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A
''A" (or Judgment) Rates - Rates that are based on the judgment
of the underwriter on an individual risk basis and not supported by loss
experience.
Abandonment - A term that applies to property and signifies both
a relinquishing of it and the letting go of all legal rights to it, as
well, with the intent to claim a total loss. Abandonment of property to an
insurance company is something insureds are expressly prohibited from
doing in most property polices.
Abandonment clause - A property policy provision that stipulates
that the insurer need not accept any damaged property that the insured
chooses to relinquish.
Absolute liability - The performance of an act so dangerous as
to be sufficient to trigger liability regardless of the degree of
negligence. Triggering explosives is often used as an example. Sending
workers aloft for construction or repair at elevated heights is another.
``Strict liability'' is another term that is sometimes used.
Accident - An unforeseen, unintended, and unexpected event,
which occurs suddenly and at a definite place. See Occurrence.
Accident frequency - The rate of occurrence of accidents. Along
with accident severity, it is taken into account in ratemaking.
Accident severity - The measure of the seriousness of a claim,
measured in, for example, dollars. Along with frequency, it is taken into
account in ratemaking.
Accident year experience - Measures premiums and losses relating
to accidents which occurred during a 12-month period.
Accommodation line - Normally unacceptable risks that are
written as an accommodation to an agent or broker who has an overall
profitable relationship with the insurer. For example: a personal auto
risk with a teenage driver of a sports car might be written if the other
lines of insurance which it carries for the customer were profitable; or
if the agency has had a good and profitable relationship with the
insurer.
Account current - A monthly statement provided by an insurer
detailing an agent's premiums, commissions, cancellations, and
endorsements.
Account selling - Account selling is trying to handle all of a
client's insurance needs, rather than providing for only a portion of
those needs.
Accounts receivable insurance - Pays for the cost of
reconstructing accounts receivable records that have been damaged or
destroyed by a covered peril. Even more important, it covers any payments
that cannot be collected because records cannot be reconstructed.
Acquisition cost - The expense undertaken to acquire new
business. The concept applies to both agents and companies. The largest
portion of an insurer's acquisition cost is agent's or sales
representative's commission or bonus.
Act of God - Acts of nature ð the term was once widely used to
distinguish between manmade events, i.e., fire, collision, and nature's
rampages in wind and flood.
Active malfunction - In products insurance, a defect or
malfunction in a product that damages the property of the user.
Actual authority - Authority that an insurer intentionally gives
to the agent. See express authority and implied authority.
Actual cash value (ACV) - A method for placing value on property
as of the time of its loss or damage. ACV may be determined as replacement
cost, new, less depreciation. The market value of an item may be used to
help determine actual cash value. Contrast with replacement cost.
Actual cash value appraisal - An appraisal to determine the
actual cash value of a building and related personal property.
Actuary - A person highly trained in mathematics and statistics
who calculates rates and dividends, and provides other statistical
information for an insurance company.
Additional insured - One who qualifies as insured under the
terms of a policy even though not named as insured. Officers of a
corporation may be included as insureds under the terms of a policy
written in the name of the corporation.
Additional living expense insurance - This coverage, found in
homeowners forms, provides payment for extra expenses made necessary by
the insured's inability to reside in the insured dwelling because of a
covered loss ð for example, restaurant meals and hotel bills. The amount
payable is the difference between normal household expenses and the
increase.
Adequate - a criterion of insurance rate regulation that
stipulates that an insurer's premium rates must be adequate to cover the
insurer's cost of doing business, claims payments, and a reasonable profit
to the insurer.
Adhesion contract - A standardized set of agreements offered by
one (usually the stronger) party to another on a ``take it or leave it''
basis. An insurance policy is an example of such a contract. The insurer
offers a personal auto policy, for example, that an individual may
``adhere to'' (or not) but in any case the individual may not change any
of its terms. Because it has the stronger position, the insurance company
has the burden to spell out its terms precisely. Such contracts are
interpreted strictly against the author of the contract. Not to be
confused with aleatory contract.
Adjuster - A person who may act either on behalf of the
insurance company or the insured in the settling a claim. Employee
adjusters work for an insurer; independent adjusters represent the
insurance company on a fee basis; and public adjusters represent the
insured on a fee basis.
Admitted assets - The highly liquid assets of an insurer
permitted by the state to be taken into account when reporting financial
condition.
Admitted company - An insurance company that is licensed
(admitted) to conduct business within a given state.
Admitted market - The range of insurance available through
admitted companies.
Advance premium - Also called ``deposit premium,'' an advance
premium is a downpayment on what will be the final premium, in policies
where the final premium is subject to audit.
Adverse selection - The tendency of poorer than average risks to
buy and maintain insurance. Adverse selection occurs when insureds select
only those coverages that are most likely to have losses.
Adverse underwriting decision - Any decision made by an
underwriter that is not favorable to the insured. Such decisions involve:
termination, declination, higher rates, or reduction in coverage. Another
example is the placing of a risk in a residual market or with an
unauthorized insurer.
Advertising injury - Claim arising out of slander, libel,
copyright infringement, or misappropriation of advertising ideas. Coverage
is provided as part of coverage B of the commercial general liability
policy.
Affinity marketing - Targeting marketing efforts toward one
group or category of client. Examples include: grocery stores; all the
employees of one company; or employees in one industry. Group business is
a type of affinity marketing.
Agency company - An insurance company that produces business
through an agency network. See direct writer.
Agency contract - The legal agreement between an insurance
agency and the insurer detailing the terms of representation.
Agency plant - The total force of agents representing an
insurer.
Agent - One who solicits, negotiates or effects contracts of
insurance on behalf of an insurer. His right to exercise various
functions, his authority, and his obligations and the obligations of the
insurer to the agent are subject to the terms of the agency contract with
the insurer, to statutory law, and to common law.
Agent's appointment - The act by an insurer that grants an agent
the authority to act as an agent for the insurer. In most states, agents
must be licensed and appointed, prior to being allowed to sell
insurance.
Agent's authority - The authority of an insurance agent to act
on behalf of the insurer he or she represents. There are several types
including: express authority (authority to act on specific instructions
only); implied authority (actions taken in accordance with prevailing
custom); or apparent authority (actions based on appearances created by
the agent and acquiesced to by the principal).
Agents errors and omissions insurance - Insurance obtained by
the insurance agent to guard against loss caused by an unintentional
failure to properly insure (or recommend insurance to) a client.
Agent's license - A certificate of authority from the state that
permits the agent to conduct business.
Aggregate deductible - A deductible provision in some property
insurance contracts where all covered losses during a year are figured
together and an insurer pays only when the aggregate deductible amount is
exceeded.
Aggregate excess reinsurance - A type of excess reinsurance
treaty that sometimes is called stop loss or excess of loss ratio
reinsurance. The retention in this type of agreement is calculated based
on all losses over the period of time that is stated in the treaty. The
reinsurer is responsible for the amount of losses between the retention
and the limit on the treaty.
Aggregate limit - The maximum amount an insurer will pay under a
policy in any one policy period.
Agreed amount clause - An agreement between underwriter and
insured whereby, in exchange for the purchase of coverage in an amount
specified by the underwriter, the insured is protected from a coinsurance
penalty.
Agreed value clause - Though rare, some policies cover for a
value agreed upon at the time of writing; if the property is lost because
of an insured peril, the amount stated in the policy will be paid. Fine
arts insured under a personal articles floater or homeowners scheduled
personal property endorsement are examples.
Aircraft coverages - Though aircraft have long been an important
element in the lives of most Americans, insurance of aircraft exposures
has remained outside the mainstream of property and liability insurance
markets. Aircraft hull and liability insurance is the counterpart of
personal or commercial auto policies coverage. Aircraft products insurance
is the counterpart of products liability cover. Air cargo insurance is
mirrored in motor truck cargo. Hangarkeepers liability is akin to
garagekeepers coverage. As with any specialty line of insurance, the
absence of standardized forms limits practice to specialists in the
line.
Alcoholic Beverage Control (ABC) laws, see Dram shop laws.
Aleatory contract - A contract in which the number of dollars to
be given up by each party is not equal. Insurance contracts are of this
type, as the policyholder pays a premium and may collect nothing from the
insurer or may collect a great deal more than the amount of the premium if
a loss occurs. Not to be confused with contract of adhesion.
Alien insurer - An insurance company formed under the laws of a
country other than the one it is doing business in.
Alienated premises - Property that has been sold by an
insured.
All risks - A property policy expression now out of fashion. It
was used to designate contracts that promised coverage against ``all risks
of direct physical loss'' in contrast to forms that covered for specific,
named perils. The word ``all'' came to be perceived as open to broader
interpretation than insurers intended and it was dropped in favor of the
promise to cover ``risks of physical loss.'' See Named perils and also
Open perils.
Allied lines - Lines of insurance that cover for perils other
than fire, that are usually sold with fire insurance, e.g., fire and
allied lines.
Alternative dispute resolution (ADR) - Methods other than
lawsuits that are designed to resolve legal disputes. Examples are
arbitration and mediation.
Ambiguity - A standard policy provision that proves to be
ambiguous may be interpreted in the light most favorable to the
insured.
American Agency System - The system of selling insurance through
agents who receive commissions in lieu of salary.
American Association of Insurance Services (AAIS) - An
association of insurance companies providing filing and various technical
services on behalf of its member companies.
Americans with Disabilities Act (ADA) - Passed by Congress in
1990, this act requires that ``reasonable accommodation'' be made in
public accommodations, including the workplace, for those with physical or
mental disability.
American College, The - An educational institute conferring the
Chartered Life Underwriter (CLU) designation.
American Lloyds - Unincorporated associations of individual
underwriters who assume specified portions of liability under each policy
issued. There is no connection with Lloyd's of London.
Anniversary date - The anniversary of the original date of issue
of a policy as shown in the declarations.
Annual aggregate deductible - A deductible applied annually to
the total amount paid in claims during a policy period. Claims are
generally subject to a per occurrence deductible; the aggregate is the
limit beyond which no further deductibles are applied.
Anti-coercion laws - Usually contained in a section of the state
code entitled ``Unfair Trade Practices,'' these provisions define the use
of coercion as an unfair practice and, hence, a violation of the state
law.
Anti-rebating laws - Laws found in all but two states which
prohibit an agent's refunding part of a commission to an applicant as an
inducement for placing insurance through the agent. California and Florida
allow rebating of commissions on a limited basis.
Apparent authority - The perceived ability of an agent to bind
an insurance contract to an insurance company. If an agent or agency holds
themselves out as representing a particular company it is reasonable for
the public to assume that such authority is established contractually,
even if it is not.
Apportionment - The method of dividing a loss between multiple
insurers that cover the same loss.
Appraisal - A determination of the value of property for the
purposes of determining the proper amount of insurance to be bought or in
adjusting a loss.
Appurtenant structure - Another structure on the same premises
as the principal structure. A detached garage on a dwelling premises is
``appurtenant'' to the dwelling. Older homeowners forms refer to the
``other structures'' protected under the HO Coverage B as ``appurtenant
structures.''
Arbitration clause - The clause in an insurance policy that
spells out how disagreements over a claim are settled.
Arson - The intentional setting afire of property.
Assigned risk - A risk not be generally acceptable to any
insurance company but for which the law says that insurance must be
acquired. Personal auto liability is one such necessary coverage.
Insurance companies doing personal auto business in a state can be
required to accept assignment of a portion of the state's unacceptable
drivers as insureds.
Assigned risk plan, see Auto insurance plan.
Association captive - A captive insurer owned by the members of
a sponsoring organization or group, such as a trade association.
Assumed liability - Liability assumed under contract or
agreement. More commonly known as contractual liability.
Assured - A party who is a potential beneficiary of an insurance
contract. The synonym ``insured'' is more commonly used.
Attorney-in-fact - An individual who is given authority to
execute legal documents, including bonds; or the manager of a reciprocal
exchange, which is an insurance arrangement whereby risk is transferred to
other members. The attorney-in-fact need not be a lawyer.
Attractive nuisance - Condition that can attract and injure
children. The occupants of land on which such a condition exists are
liable for injuries to children. Examples of attractive nuisance: swimming
pools; earth moving equipment; playground equipment.
Audit - Some policies (such as workers compensation) are written
subject to an audit. Since workers compensation premium is based on the
insured's payroll, the insurer is entitled to audit the insured's records
at the end of the policy to verify that it has collected an adequate
premium for the amount of payroll to which it was exposed.
Authorized insurer - An insurer granted permission by a state to
sell specific lines of insurance within that state.
Auto insurance plan - Program set up by various states to ensure
that everyone with a valid driver's license will be able to purchase auto
insurance. All auto insurers operating within a state are assigned
insureds in proportion to the amount of auto premium written.
Automobile liability insurance - Insurance in which the insurer
agrees to pay all sums for which the insured is legally obligated because
of bodily injury or property damage arising from the ownership,
maintenance, or use of an auto.
Automobile medical payments - Insurance applying to the medical,
hospital, or funeral expenses of anyone injured while on or in an insured
automobile. The coverage is not dependent on liability, being triggered
simply by an accident. It may be included in either the Business Auto
Policy or the Personal Auto Policy. See also Premises medical payments.
Auto physical damage insurance - Insurance on the vehicle,
itself. This usually is broken down into collision and other than
collision coverages.
Automobile shared market - A program in which all automobile
insurers in each state make coverage available to car owners who are
unable to obtain auto insurance in the voluntary market.
B
Bailee - One who has is charged with the care of the property of
another. For example, a garage is bailee of a customer's (bailor's) car
(the bailment) and a jeweler is a bailee of customers' jewelry while in
for repair or appraisal.
Bailees customers' insurance - Insurance designed to reimburse a
bailee's customers for loss without regard to liability.
Bailees floater - An inland marine form that covers ð on an open
perils basis ð a bailee's interest in personal property of others.
Bailees liability insurance - Insurance covering damage
negligently caused by a bailee or employee to goods left in their
care.
Bailment - The act of delivering property in trust to another
for a limited time and specific purpose.
Bailor - The person delivering property to another in trust.
Bankers blanket bond - A bond designed to indemnify for loss of
money, securities, etc., caused by: dishonesty of employees; robbery or
theft from the premises; or robbery or theft while the insured property is
in transit.
Basic causes of loss - The perils of fire, lightning, and
removal of property from premises endangered by those perils as shown in
the standard 1943 New York fire policy.
Basic named perils - Covered perils in a property insurance
contract: fire, lightning, windstorm, civil commotion, smoke, hail,
aircraft, vehicles, explosion and riot.
Beach plans - Sometimes known as windstorm plans or pools, these
are plans devised by coastal states to insure the windstorm exposure of
coastal properties. The plans operate in a manner similar to a joint
underwriting association, with participation by all insurers operating
within a state.
Bench error - A mistake in the production process of a product
that causes a loss. Such losses are usually covered.
Betterment - A term used to express the difference in the value
of property before loss and after restoration. If a 20-year roof is
damaged by an insured peril and it has to be replaced in its 15th year and
the restoration renews the 20-year life expectancy, the owner has obtained
a 15-year betterment in the roof. Without replacement cost insurance on
the roof, the owner is expected to reimburse the insurance company for the
``betterment'' entailed in the restoration. Also see Improvements and
betterments.
BI - A shorthand expression for ``bodily injury.''
Bid bond - Guarantees an owner, the ``obligee,'' that the
accepted contractor will actually undertake the work and that the
contractor will furnish performance, payment, and, perhaps, maintenance
bonds ð or that the contractor will pay the owner the difference between
the amount of the contractor's accepted bid and the bid of another
contractor who has to be called in to complete the project.
Binder - An insurer's agreement, by way of an agent, to provide
nonlife insurance on the spot, pending issuance of the policy
contract.
Binding authority - The authority extended to an agent by an
insurer to provide insurance, usually on a temporary basis, until a policy
can be written.
Blanket bond - An employee dishonesty or fidelity bond covering
all persons of a group or class; as opposed to bonds naming specific
individuals (name schedule) or positions (position schedule).
Blanket coverage - A means of insuring various items of property
under one limit of liability.
Blanket insurance - Insurance covering multiple items of
property as a group. Covered property may be at one location or
several.
Block policy - A block policy provides a form of inland marine
insurance. It covers loss to the property of a merchant, wholesaler, or
manufacturer including: property of others in the insured's care, custody,
or control; property on consignment; property sold but not delivered. A
block policy covers loss caused by most perils (including transportation),
subject to certain limitations as specified in the policy exclusions.
Common block policies are jeweler's block and furrier's block
policies.
Bobtailing - A trucking term that means the driving of the
tractor portion of a semi after the trailer has been delivered and
removed. A special trucking endorsement, Truckers Insurance for
Non-Trucking Use, may be necessary when bobtailing.
Bodily injury - A term that refers to physical injury, sickness,
or disease, or death resulting therefrom. In some jurisdictions ``bodily
injury'' includes emotional injury.
Bodily injury liability - Legal obligation that flows from the
injury or death of another person. This insurance is commonly limited to
bodily injury liability derived by way of negligence, but coverage of
liability by way of contract (holding another harmless) is also
possible.
Boiler & machinery insurance - Fired vessels, steam
generators, mechanical and or electrical objects and turbines, are all
examples of ``objects'' that might be listed for coverage under a boiler
and machinery policy. Coverage is for damage to covered property caused by
an accident to an object identified in the policy's schedule. Coverage
includes extra expense, automatic 90-day coverage at new locations,
defense against liability claims, and supplementary payments like those
provided under public liability policies.
Bond - A document for expressing surety. A bond engages three
entities; the ``surety'' (bonding company) sells the bond to the
``principal'' for the purpose of paying the amount the principal will owe
to the ``obligee'' upon failure of the ``principal'' to perform some act
or provide some service under agreed terms.
Bond, fidelity - A bond that guarantees the principal's
honesty.
Bond, surety - A surety bond is the financial assumption of
responsibility by one or more persons for fulfilling another's
obligations.
Book of business - The accounts written by an agent or company.
It can be expressed in a number of ways such as ``total book'' of
business, ``book of auto business,'' ``homeowners business,'' etc.
BOP (Businessowners policy), see Businessowners policy.
Bordereau - A written schedule of insureds, premiums, and losses
submitted to reinsurers under certain types of reinsurance agreements.
Boycott - Another practice defined as ``unfair'' under most
states' codes. Such a practice which occurs when someone in the insurance
business refuses to do business with someone else until that person
complies with certain conditions or concessions.
Broad form perils - A property insurance designation for
coverage that extends beyond the basic named perils.
Broad form property damage endorsement - A commercial general
liability endorsement that removes the care, custody, or control exclusion
relating to the property of others and replaces it with a less stringent
one.
Broker - One who represents the insured in arranging insurance.
A broker may also serve as the agent of an insurance company. Typically, a
broker does not have binding authority.
Builders risk insurance - A variation of property coverage
specifically applicable to construction projects. It is commonly written
in an amount to cover the value of the structure when completed. The
premium charged takes into account that values at risk increase gradually
over the term of the policy.
Bumbershoot - A form of coverage similar to an umbrella, having
to do with ocean marine risks.
Business Auto Policy (BAP) - A standardized contract for writing
liability and property coverage on commercial autos.
Business income coverage - Insurance protecting the income
derived from an insured's business activities when curtailed by a covered
peril. Coverage includes reasonable extra expense the insured undertakes
to expedite return to business operations.
Business income, dependent properties - Covering loss to an
insured when the operations of a key supplier, customer, or leader
property on which the insured's operations are dependent, are shut down by
a covered peril. Also referred to as contingent business income.
Business personal property - A term relating to ``contents'' of
a commercial enterprise. It may include furniture, fixtures, machinery and
equipment as well as stock, all other chattels owned by the insured, and
even use interest in building improvements and betterments.
Businessowners policy (BOP) - A package of property and
liability insurance for small and medium size businesses, the BOP owes its
origin to the success of the homeowners policy.
Buy-back deductible - A deductible that may be eliminated for an
additional premium in order to provide first-dollar coverage.
C
Calendar year experience - Underwriting result based on earned
premiums and booked incurred losses for the same calendar year reporting
period, regardless of the dates of the loss events. Booked incurred losses
include paid losses, beginning of year to end of year changes in case
reserves, and IBNR.
Cancellation: flat, pro rata, or short rate - In a flat
cancellation the full premium is returned to the insured. A pro rata
cancellation means the insurer has charged for the time the coverage was
in force. Short rate cancellation entails a penalty in excess of pro rata
for early termination.
Capacity - An insurer's (or reinsurer's) top limit on the amount
of coverage it has available. The term may also refer to the total
available in the respective insurance or reinsurance market.
Captive agent - A representative of a single insurer. In the
case of captive agents, the insurer owns and controls expiration dates and
policy records. A captive agent is a member of what may be called an
exclusive agency system.
Captive insurer - An enterprise with all the authority to
perform as an insurance company, but is organized by a parent company for
the express purpose of providing the parent company's insurance.
Care, custody, or control - An expression common to liability
insurance contracts. It refers to an exclusion in the policy eliminating
coverage for damage to property of others that is in the insured's ``care,
custody, or control.'' The insured has a bailee relationship to the
property, in other words, making the insured liable for the care of the
property beyond damage caused by negligence. A bailee's floater is often
used to cover the insured's obligation for the care of such property.
Cargo insurance - An inland marine or ocean marine policy
covering cargo in the care, custody, or control of the carrier.
Cash flow underwriting - Name given to an insurer's practice of
writing business in order to generate greater amounts of cash for
investment purposes with little regard for quality of the business.
Casualty insurance - The type of insurance concerned with legal
liability for losses caused by bodily injury to others or physical damage
to property of others.
Catastrophe (excess) cover - Another term for catastrophe
reinsurance, wherein the ceding company is indemnified by the reinsurer
after a specified loss amount is reached, for losses caused by
catastrophes.
Causes of loss forms - The reference is commonly to property
insurance contracts and the form in question details those perils to which
the coverage will respond. Though any property insurance contract must
name the perils it intends to cover, e.g., crop hail, earthquake, perils
of transit, and so on, the most commonly used general forms are the basic
and broad named perils forms and the special form. In contrast to the
named perils forms, that list specific perils for coverage, the special
form contract covers simply risk of direct physical loss, relying on
exclusions to delimit and define the coverage.
Cede - The transfer of all or part of a risk written by an
insurer to a reinsurer.
Cedant - A ceding insurer or reinsurer. Ceding means to
contractually transfer an portion of a risk or risks to a reinsurer.
Ceding commission - The cedant's acquisition costs and overhead
expenses, taxes, licenses and fees, plus a fee representing a share of
expected profits, which often is expressed as a percentage of the gross
reinsurance premium.
CERCLA, see Superfund.
Certificate of insurance - A written description of insurance in
effect as of the date and time of the certificate. The certificate does
not ordinarily confer any rights on the holder, i.e., the issuing insurer
does not promise to inform the holder of change in or cancellation of
coverage.
CGL (Commercial General Liability) see Commercial general
liability.
CIC - Certified Insurance Counselor.
CLU - A designation—Chartered Life Underwriter—conferred upon
individuals who have successfully completed a series of studies of life
insurance and related disciplines designed by the American College. CPCU -
A designation ð Chartered Property Casualty Underwriter ð conferred upon
successful completion of a series of 10 exams on insurance and related
disciplines designed by the American Institute of Chartered Property
Casualty Underwriters.
Civil commotion - One of the extended coverage perils, paired
with the peril ``riot,'' which refers to a less widespread or generalized
event than ``riot'' might be thought to encompass.
Claim Expense - The expense of adjusting a claim, such as
investigation and attorneys' fees. It does not include the cost of the
claim itself.
Claims-made coverage - A type of public liability insurance that
responds only to claims for injury or damage that are brought (to the
insurer) during the policy period (or during a designated extended
reporting period beyond expiration). This development was in response to
``long tail'' claims, such as those related to asbestosis injury, carrying
over many years and multiple layers of coverage limits. However, most
public liability policies are written on an ``occurrence'' basis, covering
injury or damage occurring during the policy period even if a claim is
brought months or even years later.
Clash cover - A type of catastrophe reinsurance for casualty
insurance. The retention is equal to the highest limit of any one
insurance policy covered by the agreement. Clash cover is written to cover
all losses from one source, such as a construction site.
Class rates - When property or people share a certain number of
characteristics relevant to the cost of providing them with insurance
(such as a male driver under the age of 25 without an accident)
underwriters can develop insurance rates that reflect the exposures
represented by the class and offer insurance based on a class rate rather
than by computing individual rates for each member.
Clause - A provision or condition affecting the terms of a
contract. Coinsurance, cancellation, and subrogation clauses are typical
insurance contract clauses.
Clean-up costs - Generally, those costs associated with the
clean-up of pollution.
Close or closely held corporation - A corporation that is owned
by a small number of individuals who are related. A close corporation
fills its own vacancies.
Coercion - Another act defined by most states as an ``unfair
trade practice.'' This one occurs when someone in the insurance business
uses physical or mental force to persuade another to transact
insurance.
Coinsurance clause - Coinsurance refers to the bargain between
commercial property owners and the insurance industry. This clause in
property policies encourages the property owner to gauge coverage needs by
possible, not probable, maximum loss. With $1 million at risk but a
probable maximum loss of $100,000, for example, the property owner would
probably buy $100,000 insurance and bank on avoiding the larger disaster.
The bargain offered by the insurance industry is a reduced rate per $100
of coverage if the owner agrees to buy coverage at a specified relation
(80% commonly) to value (to possible maximum loss in other words). If the
insured accepts the bargain but events prove the amount of insurance is
inadequate to the stated coinsurance percentage, the insured becomes a
coinsurer in the same ratio as the amount of insurance bears to the amount
that should have been carried.
Collapse - A property insurance peril, subject to its own
specific agreement in property policies, which otherwise insure on an open
perils basis.
Collision damage waiver - When paired with an auto rental
agreement, the rental car company agrees to waive the renter's
responsibility for any physical damage to the rental car in exchange for
an additional payment. Sometimes called a loss damage waiver.
Collision insurance - A type of physical damage insurance
available for automobiles. Coverage is triggered when damage is caused by
striking against another object.
Combined ratio - The sum of an insurance company's loss ratio
and expense ratio; used as an indicator of profitability for insurance
companies.
Combined Single Limit (CSL) - Liability policies commonly offer
separate limits that apply to bodily injury claims and to claims for
property damage. ``50/100/25'' is shorthand under such a policy for
$50,000 per person/$100,000 per accident for bodily injury claims and
$25,000 for property damage. A combined single limits policy might cover
for $100,000 per covered occurrence whether bodily injury or property
damage, one person or many.
Commercial blanket bond - A bond that covers the named insured
against employee dishonesty. A single coverage amount applies to any one
loss, regardless of the number of employees involved.
Commercial General Liability (CGL) - The CGL policy is an ISO
form, widely used to provide commercial enterprises with premises and
operations liability coverage, products and completed operations insurance
and personal injury coverage. Premises medical payments coverage is often
included as well.
Commercial lines - A distinction marking property and liability
coverage written for business or entrepreneurial interests as opposed to
personal lines.
Commissioner of Insurance - The official in a state (or
territory) responsible for administering insurance regulation; sometimes
called the Superintendent or Director of Insurance.
Common area - The part of a building or premises either owned by
or used by all tenants or tenant-owners of the building (e.g. the swimming
pool at a condominium).
Comparative negligence - A variation of contributory negligence,
in which the comparative degree of negligence for each party to an
accident is taken into account when awarding damages.
Compensatory damages - The award, usually monetary, that is
intended to compensate the claimant for injury sustained.
Completed operations insurance, see Products and completed
operations.
Completion bond - A bond that guarantees a lending institution
or other mortgagee that a building or other construction that they have
lent money on will be completed on time so it can used as collateral on
the loan.
Comprehensive personal liability insurance - Provides
individuals and family members with protection from legal liability for
most accidents caused by them in their personal lives. Note that any legal
liability claims submitted while in the course of business activities are
not covered.
Comprehensive physical damage (automobile) - Traditional name
for physical damage coverage for losses by fire, theft, vandalism, falling
objects, and various other perils. On Personal Auto Policies, this is now
called ``other than collision'' coverage. On commercial forms, it
continues to be called ``comprehensive'' coverage.
Concurrent causation - When two perils contribute concurrently
to a property loss, one excluded and the other not, the effect of the
exclusion tends to be voided in a policy covering on an open perils basis.
A concurrent causation exclusion is found in current forms.
Condition - One of the obligations of either the insured or the
insurer imposed in the insurance contract.
Condominium - Type of dwelling where the structure is owned
jointly while spaces within the structure are owned individually. Special
property and liability forms cover the interests of the condominium
association and of unit-owners.
Condominium association coverage - A policy that provides
coverage for the building, elements of the building, and liability needs
for those who collectively own a piece of property.
Condominium unit owners form - A policy that provides coverage
for the personal property, owned elements of a unit, and liability for the
individual unit owner.
Consequential loss - An indirect consequence of direct loss to
property. Business income may be lost when a store burns down, or frozen
goods may spoil when windstorm causes an interruption of power.
Consequential or indirect loss is not generally insured by policies
covering direct damage (i.e., by fire or wind as in these examples), but
insurance is readily obtainable separately for most such consequential
exposures ð business income coverage being among the most common.
Construction bond - A bond that guarantees the owner of a
building under construction that it will be completed. If the contractor
cannot finish the work, the insurer is obligated to see that the work is
performed.
Constructive total loss - This condition is said to exist when
the cost of repairs exceeds the actual cash value of damaged property.
Contingent business income, see Business income, dependent
properties.
Contingent liability - Liability imposed on a business entity
(individual, partnership, or corporation) for acts of a third party for
which the business entity is responsible.
Contract of adhesion, see Adhesion contract.
Contractors equipment floater - Coverage designed for the
special needs of contractors to insure their machinery and other
equipment.
Contractual liability - Liability that does not arise by way of
negligence but by assumption under contract. For example, in certain
leases, a tenant may assume a landlord's liability to others for unsafe
conditions on the premises. Some such assumptions are covered
automatically under the Commercial General Liability form.
Contributory negligence - A defense to a negligence action in
which it is asserted that the claimant failed to meet the standard
required for his or her own protection, and that that failure contributed
to the loss.
Controlled business - The amount of insurance countersigned,
issued, or sold by a producer covering that producer's interests,
immediate family, or employees. Many states limit the amount of controlled
business that may be written by placing a maximum percentage of all
business that may be controlled.
Convention (or statement) blank - The uniform annual financial
statement that must be filed by all insurers, as prescribed by the
National Association of Insurance Commissioners. The convention blank must
be filed annually in an insurer's home state and every state in which it
is licensed to do business.
Corporation - A business whose articles of incorporation have
been approved in some state. For insurance purposes, the type of business
structure helps to determine who is insured on the policy.
Countersignature - An authorized signature of agent or company
representative on an insurance policy. Usually pertains to policies sold
by an agent of the insurer located in another state.
Court bonds, see Judicial bonds.
Coverage trigger - In liability insurance, the ``trigger'' is
the event that brings coverage into play. It may be either an occurrence
of bodily injury or property damage; or, in a form with a claims-made
trigger, the formal making of a claim.
Covered loss - An accident, including accidental damage by
forces of nature, that brings a contract of insurance into play.
Credit card forgery - A criminal act involving the illegitimate
use of credit cards to obtain goods or money. Limited coverage for such
losses is automatically provided in most homeowners policies.
Crime insurance - A broad category covering loss of property
through criminal activity—from employee dishonesty to burglary and
robbery, computer fraud, and forgery. Crop insurance - Insurance covering
growing crops against hail, wind, and fire. Protection against a broader
range of perils can often be arranged as well.
Cross liability coverage - In the event of claim by one insured
for which another insured covered by the same policy may be held liable,
this endorsement covers the insured against whom the claim is made in the
same manner as if separate policies had been issued. However, it does not
operate to increase the insurance company's overall limit of
liability.
D
Daily - The document ð now more commonly found in electronic
than in paper form ð that provides insurer and agent with a quick
reference to all pertinent information relative to a contract of
insurance: insured's identification, location, coverage, term, premium,
and so on. Sometimes referred to as a daily report.
Data processing insurance - Coverage for electronic media,
computers, and other electronic data processing equipment.
Deadheading - A trucking term that means the driving of a
tractor-trailer that is empty, usually on the return trip from delivering
goods. A special trucking endorsement, Truckers Insurance for Non-Trucking
Use, may be necessary when deadheading.
Debris removal clause - A consequential coverage commonly
included in direct loss policies. For example, fire policies provide
limited recovery for the insured's cost of removing the debris after a
covered fire. Not to be confused with removal.
Declarations page - That part of a property or liability
insurance policy that discloses information pertinent to the coverage
promised including names, addresses, limits, locations, term, premium,
forms, and so on. The same information, perhaps in a shorthand version, is
contained as well in the daily.
Deductible - The part of the loss that is to be borne by the
insured.
Demolition insurance - When a building is damaged beyond a
certain point, say 50% destroyed, local building codes may direct that the
structure be razed. Insurance to cover this exposure (and the lost value
of the undamaged but newly razed part) can and clearly should be arranged
whenever it exists. Increased cost of construction coverage to meet
current building codes should be provided as well.
Dependent properties, see Business income, dependent
properties.
Deposit premium - When the price of insurance is tied to
fluctuating values or costs that cannot be known until the end of the
policy period, inventory or payroll are two common examples, a deposit or
provisional premium or estimated premium may be charged at the outset of a
policy with final adjustment to come at the end of the term.
Depositor's forgery insurance - Coverage against loss due to
forged checks, notes, etc. Limited coverage is automatically included in
homeowners contracts. Commercial establishments can purchase crime
coverage with this feature.
Depreciation - As property ages and becomes worn it often loses
value. That loss of value must be taken into account in any adjustment of
property insurance that covers loss of actual cash value.
Difference In Conditions (DIC) - Property insurance obtained
through the excess and surplus lines market to supplement and expand on
the property coverage available through admitted markets. DIC has been
called the property umbrella policy.
Direct damage - Physical damage caused to property by a peril
such as fire or lightning.
Direct loss - The immediate consequence of the action of an
insured peril. For example, a fire-damaged structure is a direct loss
because it is damaged directly by fire. In contrast, see Consequential
loss.
Direct premiums - Premiums collected from policyholders before
premiums for reinsurance are paid.
Direct writer - An insurer that sells coverage directly via its
own employees. Contrast with Independent agent.
Directors and officers liability insurance - A form of errors
and omissions insurance covering the directors and officers of
corporations against suits alleging they committed wrongful act(s).
Discovery period - The period of time, commonly one year, after
the termination of a surety bond during which covered loss may be
discovered, reported, and covered.
Dishonesty, Disappearance, and Destruction (3-D) policy - The
name once applied to a form used for comprehensive crime coverage. Now
known as ISO Form C.
Dram shop laws - State laws pertaining to selling and serving
alcoholic beverages and the public liability these activities may entail.
Also called alcoholic beverage control (ABC) laws.
Dram shop liability insurance, see Liquor liability
insurance.
Drive Other Car (DOC) endorsement - A business auto or garage
policy endorsement providing coverage for named individuals while driving
nonowned autos in situations unrelated to the business of the insured.
Druggists liability insurance - A form of professional liability
insurance for druggists.
Duty to defend - Part of the insuring agreement of many
policies. The insurer has the duty to defend the insured in event of a
covered loss.
Dwelling forms - Forms for coverage of dwellings and personal
property that are not eligible for homeowners coverage. Tenant occupied
rental properties are commonly insured under these forms.
E
e-business - The transaction of business by way of electronic
media, such as telephones, fax machines, computers, and
video-teleconferencing equipment. This generally is broader than
e-commerce although some may view e-business and e-commerce as
interchangeable terms.
e-commerce - The buying and selling of goods by way of
electronic media, such as telephones, fax machines, computers, and
video-teleconferencing equipment.
Earned premium - Portion of a premium for which the insurer has
already provided protection.
Earnings insurance - A simplified form of insurance covering
business income loss, limited to a set percentage of the policy's total
amount for recovery of proved loss for each 30-day period.
Earth movement - Subject to an exclusion in property policies,
this peril includes earthquake, landslide, mudflow, etc.
Effective date - The date shown in the declarations of a policy
upon which coverage is to take effect.
Employee benefits plan liability - Coverage protects the insured
employer against claims by employees or former employees resulting from
negligent acts or omissions in the administration of the insured's
employee benefits programs.
Employee dishonesty coverage - Insurance protecting employers
from loss due to theft by their employees.
Employers liability insurance - A feature of standard workers
compensation policies, this coverage applies to liability that may be
imposed on an employer outside the provisions of a workers compensation
law.
Employers nonownership liability - Employers who buy commercial
auto coverage on a basis other than ``any auto'' have this exposure
whenever an employee uses his or her own auto on the employer's
behalf.
Employment practices liability insurance - Coverage against
allegations of illegal or discriminatory hiring and firing practices,
sexual harassment of employees, and so on.
Endorsement - An amendment to a policy form.
Enterprise-wide risk management - An effort to categorize,
measure, and treat all types of risk that may adversely affect a business.
It includes both traditional hazard risks and other business risks, such
as risks posed by competitors, by economic developments, and natural
conditions the business cannot control, and by general operations.
Environmental Impairment Liability Insurance, see Pollution
liability insurance.
Equipment floater, see Floater.
ERISA - An acronym standing for the 1974 Employee Retirement
Income Security Act which regulates certain employee benefit plans.
Errors and omissions coverage - A type of professional liability
insurance, protecting the insured against claims alleging bodily injury or
property damage caused by the professional or technical incompetence of
the insured.
Estimated premium, see Deposit premium.
Estoppel - The legal doctrine that a party may be precluded from
denying that certain rights exist if, by behavior or implication that such
rights did, in fact, exist, another party has acted upon this information
to his or her detriment.
Ex gratia payment - A payment by an insurer to an insured for
which there is no contractual liability. Such payments are sometimes made
as a goodwill gesture if there is the possibility of a misunderstanding or
a mistake.
Examination under oath - Found in the conditions section of many
insurance policies, the insurer's right to examine an insured under oath
following a loss.
Excess insurance - Coverage that applies on top of underlying
insurance that is primary, i.e., that pays until its coverage limit is
exhausted at which point the excess coverage takes over.
Excess or surplus lines market - The range of insurance
available through nonadmitted insurers, i.e., insurance companies that are
not licensed in a particular state or territory. Specific provisions of
state or territorial law control placements.
Exclusive agency system, see Captive agent.
Expense ratio - The dollar amount that represents acquisition
and service costs, expressed as a percentage of written premium.
Experience - A record of losses.
Experience modification - The raising or lowering of premiums
under terms of an experience rating plan.
Experience rating - A method of rating that uses past experience
to establish current rates.
Explosion - An extended coverage peril and currently a covered
peril in nearly every policy of property insurance. The peril remains
distinct from steam boiler explosion, which is covered by boiler &
machinery insurance.
Express authority - Authority that is distinctly, plainly
expressed, orally or in writing. The express authority of an insurance
agent is given to the agent bye the insurer in the contract they each
sign. See actual authority and implied authority.
Extended coverage - An early and indivisible ``package'' of
property insurance perils said to have been devised to make possible the
spread of windstorm insurance beyond the highly exposed coastal and plains
states. For those whose exposure to windstorm was less, ``extended
coverage'' also encompassed smoke damage, hail, riot and civil commotion,
aircraft and vehicle damage, and explosion insurance. Included here for
historic purposes only since the term, extended coverage, is no longer in
general use.
Extended nonowner liability - A personal auto policy endorsement
that provides broader liability coverage for specifically named
individuals. When attached it covers: (1) nonowned autos furnished for the
regular use of an insured; (2) use of vehicles to carry persons or
property for a fee; and (3) broader coverage for business use of
vehicles.
Extended period of indemnity - A time for recovery of proved
business income loss after physical property is restored and business
reopened. The 30-day extension included in many business income forms may
be extended by endorsement.
Extended recovery period, see Extended period of indemnity.
Extended reporting period, see Claims-made coverage.
Extra expense insurance - Depending on an insured's
requirements, this coverage may be purchased as a supplement to business
income insurance, applying to expediting expenses that aid in quickly
restoring the insured's operations after a covered loss; or it can be the
primary coverage sustaining the extra cost of continuing doing business
for those insureds who would find it extremely damaging to fail to meet
customer commitments, e.g., newspapers, dairies, etc.
F
Factory mutual - A mutual insurance company insuring only
properties that meet high underwriting standards. The typical risk is
fire-resistive construction with a central station alarm.
Facultative reinsurance - A separate reinsurance agreement that
is negotiated for a particular risk or insurance policy.
Fair Credit Reporting Act - Public Law 91-508 requires that an
insurer tell an applicant if a consumer report may be requested. The
applicant must also be told the scope of the possible investigation.
Should the application be declined because of information contained in
that report, the applicant must be given the name and address of the
reporting agency. The insurer may not reveal the contents of the report.
Only the agency that compiled the report may release its contents.
FAIR plan - An acronym for Fair Access to Insurance
Requirements, these plans have been established in many states to make
fire and extended coverage (and homeowners in some states) available in
areas otherwise not addressed by the voluntary market.
Fair rental value - An amount payable to an insured homeowner
for loss of rental income due to damage that makes the premises
uninhabitable.
Farmowners-ranchowners policy - A homeowners-type package policy
adapted to include farm and ranch exposures.
FEMA - Federal Emergency Management Agency. This agency
administers the National Flood Insurance Program.
Fidelity bond, see Employee dishonesty coverage.
Fiduciary - A generic term for persons or legal entities such as
executors, trustees, and guardians appointed by the court, under a will,
or by a trust to manage, control, or dispose of the property of
others.
Fiduciary bonds, see Judicial bonds.
Fiduciary liability insurance - This insurance covers claims
arising from: (1) a breach of the responsibilities or duties imposed on a
benefit plan administrator; or (2) a negligent act, error, or omission of
the administrator.
File and use rating laws - State laws that permit the use of new
rates by an insurance company without first obtaining the approval of that
state's insurance department.
Financial responsibility clause - The clause in a auto policy
stating that, when the policy is certified as future proof of financial
responsibility, then the policy will comply with the financial
responsibility laws to the extent required.
Financial responsibility law - When applied to automobile
operations, this term signifies the minimum statutory limits of an
operator's responsibility for bodily injury and property damage caused by
negligent operation of the vehicle.
Fine arts floater, see Floater.
Fire - Combustion evidenced by a flame or glow. Insurance
distinguishes between a hostile fire (one out of bounds) and friendly fire
(such as that contained within the firebox of a stove).
Fire department service charge - A fee that may be imposed by a
fire department for responding to a call. Most fire coverage agreements
include indemnification provisions for such eventualities.
Fire legal liability - Public liability policies routinely
exclude coverage for damage to property in an insured's care, custody, or
control. This leaves a big gap in a tenant's coverage, a gap partially
filled by an exception in the commercial general liability policy that
restores limited coverage for fire damage to the landlord's building.
Perhaps the best benefit of the exception is to call attention to the
exposure so arrangements can be made for broader coverage at appropriate
limits.
Fire mark - An insignia, attached to the outside of a house that
represented the insurer of the house.
First named insured - An insurance policy may have more than one
party named as insured. In such cases, the first named insured attends to
policy housekeeping, i.e., pays premiums, initiates (or receive notice of)
cancellation, or calls for interim changes in the contract. This is
spelled out in commercial policies in the common policy conditions.
Fixtures - Generally, something tangible that is fixed or
attached, as to a building, so that it becomes an appendage or structural
part.
Flat cancellation, see Cancellation.
Fleet policy - Written for a risk that has 5 or more
vehicles.
Flesch test - A method to determine the degree of ease or
difficulty for reading material. It counts not only the number of words in
a sentence, but also the number of syllables in each word. Some states
require that insurance contracts be written so that they have a certain
readability level (often, 8th grade).
Floater - An inland marine form covering movable property
wherever located within territorial limits.
Flood - A general and temporary condition of partial or complete
inundation of dry land caused by the overflow of the natural boundaries of
a body of water or the unusual and rapid accumulation of surface water
runoff. Some insurance policies that include flood as a covered peril only
insure against damage caused by overflow of the natural boundaries of a
body of water, but other policies also may insure against surface water
losses.
Flood insurance - Flood insurance, like earthquake coverage, is
usually only of interest to those relatively few whose property is
exposed. Consequently, losses among this small group will be high and
premiums can be prohibitive. However, in 1968 the federal government
stepped in to help property owners in designated flood plains with the
National Flood Insurance Act of 1968. Coverage is not only available, but
may even be required to obtain financing for exposed properties.
Flood Insurance Rate Map (FIRM) - Provided by FEMA (Federal
Emergency Management Agency), this map delineates base flood elevations
and flood risk zones, and is used for rating purposes for flood
insurance.
Forgery or alteration coverage - This type of insurance covers
loss sustained through forgery or alteration of outgoing negotiable
instruments made or drawn by the insured; drawn on the insured's
account(s); or made or drawn by someone acting as the insured's agent.
This includes loss caused by any of the following: (1) Checks or drafts
made or drawn in the insured's name, payable to a fictitious entity; (2)
Checks or drafts, including payroll checks, executed through forged
endorsements; and (3) Alteration of the amount of a check or draft.
Form - The central document or documents of an insurance
contract. Forms may be altered by endorsement.
Fraud - The intentional perversion of the truth in order to
mislead someone into parting with something of value.
Friendly fire, see Fire.
Fronting - The practice, in reinsurance, of the ceding company
retaining only a small portion of a risk and ceding the remainder to a
reinsurer.
Functional replacement cost - The cost to repair or replace
damaged property with materials that are functionally the equivalent of
the damaged or destroyed property. For example: replacing a solid mahogany
banister with a pine banister.
Fur floater, see Floater.
Furriers customers insurance, see Bailees floater.
G
Gap coverage - Insurance for a lessee designed to cover the
difference in selling price between a vehicle's actual cash value, and the
payout left on a lease.
Garage policy - One of the early package policies, it is written
for automobile dealers and may include liability insurance for garage
operations, automobile operations, physical damage coverage on garage
owned autos, bailees coverage on customers cars, and auto and premises
medical payments coverage.
Garagekeepers liability - A bailee coverage applying to
automobiles. Commonly included in garage policies, it may be written to
provide coverage for limited perils or for comprehensive physical damage,
with or without collision damage coverage. Coverage may be expressed as
covering the legal liability of the garagekeeper or amended to cover on a
direct basis, as primary insurance or excess.
General liability insurance, see Commercial general
liability.
General partners' liability coverage - A general partner's
management and fiduciary responsibilities to a limited partnership closely
parallel the director's or officer's to a corporation. Exposure occurs
when general partners become the financial managers of a limited
partnership. The directors and officers of corporate general partners
share this type of exposure.
Glass insurance - Commercial property form that covers plate
glass, glass signs, lettering, etc.
Gross earnings coverage - An outdated term for business income
coverage.
Guarantee funds - State mandated funds collected from licensed
insurers and maintained as backup protection for policyholders of bankrupt
insurers.
Guiding principles - Suggested procedures for establishing
primacy of coverage in situations involving loss under a variety of
coverage forms and, perhaps, more than one interested party. Last
promulgated in the 1960s, the spirit of the principles survives because
insurers apparently find that the prescribed procedures commonly lead to
equitable settlements for all parties.
H
Hangarkeepers legal liability - A bailee coverage for those
charged with the care of aircraft owned by their customers.
Hard market - A condition of the insurance marketplace in which
insurance is difficult to obtain, and relatively expensive.
Hazard - Generally, a condition that increases the possibility
of loss.
Hazardous waste - Term generally used to refer to pollutants or
contaminants which result from industrial processing and must be
disposed.
Highly Protected Risk (HPR)- A building meeting certain
standards of fire protection, which is therefore eligible for a reduced
rate.
Hired auto - A nonowned auto that may be borrowed as well as
rented or leased by the insured. Personal auto policy insureds are covered
automatically for hired autos, but business auto policy insureds may not
be.
Hold harmless agreement - A contractual assumption by one party
of the liability exposure of another. Lease agreements, for example,
commonly require the tenant to hold the landlord harmless for bodily
injury or property damage experienced by others on the premises.
Hole-in-one insurance - Coverage designed for amateur golf
tournaments in which there is a substantial cash prize for anyone making a
hole-in-one.
Holistic risk management, see Enterprise-wide risk
management.
Homeowners insurance - An early and hugely successful example of
packaged property and liability insurance. A mid-twentieth century
insurance development was introduction of the so-called multiline era in
which insurers became empowered to write both property and liability forms
of insurance, making way for the first packaging of these coverages within
a single policy.
Host liquor liability - Part of the CGL, this covers the
incidental serving of alcohol by an insured who is not in the business of
serving alcohol.
Hostile fire, see Fire.
HPR, see Highly protected risk.
Housekeeping - A generalized term that refers to the overall
care, cleanliness, and maintenance of an insured's property.
Hull insurance - Ocean marine insurance covering physical damage
to the ship or vessel insured. Usually, written on an all-risks basis.
I
Impaired property - A liability exclusion relating to the
insured's faulty products or work that results in an impairment to the
property to which it is attached assuming the insured can salvage the
situation by replacing the property or redoing the work.
Implied authority - Authority granted to an agent, even though
not stated, that lets the agent perform tasks usual and necessary to
exercise the agent's express authority. See actual authority and express
authority.
Improvements and betterments - Anything that adds to the value
of property. Commonly used to describe a tenant's use interest in fixtures
added to the landlord's building. May also refer to permanent changes made
by a condominium unit-owner to his/her unit, such as the addition of new
kitchen cabinets.
Increased cost of construction - A damaged building may have to
be upgraded to be repaired under building codes in force at the time of
reconstruction. Building owners in such situations need guidance in buying
insurance to cover this added exposure.
Incurred losses - The value of claim payments plus reserves.
Indemnity - A fundamental concept governing insurance:
compensation for loss or injury sustained.
Independent adjuster - An individual or member of a firm who
contracts with insurers to investigate claims and suggest appropriate
settlements. Contrast with Public adjuster.
Independent agent - A retailer of insurance who, by contractual
arrangement with a number of insurance companies, sells and services
property and liability insurance. The independent agent ``owns'' the
policy information and expiration dates of his client's coverage and thus
controls renewals and their placement.
Independent Insurance Agents of America (IIAA) - An association
of insurance agents who are independent contractors, and represent one or
more insurers. Sometimes referred to as the Big I.
Indirect damage - Sometimes referred to as indirect loss, this
is loss resulting from a peril, but not directly caused by that peril. An
example is fire damaging a freezer (direct damage), with resultant food
spoilage (indirect damage).
Inflation guard endorsement - An endorsement attached to an
insurance policy whereby the limits of liability on a piece of property
are increased on a regular basis by a certain percentage in order to
offset increasing building costs associated with inflation.
Inherent vice - A flaw in an item of property that will, in
time, reveal itself and show the property as damaged. Property insurance
does not normally cover such damage.
Inland marine insurance - Property insurance signaling broad
coverage of properties exposed to the transportation peril and those
subject to being used or kept at a location other than the insured's
customary premises. Eligible property is identified in the Nationwide
Definition of Marine Insurance.
Innkeepers legal liability - A bailee coverage purchased
by innkeepers to cover the property of their guests.
Insolvency fund, see Guarantee funds.
Inspection Report - A report prepared for an
insurer by an outside organization. It provides information about an
applicant's or insured's physical, financial, and moral attributes.
Insurable interest - The potential for financial loss associated
with damage or destruction of property.
Insurable risk - The exposure to significant, measurable
accidental loss from identifiable perils. The exposure, while not
catastrophic, must be shared by a sufficient number of potential insureds
so that the cost of loss for one can be measured and affordably shared
throughout the market.
Insurance - A mechanism whereby risk of financial loss is
transferred from an individual, company, organization, or other entity to
an insurance company.
Insurance contract - A legal document defining circumstances
under which the insurer will pay, and the amount to be paid. Also see
Insurance policy.
Insurance exchange, see Reciprocal exchange.
Insurance Institute for Highway Safety - A not-for-profit
research organization, well-known for its auto crash tests.
Insurance policy - The document containing the contract between
the insured and the insurer which defines the rights and duties of the
contracting parties.
Insurance Services Office (ISO) - An organization providing
statistical information, actuarial analyses, policy language, and related
services for the insurance industry.
Insurance to value - The concept of purchasing an amount of
insurance that closely approximates the value of the property being
insured.
Insured - The party or parties whose interests are covered in a
nonlife insurance contract. The less common term Assured is sometimes used
synonymously.
Insuring agreement - In an insurance contract, the insurer's
promise to pay.
Integrated risk financing - A type of risk financing designed to
provide integrated protection against catastrophic losses. It may
incorporate both traditional and nontraditional types of exposures, or it
may include only traditional property and casualty risks.
Interline endorsements - Commercial endorsements that apply, or
could apply, to more than one coverage part of a package policy.
J
Jacket - The cover of an insurance policy; it usually contains
the name of the insurer, its address, etc.
Jettison - Act of throwing overboard part of a vessel's cargo or
hull in hopes of saving a ship from sinking.
Jewelers block insurance - A policy especially designed for
jewelers, it offers a combination of coverages protecting against risks of
physical loss to property at the jeweler's premises, property in transit,
or customers' property in the insured's care.
Jewelry floater, see Floater.
Joint and several liability - A legal doctrine whereby a
creditor or claimant may demand payment or sue one or more of the parties
separately, or all of them together.
Joint Underwriting Association (JUA) - These are insurance pools
representing all insurers in a state. A few servicing
carriers act on behalf of all the insurers, issuing policies, receiving
fees, and handling claims. They are reimbursed for losses, and receive
fees from the JUA to cover operating costs.
Joint venture - A venture in which two businesses join together
to share risk or expertise on a specific project or group of projects.
Jones Act - The federal act through which maritime workers are
provided workers compensation coverage (which ordinarily responds to the
mandates of particular states).
Judicial bonds - Two types of bonds available to guarantee
faithful performance of court appointed duties. Fiduciary bonds guarantee
the faithful performance of persons entrusted by the courts in the
management, conservation, and disposition of property. Litigation bonds
(or ``court bonds'') are required in court actions. Bail bonds and appeals
bonds are litigation bonds; the bond amount is forfeited if the bonded
person disappears or the appeal is lost.
Jumbo risk - A policy of insurance written with exceptionally
high limits.
K-L
Keeton-O'Connell, see No fault auto insurance.
Key employee insurance - Life insurance written on the life of
an organization's officer or other key employee, the loss of whom would
cause the organization financial hardship.
Kidnap-ransom insurance - A specialty coverage offered in the
surplus and excess lines markets that responds to ransom demands for
recovery of kidnap victims.
Lapse - Termination of a policy because of failure to pay the
premium.
Larceny - The unlawful taking of personal property of
another.
Latent defect - A hidden flaw that will, in time, cause property
damage that is uninsurable. Such damage is uninsurable because the element
of chance is no longer present.
Law of large numbers - An underlying principle of insurance: the
larger the number of participants in a given arrangement, the more
accurate the rate is to the exposure.
Leased worker - A worker leased from another organization on a
long-term basis.
Leasehold interest insurance - The insurable interest is that of
a tenant who has some years remaining under a favorable lease that is
subject to termination upon significant damage to the leased property.
Legal liability - Liability imposed by law; this includes
liability based on negligence, strict liability, or contractual
liability.
Libel - Written defamation of another's reputation.
Liberalization clause - A feature of property policies that
promises that any future change in the company's form that would broaden
coverage with no change in premium will automatically apply under the
policy currently in force.
License and permit bonds - Suretyship guaranteeing that the
principal will abide by the rules and obligations imposed by licensing
laws or ordinances. For example, an electrician may have to post such a
bond guaranteeing compliance with building codes before being licensed by
a municipality.
Limited partnership - A form of partnership that consists of one
or more general partners, who actively engage in the business, and one of
more special partners, who are not liable for the debts of the partnership
beyond their initial financial contribution. Commercial insurance policies
usually differentiate in the ``Who Is Insured'' section between
corporations, partnerships, and other business models. Therefore, the type
of model being insured is important.
Liquor liability insurance - Liability coverage for owners and
operators of establishments selling or serving alcoholic beverages.
Litigation bonds, see Judicial bonds.
Livery use - An exclusion in automobile liability policies
applying to the use of autos to carry persons for hire as in a taxi
service. A share-the-ride car pool is not livery use.
Livestock insurance - Life insurance on livestock covering death
by named perils.
Lloyd's of London - An association of individuals, called
``names,'' or groups of individuals who write insurance for their own
accounts. Lloyd's had its beginning in 17th century London in Edward
Lloyd's coffee house.
Loading and unloading exclusion - A feature of commercial
general liability (CGL) policies intended to separate that coverage from
the automobile exposure. The CGL coverage ends at the point where an item
is picked up for loading onto an auto and resumes at the point where the
item is deposited upon unloading.
Long tail - Refers to liability under policies written on an
occurrence basis. Claims stemming from injury or damage occurring years
earlier can be presented for coverage long after the policy has expired.
Contrast with Claims-made.
Longshore and Harbor Worker's Act - A federal law that specifies
compensation amounts for injured longshore and harbor workers. Formerly
referred to as the Longshoremen's and Harbor Workers Act.
Loss - An unintentional decline or disappearance in value
arising from an event.
Loss adjustment expenses - Payments by an insurer for the
investigation and settling of claims. They include the cost of defending a
lawsuit in court.
Loss assessment coverage - Insurance responding to property or
liability loss of a property owners association that are not covered by
the association's master policy.
Loss control - Actions to reduce the frequency or severity of
losses. Installing locks, burglar or fire alarms and sprinkler systems are
loss control techniques.
Loss costs - Loss data that has been modified by insurance
advisory organizations by necessary loss development, trending, and
credibility processes in order to arrive at the statistical cost of losses
to be used in establishing a premium rate.
Loss development - An actuarial method to detect and correct for
consistent errors in estimating the amount of future loss payments or the
procedure for adjusting incurred losses to reflect their future
development and ultimate value. Loss development factors are developed
actuarially and applied to current losses in order to predict what the
ultimate cost of losses will be when the claims are closed.
Loss expectancy - The underwriter's calculation of probable
maximum loss.
Loss experience - What the loss history has been on a particular
line or book of business.
Loss exposure - A set of circumstances presenting the
possibility of loss, whether or not the loss actually occurs.
Loss frequency - How often a loss occurs over a given space of
time.
Loss limit - Commonly used in financial institution bonds, a
loss limit is the aggregate amount that will be paid out under the
coverage during the policy term. Loss limits also may be used when
insuring large property risks where the exposures are spread out
geographically. In this type of situation, it is unlikely that all
property would be damaged by a single occurrence. Therefore, the amount of
insurance may be set at a loss limit per each covered occurrence.
Loss of use insurance - See Additional living expense
insurance.
Loss payable clause - A property policy provision that, at the
request of the named insured, stipulates that claims tied to losses of
certain property will be paid to both the named insured and the party
named in the subject clause.
Loss prevention - Refers to engineering or inspection activities
carried out to prevent losses in the workplace.
Loss ratio - The ratio of incurred losses including loss
adjustment expenses to earned premiums.
Loss payout pattern - Losses often are paid over a period of
years, especially in casualty lines of insurance. The payout pattern
illustrates the way that claims are paid out from the time they are filed
until they are closed.
Loss trending - A method to modify developed losses for changes
that will occur in the future. Trend factors are used by rate makers to
adjust past losses to more accurately reflect the ultimate value of the
losses being used.
Loss triangle - Used to show how losses develop, a loss triangle
is a chart that lists losses by line and by year. It shows the value of
each set of annual losses at the end of subsequent 12-month periods.
Lost policy release - A means whereby an insured may cancel a
policy by signing a statement to the effect that, since his or her policy
has been lost, he cannot return it to the insurer to effect cancellation,
but still wishes to cancel the policy.
M
MCS-90 - This is the Endorsement for Motor Carrier Policies of
Insurance for Public Liability under Sections 29 and 30 of the Motor
Carrier Act of 1980. The endorsement assures that the trucker is using
insurance to comply with the financial responsibility requirements of the
act.
Maintenance bond - Guarantees that faulty work or defective
materials charged to the bond principals will be corrected or replaced. A
maintenance bond may be included among the terms of a performance
bond.
Malicious mischief, see Vandalism.
Malpractice, see Professional liability.
Managing General Agent (MGA) - An agent standing between an
insurer and other agents. The MGA sells to retail agents, who then sell to
the consumer. MGAs often are said to have the pen because they are given
the authority to accept, underwrite, and price submissions received from
retail agents.
Manufacturers and Contractors liability (M&C) - The premises
and operations liability exposures of manufacturers and contractors
covering third parties for bodily injury or property damage negligently
inflicted in the course of daily activities.
Manufacturers Output Policy (MOP) - Policy originally designed
to cover property of a manufacturer being processed at another company; it
covers personal property away from the premises on an open perils
basis.
Manufacturers selling price clause - Clause stating that
finished goods are valued for insurance purposes at their selling price
rather than their cost of manufacture.
Manuscript policy - An insurance policy covering property or
liability exposures (or both) that is uniquely assembled from standard or
specially created forms to suit the needs of an insured.
Marine insurance - Insurance primarily concerned with
transportation exposures and property that is commonly moved around from
place to place. In America, the field is divided between Inland marine and
Ocean marine.
Maritime coverage - Crew members of vessels are subject to
Admiralty Law and may sue their employers for work-related injuries
because state workers compensation laws do not apply to them. Therefore,
special coverage must be purchased for this exposure.
Market value - The price at which insured property could have
been sold just prior to its loss or damage. Along with cost new minus use
deprecation, market value is but another gauge used to determine the loss
settlement to which an insured is entitled. The insured may choose the
gauge that produces the most favorable outcome.
Market value appraisal - An appraisal to determine the market
value of a building and related personal property.
McCarran-Ferguson Act - Passed by Congress in 1945, this act
states that regulation and taxation of insurance by the states is in the
public interest, and that congressional silence should not be construed as
a barrier to state regulation.
Medical malpractice - Type of insurance protecting physicians,
surgeons, nurses, and other medical practitioners against claims alleging
failure to perform.
Medical payments insurance - A coverage found in auto and
liability policies that pays medical expenses to injured persons without
regard to liability.
Merit rating - A form of auto rating in which an insured's past
experience as well as anticipated experience is taken into account when
arriving at a rate.
Minimum premium - An insurer's lowest charge for an insurance
policy.
Misrepresentation - Generally, misstatement of facts made on an
application for insurance. May also be misstatement of coverage made by an
agent to an insured.
Mobile equipment - Included for coverage under the commercial
general liability form, this term relates to land vehicles used in ways
that take them out of an explicit automobile liability exposure (e.g.,
vehicles used only on the insured premises, to carry certain permanently
attached equipment, that are not required to be registered, or are
designed for solely for off-road use).
Model bill - A bill drawn up for insurance regulatory purposes
by the National Association of Insurance Commissioners, with the
recommendation that it be implemented by the states.
Monoline policy - An insurance policy covering one subject of
insurance, as opposed to a combination or multiline policy.
Monopolistic state fund - Five states have their own system for
providing reparations to injured employees eligible under the state's
workers compensation act. Private insurance companies may not compete. The
states are North Dakota, Ohio, Washington, West Virginia, and Wyoming.
Moral hazard - As physical hazard relates to susceptibility to
fire or wind, the term moral hazard relates to susceptibility to loss
through moral lapse of the owner (e.g.,Burn the house down and collect
from the insurance company before losing it in a foreclosure to the
finance company.).
Morale hazard - The term morale hazard addresses the issue of an
apathetic insured (e.g., It's insured, let it burn.)
Mortgage holders clause - A standard property policy provision
that creates elements of a separate contract between a mortgage company
and an insurance company. Any loss to building or structures will be paid
to the mortgage company and insured jointly and any act of the insured
voiding coverage will not affect the mortgage holder without it first
being given an opportunity to comply with the insurer's needs.
Motor Carrier Act of 1980 - A federal law that deregulated the
United States trucking industry and transferred the enforcement of
financial responsibility requirements for truckers to the Bureau of Motor
Carrier Safety, U.S. Department of Transportation. Insurance is one method
of complying with the financial responsibility requirements.
Motor truck cargo policy - Two forms of inland marine coverage
are associated with this title, one for carriers and one for owners. As a
carrier, the insured is protected for legal liability relating to property
of others in the course of transport. As an owner, the insured is
protected for in-transit damage to its own property.
Motor vehicle record (MVR) - An official record of a driver's
accidents and traffic violations kept by the licensing state(s). Often
used to determine eligibility and/or premiums for auto insurance.
Multiline era - During the first half of the twentieth century,
insurers were licensed to write property insurance or liability insurance
but not both. Two insurers were needed to write automobile liability and
physical damage insurance, for example, in a contrivance called a
combination policy. Not long after World War II, states began licensing
insurers to write both forms of insurance introducing what was then called
the multiline era.
Mutual insurance company - A cooperative insurance company
organized and owned by its insureds.
Mysterious disappearance - A named peril in some forms. Either
theft or unexplained disappearance of covered property from a known
location may activate coverage.
N
Named insured - The party or parties specifically named as
insured in the insurance contract. Others may have claim on the coverage
of a policy by way of internal provisions, but any such right is by way of
the agreement between the named insured and the insurance company.
Named nonowner policy - Issued to someone who does not own an
automobile, but who drives borrowed or rented autos.
Named perils - A formal and specific listing of perils covered
in a policy providing property insurance. A policy covering for damage by
fire is said to cover for the named peril of fire.
National Association of Insurance Commissioners (NAIC) - An
association of insurance commissioners and superintendents formed to share
information and develop common laws and procedures for insurance
regulatory purposes.
National Association of Insurance Women (NAIW) - An
international professional insurance organization.
National Association of Professional Surplus Lines Offices (NAPSLO)
- Trade association of and providing services to surplus and excess
lines agents and brokers.
National Council on Compensation Insurance (NCCI) - National
association that collects, tabulates, and provides data used in
formulating rates for workers compensation insurance.
National Flood Insurance Program (NFIP) - A federal program
through which persons with property located in predefined flood plains can
obtain flood coverage. See Flood insurance.
Nationwide Definition of Marine Insurance - A document published
by the National Association of Insurance Commissioners that was rooted in
an older (1933) definition of ``...Insuring Powers of Marine and
Transportation Underwriters''. In general, the definition specifies
property that may be insured under marine contracts such as property in
inland transport and property regularly or routinely in transit, e.g.,
contractors equipment.
Negligence - Action or failure to act that is outside the realm
of what would be considered appropriate by ordinary, reasonably prudent
persons.
Net loss - The amount of a loss, after deductions for salvage,
other insurance, and any subrogation, that an insurer is responsible
for.
Net premium - Premium less expense, such as commission.
New York Standard Fire Policy - Once the benchmark of property
policies, it was adopted for use in all but a handful of states. The
familiar provisions of its 165-Numbered-Lines, e.g., cancellation,
mortgagee, appraisal clauses, etc., survive in Insurance Service Office
property policies as well as in independently produced forms.
No Benefit To Bailee - A clause in inland marine forms that
prevents a person in the possession of property of others from benefiting
from any insurance the owner has on the property.
No-Fault Auto Insurance - A few states have laws that partially
exempt drivers from legal liability for auto accidents. In these no fault
states car owners buy insurance to protect themselves and their passengers
from the economic and medical effects of auto accidents in addition to
liability insurance at whatever limit the statute decrees. Professors
Robert Keeton and Jeffrey O'Connell gave the no fault notion impetus with
the 1967 publication of their study After Cars Crash.
NOC - Underwriter's shorthand derived from general liability and
workers compensation rating tables that stands for not otherwise
classified meaning no more specific classification is available—as in
Clerical Office Employees NOC.
Nonadmitted insurers, see Excess or surplus lines market.
Nonowned auto - This term signifies an auto that is neither
owned, hired, nor borrowed by the insured under a commercial auto policy.
Employees' cars used in company business are commonly classified this way.
The employer's auto liability cover for use of nonowned autos is covered
by entry of symbol 1 (any auto) or symbol 9 (nonowned autos) on the
declarations page.
Nonresident agent - An agent who does not reside in the state in
which he or she is licensed.
Nose coverage - This is the opposite of Tail coverage, although
it fulfills the same need. Nose coverage most commonly provides prior acts
coverage for insureds who are moving from a claims-made coverage form to
an occurrence coverage form. It is provided by the replacement policy.
Notice of loss - Notice the insured provides to the insurer that
a loss has occurred.
Nuclear energy insurance pools - Any of the insurance pools
designed to provide property and/or liability coverage for organizations
that handle substantial quantities of nuclear material.
Nuisance Value - The amount for which an insurance company will
settle a claim—not because it is a valid claim but, because the company
considers it worth that amount to dispose of it.
O-P-Q
Object, see Boiler & machinery insurance.
Obligee - A term used in surety bonds to refer to the individual
or firm that is to benefit from the bond's protection. A performance bond,
for example, provides the obligee property owner with recourse if the
bonded contractor, the principal, fails to perform.
Obligor - A term used in surety bonds to refer to the individual
or firm bound by an obligation. Also known as the principal.
Occupancy - In general, a condition affecting the desirability
of property policies.
Occupational Safety and Health Act (OSHA) - Passed in 1970, this
law promulgated strict work-safety regulations, and set up the mechanism
to enforce these rules through fines for violations, and closure of unsafe
plants.
Occurrence - In general, an event that triggers coverage under
any policy. Specifically, an event that triggers coverage under an
occurrence-based liability policy. Such a policy covers injury or damage
that occurs during the policy period even if claim is brought months or
even years after the policy has expired. See Claims-made for the alternate
arrangement. Also see Accident.
Ocean marine - Insurance coverage for vessels and property in
ocean shipping. River marine is the term referring coverage for inland
shipments on water. Motor truck cargo refers to coverage for property
transported over highways.
Off premises cover - Commercial property policies commonly
establish a small coverage limit that applies to property temporarily away
from the insured's place of business.
Omnibus clause - An agreement in most automobile liability
policies and some others that extends the definition to include others
without needing to name them. An example would be a policy that covers the
named insured and those residing with him.
Open perils - Property coverage that applies to risks of loss on
a general basis, in contrast with policies that cover for specifically
identified perils, see Named perils. The old term for open perils was all
risks.
Open rating - A state rating system that allows the insurer to
use rates without prior approval. Also referred to as open
competition.
Operating ratio - The sum of the combined ratio plus investment
income.
Ordinance or law coverage - This insurance responds to property
loss or damage necessitating repair, demolition, or rebuilding in
accordance with current building codes.
Ordinary payroll - Payroll allotted to employees whose services
could be curtailed in event of a long-term shutdown of a business without
a harmful effect on reopening. This figure is important in calculating
business income insurance exposures.
Other than collision insurance (automobile), see Comprehensive
physical damage (automobile).
Other insurance - When two or more policies cover the same
interests for the same exposures, each policy is said to represent other
insurance to the other. Most insurance policies contain clauses that
specify how or if claims will be paid if other insurance exists for the
same exposures.
Outer Continental Shelf Lands Act - This act makes the Longshore
and Harbor Workers Compensation Act apply to work involving the
development of the natural resources of the outer continental shelf. A
special endorsement, the Outer Continental Shelf Lands Act Coverage
Endorsement, amends workers compensation policies to provide coverage for
this exposure.
Owners and Contractors Protective (OCP) Liability coverage form
- Provides coverage for the liability of an owner of land on which a
building is being constructed for the acts of the contractor handling the
construction.
Owners, Landlords, and Tenants legal liability (OL&T), see
Premises and operations liability.
Ownership of expirations - Refers to the ability of an
independent agent to place a risk with any of the companies that he or she
represents. Unless that customer goes to another agent, the current agent
owns the policy and the right to place it as he/she sees fit.
Package policy - Any combination of insuring agreements that
combines property and casualty coverages. Homeowners, businessowners, and
garage policies are examples.
Paid losses - The losses that have been paid for a claim.
Pair and set clause - Clause that stipulates that partial loss
to a pair or set of items will be valued in terms of the lost item, not on
the basis of reduced value of the pair or set.
Partial loss - A property loss that is less than a total loss,
see Constructive total loss.
Partnership - A business model in which two or more individuals
join together to conduct business and share profit and losses. Commercial
insurance policies usually differentiate in the ``Who Is Insured'' section
between corporations, partnerships, and other business models. Therefore,
the type of model being insured is important.
Pay-at-the-pump - A device for making sure all motorists are
insured; the theory is that premiums for basic liability coverage could be
collected through taxes at the gasoline pump in a relatively painless
manner, thus eliminating the uninsured motorist.
Payment bond - Sometimes also called a labor and materials bond,
this bond guarantees that bills owed by the contractor will be paid as
they come due. The agreement may be incorporated into the performance
bond.
PD - An abbreviation for property damage.
Peak season endorsement - Instead of buying insurance amounts
reflecting values at the height of inventory, some enterprises are able to
forecast times when values will be at their peak and use this endorsement
to increase the amount of insurance during that specific interval.
Pen, The, see Managing General Agent (MGA).
Per occurrence/per loss excess reinsurance treaty - An agreement
under which losses above a certain dollar amount are ceded to the
reinsurer, who is responsible for all losses from any one exposure above
this amount up to the reinsurance limit. The retention is expressed as an
amount incurred per occurrence. An occurrence may be one hurricane, one
flood, or one accident that results in injuries to multiple people.
Per risk excess reinsurance treaty - Similar to a per
occurrence/per loss excess treaty except in the matter of the retention.
The retention applies separately to each subject of insurance.
Performance bond - A bond that guarantees the property owner
(the obligee) that the contractor with the winning bid on a job will
perform as promised and on time.
Peril - A potential cause of loss.
Perils of the sea - Somewhat akin to open perils on land, the
term refers to any potential cause of loss derived from shipment on a
seagoing vessel.
Period of restoration - The period of time following a loss that
is necessary to restore a business or organization to a pre-loss
condition.
Personal articles floater - Before the advent of packaged forms
and broad coverages, households commonly had fire insurance on dwelling
and personal property with the possible addition of extended coverage. The
personal articles floater is an inland marine form that was used by the
affluent for scheduling open perils coverage for various articles and
classes of valuable personal property. A homeowners endorsement
accomplishes the same thing today and the personal articles floater is no
longer widely written.
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