Glossary of Terms (wording)
Adjuster
An adjuster is a representative of the insurer who seeks to determine the extent of the insured’s liability for loss when a claim is submitted.
AgentAn agent, or broker, represents one or more insurance companies in selling insurance.
Allowable expenseAn allowable expense is an expense specified by an insurance plan to be eligible for payment either in part or whole.
AmendmentAn amendment to an insurance policy changes the benefits, coverage, terms, or conditions.
BeneficiaryThe beneficiary is the person named by the insured to whom the proceeds of a life or health insurance policy are payable.
Bodily Injury (BI) Liability CoverageThis coverage pays, up to the coverage limits, for damages due to injury or death of others in a vehicle accident for which you are legally responsible. It also pays your legal defense costs.
Case ManagementCase management refers to a cost control method that directs the insured to the most appropriate duration and type of service. It can also refer to the monitoring of such outcomes.
ClaimA claim is a formal request to the insurance company for reimbursement for a loss, as set out in the plan.
Co-insuranceIf the insured is required to pay any portion of the covered expenses, this is known as co-insurance.
Collision CoverageThis optional auto insurance coverage pays, up to the coverage limits, for damage to your vehicle caused by a collision with another vehicle or object. Select deductibles of $100, $250, $500, or $1000 to help offset the cost of this coverage. You can save money by selecting a $500 or $1000 deductible because the larger deductible lowers your insurance costs.
Comprehensive Physical Damage CoverageAlso optional, this coverage pays, up to the coverage limits, for damage to your vehicle resulting from glass damage, collision with an animal, theft, fire, vandalism, flooding, or hail. Select deductibles of $100, $250, $500, or $1000 to help offset the cost of this coverage. You can save money by selecting a $500 or $1000 deductible because the larger deductible lowers your insurance costs.
Covered ExpenseCovered expenses are those eligible for medical care or supplies that will be paid by the insurance company.
DeductibleThe deductible is the amount the insured pays each calendar year before benefits are paid.
DependentThe insured’s dependents are the lawful spouse and unmarried children under a certain age who are eligible for coverage.
Effective DateThe date on which coverage under an insurance policy begins is called the effective date.
ExclusionsExclusions are specified conditions that are not eligible for reimbursement under a policy or plan.
Medical Payments CoverageIn auto insurance, this coverage pays, up to the coverage limits, for reasonable and necessary doctor, hospital and funeral expenses for you and your passengers injured or killed in an accident, or as a pedestrian by another vehicle, regardless of who is at fault.
Pending ClaimWhen a claim has been reported, it’s considered a pending claim until final coverage determination has been made.
PremiumThe premium is the cost for coverage during a specified period of time.
Property Damage (PD) Liability CoverageThis coverage pays, up to the coverage limits, for another individual’s vehicle or property that has been damaged in an accident for which you are legally responsible.
RiderA rider is a provision that changes, adds, or excludes various coverage’s, terms or conditions in the policy.
SubrogationSubrogation allows an insurance company to pursue a third party for claims paid that are the responsibility of that third party.
UnderwritingUnderwriting is the process that assesses and classifies the potential degree of risk an applicant represents.
Uninsured/Underinsured Motorists (UM/UIM) CoverageUM/UIM coverage pays up to the coverage limits for bodily injury to you or your family resulting from the negligence of a motorist whose liability insurance limits are insufficient.
Waiting PeriodThe waiting period is the time an employee must wait before insurance is effective or benefits are considered eligible.