Insurance Definitions

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OBLIGEE:   Broadly, anyone in whose favor an obligation runs. This term is most frequently used in surety bonds, where it refers to the person, firm or corporation protected by the bond.

OBLIGOR:   Commonly called principal; one bound by an obligation. Under a bond, strictly speaking, both the principal and the surety are obligors.

OCCUPANCY:   In insurance, this term refers to the type and character of the use of property in question.

OCCURRENCE COVERAGE:   A policy providing liability coverage only for injury or loss that occurs during the policy period, regardless of when the claim is actually made.

OPEN COVER:   An agreement whereby the Assured undertakes to declare every item (e.g. shipment, vessel, etc. as appropriate) that comes within the scope of the cover in the order in which the risk attaches. The insurer agrees, at the time of concluding the contract, to accept all valid declarations up to the agreed limit for each declaration. An open cover may be for a fixed period or always open; subject to a cancellation clause.

OVERAGE:   An additional premium charged on a cargo open cover declaration because the carrying vessel is outside the scope of the classification clause.

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PACKAGE POLICY:   An insurance policy including two or more lines or types of coverages in the same contract.

PARTIAL LOSS:   A loss under an insurance policy which does not either (1) completely destroy or render worthless the insured property; or (2) exhaust the insurance applying thereto.

PARTICULAR AVERAGE:   Accidental partial loss of the subject matter insured proximately caused by an insured peril. In a freight at risk policy the term may be applied to a claim for loss of freight following particular average loss of goods.

PAYROLL AUDIT:   An examination of the insured's payroll records by a representative of the insurance company to determine the premium due on a policy.

PERIL:   A term used in the Marine Insurance Act (1906) to denote a hazard. The principle of proximate cause is applied to an insured peril to determine whether or not a loss is recoverable. In modern practice the term "risk" often replaces "peril".

PERSONAL ARTICLES FLOATER:   Provides all risk coverage for valuable items such as furs, jewelry, etc. formerly insured under separate contracts.

PERSONAL EFFECTS FLOATER:   An Inland Marine Policy covering worldwide, except in the insured's domicile, personal effects usually carried by a tourist.

PERSONAL INJURY:   Injury other than bodily injury arising out of false arrest or detention, malicious prosecution, wrongful entry or eviction, libel or slander, or violation of a person's right to privacy committed other than in the course of advertising, publishing, broadcasting, publishing, or telecasting.

PERSONAL INJURY COVERAGE:   Liability insurance coverage for third party claims for damages which are other than physical such as libel, slander, false arrest, etc.

PERSONAL INJURY PROTECTION:   The formal name usually given to no-fault benefits in states that have enacted mandatory or optional no-fault Automobile Insurance coverages. PIP usually includes benefits for medical expenses, loss of work income, essential services, accidental death and funeral expenses.

PERSONAL LINES:   This term is used to refer to insurance for individuals and families such as private passenger automobile or homeowner insurance.

POLICY:  The written statement of a contract effecting insurance, or certificates thereof, by whatever name called and including all causes, riders, endorsements and papers attached thereto and made part thereof.

POLICY PERIOD:  The period during which the policy contract affords protection.

PRE-CERTIFICATION AUTHORIZATION:   A cost containment technique which requires physicians to submit a treatment plan and an estimated bill prior to providing treatment. This allows the insurer to evaluate the appropriateness of the procedures, and lets the insured and the physician know in advance which procedures are covered and at what rates benefits will be paid.

PRE-EXISTING CONDITIONS:  A physical condition of an insured person which existed prior to the issuance of the policy.

PREMISES:   The particular location of a property or a portion thereof as designated in a policy.

PREMIUM:  The payment for an insurance policy, usually paid periodically (annually, semi-annually, quarterly, or monthly).

PRIOR DAMAGE:  Pre-existing damage that occurred prior to the loss in question.

PRO-RATA:  Cancellation of an insurance contract by the insurance company, allowing a policyholder a share of the premium relating to the remainder of the time under the contract that bears to the total contract premium.

PRODUCTS LIABILITY INSURANCE:   Provides protection against claims arising out of the use, handling or consumption of a product.

PROFESSIONAL LIABILITY INSURANCE:   Liability insurance to indemnify professionals, doctors, lawyers, architects, etc. for the loss or expense resulting from claim on account of bodily injuries because of any malpractice, error or mistake committed or alleged to have been committed by the insured in his profession.

PROOF OF LOSS:  A statement made to the insurance company under oath setting out the basis of an insured's claim under the insurance policy.

PROPERTY DAMAGE (LIABILITY) INSURANCE:   Protection against liability for damage to the property of another not in the care, custody and control of the insured, as distinguished from liability for bodily injury.

PROPERTY INSURANCE:   Insurance which indemnifies a person with an interest in physical property for its loss or the loss of its income-producing ability.

PROSCRIPTION:  Outside of the time period in which a legal action can be commenced.

PROXIMATE CAUSE:   The immediate and effective cause of loss or damage. It is an unbroken chain of cause and effect between the occurrence of an insured peril or a negligent act and resulting injury or damage.