“Absolute” exclusions are exclusions contained in certain forms of insurance policies that exclude coverage of claims that are remotely but not directly related to the actual nature of the exclusion. The effect of such wording is to waive coverage in situations where coverage could reasonably be expected to apply. For example, an absolute exclusion in a policy written to cover the risk of insurance agent errors and omissions (E&O) could be read as either implicitly arising from or related to any actual or perceived “injury”. Suppose, for example, that an insurance agent fails to provide bodily injury (BI) coverage for a customer and the customer is later held liable for BI. The client then sues the agent for failing to obtain the appropriate insurance policy. Given the wording of the “absolute” exception noted above, the agency policy may not respond to the claim. This is because the client’s assertion indirectly originated and was “linked” to BI. In recent years, these “absolute” exclusions have become more common, and insurers are increasingly using them to deny coverage to claims that would otherwise appear to be covered.
Absolute pollution exclusion is the standard pollution exclusion in Insurance Services Office, Inc. Commercial Liability Insurance (CGL) policies. (ISO) after 1986. This exception gets its name from the removal of the “sudden and random” exception from the standard 1973 CGL pollution exception. While it removes coverage for most pollution incidents that may occur in the course of an insured person’s business operations, coverage remains for some significant impacts, most notably certain incidental pollution losses (including hostile fire), product liability and completed operations, and some cases. - the premises are operated by contractors. Since the exclusion is not really “absolute”, a more appropriate nickname for it is “pollution exclusion in broad form”, and it is used in some IRMI publications.
To accept means to agree to insure. The insurer accepts the risk when the underwriter or agent agrees to insure it and the essential elements of the insurance contract are known and agreed upon by the parties. Even if the policy has not been issued, once the risk is “accepted”, the insurer is obliged to pay the losses that arise in accordance with the agreed terms of coverage.
The access to records clause, also commonly referred to as the “check” or “audit” clause, is one of the most important contractual rights a reinsurer has under a reinsurance agreement. The purpose of this clause is to give the reinsurer the right to inspect the books and records of the cedant applicable to the reinsured business. This is one of the few methods by which reinsurers must assess the business they are contracting under a reinsurance contract and determine whether the reinsurer is complying with the terms of the contract, in particular the accuracy of the policy, assignments and premium calculations. A typical record access offer provides the following. The Reinsurer or its appointed representatives shall have free access to the books and records of the Company on matters relating to this reinsurance at any reasonable time for the purpose of obtaining information relating to this Contract or its subject matter. More recent provisions on access to records are more limited and specific as to the scope, timing and method of verification provided to the reinsurer. Clauses on access to records can be found in most reinsurance contracts. The right of inspection is so ingrained in the customs and practices of the reinsurance industry that it is supported to suggest that the reinsurer has this right even in the absence of an express reservation.
Accident (1) In common usage: an unforeseen and unplanned event or circumstance; or an accident caused, inter alia, by negligence or ignorance (Webster’s Dictionary). In insurance language, a term that is included in the insurance contract for many types of civil liability insurance. In some cases, the word “accident” is a defined term in politics. However, in most cases, the common law becomes the determining factor of what is and is not an accident for the purposes of initiating insurance coverage. (2) In boiler and machine insurance (BM), “accident” is defined in the policy as a sudden and accidental breakdown of equipment that causes damage to the equipment and requires repair or replacement. BM coverage covers loss or damage to the insured object as a result of an accident. (3) In liability insurance, especially in older forms, insurance contracts usually covered injury or loss caused by an accident that was not the result of a deliberate intentional act (even if the intentional act produced an unexpected result). The term “accident” was not defined in such policies. The trigger of coverage in the insurance agreement of modern liability policies, such as the commercial civil liability (CGL) policy, applies to an “incident”, which is defined as an accident, involving persistent or repeated exposure to substantially the same general harmful conditions. . Unlike most other modern day liability policies, the commercial motor third party liability insurance agreement still applies to injury or damage caused by an “accident”. In this case, the policy includes a kind of definition of the term “accident”, i.e. “accident” includes constant or repeated exposure to the same conditions resulting in “injury” or “property damage”. The Personal Automobile Policy (PAP) Liability Agreement states that the insurer will indemnify for bodily injury or property damage for which any insured person becomes legally liable due to a car accident. In this type of policy, the term “accident” is used in its usual sense, without including it as a specific term.
Accident and illness insurance is a class or type of insurance that pays benefits for losses caused by illness, accident, accidental death and related health care costs.
Accident data for the year is a method of organizing the loss and risk data of an insurer or a group of insurers or in the business book in such a way that all losses associated with accidents that occur during a given calendar year and all premiums received during a given calendar year are compared. the same calendar year. . Thus, regardless of the individual insurance periods and regardless of when a loss is reported or paid out, the 2015 accident data will include all insurance premiums earned during 2015 and will include all losses that occurred in 2015. annual data in their rate suitability analysis. For example, the Compensatory Loss Development Factors (LDFs) published by the National Council for Compensation Insurance (NCCI) are developed based on data from the year of the accident.
The year of the incident is the year of the incident, which is any 12-month period that tracks losses from incidents that occur during that 12-month period. The annual accident experience is calculated by adding up the total losses from any accidents that occurred during that 12-month period. Two other cost accounting terms used in claim sorting are calendar year and insurance (underwriting) year.
An accident is a death that occurs directly and solely as a result of (1) accidental injury visible on the surface of the body or revealed at autopsy; (2) disease or infection resulting directly from an accidental injury as described, onset within 30 days of the date of injury; or (3) accidental drowning.