Rider

US: (1) A document which amends the policy or certificate. It may increase or decrease benefits, waive the condition of coverage or in any other way amend the original contract. (2) A special policy provision or group of provisions that may be added to a policy to expand or limit the benefits otherwise payable. (3) A document that modifies the policy. It may increase or decrease benefits, waive a condition or coverage, or in any other way amend the original contract.
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A document that modifies the protection of a policy, either expanding or decreasing its benefits or adding or excluding certain conditions from the policy. Same as an Endorsement.
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A document, attached to a policy, that changes the policy’s coverage, either by increasing or decresing benefits, or barring some conditions from coverage.
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US: A form that is attached to a surety or fidelity bond that alters the provisions of the bond form in some manner. A rider is the surety and fidelity equivalent of an insurance policy endorsement, and though not common, insurance endorsements are sometimes called riders.
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Another term for an endorsement attached to a policy that modifies the coverage.
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MEDICAL, US: See: endorsement, amendment, and waiver .
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Usually known as an endorsement, a rider is an amendment to the policy used to add or delete coverage.

Risk Classification

The process by which a company decides how its premium rates for life insurance should differ according to the risk characteristics of individuals insured (e.g., age, occupation, sex, state of health) and then applies the resulting rules to individual applications. (See: Underwriting)
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UK: Underwriters combine individual risks into groups or ‘classes. This facilitates the underwriting process and enables individual proposals to be considered in the light of the class to which they belong. Some classes, e.g. total abstainers, mature applicants, may receive preferential treatment while others may belong to an excluded class, e.g. a motor insurer might exclude jockeys or others with a high exposure.

Risk purchasing group (RPG)

US: A group formed in compliance with the Risk Retention Act of 1986 authorizing a group of insureds engaged in similar businesses or activities to purchase insurance coverage from a commercial insurer. This is in contrast to a risk retention group (RRG), which actually bears the group’s risks rather than obtaining coverage on behalf of group members.
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A group of similarly situated persons or entities that are permitted under federal law to organize across state lines to buy insurance. The carrier that sells insurance to the group must be licensed in at least one state but need not be licensed in every state where a member of the group resides.
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UK Alternative risk transfer term that refers to collective insurance buying.

Risk-based capital (RBC) requirements

A method developed by the National Association of Insurance Commissioners (NAIC) to determine the minimum amount of capital required of an insurer to support its operations and write coverage. The insurer’s risk profile (i.e., the amount and classes of business it writes) is used to determine its risk-based capital requirement. Four categories of risk are analyzed in arriving at an insurer’s minimum capital requirement

Self-Insurance

US: (1) A program for providing group insurance with benefits financed entirely through the internal means of the policyholder, in place of purchasing coverage from commercial carriers. (2) A form of risk financing through which a firm assumes all or a part of its own losses.
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A form of risk financing through which a firm assumes all or a part of its own losses.
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An alternative to insurance through an insurer that is generally only available to very large organizations. A self-insured company must make arrangements to meet future risks by setting aside enough money for the anticipated losses and even those that cannot be anticipated.
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An insurance-like strategy for handling one’s own exposures to loss supported by the financial wherewithal to meet expected losses. Not to be confused with a decision to forego insurance.
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REINSURANCE: Setting aside of funds by an individual or organization or ceding company to meet his or its losses and to absorb fluctuations in the amount of loss, the losses being charged against the funds so set aside or accumulated
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MEDICAL, US: System or program of insurance for employees and their dependents in which employers (generally companies with 500 or more employees) establish a plan and assume the functions, responsibilities, and liabilities of an insurer. Health care expenses are paid through a special fund established by the employer. Such plans may be self-administered or the employer may contract with a third-party administrator (TPA) for administrative services only (ASO). Self-insured plans are exempted by the Employee Retirement Income Security Act (ERISA) from state insurance laws, state-mandated requirements for employer health benefit programs, state taxes on insurance premiums, and participation in state risk pools or uncompensated care plans. Also called self-funding, self-insured, employer self-insured program, or partially self-funded .
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UK: The payment of losses as they become due by an individual, partnership or corporation that retains all or part of its own risks. High frequency/low impact losses are paid out of cash flow. In other cases the firm retains the first portion of other losses to be paid out of reserves and insures the excess of the retention. Self-insurance is distinguished from non-insurance because it represents a formalised accrual of liabilities. See PLANNED RISK ASSUMPTION; CAPTIVE INSURANCE COMPANY.
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The retention of risk by an individual or organization, as distinct from obtaining insurance cover. Large commercial concerns may opt for self-insurance on the grounds that they are avoiding the extra expenses and profit loadings of an insurance policy and have sufficiently strong finances to cope with their likely losses. In practice, they will typically still seek insurance against very large losses by having insurance contracts with very high excesses. Effectively, having any non-zero excess implies a level of self-insurance. Owning a captive insurance is a means of arranging for self-insurance, with cover for every large losses being arranged by the captive by means of reinsurance.

State Insurance Department

US: A department of a state government whose duty is to regulate the business of insurance and give the public information on insurance.
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An administrative agency that licenses insurers to do business in that state, licenses insurance agents, implements state insurance laws, and supervises (within the scope of these laws) the activities of insurers operating within the state.
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MEDICAL, USA: See: state insurance commission .

Storm surge

Water that is pushed toward the shore due to the force of winds swirling around a storm advancing across a body of water. This advancing surge combines with the normal tides to generate the hurricane storm tide, which can lead to severe flooding in coastal areas. Numerous coverage disputes over the applicability of flood exclusions to storm surge losses caused by major hurricanes, such as Katrina (often called “wind versus water” cases), have arisen because this term is not often listed as an excluded peril in property insurance forms. Most courts, however, have ruled against coverage for these losses under standard property insurance policies, stating that “storm surge” is little more than a synonym for a “tidal wave” or “wind-driven flood,” both of which are excluded under most property forms. In summary, the courts have generally ruled that only flood insurance policies cover these losses.