Understanding the basics of insurance is crucial when purchasing coverage in Brazil. With so many terms unique to the insurance field, it’s easy to feel lost when reviewing a policy. Here’s a comprehensive guide to 30 important insurance terms you should know, explained in detail to guide you in getting the best from your insurance.
1. Apólice de Seguro
The apólice de seguro is the official contract between the seguradora (the company providing the coverage) and the segurado (the person or entity being insured). It outlines all the terms and conditions of the insurance coverage, including the scope, limitations, and specific protections under the policy. Each policy type—health, auto, home, or life insurance—will have its unique stipulations.
2. Segurado
The segurado is the individual or entity who receives protection under the insurance policy. It is the person who pays the premiums and claims the insurance benefits in case of an event outlined in the contract.
3. Seguradora
The seguradora is the insurance company that issues the apólice de seguro and provides financial coverage for specific losses incurred by the segurado. The seguradora determines the premiums, coverage, and payouts based on the risk level of the segurado.
4. Prêmio
The prêmio is the cost that the segurado pays, usually on a monthly, quarterly, or annual basis, to maintain the coverage. It’s essentially the price of the insurance policy, determined by factors like risk, coverage level, and policy term. Failure to pay the prêmio can lead to policy cancellation.
5. Sinistro
A sinistro refers to an event or accident that causes a loss covered by the insurance policy, such as an auto accident, illness, property damage, or theft. In the event of a sinistro, the segurado can file a claim to seek compensation.
6. Franquia
Franquia is the portion of the claim that the segurado must pay out-of-pocket before the seguradora covers the rest. The franquia amount varies based on the policy and acts as a risk-sharing mechanism that discourages minor claims.
7. Cobertura
Cobertura defines the range of risks and incidents that the insurance policy will cover. Different policies offer different types of cobertura, including comprehensive, partial, or liability-only, depending on the segurado’s needs and budget.
8. Carência
Carência is the waiting period during which the segurado is not eligible to make claims for certain types of coverage. This period helps the seguradora manage its risk, especially in health and life insurance policies, where the segurado might file a claim soon after purchasing the policy.
9. Indenização
Indenização is the compensation paid by the seguradora to the segurado or beneficiary in case of a covered loss. It’s the amount payable under the policy terms after verifying the validity of the sinistro.
10. Beneficiário
The beneficiário is the person or entity designated by the segurado to receive the indenização if the segurado dies or is otherwise unable to claim the benefits. This is most common in life insurance policies.
11. Capital Segurado
Capital segurado is the maximum payout amount that the seguradora agrees to provide in the event of a claim. It’s a predefined amount agreed upon at the start of the policy, often varying depending on the coverage type and premium amount.
12. Proposta de Seguro
A proposta de seguro is the formal application submitted to the seguradora, requesting insurance coverage. This proposal includes details of the segurado and the type of coverage desired, serving as the first step in the policy issuance process.
13. Endosso
An endosso is an amendment made to the insurance policy after it’s been issued. This can be used to change aspects like the segurado’s address, coverage limits, or adding/removing coverage.
14. Vigência
Vigência is the term or duration for which the insurance policy is active and valid. Most policies have a fixed vigência, after which they must be renewed to maintain coverage.
15. Rescisão
Rescisão is the termination or cancellation of an insurance policy. Either the segurado or the seguradora can rescind a policy, often due to non-payment of the prêmio or a violation of policy terms.
16. Prêmio Único
A prêmio único is a one-time payment made to the seguradora to secure coverage for the entire term. This is common in specific life insurance or investment-linked policies, where the segurado pays a lump sum instead of periodic installments.
17. Prêmio Periódico
Prêmio periódico is a regular payment—typically monthly, quarterly, or annually—that the segurado pays to maintain active coverage. It’s the most common payment structure for insurance policies.
18. Cobertura Compreensiva
Cobertura compreensiva is a type of extensive coverage that includes multiple risks, such as damage from natural disasters, theft, and accidents. It’s ideal for those seeking broader protection, especially for auto and property insurance.
19. Riscos Excluídos
Riscos excluídos are specific risks or situations explicitly not covered by the insurance policy. Each policy lists excluded risks, which could include acts of war, intentional harm, or specific high-risk activities.
20. Cálculo Atuarial
Cálculo atuarial is a statistical method used by the seguradora to calculate the prêmio based on various risk factors. Actuaries analyze data to estimate the likelihood of claims, helping to set appropriate premiums for different segurados.
21. Cessão
Cessão is the transfer of rights or ownership of the insurance policy from the original segurado to another party. This can happen in cases of inheritance, business transfer, or asset sale.
22. Cláusula
A cláusula is a specific provision in the insurance policy that defines a condition or term of coverage. Each policy has multiple cláusulas outlining terms such as coverage limits, exclusions, and the procedure for filing claims.
23. Bônus
Bônus is a reward given to the segurado for not filing any claims within a policy term. It often results in a reduction of future prémios and is a common feature in auto insurance.
24. Proporcionalidade
Proporcionalidade is a principle where the indemnity is proportional to the insured amount relative to the total value of the insured asset. It ensures that segurados only receive payouts that correspond to their actual coverage.
25. Seguro de Responsabilidade Civil
Seguro de responsabilidade civil covers the segurado’s liability for damages caused to third parties, such as bodily injuries or property damage. It’s mandatory for certain professions and advisable for business owners and drivers.
26. Perda Total
Perda total occurs when the insured item is considered a total loss, meaning that the cost of repair would exceed a significant percentage (often 75-100%) of its insured value. This is common in auto insurance for heavily damaged vehicles.
27. Renovação
Renovação is the process of extending the vigência of an insurance policy. Upon expiration, the segurado can choose to renew the policy for continued coverage.
28. Regulação de Sinistros
Regulação de sinistros is the process by which the seguradora assesses, validates, and settles claims filed by the segurado. The insurer examines the sinistro details and processes compensation if the claim is valid.
29. Multa
Multa is a penalty imposed by the seguradora if the segurado violates any policy terms or delays payment. Multas vary based on the infraction type and are designed to discourage policy breaches.
30. Valor de Mercado
Valor de mercado refers to the current market value of the insured asset, used to determine the compensation amount in case of a claim. For example, in auto insurance, the valor de mercado of the vehicle may be calculated to decide the payout for a total loss.
Conclusion
Knowing these terms is essential for anyone considering insurance in Brazil. Familiarity with these concepts will empower you to navigate policy documents, understand your rights and obligations, and make the best insurance decisions for yourself, your family, or your business.
