A

 

Accident: an unexpected event or circumstance without deliberate intent.

 

Accidental Bodily Injury: unexpected injury to a person.

 

Accidental Death & Dismemberment: an insurance contract that pays a stated benefit in the event of death and/or dismemberment caused by accident or specified kinds of accidents.

 

Accumulation Period: period of time insured must incur eligible medical expenses at least equal to the deductible amount in order to establish a benefit period under a major medical expense or comprehensive medical expense policy.

 

Actual Cash Value: repayment value for indemnification due to loss or damage of property; in most cases it is replacement cost minus depreciation

 

Actuary: business professional who analyzes probabilities of risk and risk management including calculation of premiums, dividends and other applicable insurance industry standards.

 

Adjuster: a person who investigates claims and recommends settlement options based on estimates of damage and insurance policies held.

 

Admission: hospital inpatient care for any medical condition.

 

Advance Premiums: occur when a policy has been processed, and the premium has been paid prior to the effective date. These are a liability to the company and not included in written premium or the unearned premium reserve.

 

Agent: an individual who sells, services, or negotiates insurance policies either on behalf of a company or independently.

 

Aggregate: the maximum dollar amount or total amount of coverage payable for a single loss, or multiple losses, during a policy period, or on a single project.

 

All-Risk: also known as open peril, this type of policy covers a broad range of losses. The policy covers risks not explicitly excluded in the policy contract.

 

Alternative Workers' Compensation: other than standard workers' compensation coverage, employer's liability and excess workers' compensation (e.g., large deductible, managed care).

 

Ambulatory Services: health services provided to members who are not confined to a health care institution. Ambulatory services are often referred to as "outpatient" services.

 

Annual Statement: an annual report required to be filed with each state in which an insurer does business. This report provides a snapshot of the financial condition of a company and significant events which occurred throughout the reporting year.

 

Annuitant: the beneficiary of an annuity payment, or person during whose life and annuity is payable.

 

Annuities – Immediate Non-variable: an annuity contract that provides for the fixed payment of the annuity at the end of the first interval of payment after purchase. The interval may vary, however the annuity payouts must begin within 13 months.

 

Annuity: a contract providing income for a specified period of time, or duration of life for a person or persons.

 

Appraisal: an estimate of value.

 

Arbitration: a binding dispute resolution tactic whereby a conciliator with no interest in the outcome intercedes.

 

Assessed Value: estimated value for real or personal property established by a taxing entity

 

Asset: probable future economic benefits obtained or controlled by a particular entity as a result of past transactions or events. An asset has three essential characteristics: It embodies a probable future benefit that involves a capacity, singly or in combination with other assets, to contribute directly or indirectly to future net cash inflows; A particular entity can obtain the benefit and control others' access to it; and The transaction or other event-giving rise to the entity's right to or control of the benefit has already occurred.

 

Asset Risk: in the risk-based capital formula, risk assigned to the company's assets.

 

Auto Physical Damage: motor vehicle insurance coverage (including collision, vandalism, fire and theft) that insures against material damage to the insured's vehicle. Commercial is defined as all motor vehicle policies that include vehicles that are used in connection with business, commercial establishments, activity, employment, or activities carried on for gain or profit.

 

Automobile Liability Insurance: coverage for bodily injury and property damage incurred through ownership or operation of a vehicle.

 

 

 

B

 

Beneficiary: an individual who may become eligible to receive payment due to will, life insurance policy, retirement plan, annuity, trust, or other contract.

 

Benefits: total expenditures for health care services paid to or on behalf of a member.

 

Blanket coverage: coverage for property and liability that extends to more than one location, class of property or employee.

 

Bodily Injury: physical injury including sickness or disease to a person.

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Bonds: a form of debt security whereby the debt holder has a creditor stake in the company. Obligations issued by business units, governmental units and certain nonprofit units having a fixed schedule for one or more future payments of money; includes commercial paper, negotiable certificates of deposit, repurchase agreements and equipment trust certificates.

 

Book Value: original cost, including capitalized acquisition costs and accumulated depreciation, unamortized premium and discount, deferred origination and commitment fees, direct write-downs, and increase/decrease by adjustment.

 

Builders' Risk Policies: typically written on a reporting or completed value form, this coverage insures against loss to buildings in the course of construction. The coverage also includes machinery and equipment used in the course of construction and to materials incidental to construction.

 

Burglary and Theft: coverage for property taken or destroyed by breaking and entering the insured's premises, burglary or theft, forgery or counterfeiting, fraud, kidnap and ransom, and off-premises exposure.

 

Business Auto: coverage for motor vehicles, other than those in the garage business, engaged in commerce. Business auto filings include singularly or in any combination coverage such as the following: Auto Liability, PIP, MP, Uninsured Motorist and/or Underinsured Motorists (UM/UIM); Specified Causes of Loss, Comprehensive, and Collision.

 

Business Owners Policy: business insurance typically for property, liability and business interruption coverage.

 

 

 

C

 

Calendar Year Deductible: in health insurance, the amount that must be paid by the insured during a calendar year before the insurer becomes responsible for further loss costs.

 

Capital and Surplus: a company's assets minus its liabilities.

 

Cash: a medium of exchange.

 

Cash Equivalent: short-term, highly liquid investments that are both (a) readily convertible to known amounts of cash, and (b) so near their maturity that they present insignificant risk of changes in value because of changes in interest rates. Investments with original maturities of three months or less qualify under this definition.

 

Casualty Insurance: a form of liability insurance providing coverage for negligent acts and omissions such as workers compensation, errors and omissions, fidelity, crime, glass, boiler, and various malpractice coverages.

 

Catastrophe Bonds: Bonds issued by an insurance company with funding tied to the company's losses from disasters, or acts of God. A loss exceeding a certain size triggers a reduction in the bond value or a change in the bond structure as loss payments are paid out of bond funds.

 

Catastrophe Loss: a large magnitude loss with little ability to forecast.

 

Ceded Premium: amount of premium (fees) used to purchase reinsurance.

 

Claim: a request made by the insured for insurer remittance of payment due to loss incurred and covered under the policy agreement.

 

Claims Adjustment Expenses: costs expected to be incurred in connection with the adjustment and recording of accident and health, auto medical and workers' compensation claims.

 

Class Rating: a method of determining rates for all applicants within a given set of characteristics such as personal demographic and geographic location.

 

Coinsurance: A clause contained in most property insurance policies to encourage policy holders to carry a reasonable amount of insurance. If the insured fails to maintain the amount specified in the clause (Usually at least 80%), the insured shares a higher proportion of the loss. In medical insurance a percentage of each claim that the insured will bear.

 

Collateral Loans: unconditional obligations for the payment of money secured by the pledge of an investment.

 

Combinations: a special form of package policy composed of personal automobile and homeowners insurance.

 

Combined Ratio: an indication of the profitability of an insurance company, calculated by adding the loss and expense ratios.

 

Commencement Date: date when the organization first became obligated for any insurance risk via the issuance of policies and/or entering into a reinsurance agreement. Same as "effective date" of coverage.

 

Commercial Auto: coverage for motor vehicles owned by a business engaged in commerce that protects the insured against financial loss because of legal liability for motor vehicle related injuries, or damage to the property of others caused by accidents arising out of the ownership, maintenance, use, or care-custody & control of a motor vehicle. This includes Commercial Auto Combinations of Business Auto, Garage, Truckers and/or Other Commercial Auto.

 

Commercial Earthquake: earthquake property coverage for commercial ventures.

 

Commercial Farm & Ranch: a commercial package policy for farming and ranching risks that includes both property and liability coverage. Coverage includes barns, stables, other farm structures and farm inland marine, such as mobile equipment and livestock.

 

Commercial Flood: separate flood insurance policy sold to commercial ventures.

 

Commercial General Liability: flexible & broad commercial liability coverage with two major sub-lines: premises/operations sub-line and products/completed operations sub-line.

 

Commercial Package Policy: provides a broad package of property and liability coverages for commercial ventures other than those provided insurance through a business owners policy.

 

Commercial Property: property insurance coverage sold to commercial ventures.

 

Commission: a percentage of premium paid to agents by insurance companies for the sale of policies.

 

Community Rating: a rating system where standard rating is established and usually adjusted within specific guidelines for each group on the basis of anticipated utilization by the group's employees.

 

Company Code: a five-digit identifying number assigned by NAIC, assigned to all insurance companies filing financial data with NAIC.

 

Completed Operations Liability: policies covering the liability of contractors, plumbers, electricians, repair shops, and similar firms to persons who have incurred bodily injury or property damage from defective work or operations completed or abandoned by or for the insured, away from the insured's premises.

 

Comprehensive (Hospital and Medical): line of business providing for medical coverages; includes hospital, surgical, major medical coverages; does not include Medicare Supplement, administrative services (ASC) contracts, administrative services only (ASO) contracts, federal employees health benefit plans (FEHBP), medical only programs, Medicare and Medicaid programs, vision only and dental only business.

 

Comprehensive General Liability (CGL): coverage of all business liabilities unless specifically excluded in the policy contract.

 

Comprehensive Personal Liability: comprehensive liability coverage for exposures arising out of the residence premises and activities of individuals and family members. (Non-business liability exposure protection for individuals.)

 

Comprehensive/Major Medical: policies that provide fully insured indemnity, HMO, PPO, or Fee for Service coverage for hospital, medical, and surgical expenses. Coverage excludes Short-Term Medical Insurance, the Federal Employees Health Benefit Program and non-comprehensive coverage such as basic hospital only, medical only, hospital confinement indemnity, surgical, outpatient indemnity, specified disease, intensive care, and organ and tissue transplant coverage.

 

Concurrent Causation: property loss incurred from two or more perils in which only one loss is covered but both are paid by the insurer due to simultaneous incident.

 

Conditions: requirements specified in the insurance contract that must be upheld by the insured to qualify for indemnification.

 

Condos: homeowners insurance sold to condominium owners occupying the described property.

 

Construction and Alteration Liability: covering the liability of an insured to persons who have incurred bodily injury or property damage from alterations involving demolition, new construction or change in size of a structure on the insured's premises.

 

Contingency Reserves: required by some jurisdictions as a hedge against adverse experience from operations, particularly adverse claim experience.

 

Contingent Liability: the liability of an insured to persons who have incurred bodily injury or property damage from work done by an independent contractor hired by the insured to perform work that was illegal, inherently dangerous, or directly supervised by the insured.

 

Continuation of Care Requirement: statutory or contractual provision requiring providers to deliver care to an enrollee for some period following the date of a Health Plan Company's insolvency.

 

Continuing Care Retirement Communities: senior housing arrangements that in addition to housing include some provision for skilled nursing care.

 

Contract Reserves: reserves set up when, due to the gross premium structure, the future benefits exceed the future net premium. Contract reserves are in addition to claim and premium reserves.

 

Contractual Liability: liability coverage of an insured who has assumed the legal liability of another party by written or oral contract. Includes a contractual liability policy providing coverage for all obligations and liabilities incurred by a service contract provider under the terms of service contracts issued by the provider.

 

Convertible Term Insurance Policy: an insurance policy that can be converted into permanent insurance without a medical assessment. The insurer is required to renew the policy regardless of the health of the insured subject to policy conditions.

 

Coordination of Benefits (COB): provision to eliminate over insurance and establish a prompt and orderly claims payment system when a person is covered by more than one group insurance and/or group service plan.

 

Copay: a cost sharing mechanism in group insurance plans where the insured pays a specified dollar amount of incurred medical expenses and the insurer pays the remainder.

 

Corrective Order: commissioner's directive of action to be completed by an insurer.

 

Covered Lives: The total number of lives insured, including dependents, under individual policies and group certificates.

 

Credit: individual or group policies that provide benefits to a debtor for full or partial repayment of debt associated with a specific loan or other credit transaction upon disability or involuntary unemployment of debtor, except in connection with first mortgage loans.

 

Credit Risk: part of the risk-based capital formula that addresses the collectability of a company's receivables and the risk of losing a provider or intermediary that has received advance capitation payments.

 

Crop: coverage protecting the insured against loss or damage to crops from a variety of perils, including but not limited to fire, lightening, loss of revenue, tornado, windstorm, hail, flood, rain, or damage by insects.

 

Crop-Hail Insurance: coverage for crop damage due to hail, fire or lightning.

 

 

 

D

 

Date of Issue: date when an insurance company issues a policy.

 

Declarations: policy statements regarding the applicant and property covered such as demographic and occupational information, property specifications and expected mileage per year .

 

Deductible: Portion of the insured loss (in dollars) paid by the policy holder

 

Deferred Annuity: annuity payment to be made as a single payment or a series of installments to begin at some future date, such as in a specified number of years or at a specified age.

 

Dental Insurance: policies providing only dental treatment benefits such as routine dental examinations, preventive dental work, and dental procedures needed to treat tooth decay and diseases of the teeth and jaw.

 

Dental Only: line of business providing dental only coverage; coverage can be on a stand-alone basis or as a rider to a medical policy. If the coverage is as a rider, deductibles or out-of-pocket limits must be set separately from the medical coverage. Does not include self-insured business as well as FEHBP or Medicare and Medicaid programs.

 

Difference In Conditions (DIC) Insurance: special form of open-peril coverage written in conjunction with basic fire coverage and designed to provide protection against losses not reimbursed under the standard fire forms. Examples are flood and earthquake coverage.

 

Direct Incurred Loss: loss whereby the proximate cause is equivalent to the insured peril.

 

Direct Loss: Damage to covered real or personal property caused by a covered peril.

 

Direct Writer: an insurance company that sells policies to the insured through salaried representatives or exclusive agents only; reinsurance companies that deal directly with ceding companies instead of using brokers.

 

Direct Written Premium: total premiums received by an insurance company without any adjustments for the ceding of any portion of these premiums to the Reinsurer.

 

Directors & Officers Liability: liability coverage protecting directors or officers of a corporation from liability arising out of the performance of their professional duties on behalf of the corporation.

 

Disability Income: a policy designed to compensate insured individuals for a portion of the income they lose because of a disabling injury or illness.

 

Disability Income - Long-Term: policies that provide a weekly or monthly income benefit for more than five years for individual coverage and more than one year for group coverage for full or partial disability arising from accident and/or sickness.

 

Disability Income - Short-Term: policies that provide a weekly or monthly income benefit for up to five years for individual coverage and up to one year for group coverage for full or partial disability arising from accident and/or sickness.

 

Dividend - a refund of a portion of the premium paid by the insured from insurer surplus.

 

Dwelling Property/Personal Liability: a special form of package policy composed of dwelling fire and/or allied lines, and personal liability insurance.

 

 

 

E

 

Early warning system: a system designed by insurance industry regulators of identifying practices and risk-related trends that contribute to systemic risk by measuring insurer' financial stability.

 

Earned Premium: portion of insured's prepaid premium allocated to the insurance company's loss experience, expenses, and profit year- to -date.

 

Earthquake: property coverages for losses resulting from a sudden trembling or shaking of the earth, including that caused by volcanic eruption. Excluded are losses resulting from fire, explosion, flood or tidal wave following the covered event.

 

EBNR - Earned but not reported: premium amount insurer reasonably expects to receive for which contracts are not yet final and exact amounts are not definite.

 

EDP Policies: coverage to protect against losses arising out of damage to or destruction of electronic data processing equipment and its software.

 

Effective Date: date at which an insurance policy goes into force.

 

Employee Benefit Liability: liability protection for an employer for claims arising from provisions in an employee benefit insurance plan provided for the economic and social welfare of employees. Examples of items covered are pension plans, group life insurance, group health insurance, group disability income insurance, and accidental death and dismemberment.

 

Employee Retirement Income Security Act of 1974 (ERISA): a federal statute governing standards for private pension plans, including vesting requirements, funding mechanisms, and plan design.

 

Employers Liability: employers' liability coverage for the legal liability of employers arising out of injuries to employees. This code should be used when coverage is issued as an endorsement, or as part of a statutory workers' compensation policy.

 

Employment Practices Liability Coverage: liability insurance for employers providing coverage for wrongful termination, discrimination, or sexual harassment of the insured's current or former employees.

 

Endorsement: an amendment or rider to a policy adjusting the coverages and taking precedence over the general contract.

 

Enrollment: The total number of plans, not the total number of covered lives, providing coverage to the enrollee and their dependents.

 

Environmental Impairment Liability (EIL): coverage for negligence or omission resulting in pollution or environmental contamination.

 

Environmental Pollution Liability: liability coverage of an insured to persons who have incurred bodily injury or property damage from acids, fumes, smoke, toxic chemicals, waste materials or other pollutants.

 

Equity Indexed Annuity: a fixed annuity that earns interest or provides benefits that are linked to an external reference or equity index, subject to a minimum guarantee.

 

Errors and Omissions Liability | Professional Liability other than Medical: liability coverage of a professional or quasi professional insured to persons who have incurred bodily injury or property damage, or who have sustained any loss from omissions arising from the performance of services for others, errors in judgment, breaches of duty, or negligent or wrongful acts in business conduct.

 

Excess and Umbrella Liability: liability coverage of an insured above a specific amount set forth in a basic policy issued by the primary insurer; or a self insurer for losses over a stated amount; or an insured or self insurer for known or unknown gaps in basic coverages or self insured retentions.

 

Excess of Loss Reinsurance: loss sharing mechanism where an insurer pays all claims up to a specified amount and a reinsurance company pays any claims in excess of stated amount.

 

Excess Workers' Compensation: either specific and/or aggregate excess workers' compensation insurance written above an attachment point or self-insured retention.

 

Expense Ratio: percentage of premium income used to attain and service policies. Derived by subtracting related expenses from incurred losses and dividing by written premiums.

 

Experience Rating: rating system where each group is rated entirely on the basis of its own expected claims in the coming period, with retrospective adjustments for prior periods. This method is prohibited under the conditions for federal qualification.

 

Exposure: risk of possible loss.

 

Extra Expense Insurance: a type of property insurance for extraordinary expenses related to business interruption such as a back-up generator in case of power failure. 

 

 

 

F

 

Face Amount: the value of a policy to be provided upon maturity date or death.

 

Facultative Reinsurance: reinsurance for a specific policy for which terms can be negotiated by the original insurer and reinsurer.

 

Fair Value: the amount at which an asset (or liability) could be bought (or incurred) or sold (or settled) in a current transaction between willing parties, that is, other than in a forced or liquidation sale. Quoted market prices in active markets are the best evidence of fair value and shall be used as the basis for the measurement, if available. If a quoted market price is available, the fair value is the product of the number of trading units times market price.

 

Farmowners Insurance: farmowners insurance sold for personal, family or household purposes. This package policy is similar to a homeowners policy, in that it has been developed for farms and ranches and includes both property and liability coverage for personal and business losses. Coverage includes farm dwellings and their contents, barns, stables, other farm structures and farm inland marine, such as mobile equipment and livestock.

 

Federal Flood Insurance: coverage for qualifying residents and businesses in flood prone regions through the National Flood Insurance Act, a federally subsidized flood insurance program enacted in 1968.

 

Federally Reinsured Crop: crop insurance coverage that is either wholly or in part reinsured by the Federal Crop Insurance Corporation (FCIC) under the Standard Reinsurance Agreement (SRA). This includes the following products: Multiple Peril Crop Insurance (MPCI); Catastrophic Insurance, Crop Revenue Coverage (CRC); Income Protection and Revenue Assurance.

 

Financial Guaranty: a surety bond, insurance policy, or an indemnity contract (when issued by an insurer), or similar guaranty types under which loss is payable upon proof of occurrence of financial loss to an insured claimant, obligee or indemnitee as a result of failure to perform a financial obligation or any other permissible product that is defined as or determined to be financial guaranty insurance.

 

Fire: coverage protecting the insured against the loss to real or personal property from damage caused by the peril of fire or lightning, including business interruption, loss of rents, etc.

 

Fire Legal Liability: coverage for property loss liability as the result of separate negligent acts and/or omissions of the insured that allows a spreading fire to cause bodily injury or property damage of others. An example is a tenant who, while occupying another party's property, through negligence causes fire damage to the property.

 

Flood: coverage protecting the insured against loss or damage to real or personal property from flood. (Note: If coverage for flood is offered as an additional peril on a property insurance policy, file it under the applicable property insurance filing code.)

 

Fronting: an arrangement in which a primary insurer acts as the insurer of record by issuing a policy, but then passes the entire risk to a reinsurer in exchange for a commission. Often, the fronting insurer is licensed to do business in a state or country where the risk is located, but the reinsurer is not.

 

 

 

G

 

Gross Premium: the net premium for insurance plus commissions, operating and miscellaneous commissions. For life insurance, this is the premium including dividends.

 

Group Accident and Health: coverage written on a group basis (e.g., employees of a single employer and their dependents) that pays scheduled benefits or medical expenses caused by disease, accidental injury or accidental death. Excludes amounts attributable to uninsured accidents and health plans and the uninsured portion of partially insured accident and health plans.

 

Group Annuities – Deferred Non- Variable and Variable: an annuity contract that provides an accumulation based on both (1) funds that accumulate based on a guaranteed crediting interest rates or additional interest rate applied to designated considerations, and (2) funds where the accumulation vary in accordance with the rate of return of the underlying investment portfolio selected by the policyholder. The contract provides for the initiation of payments at some designated future date.

 

Group Annuities – Deferred Variable: an annuity contract that provides an accumulation based fund where the accumulation varies in accordance with the rate of return of the underlying investment portfolio selected by the policyholder. Must include at least one option to have the accumulation vary in accordance with the rate of return of the underlying investment portfolio selected by the policyholder and may include at least one option to have the series of payments vary in accordance with the rate of return of the underlying investment portfolio selected by the policyholder. This annuity contract provides for the initiation of payments at some designated future date.

 

Group Annuities – Immediate Non-Variable and Variable: an annuity contract that provides an accumulation based on both (1) funds that accumulate based on a guaranteed crediting interest rates or additional interest rate applied to designated considerations, and (2) funds where the accumulation vary in accordance with the rate of return of the underlying investment portfolio selected by the policyholder. The contract provides for the initiation of payments at some interval that may vary, however the annuity payouts must begin within 13 months.

 

Group Annuities – Immediate Variable: an annuity contract that provides for the first payment of the annuity at the end of the fixed interval of payment after purchase. The interval may vary, however the annuity payouts must begin within 13 months. The amount varies with the value of equities (separate account) purchased as investments by the insurance companies.

 

Group Annuities – Unallocated: annuity contracts or portions thereof where the Insurer purchases an annuity for the retirees.

 

Group Annuity: a contract providing income for a specified period of time, or duration of life for a person or persons established to benefit a group of employees.

 

Group Health: health insurance issued to employers, associations, trusts, or other groups covering employees or members and/or their dependents, to whom a certificate of coverage may be provided.

 

Group Health Organizations – Health Maintenance (HMO): a plan under which an enrollee pays a membership fixed fee in advance in return for a wide range of comprehensive health care services with the HMO's approved providers in a designated service area.

 

Guaranty Fund: funding mechanism employed by states to provide funds to cover policyholder obligations of insolvent reporting entities.

 

 

 

H

 

Hard Market: a market characterized by high demand and low supply.

 

Hazard: circumstance which tends to increase the probability or severity of a loss.

 

Health – Excess/Stop Loss: this type of insurance may be extended to either a health plan or a self-insured employer plan. Its purpose is to insure against the risk that any one claim will exceed a specific dollar amount or that an entire plan's losses will exceed a specific amount.

 

Health Insurance: a generic term applying to all types of insurance indemnifying or reimbursing for losses caused by bodily injury or illness including related medical expenses.

 

Health Maintenance Organization (HMO): a medical group plan that provides physician, hospital, and clinical services to participating members in exchange for a periodic flat fee.

 

Health Plan: written promise of coverage given to an individual, family, or group of covered individuals, where a beneficiary is entitled to receive a defined set of health care benefits in exchange for a defined consideration, such as a premium.

 

Hold-Harmless Agreement: A risk transfer mechanism whereby one party assumes the liability of another party by contract.

 

Homeowners Insurance: a package policy combining real and personal property coverage with personal liability coverage. Coverage applicable to the dwelling, appurtenant structures, unscheduled personal property and additional living expense are typical. Includes mobile homes at a fixed location.

 

Hospital Indemnity Coverage: coverage that provides a pre-determined, fixed benefit or daily indemnity for contingencies based on a stay at a hospital or intensive care facility.

 

Hull Insurance: coverage for damage to a vessel or aircraft and affixed items.

 

 

 

I

 

Incurred Claims: paid claims plus amounts held in reserve for those that have been incurred but not yet paid.

 

Incurred Losses: sustained losses, paid or not, during a specified time period. Incurred losses are typically found by combining losses paid during the period plus unpaid losses sustained during the time period minus outstanding losses at the beginning of the period incurred in the previous period.

 

Independent Adjuster: freelance contractor paid a fee for adjusting losses on behalf of companies.

 

Independent Agent: a representative of multiple insurance companies who sells and services policies for records which they own and operate under the American Agency System.

 

Index Annuity: an interest bearing fixed annuity tied to an equity index, such as the Dow Jones Industrial Average or S & P 500.

 

Individual Annuities – Deferred Variable: an annuity contract that provides an accumulation based fund where the accumulation varies in accordance with the rate of return of the underlying investment portfolio selected by the policyholder. Must include at least one option to have the accumulation vary in accordance with the rate of return of the underlying investment portfolio selected by the policyholder and may include at least one option to have the series of payments vary in accordance with the rate of return of the underlying investment portfolio selected by the policyholder. This annuity contract provides for the initiation of payments at some designated future date.

 

Individual Annuities – Immediate Variable: an annuity contract that provides for the first payment of the annuity at the end of the fixed interval of payment after purchase. The interval may vary, however the annuity payouts must begin within 13 months. The amount varies with the value of equities (separate account) purchased as investments by the insurance companies.

 

Individual Annuities – Special: contracts with certain noteworthy attributes.

 

Individual Annuities- Deferred Non-Variable and Variable: an annuity contract that provides an accumulation based on both (1) funds that accumulate based on a guaranteed crediting interest rates or additional interest rate applied to designated considerations, and (2) funds where the accumulation vary in accordance with the rate of return of the underlying investment portfolio selected by the policyholder. The contract provides for the initiation of payments at some designated future date.

 

Individual Annuities- Deferred Non-Variable: an annuity contract that provides an accumulation based on funds that accumulate based on a guaranteed crediting interest rate or additional interest rate. This annuity contract provides for the initiation of payments at some designated future date.

 

Individual Annuities- Immediate Non-Variable: an annuity contract that provides for the fixed payment of the annuity at the end of the first interval of payment after purchase. The interval may vary, however the annuity payouts must begin within 13 months.

 

Individual Annuities- Immediate Non-Variable and Variable: an annuity contract that provides an accumulation based on both (1) funds that accumulate based on a guaranteed crediting interest rates or additional interest rate applied to designated considerations, and (2) funds where the accumulation vary in accordance with the rate of return of the underlying investment portfolio selected by the policyholder. The contract provides for the initiation of payments at some interval that may vary, however the annuity payouts must begin within 13 months.

 

Individual Health: health insurance where the policy is issued to an individual covering the individual and/or their dependents in the individual market. This includes conversions from group policies.

 

Inland Marine: coverage for property that may be in transit, held by a bailee, at a fixed location, a movable good that is often at different locations (e.g., off road constructions equipment), or scheduled property (e.g., Homeowners Personal Property Floater) including items such as live animals, property with antique or collector's value, etc. This line also includes instrumentalities of transportation and communication, such as bridges, tunnels, piers, wharves, docks, pipelines, power and phone lines, and radio and television towers.

 

Insurable Interest: A right or relationship in regard to the subject matter of the insured contract such that the insured can suffer a financial loss from damage, loss or destruction to it.

 

Insurance: an economic device transferring risk from an individual to a company and reducing the uncertainty of risk via pooling.

 

Insurance Regulatory Information System (IRIS): a baseline solvency screening system for the National Association of Insurance Commissioners (NAIC) and state insurance regulators established in the mid-1970s.

 

Insurance to Value: Amount of insurance purchased vs. the actual replacement cost of the insured property expressed as a ratio.

 

Insured: party(ies) covered by an insurance policy.

 

Insurer: an insurer or reinsurer authorized to write property and/or casualty insurance under the laws of any state.

 

Intermediary: a person, corporation or other business entity (not licensed as a medical provider) that arranges, by contracts with physicians and other licensed medical providers, to deliver health services for a health insurer and its enrollees via a separate contract between the intermediary and the insurer.

 

Internet Liability Insurance/Cyber Insurance: coverage for cyber commerce including copyright infringement, libel, and violation of privacy.

 

Irrevocable Beneficiary: a life insurance policy beneficiary who has a vested interest in the policy proceeds even during the insured's lifetime because the policy owner has the right to change the beneficiary designation only after obtaining the beneficiary's consent.

 

 

 

J

 

Joint and Last Survivor Annuity: retirement plan that continues to payout so long as at least one, of two or more, annuitants is alive.

 

Joint Underwriting Association (JUA): a loss-sharing mechanism combining several insurance companies to provide extra capacity due to type or size of exposure.

Joint-Life Annuity: an annuity contract that ceases upon the death of the first of two or more annuitants.

 

 

 

K

 

Key-Persons Insurance: a policy purchased by, for the benefit of, a business insuring the life or lives of personnel integral to the business operations.

 

 

 

L

 

Lapse: termination of a policy due to failure to pay the required renewal premium.

 

Level Premium Insurance: life insurance policy for which the cost is equally distributed over the term of the premium period, remaining constant throughout.

 

Liability: a certain or probable future sacrifice of economic benefits arising from present obligations of a particular entity to transfer assets or to provide services to other entities in the future as a result of a past transactions(s) or event(s). three essential characteristics: a) It embodies a present duty or responsibility to one or more other entities that entails settlement by probable future transfer or use of assets at a specified or determinable date, on occurrence of a specified event, or on demand; b) The duty or responsibility obligates a particular entity, leaving it little or no discretion to avoid the future sacrifice; and c) The transaction or other event obligating the entity has already happened.

 

Life – Endowment: insurance that pays the same benefit amount should the insured die during the term of the contract, or if the insured survives to the end of the specified coverage term or age.

 

Life – Flexible Premium Adjustable Life: a group life insurance that provides a face amount that is adjustable to the certificate holder and allows the certificate holder to vary the modal premium that is paid or to skip a payment so long as the certificate value is sufficient to keep the certificate in force, and under which separately identified interest credits (other than in connection with dividend accumulation, premium deposit funds or other supplementary accounts) and mortality and expense charges are made to individual certificates while providing minimum guaranteed values.

 

Life Settlements: a contract or agreement in which a policyholder agrees to sell or transfer ownership in all or part of a life insurance policy to a third party for compensation that is less than the expected death benefit of a policy.

 

Lifetime Disability Benefit: a provision in some disability income policies to recoup lost wages for the term of disability or remainder of insured's life in case of permanent disability.

 

Limited Benefit: policies that provide coverage for vision, prescription drug, and/or any other single service plan or program. Also include short-term care policies that provide coverage for less than one year for medical and other services provided in a setting other than an acute care unit of the hospital.

 

Limited Payment Life Insurance: a form of whole-life insurance with a pre-defined number of premiums to be paid.

 

Limited Policies: health insurance coverage for a certain ailment, such as cancer.

 

Limits: maximum value to be derived from a policy.

 

Line of Business: classification of business written by insurers.

 

Living benefits rider: a rider attached to a life insurance policy providing long term care for the terminally ill.

 

Long-Term Care: policies that provide coverage for not less than one year for diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services provided in a setting other than an acute care unit of a hospital, including policies that provide benefits for cognitive impairment or loss of functional capacity. This includes policies providing only nursing home care, home health care, community based care, or any combination. The policy does not include coverage provided under comprehensive/major medical policies, Medicare Advantage, or for accelerated heath benefit-type products.

 

Long-Term Disability Income Insurance: policy providing monthly income payments for insureds who become disabled for an extensive length of time, typically two years or longer.

 

Loss: physical damage to property or bodily injury, Including loss of use or loss of income.

 

Loss Frequency: incidence of claims on a policy during a premium period.

 

Loss of Use Insurance: policy providing protection against loss of use due to damage or destruction of property.

 

Loss Payable Clause: coverage for third party mortgagee in case of default on insured property, secured by a loan, that has been lost or damaged.

 

Loss Ratio: the percentage of incurred losses to earned premiums.

 

Loss Reserve: the amount that insurers set aside to cover claims incurred but not yet paid.

 

Loss Reserves: an estimate of liability or provision in an insurer's financial statement, indicating the amount the insurer expects to pay for losses incurred but not yet reported or reported claims that haven't been paid.

 

Losses Incurred: Includes claims that have been paid and/or have amounts held in reserve for future payment.

 

Losses Incurred But Not Reported (IBNR): An estimated amount set aside by the insurance company to pay claims that may have occurred, but for some reason have not yet been reported to the insurance company.

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