TERM Account Manager (Relationship / Underwriting) Acquisition Costs Beneficiary Binding Authority Binding Authority Interest Binding Authority

Territorial Limitations / Sales Territory

Bordereaux (Claims or Premium) Bordereaux Period Broker Broker authority limits Brokerage / Acquisition cost Business Producer Business Producer Audit Business Producer Audit Template Business Producer Company Business Proposal Capacity Broker Capacity Underwriter Cause

DEFINITION The Insureds interface to the Business Producer is Account Manager. Note that a Business Producer Company (Insurance company/Brokerage firm) may have a different Account Managers for each Business it carries out. The costs incurred in obtaining new business through a Business Producer, including commission or fees paid to them. The legal entity (e.g. person, company) that receives the benefits of the insurance in the event of a successful claim. An agreement that gives the Cover Holder the authority to set up insurance schemes based on the funds of Capacity Underwriters for their Business Producers Section of binding agreement that determines what can be covered in risk bound under it A geographical, or other sector constraint, placed on the sales of a Business Producer by the Binding Authority. Not to be confused with similar constraints on where a Product can be deployed irrespective of Business Producer. These constraints are indicated within the Product Type hierarchy. Listing given to Insurance company by Business Producers or TPAs of policies sold or claims dealt with during a period, usually one month, against which premiums, claims or fees are paid Period of policy declaration to Cover Holder, see Declaration Month An organisation that is a professional advisor on insurance business. Can be a Business Producer for the Insurance Company The amount in value of gross or net premium that a Business Producer can write by class of business in any 12 month period. Commission by Scheme and Product Module taken / payable by the agent(s). Can be different for each transaction in a scheme. Can be a fixed amount or a percentage. The term for all entities with whom Insurance company deals directly in negotiating Schemes whether brokers or another type of organisation. An audit carried out on a particular Business Producer. A template used in carrying out a Business Producer Audit A company that can undertake one or more Business Producer roles. A fully documented business case being offered by the Business Producer and which is agreed and signed off by all relevant parties. The result of this negotiation is the Scheme Slip. A role, with expert knowledge of the capacity market, that helps to set up Binding Authorities. The primary insurer(s) named on a Binding Authority. A role that provides the funds for paying claims in insurance agreements. Regulations govern the amount of risk they can take on based on their total funds. Cause is an occurrence that may result in the Peril and hence a loss to the Insured. A Claim must have one Cause but this may result in several Claim Items. Causes need to be arranged in a hierarchy with Unknown an option at each level. Cause Types from a hierarchy classifying Causes.

Cause Type

TERM Certificates / Policy Certificates Claim Claim Item Claim Payment Type Claim Submission

DEFINITION Certificates of insurance held by Policy Holders as proof of insurance. Usually requested by a claims handler when claim is made. The collection of all Claim Items on a Claim Submission that are covered under a specific Policy Certificate. A component of a claim which claims that an event corresponding to a specific Risk Item has occurred. A payment type that identifies the purpose of a payment to a Claimant It can happen that a Claimant submits what they will call a claim which needs to be treated as two or more Claims because it is covered under more than one Policy Certificate. However there will be one Claimant and one Cause. E.g. Travel Operator following a crash. The role making a Claim Submission. Will be linked to a Contact. A role that manages the assessment and payment of claims within limits authorised in the Scheme Slip and in the Service Agreement between the Claims Processor Company playing the role and the Cover Holder Company. A company that can undertake one or more Claims Processor roles. A classification of business defined by a Capacity Underwriter. It may take the same literal value as a Product Type but the two concepts are different. e.g. Property might be a Class of Business and a Product Type, Often referred to as Line of Business. A legal entity (other than a person) that can produce and manage products in the insurance market. A person belonging to a company or carrying out a role, such as Claimant. Currently this is the product reference code taken from Contract Referencing Diagram. This should relate to a particular scheme type and enable identification of a specific scheme given to a specific Business Producer. This allows each scheme to be allocated a number that will identify product type A role that issues Insurance products based on Binding Authorities. Its incentive is predominantly a profit share but can include a percentage of the premiums collected. It survives through a superior ability to create, and manage the performance of, insurance products. This is Insurance companys commission as noted in the Binding Authority A company that can undertake one or more Cover Holder roles The latest transaction reserving an amount of money to meet a Claim Item. Month of Business Producer declaration of sales to Insurance Company. (Could be months after date of sale.) The amount that is taken from a claim repayment value and must be paid or covered by the policy holder. Spread of premium across the life of the policy. With the option to adopt other patterns of profile if required. 1) That portion of premium earned or charged for the period of time a policy remained effective. For example, an annual policy paid for in advance would be one twelfth "earned" at the end of the first full month of its term. 2) An amount calculated by taking earned premium reserve at beginning of period plus premium written during period, less unearned premium reserve at end of period. 3) Premium actually exposed to loss.

Claimant Claims Processor Claims Processor Company Class of business

Company/Carrier Contact (Person) Contract Number

Contract Referencing Diagram Cover Holder

Cover Holder commission Cover Holder Company Current Reserve Declaration month Deductible Earnings Spread / profile Earned premium

TERM Endorsement Endorsements Section Excess Excesses Section Gross Premium Income IBNR

Initial reserve Insured Item

DEFINITION Amendment to a standard policy / certificate. A section of a policy that contains any endorsements agreed with the Policy Holder that will either restrict or extend the amount of cover given. The amount of a claim payable by the Policy Holder - see Deductible The policy component section that holds the Excess amount information Premiums value before deduction of Brokerage by Business Producer. (This can be before or after IPT/HPT/ITX) (Claims values) Incurred but not Reported. Incurred But Not Reported claims are those which have been incurred by the insured but have not yet come to his attention and/or have not been submitted to insurance company or Cover Holder for reimbursement (also known as lagged claims). A transaction reserving an amount of money to meet a Claim Item on first assessment. An Insured item is the object for which there is an insurable risk to which a Peril may occur. An Insured Item is a component of the Insured which cannot be broken down into any smaller pieces to which perils might occur separately. Brokerage or commission after all deductions (claims, Handling costs, assistance fees, printing) and before Net to UW. Also referred to as Retention. Forms the basis for the profit share calculation. A non professional insurance entity that deal direct with the Insurance Company as a Business Producer on behalf of a retailer. Role appointed to handle this specific Claim Item to ascertain the extent of liability and determine quantum for any negotiated settlement. Any endorsement which may be required on a policy to restrict the potential claims causes. An individual within the Insurance company (as Cover Holder) who is authorised in a Binding Authority to sign off new Schemes within defined limits of authority. Full or part payments towards the settlement of a Claim. A Peril is some unwanted occurrence that may happen directly to the insured. If it happens, loss is inevitable. It results from a Cause. A Peril Item is a Peril that cannot be broken down into any component perils that can happen separately to any Insured Item. As defined by the agency - the person responsible for bringing the account to the agency and made be paid a commission. People in your origination that you may be paying/ tracking commission too - either based on a Percentage of the Agency Commission or Percentage of the Premium. We have 2 types of Producers. Commissioned - creates a Payable from the system. Salaried - for those where you need to track commission either for a report or who are paid on a draw or via payroll An insurance Producer means any person (individual, corporation, association, partnership, limited liability company, limited liability partnership, or other legal entity) who or which is licensed to solicit, negotiate, or sell insurance. Solicit" means attempting to sell insurance or asking or urging a person to

Insurers Charge Intermediary Loss adjuster Loss Control Requirement Named Underwriter Payment towards claim settlement Peril Item

Producers

TERM

DEFINITION apply for a particular kind of insurance from a particular company. "Negotiate" means the act of conferring directly with, or offering advice directly to, a purchaser or prospective purchaser of a particular contract of insurance concerning any of the substantive benefits, terms or conditions of the contract, provided the person engaged in that act either sells insurance or obtains insurance from insurers for purchasers. "Sell" means to exchange a contract of insurance by any means, for money or its equivalent, on behalf of an insurance company.

Policy Certificate

Policy Holder Policy Section Policy Territorial Limits Net Premium Premium payment transactions Profit share

Proposal Form Provider Recovery

Recovery Commission Recovery Type Regulator Reinsurance Agreement Reinsurer Restricted Cover Holder Restricted Cover Holder Scheme

A document that can be presented to customers of Insurance Business Producers as a Product. This is the part of an agreement made between a Business Producer and a Policy Holder that is specific to this particular agreement. The Policy Holder will normally be given a Schedule and cover note that detail the Policy Certificate. The legal entity with which a Business Producer agrees a Policy Certificate. They are responsible for paying premiums. An identifiable section of a Policy that details a number of Risk Items covered by the Policy. The countries in which the policy is active for cover The value of premium after deduction of Acquisition Costs, taxes and fees. Transactions between the Policy Holder and the Business Producer. After deduction of all costs including Insurers charge a proportion of remaining amount is paid to Business Producer under Service Authority Agreement. Would probably not apply in the case of no agreement being in place. Variation can include losses brought forward, % split, insurance charge on Gross or Net, frequency of payment, ability to carry forward. Schemes can be settled on individual basis or grouped. (Prudent providing for recoverable balances by Capacity Underwriters). Application for insurance made by the potential policy holder A role that provides something to the Beneficiary as part of the claim settlement. E.g garage, hospital, airline. A transaction that recoups some of the money paid out in settlement of a Claim. E.g. money paid by another insurance company with whom the Policy Holder had cover for the insured event; money from a successful legal action against whoever caused the insured event. A commission paid to a TPA on the successful Recovery against a claim made. Specifies the type of transaction that has taken place, e.g. Salvage, coinsured, etc A body that places constraints on the conduct of insurance business and defines reports that must be sent to it by companies playing roles in the insurance market. The agreement between a Reinsurer and a Underwriter that insures the Underwriter against losses above an agreed level, incurred against a specific Binding Authority. A role that can undertake Reinsurance Agreements. A Business Producer that has additional defined authority to issue own documentation on own paper. A Scheme Slip that additionally confers authority on a Business Provider.

TERM Slip Retailer Risk Item Salvage Item Schedule of Cover / Risk Scheme Scheme Audit Scheme Audit Template Scheme Slip

DEFINITION The role which undertakes to sell and insurance product to policy holders. The insured event of a particular Peril Item occurring to a particular Insured Item. A sale transaction of items that can be disposed of to recover some of the money paid out against a claim. Policy Holders written confirmation or proof of type / details of insurance in place A specific insurance product that is defined and is given to a Business Producer for sale An audit carried out on the conduct of a Business Producer with respect to a specific Scheme Slip. A part of the Scheme Template offering a pro forma for the Scheme Audits to be carried out against the conduct of business under Scheme Slips creating using this Scheme Template. The agreement between a Cover Holder, a Business Producer and one or more TPAs to conduct a defined amount of insurance business with Policy Holders. These agreements are for a fixed term but may be linked by renewal to a Scheme Slip from the previous or following period. This entity represents the mechanism used by a Cover Holder to aid the production of Scheme Slips. The data which is fixed for a Scheme Template includes everything it inherits from the Products used in setting it up. The file that defines the business proposal and scheme that has been agreed with the Business Producer and Capacity Underwriter Any elements of the risk item that may influence the take on of a risk. A geographical, or other sector constraint, on where this product may be sold. Third Party Administrators who handle policy administration, claims and sometimes sales - See Claims Processor A company that can carry out one or more TPA roles. Accounting period as defined by Cover Holder / Insurer

Scheme Template

SLIP Subjectivity Territory TPA TPA Company Year of Account (YOA)

What Does an Insurance Producer Do? An insurance producer is a licensed representative authorized to sell, solicit or negotiate insurance in one or more categories. Selling refers to exchanging a contract regarding the insurance, while soliciting implies the act of convincing a client to apply for insurance, and negotiating is the process of explaining and offering advice to a prospective client. Health insurance and life insurance are two of the major types of insurance that producers work with, and an insurance producer license must be obtained in the field that the producer chooses to work in. To receive an insurance producers license, an instruction course must be taken and an examination passed. This follows an undergraduate curriculum in which the insurance producer usually majors in business, economics or finance and receives a bachelors degree in one of these areas. After the test is passed, a licensing fee must be paid before the insurance producer can begin to sell insurance. The producer is only eligible to practice in the state he or she took the exam in, and the license must

be renewed periodically. This requires several hours of continuing education courses each year to stay on top of the industry trends and knowledge. An insurance producer is similar to an insurance agent, but an agent is appointed by the insurer to act on his or her behalf. The insurer is often a firm or company rather than an individual client, and if the producer is working with an insurer, commissions, brokerages and service fees must be paid or assigned accordingly. Insurance producers are typically appointed by at least one company to conduct business rather than being responsible for finding individual clients. This is how insurance producers differ from insurance brokers. Insurance producers, however, are still regarded as individual businesspeople rather than as employees of companies or firms. Insurance producers earn a substantial portion of their living through commissions. Each time an insurance premium payment is made, the producer earns part of that amount. An insurance producer has two main functions: to help insurance companies sell the policies and to provide follow-up service to the clients. Selling the policies involves educating the clients on the type of policy that works best for them based on their finances and lifestyle. Follow-up service includes submitting all paperwork and providing continued service for the clients based on their needs and circumstances. Insurance producers often work with life and health insurance. A life insurance producer sells policies to clients who want to be sure their financial affairs are in order in case a death in the family occurs. A health insurance producer works with a clients medical plan to evaluate appropriate policies in this area.