Inglés para seguros: vocabulario esencial

"underwriting"

The process of evaluating and accepting or rejecting an insurance application and setting the premium based on assessed risk.

"After careful underwriting, the insurer declined the application due to the client's pre-existing heart condition."

"risk assessment"

A systematic evaluation of the likelihood and potential severity of a loss event before issuing a policy.

"A thorough risk assessment of the warehouse revealed several fire hazards that had to be addressed before coverage could begin."

"premium"

The amount of money a policyholder pays to an insurer, typically on a monthly or annual basis, in exchange for coverage.

"Her annual premium increased by 15% after she filed two claims in the same year."

"policy exclusion"

A specific condition, event, or circumstance listed in the policy that is not covered by the insurer.

"Flood damage was listed as a policy exclusion, so the homeowner had to purchase separate flood insurance."

"insurable interest"

The legal requirement that a policyholder must face a genuine financial loss if the insured event occurs.

"A business must demonstrate insurable interest in the key employees whose lives it wishes to insure."

"adverse selection"

The tendency for people with higher-than-average risk to seek out insurance more than lower-risk individuals, distorting the risk pool.

"Adverse selection is a major challenge for health insurers who must price policies before knowing a customer's full medical history."

"substandard risk"

A risk that is considered greater than the standard expected by the insurer, often resulting in higher premiums or limited coverage.

"The applicant was classified as a substandard risk because of his hazardous occupation as a commercial diver."

"facultative reinsurance"

A type of reinsurance negotiated individually for a single, specific risk that the primary insurer does not want to retain in full.

"The insurer used facultative reinsurance to transfer part of the risk on a $500 million offshore oil platform."

"claim"

A formal request made by a policyholder to an insurer for payment or compensation after a covered loss or event.

"She filed a claim with her insurer the same day her car was stolen from the car park."

"loss adjuster"

An independent professional appointed by an insurer to investigate a claim, assess the damage, and recommend a settlement amount.

"The loss adjuster visited the fire-damaged property within 48 hours to document the extent of the loss."

"indemnity"

The principle that insurance should restore the insured to the same financial position they were in before the loss, no better and no worse.

"Under the principle of indemnity, the insurer replaced the damaged equipment with a like-for-like model rather than paying cash."

"subrogation"

The right of an insurer, after paying a claim, to pursue a third party that caused the loss in order to recover the amount paid.

"After settling the policyholder's claim, the insurer exercised subrogation to recover costs from the negligent contractor."

"excess / deductible"

The amount the policyholder must pay out-of-pocket before the insurer covers the remaining loss on a claim.

"Because the repair bill was only $400 and the deductible was $500, it was not worth filing an insurance claim."

"fraudulent claim"

A deliberately false or exaggerated claim made to an insurer to obtain money to which the claimant is not entitled.

"The insurer's special investigations unit discovered that the policyholder had staged the accident to make a fraudulent claim."

"first party claim"

A claim filed by the policyholder directly against their own insurance policy for a covered loss.

"She made a first party claim on her homeowner's policy after the storm blew the roof off her house."

"third party claim"

A claim filed against someone else's insurance policy by a person who suffered a loss caused by that insured party.

"The cyclist injured in the accident filed a third party claim against the at-fault driver's motor insurance."

"term life insurance"

Life insurance that provides coverage for a specified period; if the insured dies during the term, the beneficiary receives the death benefit.

"He took out a 20-year term life insurance policy to protect his family while his children were still at home."

"whole life insurance"

Permanent life insurance that provides lifelong coverage and accumulates a cash value component over time.

"Her whole life insurance policy had built up significant cash value that she was able to borrow against in retirement."

"beneficiary"

The person or entity designated to receive the insurance proceeds upon the death of the insured or triggering of a benefit.

"He named his spouse as the primary beneficiary and his children as contingent beneficiaries on his life policy."

"pre-existing condition"

A health condition that existed before a new insurance policy was issued, which may be excluded or subject to waiting periods.

"Her diabetes was flagged as a pre-existing condition, so the insurer added an exclusion clause for related complications."

"waiting period"

A specified length of time after policy inception during which certain benefits are not yet payable.

"The health plan had a six-month waiting period before major dental work was covered under the policy."

"critical illness cover"

Insurance that pays a lump sum if the policyholder is diagnosed with a specified serious illness such as cancer, stroke, or heart attack.

"His critical illness cover paid out a tax-free lump sum that allowed him to take time off work during his cancer treatment."

"actuary"

A professional who uses statistics and mathematical models to assess risk and calculate premiums, reserves, and pension liabilities.

"The actuary used mortality tables to price the new annuity product and ensure the insurer held adequate reserves."

"annuity"

A financial product that provides a regular income stream, typically for life, in exchange for a lump sum payment.

"She used her pension savings to purchase an annuity that guaranteed her a fixed monthly income for the rest of her life."

"property insurance"

Insurance that provides financial protection against loss or damage to physical assets such as buildings, equipment, or inventory.

"The business purchased comprehensive property insurance covering the building and all contents against fire, theft, and storm damage."

"liability insurance"

Insurance that protects the policyholder against claims for damages or injuries caused to third parties by the insured's actions or negligence.

"The contractor's liability insurance covered the legal costs and compensation when a worker was injured on the client's premises."

"replacement cost value"

The amount required to replace a damaged or destroyed asset with a new one of similar kind and quality at current market prices.

"The policy was written on a replacement cost value basis, so the insurer paid to install a brand-new roof rather than a depreciated one."

"actual cash value"

The replacement cost of an insured item minus depreciation for age and wear and tear at the time of loss.

"Because the policy settled on actual cash value, the payout for the five-year-old laptop was far less than the cost of a new replacement."

"co-insurance"

A clause requiring the insured to carry coverage equal to a specified percentage of the property's value; penalties apply if under-insured.

"The co-insurance clause required the warehouse to be insured for at least 80% of its value or face a penalty at claim time."

"business interruption"

Insurance that covers loss of income and operating expenses when a business cannot operate due to a covered property damage event.

"After the factory fire, the business interruption policy paid the company's ongoing wages and rent for six months while repairs were completed."

"flood zone"

A geographic area identified by authorities as having a certain level of flood risk, which affects property insurance availability and cost.

"Properties located in a high-risk flood zone are often required to carry separate flood insurance as part of their mortgage conditions."

"inland marine"

A class of property insurance originally covering goods in transit; now extended to any moveable property or property at risk away from a fixed location.

"The jeweller's inland marine policy covered the gem collection both in the shop and during transport to exhibitions."

"reinsurance"

Insurance purchased by an insurance company from another insurer to manage its own risk exposure and protect against large losses.

"The primary insurer purchased reinsurance to cap its exposure on any single hurricane loss at $50 million."

"cession"

The portion of premiums and risks that a primary insurer passes to a reinsurer under a reinsurance contract.

"Under the treaty, the cedant passed a 30% cession of all commercial fire premiums to the reinsurer."

"treaty reinsurance"

A standing reinsurance agreement in which the reinsurer automatically accepts a defined portion of all risks within a specified class.

"The insurer's treaty reinsurance programme automatically covered all property policies above $10 million in sum insured."

"catastrophe bond"

A high-yield debt instrument that allows the issuer to raise funds and transfer catastrophic risk to capital market investors.

"The insurer issued a catastrophe bond to transfer earthquake risk to investors, paying them a premium in exchange for bearing losses above a trigger level."

"retention"

The portion of risk that an insurer keeps for its own account rather than passing to a reinsurer or risk pool.

"The board approved a $2 million per-event retention, with all losses above that ceded to the reinsurance treaty."

"loss ratio"

A key insurance performance metric calculated as total claims paid divided by total premiums earned, expressed as a percentage.

"A loss ratio above 100% means the insurer is paying out more in claims than it collects in premiums, indicating underwriting losses."

"combined ratio"

A measure of insurance profitability combining the loss ratio and the expense ratio; a ratio below 100% indicates an underwriting profit.

"The insurer reported a combined ratio of 94% for the year, reflecting disciplined underwriting and claims management."

"captive insurer"

A wholly-owned subsidiary created by a company to insure the risks of its parent, retaining premiums within the corporate group.

"The multinational established a captive insurer in Bermuda to manage and fund its global property and liability exposures."

"Solvency II"

The European Union regulatory framework that sets capital, governance, and reporting requirements for insurance and reinsurance companies.

"Under Solvency II, the insurer had to hold sufficient capital to withstand a 1-in-200-year loss event."

"policyholder protection"

Laws and funds designed to compensate policyholders if their insurer becomes insolvent and cannot pay claims.

"Policyholders were reassured by the government's policyholder protection scheme, which guaranteed claims up to £85,000 in the event of insurer failure."

"insurance licence"

Official authorisation granted by a regulatory authority allowing a company to sell insurance products in a specific market.

"The US start-up had to apply for an insurance licence in each state where it intended to offer coverage."

"conduct of business"

Regulatory rules governing how insurers must treat customers fairly, including disclosure, advice standards, and complaint handling.

"The regulator fined the company for breaching conduct of business rules by failing to disclose policy exclusions clearly to customers."

"insurance fraud"

Any act of deception committed by an applicant, policyholder, or claims professional to receive a financial benefit from an insurer.

"Insurance fraud costs the UK industry an estimated £1.1 billion per year, ultimately raising premiums for honest policyholders."

"run-off"

The process of managing and paying out the remaining claims of an insurer that has stopped writing new business but still has outstanding liabilities.

"The discontinued product line was placed into run-off, with a specialist firm appointed to manage the residual claims over the next decade."

"admitted insurer"

An insurance company that has been licensed and approved by the state or country's insurance regulator to conduct business there.

"Only admitted insurers are allowed to offer standard homeowner's and auto policies in most US states."

"surplus lines"

Insurance placed with non-admitted insurers for risks that the admitted market is unwilling or unable to cover.

"The unusual coastal property was insured on a surplus lines basis because no admitted carrier would accept the extreme windstorm exposure."