Open Enrollment Period
A period when eligible individuals can choose to enter or make changes to in a plan.
Open-Panel HMO Model
Insurers contract with individual or groups of physicians to provide services to the HMO insureds. Open-panel providers and facilities may also contract with other HMOs
Operational Risks
Risks related to processes and management resulting in upside and downside outcomes.
Organizing
The actions a risk manager takes to arrange and relate work to be done so that it can be performed most effectively by others.
Out-of-Pocket Maximum
In Health Insurance, a stop loss provision that defines the maximum dollar amount an insured must pay in out-of-pocket expenses during the year. Once an
Outlier
In statistics, an extreme value, or a value numerically distant from the rest of the data.
Outstanding losses
On a loss run, the amount calculated by subtracting paid losses from incurred losses and representing the remaining liability to be paid on a loss
Own Occupation
The specific regular occupation in which an individual is engaged at the time he or she becomes disabled.
Owner
The individual or entity controlling all rights, benefits, and privileges of a life insurance contract. This may or may not be the insured. Ownership may
Owner’s Equity
Value of the organization’s assets less liabilities; includes capital, surplus and accumulated retained earnings.
Paid Loss Retrospective Rating Plan
Retrospectively rating insurance plan that uses only paid losses to determine the retrospective premiums due at each adjustment. A paid loss retrospective rating plan allows
Paid Losses
Amount actually paid in losses during a specified period of time, not including estimates of amounts (i.e., reserves) that will be paid in the future
Paid-in Capital
Amount actually paid in losses during a specified period of time, not including estimates of amounts (i.e., reserves) that will be paid in the future
Paid-in Excess
Original cost of a newly issued share of common stock less its stated par value. Insurance company common stock (and commercial bank stock) often has
Paid-Up Life Insurance Policy
A policy that has no further premium payments due, but under which the insurance coverage (life benefit) remains in effect.
Pandemic Pods
Question: What are Pandemic Pods? Answer: As a consequence of COVID-19 and the closing of schools, parents have started organizing “pandemic pods,” or homeschooling pods,
Pareto Principle
In business management, the observation that 80% of effects come from 20% of the causes. Also known as “Pareto Efficiency” or the “80/20 Rule”.
Parole Evidence
Legal concept describing oral or verbal evidence. In contract law, parole evidence relates to the inadmissibility of oral representations that would otherwise alter or defeat
Partial Disability
Partial Disability – When an insured is working, but is unable to perform one or more of the major duties of his or her occupation,
Partially Self-Insured Plan
Employer retains a portion of claim risks by paying incurred claims up to an amount determined in the contract. Employers typically purchase a reinsurance policy
Participating Life Insurance Policy
A policy that pays dividends if the board of directors authorizes such payments.
Party-in-interest Transaction
Any transaction involving any fiduciary, counsel, or employee of a plan; plan service provider, or anyone with a stated interest in or relationship with a
Passive Retention
Unplanned acceptance of losses because of failure to identify risk, failure to act, or forgetting to act.
Patient Protection and Affordable Care Act (“PPACA”) (also known as Healthcare Reform)
Enacted by the federal government on March 23, 2010 to ensure consumer rights and protection for healthcare.
Payback
In financial management, the measurement of the length of time needed to recoup the cost of a capital investment.
Payout Profile
Schedule illustrating the percentage of loss dollars actually paid in settlement of claims over time.
Period Certain
A payout of a fixed dollar amount that remains the same throughout the specified annuitization period.
Periodic Inventory Accounting System
An accounting of goods sold and their corresponding costs performed at specified points during the accounting period; the most common method.
Permanent Life Insurance
A policy that offers lifetime protection by combining a cash value with death benefits.
Perpetual Inventory Accounting System
A record is made of every sale and continuous costs of each item sold are transferred from inventory asset to the cost of goods sold
Personal Property
All tangible property not classified as real property. See Real property.
Personal Property (Coverage C)
Coverage that protects the collection of property owned by an insured that is not considered part of a building or structure. It can be at
Physical Risks
A general class of risk; risks arising from property, people or information.
Physician Hospital Organization (“PHO”) System
A group of physicians or hospitals that form alliances to help providers attain market share, improve bargaining power, reduce administrative costs and sell their services
Planning
The process a risk manager takes to predetermine a course of action; an element of the managerial process.
Policy Limits
The maximum dollar amount an insurance policy will pay for a covered loss.
Policy Loan
A loan from the insurer to the policy owner, secured by the policy’s cash value.
Policy Owner
The owner of an insurance policy. The policy owner can be different from the insured.
Policy Territory
The geographical area in which accidents, occurrences, or events must happen to have coverage under the insurance policy.
Political Risk
A general class of risk; risks arising from changes in the law, governmental reinterpretations or changes in government policy.
Pooling
A self-insurance strategy used by two or more organizations that desire to share risks with each other. The organizations are not individually capable of self-insuring.
Pre-admission Certification
A healthcare provider’s authorization, or pre-admission certification, for an insured’s non-emergency hospital admission and certain covered benefits prior to an insured receiving the care.
Pre-admission Review (“PAR”)
Requirement that an insured must notify the insurer prior to an elective inpatient hospital admission after an emergency admission.
Pre-Existing Condition Limitation
Excludes coverage for conditions the policy defines as pre- existing. Under PPACA, beginning September 23, 2010, group health plans may not exclude insureds under age
Preferred Provider Organization (“PPO”) System
Insureds have the option of obtaining service within the PPO network (in-network) or with providers that are not contracted with the PPO (out-of-network). Primary Care
Preferred Stock
Type of stock issued by a corporation that has ownership privileges with respect to payment of dividends and distribution of assets greater than those of
Premium
Amount of money an insurance carrier charges to provide the coverage described in the policy.
Premium Discount
1) A discount allowed on premiums paid in advance of one year based on projected interest to be earned. 2) a discount allowed on certain
Premium Equivalent
Used in self-insured health plans, the cost per covered employee, or the amount the employer would expect to reflect the cost of claims paid, administrative
Present Value
Value today of a future payment or payments, discounted at the appropriate discount rate.
Presumptive Disability
In a disability income policy, a percentage of disability that will be considered without a waiting period if the insured suffers the total and complete
Price/earnings Ratio (P/E Ratio)
Measure of the market price of a share of common stock to its earnings; market price of a common share divided by earnings per share.
Primary Actual Losses
When computing workers compensation experience modifications, the actual loss amount (each loss equal to or less than $15,000) is included in the calculation at its
Primary Beneficiary
The person or entity named on the policy who has the first right to receive life insurance policy death benefits.
Primary Care Physician (“PCP”)
Also known as a “gatekeeper,” authorizes and refers the insured to specialists and other healthcare providers.
Private Law
The organizational charter and its by-laws control what the executives can and cannot do. Violations of these “laws” are ultra vires acts, or acts beyond
Pro Rata Reinsurance (Proportional)
An agreement to share insurance. The reinsurer gets an agreed percentage of the original premium, less a ceding commission, and pays the same percentage of
Pro-rata Reinsurance
A form of reinsurance where the treaty is set up on the understanding that a certain part of every exposure will be shared on an
Probability
Chance of something occurring within a stated time period, ranging from 0 (impossibility) to 1 (certainty).
Probable Maximum Loss (PML)
An estimate developed for property insurance underwriters that represents the worst amount of loss that is likely to happen, as opposed to the worst possible
Probate
A court-supervised process by which a will is determined to be the deceased’s final statement regarding the disposition of his or her property.
PROFocus Series
National Alliance PROFocus Series courses are open to all insurance and risk management professionals! Dues-paid National Alliance designees are eligible for update credit! PROFocus Series
Promissory Estoppel
Legal concept holding that a false statement will be treated as a promise when the listener relied upon the false statement to his/her detriment. The
Prospective Contracts
Covers losses that have not yet occurred, that may never occur and those losses that occur after the effective date of the contract.
Protected Cell Company (PCC)
A type of rent-a-captive which is permitted by legislation to legally separate the assets and liabilities of insureds as opposed to contractual separation or no
Protection
As related to property, the safeguards, equipment and measures provided by the building owner or occupant to minimize hazards.
Public Adjuster
An independent adjuster who represents policyholders in the adjustment of their losses with insurers for a fee.
Punitive Damages
Damages in excess of those required to compensate the plaintiff for the wrong done. Punitive damages, also called exemplary damages, are imposed to punish the
Pure Loss Ratio
Ratio of the losses incurred in a given period to the earned premium for that period.
Qualified Medical Expenses (“QME”)
Defined by the IRS Code Section 213 and include expenses for the diagnosis, cure, mitigation, treatment or prevention of disease, obtained from medical providers and
Qualified Plan
Concerning the income taxation of contributions, plans that cannot discriminate and must comply with specific IRS codes and regulations. Contributions are deductible from income taxes
Qualified Self-insurance
An insurance plan subject to state regulation, such as self-insured workers compensation plans or self-insured automobile liability plans, in which regulatory oversight is needed to
Qualitative Analysis
The “what” analysis; identification and assessment of loss exposures that cannot be easily measured by traditional statistical or financial methods; helps management understand the potential
Quantitative Analysis
The “how much” analysis; attempts to accurately measure risks by using acceptable traditional methodologies to calculate relative numerical values.
Quick Ratio
A liquidity ratio that measures the organizations ability to pay bills over the short term; the remainder of current assets less inventory divided by current
Quid Pro Quo
Latin for “this for that,” or “one thing for another.” In contract law, it refers to the legal consideration of values required by both parties
Quota Share Reinsurance
The primary insurer or ceding company cedes (sells) a portion of every exposure it insures within a class or classes subject to the treaty. Both
Rate Class
The manner in which a life insurance premium is determined, based upon the individual’s health condition, family history, occupation, hobbies and other factors specific to
Real Property
Land and most things attached to the land, such as buildings and vegetation.
Reciprocal
A group of individuals or organizations, called subscribers, who join together into an association for the purpose of insuring one another.
Recurring Disability
A repetitive sickness or injury that is a continuation of a prior covered sickness or injury.
Recusal
Act of abstaining from a discussion or decision because of a conflict of interest or the appearance of a conflict of interest.
Reduction (Loss Control)
The use of any one method or a combination of methods to reduce loss frequency or loss severity.
Regression
In statistics, a technique of modeling the relationship between variables by fitting a line to a scatter of dots.
Reinsurance
The acceptance by one or more insurers of a portion of the risk underwritten by another insurer that holds a contract for the entire coverage.
Reinsurance
A process involving the transfer of risk from one insurer to another insurer.
Reinsurance
A contractual agreement in which one insurer agrees to insure the assumed liabilities of another insurer, a self-insured firm, or another reinsurer.
Reinsurance Ceded
Portion of the risk that the primary or original insurer transfers to the reinsurer.
Reinsurer
Insurer who accepts all or a portion of the liabilities of the ceding or primary company.
Renewable Term Life Insurance
A policy the insured can renew without presenting evidence of insurability, also known as guaranteed renewable.
Rent-a-captive
A licensed offshore insurer owned by an outside organization, e.g., a broker, reinsurer, insurance company, or other business enterprise, which makes its services available to
Replacement Cost
The cost to replace damaged property with like kind and quality without taking into account depreciation.
Request for Proposal (RFP)
Providers are “invited” or requested to provide a proposal for insurance coverages; typically, the providers are assigned markets from which they will obtain proposals and
Required Rate of Return
Rate of return required from an investment to compensate for the level of risk involved.
Res judicata
“The matter has been decided,” a legal concept of common law stating that the prior decisions of judges and juries have determined the outcome. See
Reservation of Rights
In claims administration, a letter sent by an insurer to a claimant to preserve the insurer’s right to deny a claim following their investigation by
Residual Disability
After a period of total disability, the insured is able to return to work. However, the insured is unable to do one or more important
Residual Income
A provision in a disability income policy that provides for benefits to be paid when the insured can do some, but not all, of his
Residual Market Load (RML)
Separate charge intended to subsidize an assigned risk or involuntary market.
Resources Magazine
Resources Magazine is the official publication of the National Alliance Research Academy. Published three times a year it is an exclusive benefit for National Alliance
Respite Care
Usually associated with a long-term care situation, and normally occurs when a family member of the patient who is providing a majority of the care
Retained Earnings
Internal funds retained from net income and not distributed to holders of common stock.
Retention
Acceptance or assumption of the risk of loss, which means any loss is paid out of pocket.
Retention
1) Internal funds used to pay losses; 2) budgeted losses plus the “tolerance corridor.” See Tolerance corridor; 3) assumption of risk of loss as through
Retention Level
Amount of loss that is self-insured. It is usually expressed on a per occurrence basis and is sometimes referred to as the self-insured retention (SIR).
Retention-transfer Diagram
Graphic depiction of an organization’s financial ability and risk appetite.
Retro Adjustment
Amount of additional premium or return premium for each successive period determined by comparing the current period’s indicated retro premium to the preceding period’s retro
Retrocession
Transaction that transfers liability from the reinsurer to another insurer, perhaps even back to the primary insurer, in whole or in part.
Retrospective Contracts
Are directed to the past and contemplative of post-loss situations. Two types – loss portfolio transfers and aggregate loss contracts.
Retrospective Rating
Rating plan that adjusts the premium, subject to a certain minimum and usually a maximum, periodically to reflect the actual loss experience of the insured.
Retrospective Rating
Rating plan that adjusts the premium, subject to a certain minimum and usually a maximum, periodically to reflect the actual loss experience of the insured.
Return of Premium Rider
A rider that can be attached to many life, health, disability and LTC policies (for an extra charge), that will return all or part of
Return on Assets (ROA)
Measure of the return on assets; net income divided by total assets.
Return on Equity (ROE)
Measure of the return on equity; net income divided by stockholders’ equity.
Return on Investment (ROI)
A highly flexible ratio measuring the financial benefits of an investment activity to its costs.
Revocable Beneficiary
A status in which a life policy can be changed without the consent of the beneficiary. The owner of the policy can change any part
Rider
A provision that an insurer attaches to a policy to expand or restrict the benefits of the policy.
Risk
The chance of loss; the uncertainty of loss; the variation from the expected outcome over time; the difference between expected losses and actual losses.
Risk
Uncertainty that may be either positive or negative arising from a given set of circumstances. Common definitions also include: 1) chance or probability of loss,
Risk Mapping
Visual analytical tool utilized to communicate key risks; it presents the risks with the highest impact and probability; can range from simple to complex depending
Risk Administration
Implementation and monitoring of the Risk Management Process; a step of the Risk Management Process.
Risk Analysis
The assessment of the potential impact of various exposures on an organization; a step of the Risk Management Process.
Risk Control
Any conscious action or inaction to minimize at the optimal cost, the probability, frequency, severity, or unpredictability of loss; a step of the Risk Management
Risk Duplication
The use of back-ups for critical systems or operations; a risk control technique in which the goal is to reduce overall severity.
Risk Financing
The acquisition of internal and external funds to pay losses at the most favorable cost; a step of the Risk Management Process.
Risk Identification
Process of identifying and examining exposures of an organization; the first and most important step of the risk management process.
Risk Management
The practice of protecting an organization from financial harm by identifying, analyzing, and controlling risk at the lowest possible cost.
Risk Management
Process of managing uncertainty of exposures that affect an organization’s assets and financial statements using five steps: identification, analysis, control, financing and administration.
Risk Management Information System (RMIS)
Information system that supports the user in identifying, measuring and managing risks in the organization or other organizations.
Risk Management Mission Statement
States the purpose and overall goal of the risk management program and guides the actions and decision-making of the risk manager.
Risk Management Policy Statement
Defines the policy for managing risks and the relevance to the organization’s strategic plan, goals, and objectives; clarifies risk management goals and direction; outlines the
Risk Management Standard Operating Procedures Manual
Reaffirms and communicates senior management’s support for the risk management program to all employees with a brief statement; defines scope, responsibilities and authority of risk
Risk Management Stewardship Report
Provides an overview of risk management programs on a periodic basis to identify successes and opportunities for improvement.
Risk Prevention
An action taken to break the sequence of events that leads to a loss or that makes the event less likely; the goal of this
Risk Profiling
Measurement of expected losses for a finite period of time based on historical data including but not limited to, total losses, number of losses, average
Risk Purchasing Group
Group formed in compliance with the Risk Retention Act for the purpose of negotiating for and purchasing insurance from a commercial insurer.
Risk Quantification
Actual forecasting of loss frequency and severity to determine allocation decisions.
Risk Reduction
A risk control technique in which the goal is to reduce the severity or financial impact from losses that are not prevented.
Risk Retention
Conscious acceptance of losses that the organization or company will finance using only internal funds. See retention.
Risk Retention Group
A special type of group captive whose business is limited to liability coverage for owners/insureds. Formed under the Federal Liability Risk Retention Act of 1986,
Risk Segregation
An isolation of an exposure from other exposures, perils, or hazards; a risk control technique in which the goal is to reduce overall severity.
Risk Separation
The spread of exposures or activities over several locations; a risk control technique in which the goal is to reduce overall severity.
Risk Transfer
Risk control technique that attempts to reduce or prevent loss by transferring some or all of the risk to another organization, either through a physical
Risk Volatility
Difference between an anticipated result (loss) and the standard deviation.
Robbery
The unlawful taking of property from a person by actual violence or threat of violence.
Roth IRA
A retirement savings account that allows an individual to deposit after-tax funds (not tax-deductible) up to specified annual contribution limits and accrue earnings income tax
Salvage
1) Gross salvage is the total amount a company expects to recover from salvage, and 2) net salvage is the gross amount less costs associated
Sample
In statistics, a subset of a larger group having the same characteristics of the group.
Second To Die
A type of life insurance policy that insures two lives, also referred to as a survivorship policy, where the death benefit is payable at the
Secondary Beneficiary
A person designated by the policy owner to receive policy proceeds if the primary beneficiary is deceased at the time benefits become payable, also known
Securities Exchange Commission (SEC)
The federal agency charged with the responsibility of regulating the securities industry and enforcing federal securities regulation.
Self-dealing Transaction
Any transaction using plan assets for personal gain, transactions on behalf of persons whose interests are adverse to the plan, and personal.
Self-insurance
An insurance plan in which an organization makes a conscious decision to not purchase insurance and pay certain claim amounts using 100% internal funding. Self-insured
Self-insured Retention
Dollar amount specified in an insurance policy that must be paid by the insured before the insurance policy will respond to a loss; often used
Serious Injury
An injury resulting in death, serious impairment of body function, or permanent serious disfigurement.
Settlement Options
The choices available for the payment of death benefits. The owner can select a settlement option before the insured’s death and the beneficiary has no
Severability Clause
Contract provision that rescues the balance of a contract if one or more parts are held to be invalid or unenforceable. Also referred to as
Severity
The dollar amount of a given loss or the aggregate dollar amount of all losses for a given period.
Shared Care
A long-term care plan that allows the insured to purchase an additional Daily Benefit that either spouse may use.
Sharing
A method of handling risk that involves the potential loss exposure being distributed among a number of persons.
Short-Term Medical Policy
A temporary policy to bridge gaps in coverage during times of transition such as coverage loss due to life or job changes, employment as a
Simplified Employee Pension (“SEP”)
An individual retirement account for a self-employed person or a small company. Allows for a greater contribution maximum than an IRA.
Single Parent Captive
A type of captive that insures or reinsures the risks of its owner.
Single Premium Life Insurance
Requires one lump-sum, up-front premium and is often guaranteed to remain paid-up throughout the insured’s lifetime.
Sinkhole Collapse
Damage caused by the sudden sinking or collapsing of land into an underground empty space typically caused by water on limestone or dolomite.
Skewed Distribution
In statistics, an asymmetrical distribution in which the mass of the distribution is concentrated on one side or the other.
Skilled Nursing Facility (“SNF”)
A facility with a professionally trained staff that provides medical treatment, continuous nursing, rehabilitation, and various other health and social services to patients who are
Social Risk
A general class of risk; risks arising from public relations, loss of reputation, damage to brand, cultural issues, social direction or social media.
Sole Proprietorship
A business organization in which a sole proprietor is entitled to all profits, and will bear all losses, generated by the business and free of
Solicitor
A person who is hired and authorized by the insurance agent to solicit applications of insurance.
Specific Disease Supplemental Policy
Also known as “dread disease” insurance, it covers some expenses associated with narrowly-defined illnesses listed on the policy, most commonly available for cancer, heart attack
Specific Reinsurance
A form of reinsurance using offer and acceptance of individual risks, in which under a contract of reinsurance, the reinsurer retains the faculty to accept
Staff Model HMO
The most restrictive type of HMO where insureds select his or her primary care physician within the model but the HMO may close a particular
Standard Premium
Premium that is determined on the basis of authorized rates, any experience modification rating, applicable loss constants and minimum premiums; specifically excludes premium discounts and
Stare decisis
“Let the decision stand,” a legal concept of common law stating that the prior decisions of judges and juries have determined the outcome. See Res
Statement of Cash Flows
A report summarizing the effects of cash on the operating, investing, and financial activities of an organization for a specific period of time.
Statute of Frauds
Legal concept that holds no suit or action shall be maintained on certain classes of contracts or engagements unless there is a note or memorandum
Statute of Limitations
Any statute that prescribes the time limit in which a legal action must be brought.
Statutory Accounting Principles (SAP)
Those principles required by statute that must be followed by a regulated financial organization, such as an insurance company or bank when submitting its financial
Stockholder Equity
Net worth, retained earnings or total assets less total liabilities; sum of the book value of common stock less treasury stock, preferred stock, and additional
Stop-Loss Coverage
A form of reinsurance for self-insured employers that limits the amount the employers will have to pay for each covered employee’s and dependents healthcare claims
Straight-line Depreciation
Most commonly used method; annual depreciation = historical cost less estimated salvage value divided by years of estimated useful life.
Strategic Risks
Risks related to an organization’s strategic plan and its mission resulting in upside or downside outcomes; most likely cause of failure of organizations.
Strict Liability
Liability directed by law (statute or common law) without regard to the intention of the offender’s actions. Strict liability shifts the burden of proof; it
Strict Tort Liability
Holds sellers, distributors, and manufacturers of products responsible for defective or unduly hazardous products.
Structured Settlement
Settlement in which the plaintiff agrees to accept a stream of payments, in whole or in part, in lieu of a lump sum. Annuities are
Subject Premium
In retrospective rating plans, the portion of the premium applied to the retrospective rating formula. It is generally used to help calculate the basic premium,
Subrogation
1) The legal right of one who has paid another’s obligation to collect from the party originally owing the obligation, e.g., the insurer’s right to
Subrogation
The right of an insurance company to recover an amount of money paid to an insured for a loss when the loss is someone else’s
Substantial Performance
Legal doctrine that protects the party to a contract who makes an honest endeavor in good faith to perform his/her part of the contract with
Suicide Clause
A life insurance policy provision that states if the insured dies by suicide within a certain period of time from the date of issue (usually
Surety
Promisor under a bond; the party that promises to fulfill the obligation of the bonded party or principal; a surety company.
Surplus Share
The primary insurer or ceding company cedes to the reinsurer a pro rata share of risks, but the reinsurer only pays its percentage of losses
Surrender Benefit
An annuity contract that allows the owner to surrender the contract if income payments have not yet started. Upon surrender, the contract terminates and the
Surrender Charge
A fee charged when an owner surrenders the policy for the policy’s cash value.
Survivorship Clause
A life insurance provision stating when the death of the insured and the primary beneficiary is at the same time, the benefits would skip the
Tail Factor
When calculating loss development factors from historical data, a factor that recognizes that at some point, older data becomes unavailable or is no longer relevant
Target Premium
A suggested premium used in universal life policies that does not guarantee there will be adequate funds to maintain the policy to any time, including
Tax Multiplier
In retrospective rating plans, a factor applied to an insurance premium to cover licenses, fees, assessments, and premium taxes the insurance carrier must pay on
Tax-Deferred Growth
Growth in the value of a plan or account that is not taxed until the dollars are withdrawn at the applicable tax rate at that
Term Life Insurance
A type of life insurance that provides coverage for a predetermined amount of time.
The Coronavirus CARES Act
The Coronavirus Aid, Relief, and Economic Security (CARES) Act was passed by Congress and signed into law by President Trump on March 27th, 2020. This
The National Alliance CISR High School Program
The Certified Insurance Service Representative (CISR) Program for High School gives students the opportunity to earn a nationally recognized industry designation before they graduate. Provided by
The National Alliance for Insurance Education & Research
The National Alliance story began in 1969 in Austin, Texas when a small group of independent agents approached insurance professor Dr. William T. Hold to
Third Party Administrator (“TPA”)
An individual or company hired by an employer to process claims, pay providers, and manage other functions related to the operation of a plan.
Third-party Administrator (TPA)
Claims administrator or insurance company that processes claims on behalf of a self-insured organization.
Time Interest Earned (TIE)
A financial ratio that measures how much of the interest obligation of an organization is covered by net income; a measure of default risk; earnings
Time Value of Money
The value of money over a given amount of time considering a given amount of interest.
Tolerance Corrido
Marginal retention beyond budgeted retention that the organization may also choose to retain.
Top-down Pricing
Commonly known as manual rating or scheduled rating; an experience modification factor, scheduled credits or debits, premium discounts and/or deductible credits are applied to a
Tort
Private or civil wrong, other than a breach of contract, for which the courts will provide a remedy in the form of an action for
Total Cost of Risk (TCOR)
Sum of all quantified costs and expenses associated with the risk management function of an organization. TCOR includes insurance costs, retained losses, risk management departmental
Total Cost of Risk Allocation System
The process that identifies and attributes the total cost of risk among the various business, operating, or accounting units within an organization.
Total Incurred Losses
Incurred losses that have not been developed nor indexed for inflation.
Total Loss Ratio
Ratio of the losses incurred and the Allocated Loss Adjustment Expense (ALAE) for those losses in a given period to the earned premium during the
Transfer
A technique involving one party transferring the uncertainty of loss to another party or parties.
Transportation Cause of Loss
Includes loss or damage arising from collision, derailment, or overturn of a vehicle, stranding or sinking of vessel, or collapse of bridges, piers, or docks.
Treaty
A form of reinsurance in which a contract of reinsurance automatically establishes the terms for reinsuring a class or classes of business.
Treaty Reinsurance
The ceding company agrees to cede certain classes of business to a reinsurer. The reinsurer agrees to accept all business qualifying under the reinsurance treaty
Trend Factor
Used to adjust past loss experience to the current cost levels, generally taking into account inflation and other similar forces.
Trust
An obligation that binds a person (trustee) to deal with property in a particular way for the benefit of another person or class of persons
Two-Tier Annuities
A fixed annuity in which the interest rate credited to the annuity varies depending on the distribution option chosen by the owner.
Ultimate Losses
Total losses that will have been paid when all claims have reached final settlement.
Unallocated Loss Adjustment Expense (ULAE)
Salaries, overhead, and other related adjustment expenses not specifically allocated or charged to a particular claim. Certain insurance carriers apply a nominal flat charge to
Underwriting
The process of selecting a risk and assigning a proper rating classification (to calculate the correct premium) in a manner that the insured obtains coverage
Underwriting
The process by which the cost of the coverage is determined. Insurers (and self- funded plans) seek assistance from actuaries.
Underwriting Expenses
Expected losses, allocated loss adjustment expenses, captive expenses and any miscellaneous costs borne by the captive.
Unearned Premium
Amount of premium remaining after deducting the earned premium from written premium; the portion of a premium representing the unexpired part of the policy period.
Uniformed Services Employment and Reemployment Rights Act of 1994 (“USERRA”)
A federal regulation that requires employers to meet certain requirements for employees who are involved in the uniformed services. The rights cover: COBRA, medical, dental,
Units of Production
Depreciation charged per unit of production – historical cost less estimated salvage value divided by number of units to be produced.
Universal Life Insurance
A type of permanent life insurance policy that gives the policy owner the flexibility to change the face amount as well as the payments, has
Unoccupancy
A building that may contain furnishings and/or personal property, but it does not have people occupying it.
Usual, Customary, and Reasonable Charges
A practice using survey information that identifies medical charges by geographic area, specific medical service Current Procedural Terminology (“CPT”) code, and medical cost trends.
Utilization Review
The process of reviewing the appropriateness and quality of health care provided to patients. Utilization review may take place before, during, or after the services
Utmost Good Faith
A contract is considered to be a contract of “utmost good faith” when the parties to the contract rely heavily on the honesty and integrity
Vacancy
Not enough business personal property to conduct normal operations. In a rather broad sense, it means no contents.
Valuation Date
Cut-off date for adjustments made to paid claims and reserve estimates in a loss report.
Valued Policy
Declares the amount that will be paid in the case of a total loss of the property
Variable Annuity
An annuity with investments in separate accounts directed by the owner, such as growth, high-yield, or small cap mutual funds, etc.
Variable Life Insurance
A life insurance policy where the assets are invested in mutual funds or similar equity securities. Cash value accumulation over time will depend solely on
Variance
In statistics, the modified average of the squares of the deviation of each value from the arithmetic mean of those values. The “modified average” refers
Vesting
A term that describes the process by which a participant earns ownership rights of a benefit funded by an employer. When fully vested, a participant
Viatical
A general term referring to transactions in the viatical settlement marketplace. A viatical settlement is the proceeds from the sale of a life insurance policy
Voluntary Regulations
Rules created by professional, trade, and other organizations to internally govern their members.
Waiver
Waiver- 1) Legal concept that holds a party who intentionally or voluntarily relinquishes a known right, claim, privilege, or the opportunity from taking advantage of
Waiver
1) Legal concept that holds a party who intentionally or voluntarily relinquishes a known right, claim, privilege, or the opportunity from taking advantage of that
Waiver of Premium
An insurance policy rider that allows a policy owner to stop making premium payments if the insured suffers a disability. Premium payments will be waived
Warranty
A statement that promises or guarantees that something is absolutely true or will be true in the future.
Weighted Average
An accounting method used to value inventory and the cost of goods sold. This method applies the costs of individual items as items are sold
Weighted Average Cost of Capital (WACC)
A computation of the cost of capital from the organization’s current mix of capital sources. Capital consists of long-term debt, preferred stock, common stock, and
Weighting Value
In workers compensation experience modifications, a percentage value taken from the same actuarial tables used above to determine the percentage of excess losses to be
Weighting Value
In workers compensation experience modifications, a percentage value taken from the same actuarial tables used above to determine the percentage of excess losses to be
Whole Life Insurance
Whole Life Insurance – A type of permanent life insurance that is characterized by guarantees such as fixed death benefit, guaranteed cash value, and fixed
Whole Life Insurance
A type of permanent life insurance that is characterized by guarantees such as fixed death benefit, guaranteed cash value, and fixed premiums.
Women’s Health and Cancer Rights Act of 1998 (“WHCRA”)
A federal regulation that includes protections for individuals who elect breast reconstruction in connection with a mastectomy. Group and individual health plans that cover medical
Women’s Health and Cancer Rights Act of 1998 (“WHCRA”)
A federal regulation that includes protections for individuals who elect breast reconstruction in connection with a mastectomy. Group and individual health plans that cover medical