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The Fundamentals of Insurance Law
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Flashcards
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Insurable Interest
A legal requirement for obtaining an insurance policy, insurable interest exists when the policyholder stands to suffer a financial loss or certain kinds of loss from the damage to the insured property or person.
Indemnity
A principle that ensures that the policyholder is compensated for a loss, with the intent to restore them to the financial position they were in prior to the incident, not to allow them to make a profit.
Utmost Good Faith
A legal doctrine stipulating that all parties in an insurance contract must act with honesty and disclose all relevant facts, thus preventing misrepresentation or fraud.
Subrogation
The legal right for an insurer to pursue a third party that caused an insurance loss to the insured, in order to recover the amount of the claim paid to the insured.
Contribution
A principle that allows multiple insurers to share the cost of a claim when more than one policy covers the same insured risk.
Proximate Cause
The primary cause of the loss, which sets off a foreseeable sequence of events leading to an insurance claim, without being an interrupted by another cause.
Exclusion
Provisions in an insurance policy that outline the risks that are not covered, essentially limiting the insurer's liability for particular kinds of risks or events.
Deductible
The amount of loss that the insured is required to pay before the benefits from the insurance policy can be accessed.
Rider
An addendum to an insurance policy that modifies the terms and conditions, often providing additional coverage for specific items or conditions.
Premium
The recurring amount paid by the insured to the insurer for coverage under a policy, which can be based on various risk factors.
Policy Limit
The maximum amount that an insurer will pay under a policy for a covered loss.
Endorsement
A document that amends an insurance contract by adding, deleting, or modifying its terms or coverage.
Moral Hazard
The risk that a party insured against a certain event might in fact be motivated to make the event happen because they have insurance cover.
Coverage
The scope of protection provided by an insurance policy, including what is covered in the case of a loss and its limits.
Underwriting
The process insurers use to assess the risks of insuring a person or asset and determine the appropriate premium and terms of coverage.
Actuary
A financial professional who analyzes risks and estimates how events will affect insurance policies using mathematics, statistics, and financial theory.
Claim
A formal request by the insured to the insurance company for payment of a loss under the terms of the insurance policy.
Adjuster
An individual employed or contracted by the insurer to evaluate the extent of the insurer's liability in a claim situation.
Risk Pooling
The practice of spreading out financial risks among a large number of contributors to the insurance program to make losses more manageable.
Reinsurance
A contract between two or more insurers whereby the reinsurer agrees to cover all or part of the risks that the original insurer has assumed.
Liability
The state of being responsible for something, in insurance it refers to the insurer's responsibility to provide compensation for covered losses.
Excess
The initial amount that the insured is responsible to pay out-of-pocket before the insurer starts to reimburse for a covered loss; similar to a deductible but applied differently depending on policy terms.
Fiduciary Duty
The obligation that insurers and agents have to act in the best interest of their policyholders, placing the policyholders' interests above their own.
Bad Faith
A term used to describe dishonest or unfair practices by an insurer, such as unwarranted denial of a claim or failure to investigate a claim properly.
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