Guide for Zurich Asuransi Indonesia

As an established insurance company for years, it is our commitment to give a positive impact on the community. We understand your concerns that having an insurance policy might sometimes be confusing as you will be exposed to some brand new vocabulary. Therefore, we've served you with this glossary to help you have a better understanding of the basic terms and principles used in an insurance policy.

To summarize, your insurance policy is a commitment. Your commitment is to pay an agreed amount of money which is known as a premium, in exchange, we provide you with our best insurance cover suitable for your condition.

1. Adjuster

   Party that observes claim and its amount.

2. Appraiser

   Party who estimates the value of a object which will be insured.

3. Primary Insurance

   Basic insurance coverage of the Policy.

4. Compulsory Insurance

   An Insurance which is required by law.

5. Agent

   an individual who sells, services, or negotiates insurance policies on behalf of a insurance company.

6. Aggregate

   The total amount of payable for a single loss or multiple lossess, during a policy period.

7. Physical hazard

   Danger that caused by a physical condition.

8. Moral Hazard

   Danger caused by the moral condition of a person.

9. Administration Fee

   Costs incurred by the Insurer in connection with the issuance of the Policy.

10. Combined Ratio

    an indication of the profitability of an insurance company, calculated by adding the loss and expense ratios

11. Depreciation

    The decreasing value of the insured object.

12. Endorsement

    Documents containing changes and/or additions to the terms and conditions of the Policy, which form an integral part and become an inseparable part of the Policy.

13. Excess Claim

    The excess of maximum limit of coverage as set out in the Policy.

14. Free-look period

    Period whereas the insured could comprehend the insurance policy. In this period, if the insured want to cancel the insurance policy then there will be no cancelation fee.

15. Business Interruption

    Loss of income as a result of property damage to a business facility

16. Subject Matter Insured

    (Sharia: Insurance Object)

    Good or event that could caused loss, damage, or liability.

17. Law of the Large Numbers

    One of the principle that is used in insurance, whereas more people are insured, then occurred loss will meet the predicted loss.

18. Civil Commotions

    An Act of a large number of people acting together disrupting public peace and disturbance tumutuously with violence and a chain of destruction of a large number of properties, indicated by the cessation of more than one half of the normal activity of commercial/shopping or business areas or schools or public transportation in one city for at least 24 (twenty-four) hours consecutively commencing immediately before, curing or after the event.

19. Indemnity

    An Insurance Principle which the purposed of claim payment was to return the condition of the insured into the same condition as a moment before the loss was occurred.

20. Intermediary

    Third party which receive commission from selling insurance product.

21. Utmost Good Faith

    Insurance principle that both Insurer and the Insured have to has good faith in insurance contract.

22. Policy Schedule

    Part of an insurance policy, the policy schedule identifies the insured, details of coverage, amount of coverage and Terms & Conditions.

23. Sum Insured

    The amount stated in the Policy to be paid by the Insurer subject to the terms and conditions stated in the Policy.

24. Accident

    Incident or event that contains elements of violence, both physical and chemical, which comes from outside, occurs suddenly, is not wanted or planned.

25. Peril

    Event that can cause damage or loss to an object insured.

26. Insurable Interest

    An insurance principle which the Insured must have an financial interest with the object that will be insured.

27. Accidental Death & Dismemberment

    An insurance coverage that pays a stated benefit in the event of death and/or dismemberment caused by accident or specified kinds of accidents.

28. Riot

    An Act of a group of at least 12 (twelve) persons, who in the execution of their common purpose cause public disturbance tumultuously with violence and damage to the property of others, not amounting to Civil Commotions.

29. Boiler & Machinery Breakdown

    Coverage for the failure of boiler or machinery, including property of the insured which has beedn directly damaged by the accident, cost of temporary repairs and expediting expense, and liability for damage to the property of others.

30. Claims

    Demand by the Policy Holder to the Insurer to fulfill the Policy Holder's rights in accordance with the provisions in the Policy.

31. Automatic Reinstatement Clause

    A condition whereas the Insured undertaking to pay an additional premium at the agreed rate on the amount of loss calculated on a pro rata basis from the date of such loss to the expiry of the current period of insurance, it is agreed that in the event of loss the insurance shall be maintained in force for the full of sum insured.

32. Debris Removal Clause

    On the Cost and Expenses necessarily incurred by the insured in the removal of debris dismantling or demolishing shoring up or propping of the portion or portions of the property insured destroyed or damaged by fire or by any other peril insured, will be borne by the insurer up to specified amount.

33. Commission

    Service fees received by the Broker from the insurance company as an intermediary in placing the insurance needs of the insurance customer.

34. Knock for Knock Agreement

    An agreement between two insurance companies whereby, when both companies' policyholder incur losses in the same insured event, each insurer pays the losses sustained by its own policy-holder regardless of who was responsible.

35. Coinsurance

    Scheme of insurance which there were two or more insurer who had responsibility to cover each of certain risk respectively.

36. All Risk/ Comprehensive

    Type of insurance coverage that covers any risk that the contract does not explicitly omit.

37. Pre-existing medical conditions

    Pre-existing Medical Condition means a disease, illness, medical condition or dental condition or physical disability which at the Relevant Time.

38. Pre-Existing Condition

    Damages or defects that existed before the Insurance period began.

39. Contribution

    One of the insurance principle that two or more insurers each liable for covered loss should participate in the payment of that loss.

40. Policy Lapse

    Condition where the insurance Policy is inactive due to there is no payment from the Insured.

41. LAPS - SJK

    The Financial Services Sector Alternative Dispute Resolution Institution (LAPS SJK) is an out-of-court dispute resolution institution established on 22 September 2020 by Self Regulatory Organizations ( SROs ) and associations in the financial services sector.

42. Insurance Benefit

    The agreed insurance benefits as stated in the Policy.

43. Additional Benefit

    Additional insurance coverage to the Primary Insurance of the Policy to provide additional benefits in an insurance coverage.

44. Grace Period

    The grace period given by the Insurer to the Policy Holder to pay the premium that has fallen due.

45. Waiting Period

    Certain period of time that must be passed until insurance benefits can be used or insurance claim claims can be used calculated from the insurance period begins

46. Mortality

    Mortality: 1. Uncertainty of the time of death. 2. Death frequency.

47. Insurance Value

    The maximum value of Insurance Benefits that can be provided to the Insured due to the risks covered in the Policy.

48. Actual Value

    Amount calculated from the cost to replace or restore property of the same type and location but not exceeding or better or wider than the insured property immediately prior to the occurrence of loss or damage minus depreciation.

49. Strikes

    Deliberate act of damage, by a group of workers of at least 12 (twelve) persons or one half of the entire workforce (if the total number of workforce is less than 24 persons), refusing to work as usual in an attempt to force the employer to accept their demands or to protest against any terms of employment enforced by the employer.

50. Renewal Notice

    Information that convey to the insured on the renewal of insurance policy. The insured is required to approve this document in order to make the renewal policy is inforce.

     

51. Policy Holder

    Individuals or Entities entering into insurance agreements with the Insurer.

52. Closure of insurance

    The initial process where the prospective Insured will apply to get insurance products from the Insurer.

53. Insurer

    Party who take over other party's risk with required of payment for certain amount of premium.

54. Beneficiary

    Individuals or Entities whose names are listed in the designated Policy and are entitled to receive Insurance Benefits.

55. Exclusion

    Events for which the Benefit will not be paid which occurs directly or indirectly if it is related to the event described in the provisions of the Policy.

56. Reimbursement

    Method whereas the insured paid the loss at first, afterward the insurer will pay to the insured based on the invoice value.

57. Insurance Period

    The insurance period as stated in the Insurance Schedule starting on the date and time stated in the Insurance Schedule.

58. Over Insured

    Condition when the sum insured in the insurance policy is in excess of the insured object's fair or reasonable value

59. Under Insured

    Condition when the sum insured in the insurance policy is not enough to cover the full cost of the repairment of the object insured.

60. Double Insurance

    The existence of two active policy which cover the same risk.

61. Malicious Acts

    Act of any person(s) deliberately causing damage to the property of others driven by vengeance, hatred, anger, or vandalistic, except such acts done by the employee(s) of the insured, or any person(s) on behalf of the insured, or by person(s) entrusted by the Insured to maintain or keep such property, or by thieves/robbers/looters.

62. Insurrection/ Popular Rising

    An uprising of a majority of the people in the capital city of the country, or in three or more capital cities of the provinces within 12 (twelve) days, demanding a change in the government de jure or de facto, or open resistance against the government de jure or de facto, not amounting to a Rebellion.

63. Usurped Power

    A situation where the established government de jure or de facto has been overthrown and replaced by another power that impose and or enforce their own rules.

64. Rebellion

    A state of organized resistance against the established authority de jure or de facto with the objective to supplant or overthrow it with force using fire arms which threatens the existence of such authority.

65. Broker

    Consulting and/or intermediary services business in insurance coverage or sharia insurance and handling the settlement of claims by acting for and on behalf of the policy holder, the insured, or the participant.

66. Third Parties

    All parties who are not Insured, husband or wife, children, parents, and siblings of Insured, people who work for and people who are under the supervision of Insured.

67. Placing Slip

    approval of insurance placement documents addressed to the Insurer

68. Policy

    Insurance agreement documents in the form of hardcopy or softcopy between the Insurer and the Policy Holder, including Insurance Policies, General Policy Provisions, Endorsements and/or other changes or additions contained therein signed by the Insurer, as well as Insurance Application Letters and/or documents -documents in the Insurance application process, as well as other documents related to the Policy, which as a whole constitute an integral part and become an inseparable part of the Policy.

69. Premium

    (Sharia: Contribution)

    The amount of money that must be paid by the Policy Holder to the Insurer in connection with the insurance agreement as stated in the Policy.

70. Proximate Cause

    Direct causes of loss, without which the loss would not occur.

71. Risk Based Capital (RBC)

    One of the indicator that is used to measure insurance company's financial condition. This ratio especially measure on insurance company's ability to solve all related risks.

72. Revolution

    An uprising of the people with force to make a radical change to the current public administration system of the country or to overthrow the established government de jure or de facto, not amounting to a Rebellion.

73. Own Risk

    Specified amount should be borne by the Insured for each incident.

74. General Riplay

    Summary of Product and Service Information that is not individual or personal and prepared for all Potential Consumers

75. Personal Riplay

    Product and Service Information Summary that is specific and specially prepared for certain Potential Consumers.

76. Reinsurance

    re-insurance service business against risks faced by insurance companies, or other reinsurance companies.

77. Compensation

    Claims payment amount which had been determined in the begining of insurance.

78. Subrogation

    The Insurer shall be or would become entitled or subrogated upon their paying for or making good of any loss, destruction, damage, or expense under the Insurance Policy, whether such acts and things shall be or become necessary or required before or after the Insured’s indemnification by the Insurers.

79. Notification of Insurance Closure (SPPA)

    A written application letter or application form that must be filled out by the prospective Policy Holder and/or the prospective Insured to enter into an Insurance agreement.

80. Policy Year

    Periode satu tahun kalender yang terhitung sejak Tanggal Mulai Pertanggungan dan tiap Ulang Tahun Polis berikutnya.

81. Policy End Date

    The date on which the Policy becomes invalid as stated in the Policy.

82. Premium Due Date

    The date on which the Premium must be paid by the Policy Holder to the Insurer.

83. Policy Date

    The start date of the insurance coverage as stated in the Policy.

84. Policy Issuance Date

    The date on which the Policy was issued as stated in the Policy.

85. Third Party Liability (TPL)

    Benefit that is given to the third party when the loss is occurred. For example, benefit to the other road user when the vehicle is collission.

86. Insured

    (Sharia: Participant)

    Party which paid certain ammount of premium to get covered from certain risk through insurance product.

87. Total Loss Only

    Condition when the estimated cost of making repairs exceed the actual cash value or exceed the agreed percentage value of the object insured.

88. Policy Anniversary

    One year after the Policy Date and every one Policy Year thereafter.

89. Underwriting

    The process of assessment / valuation and classification of risk level related to a prospective Insured and decision either to accept or reject the risk.

90. Underwriter

    An insurer’s employee who decides whether or not to accept a proposal or insurance and, if so, on what terms and conditions.

91. Quotation

    Insurance offer documents addressed to the Insured