Filing an insurance claim without mastering the specific language is a surefire way of heading to failure. Whether you’ve filed other claims in the past or this is your first one, you’ll need a glossary of insurance terms. It will get you up to speed with the language used in these insurance claims.

Homeowners who’ve had their homes damaged and want to file insurance claims should find this glossary to be a great asset. You will not only learn to communicate better with the insurance company but you’ll also avoid the pitfalls that insurance adjusters often throw your way.

This blog contains ample resources that will improve your knowledge of insurance claims and other related concepts.

Actual Cash Value

Otherwise known as “ACV,” Actual Cash Value is a way of assessing the costs of damaged property by the insurance company. To reach this value, the insurance adjuster analyzes the replacement costs of the damaged property and subtracts the depreciation.

However, insurance companies often set the valuation of the property to be replaced, which makes the ACV a bit subjective. You’ll need to take notice of how the insurance company calculates the ACV.

Any Occupation Disability Insurance

If an individual can’t partake in any work that they are eligible for, they are qualified to receive benefits from insurance policies. The work type must not be restricted to precise occupations either.

Application Misrepresentation

An application misinterpretation refers to the fraudulent, negligent, intentional, or unintentional misstatement of adequate and true information on an insurance policy. Moreover, insurance companies are free to deny claims based on this. Though, there’s a degree of application misrepresentation severity that may still make you eligible for filing a claim.

Appraisal

An appraisal is the process of a dispute over the severity of the incurred losses, a concept that is part of most insurance policies these days. However, various policies may have different jurisdictions and terms for such processes.

Assisted Living

Assisted living refers to housing made for senior citizens that need help with daily routines but who don’t need intensive care yet. Some insurance policies differentiate between assisted living and nursing homes.

Bad Faith

Bad faith refers to an intentional act of deceit. Regarding insurance claims, this means that insurance companies or adjusters don’t honor their agreed-upon duties to the policyholder. In other words, they may try to take advantage of the insured.

Beneficiary

The beneficiary is the individual eligible to receive a payment from a trust, will, retirement plan, life insurance policy, or other contracts.

Benefits (Hospital and medical expenses)

This refers to all healthcare expenses that the insurance company covers.

Business Owner’s Policy

This is a particular type of insurance policy, similar to liability property and business interruption coverage, that is directed to specific businesses.

Catastrophic Loss

This stands for a devastating loss that you most likely couldn’t predict nor prevent.

Claim

A claim is the policyholder’s official request to an insurance company where they demand payment for losses or damage incurred to a property covered by the insurance policy.

Insurance Adjuster

After a claim has been filed by a policyholder, the insurance company sends an insurance adjuster to assess the policyholder’s losses and the compensation required to cover them.

Conditions

Conditions refer to the rules that a policyholder must meet if the filed claim is to be deemed valid.

Declarations

The declarations or “dec pages” are the forms included in an insurance policy that provide information about the demographic information, insurable interest, and other information of the insured and their insured property.

Direct Loss

Direct losses refer to property damage and losses caused by an event covered by the insurance policy.

Examination Under Oath (EUO)

This is a formal procedure in a court of law where an insurance company’s representative (attorney) will question the policyholder. In this case, policyholders should have an attorney of their own, since the testimony relates to the claim and loss of the insured. The insurance company’s attorney will not represent your best interest.

Exposure

A policyholder’s property is damaged or suffers a loss because of a contingency or hazard.

Hazard

A circumstance that may raise the magnitude of a loss.

Independent Adjuster

As opposed to a public adjuster, the independent adjuster is a freelance adjuster hired by the insurance company to assess your losses.

Insured

The policyholder is covered by an insurance policy.

Insurer

The insurance company that may write casualty and property insurance for policyholders (under the relevant laws).

Irrevocable Beneficiary

The beneficiary of a life insurance policy whose compensation may not be altered without obtaining consent.

Loss Payment Clause

A standard provision that provides the policyholder with a certain benefit. Insurance policies adhere to this clause when the settlement is being paid to the insured.

Negligence

A failure to exercise sufficient care of caution leads to losses or damage to oneself or others.

Nursing Home

A private healthcare institution that offers care and residential accommodation for the elderly.

Own Occupation Disability Insurance

An insurance policy that covers individuals who cannot continue their careers. This doesn’t refer to random employment, though.

Package Policy

An insurance policy that combines at least two other policies.

Policy

An official and agreed-upon contract that provides insurance terms and agreement conditions.

Premium

The policyholder’s monthly, yearly, or quarterly expenses for the insurance policy.

Primary Insurance

The insurance policy takes precedence when more than one policy covers identical losses.

Proof Of Loss

A formal statement provided by the policyholder to the insurance company detailing the reasons for a claim, which enables the company to assess its liability under the policy. Proof of loss requests needs to be filed within certain deadlines. Failing to meet these deadlines voids the claim.

Provisions

Information is highlighted in various sections of the insurance policy.

Proximity Cause

Event related to a legally recognized injury that is recognized as a cause for said injury covered by the policy.

Public adjuster

Insurance policy expert that works solely for the policyholder and who files claims on behalf of the insured to insurance companies.

Replacement Cost Value

Replacement expense of damage or losses caused by regular wear and tear, but without considering the depreciation value.

Salvage

Value remaining after a loss or damage.

Term

Timeframe within which the insurance policy remains valid

Third-Party

Any individual or entity other than the insurer and insured may be eligible for compensation due to losses caused by the insured.

Umpire

The umpire is the third member of the appraisal process for an insurance claim, aside from the two appraisers. Agreements of any two parties are valid. The umpire is an expert in replacement or repairs.