ACCIDENT: An event or occurrence which is unforeseen and unintended, and occurs suddenly and at a definite place.

ACCIDENTAL DEATH BENEFIT: Provides for additional benefit in case of death by accidental means.

ACQUISITION COST: The immediate cost of issuing a new policy, including cost of clerical work, agent's commission, and medical inspection fees.

ACTUAL CASH VALUE: The cost of repairing or replacing damaged property with other of like kind and quality in the same physical condition; commonly defined as replacement cost less depreciation.

ACTUARY: A person trained in mathematics, statistics, and accounting who is responsible for determining premium rates, reserves, and dividends as well as conducting various other statistical studies.

ADJUSTABLE LIFE POLICY: A participating life insurance contract that offers the insured flexibility to change: (1) premium payments, (2) the face amount, and (3) the mix of whole life and term insurance.

ADJUSTABLE PREMIUM: A premium which an insurance company may modify under certain special conditions in accordance with a policy provision. Also may refer to an option by the owner to elect a change in premium amount.

ADJUSTER: A person who represents an insurance company who seeks to determine the extent of the firm's liability for a loss when a claim is submitted.

ADMITTED COMPANY: An insurance company licensed and authorized to do business in a particular state.

ADVANCED FUNDED PLAN: A retirement plan that accumulates funds during the time employees are actively working.

AGENT: One who solicits, negotiates or effects contracts of insurance on behalf of an insurer.

AGGREGATE: The maximum dollar amount which may be collected for a single occurrence, during the policy period or during the insured's lifetime.

ALLIED LINES: A term for forms of insurance allied with property insurance, covering such perils as sprinkler leakage, water damage, and earthquake.

ALLOCATED BENEFITS: Benefits for which the maximum amount payable for specific services is itemized in the contract.

ANNUITY: A contract that provides an income for a specific period of time, such as a number of years or for life. The person receiving the payment is called an annuitant. Annuity payments are usually made monthly but can be quarterly, semi-annually, or annually.

APPLICATION: A signed statement of facts requested by the company on the basis of which the company decides whether or not to issue a policy. This becomes a part of the contract; places reliance on statements by the applicant.

ARSON: The willful and malicious burning of, or attempt to burn, any structure or other property, often with criminal or fraudulent intent.

ASSESSABLE: A policy which gives the insurer the right to require policyholders to pay additional premium.

ASSIGNMENT: Transfer of the ownership or benefits of a policy.

AUTOMATIC PREMIUM LOAN PROVISION: Provides that if a life insurance premium is not paid, a policy loan in the amount of the premium due will automatically be made at the end of the grace period, provided there is enough available cash value to cover the loan and its interest for one year.

BASIC HEALTH CARE POLICIES: Provide first-dollar coverage for hospital, surgical, and non surgical doctor's care, usually subject to relatively low maximum dollar amounts or days of service.

BENEFICIARY: A person designated by the policyholder to receive a specified payment upon the insured's death.

BENEFIT DURATION: The maximum period during which the disability income benefits are to be payable.

BINDER: A temporary insurance contract made by an agent of an insurance company.

BOND: A three-party contract in which one party (the surety) guarantees the specific performance of a contract or an agreement between a second party (the principal) and a third party (the obligee). The surety makes the guarantee to the obligee on behalf of the principal.

BROKER: One who represents an insured in the solicitation, negotiation or procurement of contracts of insurance.

BUSINESS INTERRUPTION: Provides coverage for a loss of INSURANCE earnings in the event that the policyholder's business is shut down by fire, windstorm, explosion, or other insured peril.

CAPACITY: The financial ability of an insurer to under-write new insurance. It is generally measured by the relation-ship of premiums written to surplus (net worth) and is modified by access to reliable reinsurance.

CATASTROPHIC LOSS: A loss (or related losses) that is unbearable in that it causes severe consequences such as bankruptcy to a family, organization, or insurer.

CEDING COMPANY: An insurance company that shifts part or all of a risk it has assumed to another insurance company. The latter is the insurer.

CHARTERED LIFE UNDERWRITER: A professional designation offered by the American College to persons who:

(1) pass a series of ten professional examinations on subjects related to life-health insurance,

(2) have at least three years of life-health insurance experience, and

(3) subscribe to a code of ethics.

CLAIM: A demand to the insurer by the insured person for the payment of benefits under a policy.

CLASS RATING: A premium rate determination in which all risks with similar characteristics are charged the same rate.

COINSURANCE CLAUSE: A clause under which the insured shares in losses to the extent that he is underinsured at the time of loss or in a proportion agreed to in advance.

COMPREHENSIVE MEDICAL: Provides benefits of both a basic and a major medical health insurance policy. It is characterized by a low deductible amount, a coinsurance (participation) clause, and high maximum benefits.

CONDITIONAL BINDING RECEIPT: A receipt given for a premium payment accompanying the application for life insurance. This binds the company if the applicant is insurable to make the policy effective from the date of receipt. If you die while your application is being processed, a claim for the death benefit will be paid only if you are insurable.

CONFINING SICKNESS: An illness which confines an insured person to their home or a hospital.

CONSEQUENTIAL LOSS: An indirect loss arising from the policyholder's inability to use the property over a period of time.

CONVERSION PRIVILEGE: Right to change from term to permanent insurance without insurability.

COORDINATION OF BENEFITS: A method of integrating benefits payable under more than one health insurance plan so that the insured's benefits from all sources do not exceed 100 percent of allowable medical expenses.

COST OF LIVING ADJUSTMENT: A retirement plan provision that increases benefits during retirement years in accordance with a cost-of-living or wage index. Usually subject to a maximum increase of 4 or 5 percent per year.

DEDUCTIBLE: A provision that requires the policyholder to contribute up to a specified sum per claim or accident toward the amount of insured loss.

DEFERRED ANNUITY: An annuity under which payments will begin at some definite future date, such as in a specified number of years or at a specified age.

DEFINED BENEFIT PLAN: Clearly defines, by its benefit formula, the amount of retirement income available at retirement.

DEFINED CONTRIBUTION PLAN: A plan which provides for an individual account for each participant based solely on the amount contributed to the account- plus earnings and forfeitures.

DIRECT LOSS: A loss that results directly from a peril such as fire.

DISMEMBERMENT: Loss of, or loss of use of, specific members of the body resulting from accidental bodily injury.

DIVIDEND: Policyholder's share in the insurer's divisible surplus funds apportioned for distribution. May take the form of a refund of part of the premium of a participating policy.

DIVIDEND ADDITION: Paid-up life insurance purchased with policy dividend and added to the face amount of the policy.

DOUBLE INDEMNITY: Life insurance policy provision which doubles the death benefit when death is caused by accident.

EMPLOYEE BENEFITS: Employer-sponsored programs to increase the economic security of employees. Both insurance and non-insurance benefits are included.

EMPLOYEE STOCK OWNERSHIP PLAN (ESOP): A profit-sharing plan where employer contributions are not a function of profits. Contributions are in the form of the employer's common stock.

ENDORSEMENT: A document which modifies the protection of a policy, either expanding or decreasing its benefits, or adding/excluding certain conditions from the policy.

ENDOWMENT: Life insurance contract that pays the face amount if the insured dies during the premium paying period or at the end of this period.

EVIDENCE OF INSURABILITY: Any statement or proof of a person's physical condition and/or other factual information affecting his/her acceptance for insurance. May also include medical exam or records.

EXCLUSIONS: Specific perils or losses listed in the policy which will not provide benefit payments.

EXPOSURE: The state of being subject to the possibility of loss.

FACE AMOUNT: The amount stated in a life insurance policy to be paid upon death of the insured or the maturity date of an endowment policy.

FAMILY INCOME POLICY: A combination of decreasing term and ordinary life insurance that, in the event of the insured's death within a specified period such as twenty years, pays a monthly income of $10 per $1000 of ordinary life face amount for the remainder of the specified period, and the face amount of ordinary life at the end of this period.

FAMILY MAINTENANCE POLICY: A combination of level term and ordinary life insurance that, in the event of the insured's death within a specified period such as twenty years, pays a monthly income of $10 per $1000 of ordinary life face amount for a specified number of years from the date of your death and the face amount of ordinary life at the end of the monthly payments.

FIDELITY BOND: A contract which indemnifies an employer for losses caused by dishonest or fraudulent acts of employees.

FIDUCIARY: One who exercises discretionary authority or control over a retirement plan or disposition of its assets; renders investments advice for a fee with respect to moneys or property of a plan or has authority or responsibility to do so; or has discretionary authority or responsibility in the administration of a plan.

FIRST-DOLLAR INSURANCE: Contracts that start paying losses without any retention, perhaps in the form of a deductible by the insured.

FLOATER POLICY: A property insurance policy in which the protection follows the property wherever it may be located.

FORTUITOUS LOSSES: Losses that occur as a matter of chance. Losses are not controlled or influenced by the insured.

GRACE PERIOD: A period after a premium payment is due, in which the policyholder may make payments and during which the policy remains in force.

GROUP INSURANCE: Insurance plan under which a number of persons and their dependents are insured by a single policy, issued to their employer or an association with which they are affiliated. Individual certificates are given to each insured person.

GUARANTEED COST POLICY: Life insurance policy which does not pay dividends. Also called non-participating.

GUARANTEED INSURABILITY: Allows the periodic purchase of additional amounts of life insurance without proof of insurability.

GUARANTEED RENEWABLE: A policy the insured has the right to continue in force by the timely payment of premiums to a specified age. During this period the insurer has no right to make changes in any provision of the contract while it is in force, other than a change in the premium rate for classes of insureds.

HAZARD: A condition that increases the probability or severity of loss.

HEALTH MAINTENANCE ORGANIZATION: An organization that provides for wide comprehensive health care services for a specified group at a fixed periodic payment.

HOLD-HARMLESS CLAUSE: A contractual provision which transfers risk from one party such as a property owner to another party such as a tenant.

INCONTESTABLE CLAUSE: A clause which provides that the insurer may not contact the validity of the contract after it has been in force for a specified period, such as two years.

INDEMNITY: A principle that says an insured should not collect more from insurance than the amount of loss.

INDEPENDENT ADJUSTER: A person who represents an insurer in settling loss claims but is not an employee of the insurer or of the insured.

INDEPENDENT AGENT: An agent who represents several companies as an independent contractor rather than an employee.

INDIRECT LOSS: A loss that arises out of a direct loss but not caused directly and immediately by that peril.

INSURABLE INTEREST: If the occurrence of a loss, such as destruction of a house by fire, willaffect you adversely, you have an insurable interest.

INSURED: In life insurance, the person on whose life a policy is issued; the subject of insurance. In property and liability insurance, the person to whom, or on whose behalf, benefits are payable.

INSURING CLAUSE: The clause which sets forth the type of loss being covered by the policy and the parties to the insurance contract.

JOINT LIFE POLICY: A special contract that insures two lives (such as husband and wife) and pays upon the first or last death.

KEY-PERSON INSURANCE: Life or health insurance to protect the firm from the loss caused by the death or disability of an employee who makes significant contributions.

LAPSE: Termination of a policy caused by the policyholder's failure to pay the premium within the time required.

LEVEL PREMIUM: A premium which remains unchanged throughout the life of a policy.

LIFE EXPECTANCY: The average number of years of life remaining for a group of persons of a given age according to a particular mortality table.

LIVERY: In automobile insurance, the carrying of passengers for hire.

LOSS CONTROL: Activities that reduce the severity of a loss that has occurred.

MALPRACTICE INSURANCE: Liability insurance policy for professionals, such as physicians and surgeons, to protect them against the risk of claims for damages in connection with professional services.

MEDICAID: State programs of public assistance to persons regardless of age whose income and resources are insufficient to pay for health care.

MEDICARE: Hospital and medical insurance provided by Social Security.

MORTALITY TABLE: Shows the number of persons living, dying and the death rate starting at a certain age by year. It is used to calculate the probability of dying in, or surviving through any period.

MORTGAGE PROTECTION: A term life insurance contract in which the amount of insurance decreases at the same pace as the principal on a mortgage loan.

NON CONFINING SICKNESS: An illness which prevents the insured person from working but which does not confine him or her to a hospital or home.

OPTIONALLY RENEWABLE: A contract of health insurance in which the insurer reserves the right to terminate the coverage at any anniversary or, in some cases, at any premium-due date, but does not have the right to terminate coverage of the insured between such policy dates.

ORDINARY LIFE POLICY: Whole life insurance on which premiums are paid for life. Also called straight life.

PAID-UP POLICY: A policy that will remain in force with further premium payments.

PARTICIPATING INSURANCE: Insurance that allows the insured to share in the profits of the insurance operation. Profits are shared in the form of dividends which may also include the refund of part or all of an initial increase or overcharge in premium.

PARTICIPATION CLAUSE: Requires the insured to pay for a specified percentage of the cost or health care services covered by a health insurance policy.

PERIL: The cause of a possible loss.

POLICY LOAN: A loan made by the insurer to the owner of a life insurance policy, using its surrender value as collateral.

POLICY TERM: The period for which an insurance policy provides coverage.

PORTABILITY: The transfer of pension rights and credits when a worker changes jobs.

PRE-EXISTING CONDITION: A physical and/or mental condition of an insured which existed prior to the issuance of his or her policy.

PREMIUM: The payment made of insurance policy.

PROBATIONARY PERIOD: A specified number of days after the date of the issuance of the policy during which there is no coverage for sickness. The purpose of this type of provision is to eliminate or to reduce adverse selection.

PRO RATA LIABILITY CLAUSE: If a loss covered by this policy is also covered by other insurance, the insurer will pay only the proportion of the loss that the limit of liability that applies under this policy bears to the total amount of insurance covering the loss.

PROXIMATE CAUSE: The cause actually responsible for the loss; the one that set in motion the events that led to a loss.

PUNITIVE DAMAGES: Damages awarded separately and in addition to compensatory damages as punishment for the wrongdoer.

QUALIFIED PLAN: An employee benefit plan which the Internal Revenue Service approves as meeting the requirements of ERISA and is entitled to certain tax advantages.

RECIPROCAL: An insurance organization in which each insured assumes a share of the risk brought to the organization by other insureds.

RECURRING CLAUSE: A provision in some health insurance policies which specifies a period of time during which the recurrence of a condition is considered continuation of a prior period of disability or hospital confinement.

REINSTATEMENT: The resumption of coverage under a policy which has been lapsed.

REINSURANCE: Assumption by one insurance company of all or part of a risk undertaken by another insurance company.

RENEWAL: The continuation of coverage under a policy beyond its original term by the acceptance of a premium for a new policy.

RIDER: A document which modifies the protection of policy, either expanding or decreasing its benefits or adding/excluding certain conditions from the policy.

RISK MANAGEMENT: An organized, formal approach to dealing with pure risks.

SERVICE BENEFIT: An insurance benefit in the form of hospital or medical care services rather than money.

SPLIT FUNDING: An arrangement whereby a portion of the contributions to a retirement plan are paid to a life insurance company and the remainder invested through a corporate trustee, mostly in equities. An insurer created to make a profit for stockholders.

SUBROGATION: Gives the insurer whatever right against third parties you may have as a result of the loss for which the insurer paid you.

SUICIDE CLAUSE: A provision that precludes the payment of life insurance death benefits for a specified period of one or two years after which suicide is paid the same as death from natural causes.

SURETY BOND: An agreement providing for monetary compensation should there be a failure to perform specified acts within a stated period.

SURRENDER COST INDEX: A measure of the cost, including interest foregone, of a life insurance policy if you keep it in force for a specified period and then surrender it for the cash surrender value.

TERM LIFE INSURANCE: A type of life insurance that pays if you die during a specified time such as a year. Term insurance usually has an increased pattern of premiums over time and is pure protection (no savings).

TRADITIONAL NET COST: A measure of the surrender cost of a life insurance policy which ignores the cost of interest foregone.

UMBRELLA LIABILITY POLICY: A form of insurance protection against losses in excess of amounts covered by other liability insurance policies; also protects the insured in many situations not covered by the usual liability policies, subject to a deductible.

UNDERWRITING: The process by which the insurer decides whether or not and on what basis it will issue a policy.

UNISEX MORTALITY FACTORS: A weighed average of male and female mortality rates. Required for employer-sponsored employee benefit plans, after August 1, 1983.

UNIVERSAL LIFE INSURANCE: A flexible life insurance contract that clearly separates its insurance, investment, and expense elements.

VARIABLE LIFE INSURANCE: An ordinary life policy in which the face amount of insurance changes in relation to the performance of its investment elements subject to a guaranteed minimum face amount.

VESTING: A provision concerning the right of pension and profit-sharing plan participants to contributions made by the employer.

WAITING PERIOD: Time between the beginning of an insured's disability and the beginning of benefit payments.

WAIVER: An agreement attached to a policy which excludes from coverage certain disabilities or injuries which are normally covered by the policy.

WARRANTY: A statement made by the applicant for insurance which, if false, provides the basis for voiding of the policy.

WHOLE LIFE POLICY: A life insurance policy which remains in force throughout the life of the insured. 

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