policy holder reading through her policy

Glossary of Insurance Terms

by Martin McRandal | 14 min read    September 16th, 2019

At Allianz, we realise that insurance can sometimes be complicated. This is why we've created this Glossary of Terms where insurance terminology is simplified and explained for you.

Principles of Insurance

Your policy of insurance is a contract. You pay the agreed premium. In return your insurer provides the insurance cover for a defined period of time.

The Principles of Insurance are basic rules which apply to insurance contracts. They include the following:

A No Claims Bonus is measured in years. It is a count of the number of years that you have not made a claim on your car, van, home, or contents insurance policy.

If you can provide evidence that you’ve gone a number of years without making a claim on your policy, you have earned a No Claims Bonus and your insurance company will apply a discount to your premium. Generally speaking, the more No Claims Bonus years you have the higher your discount might be.

A peril is a risk or cause of loss which can be identified.

Your car and home insurance policies do not cover every type of loss or damage (e.g. they will not cover losses due to wear and tear or to mechanical breakdown).

Instead, they cover loss and damage resulting from certain perils. On a car policy this can include accidental damage, fire, and theft. On a home policy this can include storm, escape of water, flood, and subsidence.

A contract of insurance requires that both the policyholder and the insurer are honest with each other and that they hide no information of relevance to the contract from each other

In practical terms this means that, when proposing for insurance, you must answer all questions honestly and fully and that you must inform the insurer of any information that you think may be relevant to the insurance for which you are proposing.

The principle applies throughout the duration of the contract of insurance, including to claims. When making a claim you are required to present the circumstances and the details of any loss honestly and fully.

The principle requires that the insurer must tell you if it wishes to alter the terms of your insurance. If for example you notify the insurer of a change of car on your motor insurance policy, the insurer must disclose to you details of any change in premium and of insurance cover terms and conditions.

The principle of indemnity deals with how the insurer will calculate your loss in the event of a claim, i.e. the basis on which claims will be settled.

Basis of claim settlement is usually defined within your insurance policy wording.

On motor insurance policies it is normal for insurers to settle a claim for loss of or damage to your car based on the market value of your car at the time of the loss, i.e. the insurer will not pay more than the market value of the car.

The basis of settlement on home insurance policies differs. The norm (with some exceptions) is for the insurer to pay for either repair of your lost or damaged property or to replace it with new property.

This principle dictates that you cannot insure something (e.g. a building or a car) if it’s loss or damage will result in you incurring no financial loss.

In most cases the property you wish to insure will be owned by you, e.g. your home contents or your car. You have an obvious insurable interest because you will suffer financially from having to repair or replace these if they are damaged or lost.

However you do not need to own something in order to have an insurable interest. Your car may be hired by you under a leasing arrangement. You may have a mortgage on your home. In these circumstances, even if it may be regarded that you are not the legal owner, you still have an insurable interest as you will be responsible for repairing or replacing the property following its loss or damage.

This principle is concerned, in the event of a claim, with identifying how the loss or damage occurred.

This is not always obvious. Say you suffer water damage to the ceiling, units and floor in your kitchen. Proximate cause is concerned with identifying what caused the damage. It may be due to a sudden and identifiable incident, e.g. a burst pipe in your bathroom upstairs. It may however be due to a build up of water over time, perhaps caused by leaking grout or sealant in your shower.

This is important because insurance policies do not cover every eventuality. They cover certain defined perils and benefits. Also every insurance policy will be subject to certain exclusions and limitations in cover.

The average clause is an industry term that covers several aspects of your policy. In sum, as the policyholder, you are responsible for making sure that your sums insured is enough to cover you.

For buildings, it must cover the cost of rebuilding your home, plus any associated costs (e.g. surveyors and architects fees) in the event of a total loss.

For contents, it must cover the cost of replacing all of the possessions in your house in the event of a total loss.

If you suffer a loss and your insurer concludes that your sum insured is inadequate, then the Average Clause entitles your insurer to reduce the sum they must pay against your claim in proportion to how much you are underinsured.

Example: You insure your Contents for €40,000. When assessing your claim, your insurer concludes that the actual cost of replacing all of your Contents is €50,000. Your insurer is obliged to pay only 80% of the value of your claim, rather than 100% if you had accurately valued your contents at €50,000.

Excess is the amount of any claim that you (the policyholder) must pay. After this amount your insurer will cover the remaining cost.

You can choose to increase your excess at policy inception or renewal in return for a reduction in premium.

The presence of an excess on your policy means that you effectively self-insure for the sum of the excess.

Insurers apply excesses to discourage small claims and to keep the overall cost of insurance down.

An insurance policy covers loss or damage resulting from the occurrence of insured perils. Please see definition below.

Example: You have water escaping from a burst pipe within the concrete floor of your kitchen. In the time it takes you to locate and have the burst pipe repaired, the water causes damage. This damage is covered under either the Buildings or Contents section of your policy.

A Trace & Access benefit helps to cover the costs of locating the leak and restoring the buildings after repair. In the example above it should pay costs associated with locating the leak, digging out the concrete floor, and relaying it after repair.

Accidental damage is a sudden or unforeseen damage caused as a result of an unexpected action or event.

Examples of accidental damage include:

  • Accidentally knocking over or dropping a TV
  • Accidentally knocking over or dropping a TVAccidentally spilling paint on furniture or flooring
  • Accidentally knocking over or dropping a TV
  • Accidentally knocking over or dropping a TVAccidental damage will not include any damage that happens over time. Also, the cause of a loss must be known in order to establish whether it is accidental damage.

Step Back Bonus Protection limits the impact of a claim on your No Claims Bonus (NCB). In the event of a claim your NCB will be ‘stepped back’ by 3 years at your next renewal.

For example, if you have a 5 year NCB when you make the claim then your NCB entitlement come next renewal will become 2 years. Without Step Back NCB Protection you lose all NCB entitlement in the event of a claim. Please note that Windscreen claims do not impact your NCB.

Step Back Bonus Protection is included as standard cover on Allianz car insurance products.

Reinstatement value is the total sum you would have to pay to rebuild your home from scratch in the event of its loss. It is the cost of:

  • rebuilding your home;
  • rebuilding your home;site clearance; plus the cost of any
  • rebuilding your home;architects’, surveyors’ and engineers’ fees and compliance with building or other regulations.

Wear and tear is the deterioration of or damage to an object that occurs as a result of its’ normal use or of its’ aging.

It is normal for insurance policies to exclude loss or damage resulting from wear and tear. This is because the purpose of insurance policies is to provide you with protection against loss caused by sudden or unexpected events. Damage caused by wear and tear is neither sudden nor unexpected

Exclusions are items or circumstances that are not covered by an insurance policy. When you arrange insurance on your car or home your insurer agrees to provide cover for a number of defined risks, e.g. fire, theft, accidental damage, etc. Your insurer will often limit the scope of cover by applying Exclusions.

Insurers apply exclusions because either they consider something to be uninsurable (e.g. loss or damage caused by wear and tear) or because they don’t want to cover loss or damage occurring in certain circumstances (e.g. loss or damage resulting from acts of war or terrorism).

Exclusions should appear prominently within your policy documents. They can appear under any of the following headings “Exclusions”, “Exceptions”, “What is not covered”

Where you have the benefit of Open driving, anyone is insured to drive your vehicle with your permission. Permitted drivers have the benefit of full policy cover. Open driving is commonly restricted by age, for example, it may apply to drivers aged 25 years and over with a full licence and clean driving record.

Driving other cars is a policy cover extension that allows the policyholder to drive a car not insured or owned by him/her. It typically provides cover only against third party risks, i.e. it does not cover damage to the vehicle being driven. Only the policyholder has the benefit of driving other cars cover. Driving other cars cover is subject to several conditions, not least of which is that it does not apply to cars that are owned by the policyholder.

Your policy of insurance operates for a pre-agreed time period, usually one year. Most insurance policies permit either the insurer or the policyholder to terminate the policy prior to the agreed expiry date. This is Cancellation.

Voidance also has the effect of terminating insurance policy cover. That however is all that it has in common with Cancellation. An insurer may decide to treat a policy as Void where they conclude that they would not have offered insurance cover had all relevant information been fully and correctly disclosed to them. The insurer will declare the policy as Void either with effect from inception date or from the date on which circumstances changed and the risk became unacceptable to them.

Material facts are information relevant to an insurance contract. Insurers use this information to assess whether the risk is acceptable and if so on what terms and at what price.

Examples in relation to car insurance are a drivers’ age, driving experience, driving conviction and penalty points history, motor accident and claims history.

For car and home insurance quotations your insurer should ask detailed questions aimed at capturing all relevant Material facts.

If you are in any doubt about whether information is material then you should discuss it with your insurer.

Home insurance policies usually provide cover for ‘Escape of Water’, i.e. for water leaking and causing damage within a home.

‘Escape of Water’ claims are common and tend to be costly. To keep the overall cost of Home insurance down, it is common practice for insurers to apply a higher than normal Excess to ‘Escape of Water’ claims.

Details of all applicable Excesses can be found in your policy (please refer to your current Schedule and policy document)

Loss Adjusters are experts in home insurance claims. If your home and/or its contents are damaged, your insurer may appoint a Loss Adjuster. Their job is to:

  • Investigate the cause of the damage/loss
  • Investigate the cause of the damage/lossAssess the extent of the damage/loss
  • Investigate the cause of the damage/lossQuantify the cost of reinstating your home and/or its contents, in order to restore you to the position you were in before the loss occurred

While Loss adjusters are experts in claims, they are not experts in the damage itself. For this reason, they may require expert advice from your appointed engineer, repair specialist, or supplier. As the policyholder, you would be responsible for the organisation and payment of these specialist services.

A Loss Adjuster is not appointed on every claim. Insurers tend to appoint them:

  • Where the loss or damage is fairly extensive and/or
  • Where the loss or damage is fairly extensive and/orWhere the cause of loss requires some investigation

When making a claim for loss or damage to your property, you have the right to appoint a Public Loss Assessor.

The role of a Public Loss Assessor is similar to that of a Loss Adjuster - to assess the extent of loss and the amount of compensation that should be paid. The key difference is that the Public Loss Assessor is appointed by you and acts in your interest. It is their sole responsibility to ensure that you get a fair settlement for your claim.

Please note: When appointing a Public Loss Assessor to act in your interests you would be responsible for paying for the service. Learn more.

When you report a claim, your insurer will want to establish the cause of loss or damage.

This is because not all causes of loss or damage are covered by insurance policies. Your insurance policy will cover loss or damage caused by specified perils. (e.g. on a Home insurance policy insured perils commonly include Fire, Theft, Escape of Water, and Storm)

Also insurance policies exclude loss or damage from certain causes (e.g. wear, tear or gradual deterioration)

When you report a Home insurance claim, Allianz will ask you to confirm the cause of damage in writing from a specialist or supplier. With this information, Allianz can assess whether or not the loss or damage is covered by your policy.

If your car is not being driven and is off the road for a period of time, you can suspend the policy cover by returning your certificate of insurance and your insurance disc to Allianz.

Your policy will remain in force but you will have either limited cover or no cover for the period of suspension.

Once you notify Allianz that your car is back on the road, full cover will be restored.

Allianz allows a refund of 80% of your premium for the period of Suspension of policy cover, subject to certain conditions being met. Please refer to “Suspending your policy” on page 7 of the Allianz Car Insurance policy for full details.

When cover is suspended for less than 30 days, refund of premium is not allowed.

Types of suspensions:

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Policy Cover
All cover suspended except for risks of
Percentage of pro rata premium for suspended period allowed
Comprehensive Fire/Theft 75%
Comprehensive All cover suspended 80%
Third Party, Fire & Theft Fire/Theft 75%
Third Party, Fire & Theft All cover suspended 80%

When Allianz pay your motor claim and are unable to make a full recovery from another source (e.g. from the insurer of an ‘at fault’ third party), that claim will affect your No Claims Bonus at your next renewal date.

Allianz will allow you to pay the cost of the claim, and in return will reinstate your No Claims Bonus. However, the claim must be paid in full before the next renewal period for the bonus to be applied to the premium. When the cost of claim is relatively small, sometimes policyholders find this to be beneficial.

Example: You reverse into a gatepost and damage your car. The sole claim is to repair damage to your car, which cost €500. If No Claims Bonus Protection is not in place then at your next renewal date, your No Claims Bonus entitlement is reduced to 0.

Allianz will allow you to reimburse to them the cost of the claim. If you choose to do so, Allianz will treat the claim as though it were a ‘non fault’ claim. Assuming there were no other claims during that period of insurance, Allianz will reinstate your No Claims Bonus. Your renewal premium will therefore be recalculated based on the number of No Claims Bonus years you have.

If there is more than one policyholder, but these ‘joint’ policyholders do not have a joint bank account, a completed Payment Mandate form will be required before the insurer pays a claim. The purpose of the form is to provide consent to the insurer to make a payment to a single nominated policyholder.

This scenario may be more common in Home Insurance policies, where the property is owned by 2 or more people.

When Allianz pays more than €3,000 on a claim, signature of the Payment Mandate form must be witnessed by a Solicitor.

An Interested Party is a financial institute, such as a bank, mortgage provider, or finance house, that has a financial interest in the vehicle or property that you’ve insured. When Allianz become aware of this Interested Party, we are obliged to note this interest.

When an insured vehicle is declared a total loss on a claim, Allianz will pay the interested party the amount they are legal entitled to at the time the claim is settled. If the claim payment is more than what was paid to the financial institution, the remaining balance will be paid to the policyholder.

This also applies to property owners when a mortgage is noted. In this case, once the claim payment reaches the threshold of the Interested Party, Allianz will name the Interested Party on the settlement cheque along with the policy holder.

For home claims, the Interested Party only needs to be named for the buildings portion of the settlement, not the contents. For this reason, in some cases Allianz will issue two cheques – one naming just the Policyholders and the other naming the Policyholders & Interested Party.

The threshold for Interested Parties can vary, and some may advise Allianz that they do not need to be named on the settlement cheque at all.

All Risks is an optional extra which protects you against loss/theft of, or accidental damage to, personal valuables. These could include jewellery, clothing, photographic, or sports equipment to name a few. This cover is for both inside and outside your home. It also covers you for items you take abroad for up to 60 days.

There are two types of All Risks cover:

Specified All Risks Cover

This allows you to list individual items on your policy and specify their individual value. Specified items might include jewellery, hearing aids, bicycles, cameras, and other valuables. Each item is covered up to the amount you insure it for.

Allianz will reimburse you for loss or damage to any item specified in the schedule up to a maximum of the sum insured specified for the item.

Unspecified All Risks Cover

This is an umbrella style cover which allows you to select a total amount that your personal effects will be covered for each year. There is no need to list each item individually. This cover is designed for valuable personal items such as glasses, jewellery, mobile phones, handbags etc.

Certain limits apply to Unspecified All Risks cover including:

  • Up to €2,000 for any one item per claim
  • Up to €2,000 for any one item per claimBicycles up to €320
  • Up to €2,000 for any one item per claimCash up to €650

You have the right to withdraw from a policy of insurance within 14 days from the starting date of cover, or from the date which you receive the policy documents, whichever is later.

To exercise this right you must notify your insurer of your intention to cancel the policy and you must return the policy documents (including any motor insurance certificate and disc) within the 14 days.

Exercising your right to cancel within the cooling off period means that no policy was ever in place. Therefore the insurer will refund any premium paid.

You cannot exercise this right where you have made a claim under the policy, and no claim may be made at a later date.

Descriptions of the application of these insurance terms to policies are described as per an Allianz insurance policy.

Allianz p.l.c. is regulated by the Central Bank of Ireland. Standard acceptance criteria and policy conditions apply.

 

Information correct as of date of publishing. This blog will not be updated or edited so the information may become outdated.

Martin McRandal
Business owner, consultant, and expert witness. Former motor and property insurance underwriter.