GLOSSARY OF ACTUARIAL AND RATEMAKING TERMINOLOGY

Term Definition
Accident An event or occurrence which is unintended, unforeseen and unexpected;
something which could not be considered as a foreseeable occurrence and
consequence of an undertaking; a casualty; mishap.
Accident Date The date of the event which gave rise to the claim.
Accident Period Period in which an accident occurs, regardless of when the policy covering it
is written, when the occurrence is reported, or when the associated claims
are closed and losses are paid.
Accident Year Case- The sum of all paid losses and case reserves for a specific accident year at a
Incurred Losses specific point in time.
Accident Year Loss experience calculated by matching the total value of all losses
Experience occurring during a 12-month period with premiums earned for the same
period.
Acquisition Cost The cost of selling insurance; normally the agent’s and broker’s commission;
any cost of putting the business on the books.
Actuary A social mathematician who uses mathematical skills to define, analyze and
solve complex business and social problems involving insurance; the work of
actuaries involves the various contingencies which face human beings and
the financial effects which such contingencies have on various insurance
programs; many of these programs involve long-range financial obligations,
for which actuarial forecasts are fundamental in maintaining a sound
financial basis - rate-making, premium and loss reserving, investment
valuation, pension benefits, and insurance statistics, among others.
Adverse Selection The conscious and deliberate selection of risks, segments of risk, or
(Anti-Selection, coverages that appear less attractive, with a higher chance of loss, than
Selection of Risk) that contemplated by the applicable rate; the selection of such risks is
adverse because the rate is inadequate; a tendency towards insuring risks
possessing negative characteristics.
Aggregate The dollar amount of insurance coverage during one specified period,
(Aggregate Limit) usually 12 months, for all insurance losses sustained during such period; the
maximum amount of coverage under an insurance policy or funding
arrangement; a limitation of the total amount of losses covered by the
insurance contract or self-insurance funding during a given period.
Allocated Loss A monetary payment or reserve used to cover expenses incurred in settling
Adjustment Expense claims; ALAE are those expenses, such as investigative fees, court fees and
(ALAE) outside legal counsel, directly attributable to and associated with settling a
particular claim.
Annual Statement The annual report format prescribed by the NAIC and the state departments
(Statutory Annual of insurance; provides a summary of the company’s financial operations for
Statement, Convention a calendar year, including a balance sheet supported by detailed exhibits
Blank) and schedules; is filed with the state insurance department of each
jurisdiction in which the company is licensed to conduct business.
Base Rates A manual rate applied to a class of policies or to similar characteristics of a
particular risk in a given territory or classification for a basic limit of liability;
price per unit of insurance.
Basic Limits The minimum amounts of insurance for which it is the practice to quote
premiums in liability insurance; additional amounts are charged for by the
addition of certain percentages of the premium for the minimum (basic)
limits.
Calendar Year Loss experience calculated by matching total value of all losses incurred
Experience during a given 12 month period with the premiums earned for same period.
Case Reserve The estimated amount of a claim payment; the sum of the values assigned
to specific claims by the entity’s case reserving procedure.
Claim A demand received by an insured for damages resulting from a medical
incident, event or occurrence.

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Term Definition
Claimant The individual or entity making a claim against an insured; one who has
suffered a collectible loss; plaintiff.
Claims-Made A coverage form that provides coverage for claims reported during the
(Claims-Made policy term or funding period which occurred subsequent to the retroactive
Coverage, date of the coverage, and prior to the end of the policy term or funding
Claims-Made Basis) period; once the policy period is over, the approximate extent of the
insurer’s liability is known; with claims-made covers which are renewed,
losses which occurred during any period when the policy was inforce are
covered if reported during the renewal term.
Combined Ratio The sum of the Incurred Loss Ratio and the Expense Ratio.
(Trade Ratio)
Credibility The relative confidence ascribed to historical loss experience; the value is
usually expressed in terms of specific mathematical formulas and is a
number between zero and one (100%); a measure of the predictive value
attached to a particular body of data; a measure of statistical reliability,
credence or believability; as the body of experience increases in volume, the
corresponding credibility also increases.
Discounted Reserve The present value of the payment of outstanding losses and loss adjustment
expenses in the anticipated future settlement amounts, calculated at
selected interest rate(s).
Earned Exposures The exposure units actually exposed to loss during the period.
Earned Premium That part of premium applicable to expired portion of policies insured, or
that part earned under an insurance policy; includes the short-rate premium
on cancellation, the entire premium on the amount of loss paid under some
policies, and the entire premium on the contract on the expiration of the
policy; that portion of the insurance premium calculated on a monthly,
quarterly or annual basis which is to be retained by the insurer should the
policy be canceled; when a premium is paid in advance for a certain time,
the company is said to “earn” the premium as the time advances, for
example, a policy written for three years and paid for in advance would be
one-third “earned” at the end of the first year.
Excess Insurance Refers to insurance that provides protection for losses greater than a
(Excess Program) specified amount.
Expected Loss Costs The loss costs at the mean confidence level; those losses associated with
the arithmetic mean; the expected value of the probability distribution of
the amount of loss which may occur during one defined period; normal loss.
Expected Loss The predicted pattern of amounts paid in the full or partial settlement of
Development claims.
Expense Ratio The ratio of expenses incurred expressed as a percentage of written
(Operating Ratio) premium; the portion of premium used to pay all the cost of acquiring,
writing and servicing a policy of insurance.
Experience The loss record of an insured or of a class of coverage; classified statistics of
events connected with insurance; the out-go or income, actual or estimated
of what happened in the past; figures may be compiled on accident year
basis, calendar year basis or policy year basis; for underwriting purposes,
the comparison of earned premium to incurred losses; the statistics related
to the events connected with the assumption of risk.
Experience The ratio of actual losses to the expected losses of an insured expressed.
Modification Factor
(EMF)
Experience Period The period of time to which historical data used for actuarial analysis
pertain.
Experience Rating An individual risk rating method in which the prospective premium is based
(Loss Rating) on the actual loss experience of an inured.
Exposure Quantity used to measure relative level of risk; unit of loss potential; risk;
chance of loss; healthcare professional liability is typically measured in
number of occupied beds, outpatient visits, etc.
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Term Definition
Exposure Rating A system for premium development and risk classification where filed rates,
(Manual Rating, Tariff rules and classifications are applied against premium exposures, as
Rating) determined by the manuals of insurance developed independently by
insurance companies or by independent rating organizations, such as the
Insurance Services Office, Inc. (ISO).
Exposure Year Earned The projection of written premium to ultimate.
Premium
Filings Formal documents submitted to state regulatory agencies by insurance
(Rate Filing, Rule companies and rating organizations containing rates, rate-making factors,
Filing, Forms Filing) loss development factors, and the rules for applying such rates and factors.
Frequency The number of claims (or occurrences) per exposure unit; sometimes
incorrectly used to refer to the number of claims or occurrences; a relative,
not an absolute, measure.
Full-Value Reserve An undiscounted provision for the payment of outstanding losses and loss
adjustment expenses in the anticipation of future settlement.
Generally Accepted A method of reporting the financial results of an insurer more in accordance
Accounting Principles with the going-concern basis used by other businesses; assigns income and
(GAAP) disbursements to their proper period, as distinguished from the more
conservative requirements of statutory accounting affecting insurers.
Gross Line The total limit of liability accepted by insurer on an individual risk.
Gross Net Premium An insurance company’s total gross premium before the deduction of any
commissions or costs, but after the deduction of reinsurance costs.
Gross Premium The written premium before deducting any premium paid for reinsurance
and in some cases before paying any return premiums.
Ground-Up Loss The total amount of loss sustained before deductions are applied for
reinsurance and before the application of a deductible.
Guaranteed Cost Premium charged on a prospective basis which may be fixed or adjustable
on a specified rating basis but never on a basis of loss experience.
Homogeneity The concept of subdividing or combining statistical data related to loss
exposures into groups exhibiting similar characteristics in order to improve
rate-making accuracy.
Increased Limits Factor The ratio applied to loss costs at a given per occurrence limit.
(ILF)
Incurred But Not The loss reserve value established in recognition of the total liability for
Reported future payments on losses which have occurred but have not yet been
(IBNR) reported to the insurance company; expected future development on claims
already reported; for claims made coverage, the term IBNR represents the
liability for unpaid claims that have been incurred and reported ,but not fully
developed.
Incurred Expense A cost of administering insurance which has happened, whether or not paid.
Incurred Loss An amount representing the losses paid plus the change in outstanding loss
reserves within a given period of time; losses which have happened and
which will result in a claim under the terms of an insurance policy or a self-
insurance mechanism; case incurred loss includes payments and reserves
for individual claims, it does not include IBNR.
Incurred Loss Ratio The ratio of losses incurred to premiums earned.
Indemnify To pay for loss suffered.
Indexing A procedure which adjusts rating factors in accordance with the fluctuations
of a published economic index such as wage, price, cost-of-living, etc.
Inflation Factor A loading to provide for increased expense costs and loss payments in the
future due to inflation.
In-Force Exposure Exposure units exposed to loss at a given point in time.
Insurance The transfer of risk from one party to another party, in which the insurer
promises to pay the insured an amount of money for economic losses
sustained from an unexpected event, during a period of time for which the
insured makes a premium payment to the insurer.
Insured The party protected by an insurance policy.
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Term Definition
Insurer The insurance company, or other organization providing insurance coverage.
Investment Income Money earned from invested assets; may include realized capital gains, or
be reduced by capital losses, over the same period.
Kenney Rule The ratio of an insurer’s net premium writings to its policyholder surplus
which is considered safe; for multiple line companies, the ratio is 3:1.
Law of Large Numbers A mathematical concept which postulates that the more times an event is
repeated the more predictable the outcome becomes.
Layer Rating The prediction of loss frequency and severity within a given layer.
Liability An obligation imposed by law or equity; money owed or expected to be
owed.
Liability Insurance Protection which pays sums that an insured is legally obligated to pay, or
that the insurer has agreed to pay, as damages to others as a result of the
insured’s negligence.
Loading An amount added to the pure risk rate applicable to a class of risk, either to
(Risk Loading) compensate the insurer for additional hazard present with an individual risk,
for the insurer’s expense, or for both.
Lognormal Distribution Probability distribution that is used as a model for claim size distribution; it
is positively skewed and has a range from zero to infinity.
Long-Tail Liability A term used to describe certain types of third-party liability exposures
where the incidence of loss and the determination of damages are
frequently subject to delays which extend beyond the term the insurance or
reinsurance was inforce; malpractice, products liability, errors and
omissions.
Loss The amount the insurer is required to pay because of a happening against
which it has insured; a happening that causes the company to pay; the
overall financial result of some operation, as opposed to profit; the amount
suffered by a person or property, with or without insurance.
Loss Adjustment Allocated - expenses incurred by the insurance company to investigate,
Expense defend and settle claims under its policies and which it specifically allocates
(LAE, Allocated Loss to claim; directly identifiable expenses distinct to a particular claim;
Adjustment Expense, Unallocated - includes the insurer’s overhead expenses and other costs of
ALAE, Unallocated Loss doing business such as payments to salaried employees ; cannot be
Adjustment Expense, specifically designated to a particular claim.
ULAE)
Loss Cost (a.k.a. Pure The portion of the premium rate that is applicable solely to loss, without
Premium) provision for company expenses or profits.
Loss Development The difference, on successive valuation dates, between observed values of
(Development, Loss paid and reserved amounts on known and reported claims.--- The difference
Lag) between the estimated amount of loss initially reported and the amount of
an evaluation of the same loss at a later date or the amount paid in final
settlement..--- The uncertainty arising out of changes over time in patterns
of emergence, development, reopening, settlement and payment of claims.
Loss Development These factors are derived by mathematical analysis, are derived from line of
Factors business loss triangles, and measure the development of losses from initial
(LDF) reporting and reserving to final closure or settlement; used to adjust
reported losses for IBNR and future development of known cases to produce
an estimate of total or ultimate loss and ALAE; tool used by underwriters to
set risk premium requirements.
Loss Distribution Scale Scales that suggest distribution of ground-up premium throughout the
layers in a risk.
Loss Event The total loss to the insurance company resulting from a single cause.
(Occurrence)
Loss Multiplier Used in retrospective reinsurance rating plans to convert losses to premium
and provide for loss adjustment expense, overhead and profit margin,
subject to established maximums and minimums.
Loss Ratio Proportionate relationship of incurred losses to earned premiums expressed
as a percentage.
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Term Definition
Loss Reserve An estimate of the amount of outstanding loss remaining to be paid for the
reported claim; estimated expected payments for reported and unreported
claims.
Loss Trend Factor Project known or developed ultimate losses to future cost levels for a future
coverage period; primarily applied in lines of business that are adversely
affected by inflation, e.g. Automobile and General Liability.
Losses Amounts paid or payable to claimants under the terms of insurance policies.
Malpractice Improper actions or failure to exercise proper skill by a professional.
Manual Documents which contain rules and other information regarding
underwriting rules, rates, tables for return premiums, deductibles, relativity
tables, minimum premiums, etc.
Manual Excess The premium for excess amounts of insurance, as determined by tables of
factors for increased limits of liability, set forth in the manuals used by
insurance companies; a logical basis for rating.
Manual Rate A charge for a unit of insurance set forth in a manual.
Merit Rating A system of rating in which the experience of the individual risk is a factor in
determining the rate.
Minimum Premium The lowest flat or earned policy charge for which a policy will be issued or
for which coverage will be provided..
Modified Expected Refers to expected loss costs, modified for the insured’s own loss
Losses experience.
Negligence The failure to exercise the care that an ordinary prudent person would
exercise.
Net Premium The gross premium less any return premium less commission.
Occurrence An incident, event or happening; in casualty insurance this term may be
defined as continual, gradual or repeated exposure to an adverse condition
that is neither intended nor expected to result in injury or damage, as
contrasted with an accident or sudden happening; in property contracts;
occurrence is usually defined as all losses within a specified period of time
involving a particular peril; general liability policies insure liability for bodily
injury or property damage that is caused by an occurrence.
Occurrence Basis Traditional method of insurance coverage whereby coverage is provided for
(Occurrence Form) losses from claims which occurred during the policy period, regardless of
when the claims are reported.
Operating Income The sum of the new investment income and net underwriting income in any
(Operating Profit) reporting period.
Overhead Fixed charges which do not vary with the amount of business done.
Paid Loss The amount of money paid on covered claims to claimants, through a
particular point in time.
Paid Loss The sum of losses for which money has been disbursed as opposed to losses
incurred, which includes losses outstanding but still unpaid.
Payback Period The period of time required for the premium to equal a single total loss, for
(Payback, Amortization the underwriter to be made whole; a term used in the rating of per-
Period) occurrence excess covers and represents the number of years at a given
premium level necessary to accumulate total premiums equal to the
indemnity; a measure of how frequently a loss might occur under the
contract.
Per Occurrence The specified maximum dollar amount that will be paid on any one event.
Retention
Permissible Loss Ratio Expected loss ratio; underwriting loss ratio; incurred losses plus loss
adjustment costs, all divided by earned premiums, which an insurer expects
to achieve for a given line of insurance for a specified period if the expected
loss ratio is achieved, and if the insurer’s operating expenses do not exceed
normal levels, the insurer earns it expected underwriting profit.
Poisson Distribution Discrete distribution employed to analyze the incidence of claims.
Policy Period The period between a policy’s anniversary dates.
Policy Year Refers to all claims and premiums that stem from a set of insurance policies
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Term Definition
issued over a 12 month period; based upon the year in which the policy
giving rise to exposures, premiums, claims and losses is effective.
Policy Year Experience Experience on business commencing with the effective date of the policy
irrespective of when the transactions took place; determines which losses
will be included in the calculation of an adjustable premium feature.
Portfolio A defined body of insurance policies inforce; outstanding losses; company
investments.
Preferred Risk The subject matter of an insurance policy considered to be particularly
desirable.
Premium Payment required for insurance; application of the rate(s) to the individual
exposures to be covered by an insurance policy.
Premium Capacity Refers to the aggregate premium volume an insurer can write.
Profit And Provisions made for expenses and profit.
Contingencies
Prospective Rating Plan The formula in an insurance contract for determining premium for a
specified period on the basis, in whole or in part, of the loss experience of a
prior period.
Pure Premium The portion of the premium that is allocated to enable the insurance
company to pay losses, but in which no loading has been added for
commission, taxes or other expenses; average loss per unit of exposure;
the product of frequency per unit of exposure and severity; the average loss
per unit of exposure.
Rate The price per unit of insurance.
Rate-Making The process of establishing rates used in insurance or other risk transfer
mechanisms
Rating Plan The structure of the various elements involved in the manual rating of a
specific risk.
Relativity Factors Factors used to develop the experience of a class of exposures relative to
the base risk class; for example, a relativity factor of 5.0 for a given class of
risk would indicate that class expected losses to be 5 times the expected
losses of the base risk class, 1.0.
Report Date The date the insurer receives notice of the claim.
Reported Loss The total paid and outstanding loss for known claims; case incurred loss.
Reporting Lag The period between the loss occurrence date and the date the loss was
reported.
Reserve A liability; an estimate of the amount an insurer expects to pay for reported
(Outstanding Loss) and estimated claims.
Retroactive Date The earliest date for which coverage is afforded under a claims-made form.
Retrospective Rating A plan or method that provides for the adjustment of final premium on the
basis of the actual loss experience under the insurance contract, subject to
minimum and maximum limits; the final adjusted insurance premium is
usually equal to the losses multiplied by a loss conversion factor.
Retrospective Rating A plan under which the premium is determined after the policy has expired
based on contractual factors, chiefly the loss experience of the insured
during the policy term.
Risk The uncertainty of loss; the tangible or intangible things, persons, entities,
items, subject to a potential loss; the subject matter of insurance policies.
Risk Classification The process of systematically arranging risks into groups or categories
(Class Plan, according similar characteristics; the purpose is to create bases for
Classification) establishing statistical experience and determining rates, and to avoid unfair
discrimination; each risk should bear its fair share of the overall cost of
expenses and losses in relation to its own relevant expenses and hazard; it
is unfair discrimination to charge different rates for similar risks, and it is
equally wrong to treat risks the same which have different costs and
expenses.
Risk Margin Provides for the risk of adverse deviation from expected losses; an amount
to provide for the uncertainty in a reserve estimate.
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Term Definition
Risk-Based Capital The theoretical amount of capital that is needed to absorb the risks of
operating a business with financial obligations to customers; the amount
necessary to ensure that the business has an acceptably low expectation of
becoming financially insolvent.
Schedule Rating An individual risk rating system that adjusts the manual or experience-
modified premium of an insured and recognizes risk characteristics that are
expected to have a material effect on the insured’s experience but that are
not actually reflected in that experience; the application of schedule credits
and debits require considerable underwriting judgment, based on objective
criteria which will result in more consistent treatment of the risk than a
rating system that relies on subjective evaluation.
Selection The process of accepting and rejecting risks in the attempt to produce a
profit in underwriting.
Self-Insurance The process of setting aside funds by an individual or organization to pay for
losses for which no commercial insurance is provided; the retention of
sufficient exposure units by an entity to permit the operation of the law of
large numbers.
Self-Insured Retention The risk of loss up to a specified retention that is assumed by the insured
(SIR) for which no commercial insurance coverage is provided.
Self-Insurer An individual, partnership or corporation who retains all or part of the risk
for its own account.
Settlement Lag The period between the date a loss is reported and the date the claim is
paid.
Severity Average loss per claim; can be expressed on a pure loss basis, excluding all
loss adjustment expenses, or can include allocated or total loss adjustment
expenses.
Statutory Accounting Those principles required by state law which must be followed by insurance
Principles (SAP) companies in submitting their financial statements to state insurance
departments; expenses must be recorded immediately and cannot be
deferred to track with premiums as they are eared and taken into revenue.
Surplus The remainder after a company’s liabilities are deducted from its assets.
Tail Exposure Refers to the liability for claims incurred before, but reported after,
cancellation or expiration of claims-made coverage.
Tail Liability Coverage Provides coverage for claims incurred before, but reported after,
cancellation or expiration of a claims made policy.
Tariff Rate The insurance rate established by the rating organization having jurisdiction
over the class and territory.
Term The length of time for which a policy of insurance is written.
Trend Prospective changes in claim costs, claim frequencies, exposures, expenses
and premiums; changes over time in the valuation variables as they affect
obligations.
Trend Factors Used to adjust the past loss experience to cost levels that will be expected
during the projected period; includes the effect of inflation and other factors
that may affect loss frequency ( the number of claims per exposure) or
severity (the average size of a claim); consideration that is given to past
and prospective change in claims cost
Trending The necessary adjustment of historical premium and loss statistics to
present levels or expected future levels; used to reflect measurable changes
in insurance experience over time caused by dynamic economic and
demographic forces; make the data useful for determining current and
future expected cost levels.
Trust Fund Legal vehicle established by the entity to allow for the systematic payment
of claims and related expenses associated with a self-insurance
mechanism..
Ultimate Incurred Final value of losses incurred by the insurance company as of the evaluation
Losses date.
Ultimate Losses Total claims payments at final settlement of all claims; prior to final
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Term Definition
settlement, estimates of ultimate losses include reported losses and IBNR
reserves.
Ultimate Net Loss The total sum which the insurance company becomes obligated to pay either
through adjudication or compromise, for litigation, settlement, adjustment
and investigation of claims and suits which are paid as a consequence of the
insured loss, excluding only the salaries of the company’s permanent
employees.
Unallocated Loss An insurer’s overhead expenses and other costs of doing business such as
Adjustment Expenses payments to salaried employees ; costs that cannot be specifically
(ULAE) designated to a particular claim.
Underwriting Expenses All expenses incurred in the underwriting of a piece of business; does not
include losses, loss adjustment expenses, investment expenses,
policyholder dividends, or income taxes.
Underwriting Profit Premiums less losses, loss adjustment expenses, underwriting expenses and
policyholders dividends.
Unreported Losses Losses that have not yet been identified by the insurer.
Written Exposures Units of exposures on policies written during the policy period in question.

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