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Wise Choices - A Primer on Basic Insurance Terms

Why Don't They Write Insurance Policies in Simple English?

Insurance policies are legal contracts between you and the company. In return for your premium dollars, the company agrees to pay your valid claims. Because the terms of what will and will not be paid must be clear and exact, technical terms are used in the wording of your policy. To help you understand these terms and your policy, we have prepared the following glossary of common insurance terms:


AccidentAct of GodActual Cash ValueAdjusterAgentCancellationCarrierCasualty InsuranceClaimConditionsDeductibleDepreciationEffective DateEndorsementFirst-Party ClaimsFloaterFlood InsuranceInjuryInsuranceInsurance CommissionerInsurance DivisionInsurance CompanyInsuredInventoryLiabilityLiability Coverage/InsuranceLossNegligencePerilPersonal Property InsurancePolicy PeriodPremiumPolicyholderProducerProof of LossProperty and Casualty InsuranceRenewalReplacement CostRiskTermTheft LimitThird-Party Claims
Accident

An event or occurrence that is unintended, unforeseen, and unexpected.

Act of God

An event beyond human origin or control (examples: lighting, windstorms, and earthquakes). Some policies do not cover losses caused by Acts of God.

Actual Cash Value

Cost to repair or replace property, taking into consideration its age and condition when it was lost or damaged (equals the replacement cost minus depreciation).

Adjuster

A person who determines the amount of loss. A "company" or "independent" adjuster represents the insurance company. A "public" adjuster represents the policyholder.

Agent

A salesperson authorized to represent an insurance company. Insurance agents are required to be licensed by the Insurance Division before doing business in Oregon. Independent agents don't work for a particular insurance company and sell the policies of more than one insurer. Exclusive agents sell the policies of only one company.

Cancellation

The ending of an insurance policy before its normal ending date.

Carrier

Same as "Insurance Company."

Casualty Insurance

Insurance to cover your legal liability for personal injuries or damage to property of others.

Claim

A person's request for payment from an insurer for a loss covered by an insurance policy. (See "First-Party Claims" and "Third-Party Claims.")

Conditions

Part of an insurance policy which states your obligations and those of your insurance company in order for the policy to be in effect.

Deductible

The amount that you agree to pay, out of your own pocket for each claim or accident before any money is paid by you insurer. A deductible may be a set amount of dollars per claim, a percentage of the actual loss, or a percentage of the value of the insured property. Example of a set amount of dollars per claim: If your policy has a $200 deductible, and your claim is $1,000, you will pay the first $200 and the insurance company will pay $800.

Depreciation

Reduction in the value of property due to age and use.

Effective Date

The day and time when a policy first becomes effective to pay covered losses.

Endorsement

An attachment to an insurance policy that adds to or changes the contract's original terms.

First-Party Claims

Claims you make to your insurance company for your losses covered under your policy. (See "Third-Party Claims.")

Floater

Additional coverage for items not otherwise covered included in the basic policy (such as jewelry or antiques).

Flood Insurance

Coverage against damage done by the rising or overflowing of bodies of water.

Injury

An act that harms or kills a person or that damages or destroys property.

Insurance

The transfer of financial risks from an individual to an insurance company. The insurer promises to pay the insured for economic losses from an accident during the period of time and under the terms covered by the policy.

Insurance Commissioner

In Oregon, the director of the Department of Consumer & Business Services also serves as Insurance Commissioner, and is appointed by the governor and confirmed by the Senate.

Insurance Division

Division of the Oregon Department of Consumer & Business Services that enforces rules for the insurance business in Oregon. The division is a valuable source of information about all types of insurance; it also handles consumer inquires and complaints.

Insurance Company

A company, which in exchange for a fee (known as a premium), agrees to pay all legitimate claims under the terms of your policy.

Insured

The person protected by an insurance policy.

Insurer

The insurance company that provides insurance coverage and services.

Inventory

A list of your possessions, their value, and serial numbers (if applicable). Items on the inventory should include furniture, rugs, drapes, artwork, china, antiques, appliances, books, clothes, jewelry, compact discs, records, tapes, linens, and musical instruments. Photos or videotapes are useful additions to your inventory list. The inventory should be kept in a safe place away from your home.

Liability

A legally enforceable financial obligation.

Liability Coverage/Insurance

Insurance which pays the losses of other people to whom you unintentionally or through negligence cause injury. Bodily injury liability coverage pays medical costs of others and your legal defense costs if you injure or kill someone. Property damage liability coverage pays claims against you if you damage someone else's property.

Loss

The amount suffered by a person or property, with or without insurance. An insurer is required to pay for losses suffered by those they have insured under the terms of the policy.

Negligence

Failure to exercise a generally acceptable level of care and caution.

Peril

Cause of loss. (Examples: fire, theft.)

Personal Property Insurance

Protects your possessions against the loss or damage according to the terms of your policy.

Policy Period

The length of time an insurance policy is effective.

Premium

The amount you pay the insurer for coverage.

Policyholder

The person who buys insurance.

Producer

An insurance agent.

Proof of Loss

Documents that you give the insurer to support your request for payment of a claim. The company uses these documents to determine whether and how much it will pay (examples: written repair estimates, police reports).

Property and Casualty Insurance

(Sometimes called Property and Liability Insurance.) Coverage other than life insurance.

Renewal

An insurance policy issued to replace an existing policy that has expired.

Replacement Cost

Cost to replace property with a comparable new item, without regard to the age or condition of the original item.

Risk

The chance of unexpected loss. Insurance is sold and bought to insure against risk.

Term

The length of time the policy is in effect. "Short term" policies usually last less than one year.

Theft Limit

The highest amount an insurance company will pay on certain items that are stolen from your home. For instance, some policies have a $5,000 limit for computers. If an item would cost more than the limit to replace, you may need to purchase supplementary coverage.

Third-Party Claims

Claims made by one person against another person's insurance company. (See "First-Party Claims.")

What if I still don't understand my policy?

Your agent is required to explain your policy to you in a way you can understand.


Oregon Insurance Consumer Advocacy also produces an index of Oregon insurance complaints. It ranks companies based on the number of complaints closed by the Consumer Services and Enforcement Section of the Insurance Division.

Money $aver

What you don't know can cost you. Understand the terms of your insurance policies so you know exactly what you're paying for. Then, if you ever have to file a claim, you won't be surprised by exclusions or deductibles you agreed to when you bought the policy.


Wise Choices is an educational series from the Oregon Department of Consumer & Business Services. It's intended to inform Oregonians about their rights in insurance, investments and banking, occupational safety and health, building codes, and workers' compensation.


The information contained in Wise Choices is in the public domain, and may be reprinted without permission.


To receive more information on DCBS programs to protect and educate consumers, please write to: DCBS Wise Choices, PO Box 14480, Salem, OR 97309-0405.

 

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