Below is
a summary of common insurance terms. These are provide as a guideline
only and clients are advised to get proper advice if unsure on anything.
Abandonment: The giving up of damaged
property - by an insured to the insurer - when total loss is
claimed.
Ab initio: Latin for 'from the
beginning' or 'from the onset.'
Acceptance: An absolute and unqualified agreement to
or approval of the terms of an offer resulting in the conclusion
of a contract.
Accident: An unforeseen and unintended
event or occurrence or an intended event which brings about unforeseen
consequences.
Accident year: Either the calendar- or accounting
year in which a loss occurs.
Accommodation business: Normally unacceptable
business taken by an insurer as a goodwill gesture, in the hope that
further business will materialise.
Act of God: An event that is the result of natural
forces and which arises without human intervention.
Adjustable policy: A policy where the exact extent of
the value at risk cannot be known in advance (e.g. goods in transit
insurance). A provisional premium is charged and adjusted at the end of
each period of insurance.
Assessor: See LOSS ADJUSTER
Adjustment premium: An additional (or return) premium
that is payable in relation to a 'deposit premium', depending on the
performance of the (insurance or reinsurance) contract.
Agent: Someone who acts on behalf of
another person (the principal), usually for reward.
All risks: A domestic / property insurance
type of cover that covers any accidental loss or damage
not excluded from the policy.
Appreciation: An increase in value of the property
insured.
Arbitration: An alternate means of settling
disputes (often where the issue concerns the amount of a claim,
and not liability) without going to court. A qualified person/s - whose
appointment has been agreed upon by the parties - will hear
the case and furnish them a decision.
Asset: Property - even an
incorporeal right - with commercial value.
Assurance: A term interchangeable with
insurance, which is often used within Life and Marine business.
Assured: Another name for an insured,
typically within a life - insured contract.
Attachment date: Another term for inception date,
being the date on which an insurance or reinsurance contract comes into
force.
Average: If the sum insured 1) under
general insurance is 2) expressed to be “subject to average”, and 3)
that insured sum is less than the actual value of the subject matter of
the insurance, then 4) any claim that is agreed under the policy will
be reduced proportionally to such "under insurance".
Avoidance of a contract ab initio : The cancellation of an contract
from its inception. Typically, retrospective in nature, and due to a
misrepresentation (disclosure or non-disclosure) of material
facts. The result is that the party relying on the cancellation
cannot be held to the agreement, subject to return of any benefit it
might have enjoyed in terms of the agreement.
Balance-of-third-party: The term used in South Africa for
the form of motor insurance which covers the insured's liability' for:
i) injury to passengers not covered in terms of the Road Accident Act
1996; and ii) damage to the property of third parties (caused by the
vehicle).
Betterment: The value of the improvement in an
insured property when it has been repaired or rebuilt following loss or
damage.
Beyond economic repair: Where the cost of repairing the
insured property, eg a car, exceeds the market value of that property.
In such circumstances the insurer will pay the insured the market value
of the insured property at the date of loss, subject to the terms of
the policy (assuming the insurer is not under any obligation to provide
a replacement).
Blanket policy: A policy covering several
items under one sum insured.
Broker: A professional, independent agent
or intermediary - representing its client - that acts as a buyer of
insurance (having been mandated by a client
to obtain coverage that suits them best). It is an agent of
the policyholder, mandated to negotiate terms and conditions
culminating in indemnity provided by an insurer.
Brokerage: a) The commission or fee paid to
the broker by the insurer for placing business with them. The
commission that is payable to a broker for placing an insurance or
reinsurance contract with an insurer or a reinsurer. A fee for service.
Although brokerage is payable by the insured as part of the gross
premium, the amount of brokerage is agreed with the insurer. The
insured may request his broker to state the amount of his brokerage on
a given placement. Similar considerations apply to reassureds under
reinsurances. b) The term brokerage may also beused to refer
to the business of a broker.
Buy back: In the context of general insurance
this refers to the purchase of cover in respect of an otherwise
excluded peril by means of payment of additional premium.
Cancellation clause: A clause in an insurance policy
which permits an insurer and/or an insured to cancel the contract
before it is due to expire / allows one party to cancel the contract
(following due notice to the other). The clause may provide for a
return of premium in respect of the unused portion of the policy.
Carrier (of risk): An insurer, or reinsurer.
Casualty: Refers to a loss, particularly the
loss of a ship (Marine).
Casualty book: A book which stands in the centre
of the Lloyd's underwriting room and which records details of vessels
which are or are likely to become total losses. (The entries are
made by a Lloyd’s waiter using a quill pen.)
Catastrophe cover: A form of excess of loss
reinsurance which protects the insurer against losses arising from
major catastrophes.
Cede: To
transfer a risk exposure under a reinsurance contract.
Claim: A demand made by the insured for payment
after the occurrence of loss or damage covered by a policy. It term may
refer to: (a) a demand made by an insured on his insurer(s)
for payment or contractual benefit under a policy; (b) a demand made by
an insurer on its reinsurer(s) to be paid under a reinsurance
contract; or (c) a demand made by a third party on a insured to be
compensated for some injury, damage or loss for which the insured
is blamed. A claim is payable under an insurance or reinsurance
contract if it was 1) caused by an insured peril and 2) it is not
excluded under the terms of that contract.
Claimant: The person making a claim.
Claim-free group: The term used in motor insurance
to indicate into which of the rating groups a policyholder will fall
according to his claims record.
Claims made policy: A policy which only pays claims
that are notified to the insurer during a specified period.
Claims notification clause: A clause in an insurance or
reinsurance contract which sets out the procedure that the insured or
reassured must follow in order to make a claim under the contract. Such
clauses frequently provide for prompt notification of claims and events
which may gives to claims in the future.
Claims ratio: See LOSS RATIO.
Co-insurance: The division of risk between two or
more carriers, where each is liable to the insured for a proportion of
the claim. This may refer to either of the following situations : (a)
where two or more insurers underwrite the same risk with several
liability such that each insurer is not bound to follow the decisions
of any co-insurer unless it has agreed to do so, or (b) where the
insured acts as its own insurer for a specified proportion of the sum
insured.
Comprehensive policy: A policy covering a
wide variety of perils.
Consequential loss: A loss arising
(directly) from another loss. The term is used to describe the class of
business also known as LOSS OF PROFITS or BUSINESS INTERRUPTION
INSURANCE.
Contingency: An unforeseen occurrence.
Contingency fund: Monies put aside by a company in
order to pay for unexpected losses.
Contra proferentum rule: Any ambiguity in contract wordings
is construed against the drafter of those wordings.
Contract: An agreement made by two (or
more) parties with the intention of creating legal obligations
between them.
Contract of Insurance: An agreement between insurer and
insured whereby, in return for payment of a premium, the insurer
undertakes to indemnify the insured upon the happening of a specified
event. An insurace policy.
Cover: The protection provided by
insurance. Insurance or reinsurance as it applies to one or more
specific risk exposures.
Cover note: A document (typically) issued by a
broker - pending the issue of a formal policy - which confirms the
arrangement of cover on behalf of a policyholder. Motor insurance cover
notes are typically issued with a short duration.
Damage: Loss of an asset (including a
justified expectancy) or incurring a liability.
Declaration Policy: A policy requiring the insured to
declare periodically the value of fluctuating items, such as stocks or
goods-in-transit, to enable the insurer to adjust the premium
accordingly.
Declinature: The refusal of an insurer or reinsurer to
offer terms of cover. See REPUDIATION.
Deductible: An American term, referring to the
amount that is deducted from some (or all) claims arising under an
insurance or reinsurance contract. The practical effect is the same as
an excess: the insured or reassured must bear a proportion of the
relevant loss.
Delegated Authority: The authority given to an agent of
an insurer to act on its behalf in accepting risks within agreed
guidelines.
Deposit premium: A premium that is payable at the
inception (start) of an insurance or reinsurance contract and in
respect of which an adjustment premium (usually an additional premium)
is due depending on the performance of the contract including,
possibly, the amount of the business that is ceded thereunder. An
advance payment made by the insured before the actual premium has been
decided.
Depreciation: The extent to which (insured)
property has diminished in value due to factors such as age, use or
wear and tear. Such devaluation "loss" is not covered under a contract
of indemnity. However an insurer may agree to provide cover on “a new
for old” basis which replaces old items with new ones.
Direct business: Insurance placed with an insurer
direct and not through an intermediary.
Duty of disclosure: The duty on the parties to a
contract of insurance to reveal all material facts to each other before
it is concluded and prior to each renewal.
Earned premium: That part of a premium relating to a
completed or expired period of risk; the actual premium chargeable
under an adjustable policy.The proportion of premium that relates to a
used period of cover.
Endorsement: Documentary evidence of some
alteration to a policy of insurance, being a document attached to a
slip, cover note or policy which evidences one or more changes in the
terms of the insurance or reinsurance contract to which it refers.
Escalator Clause: The clause in a policy which allows
the sum insured on property to rise throughout the period of insurance
in step with the assumed rate of inflation.
Ex gratia
payment: A payment made
by underwriters “as a favour” or “out of kindness” without an admission
of liability so as to maintain goodwill. A payment made to an insured
where there is no liability under the policy.
Exception: A peril specifically excluded from
the insurance.
Excess: That part of a loss for which the
insured is liable. The amount (or proportion) of losses under an
insurance contract that is the insured must bear. If the loss is less
than the amount of the excess then the insured must meet the cost of it
(unless there is other insurance in place to cover the excess).
Excesses may either be compulsory or voluntary. An insured which
accepts an increased excess (in the form of a voluntary excess) will
receive a reduction in premium. .
Excess of loss: A form of insurance where the
reinsurer agrees to pay the balance of any losses exceeding a stated
monetary amount. A type of reinsurance that covers specified losses
incurred by the reassured in excess of a stated amount (the excess) up
to a higher amount, for example £5 million excess of £1 million. An
excess of loss reinsurance is a form of non-proportional reinsurance.
Exclusion: A term in an insurance or
reinsurance contract that excludes the insurer or reinsurer from
liability for specified types of loss. An exclusion may apply
throughout a policy or it may be limited to specific sections of it. In
certain circumstances an exclusion may be limited or removed altogether
following the payment of an additional premium.
Executor: The office / person appointed to
wind-up an estate. Often named in the last will of a deceased.
Expense Loading: That part of the premium which
meets the policyholder's share of the insurer's administrative
costs
F A I S Act : Financial
Advisory and Intermediary Services Act .
F S B: Financial Services
Board - find them here.
Fee for service: Where a broker is remunerated on the
basis of a fee agreed with its client instead of brokerage. The benefit
to the broker is that, subject to the terms of agreement, the fee will
be payable whether or not cover is placed whereas brokerage is only
payable in respect of the placement of cover.
Fidelity insurance: A type of insurance which is
designed to protect a firm from losses caused by the dishonest acts of
its employees.
First Amount Payable: The amount payable by an insured in
the event of a claim See EXCESS.
First Loss Policy: An insurance policy where the
insurer pays all losses up to a given limit.
Fleet Insurance: A motor policy covering a group of
vehicles with the premiums calculated on an experience basis.
General Insurance: Insurance which is not long-term
business.
Good Faith: See UBERRIMAE FIDES.
Grace period: A short period during which cover
under an annual policy may be extended beyond its expiry date to allow
for the payment of a renewal premium. The privilege will be lost if the
insured rejects the proposed renewal terms, by his actions or words.
There are no grace periods in motor or marine insurance.
Hazard: Something that causes an exposure
to injury, loss or damage. A physical or moral feature that affects the
likelihood of a loss occurring, or has an influence on the size of the
loss.
Hazardous pursuits: Certain sports and activities are
termed hazardous pursuits and are excluded from travel insurances
(although it may be possible to have them included on payment of an
additional premium).
IBNR: Acronym for "Incurred But Not
Reported" - claims which have occurred but are not yet
reported to the insurers. Many governments require insurers to
establish reserves to cover such contingincies.
IISA: Insurance Institute of South Africa
- find them here.
Inception date: The date on which an insurance or
reinsurance contract comes into force. Also referred to as EFFECTIVE
DATE.
Incurred losses: The aggregate of the paid and
outstanding claims of an insurer or reinsurer for a year of account or
some other given period of time. These losses represent known losses to
an insurer or reinsurer and, subject to issues of proof of liability
and the determination of the final amount payable in the case of
outstanding claims, are relatively certain.
Indemnity: The placing of the insured in
the same financial position after a loss as he was in immediately prior
to the occurrence. An insured - who has suffered a loss - is
restored (so far as possible) to the same financial position that he
was in immediately prior to the loss, subject in the case of insurance
to any contractual limitation as to the amount payable (the loss may be
greater than the policy limit). Most contracts of insurance are
contracts of indemnity. Life insurances and personal accident
insurances are not contracts of indemnity as the payments due under
those contracts for loss of life or bodily injury are not based on the
principle of indemnity.
Insurable interest: An insured must have an insurable
interest - a recognised relationship - in the subject
matter of the insurance, which is to say that he stands to benefit from
its preservation and will suffer from its loss. In non-marine
insurances, the insured must have insurable interest when the policy is
taken out and also at the date of loss.
Insurance: Insurance (or sometimes
assurance) is a device for indemnifying or guaranteeing against loss or
harm arising in and from specific situtaions and / or contingincies
such as fire, accident, death, disablement, or the like, in
consideration of payment (the insurance premium) proportionate to
the risk involved. It constitutes indemnification by a contract /
policy in which one party agrees to indemnify and / or reimburse
another for loss that occurs under the terms of the contract, for the
amount for which the risks were insured. It embodies a risk transfer
arrangement whereby the responsibility for meeting losses/liability
passes from one party (the insured) to another (the insurer) on payment
of a premium.
Insurance contract: An insurance policy.
Insurance intermediary: A person through whom an insurance
contract is effected. It normally refers to an insurance broker and /
or an agent of an insurer such as a coverholder.
Insurance policy: A document evidencing a contract
of insurance.
Insured: A person who benefits from a
contract of insurance. Not neccessarily the policyholder!
Insured peril: A harmful event which is covered
under a contract of insurance.
Jurisdiction clause: A clause in an insurance or
reinsurance contract which states to which territory’s courts a
contractual dispute can / shall be referred for resolution.
Knock For Knock
Agreement: An agreement
between insurers whereby - following a collision - each pays the cost
of repairs to its own insured's vehicle (only), regardless of fault,
provided that the vehicles involved are all insured for accidental
damage.
Key person insurance: A policy that protects a firm from
loss caused by the death or disability of a 'key person' within the
company.
Lapse: The termination of an
insurance contract through the non-payment of the premium
Leading Insurer: The insurer
who accepts a share of risk on a co-insurance agreement - often the one
who first signs a broker's slip. See LEADING UNDERWRITER.
Leading Underwriter : The
underwriter of an insurance company who is responsible for setting the
terms of an insurance contract that is subscribed by more than one
syndicate or insurance company, and who generally has primary
responsibility for handling any claims arising under such a
contract.
Letter Of Acceptance: A letter
from an insurer to a proposer indicating that his application for cover
has been accepted.
Liability: A claim against
one's by another.
Liability insurance: An
insurance which covers the insured against third party claims or, in
the case of employer’s liability insurance, claims by employees,
subject to specified terms and conditions.
Life assured: The person whose
life is insured under a life insurance.
Life insurance: A policy that
pays a specified sum to beneficiaries upon the death of the life
assured, or upon the assured surviving a given number of years,
depending on the terms of the policy. Life insurance policies may be
for fixed or indefinite term. See term life as regards fixed term
policies.
Limit of indemnity: Another
term for risk- or policy limit. It refers to the maximum amount payable
under a policy, either overall or with reference to a particular
section.
Limit of Liability: The maximum
amount that an insurer will pay for one loss in terms of a liability
policy.
Loading: Those elements added
to a premium to allow for insurer's expenses.
Long tail (risk): This refers to a
type of insurance where claims may be made many years after the period
of the insurance has expired. Liability insurance is an example of long
tail business. The opposite of long tail business is short tail
business
Loss: This term generally
refers to some injury, harm, damage or financial deteriment that a
person sustains. Losses may be insured or uninsured. Whether a loss is
covered by a policy or certificate of insurance depends on the terms of
that document and local law.
Loss Adjuster/Assessor: An
independent, qualified person who assesses the size or value of a loss
on behalf of an insurer, but who may also be employed by an insured to
look after his interests in a loss settlement. A person who is
appointed to investigate the circumstances of a claim under an
insurance policy and to advise on the amount that is payable to the
policyholder in order to settle that claim. Loss adjusters are
generally appointed by underwriters but sometimes policyholders appoint
their own loss adjusters to negotiate claims on their behalf.
Loss event : The event which causes
a loss, for example a fire or hurricane.
Loss Of Profits Insurance : See
BUSINESS INTERRUPTION INSURANCE.
Loss Prevention : Activities
undertaken to prevent losses from occurring.
Loss Ratio: The ratio of
policy claims to premiums.
Market Value : The
price at which an investment can be sold or bought at any specific
time.
Material fact :
Anything which would affect the judgement of a prudent
underwriter in accepting or deciding terms for a risk. This refers to
any fact which would influence the judgment of a prudent underwriter in
deciding whether to accept an insurance/reinsurance risk and the terms
on which he would be willing to grant cover. See DUTY OF DISCLOSURE.
Material
representation: A statement that is made to an underwriter
during the negotiation of cover or the amendment or renewal of cover
which would have influenced the judgment of a prudent underwriter in
deciding whether to accept an insurance/reinsurance risk and the terms
on which he would be willing to grant cover.
Minimum premium: The
minimum amount that is payable to an insurer or reinsurer as a premium
in respect of a insurance or, more commonly, reinsurance contract which
provides for a deposit premium. The minimum premium may be the same as
the deposit premium or a different figure.
Misrepresentation: A
false statement of a material fact which can be innocent or fraudulent.
See DUTY OF DISCLOSURE.
Moral hazard:
Those personal characteristics of a prospective insured or its
employees or associates that may increase the probability or size of an
insurance loss.
Negligence: Failing
to act in what the law considers to be a reasonable manner.
Net premium: The
amount of the premium that is left after the subtraction of some or all
permitted deductions such as brokerage and (for certain types of
business) profit commission.
New-for-old: Insurance
where the replacement value of the property lost or damaged is payable
without deduction for depreciation.
Ombudsman: An
impartial mediator or informal arbitrator who acts in resolving
disputes between parties to a dispute in a cost effective and amicably
efficient manner.
Offer: The
communication of the proposed terms of a contract by one party to
another.
Operative Clause: The
clause in a policy which sets out the circumstances in which the
insurers will make claim payments.
Outstanding Claims
Reserves: The funds put aside by insurers to cover
claims that have been incurred but not yet paid.
Outstanding Losses:
Claims not yet paid where estimated figures are used in the
insurer accounts.
P P R: Policyholder
Protection Rules - find them here.
Package Policy: A policy into
which several different types of insurance have been combined.
Peril: A harmful event which
may be covered under a contract of insurance or reinsurance as an
insured peril or excluded from it. A contingency or fortuitous
happening which could cause losses.
Personal accident insurance: A
type of insurance which provides for the payment of specified sums in
the event that the insured suffers some bodily injury as a result of an
accident.
Personal lines insurance: Insurance
which is sold to individual consumers such as buildings, contents and
travel insurance. This term is used in contrast to commercial lines.
Policy: Written evidence of the
terms of an insurance contract. The memorandum of the agreement.
Policy holder: The person who
is insured under a contract of insurance.
Policy limit: Another term for
limit of indemnity. It refers to the maximum amount payable under a
policy of insurance or reinsurance, either overall or with reference to
a particular section of the policy.
Policyholder: The owner of a
policy - it might also be the insured.
Preamble Clause: The clause in
a policy which sets out the essential elements of the contract.
Premium: The amount charged by
an insurer or reinsurer as the price of granting insurance or
reinsurance cover, as stated before or after the subtraction of
brokerage and other deductions. The money paid by the insured to
the insurer for cover as provided in the policy.
Premium Rate: The price per unit of
insurance.
Prescription: The term
specified in the Prescription Act during which legal action is required
to be taken; usually three (3) years from the date that the cause of
action arose. See TIME BARRING.
Principal: A person instructing
an agent to act on his behalf.
Prior years: Earlier years.
This term usually refers to earlier years of account which have been
closed into another year of account by reinsurance to close.
Pro rata cancellation: When an
insurance contract is terminated mid-term by an insurer, the return
premium will usually be calculated on a pro rata basis. For example
this means that if a 12 month contract is cancelled 4 months before its
expected expiry date then the insured would receive back 4/12 of its
premium.
Pro Rata Premium: The premium
based on the length of time for which the insurer was actually on
risk.
Probability: The chance of an
event occurring.
Proposal Form: An application
for insurance which seeks to obtain from the proposer all the
information relating to the risk. A standard form which is
prepared by an insurer and which contains a number of questions which a
person seeking insurance is required to answer for the purpose of
enabling the insurer to decide whether or not it is willing to grant
cover and, if so, the terms on such cover. See DUTY OF DISCLOSURE.
Proposer: The individual
or organisation seeking insurance (frequently by means of completing a
proposal form).
Proviso: A policy condition
whose observance is essential for the enforcement of the contract.
Quotation: A statement of the
premium that an underwriter requires to underwrite an insurance/
reinsurance risk based on the information supplied by the person
seeking cover. A quotation may be conditional, eg it may be subject to
the provision of further information, or not. If a quotation is
accepted before it is withdrawn, then subject to the satisfaction of
any conditions that may attach to the quotation, an insurance /
reinsurance contract will be made.
Rate: The premium expressed as
a percentage of the sum insured or limit of indemnity. The sum
charged (per unit of exposure) by which the premium is calculated.
Rated Up: The
term applied to insurance where the premium is higher than usual.
Regular driver: The
person whom typically drives a specific vehicle, or more frequently
than any other person over the course of a relevant period.
Reinstatement:
The 'making good' of damaged property; the restoration of the sum
insured in terms of the policy.
Reinstatement of
cover: The restoration of cover following its exhaustion as a
result of a loss by payment of an additional (reinstatement) premium.
Many reinsurances provide for one or more automatic reinstatement of
covers.
Reinstatement Of
Sum Insured : The restoration of the sum insured after it
has been reduced through the payment of a claim.
Renewal: The
process for continuing an insurance for a further period after the
first or current period of cover has ended.
Renewal Notice: The
notice issued by a short term insurer to remind a policyholder that his
contract will shortly terminate.
Replacement: Where
an insurer agrees to replace irreparably damaged or stolen goods with
goods of a similar type and quality under a contract of indemnity
instead of paying a cash sum to the insured. See REINSTATEMENT and NEW
FOR OLD.
Replacement Cost: The
value of property as indicated by the current purchase price of a
similar article.
Representation: A
statement of fact, or an expectation. Representations made as to
material facts at the time of the negotiation of the placement,
amendment or renewal of cover must be true whereas representations as
to a matter of expectation must be made in good faith.
Repudiation: The
rejection of a claim for indemnity under a valid policy for example due
to the terms and conditions of the policy having not been complied
with, or for example where the insured has committed a breach of the
insurance contract.
Retention:
The amount of any loss or combination of losses that would otherwise be
payable under an insurance/reinsurance contract which the
insured/reassured must bear itself before the insurer or reinsurer
becomes liable to make any payment under that contract. Compare
deductible and excess. An insured or reassured may be able to insure
its retention with another insurer/reinsurer.
Retention
Limit: The maximum liability which an insurer wishes to keep for
his own account in respect of a particular risk.
Risk: This
term may variously refer to - (a) the possibility of some event
occurring which causes injury or loss; (b) the subject-matter of
an insurance or reinsurance contract; or (c) an insured peril.
It's eiother a situation which cannot be controlled or perfectly
foreseen, or the subject matter of an insurance contract.
Risk
Management: The business discipline applied by large commercial and
industrial organisation to manage those risks which can cause losses.
S
A I A: South African Insurance Association - find
them here.
S A F S I A:
South African Financial Services Intermediaries
Association - find them here.
S A S R I A: South
African Special Risks Insurance Association - find them here.
Salvage value: The estimated cash
amount that would be received if damaged property were to be sold.
Schedule: The list of personal details
of the insured and the subject matter of the insurance in a
policy.
Self-Insurance: Insurance which a
business organisation finances internally by establishing a fund to
meet losses.
Short Term Insurance : Insurance that
operates on a year to year basis and which may be terminated by the
insurer or the insured.
Short- Period Rate: The rate of
premium applied to insurances in force for periods of less than twelve
months and which is higher proportionately than the annual rate.
Short-rate cancellation: When an
insurance contract is terminated prior to its expiry date by the
insured any return premium that is payable will usually be calculated
on a time on risk basis. The result is that the insured will receive
less return premium than would be the case if the return premium was
calculated on a pro rata basis (see pro rata cancellation).
Short-tail (risk): A type of
insurance where claims are usually made during the term of the policy
or shortly after the policy has expired. Property insurance is an
example of short tail business. The opposite of short tail business is
long tail business.
Special Perils: Extra risks added to a
policy to give cover not provided in terms of the basis wording; the
term usually applies to storm, water, wind and impact damage added to a
fire policy.
Subrogation: The right of an insurer
which has paid a claim under a policy to step into the shoes of the
insured so as to exercise in his name all rights he might have with
regard to the recovery of the loss which was the subject of the
relevant claim paid under the policy up to the amount of that paid
claim. The insurer’s subrogation rights may be qualified in the
policy. In the context of insurance subrogation is a feature of the
principle of indemnity and therefore only applies to contracts of
indemnity so that it does not apply to ife assurance or personal
accident policies. It is intended to prevent an insured recovering more
than the indemnity he receives under his insurance (where that
represents the full amount of his loss) and enables his insurer to
recover or reduce its loss. The right of one party to stand in a
place of another and take up the latter's legal rights against a third
party. See SALVAGE.
Sum insured: The maximum amount that
an insurer will pay under a contract of insurance. The expression is
usually used in the context of property and life insurance where
(subject to the premium cost) the insured determines the amount of
cover to be purchased. It is the monetary limit of the insurer's
liability under a policy.
Surrender: The termination of a life
insurance policy while the life assured is still alive in return for a
cash sum.
Time-barring: Differs from the
statutory prescription period of 3 years specified in the Prescription
Act and is actually a term of the insurance contract which requires the
insured to take legal action against an insured in the event of a
repudiated claim within a certain period (usually 90 days). In this
regard it is also to be remembered that in terms of the Policyholder
Protection Rules (P P R) the insured is afforded a further 90 day
recourse period. See PRESCRIPTION.
Valued
policy: A contract in which the insurers agree to pay the sum
stated in the event of total loss without the usual allowance for
depreciation or appreciation. See agreed value policy.
Void
policy: A contract which has no legal effect and is therefore
unenforceable in a court of law. For example, an insurance contract
where the policyholder does not have an insurable interest.
Voidable
contract: A contract which may be voided at the option of
either party. For example, an insurer may avoid a policy from inception
for the misrepresentation or non-disclosure of material facts during
the negotiation of the placement, renewal or alteration of cover. An
insurer may also avoid a policy from the date of the presentation of a
fraudulent claim.
Valuations: A
list of property with values allocated to each item, as the basis of an
insurance model.
VESA
Approved: Usually reference to types of security devices that
are approved/required by the Insurer and which complies with certain
minimum specifications. For example reference to VESA level 4 alarm or
immobiliser requires that level of VESA approved security devices which
have been fitted by a VESA approved installation outlet and in respect
of which the insured can provide a VESA-approved certificate. See VSS
APPROVED.
VSS
Approved: Usually reference to types of security devices that
are approved/required by the Insurer and which complies with certain
minimum specifications. For example reference to VESA level 4 alarm or
immobiliser requires that level of VESA approved security devices which
have been fitted by a VESA approved installation outlet and in respect
of which the insured can provide a VESA-approved certificate. See VESA
APPROVED.
War
and civil war risks exclusion agreement: An agreement between
Lloyd's underwriters and non-marine insurance companies that they will
not cover certain war and civil war risks on land.
Warranty: Where
an insured or reassured promises that something will or will not be
done during the period of cover or that a particular state of affairs
exists or does not exist at the inception of cover. If the promise is
untrue or is not kept then the insurer/reinsurer may disclaim all
liability under the policy from the date of the breach, regardless as
to whether the false declaration was material to the underwriting of
the contract or causative of any loss. A warranty is a condition, which
must be complied with - literally - in every respect.
Wear
and tear: The amount deducted from a claims payment in
recognition of the depreciation of the property insured through usage
of it over time. Where cover is provided on a 'new for old basis' ie
where the insurer agrees to replace an old item with a similar new one,
no such deduction is made.
Year
of account: The year in which an insurance or reinsurance
contract that is underwritten by a syndicate is allocated for
accounting purposes and into which all premiums and claims arising in
respect of that contract are payable. Insurance or reinsurance
contracts are generally allocated to years of account according to the
calendar year of their inception date so that a contract that commences
in 2005 will normally be allocated to the 2005 year of
account.Historically syndicates have operated a three year accounting
system which means that each calendar is normally left open for two
further years before a profit or loss is determined. A year of account
is normally closed by reinsurance to close at the end of 36 months.
Compare open year of account and run-off account.