Property and Casualty Exam Flashcards

insurance policy
Terms Definitions
Abandonment
The abdication of insured property in the hands of another, or into the possession of noe on ine particular.
Accident
An unplanned, unforeseen event which occurs suddenly and at a specific place.
Actual Cash Value
(ACV) The required amount to pay damages or for property loss, which is calculated based on the property's current replacement value minus depreciation.
Additional Coverage
A provision in an insurance policy that allows for more coverage for speicifc loss expense without increase in premium.
Additional Insureds
Individuals or business that are not named as insured on the declaration page, but are protected by the policy, usually in regard to a specific interest.
Adhesion
A contract offered on a "take-it-or-leave-it" basis by an insurer, in which the insured's only option is to accept or reject the contract. Any ambiguities in the contract will be settled in favor of the insured.
Admitted Insurer
An insurance company authorized and licensed to transact business in a particular state
Adverse Selection
The endency of risks with higher probability of loss to purchase and maintain insurance more often than the risks who present lower probability.
Agent
An individual who is licensed to sell, negotiate, or effect insurance contracts on behalf of an insurer.
Agreed Value
A property policy with a provision agreed upon by the insurer and insured as to the amount of insurance that represents a fair valuation for the property at the time the insurance is written.
Aleatory
A contract in which the participating parties agree to exhance unequal amounts. Insurance contracts are aleatory in that the amount the insured will pay in premiums is unequal to the amount the insurer will pay in the event of a loss.
Alien Insurere
An insurance company that is incorporated outside the United States
Apparent Authority
The appearance or the assumption of authority based on the actions, words, or deeds of the principal or because of circumstances the principal created.
Appraisal
An assessment of property to determine either the correct amount of insurance to be written or the amount of loss to be paid.
Arbitration
Method of claim settlement used when the insured and the insurer cannot agree upon the amount of the loss.
Assignment
The transfer of a legal right or interest in an insurance policy. In property and casualty insurance, assignments of policies are usually valid only with the prior written consent of the insurer.
Authorized Insurer
An insurance company that has qualified and received a Certificate of Athority from the Department of Insurance to transact insurance in the state.
Auto
A land motor vehicle, trailer or semi-trailer designed for use on public roads, including attached machinery or equipment; auto does no include mobile equipment.
Avoidance
A method of dealing with risk by deliberately keeping away from it (e.g. if a person wanted to avoid the risk of being killed in an airplane crash, he/she might choose never to fly in a plane.
Bailee
A person or entity that has possession of personal property entrusted to him/her by the owner. For example, a television repair person that has possession of a customer's television would be a bailee.
Beneficiary
The person who receives the proceeds from the insurance policy.
Binder
A temporary contract that puts an insurance policy into force before the premium has been paid.
Blanket Bond
A type of bond that covers losses caused by dishonest employees.
Blanket Insurance
A single property insurance policy that provides coverage for multiple classes of property at one location, or provides coverage for one or more classes of property at multiple locations.
Boycott
An unfair trade practice in which one person refuses to do business with another until he or she agrees to certain conditions.
Builder's Risk Coverage Form
A commercial property form that covers buildings under construction.
Building and Personal Property Coverage Form
A commercial property form that covers buildings, and/or their contents.
Burglary
The forced entry into another's premises with felonious intent.
Cancellation
The termination of an in-force insurance policy by either the insured orthe insurer prior to the expiration date shown in the policy.
Casualty Insurance
A type of insurance that covers losses caused by injury to persons or damage to the property of others.
Cease and Desist Order
A demand of a person to stop committing an action that is in violation of a provision.
Certificate of Authority
A document that authorizes a company to start conducting business and specifies the kind(s) of insurance a company can transact. it is illegal for an insurance company to transact insurance without this certificate.
Certificate of Insurance
A legal document that indicates that an insurance policy has been issued, and that states both the amounts and types of insurance provided.
Claim
A demand made by the insured to cover a loss protected by the insurance policy.
Class Rating
The practice of computing a price per unit of insurance that applies to all applicants possessing a given set of characteristics.
Coercion
An unfair trade practice in which an insurer uses physical or mental force to persuade an applicant to buy insurance.
Coinsurance
An agreement between an insurer and insured in which both parties are expected to pay a certain portion of the potential loss and other expenses.
Commercial Lines
Type of insurance that pertains to business, mercantile or manufacturing establishments.
Commissioner (Superintendent, Director)
The chief executive and administrative officer of a state insurance department.
Common Law
An unwritten body of law based on past judicial decisions as well as usages and customs.
Complaint
A written statement of liability claim given by the claimant; a reason for a lawsuit.
Components
Factors that determine rates, including loss reserves, loss adjusting expenses, operating expenses and profits.
Concealment
The withholding of known facts which, if material, can void a contract.
Conditional Contract
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.
Conditions
The section of an insurance policy that indicates the general rules or procedures that the insurer and the insured agree to follow under the terms of the policy.
Consideration
The binding force in a contract that requires something of value to be exhanged for the transfer of risk. The consideration on the part of the insured is the representation made in the application and the payment of premium; the consideration on the part of the insurer is the promise to pay in the event of loss.
Consultant
A person who, for a fee, offers advice, counsel, opinion, or service regarding the benefits, advantages, or disadvantages promised under a policy of insurance.
Consumer Reports
Written and/or oral statements regarding a consumer's credit, character, reputation, or habits collected by a reporting agency from employment record, credit reports, and other public sources.
Contract
An agreement between two or more parties enforceable by law.
Controlled Business
An entity that obtains and possesses a license solely for the purpose of writing business on the owner, immediate family, relatives, employer and employees.
Death Benefit
The amount payable upon the death of the person whose life is insured.
Declarations
The section of an insurance policy containing the basic underwriting information, such as the insured's name, address, amount of coverage and premiums, and a description of insured locations, as well as any supplemental representations by the insured.
Deductible
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.
Defamation
An unfair trade practice in which one agent or insurer makes an injurious statement about another with the intent of harming the person's or company's reputation.
Deposit Premium Audit
A condition that allows the insurer to audit the insured's books or records at the end of the policy term to make sure adequate premium has been collected for the exposure.
Depreciation
The lessening of value of real and personal property due to age and wear and tear.
Direct Losses
Physical damage to buildings and/or personal property as a result of direct consequence of a particular peril.
Director (Commissioner, Superintendent)
The head of the state department of insurance.
Disclosure
An act of identifying the name of the producer, representative or firm, limited insurance representative, or temporary insurance producer on any policy solicitation.
Domestic Insurer
An insurance company that is incorporated in the state.
Economic Loss
The estimated total cost (both insured and uninsured) of an accident.
Endorsement
A printed addendum to a contract that is used to change the policy's original terms, conditions, or coverages.
Estoppel
A legal impediment to denying a fact or restoring a right that has been previously waived.
Excess Policy
A policy that only pays for loss after the primary policy has paid its limit.
Exclusions
Causes of loss, exposures, conditions, etc. listed in the policy for which the benefits will not be paid.
Exclusive or Captive Agent
An agent who represents only one company and is compensated by commissions.
Experience Rating
Method of determining the premium based on the insured's own past loss experience.
Exposure
A unit of measure used to determine rates charged for insurance coverage.
Express Authority
The authority granted to an agent by means of the agent's written contract.
Extensions of Coverage
A provision in some property policies which allows the extension of a major coverage to certain types of loss to property not specifically insured.
FAIR Plan
Fair Access to Insurance Requirements plan is a state-run program that makes insurance obtainable to those in high risk areas who have been unable to acquire insurance through other channels.
Fiduciary
An agent/broker who handles insurer's funds in a trust capacity.
First Named Insured
The individual whose name appears first on the policy's declaration.
Foreign Insurer
An insurance company that is incorporated in another state.
Fraternal Benefit Society
A life or health insurance company formed to provide insurance for members of an affiliated lodge, religious, or fraternal organization with a representative form of government.
Fraud
Intentional misrepresentation or deceit with the intent to induce a person to part with something of value.
Functional Replacement Cost
The cost to replace damaged property with less expensive and more modern construction or equipment.
Gross Negligence
Reckless behavior that shows disregard for the safety or lives of others.
Hazard
A circumstance that increases the likelihood of a loss.
Hazard, Moral
The effect of a person's reputation, character, living habits, etc. on his/her insurability.
Hazard, Morale
The effect a person's indifference concerning loss has on the risk to be insured.
Hazard, Physical
A type of hazard that arises from the physical characteristicsof an individual, such as a physical disability due to either current circumstance or a condition present at birth.
Implied Authority
Authority that is not expressed or written into the contract, but which the agent is assume to have in order to transact the business of insurance for the principal.
Indemnity
Compensation to the insured that restores them to the same financial position that they enjoyed prior to the loss.
Independent Agents
Agents that sell the insurance products of several companies and work for themselves or other agents.
Indirect Losses
Losses resulting from a peril, but not directly caused by it. May include business disruption, rent insurance, extra expenses, and other consequences that occur over time.
Inflation Guard
A coverage extension that automatically increases amounts of insurance on buildings by an agreed upon percentage annually.
Insurable Interest
Any interest an insured may have in property that is the subject of insurance, so that damage or destruction of that property would cause the insured financial loss.
Insurance
The transfer of the possibility of a loss (risk) to an insurance company, which in turn spreads the costs of unexpected losses to many individuals.
Insurance Policy
A contract between an insured and an insurance company which agrees to pay the insured for loss caused by specific events.
Insured
The person or organization that is protected by insurance; the party to be indemnified.
Insured Contract
A definition on liability forms that describes the types of contract in which liability is assumed by the insured and included for coverage in the policy. Examples are leases of premises, elevator maintenance agreements, easement agreements, and other agreements related to the insured's business.
Insurer
An entity that indemnifies against losses, provides benefits, or renders services (also known as the "company" or "insurance company").
Insurance Agreement
The section of insurance policy containing the insurer's promise to pay, the description of coverage provided and perils insured against.
Intentional Tort
Any deliberate act that causes harm to another person.
Interline Endorsement
A written amendment designed to eliminate redundancy and minimize the number of endorsements in the policy.
Judgment Rating
An approach used when credible statistics are lacking or when the exposure units are so varied that it is impossible to construct a class.
Law of Large Numbers
A principle stating that the larger the number of similar exposure units considered, the more closely the losses reported will equal the underlying probability of loss.
Liability
Responsibility under the law.
Liberalization
A property insurance clause that extends broader legislated or regulated coverage to current policies, as long as it does not result in a premium.
Lien
A charge, security or encumbrance on property.
Limit of Liability
The maximum amount for which an insurer is liable.
Lloyd's Associations
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
Loss
The reduction, decrease, or disappearance of value of the person or property insured in a policy, by a peril insured against.
Loss Payable Clause
A provision in property insurance that is used to cover the interest of a secured lender in personal property.
Loss Ratio
A calculation used by insurance companies to relate income from loss expenses: loss ratio = (incurred losses + loss adjusting expense) / earned premium.
Loss Valuation
A factor in determining the premium charged and the amount of insurance required.
Market Value
A seldom used method of valuing a loss based upon the amount a willing buyer would pay to a willing seller for the property prior to the loss.
Misrepresentation
A false statement or lie that can render the contract void.
Monoline Policy
A policy written separately as a single coverage.
Mutual Assessment Insurer
A mutual insurance company with the right to assess policyholder's additional amounts of premium to meet operational needs.
Mutual Companies
Insurance organizations that have no capital stock, but are owned by the policyholders.
Mysterious Disappearance
A disappearance of property that cannot be explained as to the location, time or the manner of property loss.
Named Insured
The individual(s) whose name appears on the policy's declaration.
Named Peril
The cause of loss specifically covered by the insurance policy. No coverage is provided for unlisted perils.
Negligence
The failure to use the care that a reasonable, prudent person would under the same or similar circumstances.
No Benefit to the Bailee
A provision that excludes any assignment or granting of any policy provision to any person or organization holding, storing, repairing, or moving insured property for a fee.
Nonadmitted Insurer
An insurance company that has not applied, or has applied and been denied a Certificate of Authority and may not transact insurance.
Nonconcurrency
A situation in which other insurance is wrtten on the same risk, but not on the same coverage basis.
Nonrenewal
A termination of a policy by an insurer on the anniversary or renewal date.
Notice of Claim
A provision that spells out an insured's duty to provide the insurer with reasonable notice in the event of a loss.
Occurrence
A broader definition of loss, which differs from accident in that it includes losses caused by continuous or repeated exposure to conditions resulting in injury to persons or damage to property that is neither intended nor expected.
Open Peril
Term used in property insurance to describe the breadth of coverage provided under an insurance policy form that insures against "any risk of loss" that is not specifically excluded.
Pair and Set Clause
A clause included in many property and inland marine policies, which provides that the insurer is not obligated to pay for the total value of a set of items if only one item has been lost, damaged or destroyed.
Partnership
A legal entity in which 2 or more persons agree to share the profits and losses of the business.
Passive
A description of an anti-theft device or system for autos which is activated automatically when the driver turns the ignition key to the off position and the key is removed.
Peril
The cause of a possible loss.
Personal Lines Insurance
Type of coverage available to individuals and families for non-business risks.
Policy Limits
The maximum amount an insured may collect, or for which an insured is protected under the terms of the policy.
Policy Period
A period of time a policy is in effect (also known as Policy Term).
Policyholder
The person in possession of an insurance policy; may or may not be the policyowner and/or insured.
Policyowner
The person who is entitled to exercise the rights and privileges in the policy. This person may or may not be the insured.
Premium
A periodic payment to the insurance company to keep the policy in force.
Primary Policy
A basic, fundamental insurance policy which pays first with respect to other outstanding policies.
Pro Rata
Proportional distribution of shares of the loss for each insurance policy written on a piece of property.
Producer
A person who acts on the behalf of the insurer to sell, negotiate, or effect insurance contracts; also known as an agent.
Proof of Loss
A sworn statement that must usually be furnished by the insured to an insurer before any loss under a policy can be paid.
Proximate Cause
An act or event that is the immediate or actual cause of a loss.
Pure Risk
Situations that can only result in a loss or no change; a gain is never possible. Pure risk is the only type insurance companies are willing to accept.
Rebating
Any inducement offered in the sale of insurance products that is not specified in the policy.
Reciprocal
Insurance resulting from an interchange of reciprocal agreements of indemnity among persons known as subscribers.
Reduction
Lessening the possibility or severity of a loss.
Reinsurance
A form of insurance whereby one insurance company (the reinsurer) in consideration of a premium paid to it, agrees to indemnify another insurance company (the ceding company) for part or all of its liabilities from insurance policies it has issued.
Replacement Cost
The cost to replace damanged property with like kind and quality at current price, without any deduction for depreciation.
Representations
Statements made by the applicant on the insurance application that are believed to be true, but are not guaranteed to be true.
Retention
A method of dealing with risk by intentionally or unintentionally keeping a portion of it for the insured's account; the amount of responsibility assumed but not reinsured by the insurance company.
Retrospective Rating
A self-rating plan under which the actual losses during the policy period determine the final premium (subject to a minimum and maximum premium).
Right of Salvage
A provision in property insurance policy requiring that after payment of a total loss to insured property, the insured must transfer the title (or ownership) to the property to the insurer.
Risk
Uncertainty as to the outcome of an event when two or more possibilities exist.
Risk, Pure
The uncertainty or chance of a loss occurring in a situation that can only result in a loss or no change.
Risk, Speculative
The uncertainty or chance of a loss occurring in a situation that involves the opportunity for either loss or gain.
Robbery
The taking of property from another by using violence or the threat of violence.
Salvage
The amount of money realized from the sale of damaged merchandise or property. A salvage clause is found in ocean marine insurance and usually states that the rescuers of a ship are entitled to the salvage of the ship and cargo.
Settlement
The process by which an agreement is reached and a claim is resolved in liability insurance.
Severability of Interests
A provision that insurance applies separately to each insured in a policy, treating each individual as the only insured.
Sharing
A method of dealing with risk for a group of individual persons or businesses with the same or similar exposure to loss who share the losses that occur within that group.
Specific Insurance
A property insurance policy that covers a specific kind of unit of property for a specific amount of insurance.
Speculative Risk
The uncertainty or chance of a loss occurring in a situation that involves the opportunity for either loss or gain.
Split
Separately stated limited of liability for different coverages, which may be stated on a per person, per occurrence, per policy period basis, or can be divided between bodily injury and property damage.
Stated Amount
An amount of insurance scheduled in a property policy which is not subject to any coinsurance requirements in the event of a covered loss.
Statute Law
The written law as enacted by a legislative (i.e. the laws of the state), which generally takes precedence in cases where both common law and statute law apply.
Stock Companies
Companies owned by the stockholders whose investments provide the capital necessary to establish and operate the insurance company.
Subrogation
The acquisition by an insurer of an insured's rights against any third party for indemnification of loss or other payment, to the extent that the insurer pays the loss.
Superintendent (Commissioner, Director)
The head of the state department of insurance.
Surety Bond
A guarantee that debts and obligations will be carried out, and the benefits will be paid for losses caused by nonperformance.
Surplus Lines
Insurance for which there is no readily available, admitted market.
Theft
Any act of stealing or removing property from its rightful owner. Encompasses both burglary and robbery.
Third-Party Provisions
Insurance provisions that address the rights of someone other than the policyowner to have a secured financial interest in the insured property.
Tort
A wrongful act or the violation of someone's rights that leads to legal liability. Torts are classified as intentional or unintentional (referred to as negligence).
Transfer
A basic principle of insurance under which the risk of financial loss is assigned to another party.
Twisting
A form of misrepresentation in which an agent persuades an insured/owner to cancel, lapse, or switch policies, even when it's to the insured's disadvantage.
Unauthorized Insurer
An insurance company that has not applied, or has applied and been denied a Certificate of Authority.
Underwriter
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
Underwriting
The process of reviewing, accepting or rejecting applications for insurance.
Unilateral Contract
A contract that legally binds only one party to contractual obligations after the premium is paid.
Unintentional Tort
The result of acting without proper care, generally referred to as negligence.
Unoccupied
A property that has contents or furnishing in it, but is not being used or lived in.
Vacant
A property that has no contents, furnishings, or occupants.
Valued Policy
A policy used when it is difficult to establish the actual cash value of insured property after a loss occurs because of its rarity or uniqueness. Provides for payment of the full policy amount in the event of a total loss without regard to actual value or depreciation.
Waiting Period
Time between the beginning of a disability and the start of disability insurance benefits.
Warranty
A material stipulation in the policy that if breached may void coverage.
Absolute Liability
A type of liability that occurs due to extremely dangerous operations, such as the use of explosives or working at extreme heights.
Aggregate Limit
The maximum limit of coverage available under a liability policy during a policy year regardless of the number of claims that my be made or the number of accidents that may occur.
Aleatory
A contract in which the participating parties agree to exchange unequal amounts. Insurance contracts are aleatory in that the amount the insured will pay in premiums is unequal to the amount the insurer will pay in the event of a loss.
Bodily Injury Liability
Legal liability arising from death or physical trauma to a person as a result of a negligent or purposeful act and omissions by an insured.
Combined Single
A single dollar limit of liability applying to the total of damages for bodily injury and property damage combined, resulting from one accident or occurrence.
Comprehensive Coverage
Also known as Other Than Collision coverage, it covers losses by fire, theft, vandalism, falling objects, etc.
Disability
A physical or mental impairment, either congenital or resulting from an injury or sickness.
Legal Liability
A liability under the law that occurs when a person is responsible for injuries or damages to another due to negligence.
Personal Injury Liability
Legal responsibility for an injury to the character of another person caused by libel, slander, false arrest, invasion of privacy and other acts.
Property Damage Liability
Legal liability arising from physical damage to tangible property of others caused by the negligence of an insured.
Strict Liability
A liability that refers to damages caused by defective products even though the manufacturer's fault or negligence cannot be proven.
Umbrella Liability Policy
Coverage that provides extra protection against liability, and excess amount of insurance above the primary policy.
Underinsured Motorist Coverage
Coverage in an automobile insurance policy under which the insurer will pay costs up to specified limits for bodily injury, if the liable driver's policy limits are exhausted and he/she cannot pay the full amount for which he or she is liable.
Uninsured Motorist Coverage
Coverage that allows the named insured, resident relative(s) and passengers in a covered auto to collect sums another driver would be legally liable to pay for bodily injury resulting from an auto accident, providing the accident was caused by an uninsured motorist, a hit-and-run driver or a driver whose insurance company is insolvent.
Vicarious Liability
A type of liability in which one person is responsible for the acts of another. For example, employers may be vicariously liable for the actions of their employees, and parents may be held responsible for negligent acts of their children.
Workers Compensation
Benefits required by state law to be paid to an employee by an employer in the case of injury, disability, or death as the result of an on-the-job hazard.
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