Adjuster
A person charged with investigating a claim to establish whether the company is liable and to what extent. The investigation can include interviews of the parties involved, property inspections, and reviewing hospital records or police reports.
Deductible
The amount that must be paid out of pocket by the policy holder before an insurance provider will pay any expenses. As a result, insurance premiums are typically cheaper when they involve this term.
Insurer
A person or company that underwrites an insurance risk; the party in an insurance contract undertaking to pay compensation.
Policyholder
Entity that owns an insurance policy and has the right to exercise all privileges under the contract of insurance, except where restricted by the rights of an assignee (see assignment). This term may or may not be the insured, or the sole or one of the be
Policy
A document detailing the terms and conditions of a contract of insurance.
Insured
Covered by insurance. A person or organization covered by insurance.
Peril
Anything that may possibly cause a loss.
Risk
Possibility of financial loss or injury.
Premium
Price an insured person or business pays for insurance protection for specific amount of time.
Replacement Cost
Amount that an entity would have to pay to replace an asset at the present time, according to its current worth. In the insurance industry, this is one of several method of determining the value of an insured item.
Bodily Injury
Part of your insurance policy that pays for the costs associated with injuries to the other person or people involved. This coverage also provides a legal defense in the event that you are sued for damages.
Collision
Auto coverage that reimburses the insured for damage sustained to their personal automobile, due to the fault of the insured driver. This type of insurance is often added as an extension of a basic policy.
Comprehensive Coverage
Coverage that helps pay to replace or repair your vehicle if it's stolen or damaged in an incident that's not a collision. This typically covers damage from fire, vandalism or falling objects (like a tree or hail).
Uninsured Motorist
This is a provision commonly found in United States automobile insurance policies that provides for a driver to receive damages for any injury he or she receives from an uninsured, negligent driver. The owner of the policy pays a premium to the insurance
Property Damage Liability
Insurance covers the cost of damages to someone else's property after an accident you cause. Most commonly, your property damage will pay out when you are at fault for an accident that causes damage to someone else's car.
No-fault Insurance
Any type of insurance contract under which insureds are indemnified for losses by their own insurance company, regardless of fault in the incident generating losses. In this sense, it is no different from first-party coverage.
Liability Insurance
Any insurance policy that protects an individual or business from the risk that they may be sued and held legally liable for something such as malpractice, injury or negligence. Intentional damage and contractual liabilities are typically not covered in t
Claim
Formal request to an insurance company for coverage or compensation for a covered loss or policy event. The insurance company validates this, and, once approved, issues payment to the insured or an approved interested party on behalf of the insured
Co-Insurance
A type of insurance in which the insured pays a share of the payment made against a claim.
Co-payment
A payment made by a beneficiary (especially for health services) in addition to that made by an insurer.
HMO (Health Management Organization)
It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis.
Limitations
Maximum amount of money that an insurance company will pay out for a claim in a policy period. These amounts are typically specified on the insurance policy.
POS (Point of Service Plan)
Type of managed care health insurance plan in the United States. It combines characteristics of the health maintenance organization (HMO) and the preferred provider organization (PPO). This is based on a managed care foundation�lower medical costs in exch
Primary Care Physician
Physician who provides both the first contact for a person with an non diagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis.
Maximum Out-of-Pocket Expense
The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, co payments, and coinsurance, your health plan pays 100% of the costs of covered benefits.
Medical Payments
Help pay for the medical or funeral expenses of covered drivers and passengers after an accident, regardless of fault. In most states, it's an optional addition to your car insurance policy.
Network
Refers to providers or health care facilities that are part of a health plan's (term) providers with which it has negotiated a discount.
Accidental Death and Dismemberment Benefit
Policy that pays benefits to the beneficiary if the cause of death is an accident. This is a limited form of life insurance which is generally less expensive.
Beneficiary
A person who derives advantage from something, especially a trust, will, or life insurance policy.
Cash Value Insurance
Cash amount offered to the policy owner by the issuing life carrier upon cancellation of the contract. This term is normally used with a life insurance or life annuity contract.
Medical Examination
Process by which a medical professional investigates the body of a patient for signs of disease.
Proceeds
A benefit that is paid out by any type of insurance policy as a result of a claim. These are paid out once a claim has been verified, and financially indemnify the insured for a loss that is covered under the policy.
Rider
Add-on to the primary policy, which offers benefits over and above the policy subject to certain conditions. One way to maximize the benefits on your life insurance policy and to customize it to suit your specific needs is by opting for this.
Suicide Clause
Clause in a life-insurance policy stating that the insurer is required to pay only the reserve or the total premiums paid if the policyholder should commit suicide within a stated period.
Term Life Insurance
Life insurance that pays a benefit in the event of the death of the insured during a specified term.
Term of Policy
Type of life insurance policy that provides coverage for a certain period of time, or a specified "term" of years.
Underwriter
They decide how much coverage the client should receive, how much they should pay for it, or whether even to accept the risk and insure them. This involves measuring risk exposure and determining the premium that needs to be charged to insure that risk.
Whole Life Insurance
Life insurance that pays a benefit on the death of the insured and also accumulates a cash value.
Act of God
An instance of uncontrollable natural forces in operation (often used in insurance claims).
Appraisal
This is a process frequently found in many insurance policies but is most commonly used in property damage situations. The language will usually state that this is mandatory when properly demanded by the insurer or insured.
Declarations
Located in a separate section of a property or casualty insurance policy and contain all of the basic information that defines the policy. These include the name of the insured, the amount of coverage and the name, description and location of the item or
Collateral
Something pledged as security for repayment of a loan, to be forfeited in the event of a default.
Hazard
Anything that increases the likelihood of loss through peril.
Loss
The injury or damage sustained by the insured in consequence of the happening of one or more of the accidents or misfortunes against which the insurer, in consideration of the premium, has undertaken to indemnify the insured.
Homeowner's Policy
Form of property insurance that covers losses and damages to an individual's house and to assets in the home. This also provides liability coverage against accidents in the home or on the property.
Renter's Insurance
Property insurance that provides coverage for a policyholder's belongings, liabilities and possibly living expenses in case of a loss event. This is available to persons renting or subletting a single family home, apartment, duplex, condo, studio, loft or
Peril
Anything that may possibly cause a loss.