Glossary
Insurance claim jargon, translated.
200 terms organized by topic. Use the category sections to browse, or search anytime with ⌘K.
200 pages in this collection
Coverage
84What your policy covers, what it excludes, and the language carriers use to draw the line.
- Actual Cash ValueThe depreciated value of damaged property.
- Additional InsuredA person or entity added to a policy for limited coverage.
- Additional Living ExpenseCovers temporary lodging and expenses when your home is uninhabitable.
- Agreed ValuePolicy coverage at a pre-established value, not current market value.
- All-Other-Perils DeductibleThe standard flat-dollar deductible for non-hurricane/storm perils.
- Appurtenant StructuresStructures on your property attached or functionally related to the main dwelling.
- BinderTemporary coverage document until policy is issued.
- Blanket CoverageA single limit applies across multiple locations or coverage categories.
- Builder's RiskInsurance for property under construction.
- Builders RiskInsurance during construction.
- Business InterruptionCoverage for lost income when property damage halts business.
- Business Personal PropertyContents owned for business use.
- CancellationTermination of policy before expiration.
- Citizens DepopulationTransfer of Citizens policies to private market.
- Co-InsuredAnother person listed on the policy with coverage rights.
- CoinsurancePenalty for underinsurance at loss time.
- Contractors Pollution LiabilityCoverage for pollution caused during construction work.
- Coverage ADwelling coverage for the structure of your home.
- Coverage BOther Structures coverage.
- Coverage CPersonal Property coverage.
- Coverage DAdditional Living Expense.
- Coverage EPersonal Liability coverage.
- Coverage FMedical Payments to Others.
- Covered Cause of LossAn event your policy explicitly covers.
- Debris RemovalRemoval of damaged material from site.
- Declarations PageThe front page of your policy summarizing coverages and limits.
- DeductibleThe amount you pay before coverage kicks in.
- DP-3 PolicyDwelling policy for rental properties.
- Dwelling FormPolicy form type (HO-3, HO-5, HO-6, DP-3, etc.).
- Earthquake EndorsementOptional endorsement adding earthquake coverage.
- Effective DateThe date coverage begins.
- EndorsementA policy amendment that adds, removes, or modifies coverage.
- Endorsement NumberIdentifier for specific policy endorsement.
- ExclusionA specific peril or condition your policy does not cover.
- Exclusion EndorsementAn endorsement that removes coverage for specific perils.
- Experience ModifierRating adjustment based on claims history.
- Expiration DateThe date coverage ends unless renewed.
- Extended Replacement CostCoverage beyond Coverage A limit for rebuild.
- Fair Rental ValueRent equivalent payable to landlords when a property is uninhabitable.
- First-Named InsuredPrimary insured on policy with broadest rights.
- Forced Place InsurancePolicy a lender puts on your property when you lack coverage.
- Fortification DiscountPremium credit for hurricane-resistant construction.
- Geographic Concentration RiskCarrier exposure to too many policies in one geographic area.
- HO-3 PolicyThe most common Florida homeowners policy form.
- HO-5 PolicyComprehensive homeowners policy with open peril on contents.
- HO-6 PolicyCondominium unit owner policy.
- Hurricane DeductibleA percentage-based deductible for named hurricanes.
- Insurable ValueAmount representing the property's insurable worth.
- Insurance ScoreCredit-based score used to determine premium.
- Lloyd's SyndicateLloyd's of London underwriting group.
- Loss Assessment CoverageCondo unit coverage for HOA special assessments after covered loss.
- Loss of IncomeCoverage for income lost during restoration.
- Market SharePercentage of the market held by a carrier.
- Mitigation LimitCap on reimbursable emergency mitigation expenses.
- Mold SublimitCap on mold remediation coverage.
- Named InsuredThe person explicitly listed on the policy declarations page.
- Named PerilA specific listed cause of loss.
- Named PerilsCoverage for specific listed perils only.
- Non-Admitted CarrierInsurer not licensed as admitted by the state.
- Non-RenewalCarrier decision not to renew your policy at expiration.
- Open PerilCoverage for all perils except those specifically excluded.
- Ordinance or LawCoverage for code upgrades required during rebuild.
- Ordinance or Law CoveragePays for code-required upgrades during rebuild.
- Personal Property Replacement CostRCV coverage for contents.
- Policy LimitThe maximum your carrier will pay.
- Policy PeriodThe dates during which your policy is active.
- Policy Period ExtensionCoverage continuation via endorsement.
- PremiumWhat you pay for coverage.
- Prior Approval RatePremium rate subject to OIR pre-approval.
- Property ScheduleItemized list of covered property with specific values.
- Reasonable Rental ValueMarket rental equivalent for loss-of-use calculations.
- ReinstatementRestoration of a lapsed policy.
- ReinsuranceInsurance that carriers buy to limit their exposure.
- Repetitive LossMultiple losses on same property.
- Replacement Cost ValueThe full cost to replace damaged property at current prices.
- RiderAnother term for endorsement, often used for scheduled items.
- Roof Payment ScheduleAge-based reduction of roof coverage.
- Scheduled EndorsementEndorsement listing specific items or coverages.
- Scheduled Personal PropertySpecific high-value items listed and insured above sublimits.
- SublimitA coverage cap within a broader coverage.
- Surplus LinesCoverage from non-admitted carriers.
- Umbrella PolicySupplemental liability coverage above your home and auto policies.
- UnderinsuranceCoverage insufficient for full rebuild.
- UnderwritingThe process of evaluating risk to issue a policy.
Process
34How a claim moves from notice to payment. What every step is actually called.
- Adjuster's Field NoteWritten observations the adjuster captures during inspection.
- AppraisalA binding dispute resolution process for claim amount.
- Claim NumberThe unique identifier the carrier assigns your claim.
- Claim SeverityMeasure of claim size and complexity.
- Claims HistoryRecord of your past insurance claims.
- CLUE ReportComprehensive Loss Underwriting Exchange report of claim history.
- Company AdjusterA carrier-employed adjuster who represents the carrier.
- Content CleaningProfessional cleaning of damaged household items.
- DehumidificationActive removal of moisture from damaged structures.
- First Notice of LossYour initial report of a claim to the insurance carrier.
- First-Party ClaimA claim you file against your own insurance policy.
- Hurricane SupplementalSupplemental claim specifically for hurricane damage discovered later.
- Independent AdjusterA contract adjuster hired by the carrier.
- InspectionOn-site assessment of damage by a carrier representative.
- Insurance VerificationConfirmation of active coverage at a specific point in time.
- Loss SettlementTerms defining how the loss payout is calculated.
- Managing General AgentAgent with authority to underwrite and bind coverage.
- MitigationSteps you take to prevent further damage after a loss.
- Mitigation CostReimbursable expenses for emergency damage prevention.
- Open ClaimA claim that has been reported but not yet finally resolved.
- Ozone TreatmentOxidation-based smoke and odor remediation.
- Pack-BackReturn of packed-out contents after property restoration.
- Pack-OutRemoval of contents from a damaged property for cleaning or storage.
- Partial PaymentCarrier advance before full settlement.
- Payment MilestonesDiscrete payments tied to repair progress.
- Proof of LossA sworn statement detailing your claim.
- Public AdjusterA state-licensed professional who represents policyholders.
- Quick-Pay DiscountCarrier offer of reduced settlement for rapid closure.
- Recorded StatementA recorded interview about your claim.
- ReserveCarrier-set aside funds earmarked for a claim.
- Temporary RepairsInterim repairs pending full restoration.
- Thermal FoggingSmoke remediation via heated chemical fog.
- Third-Party ClaimA claim filed against someone else's insurance policy.
- Wind Mitigation FormOIR-B1-1802 inspection documentation.
Estimating
24Scope, pricing, depreciation, and the math carriers use to come up with a number.
- Aftermarket PartsNon-OEM materials used in repairs.
- Agreed ScopeScope of loss that both parties have signed off on.
- Cost of ServiceLabor rates used in estimates, by trade and region.
- DepreciationThe reduction in value from age or wear.
- Depreciation ScheduleThe formula used to calculate depreciation on contents and materials.
- EstimateProjected cost of repair.
- Labor BurdenOverhead added to labor costs in estimates.
- Line ItemA single entry in a scope of loss, with quantity and price.
- MatchingThe legal requirement that repairs visually match the undamaged property.
- Materials TaxSales tax on materials component of estimate.
- Moisture MeterTool for measuring water content in materials.
- Non-Recoverable DepreciationDepreciation you do not get back, regardless of repairs.
- O&PContractor overhead and profit, typically 20% added to estimates.
- Price ListRegional labor and material cost reference used in estimates.
- Rebuild CostCost to reconstruct the home from foundation up.
- Recoverable DepreciationDepreciation held back from ACV payment, released when repairs complete.
- Replacement Cost EstimatorTool estimating rebuild cost.
- Sales TaxTax on material costs, added to estimates.
- SalvageValue of damaged items the carrier recovers after paying the claim.
- Scope of LossThe complete list of damaged items and their scope of repair.
- Scope SheetThe carrier's itemized list of damages.
- Thermal ImagingInfrared imaging that reveals hidden moisture and damage.
- XactimateIndustry-standard insurance estimating software.
- Xactimate UpdateQuarterly pricing update in Xactimate.
Damage
18How damage is described, classified, and disputed.
- Accidental DischargeSudden water release covered as peril.
- Catastrophic Ground Cover CollapseMandatory-coverage sinkhole event.
- Category 3 WaterHighly contaminated water requiring specialized remediation.
- Code UpgradeRepair component required by current building code.
- Consequential LossDamage resulting indirectly from a covered peril.
- Constructive Total LossRepair costs exceed the replacement value; settle at total loss.
- Dry TimeDuration and method for drying water-damaged materials.
- Frozen Pipe DamageWater damage from burst pipes in freeze conditions.
- Partial LossDamage less than total.
- Pre-Existing ConditionDamage that existed before the loss event.
- Progressive LossDamage that worsens over time after initial event.
- Pure LossDamage where the item cannot be restored and must be replaced.
- Sinkhole ActivityGeological subsidence or settlement, coverage varies.
- Smoke ResidueParticulate and chemical byproducts of combustion.
- Total LossDamage at or exceeding the cost to replace the entire structure or item.
- Water DamageDamage from water in any of several categories.
- Wear and TearGradual deterioration, typically excluded from coverage.
- Wind-Driven RainRain entering through a wind-created opening, typically covered.
Legal
40Florida statutes, doctrines, and the legal vocabulary that shows up in coverage disputes.
- Appraisal ClausePolicy provision for binding dispute resolution on claim amount.
- Assignment of BenefitsA signed document transferring your claim rights to a contractor.
- Bad FaithInsurer conduct that violates duties of good faith and fair dealing.
- Civil Remedy NoticeStatutory notice required before a bad-faith lawsuit.
- ConcealmentFailure to disclose material information; can void coverage.
- Contingent LiabilityConditional coverage based on triggering events.
- Continuous TriggerCoverage theory where multiple policy years share a progressive loss.
- Cure PeriodTime carrier has to correct a violation after notice.
- Deemed RejectedClaim rejection by operation of law.
- Demand LetterFormal written demand for payment or action.
- Duty to DefendInsurer obligation to defend insured in third-party claims.
- Efficient Proximate CauseThe dominant cause in a chain of causation.
- Examination Under OathA formal sworn examination, often required by policy.
- Examination Under Oath WaiverAgreement to forgo the carrier's right to EUO.
- Florida Statute 626.854Defines and licenses public adjusters in Florida.
- Florida Statute 626.9744The matching statute.
- Florida Statute 627.70131Sets carrier duties and deadlines.
- Florida Statute 627.70132Sets the notice-of-claim deadlines.
- Florida Statute 627.7142Homeowner Claim Bill of Rights.
- Florida Statute 627.7152AOB restrictions and consumer protections.
- Good FaithDuty of honest dealing.
- Grace PeriodTime after premium due date during which policy remains in force.
- Hold Harmless AgreementAgreement releasing a party from liability.
- Homeowner Claim Bill of RightsStatutory rights summary for Florida policyholders.
- Insurable InterestRight to insure; requires economic stake in the property.
- Make Whole DoctrineInsurer must fully compensate before seeking subrogation.
- Matching StatuteFlorida Statute 626.9744 requiring reasonable visual matching in repairs.
- Mediation ProgramFlorida-administered dispute resolution for property claims (FS 627.7015).
- Office of Insurance RegulationFlorida agency that regulates insurance carriers.
- Proximate CauseThe dominant cause of a loss in a chain of causation.
- Proximate Cause ChainSequence of events linking initial cause to final damage.
- Public Adjuster ContractWritten agreement establishing PA representation.
- ReleaseSettlement agreement terminating future claims.
- Reservation of RightsCarrier notice preserving the right to deny coverage later.
- Statute of LimitationsTime limit to file a lawsuit.
- Structured SettlementPayment over time instead of lump sum.
- SubrogationYour carrier recovering from the at-fault party after paying your claim.
- Subrogation WaiverAgreement to waive your right of subrogation.
- TortfeasorPerson or entity legally responsible for causing harm.
- UmpireNeutral third party in the appraisal process.
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