Unfavorable, detrimental, or pathologic reaction to a drug that occurs when appropriate doses are given to humans for prophylaxis (prevention of disease), diagnosis, or therapy.
Insurance Encyclopedia
Adverse financial selection
When a policyholder surrenders the policy for cash due to financial need, or because the money can be better invested elsewhere.
Adverse Possession
A possession inconsistent with the right of the true owner.
Adverse Selection
The insurance industry is built on the concept of risk, and more specifically sharing or pooling of risk. To illustrate, suppose 1 of every 100 automobiles insured is damaged and must be totaled, requiring the insurance company to pay the policyholder the full value of the vehicle. If all 100 automobile owners pay 1/100 of the value of their vehicle to an insurance company, then enough money will have been collected to cover the one vehicle that was damaged. (Expenses and profits are not included in this calculation). In reality, however, not all 100 individuals will carry full coverage on their vehicles. There is a tendency for those who are the most likely to have an accident to carry the greatest amount of coverage and those least likely to have an accident to carry the lowest level of insurance. This concept is known as adverse selection.Insurance companies often compensate for this discrepancy by charging a higher premium to high-risk individuals. For instance, for a life insurance policy, a smoker will pay a higher premium than a non-smoker because analysis of risk has indicated that the smoker has a higher probability of dying at an earlier age than the non-smoker. In the same way, automobile insurance will cost more in large urban areas with high accident rates such as Houston, while an insured in rural Texas will pay much less.Another method insurance companies use to deal with adverse selection is not insuring at all. Such is the case with flood insurance. Intuitively, only people who live in flood planes will buy flood insurance. Thus, flood insurance is provided by the federal government either directly or through a 100% reinsurance arrangement with a private insurer.
Earthquake insurance is similar to flood insurance in that only those policyholders in earthquake prone areas are likely to purchase the coverage. Earthquakes, however, are less frequent than floods and, therefore, private insurers are willing to provide the coverage for a higher premium than that charged for policyholders without earthquake coverage.
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US, MEDICAL:
Method or process used in a managed care contract where there is a risk of enrolling members who are sicker than assumed and may use expensive medical services more often.
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The tendency of persons with a higher than average probability of loss to seek or continue insurance to a greater extent that do persons with an average or below average probability of loss.
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When an individual who is a higher-than-average risk tries to buy insurance at the standard rate.
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UK:
The tendency of poorer than average risks to buy and maintain insurance. It occurs when insureds select only those coverages that are most likely to have losses. Insurers respond by making adverse underwriting decisions, i.e. those not favourable to the insured by termination, declining acceptance, higher rates or reduction in cover. See SELECTION OF LIVES.
Adverse Underwriting Decision
Any decision involving individually underwriting insurance coverage resulting in termination of existing insurance, declination of an application, or writing the coverage only at higher rates. For property and casualty insurance, it also includes placing the coverage with a residual market mechanism or an unauthorized insurer.
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Any decision made by an underwriter that is not favorable to the insured. Such decisions involve termination, declination, higher rates, or reduction in coverage. Another example is the placing of a risk in a residual market or with an unauthorized insurer.
Advertising agent’s indemnity
Comprehensive contingency insurance for an agency and its client when a film or campaign is interrupted or abandoned due to a cause beyond the control of the agency or its client.
Advertising Injury
Injury arising out of libel or slander, violation of the right to privacy, misappropriation of advertising ideas or infringement of copyright, title or slogan committed in the course of advertising goods, products or services.
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Claim arising out of slander, libel, copyright infringement, or misappropriation of advertising ideas. Coverage is provided as part of coverage B of the commercial general liability policy.
Advice
In regulating the UK insurance where the sales process involves giving advice, the essential elements in a ‘private customer advised sale’ must be (a) on the advantages and disadvantages of the customer buying or selling, and (b) a particular insurance contract(s). Generic advice, e.g. recommending that someone should buy a household policy, would not fall within the definition of advice. See ADVISING AND SELLING STANDARDS.
Advice risk
The risk of liability attaching to the insured as a result of giving advice. Solicitors, etc., are liable when ‘negligent’ advice leads to financial loss. The risk is insurable under professional indemnity insurance. Advice for which a fee is normally payable is excluded under public and products liability insurances. Advice that is incidental to supplying a product or carrying out work is not excluded but any resultant loss will only normally be within public/product liability cover if the third party suffers accidental bodily injury or damage to property.
Advised sales
See: Advising And Selling Standards.