See: exclusion(s) .
Insurance Encyclopedia
Exceptions Clause
A list in a Policy form detailing risks or loses not covered by the Policy.
Excess
Amount of any loss that is not included in the cover provided (e.g. a loss falling below the excess is not a claim). A deductible on the other hand eats into the cover. This difference only really matters where there is an upper limit on the amount of cover such as reinstatements or an annual aggregate. Also, See Also: “Deductible, Excess.”
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Insurance to cover unanticipated or catastrophic losses. Excess coverage can be specific excess, which begins paying when any single claim reaches the preestablished retention, or aggregate excess, which begins paying when the cumulative cost of all claims reaches the preestablished retention.
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UK: The amount deducted from each and every claim and borne by the insured. The excess will eliminate all claims equal to or less than the excess, and will reduce the insurer’s liability for all other claims. The excess may be compulsory or voluntary in which instance the insured’s premium is discounted. The excess is not to be confused with the excess point under layered policies. Deductible is an alternative term for excess, which should be compared with franchise sometimes called a disappearing deductible.
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The amount or proportion of some or all losses arising under an insurance or reinsurance contract that is the insured or reassured must bear. If the loss is less than the amount of the excess then the insured/reassured must meet the cost of it (unless there is other insurance in place to cover the excess). Compare deductible and retention. Excesses may either be compulsory or voluntary. An insured which accepts an increased excess in the form of a voluntary excess will receive a reduction in premium.
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UK: the first part of the cost of a claim which the insured or reinsured has to bear in accordance with the terms of the policy.
Excess aggregate reinsurance
See: Aggregate Excess Of Reinsurance.
Excess amounts
Group life or disability insurance that is presented to a specific category of insureds for enrollment that is more than normally allowed. This is based on the total number for the case.
Excess and surplus (E&
S) lines insurance Any type of coverage that cannot be placed with an insurer admitted to do business in a certain jurisdiction. Risks placed in E&S lines markets are often substandard as respects adverse loss experience, unusual, or unable to be placed in conventional markets due to a shortage of capacity. Captives sometimes qualify as E&S companies. Hefty local premium taxes are payable by the broker.
Excess and surplus (E&S) lines insurance
Any type of coverage that cannot be placed with an insurer admitted to do business in a certain jurisdiction. Risks placed in E&S lines markets are often substandard as respects adverse loss experience, unusual, or unable to be placed in conventional markets due to a shortage of capacity. Captives sometimes qualify as E&S companies. Hefty local premium taxes are payable by the broker.
Excess and Surplus Insurance
(1) Insurance to cover losses above a certain amount, with losses below that amount usually covered by a regular policy. (2) Insurance to cover an unusual or one-time risk, e.g., damage to a musician’s hands or the multiple perils of a convention, for which coverage is unavailable in the normal market. (See also “Umbrella liability” and “surplus lines.”)
EXCESS AND SURPLUS LINES
Property/casualty coverage that isn’t available from insurers licensed by the state (called admitted insurers) is often written by non-admitted insurers. Before an agent can place coverage in the non-admitted market, there must have been a good faith effort to place the coverage with an admitted insurer. Only agents licensed as surplus lines brokers can directly place coverage with a non-admitted company.State insurance departments do not have the same financial regulatory control over non-admitted insurance companies as they do admitted companies. (See Admitted Insurer). Additionally, non-admitted companies are not part of the state guaranty fund. Further, the rates and forms used by non-admitted companies are not subject to state regulation giving those companies more freedom to adjust to unusual risks.
There are two reasons the excess and surplus lines market exists. One is that an unusual risk cannot be underwritten in the same way more common risks are written. For example, an oil refinery has inherently more risk associated with it than does a convenience store. Thus, the criteria for insuring convenience stores cannot be applied to oil refineries. Second, insurance rate making is based, in part, on the law of large numbers. That is, if the insurance company can insure a large number of homogenous risks (e.g., convenience stores), statistically the company can predict with relative accuracy the number and amount of losses. Moreover, there are thousands of convenience stores and very few oil refineries. Therefore, if the oil refineries were lumped in with the convenience stores, one large refinery loss would skew the entire loss data for convenience stores. The excess and surplus lines market is designed, then, to handle the unusual and out-of-the-ordinary risk.
Excess benefits
Medical insurance coverage that has a high maximum amount of benefits and is usually for supplementing older, low-limit major medical health insurance. It has a high deductible.