Defnitions Flashcards
Insuring Agreement
Describing coverage under a policy
Elsewhere in policy may restrict or exclude coverage
Exclusions
Provisions in an insurance policy indicates what is denied coverage
Conditon
Action that insured mist take or continue to take insurance policy to remain in force insurance process a claim
Transacting Insurance
NAIC commissioner is to premote uniformity of state regulation and legislation as it concerns the industry
Licensing Requirement : Agents
Individual who sells and services insurance policies in 2 classifications
LIcensing Requirements: Independent Agent
Represents at least 2 insurance companies and gives a good price for most coverage paid on commison
Licensing Requirements :Non-resident
Markets/Insurance policies in a state which she/he isnt domiciled in
Licensing Requirements: Direct Writer
Rep 1 company
ONly sells its policies paid on a commission
Licensing Requirements: Temporary
Dept may issue a temporary license under the section 2 article who will be considered by another agent who will complete under agents insurer or health organization at least 40 hrs of training
Definition of Insured
Essential Parts of the insurance policies that explain the meaning of important word/phrases in policy
Commissioner of Insurance
Top state regulator of the insurance business who is elected or appointed by the state safe guard
1. General power duties
2. Examination of Records
3.Investigations
4.Penalties
Company must examine
once ea 6 months for the 1st 3 yrs ,once for the next 4 to 6 yrs, once every 3 years
Record examinations
Consideration
When the insured has made the payment of 1st premium and fills out an application this would constitute
Denial of License
Violated any provision of TX insurance laws
Denial of License
Made material misstatement in license application
Denial of License
Obtained or tried to obtain license by fraud
Denial of License
Misappropriated, converted, or legally withheld money belonging to insurer and insurance
Denial of License
GUilty of fraud or dishonest acts
Denial of license
Mirepresented the terms and conditions of any insurance policies or contract
Denial of License
made or caused any mishaps or incomplete comparison about terms aand conditions of any contract to try to convince owner to deny policy to renew
Denial of License
Not intrested in writing policy
Denial of License
Disability defined by the first act 12 5-6 wil not approve license
Declarations
Statement that the insure makes about loss exposures in a application for a policy
Avoidance
Staying away from bad risk
Commission Sharing
Sharing commissions between agents w/ valid license. Agents may not split commisisons w/ licensed agents
Boycott, coercion or intimidation
Entering any agreement to commit or by any converted action committing to result unreasonable retrain of or monopoly in business of insurance
Fraud
Dishonest Act
Discrimination
Discriminating rates between individuals. Discriminating in the amount of premium policy fees or rates
Reduction
To take action to reduce the possibility of severity of possible loss
Foreign
Insurance company whose domicile is in a state other than the company writing business
Personal Contract
Between insured and insurer
Express Authority
Authority formally granted in oral or written agreement by insurer
Defamation
Any oral or written statement that is false or critical of condition of any insurer which is calculated
Aletory Contract
Depends on ocurrence ea party may not give and recieve the same value
Apparent Authority
Action/Inaction by insurer gives agent the impression that he/she has certain authority
Conditional Contract
when a loss occurs both parties must meet certain conditions to make contract legally enforceable
Binder
Temporary insurance contract providing coverage until policy is issued
Agent Responsibilities
Responsibility to handle funds ethically and to keep records and remit premiums when due
Proof of loss
Documentation of loss required of a policy owner by insurance company
Defamation
To publish/spread or calculate any oral written statement which is false critical or derogatory to the financial condition of any insurer
Transfer
Shifting the individual risk of a loss to a larger similar group or transfering potential financial loss of another party
Unilateral
Act is exchanged for a promise
Implied Authority
Kind the public may reasonably believe an agent to have
Implied authority
KInd the public may reasonably believe an agent to have
Contract of Adhesion
Terms are drawn by the insurer and insured simply adheres to the terms but is able to cancel the contract at any time
Any ambiguity must be interpreted in favor of insured because insured has no control over policy
Licensing Requirements: Exceptions
Provision in insurance policy that indicates denied coverage
Licensing Requirements: Exemptions
Size of the estate passing free from estate and gift of taxes the amount as of January 1, 1987 is $600,000
Licensing Requirements: Continuing Education
Agent licensed to do business in state which plan is described as subsection (a) each agent will recieve 15hrs of education
Alien
In foreign country.IN order for insurance to be carried in a particular in state in the US it must follow insurance companies
Stock Company
Owned by share holders
Domestic
The law of the state in which a risk is located and policy is issued the insurance company is domicilied in that state
Licensing Requirements: Contract
Insurance Agreement under which the insurer is legally enforced to make a benefit payment
Licensing Requirements: Appointment
Act by company that authorizes an agent to action its behalf
Controlled Business
At least 25% will be from persons organization other than insurance agent
Licensing requirements: Limited License
Temporary License
Exposure
Possibility of loss because of condition
Sharing
More than one assumes responsibility
Mutual Insurance Companies
Owned by policy holders no stock is available on stock companies
Rebating
Giving or offering to pay as an inducement to insurance any rebate of premiums payable in contract of terms
Foreign Insurance
Organized under law of another state
Unilateral Contract
Type of contact exists when act is exchanged for promise insurance usually involves contract
Arbitration
Provision in a property insurance policy that the insured and insurer cannot agree on the amount of claim/settlement each appoint and appraiser at least 2 or 3 agree on settlement amount and is pending
Certificate of authority
written statement by an insurance company providing powers it has vested in an agent
Claim method and practices: False Advertising
Advertisement statement or announcement that contains refrence to business, insurance unture, deceptive and misleading
Renewal
A license that has not expired been revoke not suspended
Expiration
License expiration 2 years following date issued
Consideration
premium payed by insurer
Misrepresentation
intent to defraud
False Advertising
Statement/announcement that contains refrence to business or insurance business that is not true