John S. Dunne Claims Management
Professional Claims Management for Individuals and Companies
Call us on 00353-87-8288112
Here are some of the most frequently encountered terms when dealing with insurance.
Act of God
The expression Act of God refers to natural events that can't be foreseen or predicted. Insurance policies often exclude large-scale disasters or acts of war, however it is not true to say that insurance will exclude what are known as Acts of God.
An insurance policy that covers all risks - except those not listed under its exclusions. An all risks section of a home policy, for example, covers possessions such as cameras and watches when taken outside the house. Covers additional risks not normally covered under standard contents cover. Customers can specify certain possessions, such as a camera, as all risk on their policies. Will cover the items away from home, in the car, on holidays, etc.
Premium due on renewal date or at inception of an annual policy.
A policy renewable annually. For travel, an insurance policy that applies all year round rather than just for a single journey or holiday. (Some policies are not renewable.)
Category of Intermediary as regulated by Irish Financial Services Regulatory Authority. The principal distinction is that Authorised Advisor must recommend the most suitable product on the market for the client irrespective of the appointments (agencies) he holds.
Term was traditionally used to describe an independent intermediary who sells policies from several insurance companies, particularly as opposed to a tied agent.
Third party only covers legal liabilities arising from the use of a motor vehicle. Third party is compulsory under the road traffic acts. Fire and theft covers your own vehicle for fire or theft risk, and Comprehensive policies also cover accidental damage to your own vehicle.
Document issued by insurers as evidence that insurance is in force to meet the requirements of the law (notably for car insurance).
When a policyholder or beneficiary seeks payment or settlement under the terms of a policy. The term used to describe the process of getting an insurance company to pay out on the policy you bought from them.
A policy covering a number of types of loss or damage. The term is used mainly in car insurance, in which case it refers to a policy covering third party, and also fire theft and accidental damage to your own car. Open driving may or may not be included.
Part of a policy stating that certain rules must be followed, for example, the duty to take reasonable care to protect property, or to report claims to the insurance company promptly.
A document giving temporary evidence of cover while the policy and certificate are being prepared. Seldom issued nowadays as full yearly documents are usually issued immediately.
Employers Liability cover
Covers an employer's Legal Liability for injury to employees. This used to be referred to as workman's compensation policy not so long ago!
Refers to a document issued to amend a policy / schedule, which when received should be kept with the policy document.
The amount of a claim a policyholder agrees to pay if he or she suffers a loss. An excess is often standard with some policies such as car insurance or travel. So if you have an excess of €100 and agreed cost of repairing your car is €1,200 the insurance company pay €1,100 and you pay €100. Voluntary excess cuts the cost of most insurance premiums.
Specified property, person or event, which the policy does not cover.
Financial Regulator, the
The regulator in Rep. Of Ireland for Financial and Insurance services.
Financial Services Ombudsman, the
In the event that you remain dissatisfied with a regulated firm’s handling of and response to a complaint, contact may be made with The Financial Services Ombudsman, 32 Upper Merrion St., Dublin 2, lo-call 1890 88 20 90.
An Irish Government tax and levy imposed on most non-life insurance premiums, presently 2 per cent.
This must exist for a valid policy to be taken out. A simple example is that you could not insure your neighbour's house (unless you bought the house first)
The principle by which insurance policyholders are put in the same financial position after a loss as they were immediately before it.
A person covered by an insurance policy, the policyholder
Legal responsibility for causing loss or damage to or injury to someone else.
Public Loss Adjuster
A person who negotiates claims on behalf of policyholders, and is paid a fee by the policyholder for this service. Not to be confused with Loss Adjustor, whose aim is precisely the opposite - i.e. to reduce insurance company payouts.
A person, independent of an insurance company but engaged and paid by it, who checks that a claim is covered and negotiates with the policyholder the amount payable for a claim.
Information that would affect an insurance company's willingness to accept a policy, or the premium it would charge. Failing to disclose a material fact could invalidate a policy. Typical examples include previous driving convictions or a history of subsidence in a house.
No claims bonus
A discount that grows for every year without a claim. No claims bonuses are most common with motor insurance, but they are also sometimes available on home insurance. See also step back bonus, full bonus protection
Personal Accident and Sickness Cover More expensive policy, covering specific benefits if the insured person is injured and unable to work as a result of an accident or as a result of illness. Optional covers for Weekly Income and larger lump sum payouts for death, loss of limb, etc. These policies usually pay weekly benefit for shorter terms e.g. 2 years.
The document that details the contract between the insurer and the policyholder.
Policyholder Person to whom the insurer issues the policy. Normally this is the person who benefits from an insurance policy.
The amount a customer has to pay in return for insurance cover.
Public Liability Policy
Covers the insured's legal liability for injury or damage caused to others.
Notice sent to the policyholder inviting him/her to renew a policy for a further period and stating the premium payable.
Pages inserted in policy containing the policyholder's unique details, terms, and conditions, and which refers to and forms part of the policy document.
When an insurer pays a claim.
Now generally excluded from all property damage insurances.
The Third Party
Someone involved in a claim who is neither the policyholder nor the insurer. Usually refers to the other person or party involved in an accident.
The maximum an insurance company will pay for a claim. Some policies, such as travel insurance, come with built-in sums insured. Others, such as home insurance, leave it for the customer to choose the appropriate level of cover, and work out the cost accordingly. In life insurance, the amount which is guaranteed to be paid and to which bonuses may be added.
Person employed by an insurance company who decides whether to accept a risk and calculates the premium to be charged.
Utmost Good Faith And Material Facts
The insurance company depends on you acting with the utmost good faith. This means that you must tell the insurance company about any material fact' (i.e. any fact which could affect your cover, your premium or the underwriter's decision to cover you). This is very important since one of the most common reasons why insurers don't pay claims is that they don't have all the material facts.
A policy condition, which, if not met, invalidates the cover.
A damaged vehicle, which is not repairable, or one, which would cost more to repair than the car was worth before the damage occurred. Also known as a total loss'. This means that the cost of repairing the vehicle is more than it is worth at today's market value. Your insurance company's assessor will look at the car and work out what it was worth before the accident, taking into account the mileage and condition of the car. The amount paid to you will be what the car was worth before the accident, less its scrap value and any excess that applies to your policy.
INVESTIGATING CLAIMS SINCE 1998
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