Garagefathers in Exeter, CA

Glossary: “I have good brakes, do you have good insurance?”

Glossary Terms and Definitions

A licensed individual or organization authorized to sell and service insurance policies for an insurance company.
A physician who may be selected by the parties, when an injured worker is represented by an attorney, to assess any disputed medical-legal issues.
A short-term agreement that provides temporary insurance coverage until the policy can be issued or delivered.
A licensed individual or organization who sells and services insurance policies on behalf of the insured employer.
A licensed individual can act as an agent representing one or more insurers, and also as a broker dealing with one or more insurers representing the insured employer’s interests.
The termination of an in-force insurance contract by either the insured or the insurer before its normal expiration date.
Notice to an insurance company that a loss has occurred that may be covered under the terms and conditions of the policy.
The person who evaluates the damage caused by a covered loss and determines the amount to be paid under the policy terms.
Insurance coverages for businesses, commercial institutions, and professional organizations, as contrasted with personal insurance.
A portion of the policy premium that is paid to an agent by the insurance company as compensation for the agent's work
The portion of an insurance contract that sets forth the rights and duties of the insured and the insurer.
The portion of an insurance contract that sets forth the rights and duties of the insured and the insurer.
Protection that is provided under an insurance policy.
Usually, the first page of an insurance policy contains the full legal name of the insurance company, the policy number, effective and expiration dates, the premium payable, the amount and types of coverage, and the deductibles.
Some kinds of coverage have deductibles. A deductible is the amount of loss which the insured is responsible to pay. You usually pay a lower premium if you choose a higher deductible. Example: Let’s say that your Comprehensive coverage has a $500 deductible. If a storm causes $1,500 of damage to your car, you must pay the first $500. Then your Comprehensive coverage pays the rest-$1,000.
In workers' compensation, an employer may be liable two ways to an employee who incurs bodily harm on the job as a result of using a product or service produced by that employer. The employee is eligible for workers' compensation benefits and may also sue the employer because of the defectiveness of the injuring product or service.
The portion of the policy premium paid by an insured has been allocated to the insurance company's loss experience, expenses, and profit year-to-date.
The starting date of an insurance policy; the date the policy goes into force. Endorsement "Endorsement" or "endorsement form" means a form, agreement, or document that amends adds to, subtracts from, supplements, or revises a policy form and is attached to a policy form to be effective.
A contractual provision in an insurance policy that denies or restricts coverage for certain perils, persons, property, or locations.
A rating factor, which is expressed as a percentage that is used to adjust the workers' compensation policy of qualifying employers. An experience modification compares the loss or claims history of the insured employer to all other employers in the same industry that are similar in size. Generally, an experience modification of less than 100% reflects better-than-average experience, and an experience modification of more than 100% reflects worse-than-average experience.
The termination date of coverage is indicated on an insurance policy. First Party The policyholder (insured) in an insurance contract.
A cancellation that takes place on the policy effective date. No premium charge is made; however, other charges (i.e. service) may apply.
An intentionally deceptive act committed to obtain an unfair or unlawful advantage. Fraud usually involves monetary gain
The number of times a loss occurs.
A circumstance that increases the likelihood or potential severity of a loss.
In a property and casualty contract, the objective is to restore an insured to the same financial position after the loss that the insured had prior to the loss. In the most basic sense, indemnity is compensation for a loss.
A person or organization that provides claims adjusting services to different insurers on a contract basis.
A method of shifting risk from a person, business, or organization to an insurance company in exchange for the payment of premium. The insurance company commits to be responsible for covered losses. The insurance policy is generally an integrated contract, meaning that it includes all forms associated with the agreement between the insured and insurer.
When you’re reading an insurance policy, you’re bound to come across the word ‘insured’ (way) more than once and it’s important to know what it means – because it’s you! The policyholder(s) entitled to coverage under an insurance policy. ‘Insured’ is used to describe the person who is covered under an insurance policy.
The insurance company that issues insurance and agrees to pay for losses and provide covered benefits. The insurance company that issues a particular insurance policy to an insured. In case of very large risk, several insurance companies may combine to issue one policy.
A rating modification (either decrease or increase) that is based on the underwriter's experience, best judgment, and analysis in classifying and underwriting
In property and casualty insurance, a lapse is the termination of a policy because of a failure to pay a premium when due. A lapse means a life insurance policy is no longer an active contract due to missed premium payments. A life insurance policy will lapse when both premium payments are missed and cash surrender value is exhausted if it is a permanent life insurance policy. Most policies can be reinstated after a lapse.
Coverage for a policyholder's legal liability resulting from injuries to other persons or property damage. Liability insurance is a part of the general insurance system of risk financing to protect the purchaser from the risks of liabilities imposed by lawsuits and similar claims and protects the insured if the purchaser is sued for claims that come within the coverage of the insurance policy.
An insurance license allows a person to solicit and sell insurance products. The license is issued by the state insurance commissioner in the state where you intend to solicit and sell insurance and is separated into different insurance types, including life and disability, health, auto or worker's compensation.
Each kind of coverage has its own limits. The limit is the total amount the insurance company will pay for a single accident or claim. The insurance company will not pay any costs above the limits. Example: Let’s say that your auto liability coverage has a $50,000/$100,000 limit on the bodily injury for one accident. In this case, your insurance will not pay more than $50,000 for one person. It will not pay more than $100,000 for one accident.
An agent contractually authorized by an insurance company to manage all or part of the insurer's business activities. An MGA can manage the marketing, underwriting, policy issuance, premium collection, appointing and supervision of other agents, claims payments, and reinsurance negotiations of an insurance company.
A factual falsification made in such a manner that the insurance company would have refused to insure the risk if the truth had been known at policy issuance.
An insurance quote is an estimate of what your rate could be with a potential insurance carrier. Quotes are subject to change depending on how much information you give at the time of the quote.
Failure by the policyholder to pay the premium on a policy or pay the installment premium payments due on a policy.
Car insurance nonrenewal is a situation in which your car insurance company has chosen not to renew your policy at the end of its term. A nonrenewal may feel a little jarring, and you'll most likely need to get coverage from another insurer, but your rates won't necessarily increase as a result.
Occupational accident insurance coverage provides benefits to employees injured or killed in a job-related accident. Occupational accident insurance is an alternative way to fund the employer's obligation to the employee.
An illness contracted as a result of employment-related exposures and conditions. An occupational disease is covered under workers' compensation and employers' liability insurance. Both cover claims for bodily injury by disease.
Occupational accident insurance coverage provides benefits to employees injured or killed in a job-related accident. Occupational accident insurance is an alternative way to fund the employer's obligation to the employee.
A liability insurance policy that covers claims arising out of occurrences that take place during the policy period, regardless of when the claim is filed.
Insurance wrote on the personal and real property of an individual (or individuals) to include such policies as homeowners' insurance and personal auto insurance, as contrasted with commercial lines.
In insurance, the insurance policy is a contract (generally a standard form contract) between the insurer and the insured, known as the policyholder, which determines the claims which the insurer is legally required to pay. In exchange for an initial payment, known as the premium, the insurer promises to pay for loss caused by perils covered under the policy language.
A premium is an amount you pay to the insurance company to buy your auto policy. The premium covers the term or length of the policy. The term can vary from one month to one year. Most insurance companies allow you to pay the premium in installments. Ask if there is an extra fee for doing this.
An insurance producer is someone who has the proper licensing to sell insurance within a particular state. The term "insurance producer" is interchangeable with "insurance agent" and "insurance representative." Insurance producers sell insurance products on behalf of insurance companies.
Cancellation of a policy by an insurance company that returns the unearned premium to the policyholder (the portion of the premium for the remaining time period that the policy will not be in force).
Policy provisions are clauses in an insurance contract that layout the exact conditions for which coverage is provided and for what amounts, along with exclusions and other restrictions.
Appointed and regulated by the DWC's Medical Unit, a QME assesses an injured worker's permanent impairment and limitations and evaluates a wide variety of disputed medical-legal issues. Often, a QME performs a separate medical evaluation when the treating physician's assessment is disputed.
An insurance quote is an estimate of what your rate could be with a potential insurance carrier. Quotes are subject to change depending on how much information you give at the time of the quote. The more forthcoming you are with information, the more accurate your insurance quote.
Requirements developed by the CDI that implement laws passed by the legislature. Regulations go through a public comment process and must be approved by the state Office of Administrative Law.
If an insured person fails to pay the premium due to various circumstances and as a result, the insurance policy gets terminated, then the insurance coverage can be renewed. This process of putting the insurance policy back after a lapse is known as reinstatement.
The continuation of an insurance policy (offer of renewal) into a new term from the same insurance company that issued the existing policy. Schedules for Rating Permanent Disabilities. The schedules are used to determine the percentage of permanent disability of an injured worker.
A method of pricing property and liability insurance. Schedule Rating uses debits and credits to modify a base rate figured by the special characteristics of the risk exposure. Insurers develop Schedule Rating because actuarial experience shows a direct relationship between certain physical characteristics and the possibility of loss. Most schedule rating plans must be filed and approved by the CDI.
Any insurance company, that provides insurance to a buyer is called the second party. The service provider or insurance company is known as the second party. For instance, someone else drives your car and damages a person or property then third-party insurance comes into the picture for compensation.