Company complaints type of coverage descriptions

Type of Coverage is divided into seven categories.  The categories are Auto, Fire, Allied Lines & Commercial, Homeowners, Life & Annuity, Accident & Health, Liability, and Miscellaneous.  All of the major categories except the “Miscellaneous” category have subcategories that describe a more specific area of coverage within the primary category. The subcategories are divided into two categories:

Type of coverage categories


Updated 02/2011

Auto subcategories

First level

Individual Private Passenger: Personal automobile coverage for liability, physical damage, and other exposures for automobiles owned or leased by individuals or families.

Commercial: Provides coverage for liability, physical damage, and other exposures for automobiles owned or leased by businesses, partnerships, or organizations.

Motorcycle: Individual coverage for any two-wheel automotive vehicle having one or more saddles and sometimes a sidecar with a third supporting wheel.

Motorhome / Recreational Vehicles: Individual coverage for an automotive vehicle built on a truck or bus chassis and equipped as a self-contained traveling home.

Rental: Automobile insurance coverage for rented vehicles.  

Other: All other automobile coverage.

Secondary level

Liability: Policyholder's legal liability resulting from injuries to other persons or damage to their property.

Physical Damage: Provides coverage to vehicles owned, leased, or operated by a covered person due to collision or under comprehensive coverage and non-collision hazards, such as fire, theft, or falling objects.

Collision: Insurance coverage available to provide protection against physical contact of an automobile with another inanimate object resulting in damage to the insured’s’ car.

Comprehensive: Automobile insurance providing protection in case of physical damage suffered by the insured’s car, other than collision or theft.  Example: Fire, Flood.

Medical Payments: Coverage, available in various liability insurance policies, in which the insurer agrees to reimburse the insured and others, without regard to the insured's liability, for medical or funeral expenses as the result of bodily injury or death by accident under specified conditions.

Uninsured Motorists and/or Underinsured Motorists

No-Fault / Personal Injury Protection (PIP)

Personal Effects Coverage (PEC): Coverage that protects personal effects of the renter while in the rental car.

Policy Proof of Interest (PPI): Insurance covering peculiar conditions of risk concerning anticipated freight.  Example: If a company goes to pick up freight which end up being destroyed by some hazard; they suffer losses such as shipping fees.

Rental Reimbursement: An automobile coverage that pays the cost of a vehicle rental during a period the insured vehicle requires covered repair.

Surplus Lines: Coverage obtained in an unlicensed insurance company because of its unavailability in the licensed market.

Towing: An endorsement to an automobile policy that pays specified amounts for towing and related labor cost.

Other: Other secondary level coverage types not clearly fitting into any specific category in the secondary level.

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Fire, allied lines and commercial subcategories

First level

Fire, Allied Lines: Insurance covering the peril of fire damage to property, as well as extended coverage, which includes perils other than fire, such as windstorm, hail, explosion, riot, etc. along with resultant damage caused by smoke and water.  Allied lines provide further coverage against perils such as sprinkler leakage, rain and non-fire-related water damage and earthquake.

Crop / Hail: Growing crops are subject to numerous perils--bad weather, hail, fire, flood, insects, and disease.  Policies may cover one or more of these perils reducing proportionally as harvesting progresses and terminates when the harvest is complete.

Commercial MP (Multi-peril coverage): Commercial package policies which include liability, fire and allied lines coverage.

Credit Property: Insurance against loss of or damage to personal property, covering a creditor's security interest in the property, when the insurance is written as part of a loan or other credit transaction.  Can include GAP insurance as it relates to the difference between loss payments and loan indebtedness.

Dwelling Fire: Covers buildings and the personal property inside.  Designed to insure one- to four-family dwellings, whether owner-occupied or tenant-occupied, and can be used to insure mobile homes.  Policies do not include theft, liability, or medical payments coverage.

Builder’s Risk: A property insurance policy that provides direct damage coverage on buildings or structures while they are under construction.  It also covers foundations, fixtures, machinery, and equipment used to service the building, and materials and supplies used in the course of construction.

Other: Lines of property and casualty insurance that do not clearly fit in any other category in this level.

Secondary level

Liability: The portion of insurance that covers the insured for negligence against another person or another person's property.

Theft: Covers theft of the insured's property.

Windstorm : Covers Windstorms including; hurricanes, cyclones, and high wind; perils not normally covered under standard policies.

Fire - Real Property: Coverage of insured's real estate property against the peril of fire.

Personal Property: Property that is not attached to real property.  Property other than real estate, or property that is movable or separable from real estate; for property insurance purposes, tangible property, which is often called "contents.”  Personal property may be used for business purposes and therefore may be covered by a commercial policy, while personal property not used for business purposes is generally covered only by personal lines policies (such as homeowners or renters' insurance)

Surplus Lines: Coverage obtained in an unlicensed insurance company because of its unavailability in the licensed market.

Other: Other secondary level types that do not fit clearly into any specific category in the secondary level.

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Homeowner subcategories

First level

Homeowners: Coverage for homes, including dwelling coverage.  Protects owners and tenants against losses or damage to their residential property and provides protection against liability claims by others suffering injury or damages while on such property.

Group Homeowners: Homeowners insurance containing a benefit package policy that combines property and liability coverage of property and individuals.  Coverage obtained by a group member/enrollee/certificate-holder through a master contract issued to the association/group in which the individual or family belongs.

Farmowner / Ranchowner: A contract which combines personal and business multiple-line insurance; coverage for the entire farm and ranch operations, may include the dwelling.

Mobile Homeowner: Coverage for mobile homes, which are classified as portable units that are built to be towed on their own chassis with frame and wheels, but are permanently affixed to the real estate, and are designed for year-round living.

Condo/Town: Coverage protecting the insured’s personal property and loss of use.  Coverage may include protection against: fire, lightning, vandalism, malicious mischief, wind, hail, explosion, riot, civil commotion, vehicles, aircraft, smoke, falling objects, weight of ice/sleet/snow, and volcanic eruption.

Renters / Tenants: Coverage for the contents of a renter’s home/apartment and liability.  Tenant policies reflect homeowners insurance, except they do not cover the structure.  Covers inside structure changes such as carpeting, kitchen appliance, and built-in bookshelves.

Other: Does not clearly fit in any other category in this level.

Secondary level

Liability: The portion of insurance that covers the insured for negligence against another person or another person's property.

Theft: Covers theft of the insured's property.

Earthquake: Covers direct damage resulting from earthquake or volcanic eruptions.  Excluded are losses resulting from fire, explosion, flood, or tidal wave.

Flood: Coverage made available to residents of a community on a subsidized and non subsidized premium rate basis once the governing body of the community qualifies that community for coverage.

Fire - Real Property: Coverage of insured's real estate property against the peril of fire.

Single Interest: Insurance protecting the interest of only one of the parties having an insurable interest in certain property, as that protecting a mortgagee but not the mortgagor, or protecting the seller but not the buyer of merchandise.

Medical Payments: Coverage provided under the homeowner’s policy.  The insurance includes medical expenses of persons who sustain bodily injury at an insured's premises without regard to negligence.  Medical expenses include first aid, surgery, x-rays, dental services, prosthetic devices, and transportation by ambulance, and funeral services.

In-Home Business/Incidental Business: Reduces the risk of operating a small service or retail business from home.  Provides comprehensive coverage for business personal property and business general liability exposures.

Personal Property: Property that is not attached to real property.  Property other than real estate, or property that is movable or separable from real estate; for property insurance purposes, tangible property, which is often called "contents."  Personal property may be used for business purposes and therefore may be covered by a commercial policy, while personal property not used for business purposes is generally covered only by personal lines policies (such as homeowners or renters insurance).

Replacement Cost
Sum needed to replace an insured’s damaged or destroyed property with one of a like kind and quality, equivalent to actual cash value, minus physical depreciation (fair wear & tear) and obsolescence. 

Loss of Use: If your home is destroyed by an insured peril or it becomes uninhabitable because of an insured peril your standard homeowners policy provides you coverage for setting up a temporary living situation.  "Loss of Use" will cover any additional expenses caused by you having to move out of your home.

Windstorm: Covers Windstorms including; hurricanes, cyclones, and high wind; perils not normally covered under standard policies.

Surplus Lines: Coverage obtained in an unlicensed insurance company because of its unavailability in the licensed market.

Other: Other secondary level types that do not fit clearly into any specific category in the secondary level.

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Life and annuities subcategories

First level

Individual Life: Insurance covering the life of an individual with the face value usually payable at the death of the insured person.

Group Life: Life insurance coverage obtained by group member/enrollee/certificate-holder through a master contract issued to the association/group to which the individual belongs, usually paying face value benefits upon the death of the covered individual.

Individual Annuities: A policy that pays a benefit at regular intervals for the life of the annuitant or for a specified period usually beginning at retirement.

Group Annuities: Annuities purchased by a group member/enrollee/certificate-holder through a master contract issued to the association/group to which the individual belongs.  These annuities pay a benefit at regular intervals for the life of the annuitant or for a specified period, usually beginning at retirement.

Credit Life: A type of decreasing term insurance usually issued to a creditor to cover the life of a debtor for an outstanding loan.

Accelerated Benefits: Prepayment of a specified percentage of life insurance death benefits prior to death to cover the cost of treatment for life threatening disease or confinement to a nursing home.  Generally used in case of a terminal illness.  Also known as living benefits. 

Other: Does not clearly fit in any other category in this level.

Secondary level

Accidental Death & Dismemberment: A form of accident insurance, which indemnifies or pays a stated benefit to insured or his/her beneficiary in the event of bodily injury or death due to accidental means (other than natural causes).

Association: Pool (Association or Syndicate).  An organization of insurers or reinsurer through life insurance and annuities are written/purchased  with the premiums, losses, and expenses shared in agreed amounts among the insurers belonging to the pool.

Equity Indexed: Equity index futures typically have dividend rates lower than money market returns, and futures prices tend to be higher than spot index values.

Fixed: Guarantees a specific payment amount in the future.

Premium Wavier: An agreement attached to a policy which exempts from coverage certain disabilities or injuries that otherwise would be covered by policy.

Single Premium: A single premium contract is paid at the inception of the policy and the policy becomes fully paid.

Term: Life insurance in effect for a specified limited period if an insured dies within that period the beneficiary receives payment.  If the insured survives the specified limited period, the beneficiary receives nothing.

Universal: Adjustable life insurance, under which premiums flex, protection adjusts, and the insurance company discloses expenses and other charges to the purchaser.

Variable: A policy allowing premium payments to vary within certain limits at the option of the policyholder.

Whole Life: A policy remaining in full force and effect for the life of the insured with premium payments being made for the specified period.  Also known as Ordinary Life.

Other: Other secondary level types that do not fit clearly into any specific category in the secondary level.

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Accident and Health subcategories

First level

Individual: Insurance that is issued to an individual insuring one against sickness or injury.  Includes all Major Medical insurance coverage, which after the limits of coverage have been exhausted under a basic plan, medical expenses relating to room and board, physician fees, miscellaneous expenses such as bandages, operating room expenses, drugs  x-ray, and fluoroscopy are then met under a Major Medical plan. 

Group: Insurance that is issued against sickness or injury where the group is the policyholder and the individual insured is the certificate holder.  Includes all Major Medical insurance coverage, which after the limits of coverage have been exhausted under a basic plan, medical expenses relating to room and board, physician fees, miscellaneous expenses such as bandages, operating room expenses, drugs, x-ray, and fluoroscope are then met under a Major Medical plan. 

Credit Accident & Health: A type of insurance usually issued to a creditor to provide indemnity for payments or debt becoming due on a specific loan or other credit transaction should the debtor become disabled.

Other: Does not clearly fit in any other category in this level. 

Secondary level

Accident Only: Health insurance pertaining to only accident coverage.

Disability Income: Provides benefits in case of the insured's inability to perform all or part of his/her occupational duties because of an accident or illness.

Health Only: Insurance covering sickness only.  This can include an HMO (Health Maintenance Organization), who provides basic health care services to enrollees on a prepaid basis except for enrollees' responsibility for co-payments, deductible, and a PPO (Preferred Providers Organization).

Medicare Supplement (Policies or Certificates): Provides accident and health expenses not covered under Medicare.  The "policy type" identifies which of the standard Medicare supplement policies is involved in the complaint.  The various types of standard policy form choices ("A" through "J") are available for Medicare supplemental insurance coverage.  Choice "P" means those insured before June 1, 1992 and no longer being offered.  Choice "O" means "other" and not meeting any of the choices listed.

Medicare Select (Policies or Certificates): Medicare HMO (Home Maintenance Organization). Operates similar to HMOs and PPOs (Preferred Providers Organization) in arranging services for a covered persons through designated hospitals, and in some cases, physicians.  A covered person then would have expenses above which Medicare would pay covered by the insurer or HMO issuing the Medicare Select contract, so long as that person utilized the designated providers.  This permits Medicare Select to offer lower rates than standard Medicare supplement policies.

Long-Term Care: Designed to provide coverage for not less than twelve consecutive months for necessary medical services provided in a setting other than an acute care unit of a hospital.

Home Health Care: Health care provided in the home of the patient, usually by a private nurse or a state-licensed home health care agency.  Services are usually limited to part-time or intermittent nursing care and physical or occupational rehabilitation.

Mental Health: Coverage for professional mental health services.  Including psychologist, crisis centers, rehabilitative therapy, etc.  An emotional or organic mental impairment (usually excluding senility, retardation or other developmental disabilities, and substance addiction); a psychoneurotic or personality disorder; any psychiatric disease identified in a medical manual. (American Psychiatric Association's Diagnostic and Statistical Manual).

Dental: Includes dental coverage in health plans and Dental Service Plans.  Dental Service Plans are dental services provided at the expense of the plan by participating dentists or other health care personnel, in consideration for periodic payments by members or subscribers.

Limited Benefits: A life insurance policy with limited benefit payments where all benefits has been paid to the beneficiary.

Chiropractic: Covers care provided by a Chiropractor.  Normally, not seen as regular health maintenance but as a term recovery plan.

Hospital Indemnity: Provides a predetermined flat benefit for each day of hospitalization regardless of expenses incurred.

Vision: Health insurance coverage for eye examinations and eyeglass or contact lens prescriptions.

Health Insurance Portability and Accountability Act (HIPAA): Guarantees that employers are not able to impose preexisting condition limitations in the insurance they offer to new employees who had insurance coverage for at least 12 months with their previous employer.

Pre-existing Condition: An illness or disability that existed before the effective date of a health or life insurance policy.  Such a condition can result in cancellation of a policy or exclusion from coverage.

Cancer/Dread Disease: A type of medical expense policy that is designated to cover only those medical expenses incurred by an insured only for specific catastrophic illnesses, such as cancer.

Self Funded / Employee Retirement Income Security Act of 1974 (ERISA)

Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA): In the United States, a statute which requires that employers sponsoring group health plans offer continuation of coverage under the group plan to employees and their dependents who have lost coverage because of the occurrence of a "qualifying event."  Qualifying events include reduction in work hours, many types of termination of employment, death, and divorce.

Health Maintenance Organization (HMO): An organization that provides comprehensive health care services for subscribing members in a particular geographic area.  People enrolled in an HMO pay dues in return for the right to health care services at a lower-than-average cost.

Preferred Provider Organization (PPO): A health benefit plan with contracts between the sponsor and health care providers to treat plan members.  A PPO can be a group of health care providers who contract with an insurer to treat policyholders according to a predetermined fee schedule.  PPO contracts typically provide discounts from standard fees, incentives for plan enrollees to use the contracting providers, and other managed care cost containment methods.

Other: Other secondary level types that do not fit clearly into any specific category in the secondary level.

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Liability subcategories

First level

General: Coverage that pertains, for the most part, to claims arising out of the insured's liability for injuries or damage caused by ownership of property, manufacturing operations, contracting operations, sale or distribution of products, the operation of machinery, and professional services.  Covers all types of liability insurance other than employers, automobile, or product liability.

Products: Covers liability of an insurer due to personal injury, death, emotional harm, consequential economic damage or property damage arising from the use or operation of a product manufactured and/or sold by the insured.

Professional/E&O: Coverage pertaining to claims arising from the insured's liability for injuries or damage caused by acts or errors and omissions (E&O) of the insured while performing duties of his/her profession.

Umbrella: Excess liability coverage above the limits of basic liability insurance policy such as the owners, landlords, and tenants liability policy.  The umbrella policy fills gaps in coverage under basic liability policies.

Directors & Officers: Reimburses for loss because of wrongful acts by directors and/or officers while acting in their respective capacities.  It covers defense costs, charges, and expenses as well as the actual settlements from litigation.

Other: Other types of liability coverage which do not clearly fit in any other category in this level.

Secondary level

Medical Malpractice:

Pollution: Coverage for liability to third parties arising from contamination of air, water, or land due to the sudden and accidental release of hazardous materials from the insured site.  The policy usually covers the costs of cleanup and may include coverage for releases from underground storage tanks.  Intentional acts are specifically excluded.

Surplus Lines: Coverage obtained in an unlicensed insurance company because of its unavailability in the licensed market.

Other: Other secondary level types that do not fit clearly into any specific category in the secondary level.

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Miscellaneous subcategories

First level

Fidelity & Surety:

Ocean Marine: Insurance for sea-going vessels and their cargoes, including liabilities connected with them.  This covers ships or hulls, goods or cargoes, earnings (i.e. passage money, commissions, profit) and liability incurred by the owner or by any party interested in or responsible for insurable property for reasons of maritime perils while in transport.

Inland Marine: A broad form of insurance, generally covering articles in transit as well as bridges, tunnels, and other means of transportation and communication.  Besides goods in transit (generally excepting Trans-ocean), it includes numerous "floater" policies, such as those covering personal effects, personal property, jewelry, furs, fine arts, and other items of value.

Title: Insurance against the loss of the title or against expenses due to a defective title, damage suffered by reasons of liens, encumbrances upon, defects in, or the unmarketability of a title to such real property.  Coverage may extend to heirs in case of death or to the insurers of a corporate owner of property.

In-Home Business/Incidental Business: Reduces the risk of operating a small service or retail business from home.  Provides comprehensive coverage for business personal property and business general liability exposures.

Boiler Machinery: Coverage for loss arising out of the operation of pressure, mechanical and electrical equipment.  It covers loss of the boiler and machinery itself, damages to other property, legal fees, and business interruption losses.  The insurance covers business property, other property involved, and legal fees.

Private Mortgage Insurance (PMI): Insurance written by a private company protecting the mortgage lender against loss occasioned by a mortgage default

Surplus Lines: Coverage obtained in an unlicensed insurance company because of its unavailability in the licensed market.

Watercraft: Coverage for damages resulting from the operation of motor boats too large to qualify for insurance under ordinary homeowners and small business policies.  Coverage exists whether the boats are leased or owned by another party who operates them in the benefit of the business exposing them to liability.  This covers the actual boat, engine, propellers, and permanently attached equipment in and out of water while boating, launching, towing and storing.

Aircraft: Coverage on an all risk basis whether the airplane is on the ground or in the air.  Air Cargo covers legal liability for damage destruction or other loss of a customer’s property while being shipped.

Extended Warranty & Service Contracts: A policy providing repair or replacement service or indemnification for such service for the operational failure of covered property.  Examples: homeowner warranty, electronic devices warranty, etc.

Federal Programs: Programs provided or administered by the federal government including Medicare, Medicaid and the National Flood Insurance Program.

Federal Crop: Protection against natural disasters which may strike crops.  Premiums reflect actual losses incurred by farmers.

Federal Flood: Coverage made available to residents of a community on a subsidized and non subsidized premium rate basis once the governing body of the community qualifies that community for coverage under the National Flood Insurance Act.  Resident includes business and non-business operation with coverage written on structures and their contents. 

Other: Does not clearly fit in any other category in this level.

Secondary level

No secondary level insurance types for this category.

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See also