Chapter 3 - Property & Casualty Insurance Basics Flashcards

1
Q

Insurable Interest

A

Financial interest in property to be insured. Must exist at the time of loss

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2
Q

Requirements to prove insurable interest

A
  1. Legitimate financial interest in preserving the property to be insured 2. There must be no potential for gain 3. There must be potential for loss
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3
Q

Underwriting

A

The process of reviewing applications for insurance and the information on the application. Risk selection process

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4
Q

Underwriter’s function

A

Refers to the operations of an insurance company where underwriter is responsible for evaluating applications submitted to the insurer and determining whether a policy should be issued, and if so, the terms, conditions and rates for that policy

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5
Q

Loss ratio

A

Refers to a formula used by insurance companies to compare premium income to losses, including claims paid and claims-related expenses.
Formula:
(Incurred losses + loss adjusting expense) \ earned premium = loss ratio

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6
Q

Geographic Redlining

A

The practice of refusing to serve a particular area solely because of its location or because it is served by a volunteer fire department

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7
Q

Insurance credit score

A

A point system used by insurance underwriters to predict risk and possibility of claims, and determine charges for premiums

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8
Q

Insurance Rate

A

The amount charged for a particular amount of coverage. Charged per unit of exposure

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9
Q

Class rating (or manual rating)

A

Refers to the practice of computing a price per unit of insurance that applies to all applicants possessing a given set of characteristics

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10
Q

Individual rating

A

Used for unique risk. 5 rate making approaches: judgement, schedule, experience, retrospective, and merit

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11
Q

Judgement Rating

A

Used when credible statistics are lacking or when the exposure units are so varied that it is impossible to construct a class.

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12
Q

Schedule rating

A

Rates developed by applying a schedule of charges and credits to some base rate to determine the appropriate rate for an individual exposure.

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13
Q

Experience rating

A

The insured’s own past loss experience enters into the determination of the final premium.

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14
Q

Retrospective rating

A

Self-rating plan under which the actual losses during the policy period determine the final premium, subject to a minimum and maximum premium.

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15
Q

Merit rating

A

Most commonly used in personal auto. The insured’s premium is based not on the actual loss record, but on other factors that indicate the probability that loss will occur. Ex. Bad driving record

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16
Q

Loss costs

A

Rating developed by ISO provides insurer with that portion of a rate that does not include provisions and expenses (other than adjusting expense). Based on historical aggregate loss and loss adjustment expenses projected through development to their ultimate value and through trending to a future point in time

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17
Q

Components

A

Factors that determine rates including loss reserves, loss adjusting expenses, operating expenses, and profits

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18
Q

Negligence

A

The failure to use the care that a reasonable, prudent person would have taken under the same or similar circumstances

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19
Q

Elements in establishing negligence

A
  1. Legal duty 2. Standard of Care 3. Unbroken chain of events 4. Actual loss or damage
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20
Q

Legal duty

A

Shown that the defendant had a legal duty to act or not to act

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21
Q

Standard of Care

A

Defendant must have used a standard of care that breached that legal duty. Acting as a reasonable person

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22
Q

Proximate cause

A

Act or event considered a natural or reasonably foreseeable cause of the damage or event that occurs and damages property or injures a plaintiff

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23
Q

Actual loss or damage

A

Actual injury or damage must have been suffered by the party seeking recovery

24
Q

Assumption of Risk

A

Defenses against Negligence
The defense of an action for recovery for injuries attests that if a person recognizes and understands that there is danger involved in an activity and voluntarily chooses to encounter it.

25
Q

pure Comparative negligence

A

Defenses against Negligence
Allows the plaintiff (the party who brings the lawsuit) to recover the damages, as long as he or she is not 100% negligent

26
Q

Modified comparative negligence

A

Also known as “equal to or greater than” rule, the injured party may only recover damages if his or her fault is less than that of the defendant (the party being sued).

27
Q

Contributory Negligence

A

The injured party must be completely free of fault in order to collect

28
Q

Intervening cause

A

Doctrine bars or reduces

29
Q

Statute of Limitations

A

Some states have set a time limit in which an injured party may bring legal action against another party for certain types of injuries

30
Q

Property damage

A

The extent of the loss is usually simple to determine; it is measured by the actual monetary loss the injured party suffered, which is measured by the value of the property damages or destroyed and the loss of use of that asset

31
Q

Bodily injury

A

May lead to claims by the injured party not only for medical expenses and lost wages but also for disfigurement, pain and suffering, mental anguish, that and loss of consortium

32
Q

Special damages

A

Specific out of pocket expenses for medical, miscellaneous expenses, and loss of wages.

33
Q

General damages

A

Compensate the injured person for pain and suffering, mental anguish, disfigurement, and other similar types of losses. Amount is set by whatever judge/jury feels is right

34
Q

Punitive damage

A

Form of punishment for Xtreme outrageous behavior, gross negligence, or willful intent

35
Q

Absolute liability

A

Is imposed on defendants engaged in hazardous activities, such as harboring wild animals, using explosive, etc. The injured party does not need to prove negligence

36
Q

Strict liability

A

Commonly applied in product liability cases

37
Q

Vicarious liability

A

To transfer the liability for one person to another person who would probably have a greater ability to pay. Ex scope of employment

38
Q

Peril

A

A specific cause of loss

39
Q

Named peril

A

Term used in property insurance to describe the breadth of coverage provided under an insurance policy form that lists the specific covered Perils. No coverage is provided for unlisted perils

40
Q

Open peril

A

Term used in property insurance to describe the breadth of coverage provided under an insurance policy form that insures any risk of loss that is not specifically asked excluded. Aka all risks. Subject to exclusion

41
Q

Direct loss

A

Property insurance covers only DL. direct, physical damage to buildings and/or personal property

42
Q

Proximate cause of loss

A

Direct loss also includes other damage where the insured peril was the pc of l. Ex. Fire being put out and water damages wall

43
Q

Indirect loss

A

Aka consequential losses. Losses considered a result of direct loss. Ex. Homeowners living expenses and profit a business may suffer

44
Q

Blanket insurance

A

Single property insurance policy that provides coverage for multiple classes of property at one location, or for one or more classes of property at multiple locations

45
Q

Specific insurance

A

Property insurance policy that covers a specific kind or Unit of property for a specific amount of insurance. Per property

46
Q

Loss valuation

A

A factor in determining the premium charged and be amount of insurance required

47
Q

Actual cash value

A

Method of valuation reinforces the principle of indemnity because it recognizes the reduction of value of property as it ages and becomes subject to wear and tear and obsolescence
Current replacement cost - depreciation = ACV

48
Q

Replacement cost

A

Defined as the cost to replace damaged property with like kind and quality at today’s price, without any deduction for depreciation. Contrary to indemnity because following a loss it may provide the insured with a settlement in excess of the property’s actual cash value

49
Q

Guaranteed replacement cost

A

The insurance company must fully replace or rebuild the insured property without considering depreciation even if the damage exceeds the policy’s limits

50
Q

Functional replacement cost

A

The cost to replace damaged property with less expensive and more modern construction or equipment

51
Q

Market place

A

Seldom-use method of valuing a loss based upon the amount a willing buyer would pay to a willing seller for the property prior to the loss. Takes value of land and location

52
Q

Agreed value

A

Property policy with a provision agreed upon the insurer and insured as to the amount of insurance that represents a fair valuation for the property at the time the insurance is the written and suspense any coinsurance or other contribution clauses in the policy. Historical building with art. Depreciation or appreciation not accounted for

53
Q

Stated amount

A

Amount of insurance scheduled in a property policy that is not subject to any coinsurance requirements in the event of a covered loss.

54
Q

Stated amount

A

Amount of insurance scheduled in a property policy that is not subject to any coinsurance requirements in the event of a covered loss. Scheduled amount is the max amount the insurer will pay in the event of a loss.

55
Q

Policy structure

A
  • declarations
  • definitions
  • insuring agreement
  • additional coverage
  • conditions
  • endorsements
  • exclusions and policy limits
56
Q

Declarations

A

The section of an insurance policy containing the basic underwriting information, such as the insured’s name, address, amount of coverage and premiums and a description of insured locations.