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Property Insurance Claim Terms

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If you have a question about an additional property insurance claim term you would like to understand better? Submit your question to an Abba Claims Consultants Licensed Public adjuster now.  We’ll be happy to answer your question with no obligation.

A
Act of God:
Natural occurrence without human involvement that could not have been prevented. Example: lightning, tornadoes, hurricane.
Actual Cash Value (ACV): The value of the property at the time of its loss or damage. ACV may be determined by market value (the current price for a like item in the same general condition) or replacement cost new less its depreciation. The depreciation methodology & valuation is subjective.
Additional Living Expense: The total cost incurred when an insured loss requires you to live outside of your home while repairs are made. An insurer will pay any reasonable increase in living expenses, including moving expenses, motel, restaurant so that your household can maintain its normal standard of living while repairs are being made to your damaged home.
All Risk Policy: Losses are covered for wide range of causes except for those specifically excluded in the policy
Appraisal: Similar to arbitration. Appraisal is a separate evaluation between two appraisers in which the two sides try to come to an agreement on the differences. If they cannot come to an agreement, a neutral third party umpire will determine the final ruling.
Arson: The intentional setting of one’s own property in an attempt to collect insurance compensation.

B
Boiler & Machinery Insurance:
Fired vessels, steam generators, mechanical and or electrical objects and turbines, are all examples of “objects” that might be listed for coverage under a boiler and machinery policy. Coverage is provided for damage to covered property caused by an accident to an object identified in the policy’s schedule.

Coverage includes extra expense, automatic 90-day coverage at new locations, defense against liability claims, and supplementary payments like those provided under public liability policies.
Broad Form Insurance Coverage: that protects you from all risks to the building and named perils only to the contents
Builders Risk Insurance:  A variation of property coverage specifically applicable to construction projects. It is commonly written in an amount to cover the value of the structure when completed. The premium charged takes into account that values at risk increase gradually over the term of the policy.
Business Income Coverage: Insurance protecting the income derived from an insured’s business activities following a covered peril. Coverage includes reasonable extra expenses the insured incurs to expedite return to normal business operations.
Business Personal Property: A term relating to the “contents” of a commercial enterprise. It may include furniture, fixtures, machinery and equipment as well as stock, all other property owned by the insured, and even use interest in building improvements and betterments.
Binder: Temporary or preliminary coverage until a policy can be written or delivered.
Broker:  Insurance salesperson that searches the marketplace in the interest of clients, not insurance companies.
Broker: Agent Independent insurance salesperson who represents particular insurers but also might function as a broker by searching the entire insurance market to place an applicant’s coverage to maximize protection and minimize cost. This person is licensed as an agent and a broker.

C
Cancellation:
 Insurance carrier or insured stops coverage prior to the policy’s normal expiration date.
Claim: A request for reimbursement for a loss covered under the policy.
Civil Authority:  An insurance policy provision that will typically extend coverage for Business Interruption and necessary Extra Expense caused by action of civil authority that prohibits access to the described premises due to direct physical loss of or damage to property. The requirements for coverage under this provision are the existence of an order of civil authority which prohibits access to the insured premises, is caused by or results from physical damage to property other than insured property, that damage to property must be due to a peril covered under the policy, and that denial of access must be the proximate cause of loss of business income.
Civil Remedy: Notice In Florida, Civil Remedy, also known as “Bad Faith,” allows an individual to sue an insurance company for damages and to recoup court costs and attorney’s fees. In order to use this law, the person or their attorney, must submit a Civil Remedy Notice to the Department of Financial Services (DFS) and the insurance company at least 60 days prior to filing suit. This Notice must be submitted to DFS by using the DFS Civil Remedy website and then sent to the insurance company.
Company Adjuster: An adjuster who is employed and works solely for an insurance company or self-insured entity.
Conditions: The part of the insurance policy that explains the obligations of the insured and the insurance company under the property, for property and liability. It explains your duties in the event of a loss and how the company will settle.
Co-insurance: Coinsurance refers to the bargain between a commercial property owner and an insurance company. The clause in property policies encourages the property owner to gauge coverage needs by possible, not probable, maximum loss.
Collapse: A property insurance peril, subject to its own specific agreement in commercial property policies, which otherwise insure on an open perils basis.
Covered Loss: An accident, including accidental damage by forces of nature which brings a contract of insurance into play.
Coverage: The scope of protection provided under an insurance policy. In property insurance, coverage lists perils insured against, properties covered, locations covered, individuals insured, and the limits of indemnification. In life insurance, living and death benefits are listed.

D
Debris Removal:
A consequential coverage, which pays for, the insured’s expenses to remove debris of covered property caused by a Covered Cause of loss.
Declarations: Page Commonly the first page of your policy containing the name of the insured, the address, and the dollar amount of coverage provided, a description of the property, and the premium cost.
Deductible: The amount of the loss you are required to pay out-of-pocket per claim or accident.
Depreciation: The decrease in property value since the time it was built due to age or normal wear and tear.
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E
Endorsement:
An attachment to your insurance policy that adds to, removes or changes the original terms. You can negotiate various types of endorsements to tailor a policy to your special needs.
Exclusions: Certain causes and conditions that your insurance policy does not cover.
Exposure:  Measure of vulnerability to loss, usually expressed in dollars or units.
Extra Expense: Coverage If your building were rendered uninhabitable by fire or any other insured peril, it would probably be necessary to secure other quarters to continue your business operations. However, the use of such buildings would undoubtedly involve many extra expenses, such as rent, installation of telephones, etc. Extra Expense insurance covers such expenditures over and above your normal monthly expenses.

F
Fire:
Combustion evidenced by a flame or glow. Insurance distinguishes between a “hostile” fire (one out of bounds) and “friendly” fire (such as that contained within the fire box of a stove).
Flood Insurance: Policy underwritten by the federal government to cover damage from rising water. Flood Insurance Information
Fraud: The intentional perversion of the truth in order to mislead someone into parting with something of value.
Fungi: Refers to, but is not limited to, any form or type of mold, yeast, mushroom or mildew whether or not allergenic, pathogenic or toxigenic Any substance, vapor or gas produced by, emitted from or arising out of any fungi or spores or resultant mycotoxins, allergens or pathogens.

G
Guaranteed Replacement Cost Coverage:
Pays for the full cost to replace or rebuild insured property, even if it costs more than your policy limits.

I
Indemnity:
Placing the insured back into the same financial position they were in prior to the loss occurring.
Independent Adjuster: An trained and licensed insurance adjuster who works for multiple insurance companies or self-insured entities.
Inflation Guard Coverage: An automatic annual raise in your coverage limits based on the insurance company’s estimate of rising building material and labor prices.
Insurance: A mechanism whereby risk of financial loss is transferred from individual, company, organization, or other entity to an insurance company.
Insurance policy: The document containing the contract between the insured and the insurer, which defines the right and duties of the contracting parties.
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L
Law & Ordinance Coverage: 
See below Ordinance or Law Coverage
Liability Coverage: Insurance that covers for injuries to another or damage to another person’s property for which you are liable.
Limit of Insurance: The maximum amount of benefits your insurance policy pays in the event of a loss.
Loss: The dollar value of property damage or physical injuries.
Loss of Use:  An extra expense you incur while staying at a temporary location if your dwelling becomes uninhabitable.

M
Midterm Cancellation
: A cancellation that occurs during the policy term and prior to the expiration or renewal date of the policy.
Mold: A very large group of microscopic fungi that live on plant, animal or surface matter. Most are filamentous organisms and produce spores that can be air-, water-, or insect-borne. A common trigger for allergies and can be fatal if overexposure occurs. Traditionally, mold damage has been covered where it results from a covered peril, such as a broken pipe, a storm, or fire suppression efforts, but not where it occurs gradually over time due to wear and tear.

N
Named Insured:
 The party of parties specifically named as insured in the insurance contract. Others may have claim on the coverage of a policy by way of internal provisions, but any such right is by way of the agreement between the named insured and the insurance company.
Named Perils: individually itemized, covered, perils stated in your policy.
Non-renewal: The refusal by a company to renew your policy when it expires.

O
Ordinance or Law Coverage

Coverage for Loss to the Undamaged Portion of the Building Pays for the loss of value of an undamaged portion of the existing building, which must be demolished and/or removed to conform to municipal ordinance, code, etc.
Demolition Cost Pays for the cost of demolition of the undamaged portions of the building necessitated by the enforcement of building, zoning or land use ordinance or law.
Increased Cost of Construction Pays for any increased expenses incurred to replace the building with one conforming to building laws or ordinances, or to repair the damaged building so that it meets the specifications of current building laws or ordinances.
Offer:  The amount your insurance adjuster proposes to pay you for your loss.
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P
Peril
: An event that causes a loss to your home and property such as fire, windstorm, and theft. Policies have two sets of perils: covered and excluded.
Personal Property: Articles you own, wear or use while on your premises, also known as contents. Examples: clothing, furniture
Personal Property Floater: An endorsement that provides additional coverage for furs, jewelry, stamps, coins, antiques, computer, guns, and other items that exceed the normal low limits in your home policy.
Premium:  The amount of money paid for your insurance policy.
Proximate Cause: That event which, in an unbroken sequence, results in direct physical loss under an insurance policy. For example, wind is the proximate cause of loss when a windstorm blows out a window that in turn topples a lit candle that sets fire to a structure and burns it down.
Public Adjuster: Public adjusters are trained and licensed insurance adjusters who work exclusively for the policyholder rather than the insurance company. See Abba Claims Consultants explanation of the Benefits of working with a public adjuster.

R
Replacement Cost: 
Amount required to replace your damaged property with one of like kind and quality without deduction for depreciation
Risk: Has two meanings: (a) the chance of loss such as from a peril; and (b) the person that is insured by a policy.

S
Scheduled Articles: 
Addition to a homeowner’s policy to provide extra coverage for listed items. Examples: jewelry, furs, stamp and coin collections, bicycles, cameras
Settlement: The dollar amount you agree to accept from the insurance company as payment for your loss.
Sewer Back-up/Water Coverage:  Protects you against direct loss or damage caused by water entering your dwelling as a result of accidental escape of water from a sewer, storm drain, drain, sump, septic tank, eaves trough or downspout
Subrogation: A third party (e.g., the insurance company) assumes another’s legal right to collect a debt or damages.
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T
Terrorism:
An ideologically motivated, unlawful act or acts Including but not limited to the use of violence or force or threat of violence or force committed by or on behalf of any group(s), organization(s) or government(s) for the purpose of influencing any government and/or instilling fear in the public or a section of the public

U
Umbrella:
 Liability Insurance protection against losses in excess of the amount covered by other liability policies.
Underwriting The process by which an insurance company selects and classifies risks according to their degree of insurability.

V
Vacant: 
All occupants have moved out with no intention of returning regardless of the presence of furnishings In the case of a newly constructed house, no occupant has yet taken up residence

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