Sometimes
insurance terminology can be a little bamboozling so here are some commonly
used words and phrases explained
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Accidental
damage cover
Insurance that protects against damage to goods rather than loss
or theft. Not always included as part of household
or motor cover.
Act of God
(or Force majeure)
An extraordinary occurrence or circumstance that could not have been foreseen
and which could not have been guarded against; an accident due to natural
causes e.g. a destructive storm. This term is less frequently used today.
See also " Consorcio ".
"All Risks"
insurance
A type of insurance that covers all risks - except those not listed under
its exclusions .
Annual policy
An insurance policy that applies all year round rather than any other
period such as a holiday or car hire period.
Any driver
Insurance that allows anyone to drive a vehicle, not just the owner, so
long as they have permission to use the car.
Approved
repairer
A panel of repairers, usually throughout the whole country, who the insurance
company recommend to repair your car.
Arbitration
A means of arriving at an acceptable agreement between two disputing parties.
An independent person or body, often a member of the Institute of Arbitrators,
hears the arguments of both parties and makes a decision that is then
binding on all concerned.
Association
of British Insurers
An association representing some 450 insurance companies which account
for over 95% of the business transacted by UK insurance companies. It
is also the forum through which UK insurance companies collectively liaise
with Government Departments and other bodies and come together to set
industry standards and codes of practice.
Betterment
Betterment occurs where a policyholder takes
the opportunity to upgrade the lost/damaged item with a better item e.g.
a standard television is replaced with a digital surround-sound television.
The policyholder is responsible for the betterment
content of the total cost.
Bona fide
A legal term that refers to actions or persons that are honest and in
good faith .
Breakdown
cover
A policy that provides recovery and repair services for motorists. ARAG,
a specialist assistance company provides this cover for Ibex clients who have
paid the additional premium due.
Breach
A failure to comply with a policy condition e.g.
a security condition.
Broker
An agent who brings two parties together, enabling them to enter into
a contract to which he is not a principal. Remuneration is usually calculated
as a percentage of the sum involved in the contract but may be fixed according
to a tariff.
Buildings
insurance
The definition of buildings can vary between one insurer and another.
Refer to your Ibex policy booklet .
Burglary
The act of breaking into premises to commit theft .
Caveat emptor
("let the buyer beware")
A maxim implying that the buyer must be cautious, as the risk of ensuring
that the goods are as described and in working order is his and not that
of the seller e.g. a private purchase of a used car is very much subject
to caveat emptor.
Certificate
of Motor Insurance
Evidence of the existence of insurance as required by UK Law and needed
if you own a UK registered vehicle
Claim
The term used to describe the process of getting an insurance company
to pay out on the policy you bought from them.
Commission
The percentage of the premium cost an introducer
receives.
Comprehensive
cover
The most expensive form of car insurance, that offers the most comprehensive
cover. It covers damage to others' cars and to your own as well as losses
incurred by fire and theft .
Conditions
Provisions in an insurance contract that state
the rights and duties of the insured and of the insurer.
Contract
A legally enforceable agreement between two parties.
Contractual
liability
The terms of a contract to which you must abide - failure to do so can
incur financial or even criminal penalties.
Contributory
negligence
Negligence, by which a person contributes to the happening of an accident
to himself, for which others are partially, or even mainly responsible.
It was formerly a complete defence to an action for damages to prove that
the plaintiff's own negligence was the cause of the accident. Now, the
injured person will not be entitled to recover full damages for the injury
if it can be shown that, except for his negligence, the accident would
not have happened. e.g. the injured party will be regarded as bearing
a certain percentage of the responsibility for his accident and the damages
awarded would be reduced proportionately (see the definition of Damages
later).
Consensus
Ad Idem ("agreement on the same thing")
Each party has the same thing in mind when the contract wording was agreed.
Consorcio
de Compensacion de Seguros
A public institution in Spain set up to pay claims resulting from extraordinary
natural disasters - hurricanes, earthquakes, floods etc. By law in Spain all
policy wordings for Home insurance and for Spanish registered vehicles must
have a "Clause governing the indemnity of losses caused by extraordinary risks
occurring in Spain". The law establishes that when a claim falls within the
jurisdiction of the "Consorcio" the insurance company cannot make any payment
directly related to the claim. Once notified of a claim, the Consorcio send
a " Perito " (Loss Adjuster)
to assess the damage and any payment is made directly to the client.
Contents
A definition used in Household insurance to describe "moveable goods and
possessions" owned by the policyholder . If
you have insured with Ibex refer to your Eurohome policy
booklet for the definition that applies.
Contribution
Contribution occurs where two or more Insurers have an interest in the
same claim e.g. where dual insurance is held in
respect of lost baggage, the policyholder
claims against the Travel Insurer and seeks a contribution from the Household
Insurer towards the claim settlement or the Travel Insurer pays in full
and seeks a contribution from the Household Insurer.
N.B. There are insurance market agreements concerning the method by which
contribution is calculated.
Cover
In the context of insurance, cover describes the specific risk a given
policy protects you against.
Cover
Note
A temporary certificate signed by or on behalf of an Insurer, which grants
interim cover whilst proposal
form inFormation is considered and full documentation issued.
Declination
The rejection of an insurance application by an insurance company.
Default
When one insurance premium or a series of premiums are missed, the policyholder
can be referred to as being in default.
Deposit premium
The premium deposit paid when an application is made for an insurance
policy.
Disclosure
The duty of any person applying for an insurance policy to tell the insurer
all relevant inFormation affecting the risk, such as prior claims history.
It is also used to refer to the duty of an intermediary to inform his
client if commission is being paid (and, if so, how much) in respect of
the business being placed.
European
Accident Statement
A statement of facts between the two (or more) parties involved in a motor
accident. The text of the statement is the same in all language versions
thus preventing translation problems.
Excess
The amount of each and every claim which is payable by the policyholder i.e.
deducted from the claim settlement.
Exclusions
Events not covered by an insurance policy e.g. allowing drivers other than
those specified in the policy to take control of the vehicle.
Ex gratia
("As a matter of favour")
A payment made where none is strictly due, under the terms of the policy.
Expiry date
The time and date on which the cover ceases.
Fully
comprehensive
For motor insurance, a policy that covers damage to the owner's vehicle
as well as to others'.
Fraud
The varieties of fraud are infinite, and it has been said that the Courts
have never precisely laid down what constitutes fraud, or any general
rule, beyond which they will not go in giving equitable relief on the
ground of fraud. Fraud is, however, usually divided into two main classes:
(i) actual fraud; and (ii) constructive fraud. An actual fraud may be
defined as something said, done or omitted by a person with the intention
of perpetrating what he must have known to be a positive fraud.
Constructive frauds are acts, statements or omissions which operate as
virtual frauds on individuals or which, if generally permitted, would
be prejudicial to the public welfare, and yet may have been unconnected
with any selfish or evil designs.
Green card
A document issued to those motoring abroad as evidence that they have
the legal minimum insurance cover required. No longer essential for European
travel, because minimum legal cover is automatically included in EU policies
but nevertheless an essential document to have in Spain as it is recognised
by the Guardia Civil that insurance cover has been contracted.
Gross premium
The actual premium paid by the policyholder
including insurance premium tax, other local taxes and amounts due
for extensions of cover such as ARAG .
Inception
The date the policy commenced.
Indemnity
The principle by which insurance policyholders are put in the same financial
position after a loss as they were immediately before it.
Insurance Premium
Tax (IPT)
A Government tax charged as a percentage of insurance premiums.
Insurance
Ombudsman
A free and accessible means of resolving disputes between policyholders
and insurance companies.
Insured car
The insured car as specified by its registration mark on your current
schedule, receipt or certificate of motor insurance. Some motor insurance
policies insure the vehicle, and some insure the driver.
Insurer
The party to the insurance contract who promises to pay losses or benefits,
usually an insurance company.
Intermediary
A person or organisation that offers advice and arranges policies for
clients.
Insured
Peril
An event which is covered by a particular policy e.g. theft
is a fairly standard insured peril in a household policy.
Inter-Alia
("amongst other things")
The policy provides insurance for (inter-alia), loss
and damage by theft .
Lapse
The termination of an insurance policy due to non-payment of the premium
.
Lapsed policy
A policy terminated for non-payment of the premium
.
Leasehold
An interest in land or property that is restricted to a finite period
of years.
Limitations
("Statutes of")
Rights to pursue legal actions are subject to a maximum period during
which litigation can be initiated e.g. an action for personal injury must
be commenced within 3 years, although there are certain exceptions.
Lloyd's
The London-based insurance market organised into syndicates, which underwrite
most types of policy. The name is taken from Edward Lloyd who owned the
coffee shop in Tavern Street from where the market began in 1689.
Loading
The extent to which an individual is charged more than the "standard"
or "average" rate for their insurance. In terms of car insurance, this
can be due to a bad claims history, age.
Loss
Insurance people's term for being robbed, burgled
, injured or in a car accident. A loss gives rise to a claim
.
Loss
Adjuster
An independent claims specialist usually employed by the Insurer to impartially
investigate the claim and negotiate settlement.
Chartered Loss Adjusters are members of the Chartered Institute of Loss Adjusters
and are subject to the Institute's Code of
Market value
The cost of replacing your car with one of a similar make, model, year,
mileage and condition, based on market prices at the time of the loss
.
Material
fact
InFormation that would affect an insurance company's willingness to accept
a policy , or the premium
it would charge, such as previous driving convictions. Failing to disclose
a material fact could invalidate a policy.
MIB
Acronym for the Motor Insurers' Bureau, a body funded by motor insurance
companies, which deals with claims for injury compensation when the driver
at fault is not insured, or cannot be traced. The equivalent organisation
in Spain is Ofesauto.
Motor schedule
A motor schedule is a document that shows details of your policy
, excesses , endorsements
and premium that is specific to your insurance
and should be read in conjunction with your insurer's policy wording.
Misrepresentation
Misrepresentation (i.e. mis-statement of facts) may entitle the Insurer
to void the contract e.g. a Policyholder tells the
Insurer that the house has a slate roof - whereas in fact it has a thatched
roof. Insurers may need to consider whether the misrepresentation was
firstly relevant and secondly whether it was innocent or deliberate.
Negligence
An act or omission which results in a breach of a duty of care.
No claims
bonus
A no claims bonus (or NCB) is the discount that you have earned on a previous
insurance policy. Insurers give discounts determined by the number of
years that you have not had claims. The No Claims Bonus must be earned
separately on each policy or on each car.
Non-disclosure
An important but previously undisclosed fact comes to the Insurer's attention
that may give the Insurer the right to void the policy
(see " void ").
Non-fault
claim
A non-fault claim is a claim where the insurance
company is able to recover all the costs from another party.
Over insured
This is where you have taken an insurance policy that covers you for more
than you need and as such you will be paying a higher insurance premium
than you need to, for instance where the market value of your vehicle
has been overestimated.
Owner
The legal owner of a vehicle or property, not necessarily the person who
runs, maintains or uses it.
Period of
insurance
The time covered by the insurance, as shown on your current certificate
of motor insurance , schedule and receipt
"Perito"
The name for a Loss Adjuster in Spain
Personal
lines
Insurance designed for individuals rather than businesses or organisations.
Personal
possessions cover
Insurance for personal items such as money, jewellery and luggage.
Policy
The legal document issued by the insurance company to the policyholder,
which states the terms and conditions of the insurance, it may also be
called the policy contract or the contract .
Policy
booklet
This documentation contains a full list of the terms, conditions and exceptions
of your policy .
Policy
excess
The policy excess is an amount imposed by the insurance company that you are
required to contribute in the event of a claim. The policy
excess is frequently increased for younger drivers for accidental damage claims.
Policy exclusions
These are events or instances that are not covered by your insurance policy.
Policy Liability
An obligation to recompense the policyholder
under the terms of the insurance contract .
Policy schedule
A document that details how much cover you have
(the sum insured) and the premiums you have to
pay. With some policies you may get a new schedule when you renew the
policy or whenever you want to change your policy.
Policy term
The period of time for which an insurance policy provides coverage.
Policyholder
Person to whom the insurer issues the policy,
and normally the person who benefits from any insurance policy.
Precedents
Precedents are legal examples that may be followed. The word is used principally,
though by no means exclusively, to indicate one of the two following things:
1. A decision in a court of justice cited in support of any proposition;
2. A prior decision of the House of Lords is binding on all inferior courts,
though no longer necessarily upon the House of Lords itself, and nothing
except an Act of Parliament can alter it.
Premium
The single or regular periodic payment made to an insurance company in
respect of an insurance policy .
Prima Facie
("at first sight")
If the policyholder's home burns down, (at first
sight) he/she has a claim under his/her policy
since fire is one of the insured perils .
Proposal
Anyone wishing to take out insurance must complete a Proposal. This forms
the basis of the contract between the Proposer
and the Insurer .
Proposal
form
A form used to gather inFormation.
Pro rata
("proportionate")
Proportionately.
Proximate
Cause
The proximate cause is deemed to be the primary or dominant cause giving
rise to any particular loss . This is not necessarily
the first or the last cause in a chain of events.
Renewal
An agreement to continue insurance beyond any original term
.
Representation
Every statement of fact (either verbal or written) that leads to the acceptance
of the contract of insurance is called a representation.
Replacement
cost
The payment of a claim without any deduction for
wear and tear.
Res Ipsa
Loquitur ("the facts speak for themselves")
In a given set of circumstances a reasonable person would conclude that
the situation must have arisen in a particular way. This will only apply
if there is no obvious explanation of how the event has occurred. The
onus of proof is transferred to the party, who is or should be in full
possession of the facts.
Schedule
A document describing who is insured, the cover
provided and the property insured.
Settlement
When an insurer pays a claim .
Substandard
risk
Where the risk of a claim against a policy
is higher than average.
Subrogation
Taking over the policyholder 's rights to
seek recovery. The recovery is pursued in the name of the policyholder
, but the insurer is responsible for any costs
incurred in pursuing the recovery e.g. if a negligent motorist damages
a garden wall and the household insurer meets the claim for the wall,
the household insurer then has subrogated rights of recovery against the
motorist.
Sum
Insured
The maximum amount payable to the policyholder
under the terms of the policy . Alternative
accommodation and death benefits are payable in addition to the sum insured,
but are subject to their own specific limits.
Territorial
limits
The geographical limits within which your policy
is valid including travel between any of these.
Theft
The basic definition of theft is given in the Theft Act 1968, s 1, which
enacts that "a person is guilty of theft if he dishonestly appropriates
property belonging to another with the intention of permanently depriving
the other of it", it being immaterial whether the appropriation is made
with a view to gain or is made for the thief's own benefit. Sections 2-6
of the Act then expand and explain this basic definition by stating what
is meant by dishonestly (s2); appropriates (s 3); property (s 4); belonging
to another (s 5); and with the intention of permanently depriving the
other of it.
Third
Party
A person directly involved in the event leading to the claim
, but who is not a party to the contract
e.g. the policy . An injured passenger would be
a third party in the context of a motor claim.
Total
loss
When the insurance company decides it is uneconomical to repair your car
following an accident, theft , or when your car is
stolen and recovered and either it is impossible to repair; it isn't safe
to repair; it is not economical to repair your car.
Tracker
A tracker is an electronic device (normally fitted as an accessory after
purchase of the vehicle) that emits a signal enabling law enforcement
agencies to locate the car anywhere in the EU if it has been stolen.
ULR
ULR or Uninsured Loss Recovery is an additional insurance protection that
you should consider purchasing. Where a motor accident was the fault of
a third party , insurers
will attempt to recover your uninsured losses including repair costs,
policy excess, transport costs, etc. See ARAG .
Ultra Vires
("beyond the legal power or authority of a person, agent or corporation")
A client tells his broker to place his household
business with X insurer , but the broker also places
the client's motor and personal accident insurance with the same insurer
. The broker was not authorised to do so and
in these circumstances would have acted "ultra vires".
Underinsurance
Occurs where the Sum Insured is less than the correct cost/value of rebuilding/replacing
the property insured.
Underinsurance
Clause
A clause in an insurance policy which provides
that where, at the time of a loss , the sum
insured is less than the value of the property insured, then the
policyholder will be regarded as his/her
own insurer for the difference i.e. the settlement
is scaled down in proportion to the under insurance by applying the
following calculation:
Sum insured* / Value at risk* x Agreed value of claim
(see " Sum insured " and " Value
at risk ")
Underwriter
A person who decides whether a risk is insurable and if so at what premium
(cost).
Underwriting
Where an insurance company takes into account known facts like your age,
sex and health, in order to assess the likelihood of you making a claim
on the policy. Your insurance premiums
are calculated after taking these factors into consideration.
Underwriting
decision
A decision made by insurance underwriters
based on evidence supplied.
Utmost
good faith
The principle of insurance which requires a proposer to give all relevant
inFormation to the insurer.
Void
and voidable
Null and void e.g. where a policy can be treated
as though it never existed due, for example, to a material non-disclosure.
Without prejudice
An enquiry, proposal or offer of settlement
made without admission of liability. The words are used either verbally
or in writing to protect against an admission being implied.
Write-Off
When the insurance company decides it is uneconomical to repair your car
following an accident, theft , or when your car is
stolen and recovered and either it is impossible to repair; it isn't safe
to repair; it is not economical to repair your car.