Understand Terms In Clear Language
Insurance Definitions
Below are definitions to assist you. If you have any questions, please do not hesitate to contact your broker directly. We realize at times your insurance policy definitions can be confusing. Below are definitions for use with Professional and General Liability Insurance Policies:
Commercial General Liability: is the most common form of business insurance. Almost every business has it. It provides coverage for “bodily injury” and/or “property damage” you cause to a third party. It protects you and your business from accidents that occur on your property or as a result of your operation. (i.e. Slip and falls for bodily injury or water damage to an adjacent unit due to a tap left on at a hair wash station.) Commercial General liability excludes injury caused by professional services. (That is why you need professional liability insurance!)
Professional Liability is coverage for an injury you cause to a third party (client) as a result of your actions or non-actions. (I.e. infection caused by unsterilized equipment). Professional Liability only covers claims as a result of your services. (that is why you need Commercial General Liability!)
Abuse Bodily injury or personal injury, sickness, disease, mental anguish, mental suffering or shock including death resulting directly, indirectly, in whole or in part from any actual or alleged:
a. sexual, physical, psychological or emotional abuse, molestation or harassment committed by, at the direction of, or with the knowledge of any person insured by this policy; or
b. failure of any person insured by this policy to prevent sexual, physical, psychological
c. or emotional abuse, molestation or harassment.
Advertising injury: An injury arising out of one or more of the following offences committed in the course of your advertising activities, but only if such advertising relates to goods, products or services that you provide to others:
a. oral or written publication of material that slanders or libels a person;
b. organization or disparages a person’s or organization’s goods, products or services;
c. oral or written publication of material that violates a person’s right to privacy;
d. misappropriation of advertising ideas or the style of doing business; or infringement of copyright.
Aggregate: The most an insurance policy will pay for all covered losses sustained during a specified period of time, usually a year. Aggregate limits are commonly included in liability policies.
Bodily injury: Physical injury, including sickness, disease, mental anguish, mental suffering or shock including, death resulting from any of these at any time, but excluding bodily injury arising from medical malpractice.
Catastrophic Loss (Professional Liability):
The most an insurance company expects to pay for an insurance claim. In regards to yoga and RMT insurance (this limit is only $250,000. There are very few professional liability claims in this type of business and even fewer significant losses. A senior manager of professional liability claims at one of Canada’s largest insurance companies said they have never seen a claim over $250,000.
Claim(s) Any:
a. written or verbal notice of demand for compensation made by a third party against you; or
b. writ, statement of claim, summons, application or other originating legal or arbitral process, cross-claim, counterclaim or third– or similar-party notice served upon the insured. It also includes any circumstance.
Certificate of insurance: An insurance company or broker issues a certificate of insurance (COI). This certificate of insurance confirms the existence of an insurance policy and summarizes the key aspects and conditions of the insurance policy. A standard certificate of insurance lists the policyholder’s name, policy effective date, the type of coverage, policy limits, and other essential details of the insurance policy. It will also show the name and address of the person or entity requesting the coverage.
Deductible: The amount you must bear as the first part of each agreed claim or loss.
Defence costs:
a. All expenses we incur with respect to any claim we investigate or settle, or any action against you we defend;
b. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of liability. We do not have to furnish these bonds;
c. All reasonable expenses you incur at our request to assist us in the investigation or defence of the claim or action, including actual loss of earnings up to $ 250 a day because of time off from work;
d. All costs assessed or awarded against you in the action; and
e. Any interest accruing after entry of judgment upon that part of the judgment, which is within the applicable limit of liability and before we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit of liability.
f. These payments will not reduce the limits of indemnity.
Good Samaritan act: Any treatment administered by you at the scene of a medical emergency, accident or disaster where you were present following such medical emergency, accident or disaster.
Limit of Indemnity: The maximum amount a policy will pay per coverage.
Limit of liability: The limit of liability under this policy as stated in the Policy Declaration.
Medical expenses: Expenses regardless of fault for:
a. first aid at the time of accident;
b. necessary medical, surgical, x-ray and dental services, including prosthetic devices; and
c. necessary ambulance, hospital, professional nursing and funeral services.
Medical Malpractice: Any bodily injury, mental injury, mental anguish, mental suffering or shock illness, disease or death of any patient caused by any negligent act, error or omission committed by you in or about the conduct of your business.
Occurrence: Accident, including continuous or repeated exposure to substantially the same general harmful conditions.
Policy declaration: Usually, the first page(s) of a policy that states the named insured, policy terms, limits, deductibles, etc.
Policy period: The time for which this policy is in force, as stated in the Policy Declarations.
Personal injury: Injury, other than bodily injury arising out of one or more of the following offences:
a. false arrest, detention or imprisonment;
b. malicious prosecution;
c. wrongful entry into, or eviction of a person from, a room, dwelling or premises that the person occupies;
d. oral or written publication of material that slanders or libels a person or organization or disparages a person’s or organization’s goods, products or services; or
e. oral or written publication of material that violates a person’s right of privacy.
Personal and advertising injury: Injury, including consequential bodily injury, arising out of one or more of the following offences:
a. False arrest, detention or imprisonment;
b. Malicious prosecution;
c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord or lessor;
d. Oral or written publication, in any manner, of material that slanders or libels a person or organization or disparages a person’s or organization’s goods, products or services;
e. Oral or written publication, in any manner, of material that violates a person’s right of privacy;
f. The use of another’s advertising idea in your advertisement; or
g. Infringing upon another’s copyright, trade dress or slogan in your advertisement.
Products and completed operations: Includes all bodily injury and property damage arising out of your product or your work except:
a. Products that are still in your physical possession; or
b. Work that has not yet been completed or abandoned.
Property damage:
a. physical injury to tangible property, including all resulting loss of use of that property; or
b. loss of use of tangible property that is not physically injured.
Retroactive date: The date specified in the retroactive date section of the Policy Declarations of this policy. If no retroactive date is specified, the retroactive date will be the commencement of the policy period.
Warranty: is a condition set by the insurance company that you agree to follow. (i.e. all clients sign a waiver)
Still have questions regarding the Insurance Policy Definitions, please feel free to contact us at anytime.