Hazard — circumstance which tends to increase the probability or severity of a loss. Health Insurance — a generic term applying to all types of insurance indemnifying or reimbursing for losses caused by bodily injury or illness including related medical expenses. Health Maintenance Organization HMO — a medical group plan that provides physician, hospital, and clinical services to participating members in exchange for a periodic flat fee.
Health Plan — written promise of coverage given to an individual, family, or group of covered individuals, where a beneficiary is entitled to receive a defined set of health care benefits in exchange for a defined consideration, such as a premium. Hold-Harmless Agreement — A risk transfer mechanism whereby one party assumes the liability of another party by contract.
Homeowners Insurance — a package policy combining real and personal property coverage with personal liability coverage. Coverage applicable to the dwelling, appurtenant structures, unscheduled personal property and additional living expense are typical. Includes mobile homes at a fixed location. Hospital Indemnity Coverage — coverage that provides a pre-determined, fixed benefit or daily indemnity for contingencies based on a stay at a hospital or intensive care facility.
Hull Insurance — coverage for damage to a vessel or aircraft and affixed items. Incontestability Provision — a life insurance and annuity provision limiting the time within which the insurer has the legal right to void the contract on grounds of material misrepresentation in the policy application.
Estimates are established to book these claims. May include losses that have been reported to the reporting entity but have not yet been entered into the claims system or bulk provisions. Bulk provisions are reserves included with other IBNR reserves to reflect deficiencies in known case reserves. Incurred Claims — paid claims plus amounts held in reserve for those that have been incurred but not yet paid.
Incurred Losses — sustained losses, paid or not, during a specified time period. Incurred losses are typically found by combining losses paid during the period plus unpaid losses sustained during the time period minus outstanding losses at the beginning of the period incurred in the previous period.
Indemnity, Principle of — a general legal principle related to insurance that holds that the individual recovering under an insurance policy should be restored to the approximate financial position he or she was in prior to the loss. Legal principle limiting compensation for damages be equivalent to the losses incurred. This includes conversions from group policies. Inland Marine — coverage for property that may be in transit, held by a bailee, at a fixed location, a movable good that is often at different locations e.
This line also includes instrumentalities of transportation and communication, such as bridges, tunnels, piers, wharves, docks, pipelines, power and phone lines, and radio and television towers. Insurable Interest — A right or relationship in regard to the subject matter of the insured contract such that the insured can suffer a financial loss from damage, loss or destruction to it.
Bickelhaupt and Magee. Insurance — an economic device transferring risk from an individual to a company and reducing the uncertainty of risk via pooling. Insurance Holding Company System — consists of two or more affiliated persons, one or more of which is an insurer. Insurance to Value — Amount of insurance purchased vs. Intermediary — a person, corporation or other business entity not licensed as a medical provider that arranges, by contracts with physicians and other licensed medical providers, to deliver health services for a health insurer and its enrollees via a separate contract between the intermediary and the insurer.
International — includes all business transacted outside the U. Investment grade — the obligation has been determined to be in one of the top four generic lettered rating classifications by a securities rating agency acceptable to the commissioner, that the obligation has been identified in writing by such a rating agency to be of investment grade quality, or, if the obligation has not been submitted to any such rating agency, that the obligation has been determined to be investment grade Class 1 and Class 2 by the Securities Valuation Office of the National Association of Insurance Commissioners.
Joint and Last Survivor Annuity — retirement plan that continues to payout so long as at least one, of two or more, annuitants is alive. Joint-Life Annuity — an annuity contract that ceases upon the death of the first of two or more annuitants. Key-Persons Insurance — a policy purchased by, for the benefit of, a business insuring the life or lives of personnel integral to the business operations. Lapse — termination of a policy due to failure to pay the required renewal premium.
Liability — a certain or probable future sacrifice of economic benefits arising from present obligations of a particular entity to transfer assets or to provide services to other entities in the future as a result of a past transactions s or event s. Life Settlements — a contract or agreement in which a policyholder agrees to sell or transfer ownership in all or part of a life insurance policy to a third party for compensation that is less than the expected death benefit of a policy.
Also include short-term care policies that provide coverage for less than one year for medical and other services provided in a setting other than an acute care unit of the hospital. Limited Payment Life Insurance — a form of whole-life insurance with a pre-defined number of premiums to be paid. Liquor Liability — coverage for the liability of an entity involved in the retail or wholesale sales of alcoholic beverages, or the serving of alcoholic beverages, to persons who have incurred bodily injury or property damage arising from an intoxicated person. Living benefits rider — a rider attached to a life insurance policy providing long term care for the terminally ill.
Long Duration Contracts — contracts, excluding financial guaranty contracts, mortgage guaranty contracts and surety contracts, that fulfill both of the following conditions: Long-Term Care — policies that provide coverage for not less than one year for diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services provided in a setting other than an acute care unit of a hospital, including policies that provide benefits for cognitive impairment or loss of functional capacity. This includes policies providing only nursing home care, home health care, community based care, or any combination.
Long-Term Disability Income Insurance — policy providing monthly income payments for insureds who become disabled for an extensive length of time, typically two years or longer. Loss — physical damage to property or bodily injury, Including loss of use or loss of income. Loss Payable Clause — coverage for third party mortgagee in case of default on insured property, secured by a loan, that has been lost or damaged.
Loss Reserve — the amount that insurers set aside to cover claims incurred but not yet paid. Losses Incurred But Not Reported IBNR — An estimated amount set aside by the insurance company to pay claims that may have occurred, but for some reason have not yet been reported to the insurance company. Malpractice — alleged misconduct or negligence in a professional act resulting in loss or injury. Managed Care — system of health care delivery that attempts to influence the utilization, quality, and cost of services provided.
Manufacturers Output Policies — provides broad form coverage of personal property of an insured manufacturer including raw material, goods in process, finished goods and goods shipped to customers. Margin Premium — a deposit that an organization is required to maintain with a broker with respect to the Futures Contracts purchased or sold. Market Value — fair value or the price that could be derived from current sale of an asset. Mechanical Breakdown Insurance — premiums attributable to policies covering repair or replacement service, or indemnification for that service, for the operational or structural failure of property due to defects in materials or workmanship, or normal wear and tear.
May cover motor vehicles, mobile equipment, boats, appliances, electronics, residual structures, etc. Medical Only — line of business that provides medical only benefits without hospital coverage. An example would be provider-sponsored organizations where there is no coverage for other than provider non-hospital services.
Medical Professional Liability is also known as Medical Malpractice. Medicare — a state assistance program, passed under Title XVIII of the Social Security Amendments of , to provide hospital and medical expense insurance to those over 65 years of age. These contracts with CMS provide reimbursement through pre-determined monthly amount per member based on a total estimated budget.
The beneficiary may use providers outside the provider network. Does not include stand alone Medicare Part D Plans.
This is strictly supplemental coverage and cannot duplicate any benefits provided by Medicare. It may also cover some services and expenses not covered by Medicare.
Mobile Homes — Homeowners — homeowners insurance sold to owners occupying the described mobile home. Member — A person who has enrolled as a subscriber or an eligible dependent of a subscriber and for whom the health organization has accepted the responsibility for the provision of health services as may be contracted for.
Morbidity — the frequency or severity of disease or illness within a subset of the population. Morbidity Risk — the potential for a person to experience illness, injury, or other physical or psychological impairment, whether temporary or permanent. Mortgage Guaranty — insurance that indemnifies a lender for loss upon foreclosure if a borrower fails to meet required mortgage payments.
Mortgage-Backed Securities — a type of asset-backed security that is secured by a mortgage or collection of mortgages. These securities must also be grouped in one of the top two ratings as determined by an accredited credit rating agency, and usually pay periodic payments that are similar to coupon payments.
Furthermore, the mortgage must have originated from a regulated and authorized financial institution. Multi-Peril Insurance — personal and business property coverage combining several types of property insurance in one policy. Municipal Bond Guarantee Insurance — coverage sold to municipalities to guarantee the principle payment on bonds issued. Municipal obligation bond — any security, or other instrument, including a state lease but not a lease of any other governmental entity, under which a payment obligation is created, issued by or on behalf of a governmental unit to finance a project servicing a substantial public purpose, and 1 Payable from tax revenues, but not tax allocations, within the jurisdiction of such governmental unit; 2 Payable or guaranteed by the United States of America or any agency, department or instrumentality thereof, or by a state housing agency; 3 Payable from rates or charges but not tolls levied or collected in respect of a non-nuclear utility project, public transportation facility other than an airport facility or public higher education facility; or 4 With respect to lease obligations, payable from future appropriations.
Mutual Insurance Company — a privately held insurer owned by its policyholders, operated as a non-profit that may or may not be incorporated. Mutual Insurance Holding Company — a company organized as a mutual and owning a capital stock insurer or insurers for the benefit of pooling risk for many people, typically those in the same industry.
Named Insured — the individual defined as the insured in the policy contract. Named Peril Coverage — insurance for losses explicitly defined in the policy contract. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally. Negligence — failure to exercise reasonable consideration resulting in loss or damage to oneself or others.
Encourages participation by private insurers through a flood insurance pool. Occurrence — an accident , including injurious exposure to conditions, which results, during the policy period in bodily injury or property damage neither expected or intended from the standpoint of the insured. Ocean Marine — coverage for ocean and inland water transportation exposures; goods or cargoes; ships or hulls; earnings; and liability.
Option — an agreement giving the buyer the right to buy or receive, sell or deliver, enter into, extend or terminate, or effect a cash settlement based on the actual or expected price, level, performance or value of one or more Underlying Interests. Owner Occupied — homeowners insurance sold to owners occupying the described property. Package Policy — two or more distinct policies combined into a single contract. Peril — the cause of property damage or personal injury, origin of desire for insurance.
Permanent Life Insurance — policy that remains active for the life of the insured. Personal Auto Policy — coverage designed to insure private passenger automobiles and certain types of trucks owned by an individual or husband and wife. Personal Earthquake — earthquake property coverage for personal, family or household purposes.
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Personal Flood — separate flood insurance policy sold for personal, family or household purposes. Personal GAP Insurance — credit insurance that insures the excess of the outstanding indebtedness over the primary property insurance benefits in the event of a total loss to a collateral asset. Personal Injury Liability — liability coverage for those who have been discriminated against, falsely arrested, illegally detained, libeled, maliciously prosecuted, slandered, suffered from identity theft, mental anguish or alienation of affections, or have had their right of privacy violated.
Pet Insurance Plans — veterinary care plan insurance policy providing care for a pet animal e. Policy — a written contract ratifying the legality of an insurance agreement. Policy Reserve — the amount of money allocated specifically for the fulfillment of policy obligations by a life insurance company; reserves are in place to safeguard that the company is able to pay all future claims.
Preferred Provider Organization PPO — arrangement, insured or uninsured, where contracts are established by Health Plan Companies typically, commercial insurers, and, in some circumstances, by self-insured employers with health care providers. Members are allowed benefits for non-participating provider services on an indemnity basis with significant copayments and providers are often, but not always, paid on a discounted fee for service basis. Preferred Risk — insured, or applicant for insurance, who presents likelihood of risk lower than that of the standard applicant.
Premium — Money charged for the insurance coverage reflecting expectation of loss. Premiums Earned — the portion of premium for which the policy protection or coverage has already been given during the now-expired portion of the policy term. Premiums Written — total premiums generated from all policies contracts written by an insurer within a given period of time. Primary Insurance — coverage that takes precedence when more than one policy covers the same loss.
Private Passenger Auto PPA — filings that include singularly or in any combination coverage such as the following: Product Liability — insurance coverage protecting the manufacturer, distributor, seller, or lessor of a product against legal liability resulting from a defective condition causing personal injury, or damage, to any individual or entity, associated with the use of the product. Professional Errors and Omissions Liability — coverage available to pay for liability arising out of the performance of professional or business related duties, with coverage being tailored to the needs of the specific profession.
Examples include abstracters, accountants, insurance adjusters, architects, engineers, insurance agents and brokers, lawyers, real estate agents, stockbrokers. Property — coverage protecting the insured against loss or damage to real or personal property from a variety of perils, including but not limited to fire, lightening, business interruption, loss of rents, glass breakage, tornado, windstorm, hail, water damage, explosion, riot, civil commotion, rain, or damage from aircraft or vehicles. Pure Risk — circumstance including possibility of loss or no loss but no possibility of gain.
Renewable Term Insurance — insurance that is renewable for a limited number of successive terms by the policyholder and is not contingent upon medical examination. Coverage does not include the structure but does include any affixed items provided or changed by the renter. Replacement Cost — the cost of replacing property without a reduction for depreciation due to normal wear and tear.
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Reported Losses — Includes both expected payments for losses relating to insured events that have occurred and have been reported to the insurance company, but not yet paid. Reserve Credit — reduction of reserve amounts for reinsurance ceded. Residence — the domicile location of a member as shown by his or her determination as a resident.
Retention — a mechanism of internal fund allocation for loss exposure used in place of or as a supplement to risk transfer to an insurance company. Risk — Uncertainty concerning the possibility of loss by a peril for which insurance is pursued. Security — a share, participation, or other interest in property or in an enterprise of the issuer or an obligation of the issuer.
Self-Insurance — type of insurance often used for high frequency low severity risks where risk is not transferred to an insurance company but retained and accounted for internally. Short-term Disability — a company standard defining a period of time employees are eligible for short-term disability coverage, typically for 2 years or less. Short-Term Medical — policies that provide major medical coverage for a short period of time, typically 30 to days.
These policies may be renewable for multiple periods. Social Insurance — compulsory insurance plan administered by a federal or state government agency with the primary emphasis on social adequacy. Special revenue bond — any security, or other instrument under which a payment obligation is created, issued by or on behalf of a governmental unit to finance a project serving a substantial public purpose and not payable from the sources in connection with the payment of municipal obligation bonds. Benefits can be paid as expense incurred, per diem or as a principal sum.
Subrogation — situation where an insurer, on behalf of the insured, has a legal right to bring a liability suit against a third party who caused losses to the insured. Insurer maintains the right to seek reimbursement for losses incurred by insurer at the fault of a third party. Subrogation Clause — section of insurance policies giving an insurer the right to take legal action against a third party responsible for a loss to an insured for which a claim has been paid.
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Subsequent Event — events or transactions that occur subsequent to the balance sheet date, but before the issuance of the statutory financial statements and before the date the audited financial statements are issued, or available to be issued. Surety Bond — a three-party agreement whereby a guarantor insurer assumes an obligation or responsibility to pay a second party obligee should the principal debtor obligor become in default.
Tenants — homeowners insurance sold to tenants occupying the described property. Term Insurance — life insurance payable only if death of insured occurs within a specified time, such as 5 or 10 years, or before a specified age. Third Party — person other than the insured or insurer who has incurred losses or is entitled to receive payment due to acts or omissions of the insured. Title Insurance — coverage that guarantees the validity of a title to real and personal property. Buyers of real and personal property and mortgage lenders rely upon the coverage to protect them against losses from undiscovered defects in existence when the policy is issued.
Treaty — a reinsurance agreement between the ceding company and reinsurer. Umbrella and Excess Commercial — coverage for the liability of a commercial venture above a specific amount set forth in a basic policy issued by the primary insurer; or a self-insurer for losses over a stated amount; or an insured or self-insurer for known or unknown gaps in basic coverages or self-insured retentions. Umbrella and Excess Personal — non-business liability protection for individuals above a specific amount set forth in a basic policy issued by the primary insurer; or a self-insurer for losses over a stated amount; or an insured or self-insurer for known or unknown gaps in basic coverages or self-insured retentions.
Underinsured Motorist Coverage — policy option for bodily injury or property losses caused by a motorist with coverage insufficient to cover total dollar amount of losses. Compensation for the injured party is equal to the difference between the losses incurred and the liability covered by the motorist at fault. Underwriter — person who identifies, examines and classifies the degree of risk represented by a proposed insured in order to determine whether or not coverage should be provided and, if so, at what rate. Underwriting — the process by which an insurance company examines risk and determines whether the insurer will accept the risk or not, classifies those accepted and determines the appropriate rate for coverage provided.
Underwriting Risk — section of the risk-based capital formula calculating requirements for reserves and premiums. Unearned Premium — amount of premium for which payment has been made by the policyholder but coverage has not yet been provided. Unpaid Losses — claims that are in the course of settlement. The term may also include claims that have been incurred but not reported. Valued Policy — an insurance contract for which the value is agreed upon in advance and is not related to the amount of the insured loss.
Vision — limited benefit expense policies. Provides benefits for eye care and eye care accessories. Generally provides a stated dollar amount per annual eye examination. Benefits often include a stated dollar amount for glasses and contacts. May include surgical benefits for injury or sickness associated with the eye.
Warrant — an agreement that gives the holder the right to purchase an underlying financial instrument at a given price and time or at a series of prices and times according to a schedule or warrant agreement. Includes but is not limited to coverage for all obligations and liabilities incurred by a service contract provider, mechanical breakdown insurance and service contracts written by insurers.
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Premiums are made for same time period. Professional Insurance Agents of Georgia The Professional Insurance Agents of Georgia PIA of Georgia was established to promote the prosperity, growth, and perpetuation of our members as professionals in the Georgia insurance industry. Independent Insurance Agents of Georgia The Independent Insurance Agents of Georgia IIAG has been devoted to the advancement of independent insurance agents and professionalism within the industry, offering unparalledled opportunities and unrelenting advocacy for agents at home and in Washington, D.
A Accident — an unexpected event or circumstance without deliberate intent. Accidental Bodily Injury — unexpected injury to a person. Actual Cash Value — repayment value for indemnification due to loss or damage of property; in most cases it is replacement cost minus depreciation Admission — hospital inpatient care for any medical condition. Appraisal — an estimate of value. Assessed Value — estimated value for real or personal property established by a taxing entity Asset — probable future economic benefits obtained or controlled by a particular entity as a result of past transactions or events.
B BCEGS — Building Code Effectiveness Grading Schedule — classification system for assessment of building codes per geographic region with special emphasis on mitigation of losses from natural disasters. C Calendar Year Deductible — in health insurance, the amount that must be paid by the insured during a calendar year before the insurer becomes responsible for further loss costs. Claims-made Form — A type of liability insurance form that only pays if the both event that causes triggers the claim and the actual claim are submitted to the insurance company during the policy term Class Rating — a method of determining rates for all applicants within a given set of characteristics such as personal demographic and geographic location.
D Date of Issue — date when an insurance company issues a policy. Deductible — Portion of the insured loss in dollars paid by the policy holder Deferred Annuity — annuity payment to be made as a single payment or a series of installments to begin at some future date, such as in a specified number of years or at a specified age.
Effective Date — date at which an insurance policy goes into force. Exposure — risk of possible loss. F Fair Value — the amount at which an asset or liability could be bought or incurred or sold or settled in a current transaction between willing parties, that is, other than in a forced or liquidation sale. Fees Payable — fees incurred but not yet paid. H Hazard — circumstance which tends to increase the probability or severity of a loss.
Hold-Harmless Agreement — A risk transfer mechanism whereby one party assumes the liability of another party by contract Homeowners Insurance — a package policy combining real and personal property coverage with personal liability coverage. I Incontestability Provision — a life insurance and annuity provision limiting the time within which the insurer has the legal right to void the contract on grounds of material misrepresentation in the policy application. Bickelhaupt and Magee Insurance — an economic device transferring risk from an individual to a company and reducing the uncertainty of risk via pooling.
Insured — party ies covered by an insurance policy. J Joint and Last Survivor Annuity — retirement plan that continues to payout so long as at least one, of two or more, annuitants is alive. Southern Gospel. Choral score. By Graham Kendrick and Paul Baloche.
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