Chapter 8 Flashcards

1
Q

What is an application in insurance?

A

is a request for insurance that introduces the applicant to the insurance company, recognizes the broker of record, and identifies the insurer to whom the request for coverage is directed.

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2
Q

Who might apply for insurance?

A

include those with issues with their current insurer, first-time insureds, those seeking alternative quotes, individuals evaluating other agents or brokers, those needing additional coverage, or those whose circumstances no longer align with their current broker.

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3
Q

What is the basic application process in insurance?

A

provide information about themselves and their insurance needs through an online form or discussions with a broker. The intermediary asks questions to understand the applicant’s needs and collect relevant information.

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4
Q

What is the duty of disclosure in insurance?

A

requires applicants to disclose all material facts accurately and uphold utmost good faith when making oral or written applications.

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5
Q

What is a misrepresentation in the context of insurance applications?

A

involves giving false information knowingly, which could lead to denied claims or voided policies.

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6
Q

Why is note-taking critical during oral insurance applications?

A

ensures there is a clear record of the transaction, minimizing misunderstandings and documenting material facts shared during the conversation.

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7
Q

What are the benefits of a written insurance application?

A

provide consistent information gathering, eliminate transcription errors, improve customer service, document legal requirements, and offer proof of the questions asked and answers provided.

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8
Q

What role do CSIO forms play in insurance applications?

A

CSIO forms are standardized application forms that streamline the collection of information and are widely accepted by insurers for various types of coverage.

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9
Q

What is the effective date of a policy?

A

The effective date is when coverage begins, often starting at the time the application is made.

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10
Q

What is the subject of insurance?

A

The subject of insurance is the item or liability being insured, such as a home, vehicle, business property, or legal responsibility.

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11
Q

Who is a loss payee?

A

a party other than the insured entitled to insurance proceeds due to an insurable interest in the property.

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12
Q

What is a mortgage clause in insurance?

A

protects the interests of a mortgagee when a loss is denied due to the insured’s actions, provided the mortgagee was unaware of the wrongful action.

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13
Q

Why is prior loss history important in insurance applications?

A

helps underwriters evaluate risk, determine coverage terms, and predict future losses based on past claims.

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14
Q

What information about prior insurance is required in applications?

A

must provide prior insurers’ names, policy numbers, and policy expiry dates, which help verify loss history and assess risks.

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15
Q

What is the agent’s and broker’s report in insurance applications?

A

an opportunity for agents and brokers to provide additional information about clients, advocate for their risks, and highlight special considerations.

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16
Q

How does AI impact the insurance application process?

A

enables online insurance applications, automates queries through chatbots, and offers on-demand insurance coverage with customizable options.

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17
Q

Why is the named insured critical in insurance applications?

A

must have an insurable interest and be a legal entity, ensuring they can benefit financially from the policy and meet contractual obligations.

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18
Q

What is the importance of the mailing address in an application?

A

required for legal notices, such as cancellations, and ensures proper communication between the insurer and the insured.

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19
Q

What is back-dating in insurance applications?

A

is when coverage is requested retroactively, requiring further investigation to rule out fraud or verify contractual obligations.

20
Q

What information is collected for automobile insurance applications?

A

Details about the vehicle, its use, its location, who uses it, and any interested parties are collected.

21
Q

What is the role of chatbots in the insurance application process?

A

Chatbots interact with customers, answering queries and facilitating communication during the application process without needing a live agent.

22
Q

What are the two types of insurance applications?

A

can be oral or written, depending on the applicant’s interaction with brokers and the insurer’s requirements.

23
Q

What is the role of intermediaries in insurance applications?

A

Intermediaries analyze client needs, ensure accurate information is collected, and match applicants with suitable insurance coverage.

24
Q

What is the importance of documentation in insurance applications?

A

Proper documentation ensures legal compliance, reduces inaccuracies, and provides proof of the transaction.

25
Q

What are material facts in insurance applications?

A

Material facts are essential details about the risk that can influence an insurer’s decision to accept or deny coverage.

26
Q

How do intermediaries minimize misunderstandings in oral applications?

A

They document conversations, confirm details in writing, and maintain organized records.

27
Q

Why might a written application be preferred over an oral one?

A

Written applications provide a clear and consistent record, reducing risks of miscommunication and errors.

28
Q

How has technology transformed the insurance application process?

A

Technology enables online applications, instant policy issuance, and customer-friendly interfaces for a seamless experience.

29
Q

Why do insurers require loss history?

A

Loss history helps insurers evaluate risk levels, establish appropriate premiums, and design policy conditions.

30
Q

What is an insurable interest in insurance applications?

A

Insurable interest exists when the applicant would suffer financial loss from damage to the insured property or liability.

31
Q

What is the purpose of signing insurance applications?

A

To confirm the accuracy of statements made by the applicant.
To form the basis of the insurance contract.
To grant permission for investigations, such as credit checks or motor vehicle records.

32
Q

What types of signatures are acceptable?

A

Physical signatures.
Audio signatures (agreed to verbally on a recorded call).
Electronic signatures (on mobile devices or computers).

33
Q

Why is it important to have signed applications, even if not mandatory?

A

To document the information exchanged between parties.
To reduce misunderstandings and potential misrepresentations.
To ensure applicants review and confirm their information.

34
Q

How do electronic signatures vary in security?

A

Simple “click-to-sign” with no cryptographic security.
Advanced options with identity verification and high security.

35
Q

What privacy considerations exist for unsigned applications?

A

Privacy laws require express permission for investigations.
Unsigned applications may conflict with privacy legislation.

36
Q

What is ratemaking in insurance?

A

The process of establishing rates for each insurance class.
Determines the cost of a unit of insurance for a specified period.

37
Q

What is the difference between rate and premium?

A

Rate: Price per unit of insurance (e.g., per $1,000 coverage).
Premium: Total cost of the policy (rate × amount of insurance).

38
Q

How does the law of large numbers aid ratemaking?

A

Predicts losses more accurately for large groups over time.
Relies on a large sample size and stable conditions.

39
Q

What factors affect the reliability of loss predictions?

A

Sample size: Larger groups yield more reliable data.
Time period: Longer observation periods improve accuracy.
Stability of conditions: Consistent conditions ensure relevance of past data.

40
Q

What is the ratemaking process?

A

Classify risks.
Gather past loss statistics.
Calculate pure premium.
Add loadings to determine total premium.
Calculate the rate or unit cost.

41
Q

What decisions do underwriters make about risks?

A

Accept the risk.
Accept with conditions.
Reject the risk.

42
Q

What factors influence the acceptance or rejection of risks?

A

Applicant’s personal information (to assess moral hazard).
Physical hazards and exposures of the risk.
Special factors for the class of insurance.

43
Q

What is loss frequency and severity?

A

Frequency: How often losses occur.
Severity: Dollar value of losses.

44
Q

What is the purpose of underwriting rules?

A

To ensure risks align with the insurer’s guidelines.
To suggest improvements for substandard risks.
To determine the maximum retention amount.

45
Q

What is manual rating in insurance?

A

Pricing based on an individual risk’s unique characteristics.
Often used for complex risks like industrial properties.

46
Q

How do underwriters adjust rates?

A

Add loadings for features increasing risk.
Provide deductions for features reducing risk.