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Unit 15 Insurance law
Terms in this set (69)
A person who makes a determination of the value of a claim against an insurance company for the purpose of arriving at an amount for which the claim will be settled. May be an agent for the insurance company or an independent adjuster.
1. A yearly payment of a fixed sum of money for life or for stated number of years.
2. A right to receive fixed periodic payments (yearly or otherwise), either for life or for a stated period of time.
An insurance policy that provides for or pays an annuity.
a devious or deceitful intent, motivated by self interest, ill will, or a concealed purpose. The opposite of good faith. Bad faith is stronger than negligence, but may or may not involve fraud. Example: An insurance company engages in bad faith when it refuses, with no basis for its action, to pay a claim.
A person who receives a benefit
A payment made under an insurance policy, pension, annuity, or the like.
1. An intern memorandum, used when an insurance policy cannot be issued immediately, evidencing either that insurance coverage is effective at a specified time and continues until the policy is issued, or that the risk is declined and giving notice of that fact.
2. An earnest money deposit that preserves a buyer's right to purchase real estate.
Business interruption insurance
Insurance protecting against loss from the interruption of business, as distinguished from coverage upon merchandise or other property used in the business.
The act of a party to a contract ending the contract after the other party has been guilty of breach of contract. Should be contrasted with termination, which provides the party ending the contract with fewer remedies.
A provision in a contract that allows the parties to cancel the contract without obligation.
A division of the risk between the insurer and the insured. Example: a health insurance policy under which the insurance company is obligated to pay 80 percent of every claim and the insured pays 20 percent.
Automobile insurance that protects the owner or operator of a motor vehicle from loss due to damage done to his property by another.
A package of coverage provided by a policy of comprehensive insurance that protects against a myriad of perils (collision, theft, etc)
Insurance that provides coverage for various risks (Example: fire; theft; flood; wind; hail), each of which could also be covered under separate policies.
Contribution between insurers
The obligation of an insurance company that has issued a policy covering the same loss as that insured by another insurance company to contribute proportionally to the other insurer who has paid the entire loss.
In insurance, portion of a loss that the insured must pay from his own pocket before the insurance company will begin to make payment. USAGE: "because my policy has a car $500, my insurance company will pay only $2,000 of the $2,500 damage to my car".
A clause in an insurance policy providing for a waiver of premiums in the event of the insured's disability.
Insurance that provides income in the vent of disability.
A benefit payable under an insurance policy at twice face value if loss occurs under certain conditions.
Coverage of the same risk and the same interest by different insurance companies.
1. A provision in an insurance policy that removes a specified risk, person, or circumstances from coverage.
Insurance that indemnifies the insured against loss to property (Examples: a house, the contents of a house; a commercial building) due to fire.
Deceit, deception, or trickery that is intended to induce, and does induce, another person to part with anything of value or surrender some legal right.
1. A contract providing life, accident, or health insurance for a group of employees. The terms of the contract are contained in a master policy; the individual employee's participation is demonstrated by a certificate of insurance that she holds.
2. A contract providing life, accident, or health insurance for any defined group of people. The contract is a master policy and is entered into between the group policyholder
Insurance that indemnifies the insured for medical expenses incurred as a result of sickness or accident.
An insurance policy that insures homeowners against most common risks, including fire, burglary, and civil liability.
1. The act of indemnifying or being indemnified
2. Payment made by way of compensation for loss
1. To compensate or reimburse a person for loss or damage.
2. To promise to compensate or reimburse in the event of future loss or damage.
Insurance providing indemnification for actual loss or damage, as distinguished from liability insurance, which provides for payment of a specified sum upon the occurrence of a specific event regardless of what the actual loss or damage may be.
Having the qualities needed to be insurable: no preexisting health conditions, nonsmoker, under certain ages, etc.
Capable of being insured. Example: as a condition of purchasing life insurance, being in sound health at the time the policy is issued.
an interest from whose existence the owner derives a benefit and whose nonexistence will cause her to suffer a loss. The presence of an insurable interest is essential to the validity and enforce-ability of an insurance policy because it removes it from the category of gambling contract.
A contract (the policy) by which one party (the insurer), in return for a specified consideration (the premium), agrees to compensate or indemnify another (the insured) on an account of loss, damage, or liability arising from an unknown or contingent event (the risk). There are almost as many kinds of coverage as there are risks.
A person authorized by an insurance company to represent it when dealing with third persons in matters relating to insurance.
A person who acts as an intermediary between the insured and the insurer, who is not employed by an insurance company. The broker solicits insurance business from the public, and having obtained an order, either places the insurance with a company selected by the insured, or, if the insured does not select a carrier, then with a company of the broker's choice. Depending upon the circumstances, an insurance broker may represent either the insured, or the insurer, or both.
A company engaged in the business of issuing insurance policies; an insurance company.
A company engaged in the business of issuing insurance policies.
The formal name for an insurance policy.
A contract to compensate or indemnify a person for loss arising from a contingent occurrence.
Money paid to an insurer for an insurance policy.
1. To enter into a contract of insurance as an insurer; to issue an insurance policy.
2. To guarantee
A person protected by an insurance policy; a person whose property is protected by an insurance policy. One need not be the named insured (named in the policy) to be covered. A standard automobile insurance policy, for Example: usually covers any person operating the insured vehicle with the permission of the named insured.
Generally, an insurance company; that is, the party who assumes the risk under an insurance policy and agrees to compensate or indemnify the insured.
A contract (the policy) in which the insurer, in exchange for the payment of a premium, agrees to pay a specified sum to a named beneficiary upon the death of the insured.
A type of liability insurance that protects professional persons (Examples: attorneys; physicians; psychotherapists) from liability for negligence and other forms of malpractice. it is also called professional liability insurance.
An insurance policy covering the risk of loss to a ship or its cargo from the perils of the sea.
A fraudulent or deliberately inaccurate statement that is intended to cause, or causes, a person to act in reliance.
A type of automobile insurance required by law in many states, under which the insured is entitled to indemnification regardless of who was responsible for the injury or damage. Proof of negligence is not a condition of liability under such a policy.
Liability to satisfy a judgment, debt, or other obligation from one's personal assets.
Preexisting condition clause
A provision in a health insurance policy that excludes from coverage, for a specified period of time, medical conditions that existed when the insured purchased the policy.
Money paid to an insurance company for coverage by an insurance policy
Proof of loss
A written statement of the dollar amount of a loss sustained, submitted by an insured. Proof of loss is a standard requirement of casualty insurance policies.
A contract between two insurance companies under which the second company (the reinsurer) insures the first company (the insurer) against loss due to policyholder's claims.
An insurance company's insurance company.
In the context of an insurance loss, the cost of replacing insured property at its current value, as opposed to its original cost; that is, what is costs now, not what it cost when it was purchased.
A sheet or sheets of paper, written or printed, attached to a document, that refer to the document in a manner that leaves no doubt of the parties intention to incorporate it into the document. Riders are most frequently used with insurance policies to make additions or changed to the original policy.
1. The chance of loss or injury; the hazard or peril of loss that is protected by an insurance policy. Example: fire,flood;sickness
2. A gamble; a peril
Protecting one's property or business by establishing a fund out of which to pay for losses instead of purchasing insurance . Self-insurance is a means through which employers may provide workers' compensation and health coverage to their employees as an alternative to securing workers' compensation insurance and health insurance.
Straight life insurance
Life insurance in which the cash surrender value of the policy increases as the insured makes premium payments throughout her lifetime. Straight life insurance is also referred to as whole life insurance or ordinary life insurance.
the substitution of one person or group by another in respect of a debt or insurance claim, accompanied by the transfer of any associated rights and duties.
Term life insurance
Life insurance that provides protection only for a stated number of years and has no cash surrender value.
An insurance policy in which the insurer agrees to indemnify the purchaser of realty, or the mortgage, against loss due to defective title.
An insurance policy that provides coverage over and above the liability limitations of the insured's basic liability insurance policies.
The intentional relinquishment or renunciation of a right, claim, or privilege a person knows he has.
Whole life insurance
Straight life insurance or ordinary life insurance, as opposed to term life insurance or group insurance.
Workers' compensation insurance
State statutes provide for the payment by the employer of compensation to employees injured in their employment or, in case of death, to their dependents, without the need to prove any negligence on the part of the employer.
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