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Glossary of Terms Commonly Used in Insurance Policies

Below is a glossary of some of the more commonly used terms contained in, or used to describe insurance policies according the the California insurance department. This glossary is intended to provide general information only and specifically applies to California insurance matters (other state insurance departments may use slightly different terms.)

 

Insurance Professionals and Policyholders

 

Admitted Company – An insurance company authorized to do business in California.

 

Agent – A licensed person or organization authorized to sell insurance by or on behalf of an insurance company.

 

Broker – A licensed person or organization paid by you to look for insurance on your behalf.

 

Claimant – The first or third party. That is any person who asserts right of recovery.

 

Insured – The policyholder – the person(s) protected in case of a loss or claim.

 

Insurer – The insurance company.

 

Solicitor – A licensed employee of a fire and casualty agent or broker who may act for the agent or broker in some circumstances.

 

 

Policy Terminology

 

Actual Cash Value – An amount equivalent to the fair market value of the stolen or damaged property immediately preceding the loss. For real property, this amount can be based on a determination of the fair market value of the property before and after the loss. For vehicles, this amount can be determined by local area private party sales and dealer quotations for comparable vehicles.

 

Types of Insurance Coverage

Automobile Insurance – Coverage on the risks associated with driving or owning an automobile. It can include collision, liability, comprehensive, medical, and uninsured motorist coverages.

 

Binder – A temporary or preliminary agreement which provides coverage until a policy can be written or delivered.

 

Bodily Injury – Any physical injury to a person. The purpose of liability insurance is to cover bodily injury to a third party resulting from the negligent or unintentional acts of an insured.

 

Collision (Auto) – Reimburses you for damage to your automobile sustained in a collision with another car or with any other object, movable or fixed, (for example, you accidentally backed into another object while pulling out from a parking stall and causing damage to the bumper and fender of your covered automobile).

Collision Deductive Waiver – This coverage waves your collision deductible if you are hit by an negligent uninsured motorist.

 

Common Carrier Liability – Coverage for transportation firms that must carry any customer’s goods so long as the customer is willing to pay. Examples include trucking companies, bus lines, and airlines.

 

Comprehensive (Auto) – Provides coverage for any direct and accidental loss of, or damage to, your covered automobile and its normal equipment, to include but not limited to fire, theft or malicious mischief.

 

Comprehensive Glass Insurance – Coverage on an “all risks” basis for glass breakage, subject to exclusions of war and fire.

 

Credit Life Insurance – Insurance issued to a creditor (lender) to cover the life of a debtor (borrower) for an outstanding loan.

 

Disability Insurance – Health insurance that provides income payments to the insured wage earner when income is interrupted or terminated because of illness, sickness, or accident.

 

Financial Guarantee Insurance – A surety bond, insurance policy or, when issued by an insurer, an indemnity contract and any guaranty similar to the foregoing types, under which loss is payable upon proof of occurrence of financial loss to an insured claimant, obligee, or indemnitee.

 

Fire Insurance – Coverage for loss of or damage to a building and/or contents due to fire.

 

Guaranteed Insurability – An option that permits the policy holder to buy additional stated amounts of life insurance at stated times in the future without evidence of insurability.

 

Health Insurance – A policy that will pay specifies sums for medical expenses or treatments. Health policies can offer many options and vary in their approaches to coverage.

 

Homeowner Insurance – An elective combination of coverages for the risks of owning a home. Can include losses due to fire, burglary, vandalism, earthquake, and other perils.

 

Legal Insurance – Prepaid legal insurance coverage plan sold on a group basis.

 

Liability (Auto) – Coverage for a policyholder’s legal liability resulting from injuries to other persons or damage to their property as a result of an auto accident.

 

Liability Insurance – Coverage for all sums that the insured becomes legally obligated to pay because of bodily injury or property damage, and sometimes other wrongs, to which an insurance policy applies.

 

Life Insurance – A policy that will pay a specified sum to beneficiaries upon the death of the insured.

 

Medical Payments – Will pay reasonable expenses incurred for necessary medical and /or funeral services because of bodily injury caused by accident and sustained by you or any other person while occupying a covered automobile.

 

Miscellaneous Insurance – Includes insurance against loss from damage done, directly or indirectly by lightning, windstorm, tornado, earthquake or insurance under an open policy indemnifying the producer of any motion picture, television, theatrical, sport, or similar production, event, or exhibition against loss by reason of the interruption, postponement, or cancellation of such production, event, or exhibition due to death, accidental injury, or sickness preventing performers, directors, or other principals from commencing or continuing their respective performance or duties; and any insurance not included in any other classes and which is a proper subject of insurance (California Insurance Code, Section 120).

 

Mortgage Insurance – Life insurance that pays the balance of a mortgage if the mortgagor (insured) dies.

 

Team and Vehicle Insurance – Includes insurance against loss through damage or legal liability for damage, to property caused by the use of teams or vehicles other than ships, boats, or railroad rolling stock, whether by accident or collision or by explosion of engine, tank, boiler, pipe, or tire of the vehicle, and insurance against the theft of the whole or part of such vehicle (California Insurance Code, Section 115).

 

Title Insurance – Coverage for losses if a land title is not free and clear of defects that were unknown when the title insurance was written.

 

Uninsured Motorist Bodily Injury – Will pay you and your passengers for bodily injury cause by a negligent uninsured motorist, a hit-and-run driver, or by a driver whose insurer is insolvent.

 

Uninsured Motorist Property Damage – Will pay for damages to your automobile, set up to a limit, when caused by a negligent uninsured motorist.

 

Workers Compensation Insurance – Coverage providing four types of benefits (medical care, death, disability, and rehabilitation) for employee job-related injuries or diseases as a matter of right (without regard to fault).

 

 

General Insurance Terms

 

Cancellation – The termination of insurance coverage during the policy period. Flat cancellation is the cancellation of a policy as of its effective date, without any premium charge.

 

Claim – Notice to an insurer that under the terms of a policy, a loss maybe covered.

 

Claimant – The first or third party. That is any person who asserts right of recovery.

 

Decline – The company refuses to accept the request for insurance coverage.

 

Deductible – The amount of the loss which the insured is responsible to pay before benefits from the insurance company are payable. You may choose a higher deductible to lower your premium.

 

Depreciation – A decrease in value due to age, wear and tear, etc.

 

Endorsement – Amendment to the policy used to add or delete coverage. Also referred to as a “rider.”

 

Exclusion – Certain causes and conditions, listed in the policy, which are not covered.

 

Expiration Date – The date on which the policy ends.

 

Face Amount – The dollar amount to be paid to the beneficiary when the insured dies. It does not include other amounts that may be paid from insurance purchased with dividends or any policy riders.

 

Incontestable Clause – A policy provision in which the company agrees not to contest the validity of the contract after it has been in force for a certain period of time, usually two years.

 

Limit – Maximum amount a policy will pay either overall or under a particular coverage.

 

Loan Value – The amount which can be borrowed at a specified rate of interest from the issuing company by the policyholder, using the value of the policy as collateral. In the event the policyholder dies with the debt partially or fully unpaid, then the amount borrowed plus any interest is deducted from the amount payable.

 

Material Misrepresentation – The policyholder / applicant makes a false statement of any material (important) fact on his/her application. For instance, the policyholder provides false information regarding the location where the vehicle is garaged.

 

Misquote – An incorrect estimate of the insurance premium.

 

Peril – The cause of a possible loss. For example, fire, theft, or hail.

 

Policy – The written contract of insurance.

 

Policy Limit – The maximum amount a policy will pay, either overall or under a particular coverage.

 

Premium – The amount of money an insurance company charges for insurance coverage.

 

Premium Financing – A policyholder contracts with a lender to pay the insurance premium on his/her behalf. The policyholder agrees to repay the lender for the cost of the premium, plus interest and fees.

 

Property Damage – Damage to another person’s property. The purpose of liability insurance is to cover property damage to a third party resulting from the negligent or intentional acts of an insured.

 

Replacement Cost – The cost to repair or replace an insured item. Some insurance only pays the actual cash or market value of the item at the time of the loss, not what it would cost to fix or replace it. If you have personal property replacement cost coverage, your insurance will pay the full cost to repair an item or buy a new one once the repairs or purchases have been made.

 

Replacement Value – The full cost to repair or replace the damaged property with no deduction for depreciation, subject to policy limits and contract provisions.

 

Reinstatement – The restoring of a lapsed policy to full force and effect. The reinstatement may be effective after the cancellation date, creating a lapse of coverage. Some companies require evidence of insurability and payment of past due premiums plus interest.

 

Rider – Usually known as an endorsement, a rider is an amendment to the policy used to add or delete coverage.

 

Short-Rate Cancellation – When the policy is terminated prior to the expiration date at the policyholder’s request. Earned premium charged would be more than the pro-rata earned premium. Generally, the return premium would be approximately 90 percent of the pro-rata return premium. However, the company may also establish its own short-rate schedule.

 

Surcharge – An extra charge applied by the insurer. For automobile insurance, a surcharge is usually for accidents or moving violations.

 

Surrender – To terminate or cancel a life insurance policy before the maturity date. In the case of a cash value policy, the policyholder may exercise one of the non-forfeiture options at the time of surrender.

 

Underwriting – The process of selecting applicants for insurance and classifying them according to their degrees of insurability so that the appropriate premium rates may be charged. The process includes rejection of unacceptable risks.

 

Waiting Period – A period of time set forth in a policy which must pass before some or all coverages begin.

 

Source: California Deparment of Insurance