Interaction

I have sent in the filled proposal form and paid for my health insurance policy. When will I receive my policy document and health cards?

Generally, once you have submitted the proposal form and medical tests if required and made payment, you receive your policy by email within 2 working days and another 2- 3 days for the hard copy through courier. The health cards may take longer as they are sent directly by the TPA and it may take about a month. If you still do not receive the cards, do send us a mail so that we can follow up with the insurance company.

I have received the Policy document but did not receive the FPR ( First premium receipt ). Is it essential to have FPR.

First Premium Receipt is an evidence of adjustment of premium & acceptance of risk but then once the Policy is issued which is the evidence of contract, FPR becomes irrelevant. But then it is always advisable to have FPR also along with Policy document which can be showed as a proof, in case the Policy document is lost.

Can a person have more than one Health policy?

Yes. But each company will pay its rateable proportion of the loss, liability, compensation, costs or expenses. E.g. If a person has Health Insurance from company X for Rs. 1 Lac and Health Insurance from company Y for RS. 1 Lac, then in case of a claim, each policy will pay in the ratio of 50:50 up to the SI.

What is the benefit of carrying a health card?

The benefit of carrying the Health Card is that you and your family members get access to the cash less facility from the TPA’s network of hospitals. This means you can walk into any of the networked hospitals across the country and get treated without having to pay for your bills first and then claim form us. If you do not get admitted to a networked hospital, your expenses will be reimbursed within 7 days of receipt of complete documents from you. Also in the event of any unforeseen accident a third party can identify your Insurance Company and your family can be intimated.

What if I don’t remember my Card Number and Policy Number and I am in an emergency situation?

A. In case you are in an emergency situation, TPA can search your details based on the following:  Name, Address, Date of Birth  Insurer  Underwriting Office Code

I had health insurance 4 years back. How can I renew it?

You can renew your health policy only within 15 days of expiry of the previous policy(asper IRDA regulation).The company may at its discretion allow renewal within a maximum of 60 days from the expiry of the previous policy. As already four years have passed since the expiry of your policy, you need to purchase a new health insurance plan.

Can we add our new born to our existing family/family floater health policy?

Some insurance companies allow mid term inclusion of infants once they are three months old while the others allow inclusion of members only at the time of renewal.

Am I eligible for reimbursement of cost of health check-up under my policy

As per standard norms the insured shall be entitled to reimbursement of medical cost once in every four underwriting years subject to no-claim during this period. The cost shall not exceed 1% of sum insured during the block of four years.

What is a cumulative bonus in a health insurance policy?

The sum insured is increased by 5% for each claim-free year of insurance subject to a maximum accumulation of 50% during ten years.

What happens to the cumulative bonus in case there is a case there is a claim in that particular year?

In the event of a claim, the increased percentage of the Sum Insured will be reduced by 10% on next renewal but the basic sum insured will remain the same.

Is there any discount in the premium if I include my family in my insurance policy?

Yes, a discount is allowed in the total premium in the total premium to a family comprising the insured and any one or more of the following- ? Spouse ? Dependent children ? Dependent parents

What is the procedure to get Reimbursement in case of emergency hospitalization?

1 Take admission into the hospital.  2 As soon as possible, inform TPA about the hospitalization  3 At the time of discharge, settle the hospital bills in full and collect all the original bills, documents and reports. 4 Lodge the claim with TPA for processing and reimbursement by duly filling in the claim form & enclosing all original bills/vouchers/receipts.

What is the procedure to get Reimbursement in case of planned hospitalization?

1 Inform TPA about the planned hospitalization.  2 Get admitted into the hospital as planned.  3 At the time of discharge, settle the hospital bills in full and collect all the bills, documents and reports.  4 Lodge the claim with TPA for processing and reimbursement by duly filling in the claim form & enclosing all original bills/vouchers/receipts.

Is maternity covered in health insurance policies?

Most of the companies do not cover maternity and related conditions but some companies like Apollo Munich, Max Bupa have specific plans which cover maternity after specified waiting periods generally 2-4 years.For details please visit our health page.

Can I cancel my policy and if yes will I get my premium back?

Yes, the insured can cancel the policy at any time. In such a case, the company shall allow a refund of premium at company’s short period rate(given below provided no claim has occurred during the policy period up to cancellation. Period of cover up to Rate of premium to be charged 1 month ¼ of the annual rate 3 months ½ of the annual rate 6 months ¾ of the annual rate  More than 6 months Full annual

What are the situations under which one may be denied cashless hospitalization?

1. If there is any doubt in the coverage of treatment of present ailment under the Policy 2. If the information sent to TPA is insufficient to confirm coverage 3. If the ailment/condition is not being covered under the policy 4. If the request for pre-authorization is not received by TPA in time In such a situation, the Insured can take the treatment, pay for the treatment to the hospital and after discharge, send the claim to TPA for processing.

How does one get Reimbursements in case of treatment in non- network hospitals

In case of treatment in a non-network hospital, TPA will reimburse you the amount of bills subject to the conditions of the policy taken by the insured. The insured must ensure that the hospital where treatment is taken fulfils the conditions of definition of Hospital in the Mediclaim policy. TPA should be contacted within 7 days from the time of admission with the following documents in original:  1 Claim Form duly filled and signed by the claimant  2 Discharge Certificate from the hospital  3 All documents pertaining to the illness starting from the date it was first detected i.e. Doctor's consultation reports/history  4 Bills, Receipts, Cash Memos from hospital supported by proper prescription  5 Receipt and diagnostic test report supported by a note from the attending medical practitioner/surgeon justifying such diagnostics.  6 Surgeon's certificate stating the nature of the operation performed and surgeon's bill and receipt  7 Attending doctor's / consultant's / specialist's anesthetist's bill and receipt, and certificate regarding diagnosis 8 Certificate from the attending medical practitioner / surgeon that the patient is fully cured  9 Details of previous policies if the details are not already with TPA except in the case of accidents

How can I check the status of my claim

You can call the helpline number of your TPA or check on their site using your Policy number or member id. Helpline numbers and links for TPA website are available on our website.

In case of part settlement can an insured claim for the balance amount

Normally, part payments are made due to deficiency of documents or for expenses which are not covered under the policy. In case of the former if the requisite documents are made available, the claim may be considered.

Can any claim be rejected or refused

Yes, the claim, which is not covered under the policy conditions, can be rejected. In case you are not satisfied by the reasons for rejection, you can represent to the insurer within 15 days of such denial.

Will I get the entire amount of the claimed expenses

The entire amount of the claim is payable, if it is within the Sum Insured and is related with the in-house treatment as per policy conditions and is supported by proper documents, except the expenses which are excluded.

Will the medical costs be reimbursed from day one of the cover

Kindly check the plan benefits and policy wordings.

Should the claim be submitted to the Insurance Company or TPA

The claim has to be submitted directly to the TPA for timely settlement.

During the course of my treatment, can I change the hospitals

Yes it is possible to shift to another hospital for reasons of requirement of better medical procedure.However, this will be evaluated by the TPA on the merits of the case and as per policy terms and conditions.

What documents are needed for processing claims if the treatment has been done in a non-network hospital or in a network hospital where cash less facility was not granted /availed

Following documents are required for processing the claims on reimbursement basis: 1. Claim Form properly filled and signed by the claimant 2. Discharge Certificate from the hospital  3. All documents pertaining to the illness starting from the date it was first detected i. Bills, Receipts ii. Cash Memos from hospital supported by proper prescription  iii. Receipt and diagnostic test report supported by a note from the attending medical practitioner/surgeon justifying such diagnostics. Surgeon's certificate stating the nature of the operation performed and surgeon's bill and receipt  iv. Attending doctor's / consultant's / specialist's / anesthetist's bill and receipt, and certificate regarding diagnosis v. Certificate from the attending medical practitioner / surgeon that the patient is fully cured  4.  Details of previous policies : if the details are not already with TPA except in the case of accidents

What documents should one obtain before discharge from the hospital in case of cashless facility availed

All bills in original and a discharge certificate are to be left with the hospital providing cashless treatment The patient has to countersign all bills and fill the claim form and also leave the same with the hospital at the time of discharge. A copy of the bills & Discharge Summary can be carried by the patient for his records and for submission along with Pre & Post Hospitalization bills.

What are the facilities offered by a TPA

1 A 24 X 7 assistance to all policy holders through toll free number of the TPA  2 Online assistance during hospitalization and filing of claim documents  3 Assistance in providing Ambulance Services during Emergency 3 Enrollment Card against your policy, which would give you access to TPA services.  4 Cash Less service facilitation at network hospitals up to limit authorized by Mediclaim / Hospitalization Insurance 5 Claims Processing and Reimbursement for non-network hospitals  6 Other services as defined by your Employer / Insurer

I want to avail the benefits of portability and switch my health policy to another insurer. What is the procedure for that

For this as per IRDA guidelines, a policyholder should apply to the insurance company at least 45 days before the premium renewal date of the existing policy. And the policyholder has to fill in the portability form (provided by the insurer) along with proposal form and submit it to the insurance company. The insurer shall communicate its decision to the requesting policyholder within 15 days of providing all the details required by the insurer and if the insurer does not communicate its decision within 15 days, it shall not retain the right to reject such proposal.

I am currently covered under group health insurance along with my family members. Can I switch to an individual or family floater plan

Yes, with the launch of health insurance portability from 1st October , 2011, you can switch from group health policy to individual or family floater with the same insurer and after one year, you can avail portability as applicable for other individual or family floater policies.

In case of family floater health insurance what happens if the primary insured person expires? Can the policy be renewed by any of the surviving members of the policy? Also,As my age increases can I migrate from family floater to individual plan

If the primary insured person expires, the other Insured Persons may apply to continue the Policy within 30 days of his/her death provided that they have identified a new adult policyholder who is a member of their immediate family. All relevant particulars in respect of such person (including their relationship) must be given to the company along with the application. If the company accepts such application, then the Policy shall be treated as having been renewed without any break in cover. Migration from family floater to individual may be allowed on acceptance of proposal by the company.

As not all the companies provide top up cover, is it possible to buy a main policy from one company and buy the top up from some other company? Also, If main policy covers the critical illness, will the top up cover it too

Yes, you can buy health insurance policy from one company and a top up plan from another. Just make sure that your main policy has sum insured equal to the threshold level of top up plan.

What are first year/ second year exclusions

During the period of insurance cover, the expenses on treatment of certain diseases such as cataract, hernia,piles, sinusitis, benign Prosthetic Hypertrophy, Hysterectomy for Menorrhegia or Fibromioma etc. for specified periods (Please refer to your policy document for details) are not payable if contracted and/ or manifested during the currency of the policy.

Enlist some of the important exclusions under mediclaim policy.

Some general exclusions under this policy are:  1 Pre-existing diseases i.e. Any condition, ailment or injury or related condition(s) for which insured person had signs or symptoms and/or was diagnosed and/or received medical advice/treatment within 48 months prior to his/her health policy with the company. Pre existing diseases will be covered after a maximum of four years since the inception of the policy  2. Any disease contracted during the first 30 days of inception of policy except in case of injury arising out of accident  3. Certain diseases such as cataract, piles, hernia, and sinusitis etc. are excluded for specified periods if contracted or manifested during the currency of the policy.  4. Injury or Diseases directly or indirectly attributable to War, Invasion, Act of Foreign Enemy, War like operations. 5. Cosmetic, aesthetic treatment unless arising out of accident.  6. Cost of spectacles, contact lenses and hearing aids 7. Dental treatment or surgery of any kind unless requiring hospitalization  8. Charges incurred at Hospital or Nursing Home primarily for diagnostic, x-ray or laboratory examinations, without any treatment.  9. Naturopathy or other forms of local medication  10. Pregnancy & childbirth related diseases  11. Intentional self-injury / injury under influence of alcohol, drugs  12. Diseases such as HIV or AIDS  13. Expenses on vitamins and tonics unless forming part of treatment for disease or injury as certified by the attending physician.  14. Convalescence, general debility, run-down condition or test cure, congenital external diseases or defects or anomalies, sterility, venereal disease

What is the procedure for change of address for medical insurance

You can change the address by giving a request letter to the insurance company on plain paper and the insurance company will pass the endorsement and give a copy of same to you. Kindly remember to send same to your TPA also so that they can incorporate same in their records.

I have purchased a Policy from ................Insurance Co. but I am not satisfied. Can I cancel the Policy & get back my money that I paid.

If you are not satisfied with the terms & conditions of the Policy or the benefits which appears in the policy are not the same which was explained to you by the intermediary, you have an option to cancel the policy within 15 days from the date of receipt of Policy document ( free look period) & get back your money less the taxes and medical cost if any, borne by the Insurer in case of Non linked Policy & Fund value less taxes and medical cost in case of Unit linked Policy.

I have lost the Policy document, will there be any problem to get the Policy benefits in future.

As Policy document is the evidence of contract and it also mention about the beneficiary details, for all kind of benefit payments the policyholder has to submit the original policy document to the Insurer’s office. Moreover it is required for necessary endorsement related to Nomination, Assignment, mortgage etc. In case of lost policy, you have to apply to your Insurer for a duplicate policy.

I have purchased a Policy from ................Insurance Co. but I am not satisfied. Can I cancel the Policy & get back my money that I paid

If you are not satisfied with the terms & conditions of the Policy or the benefits which appears in the policy are not the same which was explained to you by the intermediary, you have an option to cancel the policy within 15 days from the date of receipt of Policy document ( free look period) & get back your money less the taxes and medical cost if any, borne by the Insurer in case of Non linked Policy & Fund value less taxes and medical cost in case of Unit linked Policy.

I have received the Policy document but did not receive the FPR ( First premium receipt ). Is it essential to have FPR.

First Premium Receipt is an evidence of adjustment of premium & acceptance of risk but then once the Policy is issued which is the evidence of contract, FPR becomes irrelevant. But then it is always advisable to have FPR also along with Policy document which can be showed as a proof, in case the Policy document is lost.

I have lost the Policy document, will there be any problem to get the Policy benefits in future.

As Policy document is the evidence of contract and it also mention about the beneficiary details, for all kind of benefit payments the policyholder has to submit the original policy document to the Insurer’s office. Moreover it is required for necessary endorsement related to Nomination, Assignment, mortgage etc. In case of lost policy, you have to apply to your Insurer for a duplicate policy.

What is the formality to get a Duplicate Policy.

You have to make a FIR with local PS giving reason of loss of Policy, since when it is noticed & simultaneously have to advertise in local Newspaper. Along with the copies of FIR & advertisement, you have to apply to the Insurer’s respective Branch office along with a nominal fees. If the Insurer is satisfied that the reason of loss is a genuine & there is no attempt of fraud, they will issue the Policy.

If FIR & advertisement is compulsory

These requirements depend on the Sum Assured & left out period of the Policy term. Insurer may waive off these requirements. e.g, if SA is small or the duplicate policy request is in the last year of Policy period before maturity.

The age proof that I submitted at the time of applying for a Policy is not correct. Will there be any Problem in future

Age is extremely vital for acceptance of a Proposal. In case the age is not correct, it is immediately to be brought to the notice of Insurer for them to take a corrective action.

What action the Insurer can take

They may declare the Policy null & void i.e. Cancel the policy , may ask for medical check up or additional special reports, may revise the premium or alter the terms & conditions of the policy by offering alternate plan/term/SA or restrict the benefits.

Suddenly, I noticed that I have not paid the premium since long. Can I pay the premium now

See, under Non linked ( traditional ) policies, Insurer do allows grace period of 30 days for Annual/Half yearly/Quarterly mode of premium & 15 days for monthly mode of premium. If the premium is not paid even within grace period, the Policy lapses. Since you have not paid the premium since long it will depend on the current status of your Policy whether payment of back log premium is possible or not.

How I will know the status of my Policy

You can visit to the website of your Insurer for online services or call them on toll free number (IVRS i.e. voice call ) which is mentioned on the Policy document. After verifying your identity, they may share your Policy status.

I am a layman don’t know how to do all these, what is the alternative

Alternative is, please check the last premium due date paid. First unpaid premium will be Last due paid + Mode e.g, if Last premium paid is June 2015 & mode is yearly then FUP is June 2016. Since it is more than 1 month & grace period is over, it is a lapsed policy. But then since it is within 6 months, you can pay the arrear premium along with interest & a simple declaration of good health form. The Policy will be brought back to in force provided there is no adverse feature in your DGH. If there is any adverse feature, then Insurer may ask for medical report special report etc & decide accordingly.

If the duration of non-payment of premium is more than 6 months cant I revive the Policy

Yes it can be revived under different scheme of revivals like Special revival scheme, Loan cum revival, Instalment cum revival & Survival cum revival scheme. But it can not be revived if the Policy is lapsed for more than 5 yrs.

If I can not revive the Policy, can I get back the premium I paid

In case of Non-linked ( Endowment) Policy, if the Premium is paid for at least 3 yrs & subsequent premium is not paid , the policy becomes paid up & the paid up value is payable on maturity or on death. The paid up policy will not participate into any further benefits. If it is Term or Risk Policy , the premium paid gets forfeited. In case of Unit linked Policy, the risk premium is adjusted out of fund value. Even though, the premium/contribution not paid, if the fund is sufficient to cover up Risk premium & other charges the Policy remains in force.

How much will be the paid up value

The paid up value is calculated as follows; PV = No of Yrs premium paid/No of yrs premium payable (PPT) * Sum Assured. Bonus, if any already vested will be attached is this.

I can not wait till maturity to receive my Paid up amount. & want my money immediately can I do that

Yes you can do that by surrendering the Policy applying to Insurer along with Original Policy document.

How much amount I will get if I surrender my policy

Surrender value will be a certain % of Paid up value. Depending on the time period of surrender from the date of commencement , the % will change. Within 1 st three yrs the % is nil. Higher the duration higher will be the % of SV factor. In case of Unit linked Policy, the surrender value is Fund value less surrender charges. However, surrender charges after 5 yrs of policy period is nil.

I have not made any nomination in my policy. What will happen in case of my death

Nomination facilitates to receive death claim amount. In absence of nomination, the Insurer will go by the law of succession certificate or Probate of will if any. In case, you have someone who have insurable interest on you ( like wife, son, daughter, parents etc ), you can register nomination immediately to avoid legal complication which is time consuming at the same time cost bearing.

I do not have any such person who can be nominated. What do I do

Other than Insurance Policy, you must be leaving behind other properties/assets of yours. In that case, Insurer will go by the Court verdict which will permit simultaneously for other properties/assets of yours.

I want to change my nominee. Can I do that

Yes you can change nomination by sending a request letter to Insurer along with Original Policy document. Insurer will change the Nomination by an endorsement on Policy document.

Can I make multiple nomination

Yes you can make multiple nomination.

Can I assign my Policy

Yes you can assign the policy if you are competent & have rights & title to deal with the policy.

Whom I can assign my Policy

You can assign the policy in favour of Insurer or Bank Against a loan or you can gift it to someone against some consideration which can be love, affection or monetary consideration.

Who will pay premium if I assign my Policy & who will get the claim benefits

If it is against a Loan favouring Insurer or Bank etc, where assignment is of conditional nature, you have to pay premium but claim benefits will go to the lender to adjust loan amount. If the assignment is absolute, then premium will be paid by the assignee & assignee or his survivor will be eligible for the claim benefits.

Can I take a loan on my Policy

This is for information only Endowment type of Policy is eligible for loan. Therefore, TERM/Risk Policy, Unit linked Policy, Annuity Policies & even some endowment policies like Money back are not eligible for loan.

How much Loan I can get

Eligible Loan amount is up to 90% of Paid up value inclusive of Bonus, if any at any point of time.

How I can repay the loan

You can repay the Loan principal along with interest under half yearly mode of payment.

What happen if I don’t repay the loan

If you do not or can not repay the Loan principal , you can only pay the interest . But then, even if you can not pay interest but you continue paying regular premium, the outstanding Loan amount inclusive of interest will be adjusted out of final claim amount. if neither the regular premium nor the principal & interest are paid & if the outstanding Loan amount exceeds the paid up value, the Policy will be foreclosed ( force-surrendered).

How do I know when I will get my maturity benefits

If you see the Policy document date of maturity is mentioned in the schedule. Moreover, as a general practice, Insurer send intimation normally in advance of 2 months prior to maturity date.

What all I have to do to get my maturity benefits

Once, you receive the intimation, you need to sign the discharge voucher giving there in details of your Bank account for direct credit of amount. You also need to submit the Original Policy document along with signed discharge voucher to the Insurance office.

I have a Money Back Policy what all benefits I am entitled to

In a Money back Policy, there is a provision of instalment benefit payable at regular interval depending on the Term of the Policy. Amount of benefit per instalment is a certain % of Sum Insured which normally varies from 10% to 30%.

What maturity benefit I am entitled to get under a money back policy

You are entitled to get Sum Insured +Bonus less the Instalment benefit already received on maturity date.

What happens if I die in between

In case of your unfortunate death, your beneficiary will be eligible to receive full Sum Insured +Bonus up to the date of death without any adjustment of installment benefits already paid to you.

My husband had a Policy but he did not pay the last year premium & died few days back before maturity. Can I get the death benefit

Normally, if the premium is not paid within grace period, policy lapses. But then, in this case, you will get full death benefit less the due premium amount & interest.

My husband had a Policy but he did not pay the premium for more than 6 months. Can I get the death benefit

Some Insurer do consider these cases under concession claim. They honour the claim if death happens within 6 months / 1 year from the date of lapse provided the policy has run for atleast 3 yrs / 5 yrs respectively but after adjustment of due premium & interest from the claim amount.

My husband had a Policy but he died within 2 yrs from the date of commencement of Policy. Can I get the death benefit

If death happens within 2 yrs from the date of commencement of Policy, Insurer consider the case as Early claim & ask for additional information & investigate the case to justify there was no fraud. If they are satisfied, you can get the death benefit.

What all documents will be required to submit for death claim

The following documents are required to be submitted to Insurer office. 1. Intimation of death from any one. 2. Death certificate in original 3. Original Policy document 4. Discharge form In addition may ask for Last Medical attendants report, hospital report, certificate of cremation or burial etc. if death is due to accident following additional documents will be required: 1. FIR 2. Panchnama of accident site 3. Police Final report 4. Post mortem report 5. Hospital reports

My husband had a Policy but he is missing for last few yrs. Can I as a beneficiary claim the death benefit

As per Indian Evidence Act, if a person is missing for more than 7 yrs, it is presumed as death. If the beneficiary represent the case to Court, the Judge may award a decree as presumption of death. But to be entitled for death benefit, the Policy premium should have been paid by the nominee/beneficiary till the date of Decree. However, Insurer may waive off the premium & consider the case.

My husband signed the discharge voucher but died of accident before maturity date, can I get death benefit.

Yes since he has died before maturity date, this will be considered as death claim & if ADB rider is there in the Policy, you will be entitled for twice the Sum Assured.

My husband had a Policy but he availed loan against Policy. How much death benefit I will be entitled

Death benefit will be Sum Assured + Bonus less O/S Loan amount for In force Policy or Paid up amount + added bonus, if any , less O/S Loan amount in case of Paid up Policy.

Although I have submitted all necessary documents to Insurer office but not received the maturity claim . What do I do. Will Insurance Company pay me interest for delay payment

Please call the Insurer office & asked them to know the status of your claim stating the Policy No or Claim Acknowledgement No mentioned in Receipt. In case of genuine delay the Insurer will pay you interest @ 2% above Bank Interest Rate.

Insurer has rejected my death claim request. What do I do.

You can write to the Ombudsman office along with all correspondence & amp; documents. Ombudsman office details are mentioned at the bottom of the Policy document.

I have taken a Unit linked Policy but the amount showing in my balance is much less than what I paid. Why it is so

In a Unit linked Policy, the balance amount after adjusting Risk premium & amp; different charges out of Total premium paid get unitized & amp; the market value of the same reflects in Account balance.

In my Unit linked Policy, what all charges are applicable

Under a Unit linked Policy, normally the charges are Risk premium , Policy administration, Fund Switching Charge, Fund management fees. Beside this there are Surrender charges & Service Taxes.

In my Unit linked Policy, if the return is guaranteed

Unit linked Policy is market-linked & the risk is borne by Policy holder. There is no guarantee of return.

In case of death , if my Unit linked Policy will take care of my Insured sum or will there be any loss

It depends on the Policy condition but mostly the amount payable under a Unit linked Policy is Sum Insured or Fund value whichever is higher.

I have noticed a clause of Premium Holiday in my Unit Linked Policy. What does it mean?. I need not to pay any premium or what

Unlike Traditional Policy where premium has to paid every year, in a Unit linked Policy even you can skip not paying annual premium. If premium is not paid no allocation of unit will be added to the Fund for that period but some units will be deducted for other charges in the policy. This is called Premium Holiday.

I have a Pension Policy. How much Pension I will get

There are two type of Pension Policy 1. Deferred Pension Policy 2. Immediate Pension Policy Under a deferred Pension Policy, premium is paid till the term of the Policy & then the Pension payment starts thereafter. In many Policies Pension amount may be mentioned on the Policy itself else the Pension amount will depend on the accumulated value against premium paid & pension rate at that time. Under immediate Pension Plan, the pension amount depends on the purchase amount & type of pension selected.

I have a Pension Policy. If I die during Policy term what will happen to my policy

If Policyholder dies during term of the Policy, the Sum Insured will be used to purchase pension as per pension type that will be selected by the nominee, provided the Policy was in force at the time of death.

What is deductible

Deductible or “excess” is the amount over and above, which the claim will be payable. There is a normal standard/compulsory excess for most vehicles ranging from Rs 50 for two-wheelers to Rs 500 for Private Cars and Commercial Vehicles which increases depending upon the cubic capacity/carrying capacity of the vehicle. However, in some cases the insurer may impose additional excess depending upon the age of the vehicle or if there is high frequency of claims.

How many Pension options are there

Normally there are 6 type of Pension which are mentioned in the Policy document such as; a. Life Pension ceasing on death b. Life Pension with return of capital c. Joint Life Pension with 100% pension to the spouse d. Joint Life Pension with 50% pension to the spouse e. Pension certain for 5 yrs, 10yrs, 15 yrs, 20yrs & 25 yrs & Life thereafter f. Joint Life Pension with return of capital on death of 2 nd life.

How I will decide which Pension option is best

See all Pension options are good but then depending on your future requirement, you can decide a particular option. However, the Pension amount will vary according to the choice of the Pension type. e.g. If someone does not have any dependant they normally prefer Life Pension here the Pension amount is highest. Alternately, if someone wants his spouse or dependant may need liquid cash in his absence they normally prefer Life Pension with return of cash. Or if someone thinks, in his absence his spouse should have a regular income during his/her lifetime then option c or d is preferable. Pension quantum is lowest in option “e” but then the Pension is guaranteed for the entire certain period so selected and then even thereafter if alive.

If I need liquid cash Can I withdraw my money under a pension Plan.

Once the full premium is paid till the Term & the Pension vest, you are entitled to get 1/3 rd of total value as commutation balance 2/3 rd will be used for Pension purchase. Under immediate Pension Plan, once pension starts you can’t withdraw cash.

I have purchased a Policy from ................Insurance Co. but I am not satisfied. Can I cancel the Policy & get back my money that I paid.

If you are not satisfied with the terms & conditions of the Policy or the benefits which appears in the policy are not the same which was explained to you by the intermediary, you have an option to cancel the policy within 15 days from the date of receipt of Policy document ( free look period) & get back your money less the taxes and medical cost if any, borne by the Insurer in case of Non linked Policy & Fund value less taxes and medical cost in case of Unit linked Policy.

I have lost the Policy document, will there be any problem to get the Policy benefits in future.

As Policy document is the evidence of contract and it also mention about the beneficiary details,for all kind of benefit payments the policyholder has to submit the original policy document to the Insurer’s office. Moreover it is required for necessary endorsement related to Nomination, Assignment, mortgage etc. In case of lost policy, you have to apply to your Insurer for a duplicate policy.

What is the formality to get a Duplicate Policy.Q. What is the formality to get a Duplicate Policy.

You have to make a FIR with local PS giving reason of loss of Policy, since when it is noticed & simultaneously have to advertise in local Newspaper. Along with the copies of FIR & advertisement, you have to apply to the Insurer’s respective Branch office along with a nominal fees. If the Insurer is satisfied that the reason of loss is a genuine & there is no attempt of fraud, they will issue the Policy.

If FIR & advertisement is compulsory

These requirements depend on the Sum Assured & left out period of the Policy term. Insurer may waive off these requirements. e.g, if SA is small or the duplicate policy request is in the last year of Policy period before maturity.

What are the quick points that I need to check in my Vehicle Insurance Policy

All the information must match with your details in RC book including CC, make model, sub type, fuel type, seating capacity (very important) etc.

What are the points that I need to check in the renewal notice

Points are: IDV is reduced by a minimum of 10% from last year, Vehicle Registration No. is correct; Premium is less than the last year (If you have not made any claim.) NCB (If applicable) is more than last year’s NCB. (Maximum 50%) Sometimes the Third Party insurance premium may get revised. This is very rare and it may cause the premium to go up.

What are the factors that one should consider before selecting an insurance company

Ideally the company that has a cashless tie-up with the widest network of service stations that you may visit in case of an accident. Secondly, the company which offers you the best rate without any excess on it. Above all, choose a company that has a good and fastest claim settling ratio and record.

What is the information one needs to furnish while intimating a claim?

The following information needs to be furnished while intimating a claim:  1 Name of Insured person who is sick or injured 2 Nature of Sickness/Accident 3 Contact Numbers 4 Policy Number (as reflecting on the Health Card) 5 Date & Time in case of accident, commencement date of symptom of disease in case of sickness 6 Location of accident

Why two insurance company’s premiums are not same

A. All the companies offer 1. Different discounts, 2. Different P.A. cover and 3. Different IDV. It is the reason of difference in premium amounts for all the insurance companies.  1. Different discount: - This mainly depends upon the claims experience of a particular company. If claims experience is good then they will offer higher discount and if claims experience is bad then less discounts are offered. 2. PA (Personal Accident): - PA cover premium will not differ from company to company but it is an optional cover you need to choose the amount how much you want to cover. Eg. One company will offer Rs. 100 as a premium and other company will offer Rs. 250 as a premium. 3. IDV: - Major factor influencing will be IDV. But be very careful, many companies reduce IDV a lot, reduced IDV means your premium will be reduced. Most important point here is at the time of claim insurance company will also have to pay less for your vehicle. (It should be reduced every year by 10% minimum to 20% maximum.) Always keep your IDV on higher side, it helps 1) During claims. 2) At the time of selling car.

What is NCB and how is it calculated

If you don’t make any insurance claim on your vehicle then you are eligible for a No Claim Bonus (NCB). This is a discount on your premium for the coming year and is calculates as under: - 1st year – 0% in Own Damage premium amount 2nd year – 20% in Own Damage premium amount 3rd year – 25% in Own Damage premium amount 4th year – 35% in Own Damage premium amount 5th year – 45% in Own Damage premium amount 6th year – 50% in Own Damage premium amount

How is depreciation on the various parts calculated

A Deduction for depreciation on various parts is calculated as under: - For all rubber/nylon/plastic parts/tyres/tubes, batteries & air bags – 50% For fibre glass components – 30% For all parts made of glass – 0% Rate of depreciation for all other parts including wooden parts will be as per age of the vehicle as follows; 7th month to 1st year – 5% 1st year to 2nd year – 10% 2nd year to 3rd year – 15% 3rd year to 4th year – 25% 4th year to 5th year – 35% 5th year to 10th year – 40% More than 10 year – 50%

What is Excess? Is Excess good or bad

Excess means the amount that will be deducted by the insurance company before making the payment to insured. There are two types of excesses. First one is compulsory which depends upon the C.C. (cubic capacity)of the vehicle and which cannot be removed from insurance policy. The second is a voluntary excess, which is given to you for reducing the premium in the policy. This is not a recommended option to avail, since it reduces the insurance claim payout if its needed. Never agree for higher excess.

What is covered under own car damage

Vehicle replacement cost or Vehicle repairing cost is paid if you have opted for this cover in your policy.

When should a vehicle be scrapped (Under total loss)

In case of an accident where the repair cost is more than 75% of car value (IDV), then insurance company will scrap the vehicle and pay the insurer the entire value of the vehicle.

When do insurance companies not pay the full IDV

If you have not reduced the car value every year minimum by 10% from last year’s IDV, then your insurance company will not pay the IDV. If you have increased the car value without any valid reason than also insurance company will not pay the entire IDV.

What is covered under third party insurance

In case of an accident, third party property damage and third party life damage is compensated.

If third party vehicle is smashed beyond repair what is my liability

Nothing. If you have valid insurance documents then entire loss is paid by insurance company and you don’t have to spend a single penny from your pocket.

Is the dispute between the insurance company and others, Am I a party to the dispute

No. once you handover the court case and papers to insurance company then they take over the case. You may however need to go once to court.

If the fault is completely mine and I also agree to same, does my liability change

No, not at all. The premium you pay covers for potential mistakes on your side.

In case of physical injury or death of passengers in my vehicle, are the medical expenses covered? Is there a special type of insurance cover

Under third party cover there is a clause called Unnamed Passenger PA (personal accident) cover. If you have opted for this cover (which is available on extra premium of maximum Rs. 100/- per person for a coverage of Rs. 2,00,000/-) then there is compensation payable to the family members in case of death. There is no cost of medical bills or any expenses payable to the injured passengers. Currently there are no options (products) for getting this covered through vehicle insurance.

Are third party medical expenses covered? Is there a special type of insurance cover

Yes. The entire expenses are paid under TP(Third Party) policy, if there is a police case, you don’t have to opt for any special policy. Unlimited medical expenses are paid under TP policy.

What is the reason for not paying the entire IDV under insurance policy, if vehicle is stolen

If you have not reduced the car value every year minimum by 10% from last year’s IDV, then your insurance company will not pay the IDV. If you have increased the car value without any valid reason, then also insurance company will not pay the entire IDV.

Do I lose my NCB in case of theft of my car

Yes. If there is a theft and you make a claim, you lose the NCB.

How much time does it take to settle my claim, under theft insurance

There are lots of documents which have to be submitted in case of theft insurance. (Approximately number = 18). Post submission of all those documents, you will be required to submit a "Final Investigation Report (FIR)". This is usually issued by/from police station after approx 3 months of the theft. The claim is paid one month after the submission of the FIR.

My Insurance has expired yesterday is there a grace period after last date for renewal without inspection/penalty

There is no grace period in Motor insurance. The NCB savings will elapse after 3 months.

Can I renew my insurance without an inspection

For third party it does not matter. But it’s mandatory for comprehensive insurance.

Can NCB be transferred if I change my insurance company

Yes. Your car carries the NCB; every company has to accept it.

What is the procedure to transfer my existing NCB to new car insurance

When you sell your car, you have to submit Form 29 & 30 to insurance company, which has information about buyer and seller including their signatures. This verifies that you have sold your car. Company then issues a No Claim Bonus Certificate which can be used on your new car.

Is an FIR required when I make a claim for a repair? (Given there are not legal issue with the damage)

It depends on a case to case basis. If a tree fell on the car and destroyed it, you can get full IDV back without an FIR.

If I lodge a claim after the expiry of my policy date for an event that occurred during the policy period, will it still be valid

Yes, you will be eligible for the claim even after the expiry of the policy date. This is because the event took place during the policy period.

Will the claim affect my renewal

In case you file a claim for any kind of damages during the insured period, at renewal, you will loose all the NCB that you have accrued over the years.

Please provide me with the list of garages in my city where I can avail cashless service

Kindly go through the list of garages where you can avail of the cashless service.

currently have a policy with other company, will I get the NO CLAIM bonus if I renew it with you

In the event of no claims, you would avail of the 'NO CLAIM' bonus, i.e., there would be a reduction of for payment of premium on renewal. If you do not make any claim over a period of time, a No Claim Bonus (NCB) is offered on renewals. This discount can go as high as 50%. However, if there is any claim, the discount (NCB) will be zero for the next renewal.

What is the procedure for recording any changes in the policy

If there are any changes in the policy like change of address or modifications to the vehicle or its use, it will be done by an Endorsement by the insurance company. Submit a letter to the insurer with proof for the changes and obtain the endorsement. Some endorsements may require you to pay additional premium. Check the correctness of the endorsement.

What is a Certificate of Insurance under Motor Vehicle Act

As per Rule 141 of Central Motor Vehicle Rules 1989, a certificate of Insurance is to be issued only in Form 51. It is only in Motor Vehicle Insurance, apart from the policy, that a separate certificate of insurance is required to be issued by insurers. This document should always be carried in the vehicle. The policy should be preserved separately at home / office.

If I fit CNG or LPG kit in my vehicle, is it necessary to inform the Insurance Company

If a CNG / LPG kit is fitted in the vehicle, the (Road Transport Authority (RTA) office where the vehicle was registered should be informed so that they make a note of the change in the registration certificate (RC) of the vehicle. The insurance company should also be informed so that the kit is covered on payment of extra premium on the value of the kit under “OD” section and also under “LO” section.

What are the documents to be kept in the vehicle while plying in public places

Documents are : • Certificate of Insurance  • Xerox copy of Registration Certificate • Pollution Under Control Certificate • Photocopy of Driving Licence of person who is driving the vehicle

Can I transfer my insurance to the purchaser of my vehicle

Yes, the insurance can be transferred to the buyer of the vehicle, provided the seller informs in writing of such transfer to the insurance company. A fresh proposal form needs to be filled in. There is a nominal fee charged for transfer of insurance along with pro-rata recovery of NCB from the date of transfer till policy expiry. It may be noted that transfer of ownership in comprehensive/package policies has to be recorded within 14 days from date of transfer failing which no claim will be payable for own damage to the vehicle.

Can I continue the insurance in the name of the previous owner even after the vehicle is transferred in RTO records in my name

No. Registration and insurance of the vehicle should always be in the same name with the same address. Otherwise the claim is not payable. A fresh proposal form needs to be filled in. There is a nominal fee charged for transfer of insurance.

I have lost the insurance policy. Can I get a duplicate one

Yes, please approach the same office, which had issued the policy, with a written request. A nominal fee is charged for issuing a duplicate policy copy.

What are the formalities for a motor insurance claim

A claim under a motor insurance policy could be ? For personal injury or property damage related to someone else. This person is called a third party in this context) or ? For damage to your own, insured, vehicle. This is called an own damage claim and you are eligible for this if you are holding what is known as a package or a comprehensive policy. Third Party Claim In a third party claim, where your vehicle is involved, it is important to ensure that the accident is reported immediately to the police as well as to the insurance company.  On the other hand, if you are a victim, that is, if somebody else’s vehicle was involved, you must obtain the insurance details of that vehicle and make an intimation to the insurer of that vehicle. Own Damage Claim In the event of an own damage claim, that is, where your own vehicle is damaged due to an accident, you must immediately inform insurance company and police, wherever required, to enable them to depute a surveyor to assess the loss. Do not attempt to move the vehicle from the accident spot without the permission of police and the insurance company.  Once you receive permission for removal of the vehicle and for repairs, you can do so.  If your policy provides for cashless service, which means you do not have to pay out of your pocket for covered damages, the insurance company will pay the workshop directly.  In either of these situations, you must intimate the insurance company immediately. Theft ClaimIf your vehicle is stolen, you must inform the police and the insurance company immediately. In addition you must keep the transport department also informed. As soon as you receive the policy document, read about the procedures and documentation requirements for claims rather than wait for a claim to arise.  If you have to make a claim, ensure that you collect all the required documents and submit them along with the requisite claim form duly filled in, to the insurance company.  There may be certain specific documentation requirements for specific types of claims. For instance in respect of a theft claim, there is a special requirement that you should surrender the vehicle keys to the insurance company.

When should I report to the police

Incidents such as "Third Party Property Damage", "Bodily Injury To Self or Third Party" or "Theft" should be reported to the nearest police station, under whose jurisdiction the incident has occurred.

What if someone else was driving at the time of the accident? Is that person covered by my policy? Will I still be covered

If the person driving the vehicle is a valid license holder, the vehicle is insured for all the accidents that occurred due to the hazards specified. To insure the person driving the vehicle, who is not the owner, an additional personal accident cover has to be taken for unnamed passengers. For the owner-driver, the policy compulsorily has a personal accident cover, as per tariff.

What if I have an accident with an uninsured vehicle? What is the extent to which I covered

If you have taken a comprehensive policy for your vehicle you are fully covered against all the hazards mentioned, irrespective of whether the other person has an insurance policy or not.

What documents are required to file a claim online

In case of own damages claim following documents are required: ? Claim form duly signed ? Valid R.C. copy of the vehicle ? Valid driving license copy ? Policy copy (First 2 pages only) ? FIR if required (For Theft, Third party Injury / Damage; Highway accidents-Major only). ? Original repair bill, proof of release and cash receipt.

What if I have an accident with an uninsured vehicle? What is the extent to which I am covered

If you have taken a comprehensive policy for your vehicle you are fully covered against all the hazards mentioned, irrespective of whether the other person has an insurance policy or not.

I am already having health insurance and want to increase sum insured, what should I do?

You can take super top up plan and increase your sum insured to desired level.

I was forced to take a Travel Insurance Policy. Is it a mandatory requirement?

To obtain a visa for some countries, overseas travel insurance is compulsory.

Where it is not a mandatory requirement, why should I take a Travel Insurance Policy?

Even where it is not, it is prudent to obtain a travel insurance policy when you are travelling on business or holiday or for education, research etc as medical treatment costs in many countries are much higher than what they are in India and are unaffordable.

Is my visa status relevant to obtain overseas travel insurance?

In most cases it would be. Normally, such policies are meant for travellers who visit other countries on business or holiday or education or other purposes and not for those residing permanently abroad.

I was forced to take a Travel Insurance Policy. Is it a mandatory requirement

To obtain a visa for some countries, overseas travel insurance is compulsory.

Where it is not a mandatory requirement, why should I take a Travel Insurance Policy

Even where it is not, it is prudent to obtain a travel insurance policy when you are travelling on business or holiday or for education, research etc as medical treatment costs in many countries are much higher than what they are in India and are unaffordable.

Is my visa status relevant to obtain overseas travel insurance

In most cases it would be. Normally, such policies are meant for travellers who visit other countries on business or holiday or education or other purposes and not for those residing permanently abroad.

What is the Validity / Policy period in my Policy

The Insurance is valid from the 1 st day of Insurance or date & time of departure from India whichever is later and expires on the last day of the number of days specified in the policy schedule or return to India whichever is earlier.

Can I travel anytime during Policy period

The Policy will be valid only if the journey commences within 14 days of issuance date of Policy.

Can I extend my policy period

There is an automatic extension of 7 days period without any charge, if necessitated by delay of public transport services beyond the control of insured person.

Can I get refund of my premium if i cancel the trip or cut shot the trip.

In case your travel doesn’t take off and you show proof of the same, policies would normally provide for premium refund subject to deductions towards administrative costs. Where travel is cut short, policies may or may not allow refund subject to certain conditions.

What all benefits are covered under a Travel Policy

It covers the following benefits: 1. Medical expenses & repatriation 2. Personal Accident 3. Loss of checked Baggage 4. Delay of checked Baggage 5. Loss of Passport 6. Personal Liability

Q. Can I claim any medical expenses during my overseas stay?

A. No, certain expenses are not covered as in below; 1. treatment that could reasonably be delayed until return to India 2. cosmetic surgery unless as a result of accident 3. routine physical examination 4. Pregnancy related expenses including childbirth, miscarriage, abortion or any complication.

If I die overseas what all benefits it will cover

Air transportation expenses or up to an equivalent amount for a local burial or cremation in the country where the death occurred.

what are the general exclusions in a Travel Policy

No claim will be paid in cases: 1. Where the insured person is travelling against the advice of the Physician, is travelling to obtain medical treatment, is on waiting list for a medical treatment, has a terminal prognosis of a medical condition. 2. Suicide, attempted suicide, venereal disease, HIV etc 3. Arising due to taking part in Naval, Military, Air force operations, Aviation, Professional sports or hazardous sports.

what are the claim process

Formalities for making a travel insurance claim A travel insurance policy is generally a package policy that includes different types of covers like hospitalisaiton, personal accident, loss/ damage to baggage, loss of passport and so on. The procedure and documents required for a claim would vary from cover to cover. All of them would be mentioned in your policy document.  For ease of procedure and your convenience, insurers normally attach the claim form with the policy document. This will contain the list of documents required in case of a claim and also the contact details including phone numbers of the claims administrator either in the destination country to which you are travelling or in another country that is designated  to receive and process your claim intimation.

Absolute Liability

Liability for damages even though faults or negligence cannot be proven.

Absolute Ownership

Absolute ownership exists where the interest or explicit right of possession of the insured is so free from limitations, qualifications or restrictions that it cannot be taken from him without his consent.

Abstract

A brief history of title to land.

Acceptance Of Risk

Acceptance of Risk is a method of assessment of risk in a Proposal by an underwriter to decide whether to accept the risk or not and if to accept at what terms & condition.

Accelerated Death Benefit

A percentage of the policy’s face amount discounted for interest that can be paid to the insured prior to death, under specified circumstances. This is in lieu of a traditional policy that pays beneficiaries after the insured’s death. Such benefits kick in if the insured becomes terminally ill, needs extreme medical intervention, or must reside in a nursing home. The payments made while the insured is living are deducted from any death benefits paid to beneficiaries.

Accident

An event or occurrence causing damage/injury to an entity and is unforeseen and unintended.

Accidental Bodily Injury

Injury to the body as the result of an accident.

Accident, Hit And Run

Accidental Death or injury arising out of the use of a motor vehicle(s) the identity whereof cannot be ascertained in spite of reasonable efforts for the purpose.

Accompanied Baggage

Baggage being taken by someone with his own person whilst travelling.

Accumulation

Percentage addition to policy benefits as a reward to the insured for continuous renewal.

Acquisition Costs

The insurer's cost of putting a new business in force, including the agent's commission, the cost of clerical work, fees for medical examinations and inspection reports, sales promotion expense, etc.

Accidental Death Benefit

An endorsement that pays the beneficiary an additional benefit if the insured dies from an accident.

Accounts Receivable (debtors) Insurance

Indemnifies for losses that are due to an inability to collect from open commercial account debtors because records have been destroyed by an insured peril.

Acts Of God

Perils that cannot reasonably be guarded against, such as floods and earthquakes.

Actual Cash Value

A form of insurance that pays damages equal to the replacement value of damaged property minus depreciation.

Actual Loss Ratio

The ratio of losses incurred to premiums earned actually experienced in a given line of insurance activity in a previous time period.

Actuarial Cost Assumptions

Assumptions about rates of investment earnings, mortality, turnover, salary patterns, probable expenses, and distribution or actual ages at which employees are likely to retire.

Actuarial Cost Methods

Methods for computing how much money must be contributed each year to fund pensions.

Actuary

An insurance professional skilled in the analysis, evaluation, and management of statistical information. Evaluates insurance firms reserves, determines rates and rating methods, and determines other business and financial risks.

Additional Insureds

Persons who have an insurable interest in the property/person covered in a policy and who are covered against the losses outlined in the policy. They usually receive less coverage than the primary named insured.

Additional Living Expenses

Extra charges covered by homeowners policies over and above the policy-holder’s customary living expenses. They kick in when the insured requires temporary shelter due to damage by a covered peril that makes the home temporarily uninhabitable.

Adjuster

An individual employed by a property/casualty insurer to EV adjusters differ from public adjusters, who negotiate with insurers on behalf of policyholders and receive a portion of a claims settlement. Independent adjusters are independent contractors who adjust claims for different insurance companies.

Admitted Company

An insurance company licensed and authorized to do business in a particular state or country.

Adverse Selection

The tendency of those exposed to a higher risk to seek more insurance coverage than those at a lower risk. Insurers react either by charging higher premiums or not insuring at all. In the case of natural disasters, such as earthquakes, adverse selection concentrates risk instead of spreading it. Insurance. works best when risk is shared among large numbers of policyholders.

Affinity Sales

Selling insurance through groups such as professional and business associations.

Affirmative Warranty

An agreement between an insurance company and an agent, granting the agent authority to write insurance from that company. It specifies the duties, rights, and obligations of both parties.

Aggravation Of Risk

To make the existing risk worse, more troublesome, etc.

Agreed Value Policy

The policy which undertakes to pay a specified amount in case of total loss. Under this case, the policy does not take into account the current market value.

Agent

Insurance is sold by two types of agents: independent agents, who are self-employed, represent several insurance companies and are paid on commission, and exclusive or captive agents, who represent only one insurance company and are either salaried or work on commission. Insurance companies that use exclusive or captive agents are called direct writers.

Aggregate Deductible

A type of deductible that applies for an entire year in which the insured absorbs all losses until the deductible level is reached, at which point the insurer pays for all loses over the specified amount.

Aggregate Limits

A yearly limit, rather than as per occurrence limit. Once an insurance company has paid up to the limit, it will pay no more during that year.

Aircraft Damange

Destruction or damage caused by Aircraft, other aerial or space devices and articles dropped there from excluding those caused by pressure waves.

Aleatory Contract

A legal contract in which the outcome depends on an uncertain event. Insurance contracts are aleatory in nature.

All-risk Agreement Or Policy

A property or liability insurance contract in which all risks of loss are covered except those specifically excluded; also called open perils policy.

Alternative Dispute Resolution (adr)

Alternative to going to court to settle disputes. Methods include arbitration, where disputing parties agree to be bound to the decision of an independent third party, and mediation, where a third party tries to arrange a settlement between the two sides.

Alternative Markets

Mechanisms used to fund self-insurance. This includes captives, which are insurers owned by one or more non-insurers to provide owners with coverage. Risk-retention groups, formed by members of similar professions or businesses to obtain liability insurance, are also a form of self-insurance.

Ancillary Charges

In hospital insurance, covered charges other than room and board.

Annual Statement

Summary of an insurer’s or reinsurer’s financial operations for a particular year, including a balance sheet.

Annual-premium Annuity

An annuity whose purchase price is paid in annual instalments.

Annuitant

An individual receiving benefit under an annuity.

Annuity

A life insurance company contract that pays periodic income benefits for a specific period of time or over the course of the annuitant’s lifetime. These payments can be made annually, quarterly or monthly. From a life insurer’s viewpoint, an annuity presents the opposite of mortality risk from a life insurance policy. Life insurance pays a benefit when the policyholder dies. An annuity pays benefits as long as the annuitant lives. With both products, the insurer’s profit or loss depends on whether it made correct assumptions about the policyholder’s life expectancy and the company’s future investment returns.

Annuity Certain

An annuity that is payable for a specified period of time, without regard to the life or death of the annuitant.

Annuity Units

A measure used in valuing a variable annuity during the time it is being paid to the annuitant. Each unit’s value fluctuates with the performance of an investment portfolio.

Application Form

Supplied by the insurance company, usually filled in by the agent and medical examiner (if applicable) on the basis of information received from the applicant. It is signed by the applicant and is part of the insurance policy if it is issued.

Apportionment

The dividing of a loss proportionately among two or more insurers that cover the same loss.

Appraisal

A survey to determine a property’s insurable value, or the amount of a loss.

Arbitration

Procedure in which an insurance company and the insured or a vendor agrees to settle a claim dispute by accepting a decision made by a third party.

Arson

The deliberate setting of a fire

Assessable Policy

A policy subject to additional charges, or assessments, on all policyholders in the company.

Assets

Property owned, in this case by an insurance company, including stocks, bonds, and real estate. Insurance accounting is concerned with solvency and the ability to pay claims. Insurance laws, therefore, require a conservative valuation of assets.

Assign

To use life insurance policy benefits as collateral for a loan.

Assignee

The party to whom the rights of the insured under a policy are transferred.

Assignment

A clause that allows the transfer of rights under a policy from one person to another, usually by means of a written document.

Assignor

The party granting the transfer of the insured’s rights to the assignee

Asymmetric Information

An insured’s knowledge of likely losses that is unavailable to insurers.

Auto Insurance Premium

The price an insurance company charges for coverage, based on the frequency and cost of potential accidents, theft and other losses.

Automatic Coverage

An insurer agrees to cover accidents from all machinery of the same type as that specifically listed in the endorsement.

Automatic Treaty

An agreement whereby the ceding company is required to cede some certain amounts of business and the reinsurer is required to accept them.

Adjusters

A name applied to claims adjusters in the field of marine insurance.

Aviation Insurance

Commercial airlines hold property insurance on aeroplanes and liability insurance for negligent acts that result in injury or property damage to passengers or others. Damage is covered on the ground and in the air. The policy limits the geographical area and individual pilots covered.

Avoidance

A right which can be exercised by an underwriter to relieve him of liability under the policy because the assured has been guilty of a breach of good faith or where the risk in voyage policy has failed to attach within a reasonable time after the underwriter wrote the risk.

Award

The decision in arbitration.

Aai (automobile Association Membership Discount)

Member of Automobile Associations is eligible for a discount. A discount @ 5% of the Own damage premium, subject to a maximum of Rs.200/ - for a Private Car and maximum of Rs.50/-for a Motorized Two Wheeler may be allowed.

Additional Driver Cover

the passengers or a hired driver are not covered under personal accident insurance. Third party cover does not include cover for your legal liability towards your paid driver. Therefore, if your car is not self-driven you need to buy a cover for your driver, under the Workmen Compensation Act

Additional Passenger Cover

This cover can be purchased with an additional premium . This covers the medical expenses of passengers in case of bodily injury due to an accident. Normally the cover is Rs 1 lakh per passenger.

Amount Payable

A payable amount is simply another way of describing a balance that is still owed or due.

Ayurveda/homeopathy

Ayurveda is an ancient medical science. The word, ayurveda is composed of two words of Sanskrit, ayur (meaning life) and veda (meaning knowledge). Thus Ayurveda is a medical science of Ancient India. It deals with matters relating to health, day-to-day life and longevity (long life).

Availed Riders

A rider is an add-on provision to a basic insurance policy that provides additional benefits to the policyholder at an additional cost. Eg ADB,CI, TI, APTD, WOB etc.

Accidental Permanent Total Disability

Accidental permanent disability rider provides a certain % of Sum assured in case of permanent loss of body parts or functions out of accidents within 180 days from the date of accident.

Bailment

A situation in which one has entrusted personal property to another.

Balance Sheet

Provides a snapshot of a company’s financial condition at one point in time.

Basic Health Insurance Policy

Hospital insurance, surgical insurance and regular medical expense insurance

Basic Limit

Usually, refers to Liability of insurer indicating the lowest amount for which a policy can be written. This amount is either prescribed by law or company policy.

Basic Rate

The standard charge for a given type of risk for basic limit.

Beneficiary

A person named in a life insurance policy to receive the death proceeds.

Bill Of Exchange

It is the bill drawn by exporter against the importer.

Bill Of Lading

Receipt for goods shipped on board a ship signed by the person who contracts to carry them, and stating the terms on which the goods are carried.

Bind

In property and liability insurance, the agent customarily is given the authority to accept offers from prospective insureds without consulting the insurer; in such cases, the agent is said to bind the insurer.

Binder

Temporary authorization of coverage issued prior to the actual insurance policy.

Blanket Bond

A fidelity bond that covers all employees of a given class and may also cover perils other than infidelity.

Blanket Coverage

Insurance coverage for more than one item of property at a single location, or two or more items of property in different locations.

Blanket Contract

A contract of health insurance affording benefits, such as accidental death and dismemberment, for all of a class of persons not individually identified. It is used for such groups as athletic teams, campers, travel policy for employees, etc.

Boiler And Machinery Insurance

Often called Equipment Breakdown, or Systems Breakdown insurance. Commercial insurance that covers damage caused by the malfunction or breakdown of boilers, and a vast array of other equipment including air conditioners, heating, electrical, telephone, and computer systems. Prevention of loss is emphasized even more than indemnification of loss.

Bodily Injury

Physical injury, including sickness, disease, mental injury, shock or death.

Bonus

The Bonus system awards discounts for claim-free driving for a certain continuous period. This goes on increasing up to a certain limit for continuous claim free years. In case of life insurance business, with profit plans are entitled to get a bonus which is generated out of actuarial surplus.

Borderline Risk

An insurance prospect of doubtful quality from an underwriting point of view to put it in one among two group of risks.

Bond

A security that obligates the issuer to pay interest at specified intervals and to repay the principal amount of the loan at maturity. In insurance, a form of surety-ship. Bonds of various types guarantee a payment or a reimbursement for financial losses resulting from dishonesty, failure to perform and other acts.

Book Of Business

Total amount of insurance on an insurer’s books at a particular point in time.

Breach Of Condition

When a condition of the insurance contract is broken by the assured, the insurer may avoid the contract from the inception.

Broker

An intermediary between a customer and an insurance company. Brokers typically search the market for coverage appropriate to their clients. They work on commission and usually sell commercial, not personal, insurance. In life insurance, agents must be licensed as securities brokers/dealers to sell variable annuities, which are similar to stock market-based investments.

Burglary

The unlawful taking of property from within premises, entry to which has been obtained by force, leaving visible marks of entry.

Burglary And Theft Insurance

Insurance for the loss of property due to burglary, robbery or larceny. It is provided in a standard homeowners policy and in a business multiple peril policy.

Burning Ratio

The ratio of losses suffered to the amount of insurance in effect.

Business Income Insurance

Coverage for the reduction in revenue in the event of an insured peril.

Business Interruption Insurance

Commercial coverage that reimburses a business owner for lost profits and continuing fixed expenses during the time that a business must stay closed while the premises are being restored because of physical damage from a covered peril, such as a fire. Business interruption insurance also may cover financial losses that may occur if civil authorities limit access to an area after a disaster and their actions prevent customers from reaching the business premises. Depending on the policy, civil authorities coverage may start after a waiting period and last for two or more weeks.

Business Pursuit

Continued or regular activity for the purpose of earning a livelihood.

Businessowners Policy

A policy that combines property, liability and business interruption coverage for small to medium sized businesses. Coverage is generally cheaper than if purchased through separate insurance policies.

Baby Vaccination

It covers the expenses incurred for the compulsory baby vaccinations

Cancelable

A health policy that can be cancelled by the insurer at any time for any reason

Capacity

The supply of insurance available to meet demand. Capacity depends on the industry’s financial ability to accept the risk. For an individual insurer, the maximum amount of risk it can underwrite based on its financial condition. The adequacy of an insurer’s capital relative to its exposure to loss is an important measure of solvency.

Capital Sum Insured

It is the sum insured of a Person for which cover is sought under a Personal Accident Policy.

Captive Agent

A person who represents only one insurance company and is restricted by agreement from submitting business to any other company, unless it is first rejected by the agent’s captive company.

Captive Insurer

A type of insurer that is generally formed and owned by potential insured to meet their own distinctive needs

Captives

Insurers that are created and wholly-owned by one or more non-insurers, to provide owners with coverage. A form of self-insurance.

Cargo Insurance

Type of insurance that protects the shipper/owner of the goods against financial loss if the goods are damaged or lost while in transit in between place of commencement and destination.

Case Management

A system of coordinating medical services to treat a patient improves care, and reduce cost. A case manager coordinates health care delivery for patients.

Cash Value

The savings element that accumulates with some life insurance policies.

Cash Value Option

An option in life insurance policies permitting the insured to take the cash value of the policy on surrender.

Cashless

It is a health insurance plan for when you get hospitalized within a Health Insurance network hospital and don’t have to pay for the hospital expenses.

Catastrophe

Term used for statistical recording purposes to refer to a single incident or a series of closely related incidents causing severe insured property losses totalling more than a given amount.

Catastrophe Bonds

Risk-based securities that pay high interest rates and provide insurance companies with a form of reinsurance to pay losses from a catastrophe such as those caused by a major hurricane. They allow insurance risk to be sold to institutional investors in the form of bonds, thus spreading the risk.

Catastrophe Deductible

A percentage or fixed monetary amount that a homeowner must pay before the insurance policy kicks in when a major natural disaster occurs. These large deductibles limit an insurer’s potential losses in such cases, allowing it to insure more property. A property insurer may not be able to buy reinsurance to protect its own bottom line unless it keeps its potential maximum losses under a certain level.

Catastrophe Factor

Probability of catastrophic loss, based on the total number of catastrophes in a state (or region) over a 40-year period.

Catastrophe Model

Using computers, a method to mesh long-term disaster information with current demographic, building and other data to determine the potential cost of natural disasters and other catastrophic losses for a given geographic area.

Catastrophe Reinsurance

Reinsurance (insurance for insurers) for catastrophic losses. The insurance industry is able to absorb the huge losses caused by natural and man-made disasters such as hurricanes, earthquakes and terrorist attacks because losses are spread among thousands of companies including catastrophe reinsurers who operate on a global basis.

Ceding Company

An insurer, also called a primary insurer, that passes on to other insurers some part of its risk under insurance policies it has accepted.

Certificate Of Insurance

A document issued to a member of a group insurance plan, describing the insurance benefits and principal provisions of the policy in brief.

Cession

A reinsurance term meaning that portion of a risk that is passed on to reinsurers by ceding companies.

Chartered Property Casualty Underwriter (ccu)

Professional designation granted to persons in the property and liability insurance field who pass a series of rigorous examinations and meet specified eligibility requirements.

Chance Of Loss

The long-term chance of occurrence or relative frequency of loss. Expressed by the ratio of the number of losses likely to occur compared to the larger number of possible losses in a given group.

Chief Risk Officer (cro)

New position within some organizations, denoting the responsibility for coordinating an enterprise risk management strategy.

Chronic Disease

A disease that is long lasting and needs to be managed over a long period of time. Examples of chronic diseases include cardiac diseases, diabetes, and arthritis amongst others.

Civil Law

Legal proceedings directed towards wrongs against individuals and organizations. Breach of contract is an example of a civil wrong.

Claim

It is a notification to an insurance company that payment of an amount is due under the terms of a policy by the insured.

Claim Amount

It is the amount payable by the insurer under a policy on a claim arising.

Claim Settling Agents

They are appointed by insurer in a foreign country abroad for survey/settlement of claims arising out of policy issued in the home country for Overseas medi-claim and marine insurance policies.

Claims Cohort

A group of claims with a common period of origin. The period is usually a calendar year, but may be shorter. The origin may be defined by the date of the occurrence of claim or alternatively by the date of reporting.

Claims Reserve

Claims provision, provision for outstanding claims/claims outstanding, claims reserve, total claim liability.

Claims Management

The functions performed in handling loss claims

Claims-made Policy

A form of insurance that pays claims presented to the insurer during the term of the policy or within a specific term after its expiration. It limits liability insurers exposure to unknown future liabilities.

Clause

Sentences and paragraphs describing coverage's, exclusions, duties of an insured, and termination of coverage, and other such parts of the insurance policy.

Claused Bill Of Lading

Bill of Lading, which has been endorsed by the ship owner, as the goods described thereon do not conform to what is offered for shipment e.g., package missing, inadequately packed.

Clean Bill Of Lading

A bill of Lading is said to be clean if it has no superimposed clause expressing of any defective condition of the packaging or of goods.

Coinsurance

In property insurance, requires the policyholder to carry insurance equal to a specified percentage of the value of property to receive full payment on a loss. For health insurance, it is a percentage of each claim above the deductible paid by the policy-holder. For a 20 percent health insurance coinsurance clause, the policyholder pays for the deductible plus 20 percent of his covered losses. After paying 80 per-cent of losses up to a specified ceiling, the insurer starts paying 100 percent of losses.

Collateral

Property that is offered to secure a loan or other credit and that becomes subject to seizure on default. (Also called security.)

Collision Coverage

Portion of an auto insurance policy that covers the damage to the policyholder’s car from a collision.

Combined Ratio

Percentage of each premium rupee a property/casualty insurer spends on claims and expenses. A decrease in the combined ratio means financial results are improving; an increase means they are deteriorating. When the ratio is over 100, the insurer has an underwriting loss.

Commercial General Liability (cgl)

A broad commercial policy that covers all liability exposures of a business that are not specifically excluded. Coverage includes product liability, completed operations, premises and operations, and independent contractors.

Commercial Lines

Products designed for and bought by businesses. Among the major coverages are boiler and machinery, business interruption, commercial auto, comprehensive general liability, directors and officers liability, fire and allied lines, inland marine, medical malpractice liability, product liability, professional liability, surety and fidelity, and workers compensation. Most of these commercial coverages can be purchased separately except business interruption which must be added to a fire insurance (property) policy.

Commercial Paper

Short-term, unsecured, and usually discounted promissory note issued by commercial firms and financial companies often to finance current business. Commercial paper, which is rated by debt rating agencies, is sold through dealers or directly placed with an investor.

Commercial Umbrella

A liability policy designed to cover catastrophic losses.

Commission

Fee paid to an agent or insurance sales-person as a percentage of the policy premium. The percentage varies widely depending on coverage, the insurer, and the marketing methods.

Common Disaster Clause

A life insurance clause stating what happens to life insurance proceeds if named beneficiaries die in a common accident.

Common Law

The unwritten law that is based on custom, usage, and court decisions; different from statutory law, which consists of laws passed by legislatures.

Completed Operations Coverage

Pays for bodily injury or property damage caused by a completed project or job. Protects a business that sells a service against liability claims.

Comprehensive Coverage

Portion of an auto insurance policy that covers damage to the policyholder’s car not involving a collision with another car (including damage from fire, explosions, earthquakes, floods, and riots), and theft.

Compulsory Auto Insurance

The minimum amount of auto liability insurance that is statutorily required.

Concealment

The failure of an applicant to reveal, before the insurance contract is made, a fact that is material to the risk.

Concurrent Causation

A legal doctrine that says if two perils (one excluded and one not excluded) occur and cause a loss, coverage applies.

Concurrent Loss Control

Activities that take place at the same time as losses to reduce their severity.

Conditional Contract

A contract, such as an insurance contract, requiring that certain acts be performed if recovery is to be made.

Conditional Receipt

A document given to an applicant for life insurance stating that the company’s acceptance is contingent upon determination of the applicant’s insurability.

Conditionally Renewable

A policy that can be can-celled or have the premiums raised by the insurer on a specific anniversary date, subject to certain reasons written into the policy.

Conditions

Circumstances under which an insurance contract is in force. Breach of the conditions is grounds for refusal to pay the loss.

Consequential Damage Endorsement

Coverage for losses incurred as a result of the failure of an insured object on the insured’s premises.

Consequential Losses

Losses other than property damage that occur as a result of physical loss to a business for example, the cost of maintaining key employees to help reorganize after a fire.

Consideration

In an insurance contract, the specified premium and an agreement to the provisions and stipulations that follow.

Contribution

Right of insurers who have paid a loss under a policy to recover a proportionate amount from other insurers who are liable for the same loss.

Constructive Total Loss

Loss occurring when property is not completely destroyed but when it would cost more to restore it than it is worth

Contingent Beneficiary

A person named in a life insurance contract to receive the benefits of the policy if other named beneficiaries are not living.

Contingent Business Income Insurance

Coverage for losses that result from losses to a supplier or customer on whom the firm depends.

Contingent Liability

Liability of individuals, corporations, or partnerships for accidents caused by people other than employees for whose acts or omissions the corporations or partnerships are responsible.

Contract

An agreement embodying a set of promises that are enforceable by law.

Contract Construction Bond

A surety bond guaranteeing that the principles will complete their work in accordance with the terms of the construction contracts.

Contract Of Adhesion

A contract, such as an insurance contract, in which any ambiguities or uncertain-ties in the wording will be construed against the drafter (the insurer).

Contractors Equipment Floater

Insures mobile equipment, such as tractors, steam shovels, drilling equipment, etc., whether it is owned, leased, or borrowed.

Contracts Without Time Element

Insure losses resulting from fire in which the loss cannot be measured either by direct damage by fire or in terms of elapsed time.

Contractual Duty

The duty of disclosure of “material information” regarding a proposal & Policy.

Contractual Liability

Liability arising from contractual agreements in which it is stated that some losses, if they occur, are to be borne by specific parties.

Contributory Negligence

Partial guilt or negligence in a civil lawsuit where both parties are to blame.

Convertible

A term policy that can be converted to permanent coverage rather than expiring on a specific date.

Cost Of Risk

The sum of (1) outlays to reduce risks, (2) the opportunity cost of activities forgone due to risk considerations, (3) expenses of strategies to finance potential losses, and (4) the cost of reimbursed losses.

Cost-of-living Rider

An endorsement that automatically increases the amount of coverage by the same percentage the Consumer Price Index has risen since policy issue.

Cost-to-repair Basis

The cost to replace property after a loss but perhaps not with like materials and labor.

Coverage

Synonym for insurance.

Cover Note

Cover note is a document granted provisionally pending the issue of a regular policy.

Credit

The promise to pay in the future in order to buy or borrow in the present. The right to defer pay-ment of debt.

Credit Derivatives

A contract that enables a user, such as a bank, to better manage its credit risk. A way of transferring credit risk to another party.

Credit Enhancement

A technique to lower the interest payments on a bond by raising the issue’s credit rating, often through insurance in the form of a financial guarantee or with standby letters of credit issued by a bank.

Credit Insurance

Commercial coverage against losses resulting from the failure of business debtors to pay their obligation to the insured, usually due to insolvency. The coverage is geared to manufacturers, wholesalers, and service providers who may be dependent on a few accounts and therefore could lose significant income in the event of an insolvency. Sometimes called bad-debt insurance.

Credit Life Insurance

Life insurance coverage on a borrower designed to repay the balance of a loan in the event the borrower dies before the loan is repaid. It may also include disablement and can be offered as an option in connection with credit cards and auto loans.

Criminal Law

Legal proceedings directed towards wrongs against society, such as rape, murder, and robbery. Charges are made by a government body, and the guilty party is subject to fine and/or imprisonment.

Critical Illness

In simple words, critical illnesses are relatively serious forms of illnesses which are more difficult to treat and require more time to treat.The federation of Indian Chamber of Commerce and Industry (FICCI) lists the following illnesses as critical illnesses: cancer, heart attack, coronary bypass surgery, heart valve repair or replacement, coma, kidney failure requiring regular dialysis, stroke resulting in permanent symptoms, major organ or bone marrow transplants, permanent paralysis of limbs, motor neurone disease and multiple sclerosis with persisting symptoms.

Crop-hail Insurance

Protection against damage to growing crops as a result of named perils.

Cumulative Bonus

The percentage at which the sum insured gets increased annually, without additional premium, e.g. Personal Accident Insurance, Mediclaim Insurance.

Chronic Care

It is medical care for permanent or long term illnesses/ chronic diseases. These include a cover for all the related diagnostics, drug expenses and regular consultation expenses that a policy holder incurs.

Cng/lpg Kit

Compressed natural gas (CNG) (methane stored at high pressure) is a fuel which can be used in place of gasoline (petrol), Diesel fuel and propane/LPG. CNG combustion produces fewer undesirable gases than the fuels mentioned above.

Chassis No

Chassis number is a unique code including a serial used by automotive industry to identify individual motor vehicle.

Cubic Capacity

This number basically is approximately the displacement volume of the engine i.e. the volume covered by the stroke of the piston multiplied by the number of cylinders the engine

Current Ncb%

No claim bonus (NCB) is a discount, given by an insurer to a policyholder for making no claims during the policy term. NCB can be accumulated over years and the discount ranges from 20% to 50% on the own damage premium.

Compulsory Deductible

The compulsory deductible amount is to be paid by the policyholder when clam arises. Deductible varies from Rs.50 for two-wheelers to Rs.500 for four-wheelers or insurer can charge higher deductible basis condition of the vehicle.

Co-payment

Co-payment in a co-payment module, the final claim amount is divided between the policyholder and the insurance company as per the predetermined percentage of co-payment in the insurance policy.

Consumable Expenses Cover

Consumables like oil, nuts, bolts etc. are not covered under the insurance. . This add-on covers expenses towards consumables which are unfit for further use, arising out of damage due to an accident or any such event.

Coverage Sum Insured

The total sum assured that is payable to policy owner in case of any exigency in a foreign county.

Coverage Deductible

It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.

Coverage Amount

Insurance coverage is the amount of risk or liability that is covered for an individual or entity by way of insurance services.

Copay

It is cost-sharing requirement applicable under a health insurance policy that provides policyholder/insured to bear a specified percentage of the admissible claim amount . A Co-Payment does not reduce the Sum Insured

Critical Illness Benefit

A benefit which helps cover for treatment of critical illnesses. Such situations entail relatively higher expenses and longer period of absence from work for the affected. While the illnesses covered and the premiums vary among insurers, most insurers cover cancer, coronary artery bypass, heart attack, kidney/renal failure, major organ transplant and paralytic stroke.

Ci – Critical Illness

A critical illness rider provides payments of sum assured to the insured on diagnosis of certain dreaded diseases like cancer, coronary artery bypass, heart attack, kidney/renal failure, major organ transplant , paralytic stroke etc.

Days Of Grace Or Grace Period

Period of time after the due date of a premium during which the policy remains in force (when both coverage of risk is available and also the premium can be paid without any late fees).

Debris Removal Clause

An extension to the standard policy to cover the cost of making a seriously fire-damaged building safe and removing debris.

Declaration

Part of a property or liability insurance policy that states the name and address of policy-holder, property insured, its location and description, the policy period, premiums, and supplemental information.

Decreasing Term

Term life insurance in which the amount of coverage declines during the period for which it is issued.

Deductible

The amount of loss borne or paid by the policyholder. Either a specified rupee amount, a percentage of the claim amount, or a specified amount of time that must elapse before benefits are paid. The bigger the deductible, the lower the premium charged for the same coverage.

Defensive Medicine

The practice of performing extra procedures and tests in addition to those that are probably necessary for a given patient in an attempt to avoid malpractice litigation.

Deferred Annuity

Benefits that begin at some specified time after the annuity is purchased.

Dependent Life

Group term life insurance covering an employee’s dependent.

Depreciation

A decrease in the value of property over a period of time due to wear and tear or obsolescence. Depreciation is used to determine the actual cash value of property at time of loss.

Derivatives

Contracts that derive their value from an underlying financial asset, such as publicly-traded securities and foreign currencies. Often used as a hedge against changes in value.

Diminution Of Value

The idea that a vehicle (or any other asset) loses value after it has been damaged in an accident and repaired.

Direct Loss

A loss that stems directly from an unbroken chain of events leading from an insured peril to the loss.

Direct Premiums

Property/casualty premiums collected by the insurer from policyholders, before reinsurance premiums are deducted. Insurers share some direct premiums and the risk involved with their reinsurers.

Direct Response

A system to distribute insurance to customers through direct mail, telephone, television, or other methods without the use of intermediaries.

Direct Sales/ Direct Response

Method of selling insurance directly to the insured through an insurance company’s own employees, through the mail, or via the Internet. This is in lieu of using captive or exclusive agents.

Direct Writers

Insurance companies that sell directly to the public using exclusive agents or their own employees, through the mail, or via Internet. Large insurers, whether predominately direct writers or agency companies are increasingly using many different channels to sell insurance. In reinsurance, denotes reinsurers that deal directly with the insurance companies they reinsure without using a broker.

Directors And Officers Liability Insurance (d&o)

Covers directors and officers of a company for negligent acts or omissions, and for misleading statements that result in suits against the company, often by shareholders.

Disability

Inability to perform all or part of one's occupational duties because of an accident or illness: see Total Disability and Partial Disability.

Double Insurance

If the insurance policy is taken from more than one underwriter where period of insurance, subject matter of insurance and sum insured are same, then this is called double insurance

Disability Income Insurance

Health insurance that provides periodic payments if the insured becomes disabled as a result of illness or accident.

Disability Loss

The inability of a person to work because of an illness or injury.

Disappearing Deductible

A deductible used in property insurance in which the size of the deductible decreases as the size of the loss increases. At a given level of loss, the deductible completely disappears.

Diversification

Process of spreading risk through a firm’s involvement in various businesses or through the location of its operations in different geographic areas.

Dividends

Money returned to policyholders from an insurance company’s earnings. Considered a partial premium refund rather than a taxable distribution, reflecting the difference between the premium charged and actual losses. Many life insurance policies and some property/casualty policies pay dividends to their owners. Life insurance policies that pay dividends are called participating policies.

Domiciliary Hospitalization

It is home based treatment done for a disease, illness or injury. It could because of lack of accommodation at the hospital or because the patient’s condition doesn’t permit them to get admitted in the hospital

Dynamic Risks

Uncertainties, either pure or speculative, that are produced because of societal changes that have national consequences.

Degree Of Risk

Relative variation of actual from expected losses.

Dental Insurance

A type of health insurance that covers dental care expenses.

Date Of Commencement Of Risk

Date from which insurance co will give coverage of Sum assured

Date Of Registration

Date of registration is a date on which the vehicle was registered with regional transport Office.

Discount On Profession

Occupation-Related Discounts. In many cases, you can actually save money on your car insurance simply by being in a “low-risk profession." Careers considered low-risk by auto insurance companies, statistically show that people in these professions exercise risky driving behaviours less often than those in other jobs

Dental Cover

Payment of medical expenses related to acute anaesthetic treatment of a natural tooth or teeth during a trip.

Dental Cover Sum Insured

Coverage amount for cost associated with dental treatment overseas.

Dental Cover Deductible

It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.

Delay Of Baggage

Payment of compensation for reasonable expenses incurred for the purchases of toiletries, clothing and medication due to a delay in checked-in baggage caused by a common carrier.

Delay Of Baggage Sum Insured

Expense for incurring a duplicate passport will be reimbursed under this cover.

Delay Of Baggage Deductible

It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.

Daily Hospitalization Allowance(daily Cash)

A daily hospital cash plan would determine coverage based on the daily allowance you choose under the plan. The range of daily cash available is from Rs.500 to Rs.3000. if the insured is admitted in the ICU, the daily cash allowance generally increases twofold or by any other factor as specified in the policy wordings

Dental Cover

Dental insurance is a form of health insurance designed to pay a portion of the costs associated with dental care.

Date Of Commencement Of Policy

Policy start date

Date Of Commencement Of Risk

Date from which insurance co will give coverage of Sum assured.

Death Benefit

Amount payable in case of policyholders death within policy term.

Description Of Fund

Nature of fund

Double Accidental Death Benefit

The amount payable in case death happens due to accident

Earned Premium

The portion of premium that applies to the expired part of the policy period. Insurance premiums are payable in advance but the insurance company does not fully earn them until the policy period expires.

Earnings Form

A commercial property form without a 50 percent or more coinsurance coverage.

Earnings Multiple Approach

A group life plan in which an employee receives one or two times salary in life insurance coverage.

Earthquake Insurance

Covers a building and its contents, but includes a large percentage deductible on each. A special policy or endorsement exists because earthquakes are not covered by standard homeowners or most business policies.

Economic Loss

Total financial loss resulting from the death or disability of a wage earner, or from the destruction of property. Includes the loss of earnings, medical expenses, funeral expenses, the cost of restoring or replacing property, and legal expenses. It does not include noneconomic losses, such as pain caused by an injury.

Effective Date

The date upon which the policy is put in force, the inception date

Electronic Commerce / E-commerce

The sale of products such as insurance over the Internet.

Elimination Period

The period that must elapse before disability income is payable under a health insurance policy covering disability income loss.

Employee Stock Ownership Plans (esops)

Deferred profit-sharing plans in which investment is usually in stock issued by the employer.

Employment Practices Liability Coverage

Liability insurance for employers that covers wrongful termination, discrimination, or sexual harassment toward the insured’s employees or former employees.

Employers Liability

Legal liability imposed on an employer making him or her responsible to pay damages to an employee injured by the employer's negligence. Generally, replaced by 'workers compensation', which pays the employee whether the employer has been negligent or not.

Endorsement

A written form attached to an insurance policy that alters the policy’s coverage, terms, or conditions. Sometimes called a rider.

Endowment Insurance

Life insurance that pays the face amount at the end of a specified time period if the insured is alive; the face amount is payable in the event of death before the end of the period.

Enterprise Risk Management

Approach for managing both pure and speculative risks together, another name for integrated risk management.

Entire Contract Clause

A life insurance contract stating that the policy and the application form constitute the entire contract between the parties.

Environmental Impairment Liability Coverage

A form of insurance designed to cover losses and liabilities arising from damage to property caused by pollution.

Equal Shares

A method of apportionment in which insurers covering the same loss share that loss equally, up to their respective limits of liability.

Equity

In investments, the ownership interest of shareholders. In a corporation, stocks as opposed to bonds.

Errors And Omissions Coverage (e&o)

A professional liability policy covering the policyholder for negligent acts and omissions that may harm his or her clients.

Escalation

Provision for automatic increases on some defined basis in premiums and sums insured.

Escrow Account

Funds that a lender collects to pay monthly premiums in mortgage and homeowners insurance, and sometimes to pay property taxes.

Estimated Maximum Loss (eml)

An expression used in fire, explosion and material damage policies only. An estimate of the monetary loss which could be sustained by insurers on a single risk as a result of a single fire or explosion considered by the underwriter to be within the realms of possibility.

Estoppel

A legal doctrine in which a person may be required to do something or be prevented from doing something that is inconsistent with previous behaviour; may prevent an insurer from denying liability after a loss.

Excess Of Loss Reinsurance

A contract between an insurer and a reinsurer, whereby the insurer agrees to pay a specified portion of a claim and the reinsurer to pay all or a part of the claim above that amount.

Exclusion

A provision in an insurance policy that eliminates coverage for certain risks, people, property classes, or locations.

Exclusions

Restrictions for the coverage provided by an insurance policy

Exclusive Agent

A captive agent, or a person who represents only one insurance company and is restricted by agreement from submitting business to any other company unless it is first rejected by the agent’s company.

Excess (also Refer Deductibles)

Agreed amount up to which no claim is paid under a policy.

Excess Of Loss Reinsurance

A form of reinsurance whereby the reinsuring company reimburses the ceding company for the amount and only the amount of loss the ceding company suffers over and above an agreed aggregate sum in any one loss or in a number of losses arising out of any one event.

Ex Gratia

A payment made where there is no legal liability

Expected Loss Ratio

The ratio of losses incurred to premiums earned; anticipated when rates are first formulated.

Expediting Expenses

The insurer agrees to pay reasonable extra cost for expediting the repair of machinery, including overtime and express transportation.

Expense Ratio

Percentage of each premium rupee that goes to insurers expenses including overhead, marketing, and commissions.

Experience

Record of losses.

Experience Rating

The system of rating or pricing insurance in which the future premium reflects past loss experience of the insured.

Exposure

Possibility of loss.

Exposure Doctrine

A liability limit that provides coverage when a person is exposed to a product or dangerous substance.

Express Warranty

A warranty actually stated in a contract.

Extended Coverage

An endorsement added to an insurance policy, or clause within a policy, that provides additional coverage for risks other than those in a basic policy.

Extra Expense Insurance

The consequential prop-erty insurance that covers the extra expense incurred by the interruption of a business; the policy pays if the business does not close down but continues in alternative facilities, with higher than normal costs.

Expiry Date

The date after which policy/contract is no longer in effect

Engine No

Engine number may refer to an identification number marked on the engine of a vehicle. The engine number includes coded information, which can be decoded to reveal information such as year of manufacture, country of manufacture, and engine type

Engine Protect Cover

This covers takes care of the expenses incurred in the repair of the engine, gearbox or differential parts that may occur due to such conditions as the leakage of lubricating oils, water ingression etc., conditions that aren’t usually covered by the primary policy.

Emi Protect

This cover protects the Emi payable towards your car loan up to a certain months in case of financial disability due to job loss.

Existing Diseases Waiting Period

Generally, pre-existing diseases (read the policy to understand what a pre-existing disease is defined as) are excluded under a Health Insurance policy. Further, the policy would generally exclude certain diseases from the first year of coverage and also impose a waiting period.

Existing Diseases Waiting Period

Generally, pre-existing diseases (read the policy to understand what a pre-existing disease is defined as) are excluded under a Health Insurance policy. Further, the policy would generally exclude certain diseases from the first year of coverage and also impose a waiting period.

Expenses To Accompanying Person

This signifies the reimbursement of daily expenses of any person who is accompanying a minor insured less than 12 years of age. The maximum payable is for 10 days.

Emergency Ambulance

Insurance co normally provides emergency ambulance charges when patient is admitted to a hospital or transferred from one hospital to another hospital

Eye Cover

Insurance co pay for cataract operations after a waiting period of 24 to 36 months up to a certain Sum insured.

Face Amount

In a life insurance contract, the stated sum of money to be paid to the beneficiary upon the insured’s death.

Facultative Reinsurance Or Facultative Obligatory Treaty (also Semi-obligatory Treaty):

A reinsurance policy that provides an insurer with coverage for specific individual risks that are unusual or so large that they aren’t covered in the insurance company’s reinsurance treaties. This can include policies for jumbo jets or oil rigs. Reinsurers have no obligation to take on facultative reinsurance, but can assess each risk individually. By contrast, under treaty reinsurance, the reinsurer agrees to assume a certain percentage of entire classes of business, such as various kinds of auto, up to preset limits.

Fair Rental Value

In a dwelling policy, the rent the building could have earned at the time of the loss whether or not it was actually rented.

Fidelity Bond

A form of protection that covers policyholders for losses that they incur as a result of fraudulent acts by specified individuals. It usually insures a business for losses caused by the dishonest acts of its employees.

Fidelity Guarantee Insurance

A Fidelity guarantee insurance indemnifies the employers against the financial loss suffered by them due to specified dishonest acts of their employees.

Fiduciary Bond

A type of surety bond, sometimes called a probate bond, which is required of certain fiduciaries, such as executors and trustees, which guarantees the performance of their responsibilities.

Fiduciary Liability

Legal responsibility of a fiduciary to safeguard assets of beneficiaries. A fiduciary, for example a pension fund manager, is required to manage investments held in trust in the best interest of beneficiaries. Fiduciary liability insurance covers breaches of fiduciary duty such as misstatements or misleading statements, errors and omissions.

Financial Planning

A process involving the establishment of financial goals, the development and implementation of a plan for achieving those goals, and the periodic review and revision of the overall plan.

Financial Risks

Risk involving credit, foreign exchange, commodity trading, and interest rate; may involve chance for gain as well as loss.

Financial Statement Analysis

A method of risk identification in which each item on a firm’s balance sheet and income statement is analysed regarding potential risks.

Financing

The function of planning and controlling the supply of funds.

Fire

Combustion in which oxidation takes place so rapidly that a flame or glow is produced.

Fire Insurance

Coverage protecting property against losses caused by a fire or lightning that is usually included in homeowners or commercial multiple peril policies.

Fixed Annuity

An annuity that pays the annuitant a guaranteed, fixed return every month for a fixed premium. The guarantee is based on the expected return of the underlying investments of the insurance company. (See Annuity)

Fixed-amount Option

A life insurance option allowing the beneficiary to take the proceeds in the form of a fixed periodic payment.

Fixed-period Option

Payment of a death benefit in equal instalments over a specified time period.

Floater

Attached to a homeowners policy, a floater insures movable property, covering losses wherever they may occur. Among the items often insured with a floater are expensive jewellery, musical instruments, and expensive apparel. It provides broader coverage than a regular homeowners policy for these items.

Floater Policy

An inland marine insurance policy that covers property subject to movement from one location to another.

Flood

(1) An overflow of inland or tidal waves, (2) unusual and rapid accumulation of runoff of surface waters, (3) landslides or mudslides, (4) excessive erosion along the shore of a lake or any other body of water, or (5) erosion or undermining caused by a body of water exceeding its anticipated cyclical levels.

Floor-of-protection Concept

An underlying principle of social insurance specifying that the goal of social insurance is to provide only limited protection, not one’s entire need.

Fob (f.o.b.)

Abbreviation for free-on-board, used in commerce to describe the value of goods at point of embarkation, excluding transport and insurance costs. Export values are usually expressed f.o.b. for customs and excise purposes, while imports are usually valued cost insurance and freight or charged in full.

Fraud

Intentional lying or concealment by policy-holders to obtain payment of an insurance claim that would otherwise not be paid, or lying or misrepresentation by the insurance company managers, employees, agents, and brokers for financial gain.

Free-of-capture-and-seizure (fc&s) Clause

A clause in ocean marine insurance that excludes war as a covered peril.

Freight

Money paid for the transportation of goods. Freight insurance is a common coverage in marine insurance, purchased by the owners of transporting vessels.

Frequency

Number of times a loss occurs. One of the criteria used in calculating premium rates.

Franchise

Deductible in which the insurer has no liability if the loss is under a certain amount, but once this amount is exceeded; the entire loss is paid in full.

Frequency Reduction

A method of loss control that lessens the chance that a peril will occur.

Friendly Fire

A fire confined to the area of a boiler, stove, or other place designed to contain it.

Fronting

A procedure in which a primary insurer acts as the insurer of record by issuing a policy, but then passes the entire risk to a reinsurer in exchange for a commission. Often, the fronting insurer is licensed to do business in a country where the risk is located, but the reinsurer is not. The reinsurer in this scenario is often a captive or an independent insurance company that cannot sell insurance directly in a particular country.

Futures

Agreement to buy a security for a set price at a certain date. Futures contracts usually involve commodities, indexes or financial futures.

Fuel Type

The type of fuel which is used in vehicle. It could be petrol diesel, CNG

Frequency Of Premium      

No of times premium to be paid in a year.

General Average Clause

A clause in ocean marine insurance that requires ship and freight interests other than the insured to respond to loses suffered by the insured interest when those losses result from voluntary, necessary, and successful sacrifice of the insured’s freight because of shipping peril.

General Damages

Damages awarded to an injured persons for intangible loss which cannot be measured directly by rupees. Popularly known as "pain and suffering." General damages are distinguished from special damages which are awarded from actual economic loss, such as medical costs, loss of income, etc.

General Insurance

Another term for property insurance.

Grace Period Clause

A clause in life insurance giving the insured an extra 30 days to pay a premium due before lapse takes place.

Graded Commission

A reduced commission justified by the size of the premium

Gross Negligence

Intentional failure to perform a duty, reckless disregard of the consequences as affecting the life or property of another

Gross Premium

The premium paid by the policyholder.

Gross Profit

The figure calculated by adding turnover to closing stock and work in progress and subtracting from this amount the sum of the opening stock and work in progress and the variables selected by the insured (usually defined as specified working expenses).

Gross Premium

The premium charge for insurance that includes anticipated cost of losses, overhead, and profit.

Group Insurance

A single policy covering a group of individuals, usually employees of the same company or members of the same association and their dependents. Coverage occurs under a master policy issued to the employer or association.

Guaranteed Renewable

A policy that cannot be cancelled by the insurer prior to a specified age. Premiums may be increased only for an entire class of insureds.

Hacker Insurance:

A coverage that protects businesses engaged in electronic commerce from losses caused by hackers.

Hail Insurance

Form of insurance that protects against loss of crops from hail

Hard Market

A sellers market in which insurance is expensive and in short supply.

Hazards

Conditions that introduce or increase the probability of loss stemming from the existence of a given peril.

Hedger

The transferor of a speculative risk via a hedging contract

Hedging

A transfer of risk from one party to another; similar to speculation and may be used to handle risks not subject to insurance, such as price fluctuations.

Hit & Run

In Motor Insurance, Accident arising out of the use of motor vehicle the identity whereof can not be ascertained in spite of reasonable efforts for the purpose.

Homeowners Insurance Policy

The typical home-owners insurance policy covers the house, the garage and other structures on the property, as well as personal possessions inside the house such as furniture, appliances and clothing, against a wide variety of perils including windstorms, fire and theft. The extent of the perils covered depends on the type of policy. An all-risk policy offers the broadest coverage. This covers all perils except those specifically excluded in the policy.

Hospice

A health care organization that provides humane, dignified care for dying patients.

Hospital Insurance

An insurance contract designed to pay hospital room and board, laboratory fees, nursing care, use of the operating room, and medicines and similar expenses.

Hospital Cash

It is a health plan that pays a specific amount per day of hospitalization to the policy holder if he/she is hospitalized.

Hospitalization

Situation when a policy holder gets admitted into the hospital for either scheduled procedures or accidents/medical emergencies for over 24 hours.Note that some Health Insurance plans also cover day care procedures and treatments i.e., a hospital stay for less than 24 hours

Hostile Fire

A fire that occurs outside of its normal confines.

House Breaking

When the theft is committed entering into or out of the premises stealthily

Housekeeping

The general care, cleanliness and maintenance of an insured property

Householders Policy

A package of insurance providing homeowners with a broad range of property and liability coverages Hull insurance (in ocean marine and aviation insurance) Coverage for physical damage to a vessel or aircraft

Hull Insurance

Property insurance policy covering a sea-going vessel.

Human Life Value

The sum of money that when paid in instalments of both principal and interest over the individual’s remaining working life, will produce the same income the person would have earned, minus taxes and personal expenses.

Holding Of Policy

It defines whether there is one person insured or multiple person insured.

Hypothecation

Hypothecation is legal term that refers to the granting of a hypothec to a lender by a borrower. In practice, the borrower pledges an asset as collateral for a loan, while retaining ownership of the assets and enjoying the benefits there from

Hijack

illegally seize (an aircraft, ship, or vehicle) while in transit and force it to go to a different destination or use it for one's own purposes.

Hijack Sum Insured

Payment of distress allowance in case of hijack of a common carrier for more than certain number of hours whilst on the trip.

Hijack Deductible

It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.

Health Checkup

Insurance co provides health checkup reimbursement up to a limit. This facility is available normally after 3-4 renewals with same insurance co.

Identity Theft Insurance

Coverage for expenses incurred as the result of an identity theft. Can include costs for notarizing fraud affidavits and certified mail, lost income from time taken off from work to meet with law enforcement personnel or credit agencies, fees for reapplying for loans and attorney’s fees to defend against lawsuits and remove criminal or civil judgments.

Illegal Contract

It is a contract, which is contrary to law and against the interests of public. It can not be sustained and does not have legal effect.

Immediate Annuity

An annuity in which benefits begin soon after the annuity is purchased.

Impact Damage

Loss or physical damage or destruction caused to the property due to impact by any Rail/Road vehicle or Animal.

Implied Warranties

Warranties not stated in a con-tract but assumed by the parties to be true.

Imputed Acts

Acts committed by one person but for which responsibility has been transferred or imputed to another.

Imputed Negligence

Case in which responsibility for damage can be transferred from the negligent party to another person, such as an employer

Inboard Watercraft

A type of watercraft whose motor is a permanent part of it.

Incontestability Clause

A life insurance clause that prevents the insurer, after two years, from denying liability under the policy for misrepresentations or concealments by the insured.

Increasing Term

Term life insurance in which the face amount of the policy increases periodically on a predetermined basis.

Incurred But Not Reported Losses (ibnr)

Losses that are not filed with the insurer or reinsurer until years after the policy is sold. Some liability claims may be filed long after the event that caused the injury to occur. Asbestos related diseases, for example, do not show up until decades after the exposure. IBNR also refers to estimates made about claims already reported but where the full extent of the injury is not yet known, such as a workers compensation claim where the degree to which work related injuries prevents a worker from earning what he or she earned before the injury unfolds over time. Insurance companies regularly adjust reserves for such losses as new information becomes available.

Incurred Claims

Incurred claims equal the claims paid during the policy year plus the claim reserves as of the end of the policy year, minus the corresponding reserves as of the beginning of the policy year. The difference between the year end and beginning of the year claim reserves is called the increase in reserves and may be added directly to the paid claims to produce the incurred claims

Incurred Losses

Losses occurring within a fixed period, whether or not adjusted or paid during the same period.

Indemnify

Provide financial compensation for losses.

Indemnify

To restore insured to the situations that existed prior to a loss.

Independent Adjuster

An individual or firm employed by an insurer to settle loss claims.

Independent Agent

Agent who is self-employed, is paid on commission, and represents several insurance companies.

Indirect Loss

A loss that occurs indirectly as a con-sequence of a given peril.

Inflation Guard Clause

A provision added to a homeowners insurance policy that automatically adjusts the coverage limit on the dwelling each time the policy is renewed to reflect current construction costs.

Inherent Nature Of The Goods

A cause of loss that stems from the product itself. A loss due to this cause releases the carrier from liability.

Inherent Vice

A characteristic depreciation such as the fading of ink, a cracking of parchment, the graying of hair

Inland Marine Insurance

This broad type of cover-age was developed for shipments that do not involve ocean transport. Covers articles in transit by all forms of land and air transportation as well as bridges, tunnels and other means of transportation and communication. Floaters that cover expensive personal items such as fine art and jewellery are included in this category.

Inland Transit Policy

A basis contract covering domestic shipments shipped primarily by land transportation systems.

Insolvency

Insurer’s inability to pay debts. Insurance insolvency standards and the regulatory actions taken vary from country to country.

Insurable Interest

A legal principle in which an insured must demonstrate a personal loss; prevents the insurance from becoming a gambling contract.

Insurable Risk

Risks for which it is relatively easy to get insurance and that meet certain criteria. These include being definable, accidental in nature, and part of a group of similar risks large enough to make losses predictable. The insurance company also must be able to come up with a reasonable price for the insurance.

Insurable Value

In business income coverage, the amount obtained by deducting variable costs and expenses (those that may be discontinued in the event of a shutdown) from the total sales.

Insurance

A system to make large financial losses more affordable by pooling the risks of many individuals and business entities and transferring them to an insurance company or other large group in return for a premium.

Insurance Rate

The price of insurance, expressed as a price per unit of coverage.

Insured Pension Plans

Employee benefit plans managed by an insurance company.

Insurer

The transferee; the person or agency providing insurance.

Insuring Agreement

The part of an insurance contract that states what the insurer agrees to do and the conditions under which it so agrees.

Integrated Risk Management

Approach for managing both pure and speculative risks together; another name for enterprise risk management.

Internet Insurer

An insurer that sells exclusively via the Internet.

Internet Liability Insurance

Coverage designed to protect businesses from liabilities that arise from the conducting of business over the Internet, including copyright infringement, defamation, and violation of privacy.

Intestacy Laws

Laws governing the distribution of an estate not disposed of by a will.

Intestate

Without a valid will.

Investment Income

Income generated by the investment of assets. Insurers have two sources of income, underwriting (premiums less claims and expenses) and investment income. The latter can offset underwriting operations, which are frequently unprofitable.

Involuntary Coverage

Government insurance required to be purchased by certain groups and under certain conditions.

Irrevocable Beneficiary

A beneficiary designation that may not be changed without the written consent of the named beneficiary.

Insurer

A Company that underwrites an insurance risk . The party in an insurance contract undertaking to pay Agreed financial compensation.

Jettison

Act of throwing overboard part of a vessel's cargo or hull in hopes of saving a ship from sinking.

Jewelers Block Insurance

An all risk insurance contract that provides jewellers with coverage to losses, which they would be exposed.

Joint And Several Liability

The legal doctrine that allows a plaintiff to collect in full from one negligent party in an accident where there are two or more negligent parties.

Joint And Survivor Annuity

An annuity issued on two lives that guarantees that the annuity in whole or in part will be paid as long as either party shall live.

Joint And X Percent Survivor Annuity

A joint and survivor annuity in which the payment after the first annuitant dies equals X percent of the benefit while both were alive.

Key Employee

An employee whose services would be difficult to replace if the employee were to die or become disabled.

Key Person Insurance

Insurance on the life or health of a key individual whose services are essential to the continuing success of a business and whose death or disability could cause the firm a substantial financial loss.

Kidnap/ransom Insurance

Coverage up to specific limits for the cost of ransom or extortion payments and related expenses. Often bought by international corporations to cover employees. Most policies have large deductibles and may exclude certain geographic areas. Some policies require that the policyholder not reveal the coverage existence.

Key Protect Cover

This add on cover takes care of the expenses incurred in the repair or replacement of car keys and locks or related mechanism that are part of insured vehicle.

Lack Of Privity

A defence in product liability cases, alleging that no liability exists because no contractual relationship exists between the manufacturer or vendor and the injured party.

Lapse

Termination of a policy due to failure by the insured to pay the premium as required

Larceny

Wrongful or fraudulent taking and carrying away by any person of the personal property of another.

Large-loss Principle

A rule for buying insurance such that serious loss exposures receive priority over less serious loss exposures.

Last Clear Chance Rule

In a case of contributory negligence, the negligent plaintiff may have a cause of action against the defendant if the defendant had a last clear chance to avoid the accident but failed to do so.

Law Of Large Numbers

The theory of probability on which the business of insurance is based. Simply put, this mathematical premise says that the larger the group of units insured, such as sport utility vehicles, the more accurate the predictions of loss will be.

Leasehold

An interest in real property created by an agreement (a lease) that gives the lessee (the tenant) the right of enjoyment and use of the property or a period of time.

Legal Injury

Wrongful violation of a person’s rights.

Legal Costs

The costs of defending a claim from a third party and claimant's costs for which an insured is liable, are usually covered by a liability policy.

Legal Liability

Any liability imposed on a person by a court of law

Lessee

The person to whom a lease is granted, commonly called the tenant.

Lessor

The person granting a lease, also known as the landlord

Letter Of Credit (loc)

Within the context of reinsurance, a banking instrument established on a 'standby' basis to secure recoverable from non-admitted reinsurers to enable the ceding company to reduce the provision for unauthorized reinsurance in its statutory statement

Liability

Any legally enforceable obligation

Liability Insurance

Insurance for what the policy-holder is legally obligated to pay because of bodily injury or property damage caused to another person.

Libel

Written, printed, or pictorial material that damages a person’s reputation by defaming or ridiculing the person.

Licensing

The incorporation of a company in the jurisdiction or the approval given to a company to underwrite insurance in the jurisdiction. These are recognized to be separate approvals and may be made in separate jurisdictions

Line

One line is equal to the ceding company 's retention. A proportional treaty may have a total capacity expressed as x lines and a reinsurer's share may be y lines

Line Of Business

The general classification of business as utilized in the insurance industry, i.e., fire, allied lines, homeowners, etc

Life Insurance

See Ordinary life insurance; Term insurance; Whole life insurance

Lifetime Maximum

A limit that applies to all benefits payable under an insurance plan. The maximum can often be restored over time, eventually allowing an insured to collect more than the stated maximum.

Limits

Maximum amount of insurance that can be paid for a covered loss.

Liquidity

The ability and speed with which a security can be converted into cash.

Lloyd’s Of London

A marketplace where underwriting syndicates, or mini-insurers, gather to sell insurance policies and reinsurance. Each syndicate is managed by an underwriter who decides whether or not to accept the risk. The Lloyds market is a major player in the international reinsurance market as well as a primary market for marine insurance and large risks. Originally, Lloyds was a London coffee house in the 1600s patronized by ship owners who insured each others hulls and cargoes. As Lloyds developed, wealthy individuals, called ?Names,? placed their personal assets behind insurance risks as a business venture. Increasingly since the 1990s, most of the capital comes from corporations.

Loading

The overhead or administrative expenses of an insurer that is included in the cost of a policy.

Long-term Care

Care and service provided to the elderly to assist them with day-to-day living.

Long-term Care Insurance

Coverage that, under specified conditions, provides skilled nursing, inter-mediate care, or custodial care for a patient (generally over age 65) in a nursing facility or his or her residence following an injury.

Long-term Care Rider

An accelerated death benefit specifically for insured’s long-term care needs.

Loss

A reduction in the quality or value of a property, or a legal liability.

Loss Adjustment Expenses

The sum insurers pay for investigating and settling insurance claims, including the cost of defending a lawsuit in court.

Loss Control

Actions taken to reduce the frequency and/or severity of losses.

Loss Costs

The portion of an insurance rate used to cover claims and the costs of adjusting claims. Insurance companies typically determine their rates by estimating their future loss costs and adding a provision for expenses, profit, and contingencies.

Loss Exposure

A potential loss that may be associated with a specific type of risk.

Loss Exposure Checklist

A risk identification tool used by businesses and individuals that lists many different potential losses. The user can determine which of the potential losses is relevant.

Loss Of Use

A provision in homeowners and renters insurance policies that reimburses policyholders for any extra living expenses due to having to live else-where while their home is being restored following a disaster.

Loss Ratio

Percentage of each premium rupee an insurer spends on claims.

Loss Reserves

The company’s best estimate of what it will pay for claims, which is periodically readjusted. They represent a liability on the insurer’s balance sheet

Loss Settlement Clause

A provision that helps determine if items will be valued at actual cash value or at replacement cost after a loss.

Legal Liability To Paid Driver

the passengers or a hired driver are not covered under personal accident insurance. Third party cover does not include cover for your legal liability towards your paid driver. Therefore, if your car is not self-driven you need to buy a cover for your driver, under the Workmen Compensation Act.

Loss Of Baggage

It is the cost of replacement of the articles for any amount up to the Total Sum Insured subject to deductible, in case personal documents and/or personal effects have been checked in on the same Common Carrier as a travelling Insured Person, are damaged or lost.

Loss Of Baggage Sum Insured

The amount that needs to be paid to claim for baggage insurance.

Loss Of Baggage Deductible

It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.

Loss Of Passport

Reimbursement of actual expenses incurred in connection with obtaining a duplicate or fresh passport if the passport belonging to the Insured Person is lost.

Loss Of Passport Sum Insured

Amount payable in case of loss of passport

Loss Of Passport Deductible

It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.

Manual

A book of rates, rules, and coverages usually available for each kind of insurance

Margin Of Solvency

The total assets of an insurance company must exceed its liabilities (other than share capital) by a relevant amount, known as the margin of solvency.

Malpractice Insurance

Professional liability cover-age for physicians, lawyers, and other specialists against suits alleging negligence or errors and omissions that have harmed clients.

Malus

On incurred claim ratio loading is applied to the renewal premium for adverse claim experience

Manifestation Doctrine

A liability limit that provides coverage when a claimant’s disease or injury is discovered.

Manifestation Doctrine

A liability limit that provides coverage when a claimant’s disease or injury is discovered.

Marine Insurance

Coverage for goods in transit, and for the commercial vehicles that transport them, on water and over land. The term may apply to inland marine but more generally applies to ocean marine insurance. Covers damage or destruction of a ship’s hull and cargo and perils include collision, sinking, capsizing, being stranded, fire, piracy, and jettisoning cargo to save other property. Wear and tear, dampness, mould, and war are not usually included.

Market Value

The price for which something would sell, especially the value of certain types of assets, such as stocks and bonds. It is based on what they would sell for under current market conditions. For example, common stock market value would be the price of the stock as of a specified date

Material

Describes misrepresentations that, had they been known at the time of a contract’s issuance, would have caused it not to be issued at all or issued on different terms.

Maternity

It is an insurance coverage plan which helps in covering all pregnancy related expenses such as clinical visits, medication and delivery costs.

Maximum Possible Loss

An estimate of the worst loss that might result from a given occurrence.

Mediation

Nonbinding procedure in which a third party attempts to resolve a conflict between two other parties.

Medical Payments

Reasonable and necessary medical expenses caused by an accident and sustained by the insured. Such expenses must occur within three years of the accident.

Medical Payments Insurance

A coverage in which the insurer agrees to reimburse the insured and others up to a certain limit for medical or funeral expenses as a result of bodily injury or death by accident. Payments are without regard to fault.

Mine Subsidence Coverage

An endorsement to a homeowners insurance policy, available in some states, for losses to a home caused by the land under a house sinking into a mine shaft. Excluded from standard homeowners policies, as are other forms of earth movement.

Misrepresentation

A practice, usually prohibited by law, in which an insurance agent makes a misleading statement in the sale of insurance.

Misstatement-of-age Clause

A clause in life insurance requiring an adjustment of the amount of insurance payable in the event the age of the insured has been misrepresented.

Misstatement-of-sex Clause

If a person’s sex has been misrepresented, the insurer adjusts the amount of proceeds payable rather than cancelling the policy altogether.

Money Supply

Total supply of money in the economy, composed of currency in circulation and deposits in savings and checking accounts.

Moral Hazard

A hazard resulting from the indifferent or dishonest attitude of an individual to seek undue advantage in relation to insured property.

Mortality Table

A table that shows the number of deaths per thousand and the expectation of life at various ages.

Mortgage Clause

A clause in insurance contracts that gives first right of recovery to the mortgagor of property that is covered.

Mortgage Insurance

A form of decreasing term insurance that covers the life of a person taking out a mortgage. Death benefits provide for payment of the outstanding balance of the loan. Coverage is in decreasing term insurance, so the amount of coverage decreases as the debt decreases. A variant, mortgage unemployment insurance pays the mortgage of a policyholder who becomes involuntarily unemployed.

Mortgage-backed Securities

Investment grade securities backed by a pool of mortgages. The issuer uses the cash flow from mortgages to meet interest payments on the bonds.

Mortgagee

A person or organization holding a mortgage

Mpl (maximum Probable Loss)

The largest loss thought probable under a given insurance policy. Normally applied to material damage risks where the total sum insured is not considered to be at risk from one loss event

Multiple Peril Policy

A package policy, such as a homeowners or business insurance policy that provides coverage against several different perils. It also refers to the combination of property and liability coverage in one policy.

Manufacturing (month/year)

The date on which the vehicle was manufactured in the car company

Medical Evacuation

Medical Evacuation & Repatriation insurance plans provide you with the protection in case you need to be evacuated or repatriate your mortal remains home.

Medical Evacuation Sum Insured

Coverage amount for Medical Evacuation & Repatriation insurance plans provide you with the protection in case you need to be evacuated or repatriate your mortal remains home.

Medical Evacuation Deductible

It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.

Medical Repatriation

Medical Evacuation & Repatriation insurance plans provide you with the protection in case you need to be evacuated or repatriate your mortal remains home.

Medical Repatriation Deductible

It is a amount which is deducted from the compensation for a specific benefit. It does not reduce the sum insured.

Maternity Cover

Maternity insurance is usually provided as an add-on or additional rider with your main health insurance policy. This insurance covers expenses related to both baby delivery options – caesarean and normal delivery.

Maternity Waiting Period

Maternity waiting period is the no of months or years when a maternity claim will not be paid by the insurer.

Mode Of Premium Payment    

Different Options to pay the premium in the insurance policy. E.g Single/Yearly/Half yearly/Quarterly/Monthly

Maturity Benefit

Maturity amount to be paid to the customer post completion of policy term.

Name

A member of a Lloyd’s association; essentially an investor and underwriter.

Named Insured

An individual in whose name the insurance contract is issued and who is specifically identified as the person being covered.

Named Peril

Peril specifically mentioned as covered in an insurance policy.

Named-perils Agreement

An insurance contract that lists perils to be insured; perils not listed are not covered.

Negative Act

A negligent act that consists of a party’s failure to do something he or she should have done.

Negligence

The failure to exercise the degree of care required by law.

Net Present Value

The present value of the cash inflow minus the present value of the cash outflow.

Net Premium

A portion of the premium rate designed to cover benefits of the policy, but not expenses, contingencies, or profit

Net Premiums Earned

Net premiums written adjusted for the increase or decrease during the year of the liability for unearned premiums

Net Premiums Written

This item represents gross premiums written (direct and reinsurance assumed) less reinsurance ceded

Net Retention

The final amount of insurance retained by the company after reinsuring such amounts as it did not wish to retain

No Claims Bonus

A reduction in the price of an insurance policy because no claims have been made on it

No-fault

Auto insurance coverage that pays for each driver’s own injuries, regardless of who caused the accident. It also refers to an auto liability insurance system that restricts lawsuits to serious cases. Such policies are designed to promote faster reimbursement and to reduce litigation.

Nomination

As per section 39 of the Insurance Act 1938, the holder of a Policy ( Life assured) can nominate a person /s who has insurable interest on the life to receive life insurance benefit on the death of the life assured.

Nominee

Nominee is the person who is nominated to receive the amount under a policy and to give a valid discharge to the insurer on settlement of claim under a life insurance policy

Non-admitted Insurer

Insurers licensed in some states or countries, but not others. Countries where an insurer is not licensed call that insurer non-admitted. They sell coverage that is unavailable from licensed insurers within the country or state.

Noncancellable

A policy that cannot be cancelled by the insurer prior to a certain age. Premiums may be increased only by the amounts specified at the time the policy is issued.

Non-owned Auto

Any private passenger auto, pickup truck, van, or trailer nor owned by or furnished for the regular use of the insured or any family member while in the custody of or being operated by the insured or any family member.

No-pay, No-play

The idea that people who don’t buy coverage should not receive benefits. Prohibits uninsured drivers from collecting damages from insured drivers.

Notice Of Loss

A written notice required by insurance companies immediately after an accident or other loss. Part of the standard provisions defining a policyholder’s responsibilities after a loss.

Ncb Retention Cover

Motor Insurance companies offer customers the options of choosing a No Claim Bonus (NCB) retention insurance add-on cover also known as NCB retention add-on. Such add-on covers offer protection for your accumulated NCB up to a certain limit. This cover may not be offered by all insurance providers.

No Of Days

No of days when certain claim is not admissible.

New Born Baby Cover

This covers the new born baby from day1 to day 90 for any in patient hospitalization. Many insurance co provide inbuilt insurance cover and may insurance company provide as a rider.

Name Of nominee

Name of the person as nominated by the Life assured to receive the death claim benefit

Name Of Appointee (if Nominee Is Minor)

The person who is the custodian of the policy till the time nominee is Minor.

Name Of Fund

Funds offered by Insurer & so selected by the Insured in which Money can be invested.

Nav

NAV is market value of investments held under the Unit-Linked Fund plus or minus the expenses incurred in purchase or sale of assets, plus the value of any current assets and any accrued income net of Fund Management Charges less the value of any current liabilities and provisions, if any.

Number Of Units

It is arrived by dividing Total fund value with NAV.

Objective Risk

The probable variation of actual from expected experience.

Obligee

In a bond, the party to be reimbursed if he or she suffers a loss because of some failure by the obligor.

Obligatory Treaty

A reinsurance contract under which business must be ceded in accordance with contract terms and must be accepted by the reinsurer

Occupational Hazards

Occupations which expose the insured to greater than normal physical danger by the very nature of the work in which the insured is engaged, and the varying periods of absence from the occupation, due to the disability, that can be expected

Occupational Disease

Abnormal condition or illness caused by factors associated with the workplace. Like occupational injuries, this is covered by workers compensation policies.

Occurrence Policy

Insurance that pays claims arising out of incidents that occur during the policy term, even if they are filed many years later.

Ocean Marine Insurance

Coverage of all types of vessels and watercraft, for property damage to the vessel and cargo, including such risks as piracy and the jettisoning of cargo to save the property of others. Coverage for marine related liabilities. War is excluded from basic policies, but can be bought back.

Ombudsman

An authority established either by the company or the Government for the quick redressal of grievances

Open-perils Agreement

States that it is the insurer’s intention to cover risks of accidental loss to the described property except due to those perils specifically excluded; also called ?all risks.?

Operating Expenses

The cost of maintaining a business’s property, includes insurance, property taxes, utilities and rent, but excludes income tax, depreciation and other financing expenses.

Open Cover

Gives to insured automatic insurance protection so that there is no risk of any shipments remaining uninsured through oversight

Open Form

A continuous policy written on a reporting basis

Operative Clause

Defines the class and nature of business covered by a specific reinsurance treaty

Opportunity Cost

The cost of keeping monies liquid in a loss reserve fund rather than using them as working capital.

Optionally Renewable

A policy that can be cancelled by the insurer on the anniversary date. No restrictions, other than the time, are placed on the insurer.

Options

Contracts that allow, but do not oblige, the buying or selling of property or assets at a certain date at a set price.

Ordinary Life Insurance

A life insurance policy that remains in force for the policyholder’s lifetime. It contrasts with term insurance, which only lasts for a specified number of years but is renewable.

Other Insurance Clauses

Clauses in practically all contracts of indemnity and valued contracts that limit the insurer’s liability in case additional insurance con-tracts also cover the loss.

Organ Donor

A person who donates an organ or organs needed for transplantation .

Organ Donor Value

Organ donor value signifies the amount of money to be paid towards the hospitalization expenses for the person who is donating his/her organ. The amount can be as high as Sum insured in the plan.

Other Rider

Any other additional coverage

Package Policy

A single insurance policy that combines several coverages previously sold separately. Examples include homeowners insurance and commercial multiple peril insurance.

Pain And Suffering Damages

Non-economic damages designed to compensate the injured party for the pain endured due to the negligent behaviour of the defendant. Often greater than economic losses, such as loss of income and medical expenses.

Pair-and-set Clause

Used to determine the loss payment when part of a set or one of a pair is lost. The insurance company will pay only the difference in the actual cash value of the item before and after the loss.

Partial Disability

An illness or injury that decreases an individual’s ability to perform some of the major duties of his or her job, but does not cause complete cessation of employment.

Participating

A type of life insurance policy in which a dividend (considered a return or a premium overcharge) is payable to the insured.

Pensions

Programs to provide employees with retirement income after they meet minimum age and service requirements. Life insurers hold some of these funds.

Per-cause Deductible

A deductible that is assessed for each new sickness or accidental injury.

Peril

Possible occurrences, such as a fire, windstorm, flood, lightning, earthquakes or theft. A named-peril policy covers the policyholder only for the risks named in the policy in contrast to an all-risk policy, which covers all causes of loss except those specifically excluded.

Permanent Disability

An illness or injury that prevents a person from working for the rest of his or her life.

Per-service Deductible

A fee that is charged for each service or visit to the physician.

Personal Articles Floater

A policy or an addition to a policy used to cover personal valuables, like jewellery.

Personal Coverages

Those lines of insurance designed to cover the risk of perils that may interrupt an individual’s income.

Physical Hazard

A condition stemming from the material characteristics of an object, e.g., wet or icy street (increasing chance of car collision) and earth faults (hazard for earthquakes)

Pilferage

Petty theft, especially theft of articles in less than package lots.

Planned Retention

A conscious and deliberate assumption of recognized risk

Policy

A written contract for insurance between an insurance company and policyholder stating details of coverage.

Policy Writing

The function of creating a specific insurance policy for a client, usually by the agent.

Policyholder

The insured in an insurance policy.

Policyholders Surplus:

The amount of money remaining after an insurer’s liabilities is subtracted from its assets. It acts as a financial cushion above and beyond reserves, protecting policyholders against an unexpected or catastrophic situation.

Political Risk Insurance:

Coverage for businesses operating abroad against loss due to political upheaval such as war, revolution, or confiscation of property

Pollution Insurance:

Policies that cover property loss and liability arising from pollution-related damages, for sites that have been inspected and found uncontaminated. It is usually written on a claims-made basis so policies pay only claims presented during the term of the policy or within a specified time frame after the policy expires.

Pooling

Sharing total losses among a group

Portability

A provision by which policy holders can change their insurance provider at their own discretion. This usually happens if the policy holder is not satisfied with the service quality of their current insurance provider, or the coverage is not enough or appropriate for the premiums being paid.

Post-hospitalization

It is treatments and expenses after getting discharged from the hospital which may be follow-up visits to the doctor, medications, etc.

Pre-admission Review/pre-admission Testing

Part of the hospital admission process where a review is done for a policy holder. Physicians or doctors at the hospital examine the policy holder’s health condition and past records before he/she is admitted in the hospital.

Pre-authorization

Applies in case the policy holder goes for admission to a network hospital. A person from the hospital staff confirms from Health Insurance about details of the policy and assesses what procedures are covered and for what amount. Example scenario: Before getting admitted in the hospital for treatment, the hospital staff will contact insurance companies to confirm if Raj is eligible for insurance. Once pre-authorization is done Raj can get admitted and treatment can begin. Also see a short video explaining the cashless claim process.

Pre-existing Condition

A health condition or disability the policy holder has had prior to applying for health insurance. Typically, pre-existing conditions are not covered by insurance policies for a period of several months.

Pre-hospitalization

It is the medical expenses taken into account before a policy holder is hospitalized.

Pregnancy Care

Insurance for expecting mothers covering expenses such as tests, checkups, medicines.

Positive Act

Action often leading to legal injury.

Post-loss Activities

Severity-reduction measures such as salvaging damaged property rather than dis-carding it.

Precertification

A cost-containment measurement requiring that certain non-emergency medical services be authorized prior to delivery of treatment.

Pre-existing Condition

A health problem that exists prior to the time when health coverage becomes effective.

Pre-loss Activities

Loss control methods implemented before any losses occur. All measures with a frequency-reduction focus, as well as some based on severity reduction, are of this type.

Premature Death

Death that occurs before the stage where it is accepted by society as part of the natural, expected order of life.

Premises

The particular location of the property or a portion of it as designated in an insurance policy.

Premium

The price of an insurance policy.

Premiums In Force

The sum of the face amounts, plus dividend additions, of life insurance policies out-standing at a given time.

Premiums Written

The total premiums on all policies written by an insurer during a specified period of time, regardless of what portions have been earned. Net premiums written are premiums written after reinsurance transactions.

Presumption Of Death

If a person is reported missing without any information for more than 7 years, as per The Indian Evidence Act, presumption of death is awarded by the Court Authority.

Primary

Describes policies that will pay up to their limits before any other coverage becomes payable.

Primary Company

In a reinsurance transaction, the insurance company that is reinsured.

Prime Rate

Interest rate that banks charge to their most creditworthy customers. Banks set this rate according to their cost of funds and market forces.

Principal

Another name for the obligor, the person bonded, in a fidelity or security bond.

Principle Of Indemnity

A doctrine that limits the amount that an insured may collect to the actual cash value of the property insured.

Private Insurance

Insurance coverage written by firms in the private sector of the economy (as opposed to government insurers).

Probate

A court process under which property is distributed and the terms of the will are carried out at the owner’s death.

Product Liability

A section of tort law that determines who may sue and who may be sued for damages when a defective product injures someone.

Product Liability Insurance

Protects manufacturers and distributors exposure to lawsuits by people who have sustained bodily injury or property damage through the use of the product.

Production

The selling function in insurer operations.

Professional Liability

Liability that arises out of the error of a professional person in performance of his or her duties.

Professional Liability Insurance

Covers professionals for negligence and errors or omissions that injure their clients.

Profits Insurance

Coverage for the loss of the profit element in goods already manufactured but destroyed before they could be sold.

Promissory Warranty

An assurance that a certain condition, fact, or circumstance will be true for the entire term of a contract.

Property Coverages

Insurance lines designed to cover perils that may destroy property.

Property/casualty Insurance

Covers damage to or loss of policyholders? property and legal liability for damages caused to other people or their property. Property/casualty insurance, which includes auto, homeowners and commercial insurance, is one segment of the insurance industry. The other sector is life/health. Property/casualty insurance is referred to as non-life or general insurance.

Pro-rata Clause

A clause that requires each insurer covering a risk to share pro rata any losses, in the proportion that its particular coverage bears to the total coverage on the risk.

Pro-rata Treaties

Reinsurance agreements under which premiums and losses are shared in some stated proportion.

Protection And Indemnity (p&i) Clause

Marine liability insurance covering ocean-going vessels.

Proximate Cause

The direct cause of loss; exists if there is no unbroken chain of events leading from one act to a resulting injury or loss.

Public Adjuster

An individual or firm hired by the insured to obtain satisfactory settlement of a loss claim.

Public Insurance

Insurance coverage written by government bodies or operated by private agencies under government supervision and control.

Punitive Damages

Assessed when it is deemed that the defendant acted in a grossly negligent manner and deserves to have an example made of his or her behaviour so as to discourage others from acting that way. Usually imposed in addition to other damages.

Pure Premium

The portion of an insurance premium that reflects the basic costs of loss, not including over-head or profit.

Pure Risk

Uncertainty as to whether a loss will occur.

Plan Name

Name of the insurance policy of the company chosen for cover

Policy Number

Unique serial no assigned to Insured person

Plan Name

Name of the insurance policy of the company chosen for cover

Policy No

A policy number is a unique identifier that attaches a policy to a specific individual. A policy number is assigned to a policy by an insurance company once you have purchased insurance from them. This number is a reference point for the insurance company.

Personal Accident To Driver/owner

"Motor insurance policy has an inbuilt Personal accident cover for the vehicle owner and driver at no extra cost, wherein the driver is covered as per the Workmen’s Compensation Act. The driver should have a valid driving license. "

Personal Accident To Passenger

"Personal accident cover for any other person can be obtained by paying an additional premium. The company will pay a fixed amount for the bodily injury or death of the passenger. "

Pre-existing Damage To Vehicle

Insurance companies carries a pre sales survey of the car for any damage that is already visible in the car.

Personal Accident

Payment of compensation if the Insured sustains accidental bodily injury during a trip resulting in death or Permanent Total Disablement or Permanent Partial Disablement within 12 months of occurrence of such injury.

Pre Hospitalization

Pre-hospitalization is additional cover benefits which the insurance company extends the policyholder whereby they provide cover for expenses covered for an illness or injury for a certain period before the treatment for that injury or illness is done in a hospital.

Post Hospitalization

Post hospitalization are additional cover benefits which the insurance company extends the policyholder whereby they provide cover for expenses covered for an illness or injury for a certain period after the treatment for that injury or illness is done

Policy Term

No of Years the policy coverage will be in force if premium is paid as per mode of premium payment so selected.

Premium Paying Term

No of years Premium needs to be paid

Premium Amount

Amount to be paid against the coverage amount

Quota Share Treaties

Reinsurance arrangements in which each insurer accepts a certain percentage of premiums and losses in a given line of insurance.

Quote

An estimate of the cost of insurance, based on information supplied to the insurance company by the applicant

Rate

The cost of a unit of insurance. Rates are based on historical loss experience for similar risks and may be regulated.

Rate Making

The process of developing pricing structures for insurance.

Ratification

A method by which an agent gains authority to write insurance. The agent writes a policy and, after the fact, presents it to the insurance company. If the insurance company approves the policy, the agent?s authority is ratified.

Reasonable And Customary

A test used to judge what expenses an insurance policy will pay. The fee is compared to prevailing fees in the area.

Reasonable Expectations

An extension of the concept of adhesion, this doctrine makes the proposition that coverage should be interpreted to be what the insured can reasonably expect.

Rebating

A practice, usually prohibited by law or the regulator, in which a sales agent in insurance returns part of the commission to the purchaser.

Receivables

Amounts owed to a business for goods or services provided.

Reciprocal

A form of insurer owned by policy-holders who exchange coverage with each other; commonly found in the field of automobile insurance.

Reduced Maternity Waiting Period

It is an additional benefit on top of health insurance plans provided by Cigna TTK Health Insurance. As the name suggests, the benefit allows for a reduced waiting time before maternity related claims can be made. Without this, the policy holder might wait up to 48 months before he or she can use the policy for a maternity related claim.

Reduced Pre-existing Diseases Waiting Period

This is an add-on benefit related to pre-existing diseases affecting the policy holder. Typically, those with pre-existing diseases cannot claim if affected by these diseases for several months after enrolling into the insurance plan. However, the ‘reduced pre-existing diseases waiting period’ add-on allows the policy holder to claim expenses faster.

Reinstatement Clause

A contract in life insurance that allows a policy that has lapsed to be reinstated.

Reinsurance

Insurance bought by insurers. A rein-surer assumes part of the risk and part of the premium originally taken by the insurer, known as the primary company. Reinsurance effectively increases an insurer’s capital and therefore its capacity to sell more coverage. The business is global and the largest reinsurers are based abroad. Reinsurers have their own reinsurers, called retrocessionaires.

Reinsurance

The shifting of risk by a primary answer (known as the ceding company) to another insurer (known as the reinsurer).

Reinsurance Pool

Provides reinsurance for a specific class of business.

Renewable Term

A life insurance policy initially written from a specified number of years and subsequently renewable for similar periods of time.

Rental Income

Rents collected from others who occupy property owned by the insured.

Rental Value

Consequential coverage that insures the loss of rents in the event of the destruction of the insured property.

Renters Insurance

A form of insurance that covers a policyholder’s belongings against perils such as fire, theft, windstorm, hail, explosion, vandalism, riots, and others. It also provides personal liability coverage for damage the policyholder or dependents cause to third parties. It also provides additional living expenses, known as loss-of-use coverage, if a policy-holder must move while his or her dwelling is repaired.

Replacement Cost

Insurance that pays the amount needed to replace damaged personal property or dwelling property without deducting for depreciation but limited by the maximum amount shown on the declarations page of the policy.

Representation

A statement made by an applicant for insurance, before the contract is made, which affects the willingness of the insurer to accept the risk.

Requisites Of Insurable Risks

From the view of the insurer, there must be a sufficient number of similar objects, the loss must be accidental and measurable, and the objects must not be subject to simultaneous destruction. From the view of the insured, the potential loss must be large enough to cause financial hard-ship, and the probability of loss must not be too high.

Res Ipsa Loquitur

(The thing speaks for itself) - a legal doctrine that enables a plaintiff to collect for losses without proving negligence on the part of the defendant.

Reserves

A company’s best estimate of what it will pay for claims

Respondeat Superior

A legal doctrine under which a principal is responsible for the acts of his or her agent.

Restoration

Restoration of sum insured is an added benefit in the health insurance products whereby in the event of claims the basic sum insured gets restored to its original value.

Retention

The amount of risk retained by an insurance company that is not reinsured.

Retrocession

The reinsurance bought by reinsurers to protect their financial stability.

Retrospective Rating

A method of permitting the final premium for a risk to be adjusted, subject to an agreed upon maximum and minimum limit based on actual loss experience. It is available to large commercial insurance buyers.

Revocable Beneficiary

A life insurance beneficiary designation that may be changed by the owner.

Rider

An attachment to an insurance policy that alters the policy’s coverage or terms.

Right Of Survivorship

Ownership of property automatically transfers to surviving owners when one of the owners dies.

Risk

The chance of loss or the person or entity that is insured.

Risk

Uncertainty as to economic loss. RISK AVOIDANCE: A conscious decision not to expose oneself or one’s firm to a particular risk of loss.

Risk Management

Management of the varied risks to which a business firm or association might be subject. It includes analysing all exposures to gauge the likelihood of loss and choosing options to better man-age or minimize loss. These options typically include reducing and eliminating the risk with safety measures, buying insurance, and self-insurance.

Risk Management Policy

A plan, procedure, or rule of action followed for the purpose of securing consistent action over a period of time.

Risk Management Process

(1) Identify risks; (2) evaluate risks as to frequency and severity; (3) select risk management techniques; and (4) implement and review decisions.

Risk Manager

An individual charged with minimizing the adverse impact of losses on the achievement of a company’s goals.

Risk Mapping (risk Profiling):

Method of risk identification and assessment by arranging all risks in a matrix reflecting frequency, severity, and existing insurance coverage.

Risk Reduction

A decrease in the total amount of uncertainty present in a particular situation.

Risk Retention

Handling risk by bearing the results of risk, rather than employing other methods of handling it, such as transfer or avoidance.

Risk Transfer

A risk management technique whereby one party (transferor) pays another (transferee) to assume a risk that the transferor desires to escape.

Risk-based Capital

The need for insurance companies to be capitalized according to the inherent riskiness of the type of insurance they sell. Higher-risk types of insurance, liability as opposed to property business generally necessitate higher levels of capital.

Robbery

Unlawful taking of property from another person by force, threat of force, or violence.

Registration Type

It implies the type of use by the vehicle owner.

Registration Number

A unique series of alpha numeric identifying a motor vehicle, assigned on registration and displayed on a number plate.

Rto Location

RTO location means the Regional transport office location where the vehicle is registered.

Road Side Assistance

Roadside assistance cover provides basic emergency assistance at the time of vehicle breakdown such as towing to nearest service center or arranging for alternate cars.

Remarks

Any additional comments

Room Rent Limit

The limit imposed on the coverage of boarding expenses or room rent of the hospital is called room rent limit.

Restore Benefit

Restore benefit feature enables the Sum insured under a policy to be immediately restored when the Sum insured is exhausted. This will be applicable for future claim in a same policy year and cannot be used in the same hospitalization.

Recovery Benefit

Both Restore and Recharge means reinstatement of the complete sum assured in the policy

Relationship With Insured

Relationship between Nominee and insured

Salvage

Damaged property an insurer takes over to reduce its loss after paying a claim. Insurers receive salvage rights over property on which they have paid claims, such as badly-damaged cars. Insurers that paid claims on cargoes lost at sea now have the right to recover sunken treasures. Salvage charges are the costs associated with recovering that property.

Schedule

A list of individual items or groups of items that are covered under one policy or a listing of specific benefits, charges, credits, assets or other defined items

Second Opinion

The policy holder consults with another healthcare professional to validate the first diagnosis or ‘opinion’.This is typically used to re-confirm that a correct diagnosis has been made.

Secondary Care

Services provided by a health care provider or specialist through a referral from another doctor (the one you went to originally).

Second-to-die Life Insurance

Life insurance policy covering two insureds, with proceeds payable only after both persons are dead.

Securities Outstanding

Stock held by shareholders.

Securitization Of Insurance Risk

Using the capital markets to expand and diversify the assumption of insurance risk. The issuance of bonds or notes to third-party investors directly or indirectly by an insurance or reinsurance company or a pooling entity as a means of raising money to cover risks.

Self-insurance

The concept of assuming a financial risk oneself, instead of paying an insurance company to take it on. Every policyholder is a self-insurer in terms of paying a deductible and co-payments. Also, a special form of risk retention in which a firm can establish a fund to pay for losses because it has a group of exposure units large enough to reduce risk and thereby predict losses.

Severity

Size of a loss. One of the criteria used in calculating premiums rates

Severity Reduction

A method of loss control that will reduce the seriousness and extent of damage should a loss occur.

Short-term Disability

When a person suffers a temporary loss of income due to an injury or illness which puts them out of work. The time period may range from 9 to 52 weeks, post which claims can be categorized for long term disability.

Single-premium Annuity

An annuity whose purchase price is paid in one lump sum.

Single-premium Life

A whole life policy paid for with one premium

Slander

Spoken words that are defamatory and/or injurious to a person’s reputation.

Social Insurance

Insurance plans operated by public agencies, usually on a compulsory basis.

Soft Market

An environment where insurance is plentiful and sold at a lower cost, also known as a buyers market.

Solvency

Insurance companies ability to pay the claims of policyholders. Regulations to promote solvency include minimum capital and surplus requirements, statutory accounting conventions, limits to insurance company investment and corporate activities, financial ratio tests, and financial data disclosure.

Special Agent

A person who is authorized to perform only a specific act or function and who has no general powers within the insurance company.

Speculative Risk

The uncertainty of an event that could produce either a profit or a loss, such as a business venture or a gambling transaction.

Speculator

A third party to which the risk of price fluctuations is transferred during hedging.

Spread Of Risk

The selling of insurance in multiple areas to multiple policyholders to minimize the danger that all policyholders will have losses at the same time. Companies are more likely to insure perils that offer a good spread of risk. Flood insurance is an example of a poor spread of risk because the people most likely to buy it are the people close to rivers and other bodies of water that flood.

Spread-of-loss Treaty

A type of reinsurance wherein losses are spread over a five-year period with little or no risk transfer after the five-year period ends.

Standard Premium

What an employer would pay at manual rates after adjustment for experience rating but before adjustment for retrospective rating.

State-mandated Benefits

Benefits that the state requires be offered to employees by employers.

Static Risks

Uncertainties, either pure or speculative, that stem from an unchanging society that is in stable equilibrium.

Straight Deductible

A deductible that applies to each loss and is subtracted before any loss payment is made.

Straight Life

A whole life policy in which premiums are payable as long as the insured lives.

Straight Life Annuity

A life annuity in which there is no refund to any beneficiary at the death of the annuitant.

Straight Term

Term insurance that covers a specific period of time and which cannot be renewed.

Structured Settlement

Legal agreement to pay a designated person, usually someone who has been injured, a specified sum of money in periodic payments, usually for his or her lifetime, instead of in a single lump sum payment.

Subjective Risk

The risk based on the mental state of an individual who experiences uncertainty or doubt as to the outcome of a given event.

Subrogation

The legal process by which an insurance company, after paying a loss, seeks to recover the amount of the loss from another party who is legally liable for it.

Suicide Clause

A clause in life insurance that requires payment by the insurer, even in the event of suicide, if the suicide occurs after a two-year period from the date the policy was issued.

Surety

In a bond, the party who agrees to reimburse the oblige.

Surety Bond

A contract guaranteeing the performance of a specific obligation. Simply put, it is a three-party agreement under which one party, the surety company, answers to a second party, the owner, creditor or oblige, for a third party’s debts, default or non-performance. Contractors are often required to purchase surety bonds if they are working on public projects. The surety company becomes responsible for carrying out the work or paying for the loss up to the bond (penalty) if the contractor fails to perform.

Surplus

The remainder after an insurer’s liabilities are subtracted from its assets. The financial cushion that protects policyholders in case of unexpectedly high claims.

Survivorship Benefit

That amount of money that becomes available for distribution to living annuitants as a result of the death of other annuitants.

Start Date

The calendar day on which a policy cover initiates. It includes the day, month and year.

Seating Capacity

Seating capacity is the number of people who can be legally seated in a specific space.

Sum Insured

Amount of Insurance coverage

Survival Benefit

Money back amount paid at regular interval to the customer as a percentage of Sum insured within policy term.

Temporary Disabilities

Illnesses or injuries that prevent a person from working for a limited time.

Temporary Life Annuity

An annuity that pays benefits until the expiration of a specified period of years or until the annuitant dies.

Term Contract

A health policy that expires at the end of a specified time and which cannot be renewed.

Term Insurance

A form of life insurance that covers the insured person for a certain period of time, the ?term? that is specified in the policy. It pays a benefit to a designated beneficiary only when the insured dies within that specified period which can be one, five, 10 or even 20 years. Term life policies are renewable but premiums increase with age.

Tertiary Care

Healthcare provided at specialty or super specialty hospitals.

Theft

Any act of stealing.

Theft Insurance

Coverage against loss through stealing by individuals not in a position of trust.

Third-party Administrator

An administrator hired by an employer to handle claims and other administrative functions associated with employee benefits. May also refer to and outside group that performs clerical functions for an insurance company.

Third-party Payer

Insurance companies such as Cigna TTK Health Insurance. When insurance companies like Health Insurance pay for the medical expenses to the hospital on behalf of the policy holder.

Title Insurance

Insurance that indemnifies the owner of real estate in the event that his or her clear ownership of property is challenged by the discovery of faults in the title.

Tort

A legal term denoting a wrongful act resulting in injury or damage on which a civil court action, or legal proceeding, may be based.

Tort Law

The body of law governing negligence, intentional interference, and other wrongful acts for which civil action can be brought, except for breach of contract, which is covered by contract law.

Tortfeasor

A wrongdoer; one who commits a tort.

Total Disability

An illness or injury that renders a person completely incapable of gainful employment during the period of disability.

Total Loss

The condition of an automobile or other property when damage is so extensive that repair costs would exceed the value of the vehicle or property.

Treaties

Reinsurance contracts.

Treaty Reinsurance

A standing agreement between insurers and reinsurers. Under a treaty each party automatically accepts specific percentages of the insurer’s business.

Trustee

The person having legal ownership of the trust property; required by law to manage and distribute it in accordance with the instructions specified in the trust agreement.

Twisting

The acts of a life insurance agent to persuade a client to drop one life policy and accept another, by misrepresenting the terms of either the present policy or the new policy, or both, to the detriment of the insured.

Total Premium

An insurance premium is the amount of money that an individual or business must pay for an insurance policy.

Total Od Premium

the premium paid for an accidental claim for damaged parts. An own damage cover in your motor insurance policy compensates you for expenses incurred to repair /replace parts damaged in the road accident

Total Liability Premium

The amount payable for third party damages in an insurance policy.It covers the insured's legal liability for death/disability of third-party loss or damage to the third-party property.

Taxes

a compulsory contribution to state revenue, levied by the government on workers' income and business profits, or added to the cost of some goods, services, and transactions.

Total Idv

Total IDV is the current market value payable to vehicle owner in case of total loss of vehicle.

Total Cover/invoice Cover

Return to invoice cover will ensure that in case of total loss or theft of your car, you will get the original invoice value, including registration charges and road tax paid, of the car and not just the insured declared value (IDV).

Total Fund

It is the sum of all funds at their market value. Total Fund Value = (Number of equity fund units x NAV of equity fund) + (Number of bond fund units x NAV of bond fund) etc

Ti – Terminal Illness

Accidental permanent disability rider provides a certain % of Sum assured in case of permanent loss of body parts or functions out of accidents within 180 days from the date of accident.

Umbrella Policy

Coverage for losses above the limit of an underlying policy or policies such as homeowners and auto insurance. While it applies to losses over the amount stated in the underlying policies, terms of coverage are sometimes broader than those of under-lying policies.

Underinsurance

The result of the policyholder’s failure to buy sufficient insurance. An underinsured policyholder may only receive part of the cost of replacing or repairing damaged items covered in the policy.

Underwriting

Examining, accepting, or rejecting insurance risks and classifying the ones that are accepted, in order to charge appropriate premiums for them.

Underwriting Income

The insurer’s profit on the insurance sale after all expenses and losses have been paid. When premiums aren’t sufficient to cover claims and expenses, the result is an underwriting loss. Underwriting losses are typically offset by investment income.

Unearned Premium

The portion of a premium already received by the insurer under which protection has not yet been provided. The entire premium is not earned until the policy period expires, even though premiums are typically paid in advance.

Unfunded Retention

Absorbing the expense of losses as they occur, rather than making any special advance arrangements to pay for them.

Unilateral Contract

A contract, such as an insurance contract, in which only one of the parties makes promises that are legally enforceable.

Uninsurable Risk

Risks for which it is difficult for someone to get insurance.

Unplanned Retention

The implicit assumption of risk by a firm or individual that does not recognize that a risk is acknowledge to exist but the maximum possible loss associated with it is significantly underestimated.

Utmost Good Faith

A legal doctrine in which a higher standard of honesty is imposed on parties to an insurance agreement than is imposed through ordinary commercial contracts.

Valued Policy

A policy under which the insurer pays a specified amount of money to or on behalf of the insured upon the occurrence of a defined loss. The money amount is not related to the extent of the loss. Life insurance policies are an example.

Vandalism

The malicious and often random destruction or spoilage of another person’s property.

Variable Annuity

An annuity whose value may fluctuate according to the value of underlying securities in which the funds are invested.

Viatical Settlement

The purchase of a life insurance policy from a terminally ill individual by an unrelated third party.

Vicarious Liability

Legal responsibility for the wrong committed by another person.

Vicarious Liability Laws

Laws requiring that parents assume liability for the acts of their children and that bar owners assume liability for the acts of their patrons. Also makes car owners liable for acts of drivers of their cars.

Void

A policy contract that for some reason specified in the policy becomes free of all legal effect. One example under which a policy could be voided is when information a policyholder provided is proven untrue.

Voluntary Act

A characteristic of a negligent act- the person committing the act chose to do so and could have chosen not to.

Voluntary Coverage

Insurance coverage purchased at the discretion of the buyer.

Voluntary Co-pay

You need to pay a certain portion of the claim amount and we will pay the rest. This option helps lower the insurance premium amount.

Vehicle Make

It implies the name of Vehicle manufacturer.

Vehicle Model

An automobile model (or car model or model of car, and typically abbreviated to just "model") is a particular brand of vehicle sold under a marquee by a manufacturer, usually within a range of models, usually of different sizes or capabilities.

Vehicle Variant

A ‘variant’ within a vehicle type shall group the vehicles which have all of the construction features in common.

Vehicle Idv

Insured Declared Value is the maximum Sum Assured fixed by the insurer which is provided on theft or total loss of vehicle. Basically, IDV is the current market value payable to vehicle owner in case of total loss of vehicle.

Voluntary Deductible

Voluntary deductible or excess is that portion of any claim, which is not covered by the insurance company. It is usually a standard amount specified in the policy document which the insured is willing to pay out of his pocket

Waiting Period

It is the time period before which a policy holder cannot make a claim after enrolling into a medical insurance plan. Typically this waiting period is for a few days.

Waiver

The surrender of a right or privilege. In life insurance, a provision that sets certain conditions, such as disablement, which allow coverage to remain in force without payment of premiums.

War Hazard Exclusion

Eliminates insurance coverage for death that is a direct result of war or other hostile action.

War Risk

Special coverage on cargo in overseas ships against the risk of being confiscated by a government in wartime. It is excluded from standard ocean marine insurance and can be purchased separately. It often excludes cargo awaiting shipment on a wharf or on ships after 15 days of arrival in port.

Warranty

A clause in an insurance contract that requires certain conditions, circumstances, or facts to be true before or after the contract is in force.

Weather Insurance

A type of business interruption insurance that compensates for financial losses caused by adverse weather conditions, such as constant rain on the day scheduled for a major outdoor concert.

Wellness

Being in good physical and mental health. Health Insurance emphasizes wellness for all its policy holders, as it ultimately reduces the chances of ill health (and in turn claims).

Whole Life Insurance

The oldest kind of cash value life insurance that combines protection against premature death with a savings account. Premiums are fixed and guaranteed and remain level throughout the policy's lifetime.

Will

A way to transfer ownership of property at death.

With-profit Policy

Policies entitled to bonus, which is paid at the time of claim-death or maturity one with-profit policies.

Without-profit Policy

These policies are not entitled to participate in bonuses.

Workers Compensation

Insurance that pays for medical care and physical rehabilitation of injured workers and helps to replace lost wages while they are unable to work.

Write

To insure, underwrite, or accept an application for insurance.

Worldwide Emergency Cover

provide foreign travel emergency health care coverage when you travel outside your home country

Waiver Of Premium On Disability

A waiver of premium rider is a clause in an insurance policy that waives the policyholder's obligation to pay any further premiums to keep the policy in force, should he become seriously ill or disabled or on his death in certain policies.

Zero Depreciation Cover

Zero depreciation cover promises comprehensive coverage without factoring in for depreciation. If the cover is opted, then the vehicle market price does not depreciate with years. The owner gets full amount of insurance in subsequent years.

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