exam queen Flashcards
AUTHORY
express
implied
apparent
AUTHORITY
Express: written in the contract.
Implied: assumed by the insurer.
Apparent: assumed by the customer also known as perceived authority. (business cards/letterhead/stationary).
Apparent Authority
assumed by the customer also known as perceived authority.
(business cards/letterhead/stationary).
Fiduciary
the agent submits a premium collected to the insurance company.
**FUNDS, money, cash, premium.
FOUR ELEMENTS OF LEGAL CONTRACT (EVERY INSURANCE POLICY).
Agreement: known as offer and acceptance. Offer- customer submits an application.
Acceptance - when the insurer issues a policy.
Consideration: both parties bring something of value. Insured- application+premium. Insurer- promise to pay a claim.
Competent properties: sound mind, old enough, and not under influence of drugs/alcohol.
Legal purpose: can not be against public policy or break the law.
Vacancy
A house is vacant when there are NO people and NO stuff.
At 61 days of being vacant, a house
will begin to lose coverage.
Unoccupancy
A house that has stuff, but NO people, however the people do intend to come back like going in a vacation
Coinsurance
a rule that says an insured needs to carry at least 80% of the replacement cost of the
home in order to have the full claim covered. If an insured carries less than 80%, the insurer will use the coinsurance equation to reduce the amount they pay for a claim
Other Insurance
a provisions in the policy that explains if there is more than one policy covering a loss, they will all need to pay a fair share of the loss to protect indemnity
Common Policy Provisions
Insured- an insured is anyone covered by the policy
First Named Insured In a Commercial(business) policy, the first named insured is the designated person
who manages the policy for the business
Named Insured- the person who bought the policy and is listed on the Declaration Page
Additional Insured -Mortgage/lien holder added via an endorsement in regard to a specific interest(mortgage/car loan)
Policy Period- states how long a policy covers an insured
Policy Territory-states where the coverage is active (US, Canada, US territories)
Policy Limits -the most amount of money the insured can collect under the policy
Cancellation-terminating an in force policy
Policy Structure
Declarations- the first page of the policy and is a policy summary of who and what is covered, by what company and for what amount
Insuring Agreement/Clause -Lists the perils insured against as well as contains the promise to pay and the parties of the contract(Parties, perils, promise, period)
Additional/Supplementary Coverage- is built in coverage to all the policies at no additional cost
Conditions- a part of the policy that lists the rules, duties, obligations, ways of behaving for both the insured and insurer
Exclusions- a part of the policy that lists what is NOT covered
Endorsements -written changes made to amend the policy, if added coverage via an endorsement, it will raise the premium
Loss Valuation- a factor in determining the premium
Replacement- the brand-new price to replace things at today’s prices. The original price paid is not Considered.
Actual Cash Value- the used value to replace things and is calculated by knowing the Replacement value
and then subtracting wear and tear(depreciation).
Functional Replacement- The modern less expensive price to make repairs like using Drywall instead of
Plaster
Agreed- A policy that sets the replacement price of an item based on a fair Valuation of the item. Agreed
is used for an item that doesn’t fluctuate much in value.
Stated- A policy that set a Maximum limit that the insurer will pay up to if they item suffers a covered
Basic Types of Construction
Fire Restive- a house that is built with material that can resist burning down for up to 2 hours. Fire resistive is the best rating.
Frame -A building that is made of wood which is flammable. Frame is the worst rating.
blanket insurance
Blanket Insurance- A single policy that covers multiple classes.
Specific Insurance
- A policy that covers a certain thing or it’s own amount of coverage.
direct loss
Direct Loss- the direct physical damage to property, which includes Proximate Cause of Loss too.
indirect loss
Indirect Loss- the losses that because of the direct loss consequences of the direct loss. A house burningdown is the direct loss, and the cost of having to stay at a hotel because of it is the indirect loss.
perils
Perils- Perils are the Causes of Loss, the reason you file a claim. A peril is the fire, lightening, wind, hail.
Insurance does not cover all possible perils.
Named Peril- A policy that will only cover perils that are named/listed on the policy. If a peril is not
named, it’s not covered.
Open Peril- A policy that will cover any perils expect what’s excluded. This is a policy that will list out
underwriting
is known as the Risk Selection Process.
Insurance is the transfer of risk so it’s important to fully access how much risk a person has to transfer. A person with multiple accidents is more likely to have more claims, so they would be transferring more risk then a person with a clean driving record.
insurable interest
Insurable Interest-You must have interest into the item/person you are insuring, meaning you get
insurance on cars you own, house your own, etc. For a person, you need to be related/married. The
memory trick is BB$. You need BLOOD, BUSINESS or MONEY to get insurance. Friends are NOT someone we have insurable interest with.
what is pure risk
Pure risk: loss of nothing. No chance of gain. Only pure risk is insurable. You get sick or you dont, your house is on fire or its not.
speculative risk?
Speculative risk: lose or gain. Like gambling. Not insurable.
handling risk
Handling Risk: I AM A STARR I share, I transfer, I avoid, I retain, and I reduce risk.
the transfer of risk
or the transfer of loss
insurance
Certificate of authority
admitted and authorized.
Allow insurers to sell in the state making them admitted and authorized.
NEVER CHOOSE CERTIFIED
owned by shareholders. Issue non participation policies. Dividends are taxed.
STOCK
owned by policy owners. Issue participating policies. Dividends are not taxed
MUTUAL
Adhesion:
the insurer writes the policy and the customer either takes it or leaves it. Insurer has stick with what they said. Insured takes all of it or not of it.
Aleatory
unequal exchange. (customer pays small monthly premium, insurer pays very large claim)
Bob pays x 1 hour 36 minutes
What part of policy lists out rules, duties, ways of behaving?
Conditions.
STATEMENTS on app that are believed to be true but are not guaranteed to be true.
Representations
ACTUAL CASH VALUE.
REPLACEMENT COST MINUS DEPRECIATION (WEAR/TEAR).
REPLACEMENT COST: BEST BUY. BRAND NEW VALUE.
Insurable interest:
must have interest on the item/person you are insuring. Carshouses you own. Person you are related to or married.. you need BLOOD BUSINESS OR MONEY to get insurance. Must be proven at the time of loss.
risk selection process
underwriting
a factor in determining the premium.
Loss valuation:
WHARVES
extended coverage perils
Windstorm
Hail
Aircraft/vehicle
Riot/civil commotion
Vol-canic eruption
Explosion
Smok
B.B BICE GOLF - broad coverage
*Bursting of heating systems
*Burglary damage
*Ice, snow, or sleet weight
*Collapse of building or part of building
* Glass breakage
*Objects falling from outside
*Leakage of water or steam damage
*Freezing of plumbing
In addition this also includes:
Lawns,Trees, shrubs, and palnts
Breakage of glass
Collapse
____ handles all insurance laws/rules/regulations in your state.
Department of insurance:
commissioner
purpose—
purpose – protect the public. ensuring insurance companies are solvent. usually every 5 years.
FLOOD is covered in
FLOOD is covered in auto. Not homeowners.
SPLIT LIMIT -
COMBINED SINGLE LIMIT -
Split limit: 25/50/25 example. First number: body injury per person. Second number: BI total. Third number: PD total.
Combined single limit: no separation per eprson/bi/pd. Whatever happens you pay 300k. Can be divided between people. One limit for
Occurrence: Pays for bodily injury and property damage for claims filed/reported during policy period, even if it has not been reported or discovered until months or years later
Retroactive date: Provides coverage only to claims that are reported during the policy, and which arise out of events which occur on or after the specified retroactive date
Appraisal: A policy condition that stipulates how the amount of damage or lost property will be determined if the insured and the principal do not agree.
ABSOLUTELY LIABILTY
dangerous. like swimming pools. pet tiger.
VICARIOUS
parent responsbile for child. old english law.
STRICT LIABILITY
strictly products.
declartions page
basic underwrtiing info.
name
address
amount of coverage / premiums
location.
insuring agreement
promise to pay.
effective / renewal dates.
Lists the perils insured against as well as contains the promise to pay and the parties of the contract(Parties, perils, promise, period
proof of loss
within 15 days after loss occurs.
insured has 90 days to submit back.
conditions
exclusions
endorsements
Conditions- a part of the policy that lists the rules, duties, obligations, ways of behaving for both the insured and insurer
Exclusions- a part of the policy that lists what is NOT covered
Endorsements -written changes made to amend the policy, if added coverage via an endorsement, it will raise the premium
A certificate of insurance is a document stating that an insurance policy is in force. It is used to provide proof of insurance to property owners, contractors, and others who may require liability insurance. Perils would be included in a binder, not a certificate of insurance. The premium amount appears only in the policy, not on the certificate of insurance or binder.
—– rights apply when a negligent third party causes a loss. Since the insurance company has paid the loss, it is granted the insured’s right to recover payment from the third party.
Subrogation
—– help reduce the number of frivolous or small claims. The deductible is the amount of each loss that the insured must bear before the policy responds to the loss. Deductibles eliminate the expense of processing small claims, resulting in reduced premiums.
Deductibles
arbitration vs apprasial
As provided by the Arbitration condition, the process of arbitration is used when the insurer and insured disagree about whether or not a claim is payable, or when they disagree about the amount payable for a covered claim.
An appraisal is a dispute resolution method used when the insured and insurer do not agree on the amount of a property loss. Arbitration is similar, but used instead for disputes regarding claim amounts or disputes regarding whether or not a loss is covered by the policy.
An insured placed with the FAJUA must be notified in writing that the insurance coverage is not through the private market within ______ of placement
10 days
New agents must take __ hours of continuing education every __ years (including a 4-hour law and ethics course specific to the license held).
and agents licensed for 6 years or more must complete __ hours.
24 hours every 2 hours
licensed for 6+ years - 20 years
The Office has __ days to approve or disapprove or request a change to the filing.
An insurer must submit the filing __ days prior to use
Application forms must be filed for approval
Every filing must include the effective date and character and extent of the changes
30 days
For a dwelling with limits of $250,000 or more, the insurer must offer hurricane deductibles of
2%, 5%, or 10% of the policy dwelling limits.
If a person and an insurer have agreed in writing to the settlement of a claim, the insurer must pay according to the terms of the agreement no later than __ days after the settlement is reached.
20
The insurer must begin investigating the claim within – working days after receiving proof of loss statements. An agent or insurer must acknowledge receipt of a communication regarding a claim within – calendar days. The insurer must pay or deny the entire portion of the claim within – days after receipt of notice of a property insurance claim.
10 days
14 calendar days
90 days
A hurricane watch or warning is issued for any part of Florida by the National Hurricane Center of the National Weather Service as the beginning of the hurricane threat, and ends – hours following the last hurricane watch or warning issued for any part of Florida by the National Hurricane Center of the National Weather Service.
72
An insurer must give the named insured at least – days’ advance written notice of nonrenewal.
45
At least – days’ written notice of cancellation must be given for nonpayment of premium.
10
HOMEOWNERS
umbrella
extends liability limits
florida required auto
Required Auto Coverage 10/20/10
$10,000 - Medical & Disability
$5,000 - Death benefits
Extended PIP - increase medical reimbursement from 80% to 100% and income loss
from 60% to 80%
Additional PIP - increase the 10,000 by
amounts of 10k, 25k, 40k, and 90k
loss payment
When an agent or a residential insurer receives a communication with respect to a
claim, the insurer must, within 14 calendar
days, review and acknowledge receipt of the
communication
Loss Assessment (HO-6)
Coverage under a unit owner’s residential property policy must include at least $2,000
in property loss assessment coverage. It must
be due to a direct loss to the property.
Deductible is no more than $250
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regulates insuarnce companies
rates / forms
solvency
market conduct
4 parts of a policy
declarations
insuring agreement
conditions
exclusions
promise to pay + perils
insurance agreement
duties and riights?
conditions
elemts of legal contract
agreement (offer/accept).
consideration (pay).
competent
legal purpose
PIP overdue if
not paid within 30 days