Glossary

A

Adjacent Structures:

Any building or structure located on the same site as the primary insured structure.  

Adjuster:

Person directly responsible for investigating and negotiating claims that arise under an insurance policy. A public adjuster represents the insured party, while the company could be represented by an adjuster who is an employee of this same company, or through an independent adjuster.  

All Risk Insurance:

A policy that provides coverage for losses caused by any event or danger, except those specifically excluded.  

Allied Lines:

Type of insurance coverage jointly underwritten with fire insurance, which covers risks that aren’t included in the basic policy.  

Appointed Risks:

All causes of loss covered under the insurance policy, and specifically designated as covered under the terms of the policy.  

Authorized Representative:

Person or corporation named by the insured to represent him or her in requesting and conducting insurance business on its behalf. This person represents different insurance companies and is licensed by the government to carry out such transactions.      

B

 

Basic Limits:

In civil liability policies, it refers to the minimum limits of liability that a policyholder can get.  

Binder:

Temporary coverage authorization that may be issued before the issuance of the policy. It must have a defined time duration and be in writing, stating the company that underwrites the insurance, the insured risks, the offered coverage, and the respective limits.      

C

 

Cancellation:

The termination of an insurance policy by the insured or the insurer, before the expiration date of said policy.  

Catastrophe:

A serious calamity or disaster that causes losses, or a series of losses, for an extraordinary amount of money.  

Claim:

Request for payment by an insured to the insurer, under the provisions of an insurance policy and for any losses incurred.  

Claims Department:

Department responsible for evaluating and adjusting the losses of those insured.  

Commercial Lines:

Insurance covering commercial and government activities.  

Commission:

A portion of the insurance premium of a policy paid tos the agent, broker or general agent as compensation for its sale.  

Compulsory Insurance:

Insurance required by the Compulsory Liability Insurance for Motor Vehicles Act. It is liable for damages caused to third-party motor vehicles as a result of a traffic accident, if the vehicle owner insured by this insurance is responsible for these damages. It covers $4,500 per accident.  

Coverage:

A term used to refer to the scope of protection provided under an insurance policy.      

D

 

Danger:

Cause of a possible loss.  

Declarations:

Section of an insurance policy containing relevant information of the insured and the coverage provided by the policy.  

Declination:

To reject or deny an insurance application.  

Deductible:

Amount of money that the insured is willing to pay in case of a loss, and that is deducted from the claim that the insurer is required to pay.      

E

 

Effective Date:

Exact date when an insurance policy is responsible for the payment of a loss; or the date on which the coverage begins to be in force under an insurance policy.  

Endorsement:

Modifications, changes or amendments made to an insurance policy once it is in force. It must be signed by an officer of the insurance company in order to be effective.  

Exclusion:

Provisions in an insurance policy that restrict or eliminate policy coverage for certain risks, persons, property types or establishments that are covered.  

Experience:

Record of an insured or particular type of business’s losses.  

Expiration:

Date on which an insurance policy coverage is no longer in force, unless it is renewed.  

Extended Coverage:

Supplementary coverage, added to the risks covered in an insurance policy coverage.      

F

 

Fire Coverage:

A type of insurance that provides coverage for direct losses caused by fires, lightning and other risks specifically mentioned in the policy. Venues or properties are also covered in them, like the content, as described in the policy.      

G

 

General Agency:

Person appointed or hired by an insurer , as an independent contractor or through commission, entirely or partially, with the general authority or obligation to inspect the granting and service operations of the insurance policies. In addition, it can appoint insurance agents and carry out other tasks as bestowed upon the agents and general agents for the insurer, by custom class or classes of issued insurances or type of insured represented.      

H

 

Home Assistance:

Emergencies arising as a result of unexpected breakdowns related to: electricity, hardware, plumbing, or glassware can be repaired immediately with this policy.  

Hurricane:

Tropical cyclone, whose sustained surrounding winds have a defined center of circulation that exceeds 75 miles per hour, and is accompanied by heavy rain and thunderstorms.      

I

 

Inspection Date:

Date on which coverage in an insurance policy goes into effect.  

Insurance:

Contract whereby a person undertakes to indemnify another, or to pay for or provide a specific or determined benefit when an uncertain event occurs, but is listed in said contract.  

Insurance Certificate:

A declaration of coverage that can replace the insurance policy as evidence of insurance, and can sometimes transfers the certificate holder the right to process claims under the policy.  

Insurance Service Office (ISO):

Name of the largest property and casualty insurance organization in the US, based in New York. Among the variety of services provided are the preparation of forms and the dissemination of data regarding costs in losses for property and casualty insurers.  

Insured:

Person, business or organization with an insurance policy, covered by said insurance.  

Insurer:

Person who offers insurance contracts.      

L

 

License:

Certificate of authority granted by the government of a state to an insurer or insurance agent, in order to enable it to act as such within the state.  

Loss:

Basis for a claim for damages under the terms of an insurance policy, or the amount that an insurer must pay a claimant for loss covered under an insurance policy.      

N

 

Named Insured:

Person, corporation or association to whom an insurance policy is underwritten, and that is specifically named as being insured under the terms of the policy. The named insured is the only authorized to: cancel a policy, request change endorsements to the policy, receive notice of policy cancellation and receive any return premium. Moreover, it is he who has the duty of paying the policy premium.  

Negligence:

Failure to act with due care, as expected of a prudent and reasonable person, under the circumstances of a particular case.      

O

 

Occurrence:

Unexpected or unintentional event resulting in a loss.  

Office of the Commissioner of Insurance of Puerto Rico:

Government agency under the Treasury Department (Hacienda) that regulates the insurance industry in Puerto Rico. It is led by the Commissioner of Insurance, an public servant that enforces the Puerto Rico Insurance Code, as established in Article 2.030.      

P

 

Personal Auto:

Insure your car with policies that protect bumper to bumper and support your liability while driving. Drive confident and calm with a Triple-S Propiedad Auto Insurance Policy.  

Personal Lines:

Insurance protections that cover individuals and / or their relatives.  

Policy:

Insurance contract that establishes the rights and duties of the insurer and the insured.  

Policyholder:

Person, organization or company under whose name an insurance policy has been issued.  

Premium:

Periodic or full payment that an insured person makes to the insurance company in exchange for the coverage described in the policy.  

Producer:

Person, corporation or partnership that represents the insured before the insurer for all matters related to their insurance contracts.  

Public Adjuster:

An individual hired by the insured party to represent him or her in a loss adjustment process against an insurance company.      

R

 

Rate:

Cost per insurance unit used as the basis for determining the premium.  

Reinstatement:

Restoring all rights under an insurance policy that have been previously canceled for non-payment or late payment.  

Reinsurance:

The process by which an insurance company shares a portion of its risks and obligations with another insurer for a portion of the premium.  

Requester:

Person appointed and authorized by an agent or broker to manage insurance claims as its representative.  

Risk:

Possibility of financial loss. It can also refer to the insured person under a policy.  

Risk Management:

Practice of assessing and managing the risks to which policyholders are exposed to, in order to minimize any losses they may have, through the design and implementation of prevention and safety programs.      

S

 

Salvage Value:

The process by which the insurer takes over a property after, having honored a claim, as a method to cut its losses. It is common when “total losses” are alleged.  

Special Risk:

Unusual risks that are not covered by regular insurance policies.  

Subrogation:

Right of an insurance company to recover the amount paid for a claim from a third party, taking the identity of the insured in the process.  

Surcharge:

A fee that is enforced on insurers by State Guaranty Funds or other regulatory authorities.      

U

 

Underwriter:

Person employed by an insurance company, responsible for determining the acceptability of insurable risks and the conditions of risk acceptance or rejection.  

Unearned Premium:

Portion of the premium that has been paid to the insurance company, but that is not a profit for the insurer. It is the part that is returned to the insured in case of a policy cancellation, or change.