21+ Useful Insurance Terms You Should Know
INSURED - A person or a
corporation who contracts for an insurance policy that indemnifies (protects)
him against loss or damage to property or, in the case of a liability policy,
defend him against a claim from a third party.
NAMED INSURED - Any person,
firm or corporation specifically designated by name as an insured(s) in a
policy as distinguished from others who, though unnamed, are protected under
some circumstances. For example, a common application of this latter principle
is in auto liability policies wherein by a definition of "insured",
coverage is extended to other drivers using the car with the permission of the
named insured. Other parties can also be afforded protection of an insurance
policy by being named an "additional insured" in the policy or
endorsement.
ADDITIONAL INSURED - An individual
or entity that is not automatically included as an insured under the policy of
another, but for whom the named insureds policy provides a certain degree of
protection. An endorsement is typically required to effect additional insured
status. The named insureds impetus for providing additional insured status to
others may be a desire to protect the other party because of a close
relationship with that party (e.g., employees or members of an insured club) or
to comply with a contractual agreement requiring the named insured to do so
(e.g., customers or owners of property leased by the named insured).
CO-INSURANCE - The sharing of one
insurance policy or risk between two or more insurance companies. This usually
entails each insurer paying directly to the insured their respective share of
the loss. Co-insurance can also be the arrangement by which the insured, in
consideration of a reduced rate, agrees to carry an amount of insurance equal
to a percentage of the total value of the property insured. An example is if
you have guaranteed to carry insurance up to 80% or 90% of the value of your
building and/or contents, whatever the case may be. If you don't, the company
pays claims only in proportion to the amount of coverage you do carry.
The following equation
is used to determine what amount may be collected for partial loss:
Amount of Insurance
Carried x Loss
Amount of Insurance
that = Payment
Should be Carried
Example A Mr. Right has an 80%
co-insurance clause and the following situation:
$100,000 building
value
$ 80,000 insurance
carried
$ 10,000 building loss
By applying the
equation for determining payment for partial loss, the following amount may be
collected:
$80,000 x $10,000 = $10,000
$80,000
Mr. Right recovers the
full amount of his loss because he carried the coverage specified in his
co-insurance clause.
Example B Mr. Wrong has an
80% co-insurance clause and the following situation:
$100,000 building
value
$ 70,000 insurance
carried
$ 10,000 building loss
By applying the
equation for determining payment for partial loss, the following amount may be
collected:
$70,000 x $10,000 = $8,750
$80,000
Mr. Wrong's loss of
$10,000 is greater than the company's limit of liability under his co-insurance
clause. Therefore, Mr. Wrong becomes a self-insurer for the balance of the
loss-- $1,250.
PREMIUM - The amount of
money paid by an insured to an insurer for insurance coverage.
DEDUCTIBLE - The first
dollar amount of a loss for which the insured is responsible before benefits
are paid by the insurer; similar to a self-insured retention (SIR). The
insurer's liability begins when the deductible is exhausted.
SELF INSURED
RETENTION - Acts the same way as a deductible but the insured is responsible for all
legal fees incurred in relation to the amount of the SIR.
POLICY LIMIT - The maximum monetary
amount an insurance company is responsible for to the insured under its policy
of insurance.
FIRST PARTY
INSURANCE - Insurance that applies to coverage for an insureds own property or a
person. Traditionally it covers damage to insureds property from whatever
causes are covered in the policy. It is property insurance coverage. An example
of first party insurance is BUILDERS RISK INSURANCE which is insurance against
loss to the rigs or vessels in the course of their construction. It only
involves the insurance company and the owner of the rig and/or the contractor
who has a financial interest in the rig.
THIRD PARTY
INSURANCE - Liability insurance covering the negligent acts of the insured against
claims from a third party (i.e., not the insured or the insurance company - a
third party to the insurance policy). An example of this insurance would be
SHIP REPAIRER'S LEGAL LIABILITY (SRLL) - provides protection for contractors
repairing or altering a customer's vessel at their shipyard, other locations or
at sea; also covers the insured while the customer's property is under the
"Care, Custody and Control" of the insured. A Commercial General
Liability policy is needed for other coverages, such as slip-and-fall
situations.
INSURABLE
INTEREST - Any interest in something that is the subject of an insurance policy or
any legal relationship to that subject that will trigger a certain event
causing monetary loss to the insured. Example of insurable interest - ownership
of a piece of property or an interest in that piece of property, e.g., a
shipyard constructing a rig or vessel. (See BUILDERS RISK above)
LIABILITY
INSURANCE - Insurance coverage that protects an insured against claims made by third
parties for damage to their property or person. These losses usually come about
as a result of negligence of the insured. In marine construction this policy is
referred to an MGL, marine general liability policy. In non marine
circumstances the policy is referred to as a CGL, commercial general liability
policy. Insurance policies can be divided into two broad categories:
·
First party insurance covers the property of the person who purchases the
insurance policy. For example, a home owner's policy promising to pay for fire
damage to the home owner's home is a first party policy. Liability insurance,
sometimes called third party insurance, covers the policy holder's liability to
other people. For example, a homeowners' policy might cover liability if
someone trips and falls on the home owner's property. Sometimes one policy,
such as in these examples, may have both first and third party coverage.
·
Liability insurance provides two separate benefits. First, the policy will
cover the damage incurred by the third party. Sometimes this is called
providing "indemnity" for the loss. Second, most liability policies
provide a duty to defend. The duty to defend requires the insurance company to
pay for lawyers, expert witnesses, and court costs to defend the third party's
claim. These costs can sometimes be substantial and should not be ignored when
facing a liability claim.
UMBRELLA LIABILITY COVERAGE - This type of liability insurance
provides excess liability protection. Your business needs this coverage for the
following three reasons:
·
It provides excess coverage over the "underlying" liability
insurance you carry.
·
It provides coverage for all other liability exposures, excepting a few
specifically excluded exposures. This subject to a large deductible of about
$10,000 to $25,000.
·
It provides automatic replacement coverage for underlying policies that
have been reduced or exhausted by loss.
NEGLIGENCE - The failure to use reasonable care. The doing of something which a
reasonably prudent person would not do, or the failure to do something which a
reasonably prudent person would do under like circumstances. Negligence is a
'legal cause' of damage if it directly and in natural and continuous sequence
produces or contributes substantially to producing such damage, so it can
reasonably be said that if not for the negligence, the loss, injury or damage
would not have occurred.
GROSS NEGLIGENCE - A carelessness and
reckless disregard for the safety or lives of others, which is so great it
appears to be almost a conscious violation of other people's rights to safety.
It is more than simple negligence, but it is just short of being willful
misconduct. If gross negligence is found by the trier of fact (judge or jury),
it can result in the award of punitive damages on top of general and special
damages, in certain jurisdictions.
WILLFUL MISCONDUCT - An intentional
action with knowledge of its potential to cause serious injury or with a
reckless disregard for the consequences of such act.
PRODUCT LIABILITY - Liability
which results when a product is negligently manufactured and sent into the
stream of commence. A liability that arises from the failure of a manufacturer
to properly manufacture, test or warn about a manufactured object.
MANUFACTURING DEFECTS - When the
product departs from its intended design, even if all possible care was
exercised.
DESIGN DEFECTS - When the
foreseeable risks of harm posed by the product could have been reduced or
avoided by the adoption of a reasonable alternative design, and failure to use
the alternative design renders the product not reasonably safe.
INADEQUATE
INSTRUCTIONS OR WARNINGS DEFECTS - When the foreseeable risks of
harm posed by the product could have been reduced or avoided by reasonable
instructions or warnings, and their omission renders the product not reasonably
safe.
PROFESSIONAL LIABILITY
INSURANCE - Liability insurance to indemnify professionals, (doctors, lawyers,
architects, engineers, etc.,) for loss or expense which the insured
professional shall become legally obliged to pay as damages arising out of any
professional negligent act, error or omission in rendering or failing to render
professional services by the insured. Same as malpractice insurance.
Professional Liability
has expanded over the years to include those occupations in which special
knowledge, skills and close client relationships are paramount. More and more
occupations are considered professional occupations, as the trend in business
continues to grow from a manufacturing-based economy to a service-oriented
economy. Coupled with the litigious nature of our society, the companies and
staff in the service economy are subject to greater exposure to malpractice
claims than ever before.
ERRORS AND OMISSIONS - Same as
malpractice or professional liability insurance.
HOLD HARMLESS
AGREEMENT - A contractual arrangement whereby one party assumes the liability
inherent in the situation, thereby relieving the other party of responsibility.
For example, a lease of premises may provide that the lessee must "hold
harmless" the lessor for any liability from accidents arising out of the
premises.
INDEMNIFY - To restore the
victim of a loss, in whole or in part, by payment, repair, or replacement.
INDEMNITY AGREEMENTS - Contract
clauses that identify who is to be responsible if liabilities arise and often
transfer one party's liability for his or her wrongful acts to the other party.
WARRANTY - An agreement
between a buyer and a seller of goods or services detailing the conditions
under which the seller will make repairs or fix problems without cost to the
buyer.
Warranties can be
either expressed or implied. An EXPRESS WARRANTY is a guarantee made by the
seller of the goods which expressly states one of the conditions attached to
the sale e.g.,"This item is guaranteed against defects in construction for
one year".
An IMPLIED
WARRANTY is usual in common law jurisdictions and attached to the sale
of goods by operation of law made on behalf of the manufacturer. These
warranties are not usually in writing. Common implied warranties are a warranty
of fitness for use (implied by law that if a seller knows the particular
purpose for which the item is purchased certain guarantees are implied) and a
warranty of merchantability (a warranty implied by law that the goods are
reasonably fit for the general purpose for which they are sold).
DAMAGES OR LOSS - The monetary
consequence which results from injury to a thing or a person.
CONSEQUENTIAL DAMAGES - As opposed to
direct loss or damage -- is indirect loss or damage resulting from loss or
damage caused by a covered peril, such as fire or windstorm. In the case of
loss caused where windstorm is a covered peril, if a tree is blown down and
cuts electricity used to power a freezer and the food in the freezer spoils, if
the insurance policy extends coverage for consequential loss or damage then the
food spoilage would be a covered loss. Business Interruption insurance, extends
consequential loss or damage coverage for such items as extra expenses, rental
value, profits and commissions, etc.
LIQUIDATED DAMAGES - Are a payment
agreed to by the parties of a contract to satisfy portions of the agreement
which were not performed. In some cases liquidated damages may be the
forfeiture of a deposit or a down payment, or liquidated damages may be a
percentage of the value of the contract, based on the percentage of work
uncompleted. Liquidated damages are often paid in lieu of a lawsuit, although
court action may be required in many cases where liquidated damages are sought.
Liquidated damages, as opposed to a penalty, are sometimes paid when there is
uncertainty as to the actual monetary loss involved. The payment of liquidated
damages relieves the party in breech of a contract of the obligation to perform
the balance of the contract.
SUBROGATION - "To stand
in the place of" Usually found in property policies (first party) when an
insurance company pays a loss to an insured or damaged to the insureds
property, the insurer stands in the shoes of the insured and may pursue any
third party who might be responsible for the loss. For example, if a defective
component is sold to a manufacturer to be used in his product and that product
is damaged due to the defective component. The insurance company who pays the
loss to the manufacturer of the product may sue the manufacturer of the
defective component.
Subrogation has a
number of sub-principles namely:
·
The insurer cannot be subrogated to the insureds right of action until it
has paid the insured and made good the loss.
·
The insurer can be subrogated only to actions which the insured would have
brought himself.
·
The insured must not prejudice the insurer's right of subrogation. Thus,
the insured may not compromise or renounce any right of action he has against
the third party if by doing so he could diminish the insurer's right of
recovery.
·
Subrogation against the insurer. Just as the insured cannot profit from his
loss the insurer may not make a profit from the subrogation rights. The insurer
is only entitled to recover the exact amount they paid as indemnity, and
nothing more. If they recover more, the balance should be given to the insured.
·
Subrogation gives the insurer the right of salvage.
In its history of
providing insurance services to its clients for over thirty years, Nausch Hogan & Murray has
provided coverage for all areas of liability - both on land and at sea.
Over the years Nausch Hogan & Murray has found it
helpful to draft a glossary of useful insurance terms that come up time and
again in discussions with an insured concerning their coverage needs. We hope
these help you as well.
Article Source: http://EzineArticles.com/expert/Carmen_A._Russo/197821
Article Source: http://EzineArticles.com/1198395
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