Commercial Lines Flashcards
What four policies are NOT part of the Commercial Package Policy (CPP)?
- Umbrella
- Aviation
- Watercraft
- Workers Comp
The Commercial Package Policy (CPP) has a common _______ page and ________ form.
Declarations Page
Conditions Form
What are the Seven parts of the Commercial Package Policy (CPP)?
- Comm Property
- Comm General Liability
- Comm Auto
- Comm Crime
- Comm Inland Marine
- Equipment Breakdown Insurance (Boiler & Machinery)
- Farm Coverage
Each coverage under the Commercial Package Policy (CPP) has it’s own ______ page and _______ forms.
Declarations Page
Coverage Forms
What is the trigger of a comm policy?
Premium
Money is ________ in a comm policy.
Consideration
Is the insurance community concerned with OSHA rules?
NO
Who is the only party that change anything on the policy?
FIRST NAME INSURED
How long does the insurer have to notify insured before cancellation for nonpayment? for anything else?
10 days
45 days
How long does the insurer have to notify insured before cancellation for any reason other than nonpayment? for nonpayment?
45 days
10 days
Who is sent the refund (if there is one) in the event of a cancellation (comm)?
FIRST NAME INSURED
- insurer cancels - pro rata refund
- insureD cancels - may be less than pro rata
Changes to policy requested by first named insured must have _______ of insurer.
consent
Insurer may examine a comm policy insured’s records (audit) up to ____ years afterward.
3 THREE
What would be the reason for an insurer to examine (audit) an insured’s records?
- adjust premium
2. insurability
What are the two things that a premium is based on in a comm policy?
- Sales
2. Payroll
Who is responsible for paying premiums and receiving any returned premiums?
FIRST NAMED INSURED
If the first named insured on a comm policy dies, their rights and duties are transferred to who?
Legal Rep
Commercial Package Policy (CPP) provides coverage for what three direct loss categories?
- Real Property
- Business Personal Property
- Personal Property of Others
Indirect losses can also be covered (loss of business)
What are the four parts of the Commercial Package Coverage Part?
- Comm Property Declarations
- Comm Property Conditions Form
- One or More of the Coverage Forms
- Building & Business Personal Property Coverage Form (DIRECT LOSS)
- Business Income Coverage Form (INDIRECT LOSS)
- Causes of Loss Form - identifies covered perils
What type of loss does the Business Income Coverage Form delineate?
Indirect Loss
If an employee (not a named insured) commits fraud, concealment or misrepresentation, the insurer can do what?
Void the contract - cancel the policy
The Control of Property condition states what?
Any act or neglect of ANY PERSON OTHER THAN YOU (named insured) beyond your direction or control will not affect this insurance
How long may legal actions be taken against an insurer by an insured (comm policy) after the date of direct physical loss or damage?
2 Two Years
What are the three major coverages on the Building & Personal Property Coverage form?
- Buildings - completed additions, permanently installed fixtures, fire extinguishers, machinery, equipment, outdoor furniture, floor coverings and appliances (HARD WIRED)
- Business Personal Property - furniture, fixtures, machinery, INVENTORY, “STOCK” (merchandise, raw materials, supplies) ON INSURED PREMISES OR WITHIN 100 FEET
- Personal Property of Others - in insured’s care, custody or control ON INSURED’S PREMISES (insured is bailee)
Examples of items covered under BUILDINGS on the Building & Personal Property Coverage form:
Buildings -
completed additions,
permanently installed fixtures,
fire extinguishers,
machinery,
equipment,
outdoor furniture,
floor coverings and
appliances (HARD WIRED)
Examples of items covered under BUSINESS PERSONAL PROPERTY on the Building & Personal Property Coverage form:
furniture,
fixtures,
machinery,
INVENTORY,
“STOCK” (merchandise, raw materials, supplies)
ON INSURED PREMISES OR WITHIN 100 FEET
Examples of items covered under PERSONAL PROPERTY OF OTHERS on the Building & Personal Property Coverage form:
in insured’s care, custody or control ON INSURED’S PREMISES (insured is bailee)
What is covered within 100 feet of premises in a Building & Personal Property Coverage Form?
business personal property
What are the FIVE Coverage Extensions in Building & Personal Property Coverage?
- Property of Others - effects of employees - $2500 limit on insured’s premises
- Property Off the Insured Premises - $10,000 limit within the coverage territory
- Valuable Papers Restoration - $2500 limit
- Newly Acquired or Constructed Property - automatically covered for 30 days
- Outdoor Property
- shrubs, plants, trees - $250 max each
- fences, antennas max total of $1000 per occurrence
- covered perils are very limited
What are THREE additional coverages in the Building & Personal Property Coverage Form?
- debris removal of covered property
- emergency removal (preservation of property) for 30 days at a new location
- Fire Dept Service Charge $1000
Eight examples of property NOT covered under the Building & Personal Property Coverage?
- Cash
- Animals (except owned as stock - pet store)
- Vehicles licensed for road use
- Exterior signs (unless attached to the building)
- Contraband
- Land
- Pilings, piers, wharves, docks
- Business personal property while AIRBORN or AFLOAT.
If a covered building is vacant for ____ days, what coverage is suspended?
60 days
- vandalism
- glass breakage
- water damage
- theft
AND reduces amount of payment on all other covered perils by 15%!!!
What would cause coverage to be reduced on a comm covered building and by how much?
60 days VACANT
15%
Another name for Indirect Loss?
Consequential Loss
In Business Interruption Insurance, what is coverage triggered by?
direct loss caused by covered peril
What is the dollar amount of coverage under the Business Interruption Insurance policy dependent on?
length of time the business is out of operation -
TIME ELEMENT
Loss of Business Income Coverage:
- Indirect Loss Coverage
- indemnifies insured for loss of profits
- payment is made for losses incurred during Period of Restoration - after 72 hour deductible
With regards to Loss of Business Income Coverage, Net Income is:
Net profit before taxes - AMOUNT THE BUSINESS WOULD HAVE EARNED HAD NO DIRECT LOSS OCCURRED.
With regards to Loss of Business Income Coverage, Continuing Expenses is:
expenses including KEY PERSON salaries, rent, advertising, phones, etc
With regards to Loss of Business Income Coverage, Extra Expense Coverage does what?
pays additional costs to keep the business operational -
What are the FOUR “Cause of Loss” Forms in Commercial Property Insurance?
- Basic
- Broad
- Special - Open Peril
- Earthquake
Sprinkler Leakage is covered under which “Cause of Loss” forms?
ALL
Sinkhole Collapse is covered under with “Cause of Loss” forms?
ALL
What regards to Commercial Property Insurance, Volcanic Actions covers what?
Ash Cloud
What is the ONLY form to cover theft in Comm Property?
Special
Which forms cover Collapse in comm prop insurance?
Broad and Special
What are the three categories of loss coverage for the Earthquake form?
- Earthquake
- Volcanic Eruption (lava)
- Underground Lava
Which forms cover Flood in comm property?
NONE
What forms cover Sewer back up in comm property?
NONE
What is Section I of a BOP?
Property Coverage
Special Form - Open Perils - includes theft
Six examples of businesses that could be covered by a BOP:
- Apartments - condo association
- Offices - Office Buildings (included retail store, professional offices) - not more than 6 floors
- Convenience stores
- Contractors (trade contractors 0 carpentry, hvac, electrical) - GCon not eligible
- Limited- Cooking Restaurant - cold food - seating not exceeding 75
- Fast Food - exhaust and fire suppress required - seating capacity not exceeding 150
Four eligible risks for comm inland marine coverages:
- Personal Property Floater Risks
- Transportation & Communication Instruments
- physical damage coverage for bridges, tunnels, piers, pipelines and power transmission lines - Domestic Shipments - Cargo
- Motor Truck Cargo - common carrier - Commercial Property Floater Risks
Three types of Comm Property Floaters:
- Contractor’s Equipment Floater
construction machinery and TOOLS
- Bailee Floater
- Other Comm Inland coverages available
- accounts receivable, comm articles, sign coverage, valuable papers and records
Examples of other Commercial Inland Marine Coverage Forms available (other than the primary three):
Accounts Receivable Cameras&Musical instruments Commercial Articles (fine arts for business) Equipment Dealers Coverage Film Coverage Floor Plan Coverage Sign Coverage Jeweler's Block Coverage Mail Coverage Physicians&Surgeons Equipment Theatrical Property Coverage Valuable Papers and Records
What’s another name for Equipment Breakdown Coverage?
Boiler & Machinery Coverage
Equipment Breakdown Coverage (aka boiler & machinery) insured both ______ loss AND _______ loss.
DIRECT AND INDIRECT
Equipment Breakdown Coverage (aka boiler & machinery) has a major emphasis on what?
inspection and prevention (loss control)
Under Equipment Breakdown Coverage (aka boiler & machinery), the insurer can cancel the policy immediately if what is found?
dangerous condition of equipment
What is the insured machinery or equipment called in an Equipment Breakdown Coverage (aka boiler & machinery)?
OBJECT
What are the four categories of OBJECTS that could be defined in an Equipment Breakdown Coverage (aka boiler & machinery)?
- Pressure and Refrigeration
- Mechanical
- Electrical
- Turbine
What are the two coverage forms for Equipment Breakdown Coverage (aka boiler & machinery)?
- Equipment Breakdown Coverage Form
- used ONLY for high-pressure objects - Small Business Equipment Breakdown Form
- automatically provides loss of business income coverage
What are Three coverage extensions (auto included) under Equipment Breakdown Coverage (aka boiler & machinery)?
- Expediting Expense
- Coverage for newly acquired equipment
- Defense Cost
Three primary exclusions to Equipment Breakdown Coverage (aka boiler & machinery)?
- Depletion, deterioration, corrosion, erosion, leakage, wear&tear
- Damage to the object while being tested
- POWER INN
In Equipment Breakdown Coverage (aka boiler & machinery), coverage is triggered by:
accident
What are the four categories of injuries or damages covered under a Commercial General Liability (CGL) Policy?
- Bodily Injury
- Property Damage
- Personal Injury
- Advertising Liability
Whose negligent acts are covered under a Commercial General Liability (CGL) Policy?
- Named Insured - with respect to the conduct of business
- individual, includes named insured AND SPOUSE
- partnership, partners and their SPOUSES
- corporation, officers, directors, stockholders (NOT SPOUSES)
- Employees - within the scope of employment
- Non-employee acting as real estate manager for the named insured
- Legal Rep in even of named insured’s death
- Newly acquired or newly formed organizations (for 90 days or upon policy expiration)
Under a Commercial General Liability (CGL) Policy, are mobile equipment operators considered employees?
YES!!
Who is NOT covered under a Commercial General Liability (CGL) Policy?
- visitors
- customers
- INDEPENDENT contractors
Four Exposures under a Commercial General Liability (CGL) Policy? - know the difference between these and Injuries or Damages
- Premises Liability
- Operations Liability
- Products Liability
- Completed Operations Liability
What determines the exposure in a Commercial General Liability (CGL) Policy?
Where
When
What
What are the THREE coverages provided automatically?
Coverage A: Bodily Injury and Property Damage
- Premises Liability
- Operations Liability
- Products Liability
- Completed Operations Liability
Coverage B: Personal Injury and Advertising Injury
Coverage C: Med Pay
Cov A for Commercial General Liability (CGL) Policy: What are the four parts?
- Premises Liability
- injury to third party claimant ON an insured premises created by negligence of insured - Operations Liability
- injury to third party claimant OFF an insured premises - WHEN THE JOB IS NOT DONE - Products Liability - injury to third party claimant of an insured premises - FAULTY PRODUCT
- Completed Operations Liability
- injury to third party claimant OFF an insured’s premises - FAULTY WORKMANSHIP
What is Coverage B on a Commercial General Liability (CGL) Policy?
Personal Injury and Advertising Injury
What is Coverage C on a Commercial General Liability (CGL) Policy?
Med Pay
What is Coverage A on a Commercial General Liability (CGL) Policy?
Bodily Injury and Property Damage
What is the coverage triggered by in comm gen liability?
date of occurrence - accident
Exclusions to Coverage A on a Commercial General Liability (CGL) Policy?
- expected or intended from INSURED’S PERSPECTIVE (assaulting a customer)
- contractual liability - Liability assumed by a verbal or written agreement is EXCLUDED, however, if insured assumed liability in the form of premises lease, liability is provided
- Liquor Liability
- WC - law obligation
- Pollution Discharge
- Aircraft, Autos, Watercraft
7 Damage to property owned, rented, or controlled by insured - (Care, Custody, Control)
8 Property damage to the insured’s faulty product
9 Property damage to insured’s faulty work
10 product recall
Two parts of Coverage B on a Commercial General Liability (CGL) Policy?
- Personal Injury
- injury to reputation or mental state - Advertising Injury
- UNINTENTIONAL
What are the exclusions to the Personal Injury part of Cov B of a Commercial General Liability (CGL) Policy?
- employment-related practices (discrimination, sexual harassment)
- libel or slander where insured knew it was false
- willful violation of law
- bodily injury
What are the exclusions to the Advertising Liability part of Cov B of a Commercial General Liability (CGL) Policy?
- any insured in the advertising business
- failure of goods to conform to advertising quality
- wrong description of prices
Med Pay under Cov C of Commercial General Liability (CGL) Policy can be paid up to ___ years after the accident? and what are the limits?
1 One year
$5000
What’s another term form Additional Coverages under a Commercial General Liability (CGL) Policy? These are free.
Supplemental Payments
What are the two limits of liability in a Commercial General Liability (CGL) Policy?
- Per Occurrence Limit
- max coverage for any ONE occurrence, regardless of persons injured
- Per Occurrence Limit - Cov A - Bodily Injury & Property Damage - $1,000,000
- Per Occurrence Limit - Cov B - Personal Injury - $1,000,000
- Per Person Limit - Cov B - Med Pay - $5000 - Aggregate Limit
- max coverage during policy year (12months) regardless of number of separate occurrences.
Two aggregate limits:
- General Aggregate Limit - $2,000,000
- Products-Completed Operations Aggregate Limit - $2,000,000
What are the two Aggregate limits in a Commercial General Liability (CGL) Policy?
- General Aggregate Limit - $2,000,000
2. Products-Completed Operations Aggregate Limit - $2,000,000
What is the per occurrence limit for Cov A in a Commercial General Liability (CGL) Policy?
Bodily Injury & Property Damage
Per Occurrence Limit
$1,000,000
What is the per occurrence limit for Cov B in a Commercial General Liability (CGL) Policy?
Personal Injury
Per Occurrence Limit
$1,000,000
What is the per occurrence limit for Cov C in a Commercial General Liability (CGL) Policy?
Med Pay
Per Person Limit
$5000
Three major conditions of a Commercial General Liability (CGL) Policy?
- Premium Audit
- auditable policy - premium is based on sales or payroll (exposure base) - premium adjusted accordingly - When Insurance does not renew
- 45 days notice before the expiration date is required to be given to the first named insured. - Coverage Territory
- Premises, Operations & Completed Ops - USA, territories, Canada
- Products - Worldwide if made in the US
What is Owners and Contractors Protective Liability?
- Optional Coverage
- Sleep Well Coverage
- MAKES DEFENSE COST FREE - LAWYERS ARE FREE
Owners and Contractors Protective Liability covers against liability arising from what?
Negligence of a Contractor or Subcontractor hired by insured.
Is wrong descriptions of prices covered under advertising and personal injury on a Commercial General Liability (CGL) Policy?
NO -
Can a commercial auto form be issued as monoline?
Yes - or part of a package
What type of business may be covered in a Comm Auto Policy?
ANY
What are the Three types of Comm Auto Coverage Forms?
- Business Auto Coverage Form (BAP)
- for insureds who own a operate autos in business activities - Garage Coverage Form
- for insureds in the business of driving, servicing, and working on NONOWNED autos - Truckers Coverage Form
- Common Carriers
- PRIVATE PASSENGER AUTOS NOT AVAILABLE
What is consider an AUTO under a Business Auto Policy (BAP)?
- designed for travel on public roads
- private or comm
- mobile equipment designed for travel on public roads (drilling rig, crane truck)
What is consider an OWNED AUTO under a Business Auto Policy (BAP)?
- autos titled to a business entity
What is consider an HIRED AUTO under a Business Auto Policy (BAP)?
- USED IN INSUREDS BUSINESS
- LEASED, HIRED, RENTED, BORROWED
- NO OWNED BY EMPLOYEES
What is consider an NON-OWNED AUTO under a Business Auto Policy (BAP)?
- used in the insured’s business that are OWNED BY EMPLOYEES
1 Covered auto under a Business Auto Policy (BAP)?
ANY AUTO
- only available for LIABILITY coverage
2 Covered auto under a Business Auto Policy (BAP)?
OWNED AUTOS ONLY
7 Covered auto under a Business Auto Policy (BAP)?
Specifically described autos only
8 Covered auto under a Business Auto Policy (BAP)?
Hired autos only
9 Covered auto under a Business Auto Policy (BAP)?
Non-owned autos only
What triggers coverage under a (BAP)?
of vehicle - 1,2,7,8,9
Under symbole #7, how long does a insured have to notify the insurer of newly acquired autos?
30 days
Under symbols #1,2,3,4,5,6 how long does a insured have to notify the insurer of newly acquired autos?
Autos covered until end of policy
Only auto symbol that will have coverage for physical damage, towing and labor?
2 - Owned Autos - business only
When is coverage triggered in a Business Auto Policy?
date of occurrence - accident
What are the two physical damage coverages available under a BAP?
- Comprehensive
2. Collision
Is Med Pay included under a BAP?
Must be added by endorsement -
What is the difference between Med pay in Personal Auto and Med Pay in BAP?
BAP - coverage is provided for only ONE year from the date of the accident
Is Uninsured Motorist Coverage included in a BAP?
Must be added by endorsement
- IF COVERAGE IS ADDED TO THE BUSINESS AUTO, COVERAGE IS NOT AUTOMATICALLY PROVIDED ON ALL VEHICLES!!!
What are the Two types of coverages available under a Garage Coverage Form?
- Garage Liability
2. Garagekeepers Coverage
What does the Garage Liability Form combine?
Business Auto Policy (BAP
and
Commercial General Liability
What is the coverage designed for in Garage Liability?
- insure businesses that drive, service and work on NON-OWNED autos
- auto dealers, auto repair shops, service stations, parking garages
What is the Garagekeepers Coverage designed for?
- a bailee coverage providing physical damage coverage for CUSTOMER’S AUTOS in care, custody, control (CCC) of the insured for storage, service or repair
- EXCLUDES coverage for all other types of business property including inventory, supplies, machinery and mechanic tools
Why Commercial Crime Insurance be necessary?
- Comm Coverage EXCLUDES loss of money, cash, securities
2. peril of THEFT excludes caused by EMPLOYEES
With regards to Commercial Crime Insurance, what is a Custodian?
- named insured, partner, employee
- inside premises
- war wagon
With regards to Commercial Crime Insurance, what is a Messenger?
- named insured, partner, employee
- outside premises
With regards to Commercial Crime Insurance, what is a Burglary?
- taking property from inside premises
- forced entry, unlawful entry
- business is closed
With regards to Commercial Crime Insurance, what is a Robbery?
- taking property and threatens bodily harm
- no weapon required
With regards to Commercial Crime Insurance, what is a Larceny?
- taking property when there IS access to the area
- shoppliftin or domestic employees
With regards to Commercial Crime Insurance, what is a Extortion?
- away from premises
- threat of bodily harm to a hostage
With regards to Commercial Crime Insurance, what is a Mysterious Disappearance?
- unexplained loss of property
- presumption of theft
With regards to Commercial Crime Insurance, what is a Securities?
- negotiable or NON-negotiable instruments
- tokens, tickets, revenue stamps
With regards to Commercial Crime Insurance, what is a Occurrence?
- loss by one or more persons
- single act or series of related acts
- limit of liability is per occurrence and NOT per person
With regards to Commercial Crime Insurance, what is a Discovery Period?
- aka Discovery Form
- period of ONE year for a loss to be discovered AFTER policy expiration IF it occurred during policy period
What are the two ways coverage can be written under Employee Theft (Comm Crime Coverage)?
- Blanket Basis
- all employees for a single amount
- limit applies per loss and not per employee
- premium for new employees is adjusted annually
- Schedule Basis
- Name Schedule
- Position Schedule
(new employees filling specified job position are covered automatically)
How is the deductible applied under Employee Theft (Comm Crime Coverage)?
Per Occurrence
What are the Three exclusions under Employee Theft (Comm Crime Coverage)?
- loss is committed by insured or his/her partners
- coverage is cancelled immediately with regards to a SPECIFIC EMPLOYEE on the discovery of a dishonest act by the insured, partner or officer
- Inventory Shortage
Where does Forgery or Alteration occur?
OFF the insured’s premises
What else is covered under Inside the Premises - Theft of Money & Securities?
Damage to the building, safe, vault, and cash register caused by theft or attempted theft.
What is covered under Inside the Premises - Robbery or Safe Burglary of Other Property?
- Any tangible property other than money and securities
- Damage to the building, safe, vault, and cash register caused by theft or attempted theft.
JEWELRY STORES
What is covered under Outside The Premises in a Comm Crime Coverage?
Losses resulting from theft, mysterious disappearance, destruction of money, securities, tangible property -
- PROPERTY OUTSIDE THE PREMISES MUST BE IN THE CUSTODY OF AN ARMORED MOTOR VEHICLE OR A MESSENGER
What is covered under Computer Fraud in a Comm Crime Coverage?
Losses resulting from the use of a computer OFF THE INSURED’S PREMISES to fraudulently transfer property
- NO COVERAGE FOR THE COMPUTER
Bonds are used to:
Guarantee Promises (obligations)
What are the three parties involved in a bond?
- Principal
- Surety
- Obligee
Who is the promise MADE TO in a bond agreement?
Obligee
Losses are expected in what agreement?
Insurance
Losses are NOT expected in what agreement?
Bonds
In a bond agreement, the Surety can ______ against the Principal.
subrogate
What is the Penalty with regards to Bonds?
The amount of the bond
- Penalty is paid by surety if the principal does not fulfill promise (obligation)
What three criteria does a Surety consider underwriting a Bond?
- Ability to perform
- Financial Strength
- Reputation and Character
What is another name for a Fidelity Bond? An example of a company that might have one?
Dishonesty Bonds - PROTECTS AGAINST DISHONEST EMPLOYEES
Merry Maids - House Cleaners
What is a Capacity Bond?
NO SUCH THING
What does a Surety bond guarantee?
Performance
What is the Principal with regards to Bonds?
Obliger
party who has agreed to fulfill obligation
What is the Obligee with regards to Bonds?
party for whose benefit the bond is written
I am the Obligee - the bond benefits me
What is the Surety with regards to Bonds?
guarantees an obligation
What do Fidelity bonds protect against?
Dishonest Employees
How long are Fidelity (dishonesty) bonds good for?
no expiration
Fidelity bonds provide the same coverage as ______ ______ ________ - _______ ______.
Commercial Crime Coverage - Employee Theft
What are the two ways in which a Fidelity Bond can be written?
- Blanket
2. Schedule
What are Surety Bonds sometimes referred to as?
Suretyship
Surety bonds are similar to a ________.
Co-signer
What are contractual surety bonds used for?
guarantee the fulfillment of contractual obligations
What are Three types of Contractual Surety Bonds?
- Performance Bond
- Bid Bond
- Labor and Material Bond
What is a Labor and Material Bond?
Payment Bond
- guarantees the contractor (principal) will complete and deliver the project free of any liens.
A fiduciary is a person ___ __ ____.
Held In Trust
In a Judicial or Litigation Surety Bond, a fiduciary, :
guarantees the faithful job performance of PEOPLE IN HIGH POSITIONS OF TRUST.
Legal Guardian
Administrator (Executor)
What are two examples of fiduciaries with regards to a Judicial or Litigation Surety Bond?
Legal Guardian
Administrator ( Executor )
What is a Bail Bond and example of?
Judicial or Litigation Surety Bond
A Permit & License Bond guarantees:
- certain types of taxes are paid
- specific laws and regulations are followed
Liquor Store Licenses
Three major parts of Professional Liability Policies:
- Do not require underlying insurance policies
- Provide coverage for financial damages (not punitive)
- Provide defense cost
What are the Two categories of Professional Liability Policies?
- Medical Professional - malpractice
2. Non-Medical - ERRORS & OMMISSIONS
What are the basic (minimum) limits in WC?
100/100/500
Bodily Accident - $100,000 each accident (per accident
Bodily Injury by Disease - $100,000 each employee
Bodily Injury by Disease - $500,000 aggregate (policy limit)
Definition of Compensable Injury with regards to WC?
- injury or disease arising out of and in the course of employment
What is also covered under wages in a WC claim?
- reasonable value of rent, lodging and board
- severance
- NOT SICK PAY
What does the Oklahoma WC Court do?
- applies the law
- responsible for resolution of DISPUTES
What are some excluded employers with regards to WC?
- Farm employers - annual payroll less than $100,000
- Domestic Employees - annual payroll less than $10,000
- Employer with FIVE or less total employees, all of whom are related by blood or marriage
- Federal Government Employees such as Longshoreman & Harbor Workers Act
Is a volunteer covered under WC?
NO
Three examples of excluded employees with regards to WC:
- Sole proprietors
- Members of Partnership
- Stockholders owning more than 10% of a Corp
The Insurer underwriting the WC coverage can ______ against the responsible party.
subrogate
Does WC have a retirement benefit?
NO
Four Benefits of WC:
- Medical Benefits
- Loss of Income Benefits
- Death Benefit
- Rehabilitation Benefit
Medical Benefits in WC claims:
Unlimited
- benefits are effective from the date of injury or loss
- no coverage for pain & suffering
- Employer must provide med care within 7seven days of KNOWLEDGE of actual injury
Loss of Income Benefits in WC claims:
70% of loss wages
- paid weekly
- exempt from federal and state income taxes
- no compensation allowed for the first 7 calendar days of loss of income- benefits begin after 7 day waiting period
Types of disability:
Temporary Partial
Temporary Total
Permanent Partial
Permanent Total
Temporary Partial disability provides what WC benefits?
70% of employees average weekly wage
max number of weeks - 156
Temporary Total disability provides what WC benefits?
70% of employees average weekly wage
period determined by doctore
Permanent Partial disability provides what WC benefits?
70% of employees average weekly wage
schedule determined by type of injury
lump sum payment will be made according to schedule set by law based on the type of injury (finger, limb, etc)
Permanent Total disability provides what WC benefits?
70% of employees average weekly wage
until employee reaches the age of maximum social security benefits
Death Benefit (Survivor Benefit)
70% of employees average weekly wage WILL BE PAID TO SPOUSE
lump sum payment will be made to the spouse ($100,000) and $25,000 to each child (dependent).
Rehabilitation Benefits:
unlimited
Does employer provide disability coverage?
NO - just workers comp, which provides coverage in the event of a disability cause by something while on the job
What are the Three methods for funding WC?
- Commercial Insurance
- Competitive State Fund
- Self Insurance
Who sets WC rates?
STATE - NOT OID
Rating of WC:
Job Classification - Code - Rate Per $100 X $ Payroll Per 100 = annual premium
Are contractors responsible for WC of subcontractors?
YES -
Contractors should require a Cert for every Sub
The only type of disability that pays a lump sum in addition to weekly pay:
Permanent Partial - loss of limb, etc
What part of the OK WC Policy protects against Common Law Claims?
Part II - Employer’s Liability Coverage
What part of the OK WC Policy protects against Statutory Claims?
Part I - WC Benefits