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Insurance Law

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Endorsement

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A document attached to an insurance policy that amends the policy in some way.

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Binder

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A temporary insurance contract that provides proof of coverage until a permanent policy is issued.

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Deductible

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The amount that a policyholder must pay out of pocket before the insurance company pays a claim.

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Claim

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A formal request by a policyholder to an insurance company for coverage or compensation for a covered loss or policy event.

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Subrogation

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The legal right held by insurers to pursue a third party that caused an insurance loss to the insured.

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Reinsurance

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An arrangement by which an insurance company transfers a portion of potential losses to another insurance company to reduce its risk exposure.

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Arbitration

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A form of alternative dispute resolution where an arbitrator hears and decides on a dispute between two parties, outside of court.

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Co-insurance

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A sharing of risk between the insurer and the insured which depends on the division of coverage for a particular loss.

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Exclusion

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Specific conditions or circumstances for which the insurance policy will not provide coverage.

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Umbrella Policy

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A liability insurance policy that protects the assets and future income of the policyholder above and beyond the standard limits set on their primary policies.

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Third-Party Administrator (TPA)

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An organization that processes insurance claims or certain aspects of employee benefit plans for a separate entity.

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Insurable Interest

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A stake in the value of an entity or event for which an insurance policy is purchased to mitigate risk of loss.

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Actuary

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A business professional who deals with the measurement and management of risk and uncertainty.

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Risk Management

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The identification, assessment, and prioritization of risks followed by coordinated efforts to minimize, control, and monitor the impact of unfortunate events.

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Premium

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The amount of money an individual or business must pay for an insurance policy.

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Underwriting

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The process by which insurers assess the risk of insuring a home, individual, or business and establish the premium that should be charged.

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Rider

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An optional add-on to a policy that provides additional benefits to the insured at an additional cost.

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Policyholder

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An individual or entity who owns an insurance policy.

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Coverage Limit

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The maximum amount an insurance company will pay for a particular loss, or for loss during a period of time.

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Liability

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The state of being responsible for something, especially by law, including the responsibility to repair damage or compensate losses.

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Indemnity

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A principle of insurance which provides that an insured should not profit from a loss but should be restored to the approximate financial position that existed before the loss occurred.

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Fiduciary Duty

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The obligation that an insurance agent or broker has to act in the best interests of the insurance policyholder.

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Good Faith

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A legal principle which refers to the duty of both parties to an insurance contract to act honestly and not mislead or withhold critical information from one another.

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Material Fact

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Any fact that would influence the insurance company’s decision to provide coverage or the terms of that coverage.

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Loss Adjustment

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The process of determining the value of the loss and the amount to be paid for the insured claim.

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