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Showing posts from February, 2024

Hired And Non-Owned Auto Insurance

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Hired And Non-Owned Auto Insurance Hired and non-owned auto insurance (HNOA) is a type of insurance for small business owners who rent or lease vehicles, or ask employees to use their personal vehicles for business purposes. This includes: 1-Rented vehicles: When a company rents a car or truck for business purposes, HNOA insurance can cover any liability arising from an accident while using the rented vehicle. 2-Leased vehicles: Similarly, if a business leases a vehicle for work, HNOA insurance can offer coverage for accidents and any associated legal expenses. 3-Employee personal vehicles: In some cases, businesses might allow employees to use their personal vehicles for work-related errands or tasks. HNOA insurance kicks in if an employee is involved in an accident while driving their personal car for business purposes and their personal insurance policy is inadequate or doesn't provide coverage. If you or an employee gets into an accident while driving a leased, rented, or

Certificate of Liability Insurance

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Certificate of Liability Insurance A Certificate of Liability Insurance (COI), also known as a general liability insurance certificate or proof of insurance, is a document issued by an insurance company that verifies the existence and details of an active liability insurance policy. It serves as proof to a third party that a business or individual has the required insurance coverage. It summarizes the key elements of your policy or multiple policies, assuring prospects and customers that your business is protected from common risks. Insurance companies provide certificates of liability insurance for a variety of small business insurance policies, including: -General liability insurance -Business owner’s policy (BOP) -Commercial auto insurance -Errors and omissions insurance (E&O) -Professional liability insurance -Workers' compensation insurance -A COI does not constitute the actual insurance policy and doesn't guarantee coverage for any specific claim. It merely ver

Risk Attaching

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Risk Attaching It refers to a specific term used primarily in reinsurance contracts. It defines the trigger point for when the reinsurer's responsibility to share losses with the ceding insurer (the primary insurer) begins. Risk attaching determines at what point the reinsurer becomes financially responsible for covered losses under the reinsurance agreement. A reinsurance contract specifies its period of effect: date of inception and date of termination. but the period during which the treaty produces its effects is not to be confused with the period of coverage. The period of coverage determines the period during which the reinsurer will be responsible for the claim arising from policies or risks ceded during the period of effect of the treaty. this period of coverage might be loss occurring, risk attaching or accounting year. Unlike loss occurring, which focuses on when the actual loss event takes place, risk attaching is forward-looking. It focuses on when the policy is

Personal & Advertising Injury

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Personal & Advertising Injury Personal and advertising injury is typically an infringement on a person or business’s personal or intellectual rights. This type of coverage is included in most commercial general liability (CGL) insurance policies. It protects businesses against financial losses arising from specific non-physical injuries caused to others, typically through their actions, publications, or advertising. These injuries are distinct from physical harm or property damage. 1) Personal injury liability typically covers legal costs and damages awarded in lawsuits alleging: -Libel: False written statements that harm someone's reputation. -Slander: False spoken statements that harm someone's reputation. -False arrest: Wrongful detainment by law enforcement. -Malicious prosecution: Initiating legal proceedings without probable cause. -Invasion of privacy: Unlawful intrusion into someone's private life. -Wrongful eviction: Removing someone from their property i

Uninsured and/or underinsured bodily injury coverage

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Uninsured and/or underinsured bodily injury coverage This is a coverage which may protect against drivers without insurance, and/or drivers with insufficient policy limits to reimburse you for damages they caused. This coverage typically pays the difference between the amount recovered from the other driver and the amount of the damages, up to the limit of the policy. 1) Uninsured Motorist: If you're in an accident with a driver who doesn't have any liability insurance and they are at fault, UMBI coverage can help pay for your medical bills, lost wages, and pain and suffering. -This is especially important because driving without insurance is illegal and unfortunately, some people still do it. 2) Underinsured Motorist: If you're in an accident with a driver who has liability insurance, but their limits are not enough to cover all of your medical expenses, UIMBI coverage can help pay the difference. -This can happen even with seemingly responsible drivers, as medical

Reimbursement

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Reimbursement This is often related to health insurance, reimbursement is the payment by an insurer of the expenses actually incurred and paid by the insured as a result of an accident or sickness, but not to exceed any amount specified in the policy, and covering only those expenses noted in the policy. Reimbursement is usually based on receipts. Reimbursement may happen in two main ways: 1. Direct Reimbursement: -You pay for covered expenses upfront (doctor's visit, medication, repair work, etc.). -You submit a claim to your insurance company with receipts and other documentation. -The insurance company reviews your claim and reimburses you for the allowed amount, based on your policy coverage and limitations. 2. Network Reimbursement: -You utilize healthcare providers or services within your insurance company's network. -The provider bills the insurance company directly. -You may be responsible for a deductible, copay, or coinsurance depending on your plan Here are so

Insurance Quote

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QUOTE A quote is an estimate of what you’ll pay for insurance from a specific insurance company. A business insurance quote is an estimate of what an insurance company will charge you for a certain kind of insurance protection. Requesting quotes from multiple insurers will help you find a reasonable deal. Here is a breakdown of what an insurance quote typically includes: the type of insurance, the amount of coverage, the premium, deductible, discounts, exclusions. In most cases nowadays, several quotes are requested and delivered online, and a licensed agent can provide guidance before you make a purchase, if needed. Before the advent of online business model to request for a quotes you may: -Call agents who represent a single company, also known as captive agents, and request quotes for the insurance you’re interested in buying -Call an independent agent (an agent who represents multiple insurers) and ask him or her to shop the market for you -Ask an insurance broker (a professi

LOSS RATIO

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LOSS RATIO The loss ratio is used by . Calculated as: cost of claims divided by premiums. The loss ratio in insurance is a key metric insurance and reinsurance companies that measures the profitability of an insurance company. It is calculated by dividing the total incurred losses (claims) by the total earned premiums. Incurred losses include claims paid, loss reserves, and loss adjustment expenses. Earned premiums represent the portion of the premiums that correspond to the coverage provided during a specific period. Loss ratio = (Incurred losses / Earned premiums) x 100 -Incurred losses include: Claims paid Loss reserves (estimated future claims) Loss adjustment expenses (costs associated with investigating and settling claims) -Earned premiums are the portion of the total premiums collected that corresponds to the coverage provided during a specific period. This is typically calculated by multiplying the gross premium by the portion of the policy period that has elapsed. In

Reporting Delay

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Reporting Delay Reporting delay refers to the time between an incident that could potentially trigger a claim and the actual reporting of that incident to the insurance company. This delay can have various consequences, depending on the specific circumstances and type of insurance involved. There are a couple of reasons that may account for Reporting Delay: 1) Unawareness: The policyholder might not be aware that the incident is covered under their policy or believe it is not severe enough to warrant a claim. 2) Neglect: Procrastination or simply forgetting to report the incident can contribute to delay. 3) Complexity: Involving multiple parties or needing to gather extensive documentation can make reporting cumbersome, leading to delays. 4) Fear: Concerns about potential premium increases or claim denial might deter timely reporting. Due to delay in reporting to the insurer a number of consequences may arise such as: -Claim denial: Late reporting can give the insurance company

Aggregate Limit

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Aggregate Limit An aggregate limit in insurance refers to the maximum amount an insurer will pay for all covered losses during a specific period, usually one year. It's like a ceiling on the insurer's financial responsibility, regardless of the number of individual claims made within that period. If you suffer a loss (e.g., damage to your business property or a customer injury on your premises), you must file a claim with your insurer to receive benefits under your small business insurance policy. The maximum amount of money your insurer will pay for all the claims you file during the policy period, typically one year, is known as your aggregate limit. Once the aggregate limit is reached, the insurer is no longer obligated to pay for any further losses during the policy period. Example: magine you have a commercial liability policy with an aggregate limit of $1 million. You face two separate claims: $750,000 for property damage and $300,000 for bodily injury. The insurer

Capitation Arrangement

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Capitation Arrangement capitation arrangement is a payment structure where a healthcare provider (HCP) receives a fixed amount of money per patient per period instead of being paid for each service they provide. This amount is typically negotiated in advance based on the expected healthcare needs of the covered population. Capitated payments are sometimes expressed in terms of a "per member/per month" payment. The capitated provider is generally responsible, under the conditions of the contract, for delivering or arranging for the delivery of all contracted health services required by the covered person. Here's how it works: -Managed care organizations (MCOs) like HMOs and PPOs use capitation to pay doctors and hospitals for their enrolled members. -The payment is fixed regardless of how often patients seek care, incentivizing providers to manage costs and promote preventive care. -The amount paid depends on factors like patient demographics, health status, and ex

ARBITRATION

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ARBITRATION alternative dispute resolution process where an impartial third party, known as an arbitrator, settles a disagreement between an insurance company and its policyholder instead of taking the case to court a neutral third party is recruited to settle the dispute. In a policy agreement an arbitration clauses are often included in insurance policies, requiring both parties to submit disputes to arbitration if they arise. Arbitration is commonly used in specific disputes, where disagreements exist about whether an incident is covered under the policy, as well as valuation disputes regarding the amount of compensation owed. Arbitration is the process of using a third party to settle a dispute instead of taking the case to court. Both sides rely on the arbitrator an unbiased individual or panel to come to an appropriate decision based on the facts of the case. -Selecting an arbitrator: Both parties can agree on a single arbitrator or a panel of arbitrators. Independent o

Difference Between Claims-Made and Occurrence Policies

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Difference Between Claims-Made and Occurrence Policies These are two basic types of commercial liability policies: The primary difference between the two has to do with the coverage trigger, the event that initiates coverage. An occurrence policy is triggered by an injury that occurs while the policy is in effect. A claims-made policy is triggered by a claim that's filed during the policy period. Claims-Made Policy: -Triggers Coverage: When a claim is made during the policy period, regardless of when the incident occurred. -Coverage Duration: Only covers claims made during the active policy period and any extended reporting period specified in the policy. Example: You have a claims-made professional liability policy for 2 years with a 1-year extended reporting period. If a client sues you in year 3 for an incident during year 1, it's covered. However, any incidents after year 2, even if reported during the extended period, wouldn't be covered. Occurrence Policy: -Tr

Cancellation Notice

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Cancellation Notice A cancellation notice in insurance informs you that your policy is being terminated either by you or the insurer. Understanding the details of such notices is crucial, as it allows you to prepare and take necessary actions. Here's a breakdown: You can usually cancel your policy at any time, but check your policy documents for specific procedures and potential fees. Calling your agent is usually the quickest and most common way to cancel your policy. Depending on your insurer, a phone call may be the end of it. However, many insurance companies require a signed cancellation notice. Insurers may cancel your policy for various reasons, including: 1-Non-payment of premiums: This is the most common reason. The specific notice period varies by state and type of insurance. 2-Material misrepresentation: Providing false or misleading information during the application process. 3-Engaging in risky activities: Violating specific policy terms or engaging in activiti

Blanket Insurance (All Risk Insurance)

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Blanket Insurance (All Risk Insurance) Blanket insurance is a single property insurance policy that covers more than one type of property at the same location, the same kind of property at multiple locations, or multiple kinds or property at two or more locations. It covers personal possessions as well as the actual dwelling, "blanketing" all the homeowners' possessions. Think of it as an umbrella that protects you from a downpour, but instead of just rain, it shields you from hail, wind, and even falling branches. Blanket insurance is fairly common in everyday life. Homeowners insurance is a type of blanket insurance, as it covers both the structure and the contents of your house against loss. For landlords that own multiple apartment units, blanket policies can provide a single limit for all properties. Note that blanket insurance offers broad coverage, it may not be a substitute for specific types of insurance, such as flood insurance or earthquake insurance, in

Personal Injury

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PERSONAL INJURY Personal injury law covers legal claims arising from physical or emotional harm caused by the negligence or wrongful conduct of another person or entity. These claims seek compensation for the damages suffered by the injured individual. Here's a breakdown of key aspects: 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 or telecasting. Contrast with Advertising Injury. Grounds to Claim for Personal Injury: 1- Negligence: The most common basis for a personal injury claim. It requires proving that the other party owed you a duty of care, breached that duty, and their breach caused your injury. 2- Intentional torts: Assault, battery, and other intentional acts that cause harm can also lead to personal injury claims. 3- Strict liability: In some cases

High Risk Occupation

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High Risk Occupation High-risk occupations can significantly impact your life insurance and other insurance premiums due to the increased likelihood of injury, illness, or death associated with the job. These factors directly influence the insurer's risk assessment and determine how much they need to charge to cover you General high-risk occupations: -Emergency services: Firefighters, police officers, paramedics, etc. -Military personnel: Active duty and deployed personnel face inherent risks. -Construction workers: Exposure to heights, heavy machinery, and hazardous materials. -Transportation workers: Truck drivers, airline pilots, sailors, etc. -Athletes and stunt performers: Increased risk of injuries due to their profession. -Deep-sea divers and miners: Work in challenging and potentially dangerous environments. Generally how do insurers analyze high risk occupations and whya Impact on different types of Insurance: -Life insurance: Higher premiums, additional requiremen

Abandonment

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Abandonment Abandonment Act of passing ownership of insured property to the insurer in the event of total loss. This takes place in certain circumstances, if the loss is unavoidable or the cost of repair exceeds the value of the property. In the latter case, the property is written off. Abandonment occurs most often in marine insurance when a vessel is declared dangerous or unseaworthy. The ship was stranded on a reef and could not be salvaged, so the owners declared a constructive total loss and gave the underwriters notice of abandonment. If a property owner's ship is sunk or lost at sea, the abandonment clause affords the owner the right to essentially "give up" on finding or recovering their property and subsequently collect a full insurance settlement from the insurer. #benewinsurance #insurtech #inclusiveinsurance #insurance #reinsurance #takaful

Pricing Tool

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Pricing tool Pricing tools play a crucial role in the insurance industry, enabling insurers to accurately assess risk and calculate appropriate premiums for individual policies. These tools leverage various data sources and sophisticated algorithms to analyze risk factors and calculate premiums. In the reinsurance industry, Pricing Tools are used on a daily basis. They are vital to assess and evaluate risks while building strong technical foundations. They make it possible to simulate pricing effects and product changes while measuring the impact on the expected performance/return. A wide range of variables are used vy insirers to determine the likelihood and severity of potential claims, including: -Policyholder demographics: Age, location, gender, health history, driving record, etc. -Property characteristics: Value, size, construction materials, location, security features, etc. -Historical data: Loss ratios, claims trends, industry data, and external factors like weather pa

Claims Leakage OR Claims Underpayment

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Claims Leakage OR Claims Underpayment Claims leakage is the difference between what an insurer actually spent to settle a claim and what they should have spent. This difference can arise from various inefficiencies or errors in the claims handling process, ultimately leading to lost value for both the policyholder and the insurer. This can lead to; fnancial loss for policyholders, reputational damage for insurers and reduced profitability for insurers. Causes of Claims Leakage: -Inefficient processes: Manual processes, lack of automation, poor communication, and inadequate training for claims adjusters can contribute to delays, errors, and missed details. -Fraudulent activity: Both policyholder fraud (exaggerating claims) and internal fraud (collusion between adjusters and providers) can lead to improper payouts. -Data inaccuracy: Incomplete or inaccurate information in policy documents or claims submissions can lead to underpayments. -Poor claims handling practices: Failure to