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Glossary of Terms

Under Construction

Accident Severity
Accidental Bodily Injury
Accidental Means
Actuary
Adjuster
Average Weekly Wage
Claim
Competitive State Fund
Compensation Act Coverage Endorsement
Compromise and Release Agreement
Employers' Liability Insurance
Governing Classification
Intermediate Report
Longshoreman and Harbor Workers'
Monopolistic State Fund
National Council on Compensation Insurance (NCCI)
Occupational Disease
Occupational Hazard
Occupational Manual
Occupational Safety and Health Act (OSHA)
Payroll Audit
Permanent Partial Disability
Permanent Total Disability
Premium
Rate
Standard Exception
Statewide Average Weekly
Temporary Partial Disability
Temporary Total Disability
Underwriting
Workers' Compensation
Workers' Compensation Catastrophe Policy
Write
Written Business



Accident Severity
A measure of the severity or seriousness of losses, rather than the number of losses. It is measured in terms of time lost from work rather than the number of individual accidents. It is another way of measuring the effectiveness of loss prevention services

Accidental Bodily Injury
An injury sustained accidentally, only the result need be accidental.

Accidental Means

Unexpected or undesignated cause of an accidental bodily injury. Under a definition of accidental means, the mishap itself must be accidental, not just the resulting injury. For example, if a worker was slicing meat and the knife slipped out of his hand and cut his foot, it would be considered accidental means. Conversely, if the worker's finger just got in the way of the knife it would be considered an accidental bodily injury.

Actuary
A math, statistics and accounting specialist who calculates rates, reserves, and dividends.

 

Adjuster
A representative of the insurer who determines the extent of the firm's liability for loss when a claim is submitted.

Average Weekly Wage
A term generally used in workers' compensation laws. It is the basis for determining weekly benefits under the law.

Claim
A demand by the insured or the insured's beneficiary for payment of the benefits provided by the contract.

Competitive State Fund
A fund established by the state to write workers' compensation insurance in competition with private insurers.

Compromise and Release Agreement
A settlement practice under which an injured worker agrees to a liability amount (usually a lump sum) in exchange for releasing the employer from further liability.

Employers' Liability Insurance
Coverage to protect an employer against claims for damages arising out of injuries to employees in the course of their work. A workers' compensation policy insures the employer against liability under state compensation laws. Employers' liability insurance provides protection in cases not covered by the compensation law.

Governing Classification
The classification assigned to the operations of an insured which carries the largest amount of payroll. For example, a roofing company has 40 roofers and five clerical staffers. The governing classification would be the roofing operations, as they carry the largest amount of the payroll.

Intermediate Report
A claim report on the condition of a continuing disability.

Longshoreman and Harbor Workers' Compensation Act
Coverage Endorsement An endorsement required by federal law for employers who employ maritime workers who work in, on, or around navigable waters of the U.S. and its territories, but not masters or members of ship crews.

Monopolistic State Fund
A state-operated company in those states having laws which require that all businesses buy workers' compensation insurance from the state. Private insurers cannot compete in these states. In the U.S.: Nevada, North Dakota, Ohio, West Virginia, Washington, and Wyoming are monopolistic state funds.

National Council on Compensation Insurance (NCCI)
An association of insurers selling compensation coverage and operating as a rating organization. NCCI collects statistics, develops rates and policy forms, and makes state filings for its members.

Occupational Disease
Sickness or disease occurring from the course of employment. State compensation laws provide coverage for this type of loss.

Occupational Hazard
A condition in an occupation that increases the peril of accident, sickness, or death.

Occupational Manual
A book listing occupational classifications for various types of work.

Occupational Safety and Health Act (OSHA)
A law that encourages employers and employees to reduce workplace hazards and improve safety and health programs.

Payroll Audit
An examination of an insured's payroll record by a representative of the insurer to determine the final premium due on a policy for the latest policy year.

Permanent Partial Disability
A condition where the injured party's earning capacity is impaired for life, but he is able to work at any gainful employment for his remaining lifetime.

Permanent Total Disability
A condition where the injured party is permanently and totally disabled, and is not able to earn wages in the same capacity or in other employment.

Premium
The price of insurance coverage for specific risk for a specific period of time.

Rate
The cost of a unit of insurance for a specified period.

Standard Exception
In workers' compensation insurance, different types of employees are classified separately for rating risks, rather than being included in the main classification for a risk. Examples would be clerical office employees, outside sales representatives, draftsmen, drivers, chauffeurs, etc.

Statewide Average Weekly Wage
A statistical computation used to determine compensation benefit amounts. Many benefits are set forth as a percentage of the SAWW.

Temporary Partial Disability
A condition where an injured party's capacity to work is temporarily impaired, but he is able to continue working in a reduced manner and is expected to make a full recovery.

Temporary Total Disability
A condition where an injured party is expected to recover, but is unable to work at all during the recovery period.

Underwriting
The process of assigning rates to insurance coverage by selecting applicable risks and classifying them according to their degrees of insurability, while rejecting any risks that do not apply.

Workers' Compensation
An insurance policy that agrees to pay benefits on behalf of an insured employer, should one of his employees become injured on the job. Or a schedule of benefits payable to an employee by his employer without regard to liability; required by state law in the case of injury, disability, or death as a result of occupational hazards.

Workers' Compensation Catastrophe Policy
An extra amount of insurance purchased by the primary insurers to cover their unlimited medical and compensation liability.

Write
To insure, to underwrite, or to accept an application.

Written Business
Insurance on which an application has been taken, but which is not yet delivered.



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