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Insurance Terms and Definitions

Commercial Auto

Auto Liability - Protection for loss incurred through legal liability for bodily injury and damage to property of others, caused by accidents arising out of the ownership, maintenance, or use of any insured auto.

Personal Injury Protection (PIP) - Available only in certain states, this adds no-fault benefits, so that in the event of an auto accident, each party collects from his or her own insurer regardless of fault. It usually applies only to bodily injury and not to property damage, though the laws vary widely from state to state.

Medical Payments - Pays the medical expenses of the insured and any passengers, irrespective of who was responsible for the accident. In some no-fault states, this has been replaced by PIP. In other states, it may supplement no-fault insurance.

Uninsured Motorists - Pays for bodily injury to an insured who is injured by an uninsured motorist, a hit-and-run driver, or a driver whose insurer becomes insolvent.

Underinsured Motorists - Protects an insured who is injured by a negligent party who is without adequate limits of insurance to cover the loss. This coverage, which usually applies only to bodily injury but may vary by state, provides payment for the difference.

Comprehensive - Provides protection against loss or damage to a covered auto resulting from loss other than a collision or upset.

Collision - Provides protection against loss or damage to a covered auto or a non-owned auto resulting from the impact with another vehicle or object. Collision losses are paid regardless of fault.

Non-Owned Auto Liability - Coverage is provided only for autos not owned, leased, hired, or borrowed by the named insured. For example, autos owned by the insured's employees, but only while used for business purposes. No physical damage coverage applies.

Hired Autos - Coverage is provided only for autos leased, hired, rented or borrowed for use in the named insured's business.

General Liability

Occurrence Policy Form - Covers bodily injury or property damage claims that occur during the policy term, regardless of when the claim is reported.

Claims-Made Policy Form - Covers claims which are made against the Insured during the policy term, regardless of when they occurred, subject to limitations.

Per Occurrence Limit - The maximum amount payable for a single event or accident, regardless of the number of claims or claimants.

General Aggregate - The maximum amount the Insurer will pay for all claims during the policy period.

Products/Completed Operations - Products coverage protects against the liability for injury, loss, or damage that an Insured may incur as the result of some defect in the product sold or manufactured. Completed Operations covers liability claims arising out of work completed away from the business premises, occurring after operations have been completed, or after an item is installed or built.

Personal/Advertising Injury - Personal injury means injury other than bodily injury, resulting from false arrest, false imprisonment, malicious prosecution, wrongful eviction, wrongful entry, invasion of privacy of a premise, libel, or slander. Advertising injury covers damages or injury sustained by a claimant in the course of the advertising activities of the Insured, such as libel, slander, or the infringement of copyright.

Fire Damage/Damage to Rented Premises - Coverage for fire damage caused by negligence on the part of the Insured, to premises rented to the Insured. (If the negligent Insured caused fire damage to property not rented to the Insured, coverage would be provided under the occurrence limit.)

Medical Expense - Medical expenses resulting from bodily injury to a third party caused by an accident on premises owned or rented by the Insured, or when caused by the Insured’s operations. These payments are made without regard to the liability of the Insured.

Employee Benefits Liability - Protects against claims made by employees or former employees caused by a negligent act, error or omission in the administration of the Insured’s employee benefit programs. Ex: providing incorrect advice or failure to enroll employees under a benefit program.

Workers’ Compensation

Workers’ Compensation - Provides benefits to employees for any injury or contracted disease arising out of and in the course of employment.

Employers Liability - Protects employers for their legal liability for injury or contracted disease arising out of and in the course of employment, when not covered under the work comp law. Before benefits are paid under this coverage, the employee must prove the employer is liable for the injury.

Experience Modification Factor - Factor is based on the insured's loss experience and is used to increase/decrease the manual insurance rates.

Monopolistic States - There are four states that require all workers’ compensation insurance to be placed with their state funds. No private insurer is allowed to write work comp coverage in a monopolistic state. These states are: North Dakota, Ohio, Washington, and Wyoming.

Other States Insurance - Provides workers’ compensation coverage if the insured expands operations into other states not declared at the time the policy is issued or renewed. If the insured elects this coverage and operations begin in a state listed under other states, the insurer provides the same coverage as if the state was declared in the policy at the time of policy issuance.

United States Longshore and Harbor Workers (USL&H) - Federal act designed to provide workers’ compensation benefits to employees who work in maritime employment upon the navigable waters of the United States and who are usually considered outside the scope of state work comp laws. USL&H coverage applies to work done in the states scheduled on the policy, and extends the definition of the workers’ compensation law to include the USL&H.

Voluntary Compensation Endorsement - Provides coverage for employees with occupations exempted from the workers’ compensation act. It does not make employees subject to the work comp law, but it obligates the insurance company to pay on behalf of the insured, an amount equal to the compensation benefits that would be payable to those employees if they were subject to the work comp law of that state.

Anniversary Rating - Anniversary Rating Date Endorsement is a workers’ compensation premium endorsement used to state the anniversary date of a workers compensation policy when it is different than the policy effective date. It states that the policy rates, premium, and any experience rating modification factor that applies may change on the anniversary rating date month and day listed on the endorsement schedule.

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