Insurance Claim Glossary | Searchable A to Z Terms

Search the glossary

A C D E H L M N O P R S U W X

Actual cash value (ACV): Replacement cost minus depreciation. Many policies pay ACV first and the balance after repairs are completed.
Additional living expense (ALE): The extra cost of living elsewhere while a covered loss makes your home unlivable. It usually falls under Coverage D, loss of use.
Adobe: Sun-dried earthen block used in traditional New Mexico walls. Water and fire damage to adobe calls for specialized repair methods and pricing.
Amount of loss: The dollar value of the covered damage. It is the question an appraisal panel decides.
Appraisal award: The written decision signed by two of the three panel members that sets the amount of loss, ideally split into RCV, depreciation and ACV.
Appraisal demand: A written notice from you or the insurer invoking the policy’s appraisal clause because the parties disagree on the amount of loss.
Canale: A projecting channel or spout that drains water off a flat roof through a parapet wall. Hail and wind can crack or loosen canales.
Competent and disinterested appraiser: The standard most appraisal clauses set: someone qualified to value the loss who has no financial stake in the outcome.
Coverage A (dwelling): The part of a homeowners policy that covers the house itself and attached structures.
Coverage B (other structures): Coverage for detached structures such as garages, coyote fences, sheds and walls.
Coverage C (personal property): Coverage for your belongings, often called contents, subject to sublimits for certain categories.
Coverage D (loss of use): Coverage for additional living expense or lost rental income while the property can’t be used after a covered loss.
Debris removal: Coverage for hauling away damaged property and wreckage. After a wildfire it can be a major expense and may have its own limit.
Declarations page: The summary page of your policy showing limits, deductibles, the policy period and attached endorsements.
Depreciation: The reduction in value for age, wear and condition that separates replacement cost from actual cash value.
Elastomeric roof coating: A flexible liquid-applied coating used on many flat roofs. Hail can fracture or puncture it, exposing the membrane below.
Endorsement: A form that adds to, removes or changes coverage in the base policy.
Evaporative cooler: A rooftop or ground-mounted swamp cooler common across New Mexico. Hail dents cabinets, and the roof jack and curb can leak.
Holdback: The recoverable depreciation an insurer withholds until repairs or replacement are completed.
Line item: A single priced entry in an estimate, such as a square of membrane or a linear foot of parapet cap.
Matching: The question of whether undamaged materials must be replaced so repairs look uniform. Policy wording and New Mexico law both matter.
Microburst: A sudden, intense downdraft that produces damaging straight-line winds, often during monsoon storms.
Mitigation: Reasonable steps to prevent further damage after a loss, such as tarping a roof or drying out a wet room. Most policies require it.
Modified bitumen: An asphalt-based roll roofing membrane widely used on flat and low-slope roofs.
Monsoon: The summer storm season in New Mexico, roughly July through September, bringing hail, heavy rain, flash flooding and strong winds.
New Mexico Property Insurance Program: The state’s FAIR plan, a market of last resort for property owners who can’t buy coverage in the regular market.
Office of Superintendent of Insurance (OSI): New Mexico’s insurance regulator. It licenses insurers and adjusters and takes consumer complaints.
Ordinance or law coverage: Coverage for added costs to bring repaired or rebuilt property up to current building codes, often subject to a percentage limit.
Overhead and profit (O&P): The general contractor’s overhead and profit, commonly 10 percent each, often disputed when several trades are involved.
Parapet: The low wall extending above a flat roof, typical of Pueblo Revival and Territorial buildings. Its caps and flashing are frequent claim items.
Percentage deductible: A deductible figured as a percentage of the dwelling limit rather than a flat dollar amount, often applied to wind or hail.
Pitch: The slope of a roof, expressed as rise over 12 inches of run. Pitch affects area, labor and safety charges.
Proof of loss: A sworn statement of the amount claimed, which some policies require within a stated time after the insurer requests it.
Recoverable depreciation: Depreciation the insurer will pay once you complete repairs or replacement, under a replacement cost policy.
Replacement cost value (RCV): The cost to repair or replace damaged property with materials of like kind and quality, without deduction for depreciation.
Reservation of rights: A letter in which the insurer handles a claim while reserving the right to deny coverage later.
Scope of loss: The list of damaged items and the repairs needed, before pricing. Many disputes are really scope disputes.
Smoke damage: Soot, odor and residue damage from fire. Wildfire smoke can affect a home that never burned, including HVAC systems and contents.
Square (roofing): A unit of roof area equal to 100 square feet.
Stucco: A cement or synthetic exterior plaster finish common across New Mexico. Hail can fracture it, and matching texture and color is often disputed.
Sublimit: A lower limit inside a coverage for a specific category, such as jewelry, mold or debris removal.
Suit limitation: A policy provision that limits how long you have to sue the insurer. Check your policy and ask an attorney how New Mexico law treats it.
Umpire: The neutral third member of an appraisal panel who decides items the two appraisers can’t agree on.
Waste factor: An added percentage of material to cover cutting, overlap and fitting, especially on hip roofs and irregular layouts.
Xactimate: Estimating software used by most insurers and many contractors to price repairs line by line with regional pricing.

Insurance Claim Terms from A to Z