Cyber Insurance Glossary

period of time insured must incur eligible medical expenses at least equal to the deductible amount in order to establish a benefit period under a major medical expense or comprehensive medical expense policy.

repayment value for indemnification due to loss or damage of property; in most cases it is replacement cost minus depreciation

(PC Insurance)a document or other presentation, prepared as a formal means of conveying to the state regulatory authority and the Board of Directors, or its equivalent, the actuary's professional conclusions and recommendations, of recording and communicating the methods and procedures, of assuring that the parties addressed are aware of the significance of the actuary's opinion or findings and that documents the analysis underlying the opinion. (In Life and Health) this document would be called an "Actuarial Memorandum."

business professional who analyzes probabilities of risk and risk management including calculation of premiums, dividends and other applicable insurance industry standards.

a person who investigates claims and recommends settlement options based on estimates of damage and insurance policies held.

insurer assets which can be valued and included on the balance sheet to determine financial viability of the company

An insurance company licensed to do business in a state(s), domiciled in an alternative state or country.

occur when a policy has been processed, and the premium has been paid prior to the effective date. These are a liability to the company and not included in written premium or the unearned premium reserve.

the social phenomenon whereby persons with a higher than average probability of loss seek greater insurance coverage than those with less risk

a group supported by member companies whose function is to gather loss statistics and publish trended loss costs.

a person or entity that directly, or indirectly, through one or more other persons or entities, controls, is controlled by or is under common control with the insurer.

an individual who sells, services, or negotiates insurance policies either on behalf of a company or independently

the maximum dollar amount or total amount of coverage payable for a single loss, or multiple losses, during a policy period, or on a single project.

method of reimbursement of a health plan with a corporate entity that directly provides care, where (1) the health plan is contractually required to pay the total operating costs of the corporate entity, less any income to the entity from other users of services, and (2) there are mutual unlimited guarantees of solvency between the entity and the health plan that put their respective capital and surplus at risk in guaranteeing each other.

an estimate of the claims settlement associated with a particular claim or claims.

an insurance company formed according to the laws of a foreign country. The company must conform to state regulatory standards to legally sell insurance products in that state.

also known as open peril, this type of policy covers a broad range of losses. The policy covers risks not explicitly excluded in the policy contract.

coverages which are generally written with property insurance, e.g., glass, tornado, windstorm and hail; sprinkler and water damage; explosion, riot, and civil commotion; growing crops; flood; rain; and damage from aircraft and vehicle, etc.

also known as open peril, this type of policy covers a broad range of losses. The policy covers risks not explicitly excluded in the policy contract.

health services provided to members who are not confined to a health care institution. Ambulatory services are often referred to as "outpatient" services.

an annual report required to be filed with each state in which an insurer does business. This report provides a snapshot of the financial condition of a company and significant events which occurred throughout the reporting year.

the beneficiary of an annuity payment, or person during whose life and annuity is payable

an annuity contract that provides for the fixed payment of the annuity at the end of the first interval of payment after purchase. The interval may vary, however the annuity payouts must begin within 13 months.

a contract providing income for a specified period of time, or duration of life for a person or persons.

an estimate of value

a binding dispute resolution tactic whereby a conciliator with no interest in the outcome intercedes.

estimated value for real or personal property established by a taxing entity

probable future economic benefits obtained or controlled by a particular entity as a result of past transactions or events. An asset has three essential characteristics: It embodies a probable future benefit that involves a capacity, singly or in combination with other assets, to contribute directly or indirectly to future net cash inflows; A particular entity can obtain the benefit and control others' access to it; and The transaction or other event-giving rise to the entity's right to or control of the benefit has already occurred.

in the risk-based capital formula, risk assigned to the company's assets.

A governmental pool established to write business declined by carriers in the standard insurance market.

a policy or rider that provides coverage only while a policyholder is confined to an assisted living facility and meets the policy requirements for coverage.

the assumption of risk from another insurance entity within a reinsurance agreement or treaty.

an insurer licensed or admitted to do business in a particular state.

theoretical amount of capital plus surplus an insurance company should maintain.

reinsurance placed with a reinsurer who is licensed or otherwise allowed to conduct reinsurance within a state.

accounting statement showing the financial condition of a company at a particular date.

an individual who may become eligible to receive payment due to will, life insurance policy, retirement plan, annuity, trust, or other contract.

coverage for property and liability that extends to more than one location, class of property or employee.

a form of debt security whereby the debt holder has a creditor stake in the company. Obligations issued by business units, governmental units and certain nonprofit units having a fixed schedule for one or more future payments of money; includes commercial paper, negotiable certificates of deposit, repurchase agreements and equipment trust certificates

original cost, including capitalized acquisition costs and accumulated depreciation, unamortized premium and discount, deferred origination and commitment fees, direct write-downs, and increase/decrease by adjustment.

an individual who receives commissions from the sale and service of insurance policies. These individuals work on behalf of the customer and are not restricted to selling policies for a specific company but commissions are paid by the company with which the sale was made

coverage for property taken or destroyed by breaking and entering the insured's premises, burglary or theft, forgery or counterfeiting, fraud, kidnap and ransom, and off-premises exposure.

loss of income as a result of property damage to a business facility.

business insurance typically for property, liability and business interruption coverage.

in health insurance, the amount that must be paid by the insured during a calendar year before the insurer becomes responsible for further loss costs.

a company's assets minus its liabilities.

statutory requirement ordering companies to maintain their capital and surplus at an amount equal to or in excess of a specified amount to help assure the solvency of the company by providing a financial cushion against expected loss or misjudgments and generally measured as a company's admitted assets minus its liabilities, determined on a statutory accounting basis.

excess (deficiency) of the sales price of an asset over its book value. Calculated on the basis of original cost adjusted, as appropriate, for accrual of discount or amortization of premium and for depreciation.

a compensation plan used in connection with some managed care contracts where a physician or other medical provider is paid a flat amount, usually on a monthly basis, for each subscriber who has elected to use that physician or medical provider. 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.

an individual who sells or services insurance contracts for a specific insurer or fleet of insurers