Glossary of Insurance Terms

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1 PATRIOT INSURANCE AGENCY, INC. DBA: Arizona Patriot Insurance Agency, Inc. in CA, NC,ND P.O. Box 1298 Sonoita, AZ Phone: Fax: Toll Free Number: Glossary of Insurance Terms Additional Insured A person or organization not automatically included as an insured under an insurance policy, but for whom limited status is arranged. Additional insured status does not extend full general liability insurance coverage to other entities, but rather provides limited coverage for an entity in the event a claim arose from your organization s acts or omissions. An additional insured is not covered for its own acts or omissions. The additional insured would have to secure its own general liability to protect itself from such claims. Aggregate Limit A type of policy limit found in the liability policies that limits coverage to a specified total amount for all losses occurring within the policy period. Bodily Injury Usually defined to include third party personal harm, sickness, disease. Care, Custody & Control A common provision in liability policies excluding coverage for physical damage or loss to property of others that is in the care, custody or control of an insured. Certificate of Insurance A document evidencing an insured s coverage, limits, policy term and insurer(s). Claim A demand by an individual or corporation to recover for an alleged loss. In order for a demand to qualify as a claim, the third party must show that duty of care was present for the insured, that the insured breached that duty and that the claimant incurred damages because of the breach. 1

2 Claims Made The report of loss must be turned in while the policy is still in force. Claims Made policies usually contain a Retroactive Date (which defines when the coverage begins. It is important that the organization maintain the original Retroactive coverage date. Crime Coverage Covers loss of money and securities arising from dishonesty, theft, burglary, mysterious disappearance, and computer fraud. Crime coverage is sometimes referred to as fidelity coverage or an employee dishonesty bond. Damages In a third party claim damages refer to both the dollar amount for medical bills resulting from an injury and lost time from work. Deductible Usually, a dollar amount the insured must pay on each loss to which the deductible applies. The insurance company pays the remainder of each covered loss up to the policy limits. Directors and Officers (D&O) Liability Insurance Covers against wrongful acts of an organization and its directors and officers. Each policy defines wrongful act differently, but, in general, it means actual or alleged acts or omissions including breaches of duty, such as mismanagement of the organization, by directors, officers, or other insureds. Most D&O policies exclude coverage for bodily injury or property damage. Employee Dishonesty Bond See Crime Coverage. Fidelity Coverage See Crime Coverage. Fire Damage Legal Liability Coverage Covers an insured s liability to a third party due to fire damage to premises rented to an insured. First Party The insured in an insurance contract. General liability coverage protects first parties from third party suits. General Liability Insurance Provides protection from claims that assert negligence against an insured resulting from third party bodily injury, personal injury, or property damage. 2

3 Hired Automobile Liability Covers bodily injury and property damage sustained by third parties which includes an automobile the organization hires, rents or borrows, but not automobiles owned by the insured, employee, volunteer, or staff. Hold Harmless Provision A contractual arrangement whereby one party assumes the Liability inherent in a situation, thereby relieving the other part of responsibility. Such agreements are typically founding contracts such as leases. Incident An accident or event that may give way to a claim at a later date. Indemnification Provision A contractual provision or agreement in which one party assumes financial responsibility for the liability of another party. An indemnification provision is often used in conjunction with a hold harmless provision. Liquor Liability Liability for damages to a third party arising from selling, servicing or furnishing alcoholic beverages. While some minor nuances exist, liquor liability is often used interchangeably with the term dram shop liability. Malpractice Insurance A form of Professional Liability insurance used to insure professionals against their liability for professional misconduct or lack of ordinary skill. Named Insured Any person, firm, or corporation, or any member thereof, specifically designated by name as insured(s) in a policy, as distinguished from the others who, though unnamed, are protected under some circumstances. Negligence Failure to use that degree of care that an ordinary person or reasonable prudence would use under the same given circumstances. Negligence may be constituted by acts of either omission or commission or both. 3

4 Non Owned Auto Liability Insurance Covers bodily injury and property damage sustained by third parties arising from an auto that the insured does not own, lease, hire or borrow. Occurrence An occurrence form will cover Bodily Injury or Property Damage that occurs during the policy Period. Personal Advertising Injury Coverage Harm done to a third party s reputation or standing in the community that arises out of one or more of the following: False arrest, detention or imprisonment; Malicious prosecution; Wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises; Written or oral publication of materials that libels or slanders a person or organization; Written or oral publication of material that violates a person s right of privacy. Misappropriation of advertising ideas or style of doing business; or Infringement of copyright, title or slogan. Premises Operations Liability Coverage Liability to a third party arising out of an insured s premises or out of an insured s business operations while such operations are in progress. Products/Completed Injury Coverage Liability to a third party arising out of an insured s products or business operations conducted away from the insured s premises once those operations have been completed or abandoned. Proof of Loss A formal statement by the insured to the insurance company regarding a loss. The purpose is to place before the company sufficient information concerning the loss to enable it to determine its liability under the policy. Property Damage A type of loss covered under many Liability contracts. Includes the insured s liability for damage to property of others or loss of use of other s property. 4

5 Reinsurance Carrier Reinsurance is a form of insurance between insurers. It occurs when an insurer (the re-insurer) agrees to accept all or a position of a risk covered by another carrier. Sprit Mountain engaged the services of Imagine Reinsurance which is rated A- by A.M. Best. Spirit Mountain Insurance Risk Retention Group, Inc. Spirit Mountain Insurance Risk Retention Group, Inc. was established in May 2005 and is domiciled in Washington, D.C. It undergoes an annual audit by a public accounting firm and also submits annual financial statements to all states Department of Insurance which provides the results of operations. Third Party Under an insurance contract, the person or organization who is making a claim for damages that allegedly result from the insured s negligence. In a liability insurance policy, the first and second parties enter into a contract to pay third party claims. Vicarious Liability Occurs when an insured is held liability for the negligent actions of another person or organization over which the insured has control. Examples include the employer-employee relationships. Waiver The surrender of a right (such as the right to file a damage claim) Workers Compensation Insurance Insurance that covers an employer s obligations under Worker s Compensation laws, which make the employer responsible for stated damages in the event of a work-related injury or illness. Worker s Compensation coverage also includes separate coverage for Employers Liability. 5

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