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Insurance · Licensing exam

Insurance: Claims and Underwriting Terms

Claims handling and underwriting terminology tested on insurance licensing exams.

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What is a request for payment under an insurance policy for a covered loss?
A claim
The amount the policyholder must pay out of pocket before insurance coverage begins.
Deductible
Cost-sharing arrangement where the policyholder pays a percentage of covered losses after the deductible.
Coinsurance
A fixed dollar amount the policyholder pays for a covered service.
Copay (copayment)
The protection provided by an insurance policy against specified losses.
Coverage
A condition or circumstance not covered by an insurance policy.
Exclusion
The process of evaluating and selecting risks to insure and determining appropriate premiums.
Underwriting
The person responsible for evaluating insurance applications and setting premiums.
Underwriter
The evaluation of the likelihood and severity of a potential loss.
Risk assessment
The specific cause or event that may result in loss.
Peril
A condition that increases the probability or severity of a peril.
Hazard
The risk that a person may deliberately cause a loss to collect insurance.
Moral hazard
The tendency of higher-risk individuals to seek insurance more readily than lower-risk individuals.
Adverse selection
The legal requirement that the policyholder stands to suffer financial loss if the insured property is damaged.
Insurable interest
The insurer's right to pursue a third party responsible for a loss to recover amounts paid.
Subrogation

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