ch 5 INSURANCE PRODUCTS -PERSONAL LINES Flashcards
What is the minimum level of cover required under the Road Traffic Act 1988
Legal liability for injury to others or damage to property
What are the four different levels of cover available under Private Motor Insurance
- Road traffic Act (RTA) only
- Third Party Only
- Third Party, fire and Theft
- Comprehensive
What is the Road Traffic Act Only
This is the minimum cover required by the Road Traffic Act 1988
What indemnity is provided by the Road Traffic Act
-Provides unlimited
indemnity for bodily injury death to third parties,
-covers up to 1.2 million pounds for loss or damage to third party property
-claimants costs and expenses and emergency medical treatment and hospital charges arising out of the use of the vehicle
Under the terms of the UE third derivative, cars used in the EU countries must provide minimum cover for either
- minimum cover required in the country the vehicle is registered in
- minimum cover required in the country in which it is being used, whichever is the greater
What indemnity does third party only cover provides
- unlimited indemnity for bodily injury or death
- 20 million pounds limit in respect to third party property damage cover
- legal cost to defend a claim
- indemnity for passenger liability
- indemnity to the insured’s employer if the policy covers b’ness use
What led to the introduction of the 20 million pounds third party property damage limit
-the Selby rail crash of 2001
What does the Third Party fire and theft cover indemnity provide
In addition to the third party only indemnity, it covers the cost of repair of compensation to the insured if the vehicle is stolen, damaged during theft or attempted theft and damage by fire,lightning or explosion
What is the Comprehensive motor policy cover
This is the widest possible protection and includes other accidental and malicious damage to the insured vehicle
The comprehensive cover is an all risk, and includes the following exclusions
- wear and tear
- depreciation
- loss of use
- mechanical and electrical failure
- Tyre damage due to punctures or blow out(any resultant damage will be covered )
For comprehensive motor cover what are the extensions, offered without additional premium
- personal accident
- medical expenses
- personal effects
- drive other vehicle extension by the insured only, and is restricted to third party cover only or even RTA cover
What are some of the optional extensions available under an additional premium for Private Motor Insurance
- Breakage of glass(non-comprehensive policy)
- personal belignings and clothing
- legal expenses
- breakdown cover
- caravan and trailers
- extended personal accident benefits
- foreign use beyond the minimum EU cover
- loss of use
What are the general exclusions for Motor cover
- Contractual Liability
- War risks
- use other that as specified
- civil and riot commotion
- Sonic bags
What is motor cover subject to
It is subject to the driver having a licence to drive the vehicle or having had a licence but not renewed yet. Ensure that driver has not been disqualified from holding it
What features are in a private motorcycle insurance not found in the private motor insurance
- there is no cover for theft of accessories /spare parts unless the cycle is also stolen
- some policies don’t provide indemnity to employers
- there is usually no personal accident, medical expenses or pr
What are extensions of cover available for additional premium
- cover for trailers
- riding other cycles extensions
What are the main types of commercial vehicle
- Goods-Carrying Vehicles
- Carriage of Passengers for hire and reward(like taxis)
- passenger-carrying vehicles (buses,coaches and mini buses)
- agriculture and forestry vehicles(tractors)
- special construction vehicles e.g special types, cranes, forklift
What is the commercial insurance concerned with
Insuring against damage to the vehicle and liabilities to others arising out of the use of the vehicle
Does commercial insurance cover damage to goods carried in the vehicle
No, it does not as this cover is already provided by a goods in transit policy. But sometimes its available under motor policies covering small vans issued to tradesman
Commercial Vehicle insurance cover is similar to private motor insurance but excludes
- driving other cars extensions
- personal accidents
- personal effects
what is the rating in commercial vehicle in respect to
It will depend on the use to which the vehicle is placed on like vehicles used for haulage rating will be different for vehicles carrying dangerous substances
Under Commercial Vehicle Insurance third party liability covers
It provides unlimited indemnity for death or bodily injury to third parties, and a limit of 1.2 million and 5.0 million for third party property damage
What other indemnities are provided by commercial vehicle insurance
- Loading/unloading
- indemnity to driver
- indemnity to user
- indemnity to passenger
- Legal cost
How does loading/unloading cover work under commercial vehicle insurance
It is covered under commercial vehicle insurance, for example if goods are dropped while unloading to a car parked close by, then indemnity will be provided
How does Indemnity to driver cover work under commercial vehicle insurance
IT will usually cover anyone who has been given permission by the insured to drive the vehicle, this cover is important to avoid potential gaps thus policy covers both the insured(firm) and the driver
How does Indemnity to user cover work under commercial vehicle insurance
insured may allow others to use the vehicle for social/domestic/pleasure purposes e.g driver taking the vehicle home in the evening
How does Indemnity to passengers cover work under commercial vehicle insurance
It indemnifies passengers for their negligent acts
What are the optional extensions available for Commercial Vehicle insurance at an additional premium
- Medical Expenses
- Windscreen cover(cost to covered damaged windscreen is very high and there may be a limit on the policy)
- loss of use
- increased limit for third party property damage i.e usually applicable for special type vehicles
- personal belongings
- indemnity to hires; cover is provided to person/company hiring the vehicle in the event of an accident/claim
- sheet/ropes-his cover includes large tarpaulins and ropes often used on large-open sided lorries
What are Contingent Third Party Insurance
This provides indemnity to policyholder(employer) where an employee is using their own vehicles on the employers business and their own insurance as been proven to be inoperative
What is a joint insured clause
when two or more named insureds are treated as separate policy holders if one has a claim against the other
What covers are included in a fleet insurance
- Contingent Third Party Insurance
- Joint insured Clause
- Occasional business use
- Roadside Assistance
- Helpline, message handling and administration
What is the purpose of fleet insurance
- To reduce administration for the policyholder and insurer by having a single-multi-vehicle policy and the premium can be adjusted according to the agreed periods
- Enables the ratings that are carried out to take into account of the individuals experience of the particular policyholder
How many parts can Health Insurance be broken down to
- Personal Accident
- Sickness
- Medical Expenses
What does Personal Accident provide indemnity for
Provides payment in the event of accidental death or bodily injury
What does Sickness provide indemnity for
Provides payment for disablement due to sickness
What does Medical Expenses provide indemnity for
Provides cover for indemnity for individuals who seek medical treatment outside the NHS when they are ill
What type of policy is Personal accident and sickness cover
They are benefit policy
Personal accidents and sickness cover can be private or group meaning
Private, they are taken out by the policyholder in respect of their own welfare. Group where by a number of people are covered under one policy, they are usually taken out by employers to protect against financial loss as a result of injury or illness to member/staff
What financial losses could an employer suffer as a result of injury/illness to an employee
-Loss of revenue through shortfalls in production
-cost of hiring temporary staff
-continuing salary to the injured/ill employee
-cost of private medical treatment fr employee is key and vital member of staff
-recruitment and training cost
lump sum payment to family of deceased employee
Personal Accident and sickness policies are often add ons to which policy
- travel
- motor
- household
- commercial combined policy
What is the age limit for Personal Accident and Sickness Policy
16-70 for personal accident
16-60 for sickness cover
What is personal accident benefits main benefit
The Main benefit is they provide lump sum payable (capital benefit) in the event of
- Death
- Loss of Limbs,eyesight,speech,hearing
- Permanent Total Disablement
- Permanent Partial Disablement
- Temporary Total Disablement
- Temporary Partial Disablement
Loss of limbs, Eyesight,Speech, hearing for personal accident covers
-The insured person must be able to prove loss is total and permanent, and most insurers require loss to have occurred at an agreed period of time 52/104 weeks from the time of original injury
Permanent Total Disablement for personal accident covers
- this situation refers to a situation where recovery is not anticipated, insurers require PTD to have occurred within agreed period from the time of the original injury i.e. 104/52 weeks
Permanent Partial Disablement(PPD) for personal accident covers
This covers permanent injury that don’t necessarily prevent the insured person returning to a relatively normal lifestyle
How is lump sum payment for permanent partial disability calculated
Continental Scale, a pre set-scale of benefits
Temporary Total Disablement
An injury that is serious but won’t result to Permanent Total Disability
How is benefit paid for Temporary Total Disablement
A weekly benefit is payable for each week of disability until an agreed limit 52/104 weeks
What type of excess to most insurers incorporate with Temporary Total Disablity
Franchise, usually 7/14/21 Days
Temporary Partial Disability
This covers an injury that results to an insured person being unable to perform a substantial part of their usual job. Person can still perform some sort of role at work and not normal job
What type of benefits do Temporary Partial Disability receive
The usual benefits payable are reduced to an agreed percentage
How is the sickness cover offered
It is usually offered as an extension to the Personal Accident policy
To whom do sickness cover provide benefits to
They provide weekly benefits for persons unable to perform any part of their normal job Temporary Total Disablement
Most Personal Accident and Sickness policies extend to include which covers
They include
- Disappearance-if insured disappears for longer than an agreed period, a lump sum applicable to death is paid
- Medical Treatment to speed up period of convalescence(recovery)
- Hospital Benefits to help pay for family travel costs
What are some of the exclusions of Personal accident and Sickness policies
- insured being under the influence of alcohol
- self-inflicted injury/disease
- Childbirth,pregnancy, VD or HIV
- pre-existing illness
- accidents while participating in racing/any dangerous sports
For Medical Expenses,typical in patient cover includes
- Hospital Charges
- Specialists fees
- Additional Costs
Under Medical Expenses what does Hospital charges include
-Incurred in surgery,theater fees,consultation,nursing and after care costs
Under Medical Expenses what does Specialist fees include
It includes Specialist consultation, and Surgeon fees
Under Medical Expenses what does additional cost include
Costs like ambulance fees
What are some of the exclusions for Medical Expenses
- Long-term residential care
- Pre-existing conditions(treatment was administered within 5 years prior to the commencement date
Building Insurance includes
This includes not only the main structure but also, garages,sheds,greenhouses,outbuildings,swimming pools,tennis courts,garden paths anything you would normally leave behind on moving from tho house is part of the building
Covers available for Building Insurance include
- Fire Lightning explosion and earthquake
- Riot/Civil Commotion, Strike/labor or political disturbances/malicious damage/vandalism
- Storm/flood
- Falling of trees/branches
- Escape of water
- Escape of oil
- Theft/attempted theft
- Impact
- Subsidence,ground heave/landslip
- Breakage/collapse of television/radio receiving aerials,aerial fitting and masts
- Accidental damage to drains,pipes,cables or underground pipes
- Accidental breakage of glass and sanitary fixtures
- Loss of rent
- legal fees, architects and surveyors fees, cost of debris removal
- Accidental Damage
Contents Insurance covers
Provides insurance for household goods and personal effects of every description,belonging to the insured/family member living in the property
What does content insurance include
- Cash and stamps(not part of a collection)up to 50-100 pounds
- Any fixtures and fittings belonging to the insured
What are the difference in content insurance compared to building insurance
- Theft or attempted theft of cash/currency/bank notes/stamps may be excluded if it doesn’t involve forcible and violent entry or exit
- Theft/attempted theft while the building is lent,let or sub-let in whole or part may be excluded if it doesn’t involve forcible and violent entry or exit
- accidental damage cover for certain contents is excluded i.e clothing/money/stamps/plants
What limits do content insurance place
Limits on single articles of value and valuable limits
How are valuable items put on content insurance
They are generally specified under the policy
What are some of the extensions for content insurance
- Temporary Removal
- Clothing and personal goods of domestic servants
- Loss of rent
- Accidental breakage of mirrors and glass or furniture
What is Temporary Removal cover
The Content policy automatically extends to cover the contents while temporarily removed but remain within the British Isles
What are some of the exclusions for Temporary Removal extension content cover
Risk of storm and flood as regard to property in transit or on the person is excluded
Under Temporary removal extension content cover what type of theft is only covered
- Theft at any bank/safe deposit/occupied private dwelling
- in any building where the insured/family member is residing/is employed/carries on b’ness
- in the course of removal to or from any bank or safe deposit while in the insured’s or the insured’s family charge
What excluded under clothing and personal goods of domestic servants
IT excludes cash, currency notes, bank notes and stamps
What does loss of rent extension under content insurance cover
It covers loss of rent and reasonable additional expenses incurred for alternative accommodation in the event of the premise becoming uninhabitable, usually limited to 10%-20% of contents sum insured
What are some of the other extensions that will include additional premium
- accidental damage to entertainment equipment/ while in the course of removal
- cost of replacing doors locks after theft of keys
What are the typical exclusion for content insurance
- Motor Vehicle
- Livestock (other than horses)
- Medal and coins, unless specifically insured
- property more specifically insured elsewhere
All household policies cover which type of liability
They cover legal liability for accidental injury/damage to material property with limit up to 1 million pounds per claim
What is the liability covered under Building insurance
It covers liability on the owner and liability incurred under the Defective Premises Act 1972 for faults in property previously owned/occupied by the insured
What is the liability covered under Content insurance
They cover liability incurred by the insured as occupier of the property, and at other premises used for temporary holiday accommodation. There will also be a personal liability cover for when the insured is away from the premises
What are some of the most common extensions for building and content insurance
- All Risks
- Money and Credit Card
- Bicycles
- Freezer Contents
- Caravans
- Small Craft
- Sports Equipment
- Personal accident, hospital cash benefit and creditor insurance
- Domestic Animals
- Legal Expenses
- Flood Re
When is an All Risk extension used under Building and Content insurance
This cover is available for personal possessions regularly taken out of the property
All Risk extension cover is in conjunction with
It’s usually in conjunction with contents cover
For All Risk insurance how are the sum insured for items allocated by the insurer
Insurers will include separate sum insured for unspecified and specified item
Unspecified Items for all risk cover
This covers items away from the insured’s address, the definition of unspecified items may be very wide (i.e personal effects/valuables/clothing) or could be more restrictive (separate item for clothing)
For unspecified items what types of property are not insurable
- For items where separate insurance is available(motor)
- individual term may not apply
- insurers are not prepared to provide automatic cover
Single limit article for unspecified items will be
it will range from 100 pounds to 1,000 pounds
What are Specified items
These are items that exceed the unspecified single article limit or special terms apply
What are some examples of specified terms
Jewelry,furs and photographic equipment
For Specified items what does the sum insured represent
Sum insured represents the replacement values
What are some of the exclusions of specified items
- wear and tear
- insect or vermin
- corrosion/rot/mildew/fungus/atmospheric conditions
- any process of heating,dyeing,alteration,repair
- deeds/bonds/documents
- scratching/denting/breakdown/faulty workmanship/materials
Money and credit card extensions covers
provides a form of an all risk cover much wider that the one included under content insurance, and it relates to accidental loss of money
Money usually cover
Cash/cheque/Postal orders/bankers’draft and postage stamps/certificates/premium bonds/luncheon vouchers/gift tokens and travel tickets
What is the limit of indemnity for money cover
200-300 pounds,an excess of 50 pounds
What are the specific exclusions for Money extension
- shortages due to error/omission
- loss not reported to the police within 24 hrs
What does the credit card extension include
It provides cover in respect of financial loss following the loss/theft if a card and its subsequent misuse
Credit card cover also includes
It includes debit and cash cards ads well as credit cards
What are some of the additional services offered by insurer to the credit card basic cover
Emergency cash and card registration scheme
What are specific exclusions for credit card cover
- unauthorized use of credit card by one of the insured’s household
- breach of the issuers terms and conditions
What does Bicycles cover extension for building and content insurance cover
This cover is for pedal cycles and accessories on an all risk basis
What are the exclusions for Bicycle cover
- loss/damage to parts or accessories
- use for racing,peacemaking,trials
- theft while unattended,unless secured
What is the cover for freezer content on building and content insurance
This cover is in respect to the deterioration of freezer content due to change in temperature/contamination as a result of accidental escape of refrigerant or refrigerant fumes
What are some of exclusion of freezer content
- fire/lightning/explosion damage
- deliberate restriction of supply by supplying authority
- willful/deliberate act of the insured
- damage after the freezer has reached say 15 years
Caravan insurers provide cover in three sections which are
- Caravan and equipment
- Clothing and Personal Effects
- Liability
What cover is provided in Caravan and equipment, on Caravan cover
Cover is in respect of all risks of accidental loss or damage to the caravan, its fixtures and fittings
What cover is provided in Clothing and personal effects , on Caravan cover
Provides an all risks cover while property is in the caravan,awning or towing vehicle
What cover is provided in Liability effects , on Caravan cover
This covers legal liability for bodily injury or damage to property caused by or in connection with the caravan up to a limit of indemnity
What are specific exclusions for Caravans cover
- all risk exclusions like wear and tear
- theft while left unattended,unless closed and locked
- hire or reward
- business use
- storm or flood to an awning
How are small crafts defined as
They are defined as vessels not exceed 16 feet overall and with design speeds not exceeding 17 knots (20moh)
small craft extension cover is usually provided under namely four sections including
- accidental loss/damage to craft/machinery and equipment
- personal effects
- salvage charges
- liability to third party and passenger up to a specific limit
Small Craft cover excludes
- use for hire or reward/business use
- liability for injury to employees
- theft of outboard motors/gear and equipment subject to security
Sports Equipment Cover
Covers accidental loss/damage to sports equipment and specialist sports clothing owned by any member of the household
Sports Equipment cover applies to
Anywhere in the British Isles, and for a limited period world wide in any one period of insurance
What are the specific exclusions for sport equipment cover
- Motor Vehicle/trailers/caravans/ts
- living creatures
- pedal cycles
- golf balls
- camping equipment
- non specialist sports clothing
- equipment for certain hazardous pursuits
Personal accident.hospital cash benefit and creditor insurance extension for building and content insurance covers
It covers against the risk of personal accident/sickness,redundancy or unemployment for the insured and their family
Personal accident.hospital cash benefit and creditor insurance extension also provides which cover
It covers against the inability to continue a credit installment in the event of redundancy/unemployment limited to 24 months excludes the first month of any period
Domestic animals extension covers
This cover is available for horses/ponies/domestic cats and dogs
What cover does domestic animal for Horses and Ponies provide
It covers death from accident/sickness/disease/economic slaughter and loss by theft/straying. Also cover includes temporary incapacity,veterinary fees,saddles,bridles/other riding track,third party liability,personal accident to the rider and accidental damage to the horseback trailer
What cover does domestic animal for Cats and Dogs provide
This covers veterinary fees,accidental death, death from illness, loss by theft,kennel fees while owner is hospitalized,advertising and reward, third party liability and holiday cancellation following emergency surgery to the pet
Legal expense extension covers the following
- Recovery Costs
- Civil defense Cost
- Prosecution defense cost
- Employment Disputes
Under the legal expense extension,what does the recovery cost cover
it covers cost for legal action taken to enforce the legal rights of the insured against third parties
Under the legal expense extension,what does the civil defense costs cover
It covers cost for the defense of certain types of civil claims not covered by other forms of insurance
Under the legal expense extension,what does the prosecution defense cost cover
cost for the defense of certain criminal charges which may arise from unwitting act of the insured
What is the limit of liability for legal expenses
It is usually up to 50,000 pounds for incurred costs and expenses
What does the legal expenses extension under the content and building insurance not cover
- Claims relating to events that have occurred outside the UK, the channel Island and isle of man
- appeals
- costs and expenses not agreed by the insurer
- claims arising out of the insured’s b’ness/deliberate or criminal act/omission/libel and slander/divorce/marriage matters and dispute between landlord and tenant
What does the Consumers Right Act 2015 state about ancillary policies
Ancillary policies, those cross sold as add on to customers at point of sale when obtaining cover for other classes of insurance(like motor). The Consumers Right Act states that any ancillary product and service must be affirmed positively by a customer rather than sold assumptively/without it being clear that a choice to not take the cover exists
How did Flood Re come about
After the Qater Act 2014 and the Flood Re Reinsurance (Scheme and Scheme Administrator Designation )Regulation 2015
How was Flood Re created
It was a created as a non- profit fund similar to Pool Re, its a reinsurance company owned and managed by insurers, and funded by levies on member insurers
What is the total Levy of the Flood Re
180 million pounds
How is the Flood Re Levi allocated to the individual insurers
The levy for individual insurers is based in the insurer’s share of the total home insurance market, and this cost of the levy is then passed down to home insurance policyholders, those at the highest risk contribute the most
How is affordability for high risk policyholders of Flood Re ensured
The individual cost paid by this policyholder will be based on the council tax band of their property and the charges per council tax band are set out in the legislation
What is the aim of Flood Re
To ensure that properties at significant risk of flood can still benefit from access to affordable flood cover without large excesses and barriers to indemnity
What does Flood Re cover
It covers eligible residential properties (homes)
What does Flood Re not cover
Business (including SME)
- Properties built after 01/01/2009
- flats in leasehold blocks containing four or more homes
Floor Re is set up to cover a vast majority of flood claims, what happens if there is a significant flood events (3 billion)
Then the government will step in as an insurer of last resort, they will cover the cost initially
Most Travel Insurance cover the following policies
- Personal Accident
- Medical and associated expenses (up to 1 m)
- Loss of deposits
- Baggage/personal effects and money
- Personal liability
- delayed baggage
- Hospital Cash Benefits
- Travel Interruption
- Travel delay
under Travel insurance what does personal accident benefits proved
-They provide indemnity of 10000-25000 pounds for death/loss of eyes/limbs/permanent total disablement
Under Personal Accident benefit for Travel Insurance what is excluded and can only be included with an additional premium
Hazardous Activities
What does Loss of Deposit cover under Travel Insurance
If the holiday is cancelled due to a necessary and unavoidable holiday cancellation
What are the optional extensions available under Travel Insurance
- Failure of tour organizer
- Lack of service/amenities
- Loss of Passport
- Legal Expenses
What are the general Exclusions of Travel Insurance
- Pregnancy and Child Birth
- Physical/ Mental disability
- suicide
- damage to fragile objects
- confiscated luggage
Extended Warranties Insurance covers
This insurance applies to buyers of mechanical and electrical goods. The cover extends the warranty of the purchased mechanical and electrical goods
What does the Extended Warranty policy cover and who issues them
The policy covers free repairs following an electrical and mechanical defects. It is issued by insurers and some large authorized retailers
What other cover does Extended Warranty provide
It covers all of an insured’s electrical products,and there is a small condition that repair should be done by the supplier
What are the exclusions of the Extended Warranty policy
- War
- Negligent handling/failure to comply with manufacturers’ instructions
- Risk usually covered by household policy
- Cost of repairs to bulbs/aerials/external wires/knobs/handles/driving belt etc
