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The following terms may be found in OID brochures and are designed to be general definitions of common insurance terms. These terms are not derived directly from state statutes or rules. It is not meant to be all inclusive but should help with your understanding of the documents. If you have any questions regarding what a particular definition means, please e-mail us by clicking here.
ACTUAL CASH VALUE
An amount equivalent to the fair market value immediately preceding the loss of the stolen or damaged property. For real property, this amount can be based on a determination of the fair market value of the property before and after the loss. For vehicles, this amount can be determined by local area private party sales and dealer quotations for comparable vehicles.
An insurance company authorized to do business in California.
AFFORDABLE CARE ACT (ACA)
Legislation signed by President Obama on March 23, 2010, that made historic changes in the availability and delivery of health insurance, Medicaid and health policy nationwide. Commonly referred to as the health reform law, Patient Protection and Affordable Care Act (PPACA), the Affordable Care Act (ACA) and Obamacare. The final provisions of the law went into effect on January 1, 2014, providing a place where individuals and small business owners can shop and compare health insurance plans before enrolling. This law requires all eligible individuals and certain size businesses to have health insurance or pay a fee or tax.
A licensed person or organization authorized to sell insurance by or on behalf of an insurance company.
Coverage for the insured in the event that the insured's negligent acts and/or omissions result in losses in connection with the use, ownership, or maintenance of aircraft.
Coverage on the risks associated with driving or owning an automobile. It can include collision, liability, comprehensive, medical, and uninsured motorist coverages.
A temporary or preliminary agreement which provides coverage until a policy can be written or delivered.
Any physical injury to a person. The purpose of liability insurance is to cover bodily injury to a third party resulting from the negligent or unintentional acts of an insured.
BOILER AND MACHINERY INSURANCE
Covers losses resulting from the malfunction of boilers and machinery. This coverage is usually excluded from property insurance creating the need for this separate product.
A licensed person or organization paid by you to look for insurance on your behalf.
Coverage against loss as a result of forced entry into premises.
The termination of insurance coverage during the policy period. Flat cancellation is the cancellation of a policy as of its effective date without any premium charge.
Notice to an insurer that under the terms of a policy, a loss maybe covered.
The first or third party. That is any person who asserts right of recovery.
Reimburses you for damage to YOUR automobile sustained in a collision with another car or with any other object, movable or fixed (for example, you accidentally backed into another object while pulling out from a parking stall causing damage to the bumper and fender of your covered automobile).
COLLISION DEDUCTIVE WAIVER
This coverage waives your collision deductible if you are hit by a negligent uninsured motorist.
COMMON CARRIER LIABILITY
Coverage for transportation firms that must carry any customer's goods as long as the customer is willing to pay. Examples of transportation firms include trucking companies, bus lines, and airlines.
Provides coverage for any direct and accidental loss of, or damage to, YOUR covered automobile and its normal equipment, including, but not limited to, fire, theft or malicious mischief.
COMPREHENSIVE GLASS INSURANCE
Coverage on an "all risks" basis for glass breakage, subject to exclusions of war and fire.
CREDIT LIFE INSURANCE
Insurance issued to a creditor (lender) to cover the life of a debtor (borrower) for an outstanding loan.
The company refuses to accept the request for insurance coverage.
The amount of the loss which the insured is responsible to pay before benefits from the insurance company are payable. You may choose a higher deductible to lower your premium.
A decrease in value due to age, wear and tear, etc.
Health insurance that provides income payments to the insured wage earner when income is interrupted or terminated because of illness, sickness, or accident.
Amendment to the policy used to add or delete coverage. Also referred to as a "rider."
Certain causes and conditions, listed in the policy, which are not covered.
The date on which the policy ends.
The dollar amount to be paid to the beneficiary when the insured dies. It does not include other amounts that may be paid from insurance purchased with dividends or any policy riders.
FINANCIAL GUARANTEE INSURANCE
A surety bond, insurance policy or, when issued by an insurer, an indemnity contract and any guaranty similar to the foregoing types, under which loss is payable upon proof of occurrence of financial loss to an insured claimant, obligee, or indemnitee.
Coverage for loss of or damage to a building and/or contents due to fire.
GOOD DRIVER DISCOUNT
To be eligible for the Good Drivers Discount, all operators of the insured vehicles must have been licensed for three or more years, must have no more than a one point charge on their driving records, and must not have been determined "at fault" in an accident resulting in bodily injury or death to any person.
The duty of "good faith and fair dealing" basically means that your insurance company must adjust your claim (either pay it or deny it) within a reasonably prompt time, must cooperate with you regarding the claim (timely respond to your letters and phone calls), must tell you in writing precisely why it is denying the claim specifying each contract term or provision upon which it relies, and must attempt to find a basis to pay the claim rather than find reasons to deny it. Please Note: Good faith is a relationship between you and your insurer.
A period (usually 31 days) after the premium due date, during which an overdue premium may be paid without penalty. The policy remains in force throughout this period.
An option that permits the policy holder to buy additional stated amounts of life insurance at stated times in the future without evidence of insurability.
A policy that will pay specific sums for medical expenses or treatments. Health policies can offer many options and vary in their approaches to coverage.
An elective combination of coverages for the risks of owning a home. Can include losses due to fire, burglary, vandalism, earthquake, and other perils.
A policy provision in which the company agrees not to contest the validity of the contract after it has been in force for a certain period of time, usually two years.
Under the ACA, starting January 1, 2014, consumers and their dependents including children were required to have “minimum essential coverage” or pay a penalty, unless they fit within an exemption. This requirement is commonly known as the “individual mandate.”
The policyholder - the person(s) protected in case of a loss or claim.
The insurance company.
Prepaid legal insurance coverage plan sold on a group basis.
This coverage will pay for BODILY INJURY and/or PROPERTY DAMAGE to the OTHER party for which you become legally responsible because of an automobile accident.
Coverage for all sums that the insured becomes legally obligated to pay because of bodily injury or property damage, and sometimes other wrongs, to which an insurance policy applies.
A policy that will pay a specified sum to beneficiaries upon the death of the insured.
Maximum amount a policy will pay either overall or under a particular coverage.
The amount which can be borrowed at a specified rate of interest from the issuing company by the policyholder, using the value of the policy as collateral. In the event the policyholder dies with the debt partially or fully unpaid, the amount borrowed plus any interest is deducted from the amount payable.
Coverage for goods in transit and the vehicles of transportation on waterways, land, and air.
The policyholder / applicant makes a false statement of any material (important) fact on his/her application. For instance, the policyholder provides false information regarding the location where the vehicle is garaged.
Will pay reasonable expenses incurred for necessary medical and /or funeral services because of bodily injury caused by accident and sustained by YOU OR ANY OTHER PERSON WHILE OCCUPYING A COVERED AUTOMOBILE.
Includes insurance against loss from damage done, directly or indirectly, by lightning, windstorm, tornado, earthquake or insurance under an open policy indemnifying the producer of any motion picture, television, theatrical, sport, or similar production, event, or exhibition against loss by reason of the interruption, postponement, or cancellation of such production, event, or exhibition due to death, accidental injury, or sickness preventing performers, directors, or other principals from commencing or continuing their respective performances or duties; and any insurance not included in any other classes and which is a proper subject of insurance (California Insurance Code §120).
An incorrect estimate of the insurance premium.
Life insurance that pays the balance of a mortgage if the mortgagor (insured) dies.
The cause of a possible loss. For example, fire, theft, or hail.
The written contract of insurance.
The maximum amount a policy will pay, either overall or under a particular coverage.
The amount of money an insurance company charges for insurance coverage.
A policyholder contracts with a lender to pay the insurance premium on his/her behalf. The policyholder agrees to repay the lender for the cost of the premium plus interest and fees.
PRE-EXISTING MEDICAL CONDITION
An illness or medical condition for which an individual received medical advice, diagnosis, care or treatment. Effective January 1, 2014, plans must include new consumer protections. Health insurers can no longer deny applicants or refuse to renew coverage because of a pre-existing medical condition. They also can’t charge a higher premium due to a person’s gender or health condition.
When the policy is terminated midterm by the insurance company, the earned premium is calculated only for the period coverage was provided. For example: an annual policy with premium of $1,000 is cancelled after 40 days of coverage at the company's election. The earned premium would be calculated as follows: 40/365 days X $1,000=.110 X $1,000=$110.
Damage to another person's property. The purpose of liability insurance is to cover property damage to a third party resulting from the negligent or intentional acts of an insured.
An estimate of the cost of insurance based on information supplied to the insurance company by the applicant.
The cost to repair or replace an insured item. Some insurance only pays the actual cash or market value of the item at the time of the loss, not what it would cost to fix or replace it. If you have personal property replacement cost coverage, your insurance will pay the full cost to repair an item or buy a new one once the repairs or purchases have been made.
The full cost to repair or replace the damaged property with no deduction for depreciation, subject to policy limits and contract provisions.
The restoring of a lapsed policy to full force and effect. The reinstatement may be effective after the cancellation date, creating a lapse of coverage. Some companies require evidence of insurability and payment of past due premiums plus interest.
Usually known as an endorsement, a rider is an amendment to the policy used to add or delete coverage.
When the policy is terminated prior to the expiration date at the policyholder's request. Earned premium charged would be more than the pro-rata earned premium. Generally, the return premium would be approximately 90 percent of the pro-rata return premium. However, the company may also establish its own short-rate schedule.
A licensed employee of a fire and casualty agent or broker who may act for the agent or broker in some circumstances.
Coverage for property damage caused by untimely discharge from an automatic sprinkler system.
An extra charge applied by the insurer. For automobile insurance, a surcharge is usually for accidents or moving violations.
To terminate or cancel a life insurance policy before the maturity date. In the case of a cash value policy, the policyholder may exercise one of the nonforfeiture options at the time of surrender.
TEAM AND VEHICLE INSURANCE
Includes insurance against loss through damage, or legal liability for damage, to property caused by the use of teams or vehicles other than ships, boats, or railroad rolling stock, whether by accident or collision or by explosion of engine, tank, boiler, pipe, or tire of the vehicle, and insurance against the theft of the whole or part of such vehicle (California Insurance Code §115).
Coverage for losses if a land title is not free and clear of defects that were unknown when the title insurance was written.
The process of selecting applicants for insurance and classifying them according to their degrees of insurability so that the appropriate premium rates may be charged. The process includes rejection of unacceptable risks.
UNINSURED MOTORIST BODILY INJURY
Will pay you and your passengers for BODILY INJURY cause by a negligent uninsured motorist, a hit-and-run driver, or a driver whose insurer is insolvent.
UNINSURED MOTORIST PROPERTY DAMAGE
Will pay for damages to your automobile, set up to a limit, when caused by a negligent uninsured motorist.
A period of time set forth in a policy which must pass before some or all coverages begin.
WORKERS COMPENSATION INSURANCE
Coverage providing four types of benefits (medical care, death, disability, and rehabilitation) for employee, job-related injuries or diseases as a matter of right (without regard to fault).
Arrestee - A person in custody whose release may be secured by posting bail.
Bailee - A person or concern having possession of property committed in trust from the owner.
Bid Bond - A guarantee that the contractor will enter into a contract, if it is awarded to him, and furnish such contract bond (sometimes called "performance bond") as is required by terms thereof.
Court Bonds - All bonds and undertakings required of litigants to enable them to pursue certain remedies of the courts.
Effective Date - The date on which an insurance policy or bond goes into effect and from which protection is furnished.
Fidelity Bond - An obligation of the insurance company against financial loss caused by the dishonest acts of employees.
Judicial Bond - A bond required in civil and criminal court actions.
Named Schedule Bond - A fidelity bond providing coverage for persons listed or scheduled on the bond.
Obligee - Broadly, anyone in whose favor an obligation runs. Frequently used in surety bonds, this refers to the person, firm or corporation protected by the bond.
Obligor - Commonly called "principal," one bound by an obligation. Under a bond, strictly speaking, both the principal and the surety are obligers.
Power of Attorney - Authority given one person or corporation to act for and obligate another, to the extent laid down in the instrument creating the power.
Principal - A person or organization whose obligation is guaranteed by a bond.
Surety- An arrangement whereby one party becomes answerable to a third party for the acts of a second party. Customarily an insurance company, the party in a suretyship arrangement who holds himself responsible to one person for the acts of another.
Surety Bond - A bond which the surety agrees to answer to the obligee for the non-performance of the principal (also known as the obligor).
Suretyship - Stated in its simplest terms, suretyship embraces all forms of obligation to pay debts or answer for the default of another.