| Actual
Cash Value (ACV) |
Fair
market value of stolen or damaged property at the time
of the loss. |
| Additional
Living Expense |
An
insurance coverage found in all homeowner's policies.
It provides indemnity for expenses incurred for usual
living expenses more than the amount normally expended.
It does not pay all living expenses, only the expenses
over the insured's normal expenses. |
| Adjuster |
A
person or organization licensed by the Sate of California
to evaluate the amount of damage to your property. |
| Adjustment |
The
determination of the amount of loss, the cause of the
loss, and the final settlement in cash value after all
factors have been considered. |
| Agent |
A
person or organization licensed by the State of California
to sell insurance by or on behalf of an insurance company. |
| Appraisal |
The
resolution of a dispute as to the amount of a claimant's
loss by two disinterested parties (the appraisers), with
both sides being bound by the appraisers' decision. |
| Arbitration |
The
resolution of a dispute by a person chosen by the opposing
parties, who have agreed in advance to abide by the decision
of the third party. |
| Attorney
in Fact |
One
who is authorized to perform certain acts for another
under a power of attorney. The power of attorney may be
general or limited to a specific act or acts. |
| Average |
A
term used in settlement of claims. It may have originally
come from the French word avarie, meaning loss
or damage. There are both general and particular average
clauses. Average clauses are the precursor of co-insurance
clauses. They refer to any partial loss or damage due
to insured perils. It requires the insured to maintain
coverage equal to a stated percentage of the actual cash
value of the subject of the subject of the insurance,
otherwise the insured must pay a part of the loss. |
| Average
clauses |
Clauses
in a property policy that determine the amount of particular
average loss recovery. Average clauses are seldom found
in modern property or inland marine policies but are often
found in marine polices. |
| Bad
Faith |
A
tort created by judicial decision that allows an insured
to recover tort damages (bodily injury, emotional distress,
loss of use, trouble and inconvenience, and punitive damages)
if an insurer intentionally, or in willful disregard of
the rights of the insured, does something that deprives
the insured of the right to recover the benefits of the
policy. |
| Broker |
A
person or organization licensed by the Sate of California,
retained by you, to obtain insurance for you. |
| Cancellation |
The
termination of your insurance coverage during the period
in which your policy is in effect |
| Claim |
Notice
which you give to your insurance company when you suffer
a loss which may be covered by the terms of your insurance
policy. |
| Claimant |
Any
person who asserts the right to recover losses under a
policy |
| Co-insurance
or Average Clauses |
A
provision in an insurance policy where the insured promises
to purchase insurance equal to the value, or a stated
percentage of the value of the property, the risk of loss
of which is insured, or face a penalty equal to a percentage
of the loss that is the same as the amount he or she failed
to insure. |
| Company
Adjuster |
An
employee of an insurance company who negotiates and settles
claims against the insurer. |
| Concealment |
The
failure to advise an insurer of facts known by the insured
to be material to the decision of the insurer to insure
or not insure. |
| Declarations
Page |
Usually
the first page of a policy or any page that sets out the
name of the insured, the name of the insurer, the effective
dates of the policy, the policy limits, the premium charged,
and the property or liability the risk of loss of which
is insured. It identifies the forms or policy working
applicable to the insurance coverage. Often it includes
material representations made by the insured regarding
the risk. |
| Deed |
The
written instrument which, when properly executed and delivered,
conveys title to real property. |
| Deed
of Trust |
An
instrument which is evidence of a pledge of real property
as security for a debt, where the title to the real property
is held by a third party in trust, while the debtor repays
the debt to the lender. The debtor is known as the trustor,
the lender is known as the beneficiary, the third party
is known as the trustee. |
| Demurrer |
A
pleading filed in response to a complaint or lawsuit.
The demurrer assumes that everything alleged in the comlaint
is true and contends that even if the plaintiff proves
everything he claims true, he will still lose the suit.
Although demurrers are often sustained the court will
usually allow the plaintiff the opportunity to amend the
complaint to make it better. |
| Denial |
The
insurance company's refusal of the insured's claim. |
| Deductible |
The
amount of loss for which the insured is responsible before
the benefits from the insurance company are payable. |
| Depreciation |
The
decrease in the value of your property due to age or wear
and tear. |
| Dwelling |
A
dwelling is a building occupied principally by people
as a home. A dwelling policy will sometimes restrict the
number of families allowed coverage (usually one to four
families). |
| Endorsement |
An
amendment to the policy which adds or deletes coverage
under the terms of the policy. |
| Exclusion |
Certain
damage or causes of damage identified in the policy, for
which there is no insurance coverage. |
| Grace
Period |
A
period after the premium due date, during which an overdue
premium may be paid without penalty. During this time,
there is no lapse in coverage and the policy is still
in force. |
| Homeowners
Insurance |
Coverage
for the risk of owning a home, including losses due to
fire, burglary, vandalism, earthquake or other perils. |
| Independent
Adjuster |
A
person, firm, or corporation that holds itself out for
employment to mare than one insurance company, is not
a regular employee of the company, does not work exclusively
for one company and is paid in each case assigned for
time consumed and expenses incurred. |
| Insurance
Adjuster |
A
person who, for any consideration whatsoever, engages
in business or accepts employment to furnish, or agrees
to make, or makes, any investigation for the purpose of
obtaining, information in the course of adjusting or otherwise
participating in the disposal of, any claim under or in
connection with a proof of loss or engages in soliciting
insurance adjustment business. |
| Insurance
Agent |
A
person authorized, by and on behalf of an insurer, to
transact insurance |
| Insurance
Broker |
A
person who, for compensation and on behalf of another
person, transacts insurance other than life with, but
not on behalf of, an insurer. |
| Insured |
The
policyholder. The person(s) or entity protected in case
of a loss. |
| Insurer |
The
insurance company |
| Litigation |
The
act of contesting the law. |
| Mediation |
To
arbitrate or settle through an intervening party. |
| Mortgagee |
The
mortgage company |
| Mortgager |
The
insured |
| Nonwaiver
Agreements |
A
Non-Waiver agreement is a document drawn by the insurer
and signed by the insured in which they agree that neither
party waives any rights under the policy while the claim
is being investigated. |
| Peril |
The
cause of a loss |
| Policy |
The
actual written insurance contract |
| Policy
Limit |
The
maximum amount which the insurance company is obligated
to pay under the terms of an insurance policy. The limit
can be either for the entire policy or for a specific
coverage. |
| Premium |
The
amount of money which the insurance company charges to
provide insurance coverage. |
| Proof
of Claim |
Written
proof, such as claims forms, medical bills or any material
and relevant documentation in the claimant’s possession
that supports the magnitude or the amount of the claimed
loss. |
| Proof
of Loss |
The
sworn statement of the insured, as required by the conditions
of a policy of insurance, setting forth the insured’s
knowledge and belief as to the date, time and cause of
loss; the encumbrances on the property; the persons with
interest in the property; the value of the property; the
amount of loss; and the amount of claim. |
| Replacement
Cost |
The
actual cost to repair or replace damaged property which
is covered under the terms of the policy. Some insurance
companies deduct depreciation from this amount when making
payment or only pay the fair market value of the damaged
property until the work is actually completed or the item
replaced. |
| Replacement
Value |
The
actual cost to repair or replace damaged property. |
| Rider |
An
amendment or endorsement to the insurance policy which
adds or deletes coverage |
| Scope
of Loss |
An
agreement between the insured and the insurer as to the
extent of loss. |
| Statute
of Limitations |
The
period of time between the date of loss and the deadline
for you to file a lawsuit for a claim. |
| Umpire |
A
neutral third party selected by the two opposing appraisers
for a property appraisal who resolves any differences
between the two appraisers. |
