Insurance Exam Flashcards

0
Q

Indemnity

A

To restore policyholder to pre-loss condition; make whole

- no better, no worse

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1
Q

Insurance

A

Transfer of risk from insured to insurer

- Transfer chance of loss to insurer 
 - Thru legal contract
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2
Q

Reinsurance

A

The insurance company’s insurance company

- insurance company determines retention limit and buys reinsurance for the balance
- also known as "pooling the risk"
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3
Q

Risk

A

Uncertainty of Future Outcome, Financial Loss

Pure = Chance of Loss Only > covered by insurance

Speculative = chance of loss or gain > cannot be covered by insurance

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4
Q

STARR - Methods of handling risk

A

Methods of Handling Risk:
> Sharing = chance of loss is shared among many individuals - called pooling the risk
> Transfer = shifting financial burden of loss from insured to another party. This is thee purpose of insurance
> AVOIDANCE - avoiding a particular activity that could turn into a loss
> Retention - Accepting the possibility of a loss yourself by insuring only above a certain $ amount
- deductible is a certain type of risk retention
> Reduction - Taking action to reduce the possibility of loss - control

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5
Q

CANHAM - Elements of Insurable Risk

A

Elements of an Insurable Risk
> Calculable - prior loss statistics available
> Affordable - premium affordable to consumers
> NON-CATASTROPHIC - no earthquake, war, terrorism
> Homogenous Exposures - similar exposures
> Accidental - not intentional
> Measurable - # & $ amounts

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6
Q

Perils

- Policy Written in 2 Forms

A

Causes of Loss = Common Causes incl fire, wind, lightning

Policies written in 2 forms:

  • Specified (named) = Perils covered specifically listed in policy
  • Open Peril (All Risk) = specifically lists excl, everything else is covered
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7
Q

Hazard

- PMM

A

Hazards increase the chance of loss
- Physical - material characteristics
- Moral - dishonest tendencies
- Morale - careless irresponsible attitude
> Statement that best describes Hazard
- a condition increasing chance of loss

Hazard increase the chance or severity of loss

- cracked sidewalk 
- intentionally burn down house 
- leave keys in unlocked car
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8
Q

Insurable Interest

  • PEP
  • All ins contracts are required to contain an element of:
A

All insurance contracts are required to contain an element of insurable interest:

  • Personal/ Financial Interest
  • Economic Loss ($$) Required
  • For Property and Casualty must exist @ time of loss

PQ: All of the following are examples of insurable interest EXCEPT….
- Property person expects to inherit

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9
Q

Loss Valuation

A

The process of determining the value of the loss:

  • Replacement Cost - today’s cost to fully replace lost/damaged property w/ like kind or quality property - w/o deduction for depreciation
  • Actual Cash Value (ACV) - replacement cost minus depreciation > wear, tear, obsolescence
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10
Q

Valued Policy

A
  • a loss valuation
  • law
  • is an exception to the principal of indemnity. Under this provision the insurer is liable for the full amount of damages up to the policy value
  • insurer responsible regardless of loss
  • 90 days to see
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11
Q

Proximate Clause

A

The cause responsible for the loss:
- closely related to direct loss; insured peril is required
- unbroken chain of events
- had it not been for THIS occurring THIS would not have occurred
> Look for what started the loss

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12
Q

Limits of Liability

- 3 different ways

A
Max amount of coverage agreed to be paid in the event of a loss. 
> Stated 3 Different Ways: 
	- Combined
	- Split Limits 
	- Aggregate Limit
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13
Q

Deductible

A

Deductible is an example of Retention
- is a certain type of risk retention

Retention = accepting the possibility of a loss yourself by insuring only above a certain $ amount

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14
Q

Accident / Occurrence

A

An event that is sudden & unexpected
- financial loss occurs
- the specific time & place can be proven
—————————————————————-
An event that happens over time
- can be a series of accidents
- can be continuous or repeated exposure to conditions
- results in injury or disease (black lung disease)

> is not expected

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15
Q

Short Rate / Pro-Rate

A

> Company keeps penalty (service charge)
Insurer cancelled; insured received full unearned premium; no penalty

  • part of policy termination
  • how premium is refunded
16
Q

CLAC

- Elements of Legal Contract

A

Elements of Legal Contract:
> Competent Parties = not minors, mentally/ legally incompetent, alcohol/drug influence, enemy aliens
> Legal Objective = contract must be purchased for a legal purpose
> Agreement = offer & acceptance
> Consideration = exchange of values ($ = promises)

17
Q

Unilateral Contract / Aleatory Contract

A

Part of special features of Ins Contracts

Only enforced by one party to the contract
- one sided, only the insurer has promise to keep
—————————————————————-
Insurance Contract is valid even though there are unequal exchanges between parties
- small premium paid or partial accident occurs full limit is paid out regardless

18
Q

Insured

A

is policyholder, person, business, or entity whose interest is protected in policy.

  • Named Insured = specifically designated by name (Dec page)
  • First Named Insured = listed first on Dec, may have a higher level of duties or rights under the policy
  • Additional Insured = in addition to the Insured, is listed on Dec Page has an insurable interest
19
Q

Legal Issues Affecting Insurance Contracts

- RURWCFBW

A

> Reasonable Expectations = what the avrg persn would infer from a policy or contract
Utmost Good Faith = honest, cooprtn, and full disclosur or parties to a contract
Representations = oral or written statements, true to the best knowledge & belief of party making stmnt
Warranty = guarantees answers on the app, these can void the policy
Concealment = failure to disclose all material facts
Fraud = intentional misrepresentation of a material fact
Binder = temp contract pending issue of the policy
Waiver = voluntary relinquishmnt of a known right

20
Q

Surplus Lines Insurance

A

Insurers risks not available in standard market due to unusual risk characteristics

21
Q

Producer/Principal Relationship

A
Agent = someone who acts on behalf of another 
Principal = party to whom action is taken 

> Agent (Producer) represents Principal (Carrier)

Broker represents client

22
Q

3 Types of Authority

- AIA

A

> Actual/ Expressed = written authority
- authority as specified in the producer’s contract
Implied = authority not expressly granted, but a producer is assumed to have in order to transact the biz of the principal
Apparent = authority a reasonable person would assume a producer has based on the producer’s actions and statements

23
Q

Insurers/ Insurance Organizations

Domicile

A
Domestic = w/in state 
Foreign = outside of state 
Alien = outside U.S.
24
Q

Stock Insurers

A

Owned by their stockholders who rcv dividend as stock value or periodic dividend payments

25
Q

Reciprocal Insurer

A

Insurance Companies made up of policyholders who insure other policyholders

Reciprocals are managed by an Atty-in-fact

26
Q

Mutual Insurers

A

Owned by their policyholders who rcv the dividends directly as end-of-yr policy additions or cash

  • Not for profit
  • Issue participating policies
27
Q

Underwriter

A

EE of Insurance Company who is responsible for the selection, classification, and acceptance or rejection of a proposed Insured

U/W does not make proposals, producers do

28
Q

Adverse Selection

A

Tendency for pple w/ greeater-than-ave exposure to loss to purchase insurance
- pple living near earthquake fault lines will want earthquake ins

Insurance Company that write too many greater-than-ave risk (exposure) is subject to adverse selection and may experience financial loss & decreased profitability

U/W are responsible for protecting the insurer against adverse selection