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Insurance:
Risk:
Exposure:
Insured:
Insurer:
Limit of Liability:
Per Occurrence Limit:
Insurance:
A contractual agreement that exist when one party (the insurer or insurance carrier) for a consideration (the premium) agrees to reimburse another party (the insured or our client) for loss to a specified subject (the risk) caused by designated contingencies.
Risk:
The chance or uncertainty of loss.
Exposure:
Almost identical to risk, an exposure is a condition or situation that presents a possibility of loss.
Insured:
The person(s) or entity that is protected under an insurance contract.
Insurer:
The insurance company that undertakes to indemnify for losses.
Limit of Liability:
The maximum amount that an insurer agrees to pay in the case of a loss.
Per Occurrence Limit:
The maximum amount an insurer will pay for injury from covered losses arising from one occurrence (multiple claimants possible).
Aggregate Limit:
Occurrence Policy:
Claims-made Policy:
Retroactive Date:
Prior & Pending Litigation Date:
Deductible:
Self-Insured Retention (SIR):
Third Party Administrator (TPA):
Aggregate Limit:
The maximum amount an insurer will pay for all covered losses for the policy period.
Occurrence Policy:
An insurance policy that covers all claims that occur during the policy period regardless of when they are reported.
Claims-made Policy:
An insurance policy that covers claims first made (reported or filed) during the year the policy is in force for any incidents that occur that same year or during any previous period after the stated retroactive date.
Retroactive Date:
Under a claims-made policy, any damages or injuries that occurred prior to this specified date will not be covered by this policy.
Prior & Pending Litigation Date:
An exclusion that precludes coverage for claims from litigation that was pending prior to the inception of the policy or the specified date if different. The intent is to avoid continual exposure as the claimants expand allegations to include entities rather than just individuals.
Deductible:
A portion of a covered loss that is not paid by the insurer and is ultimately the responsibility of the insured. Typically, under a deductible program, the insurer is required to handle all covered claims and will make all payments associated with the claim including the deductible amount. The insured will then reimburse the insurer at a later date if financially capable.
Self-Insured Retention (SIR):
Similar to a deductible in that it is a portion of a covered claim that the insured is responsible to pay; however, SIRs are typically larger amounts, and claims that fall within this retention must be handled by a party other than the insurer. The “self-insured” portion of this term refers to the ideology that the insured is assuming this portion of its insurance internally.
Third Party Administrator (TPA):
A firm that handles various administrative responsibilities on a fee-for-service basis, including claims administration or risk management information systems, on behalf of the insurer or the insured. Typically, an insured will acquire the claims handling services of a TPA when utilizing an insurance program in excess of a self-insured retention.
