Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IF8 > Chapter 9 > Flashcards

Chapter 9 Flashcards

1
Q

When loss, damage or injury occurred who do the initial responsibilities fall on?

A) insurer
B) insured

A

B) insured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do theft and malicious damage claims require notification to

A) insurers
B) police

A

B) police

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who does the onus of proof initially fall on

A) insured
B) insurer

A

A) insured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What two things must the insured prove for the onus of proof

A

That an insured peril arose

The amount of the loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is the below an implied or express duty

Advise the appropriate authorities in the event of loss or damage

A

Implied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Is an insurance policy intangible or tangible

A

Intangible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is the onus on the insurers if they wish to decline to pay a claim

A) because of a policy exclusion
B) because of a policy condition

A

A) because of a policy exclusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is the below an implied or express duty

Do not hinder the insurer in the claims investigation process

A

Implied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is the below an implied or express duty

A claim will be in valued if these duties aren’t performed

A

Implied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is the below an implied or express duty

Take all steps to prevent a loss from spreading

A

Implied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Is the below a policy condition or claim condition

Notification to other authorities-
The policy must be notified immediately of any loss of damage cause malicious damage or theft

A

Claims conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is the below an implied or express duty

A breach of conditions allows the insurer to repudiate the claim

A

Express

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is the below an implied or express duty

Specifically written into the contract and are usually found in the general policy conditions

A

Express

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is the below a policy condition or claim condition

Notification to insurers- the usual requirement is for the insured to notify insurer as soon as possible

A

Claim condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Is the below a claim form or notification form

Provide sufficient info to permit the insurer to begin processing any claim

A

Claim form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Is the below a claim form or notification form

Establish whether the insured is entitled to indemnity under the policy- the insurer must satisfy itself that the loss is covered under the terms

A

Claim form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Is the below an implied or express duty

Some reinforce the implied conditions and therefore a contractual as well as common law requirement

A

Express

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Is the below a policy condition or claim condition

Notification to insurers- claims for riot, civil commotion and malicious damage must be notified within 7 days as the insurers have a right of recovery against the policy but only have 42 dYs for the claim
capped to £1m

A

Claim conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How many hours of the day are telephones manned for:

A) 24 hours
B) 9-5

A

A) 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Is the below a policy condition or claim condition

Third party claims- insurers need to retain control over any liability claims and therefore require that the insured:
Immediately passed on unanswered any communications from third parties
Doesn’t admit to repudiate liability or offer to settle the claim
Allows insurers to take over and conduct any claim from or against third party

A

Claim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Is the below a policy condition or claim condition

Prevention of further damage- the insured must take reasonable precautions to prevent further damage

A

Claim condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Is this a liability claim or theft claim

Details of any other insurances

A

Liability claim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Is the below a policy condition or claim condition

Assisting the claims process- the insured just provide insurers with all the info and help they require in respect of the claim

A

Claims condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Do most insurers operate a freephone number for claims

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Is the below a claim form or notification form

Provide sufficient info to permit the insurer to begin processing any claim

A

Claim form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the most common sense means of obtaining full details of the claim

A) a claim form
B) a notification form

A

A) a claim form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Is the below a claim form or notification form

Enable the insurer to take a preliminary view on whether there is likely to be a claim from a third party

A

Claim form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Is the below a claim form or notification form

Enable the insurer to consider whether any potential recovery rights may exist

A

Claim form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What two things require by insurers when a loss occurs for a claim form

Starting with claimants details (name, address, phone number, policy number)

A

Date, cause and circumstance or loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Is this a liability claim or theft claim

Details of the persons or property injured or damaged and estimated amount of loss

This will enable insurers to put a reserve on a claim

A

Liability claim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Is the below an implied or express duty

Act as though uninsured and take all reasonable steps to minimise the loss

A

Implied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Is the below a policy condition or claim condition

Notification to insurer- if the initial notification is by telephone it needs to be followed up in writing within 30 days

A

Claims conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Is this a liability claim or theft claim

Details of any other interests in the property (mortgage company etc)

A

Liability claim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Is this a liability claim or theft claim

Details of any other party who may be liable for the loss

A

Liability claim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Other than the claim form what is the below supporting evidence

Receipts for purchases or repairs

A) property claims
B) theft claims
C) employers and PL claims

A

A) property claims

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Other than the claim form what is the below supporting evidence

Police report.

A) property claims
B) theft claims
C) employers and PL claims

A

B) theft claim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Other than the claim form what is the below supporting evidence

A copy of the entry in the accident book

A) property claims
B) theft claims
C) employers and PL claims

A

C)EL and PL claims

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Who needs to establish the following the insured or the insurers

Cover was in force at the time of the loss

A

Insurer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Who needs to establish the following the insured or the insurers

The claimant is either the insured named in the policy or a person entitled to indemnity

A

Insurer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Who needs to establish the following the insured or the insurers

The peril or event is covered by the policy

A

Insurer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Who needs to establish the following the insured or the insurers

The insured had taken reasonable steps to minimise the loss

A

Insurer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Who needs to establish the following the insured or the insurers

All conditions and warranties have been complied with

A

Insurers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Who needs to establish the following the insured or the insurers

The duty of disclosure was originally complied with

A

Insurer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Would the below claim be valid or partially met

Application of voluntary or compulsory excesses

A

Partially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Who needs to establish the following the insured or the insurers

The value of the loss is reasonable (looking at catalogues, price lists etc)

A

Insurers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Who needs to establish the following the insured or the insurers

No exceptions apply

A

Insurers

47
Q

If the claim is valid what will happen

A) all requirements are met
B) they are only partially met
C) they are invalid

A

All requirements are met

48
Q

Would the below claim be valid or partially met

The sun insured or limit of liability loss is greater than the limit the insureds recovery is limited to this amount

A

Partially met

49
Q

What is the below

When a claim involves personal injury

A) claims inspector
B) loss adjuster
C) solicitor
D) doctor

A

D) doctor

50
Q

Is the below a valid or invalid claim

Conditions are not complied with or if fraud can be proved

A

Invalid

51
Q

Is the below a claim handler or loss adjuster:

Deal with all claims quickly and fairly
Distinguish between real and fraudulent claims
Settle claim costs effectively

A

Claims handler

52
Q

What is the below:

Employee of the insurer whose role is to assess insurance losses where further investigation is required. Often involve visiting the insurers to obtain further details of the claim.

A) claims inspector
B) loss adjuster
C) solicitor
D) doctor

A

A) claims inspector

53
Q

Does the below apply to the insurer or intermediaries

Avoid conflicts of interest, unless the circumstances have been disclosed to the customer

A

Intermediaries

54
Q

What is the below

An independent person appointed by the insurance company: their role is to investigate the claim on the insurers behalf for which they are paid a fee.

A) claims inspector
B) loss adjuster
C) solicitor
D) doctor

A

B) loss adjuster

54
Q

What is the below:

Checks the adequacy of the suns insured and the cause of loss
Ensures that any losses are minimised
Negotiates a settlement that is fair and acceptable
Recommend settlements to insurers

A) claims inspector
B) loss adjuster
C) solicitor
D) doctor

A

B) loss adjuster

55
Q

What is the below

Complex liability claims they will be appointed to defend the claim on the insureds behalf and will pay any legal costs involved

A) claims inspector
B) loss adjuster
C) solicitor
D) doctor

A

Solicitor

57
Q

Is the below a claim form or notification form

Enable the insurer to take a view as to the severity

A

Claim form

58
Q

What are the 4 advantages of using recommended suppliers and repairers
Starting with the work will be carried out quickly

A

2- insurer can control the standard of work completed by the repairer
3- the insurer can control the costs involved
4- there is no need to obtain estimates

59
Q

What is the below

Will consider the circumstances of the claim or determine whether the insured is legally liable and seek further info and ensure correct legal procedures are followed

A) claims inspector
B) loss adjuster
C) solicitor
D) doctor

A

C) solicitor

60
Q

What is a reserve

A) an AP
B) realistic estimate of the cost of a claim

A

B) realistic estimate of the cost of a claim

61
Q

What do insurers have to submit to the PRA each year

A) financial statements showing estimate of outstanding claims
B) financial statements showing reserves

A

A) financial statements showing estimate of outstanding claims

62
Q

What will future projections produce it estimated claims figures are inaccurate

A) inappropriate rates
B) incorrect premiums

A

A) inappropriate rates

63
Q

Why is it an importance element of an insurer to keep adequately estimated and up to date

A) a snapshot can be taken at any time of the profitability
B) to ensure compliance with the LRA

A

A) a snapshot can be taken at any time of the profitability

64
Q

What 2 things will accurate claims reserving for an insurer involve starting with

1- examination of past data on claims including claims amounts

A

2- use of the past data and adjusting it to take account of any changes in the law inflation and external influences

65
Q

If a claim is paid in stages what happens with the outstanding reserves

A)it has to be repaid
B) can be reduced in accordance with payment made

A

B) can be reduced in accordance with payment made

66
Q

What will a central reserve cover

A) unknown exposures/ losses which may arise
B) it will reduce the company’s payment reserve

A

A) unknown exposures/ losses which may arise

67
Q

What will a central reserve be put on

A) theft
B) asbestos
C) stress

A

B & C

68
Q

What is the general rule for insurers handing claims

A) they are responsible of the claim regardless if its delegated authority

B) they aren’t responsible

A

A) they are responsible of the claim regardless if its delegated authority

69
Q

Does the below apply to the insurer or insured

Handle claims promptly and fairly

Provide reasonable guidance to help a policyholder make a claim

Not unreasonably reject a claim

Settle claims promptly

A

Insurer

70
Q

Does the below apply to the insurer or intermediaries

Forced any claim notification promptly to the insurer

A

Intermediary

71
Q

What four claims can be settled

1- money

A

2- repairs
3- replacement
4- reinstatement

72
Q

Does the below apply to the insurer or intermediaries

Manage conflicts of interest fairly

A

Intermediaries

73
Q

Would the below claim be valid or partially met

Average clause

A

Partially

74
Q

What under common law does the legal right have for claims

A) payment of money
B) recovery of goods

A

A) payment of money

75
Q

What is the easiest way to grant indemnity

A) repair
B) money

A

B) money

76
Q

What does a form of discharge do?

A) close the claim
B) avoids the possibility of the claim being reopened at a later date

A

B) avoids the possibility of the claim being reopened at a later date

77
Q

Is the below mediation or conciliation

If they can reach an agreement they are free to pursue other legal remedies/ options

A

Mediation

78
Q

In the case of liability insurance who is payment made to?

A) insured
B) third party

A

B) third party

79
Q

Is reinstatement often used?

A

No

80
Q

What does reinstating mean if the amount exceeding the sum insured

A) means accepting responsibility to pay the full amount

B) insurers are liable

A

A) means accepting responsibility to pay the full amount

82
Q

Does the below apply to the insurer or intermediaries

Inform the customer if it’s acting for the insurer in relation to a claim under a policy

A

Intermediaries

83
Q

What is salvage

A? The remaining value of the property

B) the scrap of the vehicle

A

A? The remaining value of the property

84
Q

Is the below a fraud prevention or a fraud condition

Shared databases such as Claims and Underwriting Exchange.
Cue was established to help prevent multiple claims fraud and the misrepresentation of the claims history. Info is supplied by insurers and the database is shared by insurers

A

Fraud prevention

85
Q

In the claims process it is important that opportunities for recovery

A) are not missed or ignored
B) are exempt

A

A) are not missed or ignored

86
Q

Where she does the right or recovery arise

A) where lost or stolen property is found after the claim has been settled
B) where the third party is believed to have caused the loss or damage

A

A) where lost or stolen property is found after the claim has been settled

87
Q

If the stolen item is recovered what will insurer prefer

A) to have the claim money reimbursed to them and the insured to keep the recovery item

B) insured can replaced it with previous claims

A

A) to have the claim money reimbursed to them and the insured to keep the recovery item

89
Q

What is arbitration intended to deal with

A) disputes about the amount to be paid in settlement of a claim

B) providing liability

A

A) disputes about the amount to be paid in settlement of a claim

90
Q

What is the judgement of the arbitrator

A) binding
B)in favour of the insurers

A

A) binding

91
Q

Is the below benefits of alternative dispute resolution or arbitration

It is less costly than proceeding through a court trial

It can be timed to suit the parties

Settlements are confidential between the parties

Speed of completion

A

ADR

92
Q

What happens if the claim money can’t be reimbursed under right of recovery

A) the insured will be allowed to keep the item

B) the insurer will try to arrange for the insured to take back the items and make a suitable allowance for the damage

A

B) the insurer will try to arrange for the insured to take back the items and make a suitable allowance for the damage

92
Q

What does a mediator act as?

A) a facilitator
B) conciliator

A

Facilitator

93
Q

Is the below mediation or conciliation

Any agreement reached to settle the dispute is made solely by the parties themselves

A

Mediation

94
Q

Is the below a fraud prevention or a fraud condition

Cognitive interviewing and conversation management

Involves a structured approach to interactions such as telephone conversations with the claimant

A

Fraud prevention

95
Q

What does the fraud condition mean:

A) can refuse to pay a claim and will declare the policy void from the fraudulent act without any refund of premium

B) if guilty of fraud the policy can be cancelled ab initio

A

A) can refuse to pay a claim and will declare the policy void from the fraudulent act without any refund of premium

96
Q

Is the below mediation or conciliation

Less frequently form of ADR. The conciliators role is to lead the parties to a settlement

A

Conciliation

98
Q

Is the below mediation or conciliation

The parties have to decide in advance whether they will be bound by the conciliators recommendations and if they agree to do this they will not usually have any recourse to the more formal court system

A

Conciliation

99
Q

Is the FOS membership compulsory for insurers and intermediaries

A

Yes

100
Q

What was the FOS formed under?

A) the financial services and markets act 2000
B) the FCA
C) ICOBS

A

A) the financial services and markets act 2000

100
Q

Is the below an eligible complainant to the FOS

A trust with a net asset of less than £1m

A

Yes

102
Q

Is the below an eligible complainant to the FOS

A Consumer

A

Yes

103
Q

Is the below a fraud prevention or a fraud condition

Voice stress analysers

Lie detectors

A

Fraud prevention

104
Q

Is the below a fraud prevention or a fraud condition

Insurance Fraud Register (IFR) established in 2012 and aims to encourage firms to share info to prevent fraudsters moving from insurer to insurer in a bit to deter offenders

A

Fraud prevention

106
Q

Is the below an eligible complainant to the FOS

A charity with an annual income of less than £1m

A

Yes

106
Q

How long does the customer have to send the complaint to FOS

A) 8 weeks
B) 12 months
C) 6 months

A

C) 6 months

107
Q

Any decisions which the FOS makes where the award is up to £150k is

A) binding on insurance and intermediaries
B) binding on insurers only

A

A) binding on insurance and intermediaries

109
Q

Is the below a fraud prevention or a fraud condition

Insurance Fraud Investigators Group

Organisations dedicated to the detection and prevention of insurance fraud. Non profit. Members include insurers, lawyers, loss adjusters and investigation agencies

A

Fraud prevention

110
Q

Under the ABI how much did 125,000 cases of frauds cost in 2016

A) 1 billion
B) 1.3 billion

A

B) 1.3 billion

111
Q

Is the below an eligible complainant to the FOS

A micro enterprise who employs fewer than 10 people and a turnover of less than 2m

A

Yes

111
Q

What are four types of fraudulent claims starting with bogus claims

A

2- misrepresentation of claims
3- inflated claims
4- multiple claims

111
Q

Is the below a fraud prevention or a fraud condition

Specialist software

A

Fraud prevention

112
Q

Is the below a fraud prevention or a fraud condition

Insurance fraud Bureau/ tackles the problem of organised fraud and analyses data from various industry databases

A

Fraud prevention

112
Q

Is the below possible indicator of fraudulent claim

Made soon after policy inception
Where the insured had no documentation where claims are inconsistent
Where the loss wasn’t report to police
Poor claims history

A

Yes

113
Q

What offered new opportunities to fight fraud

A) social media and internet
B) social media only

A

A) social media and internet

114
Q

Is the below a fraud prevention or a fraud condition

Claims handlers

A

Fraud prevention

IF8 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions