Professional indemnity and public liability insurance jargon buster

Please note: Explanations to the terms on this page are intended for information only. For definitions relating to a specific insurance product please refer to the relevant policy wording.

Click on a letter below and choose the professional indemnity or public liability insurance term that you would like explained:

 
AFCA – Australian Financial Complaints Authority

The Australian Financial Complaints Authority or AFCA is an external dispute resolution scheme for consumers who are unable to resolve complaints with member financial services organisations. back to the top

Aggregation of claims

This refers to a clause that combines two or more interrelated claims covered by the policy, to enable them to be treated as a single loss for the purposes of applying the policy Limit of Liability and deductible or excess. Typically an aggregation clause would provide that all claims arising out of, based upon or attributable to a single act, error or omission or series of acts, errors or omissions attributable to the one source or original cause will be considered a single claim and only one excess or deductible and one Limit of Liability will be applied.

Note: Not all professional indemnity policies include this clause.  back to the top

Automatic reinstatement (also known as Increased aggregate limit of indemnity)

Unless otherwise specified in the policy the Limit of Indemnity (see definition) of a policy represents the maximum amount that can be paid in any one policy period.

AUZi and W. R. Berkley Insurance Australia include a clause known as an Automatic Reinstatement Clause which allows the Limit of Indemnity to be ‘reinstated’ for new or unrelated claims, should the original sum be depleted by a claim or series of claims that equals the Limit of Indemnity.

However, no one claim payment by the insurer will exceed the policy Limit of Indemnity.

For example, if the Insured purchases a policy with a $1,000,000 limit of indemnity, and the policy contains one automatic reinstatement the policy provides cover for claims aggregating up to $2,000,000 during the period of insurance, subject to any one claim being no greater than $1,000,000.

Note: Our policy offers an Automatic reinstatement as a standard feature, however, some professional indemnity policies only provide this on an optional basis. Please check the quote or policy wording to ascertain whether the policy contains an Automatic reinstatement clause and the number of reinstatements provided. back to the top

Average provision

This refers to professional indemnity policies which provide a Costs Exclusive Limit of Indemnity (see definition). Where the total amount of a claim (including the claimant’s costs and expenses incurred in bringing the claim) exceeds the Limit of Indemnity, then the Insured costs (see definition) covered under the policy will be calculated on the basis of the proportion which the Limit of Indemnity bears to the total amount of the claim.

For example:
In a situation where the insured has a professional indemnity policy with a Limit of Indemnity of $2,000,000 and a claim is made for $4,000,000 including claimant’s costs and expenses with Insured Costs of $600,000 the amount payable by the insurer under an Average provision clause would be as follows:
1. $2,000,000 in respect of the claim including claimant’s costs and expenses; and
2. 50% of the Insured costs of $600,000, being $300,000 as the $1,000,000 Limit of Indemnity represents 50% of the total cost of the claim.

This leaves an uninsured amount of $1,300,000

Note: If the Professional Indemnity policy provides a Costs inclusive limit of indemnity (see definition), then the uninsured amount would be $1,600,000. back to the top