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Insurance Terminology

This information is not to be considered policy language or legal advice and is not a substitute for competent insurance and legal assistance from a licensed insurance agent or attorney, respectively. The information contained is general in nature, and is designed to provide guidance in the understanding of terms used, both in this website, and by the insurance industry as a whole. Each company may interpret definitions slightly different, and these do not reflect the opinions of any one company.

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Accident Medical Coverage: Coverage for medical expenses (doctor bills, ambulance, hospital, and medication bills) incurred as a result of an injury while participating in an insured activity. This is typically written on an excess basis over any other collectible medical insurance the injured person might have available to them. The coverage responds only to injuries sustained while that person is participating in your activities.

Accidental Death & Dismemberment: Coverage for the accidental death, or the loss of limb or limbs as a result of participation in an insured activity or event.

Aggregate: A limit, specified in the policy, that is the maximum total amount that the policy will pay for all losses sustained during the policy period. Aggregate limits typically appear in general liability policies, but are not often used in property insurance, except with respect to certain catastrophic exposures such as earthquake or flood. There may be several aggregates within the policy. One is a coverage aggregate, while the other is a policy aggregate. The coverage aggregate is the most that particular coverage will pay for all losses incurred during the policy period. The policy aggregate is the most the policy will pay for all coverages for all losses incurred during the policy period.

Application: A questionnaire which is filled out by a person seeking a coverage quotation from an insurance company. The questionnaire contains information required by the insuring company to evaluate the risk, underwrite the exposure, and rate the hazards and coverages being requested. Applications are typically completed by the insured party, but the party's representative (agent or broker) may also complete the form on the party's behalf. There may be multiple applications, depending on the scope of the coverage being requested. Most applications, particularly in Personal Insurance, are actually attached to and made a part of the insured's policy (this is not the case with Property & Casualty policies issued by K&K, where the application is merely the means to obtain information, and not made a part of the policies we issue, but does apply to our disability insurance programs).

Assumption of Risk: A contract under which one party's legal liability for damages is assumed by the other party to the contract.

Audit: An examination of the books of accounts, vouchers or other records of a person, corporation, firm or other organization for the purposes of ascertaining the accuracy or inaccuracy of the record (in insurance, the rating base).

Automatic Additional Insured: A clause in the policy that extends coverage to specified persons or organizations who may be involved in your activities or operations, without you having to specifically request them by name. Typically these are landlords, lessors or equipment or municipalities. However, coverage will usually extend as their interest may appear in your activities or operations only.

Automobile Liability Coverage: Protection for the insured (you) against loss arising out of legal action (liability) when his/her auto injures others or damage their property (includes Bodily Injury Liability and Property Damage Liability).

Automobile Physical Damage: The Collision and other than Collision coverage provisions in the automobile insurance policy.

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Bind Order: The oral or written acceptance of a quotation of insurance by the insured party.

Binder: A written document reflecting immediate insurance protection, valid for a specified period of time. Designed to provide temporary coverage until the actual policy can be issued. The binder provides a summary of coverage to be provided by the policy, along with pertinent information such as limits and coverages.

Blanket Coverage: A blanket form is one in which property is insured under a single amount applying to several different pieces of property rather than a specific amount of insurance on each property.

Bodily Injury Liability Insurance: This coverage protects an insured against legal action (liability) for injury to another person arising from an accident or occurrence.

Boiler & Machinery: Mechanical Breakdown - This form of insurance provides mechanical breakdown coverage generally not available under any other insurance policy. This provides protection against the catastrophic effects of property loss, such as a steam boiler explosion or an expensive breakdown of machinery and equipment. This includes more than just boilers and steam vessels, but also includes refrigeration equipment, air conditioning equipment, various types of piping, turbines, engines, pumps, compressors, blowers, gearing, shafting, electric motors, generators, transformers, and assorted other types of mechanical and electrical equipment.

Bound: The past tense of bind, an account that has already had the quotation of coverage accepted by the insured party.

Broadened Coverage Form: Commercial General Liability - This endorsement to the Commercial General Liability Policy form expands coverage or provides additional coverage(s) in the following manner:
  • Exclusion a. is amended to include coverage for reasonable force to protect persons or property.

  • Coverage for Non-Owned Watercraft is extended to include watercraft up to 51 ft. in length.

  • Coverage for cost of bail bonds is increased from $250 to $1000.

  • Coverage for the reasonable costs incurred by the insured at our request is increased from $250 to $500.

  • Coverage for newly acquired or formed organizations is increased from 90 days to 180 days.

  • Coverage is automatically provided for an Additional Insured that is:

  • A person or organization to whom you are obligated by virtue of a valid written contract, but only with respect to your activities or operations.

  • A person or organization that is a lessor or equipment leased to you.

  • Knowledge of occurrence definition added.

  • Unintentional Error or Omission definition added.

  • Waiver of Right of Recovery provision added.

  • Bodily injury definition is redefined to include mental anguish, mental injury, shock, fright, humiliation, or emotional distress.

  • Personal injury definition redefined to:

  • False Arrest, detention or imprisonment;

  • Malicious prosecution or abuse of process;

  • Wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord or lessor;

  • Any publication of materials, including but not limited to oral, written televised, videotaped or electronically transmitted publication of materials that slander or libels a person or organization or disparages a person's or organization's goods, products or services;

  • Any publication of materials, including but not limited to oral, written, televised, videotaped or electronically transmitted publication of material that violates a person's right of privacy;

  • The use of another's advertising idea in your "advertisement"; or

  • Infringing upon another's copyright, trade dress or slogan in your "advertisement".

  • Damage to premises rented to you is expanded to both fire and explosion.

  • Fire Damage Legal Liability coverage is increased from $50,000 to $300,000.
Business Income: Coverage for loss of income in case the insured's business is shut down by a covered cause of loss. It often pays for such expenses as the rebuilding of an accounts receivable data base, cleaning computers, leasing temporary office space, and similar losses associated with a disaster.

Business Interruption Insurance: (See Business Income above).

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Cancellation: The discontinuation of the insurance policy before its normal expiration date.

Carrier: The insurance company or the one who agrees to pay for covered losses.

Casualty Insurance: (also referred to as liability insurance) Insurance primarily concerned with the legal liability for losses caused by injury to persons or damage to property of others. Also includes, among other coverages, automobile, workers compensation, employer's liability, general liability, plate glass, theft and personal liability. It excludes life, fire and marine insurance.

Claims-made Form: A type of liability policy which covers claims which are presented to the carrier while the policy is in effect. Once the policy has expired, no claim is paid under the policy which had not been presented to the carrier, even if the claim occurred during the policy period.

Coinsurance: A provision in the property insurance policy which requires the insured to carry insurance equal to a certain specified percentage of the value of the property for the insured to receive full payment of a loss up to the amount of the policy. Otherwise, payment would be only a percentage of the actual loss (penalty), the percentage is determined by the amount of insurance carried to what should have been carried, as determined by the carrier.

Collision Insurance: Protection against loss resulting from any damage to the policyholder's automobile caused by a collision with another vehicle or object, or by upset of the insured automobile, whether it was the insured's fault or not (other than his/her own willful act).

Combined Single Limit: A liability coverage limit that combines both Bodily Injury and Property Damage into one aggregate amount.

Commercial General Liability Policy: Often referred to as CGL, this policy provides broad protection for situations in which a business must defend itself against lawsuits or pay damages for personal injury or property damage to third parties. The two basic coverage forms available under the CGL are an occurrence form and a claims-made form, providing an extended reporting period. These forms include the following coverages:
  • Bodily Injury and Property Damage Liability,
  • Personal Injury and Advertising Injury Liability,
  • Medical Payments and as applicable,
  • Products and Completed Operations coverage.
Unless modified, an aggregate limit applies to the first three coverages, and a separate aggregate applies to the Products and Completed Operations coverage. Coverage is provided for most of the premises, products, completed operations, personal injury, advertising, and contractual liability exposures of an organization. This coverage form may be issued as a stand alone policy, or in conjunction with other coverage forms like Commercial Auto, Property, or Inland Marine.

Commercial Insurance Coverages: Definitions of many commercial coverages (those which are applicable to lines of business insured through the K&K programs are indicated in blue) are listed alphabetically throughout the glossary. Among these coverages are Aviation Insurance, Cargo Insurance, Commercial Credit Insurance, Commercial Multi-Line Policy, Crop-Hail Insurance, Employers' Liability Insurance, General Liability Insurance, Kidnap and Ransom Insurance, Inland and Ocean Marine Insurance, Products Liability Insurance, Professional Liability Insurance, Public Liability Insurance, Rain Insurance, Surplus Lines, Title Insurance and Workers Compensation.

Commercial Multi-Line Policy: Package type of policy that includes a wide range of essential property and liability coverages for servicing businesses.

Compulsory Auto Liability Insurance: Insurance laws in some states require motorists to carry at least certain minimum auto liability coverages for bodily injury and property damage.

Conditions: Provisions of the insurance policy which state the rights and duties of the insured and insurer.

Contingent Liability Insurance: Covers the insured individual or business in cases of indirect or "contingent" liability, where direct liability for an accident, for example, falls on another, but because of the relationship between the insured and the other party, the insured might still be held indirectly liable.

Contractual Liability Insurance: Provides coverage for claims arising out of liability that has been assumed by the insured under a written or oral contract.

Coverage: The scope of the protection provided under a contract of insurance; any of several risks covered by the policy.

Covered / Insured Peril: The perils of loss you are protected against by the insurance policy. Examples of perils include, fire, lightening, theft, and vandalism.

Crime: This insurance is designed to protect you from loss of money and securities resulting from a theft, or employee dishonesty.

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Damage to Premises Rented To You: Under your general liability, this coverage will pay for damages to any one premises you rent, but do not occupy, or in the case of fire or explosion, while rented to you or temporarily occupied by you with permission of the owner, but only to the limit designated on the policy declaration page.

Declarations: That part of the policy describing the named insured, address, effective date, term of the policy, applicable coverages, the amount of insurance and the premium.

Deductible: A provision in an insurance contract stating that the insurer will pay that amount of any insured loss that is in excess of a specified amount. The specified amount is the deductible.

Directors & Officers Liability: Designed for the Directors and Officers of boards, corporations, or nonprofit organizations, this coverage provides protection for claims arising from the fiduciary duties owed the corporation, shareholders, or other third parties from certain fiduciary, tortuous conduct, fraud or deceit, or the violation of certain statutes.

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Earned Premium: That part of the total property/casualty policy premium earned by the insurance company which applies to the expired portion of the policy period.

Employee Benefit Liability: This coverage protects you, an employer, from claims by employees or former employees resulting from negligent acts or omissions in the administration of your employee benefits programs. Employee benefits programs can be defined include group life, health, and accident insurance, profit sharing plans, employee stock subscription plans, and workers compensation, unemployment insurance, social security benefits, disability benefits, etc.

Employers' Liability Insurance: Provides protection for the employer for those bodily injuries, whether accident or disease, sustained by employees in the course of employment, not otherwise covered under workers compensation law.

Endorsement: An additional piece of paper, which was not part of the original insurance contract, that cites certain terms, conditions, or changes, and which becomes a part of the insurance contract. Additions to personal lines insurance policies are accomplished through the use of riders, which are similar to endorsements.

Employment Related Practices Liability: This insurance defends and pays losses incurred by you for wrongful employment acts. Wrongful employment acts includes alleged acts of discrimination, harassment, negligent hiring and/or inappropriate employment decisions made by you, against employees, both past and present, or an applicant for employment.

Errors & Omissions Liability: This insurance provides defense and pays losses which you are legally obligated to pay for monetary losses incurred by third parties as a result of your wrongful acts (errors or omissions committed solely in the performance of, or failure to perform professional services). Unlike Directors & Officers coverage, which is restricted to those individuals, this coverage is typically written for the corporation or organization.

Excess / Umbrella: This type of liability insurance provides coverage over a single underlying policy, or several different underlying policies. The limits provided by this policy will not respond to the loss until after some specified underlying policies limits are spent, exhausted, or otherwise not available. If underlying limits are not available, and the coverage is not excluded from the Excess/Umbrella coverage, this policy will respond as primary.

Exclusion: A provision in the insurance policy which denies coverage for certain perils, persons, property or locations.

Extra Expense: This insurance is designed to pay for costs in excess of normal operating expenses that are incurred by a business in order to continue operations without interruption after a direct property loss, or in order to minimize the interruption. This coverage is not a substitute for Business Income (Interruption) coverage, as this coverage does not provide any recovery for any loss of income, despite all efforts to continue operations.

Exposure: This term in the insurance field may have several meanings:
  1. Possibility of loss,
  2. A loss potential as measured by type of construction, area or values,
  3. A possibility of a loss being communicated to an insurance risk from its surroundings, or
  4. The unit of measure of the amount of risk a company assumes (for example 50,000 spectators are a single event).
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Fire Damage Legal Liability (Damage to Property Rented to You): Contained within the Commercial General Liability coverage part, this coverage provides protection for damage to property rented to you (landlord's building), should damage occur as a result of fire. This coverage is provided at a separate limit from the property damage liability limit, typically at a lesser amount.

Fire Insurance: Coverage is provided to protect the insured property from the peril of fire and lightening.

Fleet Policy: An auto policy covering a number of vehicles owned by a single insured.

Floater: A form of insurance that applies to movable property, whatever its location, within the territorial limits imposed by the contract. The coverage "floats" with the property.

Flood Insurance: Coverage against loss resulting from the flood peril, widely available under a program developed in 1968 by the private insurance industry and the federal government.

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Garage Liability: Insurance to protect garages, service stations, vehicle rental agencies, car washes, owners of automobile, trailer, or RV vehicle dealerships from liabilities arising out of their business operations and the sale or use of autos, from claims alleging bodily injuries or property damage caused by the operator's negligence.

Garagekeepers' Liability (Garagekeepers Legal Liability): An insurance contract that protects a garage operators against direct damage or legal liability for damage to vehicles in his care, custody or control caused by specific perils. This coverage is included as part of a garage coverage or as a separate endorsement.

General Liability Insurance: A broad term meaning liability insurance, other than automobile liability or employers' liability, written to cover professional and commercial risks. In respect to commercial liability, various available coverages could cover such risks as premises and operations, contractual liability, products and completed operations. A form of insurance designed to protect owners and operators of businesses from a wide variety of liability exposures. These exposures could include liability arising out of accidents resulting from the premises or the operations of an insured, products sold by the insured, operations completed by the insured and liabilities assumed by the insured through specific types of contracts.

Glass Insurance: Protection for loss of or damage to glass and its appurtenances.

Good Driver Plan: An auto insurance rating program that reflects the insured's accident and traffic violation record as a factor in determining the premium.

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Hazard: The presence of a condition that could cause loss or injury to property or persons. For example, smoking in bed increases the chance for loss of property and life resulting from fire.

Health Insurance: There are two major types:
  1. Disability income insurance pays for loss of income due to disability;
  2. Medical expense insurance pays for hospital, doctor and other medical expenses.
Both of these generally pay for losses arising from sickness or accidents. Some policies, referred to as "accident policies", do not cover sickness.

Hold Harmless Agreement: A statement or warranty, typically in contracts, whereby one party agrees not to pursue legal action or suit for injuries sustained by that party, as a result of the actions of the other party. A contractual assumption of the liability exposures of another. As an example, a lease agreement commonly requires the tenant to hold the landlord harmless for bodily injury or property damage experienced by others on the premises.

Hull Policy: An ocean marine or aviation insurance contract covering damage to or loss of a ship or plane, but not the contents.

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Improvements and Betterments (Tenants): Insurance coverage that protects a tenant or lessee of real property against loss as a result of a covered cause of loss, of improvements made by him/her to the real property in which he/she resides. Some property policies use the term "improvements and additions" in describing the coverage.

Indemnity: In general, means reimbursement for loss, but also is used to mean a benefit provided by a policy.

Inland Marine: This insurance coverage (sometimes referred to as a floater) is just property insurance for property loss exposures which cannot be conveniently or reasonably confined to a fixed location or a standard form. This may include movable property, instrumentality's of transportation and communications (such as bridges, roads, piers, and television and radio towers), and the legal liability coverage of bailees. This also includes electronic data processing equipment.

Insurance to Value: Insurance written in an amount approximating the value of the property insured.

Insured: A person covered by an insurance policy.

ISO: The abbreviated reference to Insurance Services Office, Inc. The organization, whose members are insurance companies nationwide, is the largest rating bureau in the United States. ISO is responsible for many lines of insurance, including fire, commercial and personal auto, homeowners, general liability, inland marine, and crime. It handles both personal and commercial lines, as well as both property and liability. The main function of ISO is the development of standardized industry coverage forms and rates.

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Kidnap and Ransom Insurance: Written for financial institutions and other corporations, this insurance covers named employees for individual or aggregate amounts paid as ransom, with deductibles requiring the insured to participate in approximately 10% of any loss.

Knowledge of Occurrence: Typically in a policy, this will describe when knowledge of an accident or occurrence is considered to be known to the insured person. Language may read as follows:
  • Knowledge of the occurrence, claim or suit by the agent, servant, or employee of an insured shall not in itself constitute your knowledge unless one of your offices, managers or partners have received notice of the occurrence, claim or suit.

  • Failure by the agent, servant or employee of an insured (other than an officer, manager or partner) to notify us of an occurrence shall not constitute a failure to comply with the provision in your policy titled duties in the event of occurrence, offense, claim or suit.
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Lapsed Policy: An insurance policy which has passed its expiration date without renewal or continuation of the coverage provided by the policy.

Legal Liability to Participants: This coverage typically refers to persons while practicing for, or participating in contests or exhibitions of an athletic or sports nature. The coverage responds to and defends you in a suit being made against you, by a participant in a contest or exhibition (of an athletic or sports nature) which you control, promote, or sponsor.

Liability Insurance: Provides protection for the insured against loss arising out of his/her legal liability to third parties.

Liability Limits: The stipulated sum or sums beyond which an insurance company is not liable to protect the insured.

Limit: The maximum amount of benefit that an insurer agrees to pay in the event of a loss.

Line of Insurance: A type or kind of insurance.

Litigation: The process of a lawsuit.

Liquor Liability: This type of liability insurance provides coverage for bodily injury or property damage for which you may be held liable by reason of:
  • Causing or contributing to the intoxication of any person;

  • Furnishing alcoholic beverages to a person under legal drinking age or under the influence of alcohol; or

  • Violating any statute, ordinance, or regulation relating to the sale, gift, distribution, or use of alcoholic beverages.
This coverage only applies if you are involved in the following activities:
  • Manufacturing, selling, or distributing alcoholic beverages;

  • Serving or furnishing alcoholic beverages for a charge, whether or not such activity requires a license or is for the purpose of financial gain or livelihood; or

  • Serving or furnishing alcoholic beverages without a charge, if a license is required for such activity.
Loss: An occurrence that is the basis for submission and/or payment of a claim. Losses can be covered, limited or excluded from coverage, depending on the terms of the policy.

Loss Control Representative: Insurance company employee or subcontractor that perform loss control surveys (for underwriting purposes) and prepare written loss control reports that outline their findings. The Loss control representative provides a value added risk control service to the policyholder.

Loss Experience: The loss record of an insured or of a particular class of coverage.

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Malpractice Insurance: Coverage afforded to a professional practitioner, such as a doctor or a lawyer, against liability claims for damages resulting from alleged negligence in the performance of the insured's services.

Marine Insurance: (See Inland Marine or Ocean Marine Insurance).

Medical Expense Payments: This is a coverage under the General Liability coverage. This coverage will reimburse an injured party for medical and/or funeral expenses incurred as a result of bodily injury or death sustained by accident under the conditions specified in the policy, regardless of whether you are liable or not. The most we will pay for any one person is the limit specified in the policy.

Medical Payments Automobile Insurance: Coverage, in states which are other than a no-fault state, which pays medical and hospital expenses and the expense of funeral services resulting from an automobile accident, regardless of the liability of the insured. This is a first-party coverage.

Minor: In most states, a person under the age of 18.

Multi-Peril Policy: A package policy that provides protection against a number of separate perils. Multi-peril policies are not necessarily multiple-line policies, since the combined perils may be all within one insurance line, such as property.

Multiple-Line Policy: A package policy which combines coverages from both the traditional property and liability lines.

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Named Perils: Coverage in a property policy that provides protection against loss from only the perils specifically listed in the policy rather than protection from physical loss. Examples of named perils are fire, windstorm, theft, smoke, etc.

Negligence: The failure of a person to exercise the care that a prudent person would exercise under similar circumstances.

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Occurrence: Means an accident, including continuous or repeated exposure to substantially the same general harmful conditions.

Ocean Marine Insurance: Coverage on all types of vessels, including liabilities connected with them, and coverages on their cargoes.

Other Than Collision Coverage: Protection against loss resulting from damage to the insured auto, commonly called "comprehensive auto coverage". Broad coverage is provided and includes protection from such hazards as fire, theft, glass damage, wind, hail and malicious mischief. This is a first-party coverage.

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Partial Disability: An impairment that prevents the insured from performing one or more, but not all, important duties of his/her job.

Peril: The cause of a possible loss, such as fire, windstorm, theft, explosion or riot.

Personal Injury Liability Insurance: Protection against liability for damages other than physical injury arising out of false arrest, detention or imprisonment, or malicious prosecution; libel, slander or defamation of character; invasion of privacy, wrongful eviction or wrongful entry.

Personal Injury Protection (PIP): That section (in a no-fault state) of the automobile policy that covers the treatment of injuries to the driver and passengers of an insured's car.

Personal Lines: Types of insurance written for individuals or families, rather than for businesses.

Policy: The name generally used to mean the written contract of insurance.

Policyholder: The one who owns the insurance policy. Their name is the one that appears on the Declarations under the title of Named Insured or Policyholder.

Pollution Insurance: This is a coverage that protects an insured from property loss or liability arising from pollution-related damages. Pollution may be the contamination of water, soil, or air by means of solid, liquor or gaseous (vapors, smoke or heat) contaminants.

Pre-Existing Condition: A physical condition that existed prior to the issuance of the insurance policy.

Premises: The buildings, other structures and land where the insurance protection is applicable. It is usually described and defined in the property casualty policy.

Premium: The amount of money charged the policyholder for the insurance policy.

Products Liability: The section of the policy that protects against financial loss arising out of legal actions (liability) incurred by a manufacturer, merchant or distributor because of injury or damage resulting for the use of a covered product.

Professional Liability: There are many occupations and fields of endeavor which are regarded as "professional" in today's society. This coverage is designed to provide protection for liability claimsresulting from errors in judgement, breach of duty, failure to conduct one's self to a professional standard of care, act or omission.

Proof of Loss: Documentation presented to the insurance company by the insured in support of a claim so that the insurer can determine its liability under the policy.

Property Damage Liability Coverage: Protection against loss from legal action (liability) for damage to the property of others.

Property Insurance: Provides protection against loss or damage to the insured's (your) property, caused by the specified Causes of Loss (perils) as appear in the policy.

Property Coverage (Expanded) Form (TUX): A K&K form, which includes over 30 expanded coverage over the standard ISO Property form, including but not limited to:
  • No Coinsurance on Building and Business Personal Property Coverages

  • Increased Cost of Construction included

  • Demolition Coverage included

  • Building Ordinance Coverage included

  • Back-Up of Sewers & Drains Included

  • Electrical Injury, except Electrical Arching included

  • Collapse included

  • Marring & Scratching included

  • Electronic Data Processing Equipment and Media at a limit of: $25,000

  • Lost Data Preparation at a limit of: $25,000

  • Extra Expense at a limit of: $25,000

  • Property In Transit at a limit of: $25,000

  • Newly Acquired Buildings at a limit of: $1,000,000

  • Newly Acquired Personal Property (YBBP) at a limit of: $500,000

  • Pollution Clean-Up and Removal at a limit of: $25,000

  • Signs (On premises / each sign) at a limit of: $5,000

  • Outdoor Property (Specified perils) at a limit of: $25,000

  • Personal Property of Others (Incl. Employees) at a limit of: $25,000

  • Personal Property - Unnamed Locations at a limit of: $250,000

  • Fire Department Service Charge at a limit of: $25,000

  • Fire Protective Equipment Discharge at a limit of: $5,000

  • Installation at a limit of: $5,000

  • Brands & Labels at a limit of: $5,000

  • Deferred Payments at a limit of: $5,000

  • Debris Removal at a limit of: 25% + $25,000

  • Fine Arts at a limit of: $15,000

  • Accounts Receivable at a limit of: $25,000

  • Valuable Papers & Records - Cost of Research at a limit of: $25,000
With optional coverage/conditions like:
  • Business Income with Extra Expense (Including Rental Value)

  • Builders Risk

  • Replacement Cost Valuation

  • Actual Cash Value Valuation

  • Broad Form Property / Business Income Cause of Loss

  • Special Form Property / Business Income Cause of Loss

  • Earthquake

  • Flood
Property / Casualty Insurance: One of the three (3) larger classifications of insurance (the other two are Life, Health and Accident, and Surety & Bonds. Property and Casualty refers to the group of coverages including Property, Crime, Liability, Auto, Workers Compensation and Errors and Omissions. This group of coverages is further broken down in to two subgroups, Personal and Commercial insurance. Personal insurance is typically issued to an individual, and includes coverages like Homeowners, Personal Auto and Personal Umbrellas. Commercial Insurance is typically issued to corporations or organizations, or to the individual who owns a business operation, and includes coverages like Commercial Property, Commercial Auto, and Commercial General Liability.

Proximate Cause: The dominate cause of loss or damage; an unbroken chain of events between the occurrence of an insured peril and the damage to property. As an illustration, weather damage occurring from fire-fighting activities is covered under the fire policy because fire was the proximate cause of the loss.

Public Liability Coverage: A generic term meaning insurance to cover risks against liability exposures other than those involving employees, or arising out of the use of autos, aircraft, or watercraft. This is frequently interchanged with the terms General Liability or Commercial General Liability.

Purchasing Group: An entity that offers insurance to a group of homogeneous (similar) businesses with similar exposures or potential for similar exposures.

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Rain Insurance (Cancellation Insurance): Insurance protection against loss due to rain, hail, snow or sleet, which causes cancellation or reduced earnings of an outdoor event.

Rate: A charge per unit in determining insurance premiums.

Reinstatement: The restoration of a lapsed insurance policy to its original provision, being in full force and effect.

Retention: The net amount of risk retained by an insurance company for its own account or that of specified others, and not reinsured.

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Schedule: A list describing the property or items insured under the policy and the extent which they are insured.

Self-Insurance: A form of risk financing through which a firm assumes all or a part of its own losses. Self-Insurers may purchase insurance to cover excess losses.

Specified Perils: (See Named Perils)

Stop Gap Endorsement: Provides employer liability coverage for work-related injury arising out of incidental operations or exposures in the monopolistic fund states (as of October, 2001, the monopolistic states are: North Dakota, Ohio, Washington, West Virginia and Wyoming).

Subrogation: A principle of law incorporated in insurance policies that enables the insurance company, after paying a loss to its insured, to recover the amount of the loss from another who is legally liable for it.

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Theft Insurance: Protection for loss of property due to stealing, including burglary, robbery and larceny.

Third Party: A person who files a liability insurance claim against another person or entity (first party).

Tort: Any wrongful act, damage or injury done willfully, negligently or in circumstances involving strict liability, but not involving breach of contract, for which a civil lawsuit can be brought.

Total Disability: Disability that prevents a person from performing (a) any of his/her occupational duties, or (b) any duties for which he/she is reasonably qualified. Definitions vary within policies.

Towing Coverage: Insures against charges for towing and road service at the place of disablement, with a maximum amount stipulated for each occurrence.

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Umbrella Coverage: (See Excess/Umbrella Coverage)

Underwriter: An employee of an insurance company who is a selector of risks. The underwriter is expected to select business that will produce an average risk of loss no greater than anticipated for the class of business. The term may also be an agent or other field representative who is referred to as a "field underwriter".

Unearned Premium: The portion of a property/casualty insurance premium that applies to the unexpired portion of the policy period.

Uninsured Motorists Coverage (UM): Pays the policyholder and passengers in his/her car for losses sustained by reason of bodily injury, sickness, disease or death caused by the owner or operator of an uninsured automobile or a "hit-and-run" driver.

Uninsured Motorists Property Damage Coverage (UMPD): Provides coverage to a vehicle involved in an accident with an uninsured motorist. UMPD is similar to "collision coverage", and is not available to those who purchase "collision coverage".

Unintentional Error or Omission: Typically in the policy, this will describe the effect upon the policy of an error, omission or misrepresentation of information on your application, or with information presented at the time of a claim. Language may read as follows:
  • Any unintentional error or omission in the description of or failure to completely describe, any premises or operations intended to be covered by this coverage part will not invalidate or affect coverage for those premises or operations. However, you must report such error or omission to us as soon as practicable after its discovery.
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Valuation: The process of determining the company's liabilities under the policy obligations is known as policy valuation. The process of determining the value of the company's investments is known as asset valuation. Minimum valuation standards are usually prescribed by state laws.

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Waiver and Release of Liability: An agreement obtained by an insured from an individual or group whereby they forfeit their rights to take legal action against that insured. An illustration of this would be an individual wishing to participate in a sport might have to sign a "waiver and release" stating they will not sue if they are injured while playing the sport, whether there is negligence or not.

Waiver of Right of Recovery: In the insurance policy, if a claim is paid under the policy, which is also covered by another person, organization, or other insurance policy, the insured or the insurance company has the right to pursue collection of the amount paid, or any portion thereunder, from that other party. A Waiver of Right of Recovery means that the insured has agreed, prior to a claim, that no one will not attempt to collect (sometimes referred to as subrogation) from the other party, any amounts paid under the insurance policy, even if those amounts should have been paid by them or their insurance. If the insurance company has agreed to put the Waiver of Right of Recovery provision in the policy, it typically acknowledges that its right of recovery is forfeited, provided the insured has so agreed with another party to waive their right of recovery. Typical language to this effect can be seen below:
  • We waive all rights of recovery when you have agreed to waive your rights of recovery when required by a written contract. However, this provision only applies if the written contract was executed prior to the date of the occurrence.
Weekly Indemnity: The insurance will pay, after an established waiting period, an agreed weekly sum for lost wages incurred by person (if at the time of the injury they were gainfully employed), if they are unable to work as a result of injuries incurred during an activity, operation or event of yours.

Workers Compensation: A system (established under state laws) under which employers provide insurance for benefit payments to employees for their work-related injury, death and disease regardless of fault. Not to be mistaken as health insurance. This coverage form provides coverage in two ways:
  1. Compensation for the employee for job-related injuries, irregardless of negligence, and
  2. Protection (Employers Liability) from liability suits brought by workers against the employer.

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