Insurance Terms Flashcards

1
Q

Risk

A

The chance of a financial loss

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2
Q

Peril

A

Something that causes a loss

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3
Q

Contract

A

document representing the agreement between an insurance company
and the insured. Central to any insurance contract is the insuring agreement, which
specifies the risks covered, the limits of the policy, and the term of the policy

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4
Q

Hazard

A

Something that increases the probability that a loss will occur

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5
Q

Insurers

A

a person or company that underwrites an insurance risk; the party in an
insurance contract undertaking to pay compensation

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6
Q

Indemnify

A

Indemnification is an agreement where your insurer helps cover loss,
damage or liability incurred from a covered event. Indemnity is another way of
saying your insurer pays for a loss, so you don’t have financial damages

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7
Q

Insureds

A

One who has or is covered by an insurance policy

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8
Q

Losses

A

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

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9
Q

Direct Loss

A

physical harm to tangible property

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10
Q

Indirect Loss

A

Economic loss which flows as a result of direct loss

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11
Q

Liability

A

an insurance product that provides
an insured party with protection against claims resulting from injuries and damage

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12
Q

Speculative Risk

A

uncertainty about an event under consideration that could
produce either a profit or a loss, such as a business venture or a gambling
transaction. A pure risk is generally insurable while speculative risk is usually not

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13
Q

Pure Risk

A

risks that are beyond human control and result in a
loss or no loss with no possibility of financial gain. Fires, floods and other natural
disasters are categorized as pure risk, as are unforeseen incidents, such as acts of
terrorism or untimely deaths

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14
Q

Personal Pure Risks

A

risks affecting an individual that result in a loss or reduction of
personal assets. Unemployment is an example of pure risk. An illness that requires
expensive medical treatment and thus reduces personal assets is another example.
Other types of personal pure risk include a house fire, disability and premature
death

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15
Q

Property Pure Risk

A

include the potential of fire, floods, hurricanes and other
natural disasters to damage or destroy property, including buildings and the
contents of buildings. The loss of property due to theft also falls into this category.
Property pure risk can incur both direct and indirect losses

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16
Q

Liability Pure Risks

A

risks arising from litigation against a person or organization. For
example, homeowners could be sued for medical expenses, lost income or other
damages by someone who slipped on their walkway

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17
Q

Control Risks

A

Avoidance, The technique of minimizing the frequency or severity of
losses with training, safety, and security measures

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18
Q

Loss Control

A

Be safe, act in a safe manner. i.e. wear a seat belt

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19
Q

Retention

A

(1) Assumption of risk of loss by means of noninsurance, self-insurance,
or deductibles. Retention can be intentional or, when exposures are not identified,
unintentional. (2) In reinsurance, the net amount of risk the ceding company keeps
for its own account

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20
Q

Transfer Risk

A

Risk transfer is a risk management and control strategy that involves
the contractual shifting of a pure risk from one party to another. One example is
the purchase of an insurance policy, by which a specified risk of loss is passed from
the policyholder to the insurer

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21
Q

Personal Contract

A

Policies cover people who own and operate things, such as
automobiles

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22
Q

Warranty

A

A policy condition, either based on information in the insureds
application or inserted by the insurer. It is a guarantee of a fact

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23
Q

Misrepresentation

A

An untrue statement by the insured, made in an application for
insurance but which does not become a part of the policy

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24
Q

Abandonment

A

Property insurance policies usually contain an abandonment clause,
stating the insured cannot dump damaged property on the insurer and demand its
full value

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25
Q

Proximate Cause

A

The cause having the most significant impact in bringing about
the loss under a first-party property insurance policy, when two or more
independent perils operate at the same time (i.e., concurrently) to produce a loss.
Courts employ a set of rules to resolve causation disputes when a property policy
states that it covers or excludes losses “caused by” a peril and there is more than
one peril at work in a fact pattern. Under common law, whether the policy provides
coverage depends on which peril is chosen as the proximate cause

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26
Q

Actual Cash Value(ACV)

A

Replacement Cost minus Depreciation

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27
Q

Coinsurance

A

The amount, generally expressed as a fixed percentage, an insured
must pay against a claim after the deductible is satisfied. It’s ultimately a way for
the insured and insurer to share responsibility for the risk. It can also help reduce
the cost of the insurance policy premium. Coinsurance can be written on an 80/20,
90/100, or 100% rule

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28
Q

Insurable Interest

A

type of investment that
protects anything subject to a financial loss. A person or entity has an
insurable interest in an item, event, or action when the damage or loss
of the object would cause a financial loss or other hardships

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29
Q

Policy

A

a document detailing the terms and conditions of a contract of
insurance

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30
Q

Binder

A

temporary policy that serves as a placeholder until your formal
policy is issued. Issuing a new policy can sometimes take a few days or
weeks, depending on the underwriting process

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31
Q

Contract

A

document representing the
agreement between an insurance company and the insured. Central to
any insurance contract is the insuring agreement, which specifies the
risks covered, the limits of the policy, and the term of the policy

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32
Q

Consent

A

permission for something to happen or agreement to do
something

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33
Q

Consideration

A

For insurers, consideration also refers to the
money paid out to you should you file an insurance claim. This
means that each party to the contract must provide some value to
the relationship

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34
Q

Legal Capacity

A

refers to the availability of insurance necessary to
meet the demand. It is often determined by the consumer’s ability
to accept risk. i.e. must be of legal age…

35
Q

Legal Nature

A

Must be allowed in the eyes of the law

36
Q

Law of Large Numbers

A

the average of a large number of results closely
mirrors the expected value, and that difference narrows as more results
are introduced

37
Q

Negligence

A

failure to act in a way that a reasonable person would
when faced with the same situation and circumstances. In insurance,
insurance negligence is when a policyholder or someone else in the
household might be negligent if the failure to act leads to damages

38
Q

Duty

A

You have the responsibility to do the correct action

39
Q

Breach of Duty

A

not doing the correct action

40
Q

Causes

A

Bodily Injury or Property Damage

41
Q

Financial Loss

A

Result of the above causes harm to another

42
Q

Adhesion

A

an agreement between two parties where one party has a significant
power advantage in setting the terms of the agreement

43
Q

Aleatory

A

something is dependent on an uncertain event, a chance occurrence.
Aleatory is used primarily as a descriptive term for insurance contracts. An
aleatory contract is a contract where performance of the promise is dependent
on the occurrence of a fortuitous event

44
Q

Unilateral Contract

A

a contract in which only one party makes an enforceable
promise. Most insurance policies are unilateral contracts in that only the insurer
makes a legally enforceable promise to pay covered claims. By contrast, the
insured makes few, if any, enforceable promises to the insurer

45
Q

Domestic Insurer

A

an insurer admitted by and formed under the laws in the state
in which the insurance is written

46
Q

Foreign Insurer

A

insurance company that is located in one state but which writes
policies for clients in another state

47
Q

Alien Insurer

A

insurance company based outside the United States

48
Q

What are the 3 types of Hazards?

A

Physical, Moral, and Morale

49
Q

Physical Hazard

A

actions, behaviors, or conditions that cause or contribute to
peril

50
Q

Moral Hazard

A

changes that might occur and increase the risk of loss when a
person knows that insurance will provide coverage

51
Q

Morale Hazard

A

a term used to describe a subjective hazard that tends to
increase the probable frequency or severity of loss due to an insured
peril. For example, an insured’s attitude may be indifferent if a loss
occurs because they have insurance

52
Q

Proximate Cause

A

direct cause of loss, without which the loss would not occur;
therefore, it is a highly relevant principle in the insurance industry. For an act or
event to be considered a proximate cause, it does not necessarily have to directly
precede a loss or begin a chain of occurrences leading to the same. Establishing a
proximate cause is important in determining whether coverage applies or if
liability can be imposed on the negligent party

53
Q

Property Insurance

A

insurance on the things you own

54
Q

Liability Insurance

A

insurance product that provides an insured party with
protection against claims resulting from injuries and damage to other people or
property. Liability insurance policies cover any legal costs and payouts an insured
party is responsible for if they are found legally liable. Intentional damage and
contractual liabilities are generally not covered in liability insurance policies.
Unlike other types of insurance, liability insurance policies pay third parties, and
not policyholders

55
Q

Assumption of Risk

A

If a person knows the consequences of a particular act and
voluntarily accepts that risk, he or she is solely responsible for any resulting injury

56
Q

Abandonment

A

Property insurance policies usually contain an abandonment
clause, stating the insured cannot dump damaged property on the insurer and
demand its full value

57
Q

Comparative Negligence

A

a principle of tort
law that applies to casualty insurance in certain states. Comparative
negligence states that when an accident occurs, the fault and/or
negligence of each party involved is based upon their respective
contributions to the accident. This allows insurers to assign blame and
pay insurance claims accordingly

58
Q

Actual Cash Value (ACV)

A

property and auto physical damage
insurance, one of several possible methods of establishing the value of
insured property to determine the amount the insurer will pay in the
event of loss

59
Q

Replacement Cost

A

It is usually defined in the policy as the cost to
replace the damaged property with materials of like kind and quality,
without any deduction for depreciation

60
Q

Valued Policy

A

a policy that pays the amount of the insurance
regardless of the ACV, if a total loss occurs

61
Q

Coinsurance

A

the amount, generally expressed as a fixed
percentage, an insured must pay against a claim after the deductible is
satisfied. In health insurance, a coinsurance provision is similar to a
copayment provision, except copays require the insured to pay a set
dollar amount at the time of the service. Some property insurance
policies contain coinsurance provisions

62
Q

Specific Insurance

A

a type of property insurance in which only one
individual property is covered by the policy. Specific insurance is an
alternative to blanket coverage, in which a policy can cover many
different properties or locations

63
Q

Blanket Insurance

A

a type of insurance policy that insures the common
areas of a condominium or townhome. It also covers the common
property in an area governed by a homeowner’s association, or HOA

64
Q

Mortgage Clause

A

an important provision in a property insurance policy
that ensures that the insurance company will pay the mortgagee in the
event that loss or damage occurs to a mortgagor’s property. The clause
is an important measure that mortgagees take to protect their
investment in a mortgagor’s property

65
Q

Loss Payable

A

Insurance provision authorizing payment in the event of
loss to a person or entity other than the named insured with an
insurable interest in the covered property or, in some cases, jointly to
the insured and the other person or entity

66
Q

Lienholder

A

If you finance a car, a lienholder may be listed on your car’s
title and your car insurance policy until you pay it off. A lienholder is a
lender that legally has an interest in your property until you pay it off in
full. The lender — which can be a bank, financial institution or private
party — holds a lien, or legal claim, on the property because they lent
you the money to purchase it

67
Q

Subrogation

A

a right held by most insurance carriers to legally pursue a
third party that caused an insurance loss to the insured. This is done in
order to recover the amount of the claim paid by the insurance carrier
to the insured for the loss

68
Q

Severability

A

a policy provision clarifying that, except with respect to
the coverage limits, insurance applies to each insured as though a
separate policy were issued to each. Thus, a policy containing such a
clause will cover a claim made by one insured against another insured

69
Q

Liberalization

A

a provision that extends to persons already insured
under a particular policy the broadened coverage features that may be
introduced in subsequent editions of that policy form

70
Q

Warranty

A

(1) A guarantee of the performance of a product. Product
warranties are included within the definition of the named insured’s
product in general liability policies. (2) A statement of fact given to an
insurer by the insured concerning the insured risk which, if untrue, will
void the policy

71
Q

Representation

A

a statement made in an application for insurance that
the prospective insured represents as being correct to the best of his or
her knowledge

72
Q

Misrepresentation

A

a material misrepresentation occurs when the
insured makes an untrue statement that: 1) is material to the
acceptance of the risk; and 2) would have changed the rate at which
insurance would have been provided or would have changed the
insurer’s decision to issue the contract

73
Q

Concealment

A

a willful act of holding back information that may be
pertinent to the issuance of an insurance policy even though the
insured was not asked about that particular subject. A concealment can
result in the voiding of a policy

74
Q

Liability Limits

A

the stipulated sum or sums beyond which an insurance
company is not liable for payments due to a third party. The insured
remains legally liable above the limits

75
Q

Single

A

auto insurance that provides one flat amount for coverage
limits.

76
Q

Split

A

provides a specific limit per person for bodily injury and a total
amount the insurance company will pay for all injury as a result of one
accident

77
Q

Aggregate

A

the amount an insurer will pay for each individual claim
made during the policy period, the aggregate limit is the maximum
amount an insurer will pay for all such claims made against the insured
during the policy period, no matter how many separate claims might be
made

78
Q

Deductibles

A

The amount you pay for covered health care services
before your insurance plan starts to pay

79
Q

Straight Deductible

A

a deductible that is a constant value (as a
specified amount)

80
Q

Percentage Deductible

A

a percentage of the insured value.

81
Q

Franchise Deductible

A

a minimum amount of loss that must be
Incurred before insurance coverage applies

82
Q

Coverages

A

the amount of risk or liability that is covered for an
individual or entity by way of insurance services. Insurance coverage,
such as auto insurance, life insurance—or more exotic forms, such as
hole-in-one insurance—is issued by an insurer in the event of
unforeseen occurrences.

83
Q

Primary Coverage

A

insurance coverage that pays
out regardless of whether there are other insurance polices
covering the same risk. Primary coverage is contrasted with
secondary coverage, which only pays out after a primary
insurance policy has paid out

84
Q

Excess Coverage

A

Pays when Primary can’t pay