ACCIDENTAL
Means an unlooked for event, outside of the control of the customer; something which may happen, not something which must happen.
ADJUSTERS
These are professional firms, appointed by insurance companies to guide you through the more complex claims and negotiate settlement.
ALL RISKS
This is a term used widely in the insurance business which is in many ways a misnomer. There is no insurance policy that can cover everything.
The usual definition which is accepted is that of “accidental physical damage to property”.
"ACCIDENTAL PHYSICAL DAMAGE TO PROPERTY"
There are exclusions for events which are not accidental or are inevitable or are someone else's responsibility.
Some of these, such as breakdown, may be included for an extra premium.
You are usually responsible for the first part of any claim, this is called an EXCESS or DEDUCTIBLE
ALL RISKS (what is usually excluded)
- Wear, tear
- gradual deterioration
- depreciation in value
- insects, vermin
- corrosion, mildew, fungus, atmospheric conditions
- the action of light
- any process of heating, drying, cleaning, dying
- alteration of repair
- scratching, denting
- breakdown( sometimes included for an extra premium)
- misuse
- faulty workmanship or design
- use of faulty materials
- confiscation or detention by customs and the like mechanical breakdown or derangement unless caused by accidental damage
- loss or damage to firearms by rusting, bursting or derangement
ARBITRATION
This is a provision in insurance policies that simplifies the process where there is a dispute as to the amount to be paid, the insurers having agreed that there is liability to pay.
AVERAGE
Also known as the "Under-insurance" clause. The pricing for insurances on property is based on the concept that the full value at risk is insured by you. If you attempt to save money by under-insuring any claim payment will be reduced by the percentage of under-insurance.
AVIATION
This is the class of insurance that deals with coverage for aircraft, large and small. Also includes cargo sending by air. However these are frequently insured on the same basis as marine cargo, see below.
BOILER EXPLOSION/BREAKDOWN
A specialised coverage that addresses the risks associated with pressure vessels, including explosion, implosion and damage to surrounding property. There are also legal inspection requirements that are often provided in conjunction with insurance.
BROKER
A professional intermediary who acts on behalf of customers to arrange appropriate insurance programs.
BUILDINGS
It is usual on insurance policies to specify in a definition what is included, in addition to the basic structure, such as awnings, shades, small outbuildings, and retaining walls. This definition, subject to the insurer's agreement can be customized to meet your actual circumstances if the standard policy definition is insufficient.
BURGLARY
The forcible entry to or exit from premises in an attempt to remove or damage property which does not belong to the perpetrator. In a legal sense burglary" is committed during the hours of darkness whilst housebreaking is committed during daylight hours.
BUSINESS INTERRUPTION
When business property is damaged the reinstatement is not immediate and the earnings of the business can suffer and additional costs may be incurred. Business Interruption insurance can be tailored to cover the specific financial losses of a business following damage that is insured on a material damage policy.
CATASTROPHE PERILS
This is the expression that is used to describe hurricane and earthquake and resultant events such as flooding. CONDITION
In an insurance policy "conditions" are the rules for the operation of the cover. For example a claims condition tells you what you must do to make a claim.
CONTENTS
Usually a definition in your policy that is intended to be all embracing. It is always possible to customize a standard definition. It would include stock, fixtures and fittings, office equipment and the like.
CONTRIBUTION
A legal principle that ensures that if you have more than one policy covering a loss you can only claim once, or the two or more policies contribute in proportion, so that you only recover what you have actually lost.
DEDUCTIBLE
Sometimes called an "Excess", it is the first part of any claim for which you the customer is responsible. The intention is to exclude small claims so as to keep premium costs down.
DENTAL
Both personal and group health insurance schemes can include an item for dental treatment. Not all costs are covered and you should ask for a list of permitted work.
DETERIORATION OF FOOD OR DRINK
Damage to the contents of a refrigerator or freezer caused by a change in temperature or the freezer or refrigerator in the home or by contamination by accidental escape of refrigerant or refrigerant fumes is covered if it is caused by an insured risk such as fire, hurricane or earthquake.
EMPLOYEE BENEFITS
This is a general term given to pension, life and health schemes that are available.
EMPLOYERS LIABILITY
An employer has a wide responsibility for those who work for him. This includes safe working systems, adequate training, supervision and safety clothing. If an employee is injured as a result of a shortfall in any of these responsibilities he or she can sue the employer for damages. Such claims, including any necessary legal expenses are insured by an Employers Liability policy.
ENDORSEMENT
A document that records a change to an insurance policy.
EXCESS
The first part of any claim for which you are responsible. Also called a "deductible".
EXCLUSION
Something that is not covered by your policy. Exclusions can be standard ones such as war risks or risks which can sometimes be insured for an extra premium, if you require.
EXPLOSION
Involves rupture or collapse due to internal force of a vessel such as a boiler. Alternatively it can be a force generated by a physical reaction, of a gas for example, usually causing damage.
EXTENSIONS
Where the standard insurance does not meet your requirements it is often possible to negotiate extra cover, which is referred to as an extension.
FIRE
This means in an insurance context that there should be actual ignition, and there should be something on fire which should not be on fire, all of which should be accidental as far as you, the customer, is concerned.
FIRST LOSS
Some insurances on property present a risk where it is virtually impossible for everything insured to be lost or damaged. In these circumstances the customer chooses a figure that represents the likely loss and it is this amount, called "first loss" that is insured. Commonly used for theft insurance.
FLOOD
This term implies the escape of water from its natural confines, including those such as rivers, normal sea levels, tanks and reservoirs which are man made.
GENERAL INSURANCE
A term used to describe all insurances other than life or health. It includes fire, motor and liability risks.
GOOD FAITH
Because the customer knows more about the risk he is insuring than the Insurers the Law requires that "utmost good faith" is observed. This means that you must tell the insurers everything about your risk that would affect their judgment in deciding whether to insure you or not and at what cost. If you conceal such a fact that is material your insurance will be invalid. We can help you to meet this requirement when arranging or renewing your insurance.
GROUP LIFE
An arrangement whereby a group of employees are provided with life insurance benefits whist employed in a company.
HURRICANE
A risk that is specifically mentioned on property insurances. There is no problem whether or not you are dealing with a hurricane since official sources will announce "tropical storm" or "hurricane" together with safety measures to be taken. The category depends on the force of the winds involved. There is always an "Excess" or "Deductible" for this risk.
INDEMNITY
A fundamental principle of insurance based on fairness. The law of Indemnity says that you can only recover on an insurance policy what you have actually lost, no more no less. In practice most claims are settled by the payment of cash. The amount is however agreed with you as being the value of your loss. There are various insurances that modify this principle both to your advantage but also negatively. Refer to the note on "Excesses" or "Deductibles". If in doubt, please discuss your requirements with us.
INSURABLE INTEREST
Insurable interest is a basic requirement of any contract of insurance; it can be defined as the legal right to insure arising out of a financial relation-ship, recognized at law, between the person insured and the subject-matter of insurance. This relationship is assumed to be one where you benefit from the safety of the subject matter of the contract or will be prejudiced by it loss or damage. The subject-matter of the insurance contract is the name given to this pecuniary interest which a person has in property that can be lost or damaged or legal liability that can arise for an accident to a visitor due to a defect in premises.
INSURANCE ACT
This is the Statute that regulates the conduct of insurance in the Cayman Islands. INSURANCE - LEGAL PRINCIPLES
These will be found elsewhere in these notes and include "Insurable Interest", "Indemnity", "Utmost Good Faith", "Contribution", "Subrogation" and "Proximate Cause".
INSURERS
These are the companies, registered under the Insurance Act, who actually carry the risks that you insure and who are responsible for paying claims.
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LARCENY
Similar to theft, legally used to describe the act of taking property which does not belong to you whilst you are lawfully on the premises which contains the property, without any violent or forcible entry. This risk is not always covered on insurance policies. If it is a serious risk for you, please discuss it with us.
LEGAL FEES
Insurances on legal liabilities frequently require the intervention of a lawyer and sometimes litigation. Insurers will meet the necessary legal fees where they have agreed that they are necessary. However, the customer does not have the right to engage a lawyer and send the bill to Insurers.
LIABILITY
This means responsibility, usually of a legal kind, where you have caused injury or damage to another by some act of carelessness. Liability insurances are designed to protect you against the different ways in which liability can arise.
These include Public, Products, Employers and Personal liabilities. Please refer to separate notes on these.
LIMIT OF INDEMNITY/ LIMIT OF LIABILITY
This is the maximum amount that your Insurers will pay for any one claim or number of claims arising from one insured. Its application will vary on different policies; it is most common on insurances that cover your legal liability. We can advise you on desirable limits to protect you, based on current Court awards.
LOCAL MARKETS
When brokers or insurers use this term they mean the Caymanian insurance market as opposed to the international or overseas markets, such as London, that are used for some very large risks.
LOSS CONTROL
This is a popular expression for inspection of risks, such as factories, by insurers in connection with their underwriting to establish the premium to charge.
MALICIOUS DAMAGE
Damage to property caused by someone other than the person who is insured which is done deliberately to cause damage or destruction. Normally covered on modern property insurances.
MACHINERY BREAKDOWN
A type of insurance used mainly for production machinery in factories. It is additional to the normal cover on damage that is available. As its name suggests it insures the damage caused by unforeseen breakdown of a machine. It does not cover lack of maintenance or normal wear and tear. Cover is also available for some of the consequential losses following breakdown.
MARINE
The oldest form of insurance which is concerned mainly with the insurance of vessels that travel on water and their cargo.
MATERIAL DAMAGE
This is a general term used by Insurers to refer to physical damage to property by the various risks that may be insured.
MEDICAL
As part of Health insurance schemes certain specified Medical costs are insured. Sometimes referred to as medical benefits.
MOTOR
A class of insurance that includes private cars, motor cycles and commercial vehicles of all types. There are different levels of cover available. We can advise on suitability and cost for you.
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OVERSEAS MARKETS
As opposed to our local markets it is sometimes necessary, with official permission, to arrange insurances on one of the international or overseas markets, such as London or New York.
PENSION
Retirement plans or savings schemes are known as pension insurance. They provide benefits at a specified time in the future. They are frequently arranged, for example as a group pension plan to lock in the benefits so that the beneficiary, after a certain period, can only take the benefits at retirement age.
PERSONAL ACCIDENT
A type of insurance, often added as an extra benefit to other insurances whereby benefits are provided for accidental death, disablement and long and short-term disability. Does not cover sickness, which is a different type of insurance.
PRODUCTS LIABILITY
This is a branch of legal liability insurance that relates to products that you manufacture, sell or supply.
PROXIMATE CAUSE
If you wish to claim on your insurance policy the loss or damage must be "proximately caused" by a risk that is insured. Think of a line of dominoes standing up face to face. If you push the first one it will knock over the second one and you will have set of a chain reaction. As long as the first action in the chain is covered all subsequent damage will be covered too. There are some exceptions; here you must consult us for precise advice, relevant to your situation.
PUBLIC LIABILITY
An insurance that protects you against your legal responsibility for injury to other people or damage to their property. There are several different policies designed to meet specific needs, business, professional and personal. They usually include legal costs related to an action against you for which your policy provides protection. We can advise you as to which one is appropriate for you.
PREMIUM FINANCING
Because insurance premiums can be substantial there are specialist institutions who will provide finance to pay the insurers which you reimburse to them over six or nine months. We can arrange this for you.
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RESIDENTIAL RISKS
Means the private house or its contents that are insured. Common terms used by insurers include "Householders", "Homeowners" and "Coverall".
Beware of the words "All Inclusive" or "comprehensive" that are often used in connection with these terms, there is no such thing as an insurance policy that can cover every eventuality. Nevertheless, locally available policies do offer wide cover.
RISK ANALYSIS
This is another term for Risk Management. RISK MANAGEMENT
Do not confuse this with insurance. It is the process whereby you assess all of the possible events that could interfere with your business objectives. Having identified them a plan should be conceived to deal with each. This is a complex process on which we can advise you. SCHEDULE
Part of your policy that groups the relevant information to your risk, who and what is covered and for what period.
SCHEMES
These are special arrangements for groups of people that usually provide preferential terms. They exist for life, health and motor risks and also for certain trade groupings.
STOCK
May be defined on the policy but the customer is always able to adopt a description that fits a particular business.
SUBROGATION
This is a legal principle that does not affect the customer directly. It enables your insurer, once a claim has been settled to pursue recovery against anyone responsible, for example a negligent motorist who damaged your vehicle. Such a recovery helps to keep net claims costs and eventually premiums to a minimum.
SUBSIDENCE, HEAVE AND LANDSLIP
An upward, downward or lateral movement of land which causes damage to property, not normally covered on commercial property insurance, but may be offered by some household insurers. Insurers will have areas where, nevertheless, they are not willing to give cover because of regular incidents.
THEFT
Means taking the property of someone else without any intention of returning it. On a property insurance policy there is normally a requirement for the act to follow violent and forcible entry to or exit from your premises. Motor policies will cover this risk but may have conditions as to the security of your vehicle.
UNDER-INSURANCE CLAUSE
Also known as the "Average" clause. Because property insurance rating is based on the assumption that everyone insures the full value at risk, insurers take precautions to penalize those that do not do so and who do not contribute their fair share to the insurance claims fund. Remember, this fund is merely the total of all premiums that customers pay. Where you under-insure your property, any claim will be reduced by the same percentage as your amount insured bears to the actual value.
UNDERWRITING
This is the process whereby Insurers decide whether to accept your risk and what price to charge. You are normally asked to help them in this process by completing a proposal form that groups together the relevant information about you and what you are insuring.
UTMOST GOOD FAITH
Because the customer knows more about the risk he is insuring than the Insurers the Law requires that "utmost good faith" is observed. This means that you must tell the insurers everything about your risk that would affect their judgment in deciding whether to insure you or not and at what cost. If you conceal such a fact that is material your insurance will be invalid. When you are insuring we will help you to complete any necessary forms and discuss your situation with you. In the end it is better to disclose everything, whether or not you feel it is material and let your insurers decide.
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WARRANTY
This term has a special meaning on insurance policies. The insurers will either require you to do or not to do something that effects the risk. For example, not to use certain flammable liquids in a process or to remove waste from a factory daily. Any failure to observe a warranty will invalidate your insurance. We will draw any such requirements to your attention when handling your insurances and check at each renewal that the circumstances are unchanged.
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