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Basic Principles of Life and Health Insurance
Keywords
44
Insurance
Professional
11/05/2024

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Term
Actuarial Department
Definition
: This is the department that calculates policy rates, reserves, and dividends.
Term
Adjuster
Definition
: This is the person who investigates claims and arranges for them to be settled or denied.
Term
Admitted Insurer
Definition
: This is an insurer who has received a certificate of authority from a state’s department of insurance which authorizes them to conduct insurance business in that state.
Term
Agent
Definition
: This is an individual or organization that’s authorized to solicit, sell, and transact (bind) coverage for specific insurance providers under the terms of one or more agent contracts.
Term
Alien Insurer
Definition
: In the United States, this is an insurer whose principal office and domicile location is outside this country.
Term
Authorized Insurer
Definition
: This is an admitted insurer.
Term
Broker
Definition
: This is a person who represents himself and the insured (i.e., the client or customer). A broker cannot bind coverage on behalf of an insurance carrier because a broker is not appointed as an agent.
Term
Captive Insurer
Definition
: This is an insurer that’s established and owned by a parent firm for the purpose of insuring the parent firm’s loss exposure.
Term
Certificate of Authority
Definition
: This is a license that’s issued to an insurer by an insurance department (or equivalent state agency) that authorizes that company to conduct insurance business in that particular state.
Term
Claims Department
Definition
: This is the department that’s responsible for processing, investigating, and paying claims.
Term
Divisible Surplus
Definition
: This is the amount of earnings that are paid to policy owners as dividends after the insurance company sets aside funds required to cover reserves, operating expenses, and general business purposes.
Term
Domestic Insurer
Definition
: This is an insurer with its principal or home office in the state in which it’s authorized.
Term
Foreign Insurer
Definition
: This is an insurer whose principal office or domicile location is in a state that’s different from the state in which it’s transacting insurance business.
Term
Fraternal Benefit Society
Definition
: This is a non-profit benevolent organization that provides insurance to its members.
Term
Independent Insurance Agency
Definition
: This is an agency that any number of insurance companies through contractual agreements.
Term
Insurance
Definition
: This is the transfer of risk through the pooling or accumulation of funds.
Term
Insured
Definition
: This is the customer who receives insurance protection under an insurance policy.
Term
Insurer
Definition
: This is an insurance company.
Term
Lloyds of London
Definition
: This is NOT an insurer but a group of individuals and companies that underwrite unusual insurance policies.
Term
Marketing Division
Definition
: This is the division that’s responsible for acquiring prospective applicants through various advertising media.
Term
Monoline Insurer
Definition
: This is an insurance carrier that only sells one line of insurance.
Term
Multi-Line Insurer
Definition
: This is an insurance company or independent agent that provides a “one-stop-shop” for businesses or individuals who are seeking coverage for all of their insurance needs. For example, many large insurers offer individual policies for automobile, homeowner, long-term care, life, and health insurance needs.
Term
Mutual Insurance Company
Definition
: This is an insurance company that’s characterized by having no capital stock, being owned by their policy owners, and typically issuing participating insurance.
Term
Non-Admitted (Unauthorized) Insurer
Definition
: This is an insurer that has not received a certificate of authority from a state’s department of insurance which authorizes it to conduct insurance business in that state.
Term
Nonparticipating Policy
Definition
: This is a policy that’s typically issued by stock companies. This type of policy doesn’t allow policy owners to participate in dividends or to elect the board of directors.
Term
Participating Policy
Definition
: This is an insurance policy that pays policy dividends to policy owners. By receiving dividends, policy owners share in the company’s divisible surplus and also elect the company’s board of directors.
Term
Personal Producing General Agency (PPGA)
Definition
: This is an agency that represents one or more specific insurers. A PPGA is a similar agency system, but PPGAs don’t recruit, train, or supervise career agents.
Term
Policy owner
Definition
: This is the person who’s responsible for the payment of premiums and who possesses all ownership rights of the contract. Typically, the policy owner is also the insured.
Term
Private (Commercial) Insurer
Definition
: This is an insurer that’s owned by private citizens or groups that offer one or more insurance lines. Commercial insurers are NOT government-owned.
Term
Producer
Definition
: This is an individual who’s licensed by one or more states to sell, solicit, or transact insurance in a given state.
Term
Proposed Insured
Definition
: This is the person whose life will be covered by an insurance policy. (See also: Insured).
Term
Public Adjuster
Definition
: This person acts on behalf of a consumer who’s settling an insurance claim.
Term
Reciprocal Insurer
Definition
: This is an unincorporated organization in which all members insure one another. An attorney-in-fact manages it.
Term
Reinsurance
Definition
: This is the acceptance by one or more insurers (referred to as reinsurers) of a portion of the risk being underwritten by another insurer that has contracted with a consumer to cover the entire risk.
Term
Reinsurer
Definition
: This is a company that provides financial protection to insurance companies. Reinsurers handle risks that are too large for insurance companies to cover on their own and make it possible for insurers to obtain more business than they would otherwise be able to obtain.
Term
Risk Retention Group
Definition
: This is a group-owned liability insurer that assumes and spreads product liability and other forms of commercial liability risks among its members.
Term
Sales Department
Definition
: This department acquires clients through one-on-one meetings in which consumers complete applications.
Term
Self - Insurer
Definition
: This is a company that establishes a self-funded plan to cover potential losses rather than transferring the risk to an insurance company.
Term
Service Representatives
Definition
: These are customer service employees. Service representatives are not required to obtain a license because they neither sell nor solicit coverage, and they don’t bind coverage.
Term
Solicitors
Definition
: These are the individuals who solicit and schedule sales meetings between consumers and the producers for whom they work. Some states separately license these individuals.
Term
Stock Insurance Company
Definition
: This is an insurance company that’s owned and controlled by a group of stockholders (or shareholders) whose investment in the company provides the safety margin necessary in the issuance of guaranteed, fixed premium, nonparticipating policies.
Term
Surplus Lines Insurance
Definition
: This is non-traditional insurance that’s only available from a surplus lines insurer. This type of insurance provides coverage for substandard or unusual risks and is not available through private or commercial carriers.
Term
Unauthorized Insurer
Definition
: This is a non-admitted insurer.
Term
Underwriting Department
Definition
: This is the department within an insurance company that’s responsible for reviewing applications, approving or declining applications, and assigning risk classifications.
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