Loss Assessors Advice

Loss Assessor Glossary

These loss assessor terms should help you to understand you insurance policy as well as the process of making a claim. However, if there is anything within your policy that are not entirely up to speed with, then please call us on or drop us a line

A

Accident

This is an unexpected and unplanned event resulting in damage i.e. flood or fire damage. One of the first questions asked after an accident is ‘am I insured for that?’

Accident Year

The calendar or accounting year where the loss occurred.

Ab initio

The Latin for ‘from the beginning’. You will often find this term in your insurance policy.

B

Beyond Economic Repair

The cost of repairs exceeds the value of the property. In this case, the insurance company will usually pay out the market value of the property at the time of the loss. This will only be subject to the terms of the policy.

Business Interruption

If the damage to your business means that you are unable to continue trading or is hindered in some way, your insurance company will cover these costs. This is obviously subject to your policy.

C

Certificate of Insurance

The document that explains what your insurance covers. The details tend to be outlined in your insurance policy.

Claim

There are three ‘types’ of claims, how they are made and who by:

1 – a claim made by the policy holder to their insurers for payment in relation to a loss as outlined in their policy.

2 –a claim made by the insurer to its reinsurers, usually to be paid under a reinsurance

3 – a claim made by a third party against the policyholder

Claimant

The individual seeking compensation is called the Claimant

E

Economic Limit

This is the limit that insurers will pay up to on a claim, which is where they believe will place you back in the same position, prior to the loss.

Employers’ Liability Insurance

It is compulsory for all employers to have liability insurance and is required for when a employee is pursuing compensation from their employer. An example of this could be sexual discrimination or injury in the work place.

Excess

This is the agreed amount paid by the claimant in the case of making an insurance claim. The amount is either some or all of the cost of the loss.

Exclusion

These are the specific types of loss that your policy does not cover and that your insurance company is ‘excluded’ from pay out against.

Ex gratia payment

This is a payment which is made by the underwriters almost as an act of kindness to maintain goodwill and without admitting liability.

I

Indemnity

This is where the individual is compensated and where the loss is restored, as far as possible, to the same position financially as they were in before they suffered the loss. This is not the same as ‘new for old’.

Insurance

This is a contract that states that the insurer promises to pay the policy holder in the event of an accident. This is in exchange for a premium.

Insurance Company

This is the company that covers the risks of the policy holder. In the event of a loss, the insurer will compensate the policyholder.

Insurance Policy

This is the contract between the insurer and the insured party that states the terms of the agreement including an exclusions or clauses.

Insured

Also known as the policyholder, this is the person who is insured as the stated within the contract of insurance.

L

Loss Assessor

A loss assessor works on behalf of you, the policy holder, to get you the best possible settlement from your insurance claim. They take a small percentage of the final agreed sum.

Loss Adjuster

A loss adjuster works on the behalf of insurance company to assess the losses and settle the policy.

Liability Insurance

This is an insurance covering the insured against third party claims. In the case of employers liability insurance, (also known as fidelity insurance) this covers employers against claims by employees.

Loss

There are different types of loss and they could be caused by a number of factors. Whether this be fire, flood, smoke, water, theft, burglary, or subsidence.

Loss event

This is the event that has caused the loss that you are claiming for.

P

Policy

This is the contract that binds you and the insurance company and is also known as a contract of insurance.

Policyholder

This is the person who is insured under the contract of insurance.

S

Sum Insured

This is the maximum amount that your insurance company will pay out under a contract the of insurance.

T

Total Loss

Total loss occurs when the subject of the claim, i.e.: the property, is beyond repair.

Third Party

Someone, other than the insurer or the insured, who has suffered some sort of loss.

U

Underwriter

Depending upon the context of the claim, this could refer to the employee of a managing agent, insurance company or reinsurance company who has ‘underwritten’ the policy of a particular insurance contract.

V

Void policy

This is a contract that no longer has legal effect and is therefore unenforceable in a court of law i.e.: the policyholder no longer owns the property that has been insured.