease, and disability. Also known as Fraternal Associations
Fraud – Hard
Deliberately faking or causing an incident in order to collect money
Fraud – Soft
Inflating the gravity or the extent of claims in order to receive a higher indemnification.
Free on Board (FOB)
Destination Point
A term used in Ocean Marine insurance. It means that the title to the property being shipped remains with
the shipper until it arrives at the buyer’s destination and the buyer accepts the property
Free on Board (FOB)
Shipping Point
A term used in Ocean Marine insurance. It means that the title to the property being shipped transfers to
the buyer as soon as the property leaves the shipping dock.
Full Release Settlement
A settlement option whereby the insurer pays all damages at once in an immediate “lump sum” and the
claimant signs a “full release form” which releases the insurer from any further liability. This is the most
common settlement option.
Good faith
Acting honestly and fairly, with good intentions and full disclosure.
Government Insurance
An insurance program where risks are transferred to a government agency. Also known as social
insurance. Government insurance usually exists in situations where the exposure to loss is too high for
private insurers to reliably insure risks.
Group Risk Income
Protection
A form of Crop Revenue Insurance that protects a whole county or area instead of individual farmers.
Automatically indemnifies if county income falls below a certain level.
Guaranteed Renewable
Policy
A disability or life insurance policy that cannot be canceled by the insurer until the insured reaches a
certain age. The insurer may increase the premiums over the life of the policy
Guaranty Association
A non-profit association of insurers from similar markets that handle and pay claims for insurers that have
been declared insolvent
Hazard
An instance, behavior, or condition that increases the chance of incurring a loss, or increases the severity
of the loss
Hazard — Legal
Any legal action that increases the chance of a loss
Hazard – Moral
Conscious and deliberate action on the part of the insured that increases the chance of a loss. All
conscious acts committed with a hope to defraud the insurance company are moral hazards
Hazard – Morale
Unconscious tendency of insured people to engage in riskier behavior
Hazard – Physical
Any physical condition that increases the chance of a loss.
Health Insurance
Portability and
Accountability Act (HIPAA)
A 1996 US law protecting consumer privacy, regulating collection, use and storage of private medical
information. Deals mainly with the portability of health insurance and dictates that all employees must be
eligible to participate in health insurance coverage when they join a new company, regardless of current
health status
Health Maintenance
Organization (HMO
A managed care organization that provides health insurance to individuals through a provider network.
Provides a broad range of comprehensive medical care.
HO-2
The “broad” form of homeowners insurance; a basic, named-peril HO form that nevertheless is less
limited than the HO-8.
H0-3
“Special form” of homeowners insurance; all-peril coverage for structures, named-peril coverage for
contents.
H0-4
“Contents broad form”; named-peril renter’s policy covering only personal property and any structural
improvements made at the tenant’s own expense.
H0-5
“Comprehensive form” of homeowners insurance; provides all-peril coverage for both structures and
contents.
H0-6
“Condo” or “unit owner’s form”; named-peril homeowners policy covering personal property and the
surface structure of a condominium.
H0-8
“Modified coverage form” of homeowners insurance; named-peril coverage for structures and contents,
fewer perils covered.
Homeowners Policy
An insurance policy that combines property coverage with liability coverage for a person’s home.
Hospital Expense
Insuranc
Provides coverage for a variety of hospital expenses, including room and board, medical expenses, lab
fees, and nursing care.
Hospital Indemnity
Insurance
A supplemental coverage that provides a flat amount of indemnification per day for hospitalization
Impaired Property
Property that is defective because the insured’s deficient or incomplete additions or work
Income Protection (Crop
Insurance
A form of crop revenue insurance. Relatively inexpensive, it provides a fixed revenue guarantee based on
early commodity prices for the crop type.
Indemnification
Reimbursement for a loss, which leaves the claimant in the same financial position that she was in before
the loss.
Indemnify
To restore by payment, repair, or replacement
Indemnity Insurance
Insurance that indemnifies loss as opposed to liability
Inducements
Actions, items, or promises made to someone in order to motivate them to act in a certain way. Examples
of inducements include kickbacks, gifts and bribes.
Inherent Vice
A characteristic in a thing itself that causes gradual deterioration or self-destruction. Losses or damage
related to inherent vice are not insurable
Inland Marine Insurance
Insurance that covers property being transported over land, or property that is involved in the
transportation of goods
Instrumentalities of
Transportation and
Communication
A term used in Inland Marine insurance that refers to property directly related to transportation and
communication, including bridges, tunnels, roads, dams, piers and docks, oil pipelines, power
transmission lines, and radio and TV towers
Insurable acreage
All of the acreage of the insured crop, for which a premium rate is provided in the actuarial documents, in
which the insured has a financial interest, and which is planted in the county listed on the application
Insurance
A financial device that transfers the risk of unexpected, catastrophic losses from one party to another.
Insurance Commissioner
Most states have an insurance commissioner who is responsible for regulating many aspects of the
insurance industry (especially those concerning the financial solvency of the insurers doing business in
the state). The commissioner oversees the financial stability of insurers and regulates the rates that
insurers charge
Insurance Company
Company which sells insurance policies to individuals or to other companies.
Insurance Fraud
Using insurance to obtain money unlawfully. This can be done by a policyholder, or by an insurer or an
insurer’s employees. There are two kinds of insurance fraud: soft fraud and hard fraud
Insurance Information and
Privacy Protection Act
(IIPPA)
Regulates how an insurance company can use consumers’ private information. Deals specifically with
how insurance companies collect, use and share personal information about their policyholders and gives
the consumer the opportunity to prevent certain information from being shared. Requires that insurers tell
consumers why insurance coverage was declined or why insurance claims were denied.
Insurance Policy
A contract wherein an insured pays premiums to an insurer in exchange for financial protection in the
event of a covered loss.
Insurance Rating Systems
Methods of evaluating the risk involved in insuring a person, property, or a corporation. Insurers use
rating systems to calculate premiums
Insured
A person or entity who is covered under an insurance policy
Insured crop
The crop in the county for which coverage is available as specified by the policy.
Insurer
The person or entity providing coverage to one or more insureds
Insuring Agreement
A section of an insurance policy that summarizes the insurer’s promise to pay. Includes list of covered
property and perils
Interest
Direct financial interest in protecting a unit.
Intervening Cause
A separate occurrence that “intervenes” between a defendant’s actions and damage or loss to another
person. An intervening cause may decrease the defendant’s liability, if the defendant can show that it was
the intervening cause (rather than the defendant himself) that caused the damage or loss
Joint Liability
Liability shared by two or more persons.
Jones Act (Merchant
Marine Act)
Protects injured seamen by allowing them to sue for damages and to choose a jury trial. Seamen are
covered by the Jones act instead of by workers’ compensation insurance.
Judgement
An official court ruling forming a final decision resolving a dispute or forming a final decree.
Kickbacks
Any sort of reward or remuneration for referrals or favors; for example, a body shop giving money to an
adjuster for referring customers. This is unethical behavior.
Landlord
One who has leased property to a tenant
Late Planting Period
25 days after the final planting date, during which the yield and/or revenue guarantee drops by one
percent per day
Law and Ordinance
Coverage
Covers the repair or upgrade cost when new building codes, laws, or ordinances go into effect. A
common endorsement in both residential and commercial policy packages. Also known as Code Upgrade
Coverage.
Leased Worker
Worker hired through a labor leasing firm.
Legal Purpose
One of the four qualifications of a legally binding contract. The purpose of the contract must be legal (e.g.
no contracts for illicit drug deals).
Liability
An obligation to do or not to do something; responsibility for an action.
Liability Insurance
Liability insurance indemnifies a third party for damages caused by the insured’s negligence
Liability – Employer
Protects employers from claims not covered by workers’ compensation for damages and bodily injury
caused to employees while performing under the scope of their employment.
Liability – Product
Protects a policyholder from legal liability for damages to third parties caused by the manufacturing,
merchandising, distributing, or operation of a product
Liability – Professional
Professional Liability Coverage protects professionals such as doctors, lawyers, engineers, architects,
etc. It includes two types of coverage: malpractice insurance and errors and omissions insurance
Liability – Public
Protects individuals and commercial venues from any property damage or personal injury they may cause
to the general public
Libel
Damage to another’s name or reputation in print. See also: “Defamation.”
Liberalization
The liberalization clause in an insurance contract is a condition that states that the insurer can add or
broaden coverage at any time without writing up a new contract. This clause guarantees that, in the case
of legislative action that broadens insurance coverage without any increase in premiums, this additional
coverage must take effect in existing policies as well as in new policies.
License
A document that shows that a person has been granted authority by the state to act as an insurance
agent, broker, or adjuster
Limit
The limits of an insurance policy represent the highest amount an insurer will pay. Any cost above the
limits of insurance is the responsibility of the policyholder.
Limit – Aggregate
The total amount the insurer will pay for all losses during the policy period. Often appears preceded by an
occurrence limit (e.g. 100,000/1,000,000). The first number indicates the maximum payout for covered
losses in any single occurrence, and the second number indicates the total amount the insurer will pay for
all covered occurrences during the policy term
Limit – Single
Establishes 1 maximum limit for liability damages caused by the policyholder. Contrast with split limits
Limit – Split
An insurance provision that specifies different coverage limits for different parts of a claim. The most
common example is split limits in a personal auto policy, which includes 3 different limits of liability: (1)
maximum limit for bodily injury for any one individual, (2) maximum limit for bodily injury to multiple people
in any one accident or occurrence, and (3) maximum limit for property damage in any one accident or
occurrence.
Litigation
An action brought in court. Litigation takes place when an insurer and a policyholder disagree about a
settlement amount and cannot resolve their differences through any sort of negotiation.
Livestock Floater
Optional farm insurance coverage. Provides stand-alone protection for six kinds of domesticated animals
on a scheduled or unscheduled basis. Includes coverage for animals while in transit.
Longshore and Harbor
Workers’ Compensation
Act
Federal program that provides compensation and medical care to employees who are injured while on the
job on navigable waters of the United States.
Loss
Bodily injury, property damage, or damage caused by the insured’s negligent acts; loss is the the basis for
an insurance claim. Loss can also mean the sum the insurer will have to pay.
Loss – Direct
Physical harm to tangible property caused by a peril.
Loss – Indirect
An economic loss that results from the direct, or physical, loss.
Mail Coverage
A controlled Inland Marine coverage form providing open peril coverage for property sent by registered
mail. The shipper is responsible for reporting the value of property shipped with this coverage.
Major Medical Coverage
A helath insurance plan that does not restrict the policyholder to a network, provides limited coverage but
high medical coverage limits, and involves high deductibles and coninsurance rates
Machinery
Machines or the parts of a machine
Malpractice
Negligent or improper actions on the part of doctors, lawyers, and accountants etc., resulting in damage,
injuries, or losses to the person receiving their services
Marine Insurance
Covers items that are being transported, as well as the vehicles used for transportation.
Market Value
The price something will sell for in the open market, or “fair market value.”
McCarran-Ferguson Act
1945 US Law exempting insurance from most federal regulation, and placing it under the authority of the
individual states
Mechanical Breakdown
Insurance (MBI)
Covers losses due to breakdown of motor vehicles
Mediation
A method of negotiation that utilizes a neutral third party adviser to reach a mutually-agreeable solution.
Mediation differs from Appraisal in that the decision is not binding to the opposing parties.
Misappropriating Salvaged
Property
When an adjuster takes possession of salvaged property for his own use or the use of another. This is
unethical behavior. See also: “Salvaged Property
Misrepresentation
Any false or misleading statement
Mobile Agricultural
Machinery and Equipment
Coverage Form
A commercial property form that provides coverage for farm machinery and equipment when it is the only
exposure, or when coverage must be written separately
Motor Truck Cargo
An uncontrolled inland marine coverage form that protects the carrier of shipped goods while the
shipment is in transit
Multi Peril Crop Insurance
(MPCI)
A form of Crop Yield insurance that offers broad coverage for a multitude of perils. MPCI is subject to
federal regulation because it is subsidized by the government. Coverage applies per unit.
Mutual Insurance
Company
An insurance company that is owned by its policyholders who participate in dividends. These companies
have no shareholders and are not traded publicly.
Named Peril Policy
A policy that names all perils that will be covered. Contrast with open-peril policies
National Association of
Insurance Commissioners
(NAIC)
A non-profit coalition of state insurance agencies that works to protect consumers and harmonize state
laws and regulations
National Association of
State Departments of
Agricultural Research
Foundation
A non-profit association of public officials representing the Commissioners, Secretaries, and Directors of
Agriculture in the fifty states and four territories
National Center for
Agricultural Law Research
and Information
Independent agricultural and food law research and information center created to address the complex
legal issues affecting American agriculture
National Crop Insurance
Services (NCIS
A non-profit international organization specializing in statistical data analysis and reporting related to crop
insurance risk management.
National Flood Insurance
Program (NFIP)
A program that provides insurance for communities that suffer flood damage and are willing to participate
in the FEMA’s floodplain management system.
National Resources
Conservation Service
A federal agency within the USDA that works with private landowners and operators to help them protect
their natural resources
Negligence
The failure to exercise a reasonable degree of care in a particular situation.
Negotiations
Negotiations take place when the insurer and the claimant do not agree about an indemnification amount.
The insurance adjuster is often the one who will carry out the negotiations
Non-Commercial
Non-Commercial insurers are not-for-profit insurance companies that return profits to policyholders by
reducing premiums or expanding benefits
Nonconcurrency
The situation in which 2 or more policies covering the same risk have different inception and expiration
dates. Since the policies operate on different calendars, losses on the base policy may not count toward
the limit which triggers the excess policy’s coverage.
Non-Waiver Agreement
An agreement that the insurer asks the claimant to sign which states that the insurer’s investigation of the
loss can’t be used later on as proof that the loss is covered under the policy.
No Release Settlement
A settlement option whereby the insurer simply pays the bills submitted by the claimant, but the claimant
does not sign a release form to verify the payment. Usually, the checks issued to indemnify the claimant
act as a substitute for a release form. Also known as “Walk-away” Settlement
Obligee
The party in a “surety bond” that wants a guarantee that the principal will perform as promised, and is the
recipient of the contractual obligation. See also: “Principal” and “Surety (Guarantor).”
Occurrence
An unexpected event or circumstance that causes injury or damage
Occurrence Form Policy
A liability policy in which the insurer covers losses that occur during the policy period, no matter when the
claim is filed. The opposite of a claims-made form.
Ocean Marine
Insurance designed to protect property being transported overseas
Open Peril
An open perils policy covers all causes of loss except for those explicitly excluded. Also known as “All
Peril.”
Optionally Renewable
Policy
The insurer retains the option to continue coverage for the insured upon expiration of the current policy
period. The insurer may renew coverage or cancel coverage for any reason.
Out-of-pocket Expenses
Usually refers to any deductibles, coinsurance, or copayments that the policyholder pays as part of a
health insurance program
Overinsurance
Overinsurance means having insurance on a risk for more than the risk is worth. If a policyholder is
overinsured, the insurer will only indemnify a loss up to the insurable value. If the insured purposefully
overinsured the risk with the intent to commit insurance fraud, the insurer is not bound by the policy to pay
anything.
Partial Release Payment
A settlement option whereby the insurer pays a part of the claim before settling the entire claim. This kind
of settlement is common when one part of a claim is still being negotiated or where the full amount of
damages is as yet unknown (in the case of bodily injury, for example).
Peril
The actual cause of loss or damage, such as lightning, fire, or theft
Personal Articles Floater
(PAF)
Coverage for several types of property combined into a single policy; intended for property that does not
have a sufficient coverage limit in a homeowners policy. This form will specify the coverage and premium
amounts of each type of property listed. Personal Articles Floaters always provide open peril coverage,
their coverage applies anywhere in the world, and they do not have deductibles
Personal Auto Policy
(PAP)
A package policy that combines property damage and liability insurance for motor vehicles
Personal Injury
Damages to a third party’s character, reputation, or standing in the community
Personal Lines Insurance
Protects the personal and real property of an individual. A personal auto policy and a homeowners policy
are examples of personal lines of insurance, as opposed to commercial lines
Personal Injury Protection
(PIP)
A form of no-fault auto insurance utilized in some states
Personal Property Floater
Protects property owners from damage or losses to personal articles while in the process of transport
Plaintiff
The person who brings a case against another person in court
Point of Service (POS)
A type of group health insurance plan that combines characteristics of the HMO and the PPO plans.
Allows the insured to choose his own primary physician within the network and that physician becomes
the insured’s “point of service.”
Policy Period
The beginning and end dates of coverage. Found on the Declarations Page.
Policyholder
Also called the “insured”, a policyholder is a person who has purchased an insurance policy—or
contract—from an insurer.
Pollutant Cleanup and
Removal Coverage
Provides coverage in cases of accidental pollutant damage that results from a covered loss.
Power to Bind
One manifestation of the authority given to insurance agents by the principal. The principal is bound by, or
must adhere to, the guarantees and statements made by its agent
Preferred Provider
Organization (PPO)
Like an HMO, this group insurance plan provides insurance by contracting a network of physicians,
hospitals and medical care providers. Differs from an HMO in that members have more freedom to go
outside of the network to choose their own physician
Premium
A scheduled and affordable fee, paid by the policyholder to the insurer, in return for coverage.
Preponderance of
Evidence
A preponderance of evidence is enough evidence to make it more likely that an argument is true than that
it is false. In a civil trial, the plaintiff needs to provide a preponderance of evidence in order to win her
case.
Primary Insurance
Primary insurance pays first, before other policies that apply to the same loss. See also: “Excess
Insurance.”
Principal
The principal refers to an agent’s employer (usually an insurance company, but it could also mean anyone
who contracts the agent to work on their behalf and gives her the authority to do so). In a surety bond or
suretyship, the principal (obligor) is the party that first agrees to fulfill an obligation, and is the one who
purchases the bond.
Principle of Indemnity
The principle behind all insurance contracts. It states that, when a loss occurs, the insured should be
restored to his or her financial condition before the loss occurred, no better, no worse. The insured cannot
profit from a loss
Privacy
In insurance, the right of consumers to have their personal information protected.
Private Insurance
Private insurance is the term for any insurance other than social insurance. Social insurance programs
are run by the government instead of by private individuals
Private Crop Insurance
Crop insurance that does not fall under the Federal Crop Insurance Program and is provided directly to
farmers by private insurers
Proof of Loss
The form or statement that the policyholder is required to submit to the insurer before she can be
indemnified for a loss
Property Damage (PD)
Damage or loss of use of personal property.
Pro Rata Apportionment
When a loss is covered by more than one policy, the policies split the loss, based on the percentage of
coverage each policy provided. For example, if a couple has 2 dwelling policies, one for $100,000 and the
other for $50,000, and a loss occurs, the first policy will pay 2/3 of the loss, and the other policy will pay
1/3.
Proximate Cause
The original occurrence, the source, of all the subsequent damages
Punitive Damages
Intangible damages awarded to the plaintiff when the defendant’s actions show intentional heinous,
antisocial behavior or extreme indifference to harm. These damages are determined by the court and the
adjuster cannot negotiate them.
Rating System
A risk management technique by which insurers identify hazards, assign risks to different classes, and set
premiums accordingly. There are also rating systems whereby agencies rate different insurers’ financial
well-being, to educate the public and try to prevent insurer insolvency.
Rebate
Refunding part of a premium, due to the creation of a new contract or change to an existing contract
Reciprocal Insurer
An unincorporated organization of subscribers that operates through an attorney-in-fact to provide
insurance benefits for its members.
Reinsurers
Companies which sell insurance to insurers to reduce the insurer’s exposure to loss.
Replacement Cost (RC)
A method of valuation based on the cost of replacing an item at current market prices, regardless of
depreciation
Reporting
One of the adjuster’s duties is to report to the principal. The adjuster must give the principal frequent
updates of her progress on any given claim.
Reservation of Rights
A notification that an insurer might give to an insured, informing him that a reported loss might not be
covered under his insurance policy
Residual Market
State run, or state subsidized, program that provides insurance coverage to high-risk individuals. Residual
market programs collect and maintain large premium pools made of required contributions from other
insurers. Also known as “Shared Markets” or “Involuntary Markets.”
Retroactive date
Date preceding a policy period before which the policy will not cover occurrences.
Revenue Protection (Crop
Insurance)
This MPCI policy insures against losses caused by low yield, low prices, or a combination of both. This
coverage is broader than yield protection, since it can account for falling prices as well as poor
production. The revenue guarantee is based on the higher of: harvest-market price or early market price.
Previously called Crop Revenue Coverage (CRC).
Revenue Assurance (Crop
Insurance) Protection
Guarantee
A form of crop revenue insurance that provides a fixed revenue guarantee based on average county
prices.
Risk
In the insurance industry, risk can have two meanings: 1) the potential for financial loss; being exposed or
open to damage, and 2) an insured item.
Risk – Pure
Risk that does not entail the possibility of gain; the only possible outcomes are a loss or no loss. Insurable
(as opposed to speculative risk which is uninsurable).
Risk – Speculative
Risk that might result in gain, loss, or no change in circumstance (as opposed to pure risk, which does not
include the possibility of gain). Uninsurable
Risk Avoidance
Insurers’ practice of denying insurance applications that they believe would involve an inordinate amount
of risk.
Risk Management
Measures taken by an insurance company to ensure that their exposure is not too high and to control the
effect of a loss; for example, an insurer might charge higher premiums to drivers who have received
speeding tickets
Risk Management Agency
A federal agency under the USDA that administers the Federal Crop Insurance Program.
Risk Purchasing Groups
Groups of people with similar insurance needs who form an organization to buy insurance as a group.
Risk Reduction
An insurer practices risk reduction when it takes precautions in order to reduce its exposure; for example,
requiring that all homes insured by a homeowners policy have fire alarms installed.
Risk Retention
An insurer practices risk retention when it chooses to insure a risk instead of denying coverage.
Risk Retention Group
(RRG)
A group in which the members insure each other, using their own capital to write insurance policies
Sales Closing Date
The last date on which an insurance application for a particular crop can be completed and signed
Salvage
Salvage is damaged property that has cash value. In homeowners insurance, the policyholder has the
option of keeping the salvage and accepting a smaller settlement from the insurer. The insurer has the
option of keeping the salvage if they have fully indemnified the insured.
Scheduled Payment
Release
Sometimes called “open-ended release” or “rehabilitation settlement.” The insurer agrees to pay all of the
special damages and general damages that have accumulated so far, and agrees to pay special
damages in the future.
Settlement
A resolution of a dispute, or an agreement. Settlement allows an insurer and a claimant to resolve a case
before it reaches a court of law.
Settlement Padding
Increasing the settlement amount dishonestly in order to increase one’s commission. This is unethical and
criminal behavior
Severability of Interests
An insurance provision that states that coverage applies to each insured separately, as if no other insured
existed. Each individual insured is protected as a separate entity, even against other insureds (if one
insured were to file a claim against another insured), but the limits of the policy still apply to all insureds
collectively. Also known as “Separation of Insureds.”
Slander
Damage to another’s name or reputation in speech. See also: “Defamation.”
Small Grains
In crop insurance, a provision that covers reduction in crop quality, as well as crop-yield losses. Small
grains are wheat, barley, and oats. See also: “Coarse Grains”
Standard Fire Policy
The basic foundation for all homeowners and commercial property policies issued today. Developed in
1918 to provide insurance protection for both homeowners and commercial property owners, it was
typically a named peril policy, but it only protected against losses from fire and lightning on an Actual
Cash Value basis
Stated Value
A valuation method in which the insured simply assigns the risk a value at the outset of the policy. The
insurer will pay this amount in case of a total covered loss
Statute of Limitations
A statute based on the common law legal system that specifies the maximum period of time, after
damages occur, that legal proceedings based on those damages may be initiated.
Statutory Law
Based on laws set forth by a governing authority; i.e. state legislature
Stipulation
A stipulation is something specifically agreed to in a contract, such as an insurance contract.
Stock Insurance Company
A Stock Insurance Company is owned by stockholders, as opposed to its own policyholders (as is the
case with Mutual Insurance Companies).
Strict Liability
Holds a party 100% liable for damages when the activity or instrument they are performing is inherently
dangerous.
Structured Settlement
A settlement option whereby the insurer indemnifies the claimant in a series of smaller payments over a
set period of time, instead of paying all at once. Typically reserved for claims involving a very large
settlement amount, and the insurer often has to pay some of the amount in a lump sum up front.
Subrogation
The transfer of rights that occurs when an insurer indemnifies a claimant for a loss. The claimant transfers
to the insurer his right to collect the amount of the indemnity from the guilty party.
Sudden and Accidental
Tearing Apart
A peril covered in some property insurance policies. It refers to damage caused by rupture, cracking,
burning, or bulging of a steam or hot water heating system, an air conditioning or automatic fire sprinkler
system, or an appliance for heating water. Unlike accidental discharge, this peril includes coverage for the
system or appliance itself
Supplementary Payments
Coverage provided in liability policies to help with a variety of expenses that the insured may incur at the
request of the insurer in the event of a claim or lawsuit, such as lost wages, bail bonds, and records filing
fees. It is separate from, and not restricted by, the liability limits of the policy.
Surety Bonds
An arrangement where one party promises to perform for another party, and a third party guarantees this
promise. Then, if the party making the promise does not perform, the third-party steps in to fulfill the
obligation. This is not insurance because it involves three parties instead of two. Also known as a
“Suretyship.” See also: “Principal,” “Obligee” and “Surety (Guarantor).”
Surety (Guarantor)
With regard to a surety bond, the surety is the party (often an insurance or bonding company) that
guarantees the obligee that the principal will fulfill its contractual obligations. If the principal fails to
perform, the surety will pay the bond amount to the obligee and then go after the principal to recover their
losses. See also: “Principal” and “Obligee.”
Surgical Expense
Insurance
Provides indemnification for physician costs associated with surgical procedures.
Third Party Administrator
(TPA)
A licensed organization that collects premiums and processes claims for an insurer; basically, a company
doing another company’s outsourced administrative tasks. The risk of loss remains with the insurer, not
the TPA.
Third Party Claim
A claim filed against an insurance policy by a third party not named on that policy. Used for liability claims
Time Element Coverage
Provides coverage for an indirect loss that occurs as the result of a direct loss, when covered property
can’t be used and therefore causes an indirect loss. Usually an endorsement within a commercial
package policy
Tort
Any civil wrongdoing, whether intentional or unintentional, resulting in a court action to remedy.
Tort – Intentional
A premeditated wrongful act that causes intentional or intentional damages to another party.
Tort – Negligent
When a negligent act causes unintentional damages to another party.
Tort law
The body of law that addresses and provides remedies for any civil wrongdoing performed on another
party.
Tortfeasor
The defendant in a court case who committed the tort; also known as the defendant
Transitional yield
County 10-year yield average as determined by the National Agricultural Statistical Service. Used when issuing a crop insurance policy to a farmer who lacks four years of yield records on which to base coverage and premium amounts.
Transportations Form
An Inland Marine form designed to cover businesses that ship or receive merchandise, as well as cargo
while in transit. This can include travel by truck, train, ship, mail, or plane
Trigger
An event that “triggers” the coverage provided under a Commercial general liability (CGL) policy: in
claims-made, it is a claim, in occurrence form, it is the “occurrence.”
Trip Transit
An uncontrolled Inland Marine coverage form which insures a single shipment. Coverage applies from the
trip origination point to its destination.
Trustworthiness
The virtue of carrying out responsibilities reliably, worthy of being trusted. A necessary attribute of
insurance adjusters
Umbrella Liability Policy
An umbrella policy provides liability coverage over and above the normal or base limits of liability in a
policy. An umbrella policy is a type of Excess Liability.
Uncontrolled Line Floaters
As opposed to controlled line floaters, which are standard forms, uncontrolled line floaters are nonstandard
forms tailored to meet the needs of the insured. They are not filed with state departments of
insurance. They cover movable property and are typically used in Inland Marine insurance.
Underinsured
Not sufficiently insured against particular losses. For example, any home insured at less than 80% of its
value is considered underinsured.
Unfair Claim Settlement
Practices
Dishonest or unfair behavior related to settling insurance claims which is specifically proscribed by state
law.
Unilateral
A characteristic of insurance contracts. It means that only one of the parties (the insurer) makes a
promise to perform. The insurer is obligated to fulfill this promise, whereas the insured is free to void the
contract at any time
Uninsurable
Risks are said to be uninsurable when they do not meet certain qualifications. For example, an insurable
risk cannot involve a loss that the insured deliberately causes. Certain perils are too catastrophic to be
insurable (like war or nuclear events).
Unscheduled
Unscheduled property is property covered under an insurance contract that is not listed item by item (as
“Scheduled” property would be listed).
U.S. Environmental
Protection Agency
Federal agency primarily responsible for the implementation of most federal laws designed to protect,
enhance, and conserve the nation’s natural resources.
Utmost Good Faith
A characteristic of insurance contracts: ‘utmost’ meaning the ‘highest degree’ and ‘good faith’ meaning,
“act with honesty, fair dealing and full disclosure.” All parties to an insurance contract must act with
utmost good faith. It also applies to a fiduciary agent’s responsibility towards the principal.
Valuable Papers Business
Coverage
Provides indemnification when a business experiences a loss of vital business records
Valuation
The process of estimating what an item is worth. Methods of valuation include “Actual Cash Value,”
“Replacement Cost,” “Stated Value,” and “Agreed Value.”
Value
The estimated or appraised worth of an item, used to determine the replacement cost or indemnification
amount.
Valued policy
A policy in which the insurer and the insured agree to a specific value prior to the start of the policy. If the
item is lost or destroyed, the insurer pays the amount agreed upon
Vicarious Liability
When an act of negligence is transferred from one party to another, such as from employee to employer
or from child to parent
Waiver
A waiver is a voluntary act of relinquishing a known right, claim or privilege. Either an insured or an
insurer may waive rights. There are two types: express and implied.
Waiver – Express
An explicit relinquishment of a right.
Waiver – Implied
An implicit relinquishment of a right through behavior that seems to assume that the right does not exist
Waiver of Sovereign
Immunity
Sovereign Immunity disallows an individual to sue a governmental entity; the waiver of sovereign
immunity allows individuals to sue governmental entities under specific circumstances
Warranty
An ongoing assurance made by the insured that certain conditions in an insurance contract will be met
(for example, that the insured will maintain functional fire alarms).
Workers’ Compensation
(WC)
A form of insurance that covers medical costs and lost wages in the event of a work-related injury,
disease, or disability sustained by an employee. Purchased by employers as an “exclusive remedy” to
ensure that employees will not sue the employer.
Wrongful Death Act
Allows the individuals who are associated with a deceased person who was killed because of a negligent
act to sue the responsible party
Yield Protection (Crop
Insurance
Determined by Average Crop Yield, this Multi-Peril Crop
Insurance (MPCI) policy protects a farmer from losses caused by low crop yield.
An applicant who fails two examinations for the same line of authority must wait how long to take another examination for that line of authority
3 months
Payments for losses that cannot be precisely measured, such as the loss of companionship of spouse from another, are called __.
General damages
Transfering is a method of handling risk. Which of the following best describes the concept of transfer
Purchasing insurance
Which of the following terms indicates that an insurance contract contains the enforceable promises of only one party
Unilateral
Dennis purchased a small manufacturing firm and wants to purchase coverage for the premiums-operations and products-completed operations exposures. Which of the following types of insurance should he purchase
Commercial general liability
With regard to insurance, risk can be defined as
Uncertainty of financial loss
Which department within an insurance company organization is typically responsible for helping to cover the insurers exposed loss
Reinsurance department
Joanne and Steven have a plied for automobile insurance with ABC auto insurance. When the agent asked if anyone else drives a car they lied and do not tell him that your neighbor George who lost his drivers license due to drunk driving uses one of their cars on a regular basis to drive to work. Once the company found how about George after he had an accident they denied the claim siding with legal concepts as a reason
Fraud
All the following are optional property coverage is under business owner policies
Money and securities
Mechanical breakdown
Outdoor signs
In Alabama, the Commissioner of Insurance is
Appointed by the governor and serves a rearm concurrent with that of the governor
For an injury producing temporary total disability under Worker’s Compensation the compensation is what percentage of the employees average weekly earnings at the time of the injury subject to a maximum and minimum weekly compensation specified in the law
66-2/3%
Aviation physical damage coverage also known as aircraft hull insurance covers all of the following
Controls
Electronic navigation
Engines
These are the following things that are not covered by jewelers block coverage
Property being worn by the insured
Property exhibited in a showcase away from the premises
Property in transit by mail
The face amount of insurance provided by an industrial fire policy covering buildings under the same ownership may not exceed what amount for a weekly policy
$7,500.00
A binder is not valid be on the insurance of the policy for which it was given or Beyond how many days
90
What is the maximum amount that the business owner policy will pay for property damage to an outdoor sign not attached to a building
$2,500
Which of the following amounts is the maximum that an insurer will pay in case of a loss
Limit of liability
The insured is looking for the amount of coverage in a property and casualty policy. This information is found in the
Declaration
Comprehensive coverage pays for all the following damages
Explosion
Hitting a deer
Glass breaking
In a climate liability policy the specific date shown in the declarations indicating the first aid events are covered by the policy is called its
Retroactive dates
Self insurance is an example of what type of risk management
Retention
Which of the following is a type of surety bond
Bid
Performance
Fiduciary
Coverage for Worker’s Compensation may be obtained from all the following
Private insurance
Self insurance
The federal employers liability act
In legal terms voluntary relinquishment of a known right is called a
Waiver
These would use an error and omissions policy
Consultant
Attorney
Insurance agent
Which of the following is an eligibility requirement for homeowners policy
Named insured is the owner occupant of dwelling
No more than four families occupy the home
Dwelling is a seasonal residency
The greatest differences between the dwelling basic form DP1 in the broad form DP2 is that DP to automatically include coverages for
Vandalism and malicious mischief
Describes a major difference between surety bonds and insurance
Bonds guarantee something will happen. Insurance protects if something happens
When does flood insurance take affect
As soon as the policy is issued
The continuing education requirements do not apply to a producer who has been license in Alabama for 15 years and who is at least how many years old
60
All the following statements regarding part D coverage for damage to your auto are covered
(The coveragePays for the bag and indirect loss to the name insured rental or borrow
(This coverage is commonly known as physical damage coverage
(This coverage pays for the right and indirect loss to the name insurance cover Auto
How is burglary defined
Taking a property from inside the process by a person unlawfully entering or leaving the premises as evidence by marking of forcible entry and exit
And insured who needs coverage against the breakdown of boilers and other machinery equipment should purchase
Equipment breakdown coverage
Which of the following classes of property are specifically excluded from coverage C personal property
Credit card
Animal birds or fish
Property rented to others of the residence premises
A bailee is
Someone who has taken temporary custody of another persons property for a special purpose
And occurrence is best described as something that
May take place over time
Are the following losses of cattle would be covered under a broad form farm policy
(Lost due to an accident while loading into railroad cars
(Lost due to accident shooting of the cattle by neighbor
(Lost due to an attack by wild animals
Which one of the following Vons is purchase to protect an employer from the action of dishonest employee
Fidelity
The business owner policy will pay reasonable expenses for
One year from date of accident
The principle that restore someone to the condition he enjoyed before a loss is
Indemnity
If an employee dies at it as a result of a work related accident the occupational disease the employer must pay burial expenses up to
$6,500.00
And insurance may not transaction business in Alabama unless authorized by
A certificate authority
Which of the following endorsements will change coverage C personal property into the H03 from name peril to open peril
Special personal property
The federal government is not obligated under the TRIA to make payments for any proportion of loss that exceeds how much annually
$100 billion
What kind of insurance company is an insurance company owned by its policy owner
Mutual
Under the commercial article coverage form additional acquire property is automatically covered for up to
30 days if it is a type of property already covered by the form
A claim made policy cover claims that are
First reported during the policy period provided the event occurred after the retroactive date (if any) state in the policy
A commercial package policy must include
The common policy declaration in the common policy conditions
Workers compensation benefits for temporary partial disability will be paid for maximum of
300 weeks
Which of the following statements regarding personal liability coverage is correct
It is automatically included in both a dwelling and homeowner policies
Both parties rely on statements made to each other when writing a contract this contract is known as
A contract of utmost good faith
And insurance a waiver is best considered as
The voluntary surrender of a know right
If the policy limit of the building and personal property coverage form have been exhausted how much additional coverage is available for debris removal
$25,000
Which of the following lines of insurance is most commonly sold through debit agency system
Industrial fire
Twisting is a form
Misrepresentation
Which of the following employees is subjected to workers compensation laws
State of Alabama employee
For personal property coverage who is insured by a homeowners policy
) I live in housekeeper requested by the name insured
) the names insured
) a 20 year old resident
A minimum capital required to form an organize a new domestic stock life insurance company in Alabama in
$1 million
A personal auto policy provides coverage for all the following drivers of an insured car
)the insureds spouse
)a neighbor who uses the car but has premmison from the named insurer
)the insured child who attends school in another state
Which of the following is an example of an insurable interest
) A man’s interest in the improvement he has added to his lease apartment
) A dry cleaner interest in his customers clothing in his custody care or control
) A woman’s interest in the home she owns
Under the building and personal property coverage form how much for an insurance pay for fire department service charges
Up to $1,000
What nonprofits Occie should in Alabama protects owners of policies issued by insolvent insurers
Alabama insurance guaranty association