Our insurance terms glossary is divided alphabetically by insurance terms in a quick reference guide to assist understanding the language commonly used by insurance companies. Policy documents contain a number of insurance terms because they typically define the limitations of risk and liability on the insured and any exclusions of coverage.
If you plan to start a new policy or renew your current policy with a carrier or agency, it is important to review and understand the policy differences behind individual quotes from multiple carriers. Lower policy premiums may be the result of decreased payout benefits, higher deductibles, or maximum damages allowed. It is important to identify these unique features in any policy comparison, otherwise a lower price may come at a much higher cost when you have to file a claim for loss or damages in the future.
A combination of two or more individual polices or coverages into a single policy. A homeowners policy, for example, is a package combining property, liability and theft coverages for the homeowner.
(1) Insurance on which all required premiums have been paid.
(2) The reduced paid-up insurance available as a non-forfeiture option.
Physical examination of an applicant by a trained person other than a physician.
The result of an illness or injury which prevents an insured from performing one or more of the functions of his/her regular job. See also Disability.
Partial Disability Benefits
A benefit sometimes found in disability income policies providing for the payment of reduced monthly income in the event the insured cannot work full time and/or is prevented from performing one or more important daily duties pertaining to his occupation.
Life insurance under which an insurance company agrees to distribute to policyholders the part of its surplus which its Board of Directors determines is not needed at the end of the business year. Such a distribution serves to reduce the premium the policyholder had paid. See also: Policy Dividend; Nonparticipating Policy.
Patient Protection And Affordable Care Act
Also known as the Affordable Care Act, ACA, or Obamacare, is a law enacted on March 23, 2010, that governs healthcare coverage in the U.S.
Pension Benefit Guaranty Corporation (PBGC)
The Federal body responsible for administering a retirement insurance programs, under ERISA.
A series of payments to be provided to past employees in accordance with the rules of pension plan of a company or other organization.
A plan established and maintained by an employer, group of employers, union or any combination, primarily to provide for the payment of definitely determinable benefits to participants after retirement.
Pension Trust Liability Insurance
See Fiduciary Liability Insurance.
A provision in a health insurance contract that the insurer and insured will share covered losses in agreed proportions. Also see Coinsurance.
Bond issued by a surety or insurance company to guarantee performance under or in conjunction with a contract.
The cause of a possible loss, such as fire, windstorm, theft, explosion, or riot, covered in an insurance policy.
Perils Of The Sea
All perils which are unique to transportation and which could not be prevented by reasonable efforts, including sinking of the vessel, stranding, heavy weather, lightning, collision with other vessels or submerged objects (such as Titanic’s iceberg), and damage by sea water when caused by an insured peril.
Permanent Life Insurance
A phrase used to cover any form of life insurance except term; generally accrues cash value, such as whole life or endowment.
A term used to refer to the length of time insurance remains continuously in force.
Personal Articles Floater
A form of coverage designed to meet the needs for insurance on moveable property. The coverage usually protects against all physical loss, subject to specific exclusions and conditions. Examples of property that can be covered include jewelry, furs, silverware, fine arts.
Personal Injury Liability Insurance
Coverage designed to protect against false arrest, detention or imprisonment, or malicious prosecution; libel, slander, defamation, or violation of right of privacy; and wrongful entry, eviction, or other invasion of right of private occupancy.
Personal Injury Protection (PIP)
First-party no-fault coverage in an automobile insurance policy in which an insurer pays, within the specified limits, the wage loss, medical, hospital and funeral expenses of the insured.
Those types of insurance, such as auto or home insurance, for individuals or families rather than for businesses or organizations.
A person appointed through the will of a deceased or by a court to settle the estate of one who dies.
Damage to or loss of the auto resulting from collision, fire, theft or other perils.
Physician’s Expense Insurance
Coverage which provides benefits toward the cost of such services as doctor’s fees for nonsurgical care in the hospital, at home or in a physician’s office, and X-rays or laboratory tests performed outside the hospital. (Also called Regular Medical Expense Insurance.)
The person or persons controlling the money or property contributed to a pension, health or other plan, usually designated in the plan agreement.
Person who brings a case or complaint against another in the court of law.
Plate Glass Insurance
Coverage designed to provide special protection, except for the perils of war, nuclear reaction, and fire. (Fire is covered under the building policy.) This coverage is for full replacement cost and covers the expense of repairing frames, installing temporary plates, or boarding up openings of plate glass windows.
Platinum Health Plan
An ACA Plan designed to yield the lowest out-of-pocket expenses among the four metal plans, but usually carries the highest premium.
Often known as open-ended HMOs or PPOs, these plans permit insureds to choose providers outside the plan yet are designed to encourage the use of network providers.
The legal document issued by an insurance company to a policyholder, which outlines the conditions and terms of the insurance; also called the policy contract or the contract.
A refund of part of the premium on a participating life insurance policy reflecting the difference between the premium charged and actual experience.
A loan made by a life insurance company from its general funds to a policyholder on the security of the cash value of a policy.
The measure of the funds that a life insurance company holds specifically for fulfillment of its policy obligations. Reserves are required by law to be so calculated that, together with future premium payments and anticipated interest earnings, they will enable the company to pay all future claims. Compare Reserve.
That period for which an insurance policy provides coverage.
A person who pays a premium to an insurance company in exchange for the insurance protection provided by a policy of insurance.
Sum left after liabilities are deducted from assets. Sums such as paid-in capital and special voluntary reserves are included in this term. This surplus is an additional financial protection to policyholders in the event a company suffers unexpected or catastrophic losses.
Pollution Legal Liability Insurance
Coverage designed to protect for (1) all sums the insured is legally obligated to pay as a result of emission, discharge, release, or escape of any contaminants, irritants, or pollutants into or on land, the atmosphere, or any water course or body of water, provided this results in environmental damage;
(2) to reimburse reasonable and necessary cleanup costs incurred in the discharge of a legal obligation validly imposed through governmental action, provided such expense is incurred because of environmental damage, and
(3) for defense of any claim or suit that is the subject of this insurance.
Exposure to lawsuits for injury or cleanup costs that result from pollution damage.
An organization of insurers or re-insurers through which particular types of risk are underwritten and premiums, losses and expenses are shared in agreed-upon amounts.
The right to transfer pension rights and credits when a worker changes jobs.
Process in which a health care professional evaluates an attending physician’s request for a patient’s admission to a hospital by using established medical criteria.
A physical and/or mental condition of an insured which first manifested itself prior to the issuance of his/her policy or which existed prior to issuance and for which treatment was received.
Preferred Provider Organization (PPO)
An arrangement whereby a third-party payer contracts with a group of medical care providers who furnish services at lower than usual fees in return for prompt payment and a certain volume of patients.
Evidence of ownership which entitles the holders to receive dividends from the corporation before the common stockholders, but after bondholders, and which usually also provides a claim prior to common holders to corporate assets if the corporation is dissolved.
The sum paid by a policyholder to keep an insurance policy in force.
Payment terms that allow the insured to pay part of the premium when coverage takes effect and pay the rest during the policy period.
A loan, sometimes made by a third party, made for the purpose of paying premiums to the insurer.
A tax, imposed by each state, on the premium income of insurers doing business in the state.
Premium Tax Credit
A refundable tax credit available to those households that have obtained healthcare coverage in the Marketplace.
Prepaid Group Practice Plan
A plan under which specified health services are rendered by participating physicians to an enrolled group of persons, with a fixed periodic payment in advance made by or on behalf of each person or family. If a health insurance carrier is involved, a contract to pay in advance for the full range of health services to which the insured is entitled under the terms of the health insurance contract. Such a plan is one form of Health Maintenance Organization (HMO).
Insurance that pays compensation for a loss ahead of any other insurance coverages the policyholder may have.
Your primary residence, is your main residence, where you typically live. You can only have one primary residence.
Primary use refers to how you typically use your vehicle; for example, driving to work or school.
The individual that drives your car most often.
The amount payable, under life and health insurance policies, in one sum in the event of accidental death and in, some cases, accidental dismemberment. When a contract provides benefits for both accidental death and accidental dismemberment, each dismemberment benefit is an amount equal to the principal sum or some fraction thereof.
The court-supervised process of validating or establishing a distribution for assets of a deceased including the payment of outstanding obligations.
That portion of the assets and liabilities whose distribution is supervised by the courts in the probate process.
A period from the policy date to a specified time, usually 15 to 30 days, during which no sickness coverage is effective. It is designed to eliminate a sickness actually contracted before the policy went into effect.
Legal liability incurred by a manufacturer, merchant, or distributor because of injury or damage resulting from the use of its product.
Product Liability Insurance
Coverage designed to provide protection against financial loss arising out of the legal liability incurred by a manufacturer, merchant, or distributor because of injury or damage resulting from the use of a covered product.
Professional Liability Insurance
See Errors and Omissions Insurance.
Professional Review Organization (PRO)
An organization in which practicing physicians assume responsibility for reviewing the propriety and quality of health care services provided under Medicare and Medicaid.
Proof Of Loss
Documentary evidence required by an insurer to prove a valid claim exists. It usually consists of a claim form completed by the insured, and for health insurance claims by the insured’s attending physician. For medical expense insurance itemized bills must also be included.
Something that has value and is owned by a person or business.
Property Damage Coverage
An agreement by an insurance carrier to protect an insured against legal liability for damage by an insured automobile to the property of another.
Insurance providing financial protection against the loss of, or damage to, real and personal property caused by such perils as fire, theft, windstorm, hail, explosion, riot, aircraft, motor vehicles, vandalism, malicious mischief, riot and civil commotion, and smoke. Available on Special and All-risk forms, depending on the property being insured.
Property Management Errors And Omissions Insurance
Coverage designed to pay on behalf of the insured all sums he/she becomes legally obligated to pay by reason of any act, error, or omission rising out of services rendered or that were failed to render. Such services include arranging for property maintenance, renting or leasing, construction, alteration, land development, etc. Coverage also provides for defense of any claim or suit that is the subject of this insurance.
The adjustment of benefits paid because of a mistake in the amount of the premiums paid or the existence of other insurance covering the same accident or disability.
An advancement of payment for health care charges that are likely to occur.
A standardized life insurance plan, approved and qualified as to its concept by the Internal Revenue Service, which is made available by companies, banks and mutual funds for employers’ use.
A clause, sentence or paragraph of an insurance contract that describes or explains a feature, benefit, condition, requirement, etc. of the insurance protection afforded by the contract.
(1) The principal cause of loss or damage;
(2) An unbroken chain of events between an event and damage.
A court-awarded amount that exceeds the economic losses and general damages of a defendant and is intended solely to punish the plaintiff.
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