Continuing Education Flashcards

1
Q

What is PURE risk?

A

Pure risk is the risk involved in situations that present the opportunity for loss but no opportunity for gain. It’s either loss or no loss. Flood, lightning, earthquakes, etc. Generally insurable.

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2
Q

What is SPECULATIVE risk?

A

Speculative risk is the uncertainty about an event under consideration that could either produce a loss, no change, or a profit/gain. Investing in stock market or engaging in new business. They usually create risks where none were before and are generally uninsurable.

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3
Q

What is a loss?

A

A loss is an unplanned reduction in the value of something. It always involves an unplanned reduction in value.

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4
Q

What is a PERIL?

A

A peril is a direct or proximate cause of loss. The 3 categories are:
Natural perils - Mother Nature
Human perils - Theft, vandalism, violence, carelessness
Economic perils - Recession or changes in consumer preferences and in technology.

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5
Q

What is a HAZARD?

A

A hazard is a condition or action that increases the probability/frequency or the magnitude/severity of a loss. There are 4 types of hazards.

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6
Q

What are the 4 types of hazards?

A

Physical hazard- condition/situation that increased the probability or severity of a loss.

Moral hazard- concerns the likelihood of intentional acts committing by the insured that creates or exaggerates a loss.

Attitudinal(morale) hazard- An indifference to loss simply because insurance exists.

Legal hazard- Various conditions/situations that present the possibility of loss, whether or not a loss ever occurred.

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7
Q

What is LOSS EXPOSURE?

A

Any condition/situation that presents the possibility of a loss, whether it occurs or not. Loss exposure has 4 categories.

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8
Q

What’re the 4 categories of LOSS EXPOSURE?

A

Loss frequency - How often a loss is expected to occur within a given period of time.

Loss severity - The amount of loss, measured in dollars, for a specific occurrence.

Total dollar losses - Total dollar amount of losses for all occurrences of a given type during a specific time period. TOTAL DOLLAR LOSS is frequency times severity.

Timing - Relevant with respect ti both the occurrence of the loss and the time when an insurer pays the resulting claim.

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9
Q

What’re the 4 phases of risk management?

A

E.A.E.A.

1.) Evaluating loss exposure.
2.) Appraising the feasibility of alternative risk management techniques.
3.) Establishing a risk management program
4.) Adapting to change

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10
Q

What is a property loss exposure?

A

Property Loss Exposure is the possibility of loss resulting in the damaging, destruction, taking, or loss of use of property that one has a financial interest in. Includes partial and total losses.

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11
Q

What is LIABILITY LOSS EXPOSURE?

A

Liability Loss Exposure is the possibility of a claim allege that a person/organization is legally responsible for another parts injury or damage. Can be by tort(negligence or slander)or by an action that is wrong against society rather than an individual/specific entity(such as environmental pollution).

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12
Q

What are some risk management evaluation tools?

A

1.) Questionnaire
2.) History to partial losses
3.) Financial statements and records
4.) Flowcharts of operations
5.) Personal inspections of facilities by someone with risk management experience

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13
Q

What are the 7 organizational goals for risk management?

A

1.) Meeting legal requirements
2.) Abiding by ethical standards
3.) Achieving specified financial operating results
4.) Maintaining continuous/stable operations
5.) Reaching growth targets
6.) Addressing humanitarian concerns
7.) Serving any goals that may be important to a specific organization

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14
Q

What are the 4 types of COST OF RISK expenses?

A

1.) Insurance premiums
2.) Cost of restoring uninsured losses(including deductibles)
3.) Expenditures for safety measures
4.) Administrative costs of operating the organizations risk management program.

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15
Q

What are the 5 basic Risk Control techniques?

A

1.) Exposure avoidance - completely eliminates an org’s loss exposure
2.) Loss prevention - reduces probability of losses
3.) Loss reduction - reduces size or severity of potential losses
4.) Segregation of exposures - divided a single exposures into several smaller, more easy to handle exposures
5.) Contractual transfer - separates several exposures from one another legally rather than physically

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16
Q

What is RISK RETENTION?

A

Risk retention uses funds from within an organization to pay for losses it incurs. It’s usually less expensive than purchasing insurance due to frictional costs. Deductibles and loss-sensitive insurance rating plans are complex forms of retention.

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17
Q

What are some retention-funding alternatives?

A

1.) Current expensing of accidental losses - used for minor accidental losses that occur more frequently than major ones and thus can be anticipated and absorbed.

2.) Use of unfunded reserves - Used for accidental losses that are more frequent or severe than can be easily absorbed through current expensing.

3.) Use of funded reserves - used for loss exposures for which the firm does not have/chooses not to use its insurance when an unfunded reserve would not provide sufficient financial security.

4.) Drawing on borrowed funds - used for serious accidental loss for which there is no applicable insurance/none was available and absorption as a current expense would greatly damage and effect the firm.

5.) Creating/relying on a “captive insurer” - used for losses that occur frequently and are to some extent able to be budgeted. A captive is a highly formalized arrangement for retaining losses, it’s an insurance company that has as its primary purpose the financing of the risk of its owners/participants.

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18
Q

What are the 3 most common forms of transfer for risk financing?

A

1.) Commercial insurance
2.) Contractual(non-insurance)transfer for risk financing
3.) Operation of general law(tort law and statute)

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19
Q

What are some actions included in appraising the feasibility of alternative risk management techniques?

A

1.) Determining where the company can get the biggest bang for their buck by applying certain techniques.

2.) Looking for contractual alternatives to assuming exposures

3.) Determining how the company wants to fund losses that occur and it’s risk appetite.

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20
Q

What is defined as REAL property?

A

Real property is land and anything affixed to the land such as a building or other structures. Fixed and immobile.

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21
Q

What is defined as PERSONAL property?

A

Personal property is anything that is not real property such as all loose, mobile items like clothing, furniture, jewelry, lawn mowers, tv’s. Anything not permanently fixed to the foundation or building.

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22
Q

What are fixtures?

A

Fixtures are loose articles of personal property attached to real property such that they become a part of it and not to be removed. Ex- wall to wall carpeting, air conditioner, etc.
Outdoor fixtures are attached to the land itself rather than a structure, like a flag or light pole.

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23
Q

What are trade fixtures?

A

Trade fixtures are what a tenant installs fixtures on commercial property specifically for its use in a trade or business. If the comm. lease gives the tenant the right to remove the fixtures at the end of the lease. They are useful to the specific tenant but wouldn’t be for any other tenant.

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24
Q

What is TANGIBLE property?

A

Tangible property is property that has physical form such that it can be seen, felt, touched, or handled. Can be real or personal property. Like a house or a car.

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25
Q

What is INTANGIBLE property?

A

Intangible property cannot be seen, felt, touched, or handled. Can be real or personal. Ex- an easement over someone’s property or a patent. No coverage options possible for losses to intangible property.

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26
Q

What is a LEGAL TITLE?

A

A legal title refers to the right of control over property and which Carrie’s the legal responsibility for it.

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27
Q

What is EQUITABLE TITLE?

A

Equitable title is the beneficial use of the property.

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28
Q

What is a BAILMENT?

A

A bailment is a contractual arrangement initiated by the owner of a piece of property who temporarily transfers possession of the property to another party for a specified purpose.
The owner of the property is the “bailor”.
The party to whom the property is transferred to is the “bailee”.

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29
Q

What is a LIEN?

A

A lien is a charge or responsibility on either real or personal property of a debtor that gives the lien holder a security interest in that property. Ex- the right to take and hold property until the debtor pays the debt or fulfills a duty that is owed.

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30
Q

What is a MORTGAGE?

A

Mortgage is a specific type of lien created by a written instrument in which the party giving the mortgage(the owner/“mortgagor”)transfers a security interest in real property to the party receiving the mortgage(mortgagee). The purpose is to secure a loan.

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31
Q

What is REPLACEMENT COST?

A

Replacement cost is the amount of money needed to repair your home at today’s prices of building supplies; or replace your belongings at today’s cost of the similar or like item.

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32
Q

What is Actual Cash Value/ACV?

A

ACV is a replacement cost minus depreciation-as fair market value. It is equivalent to the cost to replace the damage/destroyed item(s) with a similar item in the present day marketplace minus a deduction from the replacement cost for reflecting depreciation(for wear and tear given the damaged items age and use).

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33
Q

What is TORT LAW?

A

Tort law is a civil wrong, other than a breach of contract, for which the law provides money damages as a possible remedy. In order for a tort to occur, there must be an unjustified breach of a legal duty causing direct damage.

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34
Q

What is NEGLIGENCE?

A

Negligence is the failure to use a reasonable degree of care under a given set of circumstances.

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35
Q

What are the 4 elements of COA for negligence?

A

1.) Duty
2.) Breach
3.) Proximate cause
4.) Damages

36
Q

What is LOSS POOLING?

A

Loss pooling involves the sharing of total losses sustained by a few pool participants. Decreases the amount of uncertainty present in a given situation. Takes advantage of the law of large numbers which stated that as the number of homogeneous but separate and independent loss exposures united(homes insured)increases, the predictability of future losses also increases.

37
Q

What is IDEMNIFICATION?

A

Idemnification is the security against legal liability for one’s actions. The goal is the put the insured back to the same financial position they were in prior to the loss.

38
Q

What are 4 different types of insurance?

A

1.) Property & Liability
2.) life & health
3.) Government(national flood, federal crop, unemployment).
4.) Reinsurance(an arrangement whereby an insurer transfers all or part of a risk to another insurer to provide protection against the risk of the first insurance.)

39
Q

What is SUBROGATION?

A

Subrogation is the right your insurance company holds under your policy — after they’ve paid a covered claim — to request reimbursement from the at-fault party. This reimbursement often comes from the at-fault party’s insurance company.

40
Q

What is INSURABLE INTEREST?

A

Insurable interest is the insureds financial interest in the value of the subject of insurance. Insured must clearly prove a personal stake in the item being insured in order to collect compensation due when a peril causes a loss.

41
Q

What is the Transfer of Unequal Values/“Aleatory contract”?

A

Aleatory Contract is an agreement concerned with an uncertain event that provides for unequal transfer of value between the parties. Insurance policies are aleatory contracts because an insured can pay premiums for many years without sustaining a covered loss

42
Q

What is Contract of Adhesion?

A

A contract of adhesion, is a contract where the parties are of such disproportionate bargaining power that the party of weaker bargaining power could not have negotiated for variations in the terms of the contract. Encourages clearly written and well explained wording of terms of policies.

43
Q

What are 5 key requirements of Ideally Insurable Loss Exposures?

A

1.) Large numbers of similar exposure units
2.) Accidental & unintentional loss
3.) Definite & measurable loss
4.) Low probability of a catastrophic loss
5.) Calculable probability of loss

44
Q

Principles of authority by an agent?

A

1.) Express Authority- explicitly stated by the principal either orally or in writing.
2.) Implied authority- consists of those powers incidental and necessary to carry out a grant of express authority.
3.) Apparent authority- not technically granted by the principle directly to the agent but arises out of the impression the principal gives to the public at large such that the agent appears to be authorized to act a certain way.

45
Q

What is UNDERWRITING?

A

Underwriting is the process of determining whether to accept a risk and, if so, what amount of insurance the insurer will write on the acceptable risk and at what rate.

46
Q

What are some underwriting risk analysis sources?

A

1.) Application
2.) Agency report
3.) Loss history data
4.) Motor vehicle record
5.) Inspection report and photos(as required)
6.) Loss control report
7.) Credit information(if applicable)

47
Q

What are 2 types of CLAIMS ADJUSTERS?

A

1.) Staff adjusters- those who are employed by insurers.
2.) Independent adjusters- those employed by adjusting firms whose services are contracted for by insurers, self insured organizations, and self insured government entities.

48
Q

What are duties required by the insured after a loss?

A

1.) Provide notice of an occurrence/loss.
2.) Submitting proof of loss(to support a property claim).
3.) Cooperating with the insurer during the adjustment process.
4.) Submitting to an examination under oath(EUO)if requested.
5.) Truthfully representing pertinent facts.

49
Q

What are types of provisions insurance policies contain?

A

1.) Declarations/Information page
2.) Insuring agreement
3.) Covered perils
4.) Exclusions
5.) Definitions
6.) Conditions
7.) Endorsements

50
Q

What is DECLARATIONS in a policy?

A

The declarations provide info about the insured, the policy, and the insurer. Name and address, type of organization, policy period, policy limits, deductibles, and premiums.

51
Q

What is the INSURING AGREEMENT in a policy?

A

The insuring agreement states the coverage provided by the policy. Sets the basic promises under the policy. In the Insuring Agreement, the insurer agrees to do certain things such as paying losses for covered perils, providing certain services, or agreeing to defend the insured in a liability lawsuit.

52
Q

What are COVERED PERILS in a policy?

A

Covered perils is an event that your insurance will cover. When you file a claim for a covered peril — such as a lightning strike, fire, theft, vandalism, wind, or hail damage — your insurance company will reimburse you for the damage less your homeowners insurance deductible.

53
Q

What are EXCLUSIONS in a policy?

A

Exclusions limit the coverage granted in property and liability insuring agreements. They can apply to specified perils(earthquake or flood)or specified losses(testing or intentional losses). They can also contain exceptions and help eliminate or reduce overlapping coverage, remove coverage not needed, remove coverage for uninsurable risks, reduce incentive to create losses.

54
Q

What are DEFINITIONS in a policy?

A

The “Definitions” section defines common words, narrows their meanings, and helps avoid ambiguity that could work against the insurer in a court of law. Common words may have limited definitions in a particular insurance contract.

55
Q

What is the CONDITIONS of a policy?

A

Conditions define both the insured and insurers rights and responsibilities under the policy. Ex- terms under which the policy can be cancelled, subrogation rights, insured duties in the event of a loss, and how losses will be apportioned between insurers when more than one policy applies to a loss.

56
Q

What are ENDORSEMENTS of a policy?

A

Endorsements is an amendment to an existing insurance contract that changes the terms of the original policy. It can include granting additional coverage, restricting/eliminating coverage provided in the basic policy, changing coverage by changing or adding definitions, modifying the rights of the insurer or insured by changing/adding conditions, scheduling covered persons, projects, or property.

An endorsement/rider can be issued at the time of purchase, mid-term or at renewal time.

57
Q

What are PACKAGE POLICIES?

A

Package Policies is a single policy that includes two or more coverages that can also be written as separate policies. Usually refers to policies that provide both property coverage on buildings and/or their content and general liability coverage under one master policy.

58
Q

What are some cardinal rules of contract interpretation?

A

1.) Determine the contractual intent of the parties
2.) Read the contract as a whole
3.) Render no provision superfluous
4.) Avoid absurd results
5.) Plain meaning rule
6.) Adopt reasonable constructions favoring the insured
7.) Avoid unreasonable constructions

59
Q

What are the HOMEOWNERS policy forms?

A

1.) HO 2- Broad form
2.) HO 3- Special form
3.) HO 4- Contents broad form
4.) HO 5- Comprehensive Broad Form
5.) HO 6- Unit-owners form
6.) HO 8- Modified coverage form
7.) HO 14- Contents comp form(created 2022 as an alternative to HO 4)

60
Q

What does HO 2 cover?

A

HO 2 insures the dwelling, other structures, and personal property on a named peril basis; in addition, covers loss of a use, personal liability, and medical payments.

61
Q

What does HO 3 cover?

A

HO 3 insures the dwelling and other structures on an all risk basis and it insured personal property on a named perils basis with 16 perils specified. Also covers loss of use, periodontal liability, and medical payments.

62
Q

What does HO 4 cover?

A

HO 4 is designed for tenants of houses/apartments. It insures tenants personal property on a named perils basis and provides loss of use, personal liability, and medical payments coverage. No dwelling or other structures coverage is provided except for building additions and alterations paid by the insured.

63
Q

What does HO 5 cover?

A

HO 5 insures dwelling, other structures, and personal property on an all risk basis; in addition, covers loss of use, personal liability and medical payments. It provides the most expensive coverage available under the ISO homeowners program.

64
Q

What does HO 6 cover?

A

HO 6 is designed for the owners of condominium units and cooperatives apartment units. Primarily covers personal property on a named peril basis with limited dwelling coverage(improvements, betterments, and items of real property pertaining exclusively to the residence premises). Also covers loss of use, personal liability, and medical payments.

65
Q

What does HO 8 cover?

A

HO 8 insures the dwelling and other structures bases in the amount required to repair or replace the property using common construction materials and methods. Designed to insure older homes when the replacement cost of a house may substantially exceed its market value. Covers loss of use, personal liability and medical payments.

66
Q

What does HO 14 cover?(alternative to HO 4)

A

HO 14 is designed for tenants of houses or apartments. It insured a tenant’s personal property on all risk basis and provides loss of use, personal liability, and medical payments. No dwelling or other structures coverage provided.

67
Q

What perils do each HOMEOWNERS POLICY cover?

A

1.) Fire or lightning: HO2, HO3PP, HO4 &6, HO8.

2.) Windstorm or hail, explosion, riot, civil commotion, aircraft, vehicles, or smoke: HO2, HO3PP, HO 4&6, HO8.

3.) Vandalism/Malicious mischief: HO2, HO3PP, HO 4&6, HO8.

4.) Theft: HO2, HO3PP, HO 4&6, HO8.

5.) Falling objects; weight of ice/snow/sleet; accidental discharge or water or steam; sudden and accidental tearing apart of a heating system or appliance; freezing; sudden accidental damage from electrical current: HO2, HO3PP, HO 4&6.

6.) Volcanic eruption: HO2, HO3PP, HO 4&6, HO8.

7.) Additional risks w/ certain exceptions(special coverage): HO3, HO5, HO14

68
Q

What are some components of a COMMERCIAL GENERAL LIABILITY(CGL)?

A

1.) Common policy declarations
2.) Common policy conditions
3.) CGL declarations
4.) CGL coverage form
5.) Broad form nuclear exclusion
6.) Endorsements, if applicable

69
Q

What are PUNITIVE DAMAGES?

A

Punitive damages are amounts above and beyond and compensatory damages that indemnify a claimant for injury or damage.

70
Q

What is the “four corners test” for CGL?

A

“Four-Corners” Test — the legal principle that an insurer owes a duty of defense to its insured if the formal allegations of a claim or suit match the literal provisions of the insurance policy, regardless of any differing or contradictory facts known or knowable to the insurer. Any doubts are resolved in favor of the insured.

71
Q

What is the “Extrinsic Facts” test for CGL?

A

Extrinsic Facts” Test — the legal principle that an insurer owes a duty of defense to its insured when the actual facts of a claim or loss match the provisions of the insurance policy, regardless of the language in which the claim is asserted against the insured.

72
Q

What does Coverage A in a CGL include?

A
73
Q

What does Coverage B in a CGL include?

A

Personal and advertising injuring liability. In addition to bodily injury and property damage, CGL policies also provide coverage for personal and advertising injuries. Coverage B contains its own insuring agreement and responds to liability claims alleging personal injury and advertising injury.

74
Q

What is Coverage C in a CGL?

A

Medical payments. Pays for all necessary and reasonable medical, surgical, ambulance, hospital, professional nursing and funeral expenses for a person injured or killed in an accident taking place at the insured’s premises or arising from business operations. Within ONE YEAR.

75
Q

What is Executive Liability insurance?

A

An executive is a person who performs executive, managerial, or supervisory functions within a business both for profit and non profit. executive insurance is a group of coverage types designed to protect companies and leaders from various business risks. It usually includes directors and officers insurance and employment practices liability insurance.

76
Q

What is Professional Liability Insurance?

A

A professional is a person who provides a service in accordance with an established set of standards, depending on the profession. PL insurance helps cover you and your company if you make a mistake in the professional services given to a customer or client. This coverage is also known as errors and omissions insurance (E&O).

77
Q

What is Directors & Officers Liability Insurance?

A

Directors and officers (D&O) liability insurance protects the personal assets of corporate directors and officers, and their spouses, in the event they are personally sued by employees, vendors, competitors, investors, customers, or other parties, for actual or alleged wrongful acts in managing a company.

78
Q

What is Fiduciary Liability Insurance?

A

iduciary liability insurance, also known as management liability insurance, is intended to protect businesses and employers against claims resulting from a breach in fiduciary duty. Essentially, the policy protects parties against liability for managing or administering employee benefits plans.

79
Q

What is Employment Practices Liability Insurance?

A

Employment Practices Liability Insurance (EPLI) includes coverage for defense costs and damages related to various employment-related claims including allegations of Wrongful Termination, Discrimination, Workplace Harassment and Retaliation.

80
Q

What are the 6 items listed under the DECLARATIONS page in an auto policy?

A

1.) named insured and form of business. Also mailing address, policy period, premiums, and maybe list of endorsements and counter signature at bottom.
2.) Schedule of coverages and covered autos. Includes liability, PIP, auto medical payments, uninsured motorists(UM),underinsured motorists(UIM),physical damage comp, specified cause of loss, collision, towing and labor.
3.)Schedule of owned autos
4.) Schedule of hired or borrowed auto coverage and premiums
5.) Schedule of non-ownership liability
6.) Schedule for gross receipts or mileage rating

81
Q

What’re the 10 symbols under Item 2 an auto policy?

A

Symbol 1 - any auto
Symbol 2 - owned autos only
Symbol 3 & 4- owned private passenger autos and owned autos other than private passenger autos
Symbol 5 & 6- owned autos subject to no-fault and own auto is subject to a compulsory uninsured motorist law
Symbol 7- specifically described autos
Symbol 8- hired autos only
Symbol 9- nonowned auto’s only
Symbol 19- mobile equipment, subject, compulsory, or financial responsibility or other motor vehicle insurance law only

82
Q

What does the auto liability insuring agreement state?

A

It states that the insurers obligation to respond to a claim or suit against an insurer for damages because of bodily injury, property damage, or pollution cleanup costs resulting from the ownership, maintenance, or use of an auto. The damages or cleanup costs must be caused by an accident as defined in the policy.

83
Q

What is Temporary Total Disability in Workers comp?

A

It is the most common type of disability. It means they are expected
to recover from the injury/injuries and return to work but is unable to do work while recovering.

84
Q

What is Permanent Total Disability in Workers Comp?

A

It means that the injury/injuries suffered leaves the employee unable to do any kind of work for the remainder of their life.

85
Q

What is Temporary Partial Disability in Workers Comp?

A

The employee can still do some work but is unable to earn their usual wage until full recovery.

86
Q

What is Permanent Partial Disability in Workers Comp?

A

When the employee suffers and injury/injuries from which they will never recover but the injury is such that the ability to work is only partially affected.