Glossary of Insurance Terms

Glossary of Insurance Terms

Accident and Health – Including two main types of business – personal accident and medical expenses. Personal accident policies will pay a lump sum or weekly benefits in the event of accidental death or a specified injury e.g. loss of arm. Medical expenses insurance will pay the costs of treatment for acute conditions. Act of God – An event that is not the fault of any individual. Acts of God can be insurable. Actuary – A professional person qualified to apply mathematical principles to solving long-term financial problems. Additional Premium – A further premium payable by the insured as a result of policy endorsement that may have increased the risk or amended the policy conditions or sum insured. Advance Profits Insurance – Business interruption insurance of the expected profits of a new enterprise or an extension to an existing business. Agent – A person who acts for one or small number of companies, particularly in selling insurance. Aggregate Limit of Indemnity – The maximum amount an insurer will pay under a policy in respect of all accumulated claims arising within a specified period of insurance. All Risks – Wider cover than given under a normal property insurance policy. Covers any loss or damage apart from exclusions stated in the policy. Annual Business – Business written and renewable on an annual basis. Annual Premium – See Regular Premium. Appointed Representative – A firm or person who acts as agent for a ‘principal’ that is itself authorised by the FSA and that accepts responsibility for the representative’s activities. Assets – Your money, and things that you own which are worth money, such as house or shares. Assistance – The provision by an insurer or a service company of immediate practical help to resolve an insured problem (e.g. arranging medical treatment abroad/organising a roadside repair). Assurance – See Insurance. Authorised Insurer – An insurance company authorised under the Insurance Companies Act 1982 to carry on one or more classes of insurance business in the UK, and supervised by FSA. Average – A policy condition that requires the amount of a claim payment to be reduced proportionately if the policyholder has not insured his property for the full amount of its value or replacement cost. Betterment – The principle by which a claimant has to make a payment towards the cost of the claim because his or her property will be in better condition after repair than before the loss or damage occurred. Broker – An insurance intermediary who advises his clients and arranges their insurances or investments. Buildings Insurance – A policy covering the structure of a house or other building against a number of different risks. Business Interruption – See Consequential Loss. Cancellation – The process whereby units are cancelled to pay for certain expenses of unit linked funds. Capacity – The measure of an insurer’s ability to write new business. It depends on the maintenance of adequate reserves to service its financial liabilities. Captive Insurer – An insurance company set up by an industrial or commercial company, for example an oil company, to provide insurance to that company only. Certificate – Document issued by insurers as evidence that insurance is in force to meet the requirements of the law (notably for motor and employers’ liability insurance). Claim – When a policyholder or beneficiary seeks payment or settlement under the terms of a policy. Claim Frequency – The number of claims made per policy year. Claims and Underwriting Exchange – Computerised register of information from proposal, claims and renewal forms, shared by insurers as part of their efforts to combat fraud. Claims Equalisation Reserves – Funds set aside by insurers to cover the extra claims made during years when losses are severe. Claims Incurred – The amounts paid during the year plus the amounts outstanding at the end of the year, less amounts outstanding at the start of the year. The claims incurred figure shown in the revenue account tables is net of reinsurance recoveries. Claims Ratio – See Operating Ratio. Co-Insurance – An arrangement whereby a number of separate insurance companies share in the cover of one particular risk. Commercial Business – Any policy taken out by a company, partnership or organisation to cover their trade, business or profession. Commission – Money paid by an insurance company to a broker/intermediary/agent for selling policies. Common Law – The common law consists of the ancient customs and usages of the land, which have been recognised by the courts and given the force of law. It is in itself a complex system of law, both civil and criminal, although it is greatly modified and extended by statute law and equity. It is unwritten, and has come down in the recorded judgements of judges who for hundreds of years have interpreted it. Company Agents – Any persons selling insurance on behalf of one or a small number of companies, but not necessarily employed by the company. Composite Insurer – A company that transacts both life and non-life insurance. Comprehensive Cover – A policy covering a number of types of loss or damage. The term is used mainly in motor insurance, where it means that, in addition to third party cover (see Non-comprehensive Cover), the policy provides compensation to the policyholder if the insured vehicle is destroyed or damaged by accidental means. Policies may also offer additional benefits such as medical expenses and legal costs. Concealment – Deliberate suppression by a proposer for insurance of a material fact relating to the risk, usually making the contract null and void. Condition – Part of a policy stating that certain rules must be followed, for example, the duty to take reasonable care to protect property, or to report claims to the insurance company promptly. Consequential Loss – Insurance covering the loss of profits of a business and certain other costs resulting from fire or other insured events. Also known as Business Interruption. Construction & Engineering – Business covering Contractors All Risks, Engineering All Risks, Computer policies and Inspection. Contents Policy – A policy covering the contents of a home or other building against a number of different risks. Contribution – The principle of contribution applies where a risk is insured on more than one insurance policy (for example on a travel and household policy), and the two insurers concerned may share the cost of any claim. Cover Note – A document giving temporary evidence of cover while the policy and certificate are being prepared. Credit – A form of protection to traders and manufacturers against financial losses caused by the insolvency or default of their customers to whom credit has been granted for either the sale of goods or for the completion of work. Creditor – A policy providing protection against the inability to repay a loan, a credit card balance or a mortgage. Deductible – The specified amount a loss must exceed before a claim is payable. Only the amount that is in excess of the deductible is recoverable. Direct – Insurance sold without the intervention of an intermediary. Included in this category are sales via newspaper advertisements, telephone sales and business through branch offices. Earned Premium – The amount of the premium that relates to the proportion of the policy term that has already run its course. Employers’ Liability – A compulsory class of insurance that all employers must have to cover them against claims by employees who are injured at work. Endorsement – A written change to an insurance policy which becomes part of it. Equalisation Reserves – Funds set aside by insurers to cover the extra claims made during years when losses are severe. Ex Gratia Payment – Any payment made by an insurance company which is not strictly necessary, under the terms of the policy. Excess – An amount of money that the policyholder has to pay towards the cost of a claim, for example, the first £50. Excess of Loss Policy – Covers claims costs exceeding an amount specified in the policy. Exclusion – Specified property, person or event that the policy does not cover. Expenses – Costs incurred in the running of the business, including commission paid to sales staff. Expenses Ratio – See Operating Ratios. Export Credit Insurance – A policy providing cover for exporters? losses arising from non-payment. Exposure – Whether, and the extent to which, an insurer is subject to losses arising from a particular risk. Extended Warranty – A policy that allows the manufacturer’s warranty on a product to be extended for a further period of time. Facultative Reinsurance – Reinsurance that is individually arranged on a particular risk. The terms on which it is accepted are subject to negotiation and the reinsurer is thus able to accept or reject the risk offered. Fidelity & Contract Guarantee – Insurance which provides cover to businesses to reimburse them for theft or other misappropriation of money or stock by staff. Contract Guarantee provides cover for financial loss caused by failure to complete a contract on time. Financial Ombudsman Service – An organisation established by major insurance companies to settle disagreements between customers and companies. The service oversees the interests of policyholders whose complaints remain unsolved through normal company channels of communication. The service is available to all those holding personal cover. The decision of the Ombudsman is binding on the insurer, although the insured may appeal to the court if he so wishes. See Financial Ombudsman Service. Financial Services Authority – The Financial Services Authority (FSA) is an independent non-governmental body, given legal powers by the Financial Services and Markets Act 2000 to regulate the financial services industry in the UK (see Financial Services Authority (FSA). Financial Services Compensation Scheme – The Financial Services Compensation Scheme (FSCS) is a safety net for customers of financial services firms. It pays compensation if an authorised firm is unable to pay claims against it, usually because it has gone out of business. The Scheme is funded by the industry and covers deposits, insurance and investments. Fire Claim – A claim arising from damage caused by fire and explosion following fire. First Loss Insurance – Insurance where the sum insured is accepted to be less than the value of the property but the insurer undertakes to pay claims up to the sum insured, without application of average. Foreign Controlled Company – One whose ultimate parent (by-passing the existence of a UK holding company) owns more than 50% of the UK company or subsidiary. Free Reserves – Money which companies have available which is not ear-marked for any specific known liability, and so would be available to meet unexpected occurrences. Freedom of Services – This European Directive gives the freedom to insurance companies and their branches (UK or overseas) authorised in one EEA country to write business in any other EEA country without having to receive authorisation from the supervisory authority in that country. Friendly Society – Similar to a Mutual insurance company. A friendly society is owned by and established for the benefit of its members, mainly through the provision of life insurance and sickness benefit. General Insurance – Insurance of (non-life) risks where the policy offers cover for a limited period, usually one year. General Liability – Liability insurance covers the policyholder’s legal liability for injury, property damage or financial loss caused to others. Green Card – A document issued to policyholders motoring abroad as evidence that they have the minimum insurance cover required by the law of the country visited. No longer required for European travel, because minimum legal cover is now automatically included in UK policies. Home Foreign Policy – A policy that provides insurance cover where the business is written in one country, although the risk is actually situated abroad. Household Business – Includes insurance of both domestic structure and contents, together with any ”add-ons” included within the policy such as legal expenses and public liability. Inception Date – The date when cover under a policy starts. Increase in Cost of Working – Under a business interruption policy some cover is provided for additional expenditure incurred by the insured solely for the purpose of reducing the shortage in production following an insured event. Indemnity – The principle by which policyholders are put in the same financial position after a loss as they were immediately before it. Independent Intermediary – See Intermediary. Index-linked – Insurance where the amount of cover changes automatically in line with an index. Examples are the cost of rebuilding a house or replacing its contents. Insurable Interest – A principle of insurance which states that you may only take out insurance if you would suffer a financial loss if the event covered by the policy happens. Individuals have an unlimited insurable interest in their own life and that of their husband or wife. Insurance – A service that offers financial compensation for something that may or may not happen. Originally the term ‘assurance’ was generally used for life insurance, but now the two words are interchangeable. Insurance Company – A company that takes on risks under the policies it sells in return for the payment of premiums. Companies may be ‘mutual’ (owned by the policyholders) or ‘proprietary’ (owned by the shareholders). Insurance Premium Tax (IPT) – A tax imposed on most non-life insurance premiums. Insured – A person covered by an insurance policy. Insured Turnover – The amount of turnover that a company has insured. Insurer – See See Insurance Company and Lloyd’s of London. Intermediary – Person or organisation that doesn’t offer their own products but advises on or sells products from product providers such as insurance or investment firms. Investment – The act of allowing someone else to have use of your money in return for payment of interest and/or a share in profits that may be made. Invisibles – Income received by a nation from trading in services rather than goods. Key Features – A document that insurance and investment firms must produce, by law, that sets out the main features of the plan. Key Person Insurance – In the event of the death of a key employee on whom the business depends for its continued profitability, or even existence, this type of cover provides a sum of money which can be used to pay for the cost of finding and training a successor, and to compensate for reduced profitability. Knock-for-Knock – An agreement whereby each motor insurer paid for damage to its policyholder’s car, regardless of which driver was to blame, providing the policy covered damage to the policyholder’s own car. No longer in operation. Lapse – The non-renewal of a policy for any reason. Legal Expenses Insurance – Covers the cost of legal proceedings in circumstances defined in the policy. Liability – Legal responsibility for causing loss to someone else by injuring them or damaging their property. Lloyd’s Members – Individuals on whose behalf Lloyd’s of London policies are issued. They pledge all their personal wealth to pay losses. Corporate members were also introduced in 1994. Lloyd’s of London – An insurance market organised into syndicates, which underwrites most types of policy. Loading – An extra premium you are charged because of a higher risk such as poor health or dangerous job. London Market – A distinct, separate part of the UK insurance and reinsurance industry centred on the City of London. It comprises insurance and reinsurance companies, Lloyd’s syndicates, protection and indemnity clubs (originally created to serve the marine industry), and brokers who handle most of the business. There is general agreement that the core of its activity is the conduct of internationally traded insurance and reinsurance business. Loss – Another term for a Claim. Loss Adjuster – A person, independent of an insurance company but engaged and paid by it, who checks that a claim is covered and negotiates with the policyholder the amount payable for a claim. Loss Assessor – A person who negotiates claims on behalf of policyholders. Marine, Aviation & Transport (MAT) – The class of insurance which covers damage to both the hull and cargo of ships or aeroplanes, along with the liability for property damage, injury and death to passengers and others. Indemnities are also provided for the goods that may be lost or damaged whilst in transit. Material Fact – A fact that would influence an insurer’s decision on whether to issue a policy, and on what terms and conditions. You must state any material facts when you apply for cover. Mechanical Breakdown Insurance – Covers against the cost of breakdowns of household appliances or motor vehicles. Motor – Motor policies cover the legal liabilities arising from the use of a motor vehicle. Private car, motorcycle, commercial vehicles and fleets are all included within this category. Comprehensive policies also cover damage to the vehicle. Motor Insurance Anti-Fraud and Theft Register – Computerised record of claims for stolen or written-off vehicles. Used by insurers to detect multiple, and therefore fraudulent, claims. Mutual – An insurance company which is owned by its policyholders. Negligence – Perhaps the most common form of tort. In Blyth v Birmingham Waterworks Co. (1856) it was defined as ”the omission to do something which a reasonable man guided by those considerations which ordinarily regulate the conduct of human affairs would do, or doing something which a prudent and reasonable man would not do”. Gives rise to civil liability. New-For-Old – Cover for property where an item lost or destroyed would be replaced with a brand new one, with no deduction for wear and tear. Also called Replacement-as-New. No Claim Discount (or Bonus) – A reduction in a renewal premium to reflect a claim-free record; used most often in motor insurance. Non-comprehensive Cover – A policy covering a limited number of types of loss or damage. The term is mainly used in motor insurance, where a vehicle may have RTA cover – the minimum cover provided by the Road Traffic Act; third party cover, which indemnifies the policyholder for damage caused to other people’s property and injury that may be caused to others; or third party, fire and/or theft cover which additionally provides compensation to the policyholder if the insured vehicle is destroyed or damaged by fire and/or theft. Non-Disclosure – Where you or anyone acting for you, fails to state a material fact when applying for insurance. Non-proportional Treaty Reinsurance – This relates to the whole of a certain class of business and is a way of limiting the loss made by the ceding office. Operating Ratios – Figures showing ratios of claims, expenses and underwriting in relation to premium income. Outgo – The total expenditure of an insurer in relation to any class of insurance business, comprising the cost of claims and the insurer’s business expenses, including any commission paid to sales staff, Brokers or Intermediaries, together with amounts set aside for Reserves. Pecuniary Loss – This class of business loss relates to financial losses that may have occurred, e.g. Consequential Loss and Mortgage Indemnity policies. Personal Accident Insurance – A policy that pays specified amounts of money if the policyholder is injured in an accident. Depending on the type of disability, the payments may be made weekly, for a set period, or as a lump sum. Personal Lines – Any policy taken out by an individual in his/her private capacity. Pluvius Insurance – Covers against losses arising as a result of bad weather. Policy – The document giving full details of the contract between the insurer and the policyholder. Policyholder – Person or organisation to whom the insurer issues the policy. Normally the person to whom benefits are payable. Pool Re – A Government-backed reinsurance scheme that meets the cost of claims over £100,000 occurring as a result of terrorist attacks in Great Britain. Premium – The amount paid by the policyholder for insurance. Private Medical Insurance – A policy that covers the cost of private medical treatment. Product Liability Policy – Protects businesses against liability claims resulting from defects in the products they sell. Professional Indemnity – Provides protection to businesses against errors cause in their professional capacity e.g. solicitors who incorrectly advise clients. Property Damage – Property policies cover specified property that may be damaged or destroyed by events or perils such as fire, storm or theft. Proportional Treaty Reinsurance – Agreements in which the reinsured and the reinsurer participate in premiums and losses in a fixed proportion. It can apply to both facultative and treaty reinsurance. Proposal Form – An application for insurance cover. Proposer – Person or company who applies to take out insurance. Proprietary Companies – Those that are owned by shareholders. Provision of Services – See Freedom of Services. Provisions – See Reserves. Public Liability – The insurance of liability for accidental bodily injury or damage to the property of third parties. Rate – The price of insurance, usually expressed as the cost of a unit of cover, e.g. £x per £1,000. Reinstatement – Making good. Where insured property is damaged, it is usual for settlement to be effected through the payment of a sum of money, but a policy may give either the insured or insurer the option to restore or rebuild instead. Reinsurance – Reinsurance is the cover insurance companies can purchase to protect themselves against large losses or an unexpected aggregation of losses. Renewal Notice – Notice sent to the policyholder inviting him/her to renew a policy for a further period and stating the premium payable. Replacement-as-New – See New-for-Old. Reserves – Money put aside by insurers to meet known or possible future liabilities. They can broadly be divided into Technical Reserves and Free Reserves. Revenue Account – The financial statement containing the underwriting results. It usually shows premiums, claims incurred, commission, expenses and the transfer to/from the Profit & Loss Account. Risk Management – The identification, measurement and economic control of risks that threaten the assets and earnings of a business or other enterprise. Salvage – A recovery of all or part of the value of an insured item on which a claim has been paid. The insurer will normally dispose of the item and apply the proceeds to reduce the cost of the claim. Schedule – The part of a policy containing information peculiar to that particular risk. The greater part of a policy is likely to be identical for all risks within a class of business covered by the same insurer. Solvency Margin – The excess determined in accordance with the insurance supervisory rules of the insurer’s assets over its liabilities. Under those rules, this is required to be not less than a prescribed minimum. Solvency Ratio – The ratio of the net assets of a non-life insurer to its annual net written premiums. Statute Law – Presently the most important source of law is statute law, otherwise known as Acts of Parliament, which may create entirely new law, over-rule, modify, or extend existing principles of common law and equity, and repeal or modify existing Statute law. Subject to Survey – Phrase used by an insurer to signify provisional acceptance of an insurance pending inspection by a surveyor whose report is necessary to determine the rate and conditions applicable. Subrogation – The right of an insurer who has indemnified a policyholder to take over any legal rights the policyholder may have had in respect of that particular claim. Subsidence Claim – A claim arising from subsidence, heave and landslip. Sum Insured – The amount for which property is insured, and the maximum amount that the insurance company will pay for any claim. In life insurance, the amount that is guaranteed to be paid and to which bonuses may be added. Surety Bond – A guarantee to pay the direct loss and damage suffered as a result of a breach of contractual obligations. Syndicate – Group of underwriters at Lloyd’s of London. Technical Reserves – Money put aside to meet specific items, usually for events that have already happened. The four main types of technical reserves are for unearned premiums, unexpired risks, unreported claims and outstanding claims. Theft Claim – One arising from burglary, robbery and theft under the Theft Act 1968 in England and Wales, and burglary, robbery, housebreaking and larceny in Scotland and Northern Ireland. Third Party – Someone involved in a claim who is neither the policyholder nor the insurer. Third Party Administrator – An organisation to which an insurance company contracts out administration. Tied agent – A sales person who sells the policies of only one insurance company. Some sales people are tied to several companies – this is known as a multi-tie. Total Loss – See Write-Off. Trading Result – An insurer’s overall profit/loss calculated as the Underwriting Result plus Investment Income. Travel – A policy that covers a combination of loss of baggage, medical expenses, legal fees, and change in travel arrangements. Treaty Reinsurance – An agreement between offices whereby the ceding company is bound to cede and the reinsurer bound to accept a share of all risks defined in the treaty. Trust – An arrangement whereby control over an Asset is transferred to a person or organisation (known as the “trustee”) for the benefit of someone else (known as “the beneficiary”). Trustee – A person appointed to manage and safeguard the assets of a trust. Underinsurance – When the sum insured is not enough to cover the maximum possible loss or damage. Underwriter – Person who decides whether to accept a risk and calculates the premium to be charged. Underwriting Ratio – See Operating Ratios. Underwriting Result – The profit or loss achieved by an insurer on insurance underwriting activity, calculated as premium income less the cost of claims and the insurer’s expenses in connection with that business (ie “outgo”). It has been common for insurers to make underwriting losses since they also receive investment income which generally offsets the underwriting loss. Uninsurable Risk – A risk where loss is either inevitable (e.g. a house already on fire or a person suffering from a terminal illness) or gradual (e.g. rust and corrosion). Utilities / Retailers / Affinity Groups – Institutions which sell insurance policies to their customers but it is not their primary product or service. These policies are underwritten by established insurers. Utmost Good Faith – The principle of insurance which requires proposers to give all relevant information to the insurer and requires insurers to deal openly and honestly with policyholders. Warranty Insurance – This type of insurance provides cover against the cost of repairs to broken down household appliances. Wear and Tear – This is the amount deducted from claims payments to allow for any depreciation in the property insured that is caused by its usage. Weather Claim – One arising from burst pipes, storm and weather damage. Write-Off – A damaged vehicle which is not repairable, or one which would cost more to repair than the car was worth before the damage occurred. Also known as a Total Loss. Written Premium – Premium income due to the insurer on the risks accepted during the year.