Insurance Notecards #2 Flashcards
Personal Effects Floater
Covers items carried by tourists and travelers around the world.
Scheduled a sublimit to 10% of scheduled limits
Insurer pays up to $100
Tort exemption
With the no limitations lawsuit option a person is liable for non-economic loss
Liability may extend to person who are not required to keep PIP Cov
If no tort selection, limitations on lawsuit applies
Purpose of NJIUA
Provide needed goods, services, jobs
Attract and retain private capital in central city areas
Provide insurance to enable homeowners to purchase and improve property
Dwelling insured by NJIUA cost and coverage
600k and max PPC if coverage is 50% of building limit
Producers that hold a resident producer license in a state other than NJ may obtain a non resident license if:
The person is currently licensed in good standing in their home state
Paid required fees
Reciprocal basis
A nonresident producer must file a change of address and provide certification from the new resident state within 30 days of legal change of residencey
Certificate of Diligence Effort
Producer and surplus line agent must keep certificate at least 5 years
Applies only after declined 3 times by issuer
Submit to surplus agent within 30 days
General Service Fee
1 Per year
May not exceed $20
No fee for sale or service of insurance
To be negligent
Duty owed
Violation of duty
Proximate cause
Foreseeable consequences
HO 1 Section is
Coverages A, B, C, D
Dwelling
Other structures
Personal Property
Loss of use - Additional living, fair rental
HO 2 Section is
Coverages E and F
Personal Liability
Medical Payments
Only renew / cancel policy after X days
Not less than 30 or more than 120
Net Participation determines
Profit or loss relative to all participants
Personal Jewelry Floater
30 days auto coverage
25% of amount of insruance or less than 10k
Broker
Represent insured
Place insurance with company not an agent
Penalty for decpetion
5k and 10k if they know
insuranable interest
Lawful and substantial economic interest in safety or preservation of property from loss and destruction
FAIR Plan
Provide adequate market, a means to purchase basic property insurance when it cant be obtained by regular markets
Loss paid by insurance industry
Must be insurable risk
Every Insurer must be a member of the association
Fine Art Floater
Excluded: Breakage of window, glass wear
Covered: Fire or lightning, explosion, windstorm, earthquake, theft
90 days 25% coverage
Fraud act violation costs
1 - $5k
2 - $10k
3 - $15k
Unfair method of competition violation
$5k initial
$10k secondary
Essential property insurance
Minimum insurance provided by FAIR plan, as defined and limited in the policy with extended coverage
FAIR Violation
1 - $2k
2 - $5
PAIP Rates (Personal Auto Insurance Plan) Collision and comprehensive
Valued between 15k and 25k - Must be experience rated
25K and up must be experienced rated
Uninsured Definition
Hit and run vehicle
BI liability but was denied
BI but insurer was insolvent
Special Automobile insurance
Uninsured Coverage Requirments Limit
250k per person BI
500k per accident BI
100k Per person damage - $500 deducible
US vs South EAsten Associations
Insurance was interstate Commerce and when conducted across state line subject to federal regulations
Minimum Liability Coverage for uninsured BI
15k for 1 person
30k for 2+ people
5k for property damage caused by uninsured, $500 deductible
Eligibility Points
Point value based on driving record
Auto Inspection after accident
Inspect auto before coverage
Request inspection of damage before repair
Can pick repair shop but might invalidate warranties
No inspection for new cars
Denial of coverage Median
The applicant same median the application is made and why it is denied
If orally, written explanation within 90 days
Required to insure
Must provide auto coverage if eligible except:
Exceed quota of UEZ
Financially unsafe
May dey coverage as allowed by Law competition
Residence burglary and robery limits
15k
PAIP Service Carriers
LAD
UEZ Program
Underserved areas
Designed to increase insurance
Quarterly report within 10 days of quarter ending
Violation - 1k, 2k not exceed 5, suspension of insurance certificate
PAIP Coverage to NJ
Qualified applicants and apportion these risks equally among insurer in order to insure competition in auto market
Must be NJ resident and garaged in NJ
Expect military
Permanent total
Injury prevents worker from being able to do any work for rest of life
Schedule of benfits
Temporary Total
Injury employee is expected to revoer and return to work
Unable to do work while recovery
Temporary Partial
Do some work but is unable to earn full wage until recovered
Permanent Partial
Employee is able to do some work but will never fully recover
CAIP Purpose
Provides and apportions among insurers coverage for commercial auto
Every insurer must participate
Applicant = owner of vehicles in NJ who is unable to obtain insurance
5+ vehicles = fleet
CAIP Liability Single Limit Coverage
Single limit 35k
Coverage 5 mill excess is conditioned being able to get reinsurance
CAIP Physical Damage
Provides mandatory PIP coverage
Physical Damage Cov = Private passenger, light truck, motorcycle,
Policy may not provide if 25 older, trucks, 20+ persona car
Comp + Collision = ACV - Deductible
CAIP Service Carrier
Profits credited
Losses will be charged for each participant, annual audit of carrer
Cant be government commitee
20 days to appeal
CAIP COv
Policy may not be more than 5 years
Must certify inability to obtain insurance on ordinary market in 60 days
Quality = NJ
PIP Coverage Personal Injury Protection
15k and up to 250k per person per accident
25k medically necessary for treatment of nerve or disfigurement
Loss of income = $100 / 5,2k life time
Essential Benefits = $12 0 4.3k life time
Funeral Benefits = 1k
Paul vs Virgina
Each state to regulate insurance
Reversed 1944
Basic Act Policy non renwal days
60 days but no more than 90
PIP Nonrenwal
15 days cancelled if no premium
20 days is cancelled
PIP Payments of benefits
60 days
If investigate claim = 45 days
5k, 1k, 1.5k, 2k, 2.5k
Deductible for accident if coverage health not in forced because covered accident = 750
Mccarren Ferguson 1945
Public law 15
Regulate and taxation on insurance by individual state
Power = state
Federal can intervene
PAIP Coverage bodily sublimits
250 /500/ 100
Physical damage = ACV - Deductible up to 60k
PAIP Split limits or combined
50 / 100 / 25
Producer May Not
Issue policy, binder, or cancellation. Change coverage through endorsement assign any loss
Notice of non payment of premium
10 days
Mercantile Rate
inside = $1k
Outside = $1k
Outside with armed guard = $5k
Safe Burglary = $5k
Open stock = $10k or coninsurance limits
Notice of Moral Hazard
10 days
If insured will destroy covered property for purpose of collecting proceeds
Office Burglary and Robbery Limits
1k
Store keeps burglary and robbery
1k
Personal limits building and contents
900k
600k building
300k contents
Musical Instrument Floater
If instruments are used by any person in a paid performance, must have performance for pay coverage
Named Perils
30 days, 25% coverage / 10k or less
Scheduled Benefits
Applies to specific permanent injuries such as a $ amount for loss of an eye or hand
Coastal Prep and Hurricane Risk
May increase rates by 5% max
Must file within 30 days
When H/O insurance policy is delivered:
Explain hurricane deductible program
Flood insurance program
Policy summary
Commercial Limits
1.5mm
Symbol 19
Mobile equipment
Symbols 30
Autos left with insured for service, repair, storage
Symbol 31
Dealers, autos, physical damage covered
Workers Comp Section
Part 1 - W.C Insurance
Part 2 - Employers Liability - Limits
Part 3 - Other state insurance
Part 4 - Duties if injuries occur
Part 5 - Premium
Part 6 - Conditions - Cancellation policy
Rate and rate making
Must have five rates with commission
At least 30 days before
Must consider:
Past and prospective loss exp
Foreseeable and catastrophic hazard
Reasonable profit
Camera Floater
30 days
25% or 10 whichever is less
TV Camera are excluded
Notification NJ a producer has been appointed
15 days of a contract signed or when producer sublimit first policy application
Commercial insurance deregulation act of 1982
Encourage price competition - to prevent monopolies
Exportable list
Risks for which no market insurs
List created by commissioner
Only coverages on list may be placed with surplus lines
Insurance agent
Sell, solicit, negotiate - insurance ocntract
Collect premiums and countersign
HO-6
Unit Owners -
Named Perils - A & C - Can add B through endorsement
Insures real property
H0-8
Modified Form
Named perils, Older homes
ACV - if exact materials are avaiable - R.C
HO-5
Broadest coverage - A,B,C
A B - RV
C - ACV
HO-4
Renters and tenants
Personal Prop = C
HO-3
Special Form
A & B open peril = replcaement cost
C = named p erils
HO-2
Braod Form
Named perils - A, B, C
Replacement cost - A & B (losses to the dwelling)
COverage C = ACV (Personal Prop)
DP-3
Special form - open.
Dwelling and contents - RC / Personal Property - ACTV
excluded
Ordinance or law.
Earth movement.
Water damage.
Power failure.
Neglect.
War.
Nuclear hazard.
Intentional loss.
Governmental action.
Mold.
DP-2
Broad named perils
Lossing to dwelling RC / Personal Property ACV
Fires and lightning
Hailstorms and windstorms
Smoke
Explosions - both internal and external
Riots or civil commotions
Burglary
Vandalism
Accidental or sudden power surges
Vehicle damages
Aircraft damages
Accidental or sudden water damage
Freezing pipes
Volcanic eruptions
Falling objects, like a tree
Snow
Structure collapse
Glass breakage
Accidental or sudden cracking, bulging, or tearing
DP-1
Basic & EC
ACV
Named
Fire lightning, explosion
Fire and lightning
Internal and external explosions
Windstorms
Hail
Riots and civil commotions
Smoke
Aircrafts
Vehicles
Volcanic explosions
Symbol 9
Non owned autos only
insured does not own, lease, hire or rent
Used for business
Symbol 8
Hired autos only
Insured leases, hires, rents,
May not owned by insured
Symbol 7
Described vehicles listed on declaration
Symbol 6
Owned autos subject to a complosorty uninsured motorist law
Symbol 1
Any auto if it is used in the insureds business
Symbol 2
Owned Auto only
Symbol 3
Owned private passanger auto only
Symbol 4
Owned auto other than private
Symbol 5
Owned autos subject to no fault
Personal articles floater
ACV / worldwide / open peril
Insures individual on items on scheduled basis - personal property
Vicarious Liability
Assigned to one party for conduct to another, based on relationship
attachment of responsibility to a person for harm or damages caused by another person in either a negligence lawsuit or criminal prosecution.
Uninsured Motorist
Coverage if insured is involved in accident with at fault uninsured
Revoke producer license is/for
Failure to pay tax
Cheat on exam
Convicted of a felony
SERP
Can’t cancel premium once paid
1 time charge
endorsement purchased within 60 days to end
Comparative negligence
Tort principle used by the court to reduce the amount of damages that a plaintiff can recover in a negligence-based claim according to the degree of negligence each party contributed to the incident.
Installation Floater
Property being installed Electrical / plumbing / heaitng
Equipmente used by contractor for installation is seperate
Aggregate Limit
Applies to losses from all occurences within a specific time period
Prior Approval
Requires rates cannot be used until the commissioner approves the rate, or until a set time period has expired
How long does coverage extend for new cards
14 days
Personal Auto A,B,C,D
A - Liability
B - Medical Payments
C - Un/underinsured Motorist
D - Damage to your auto
Part A Liability Covers
Named insured
Insured spouse
Other family member who resides with the named insured
Any person borrowing a covered auto with permission
Pure no fault plan
A pure no fault plan system would abolish use of the tort system for bodily injuries from an auto accident
Does liability pay the owner
NEVER
What personal automobile are required to be purchased together
Bodily Injury and Property damage
Who gets paid for property damage - Personal Auto
Other guy
Who gets paid for phsyical damage - Personal Auto
Me
Liability payment
Inside car = Med pay
Outside car = liability
Does medical pay for someone getting in / out of your car
YES MEDICAL PAY
DO You and your resident relatives have medical payment coverage while occupying a vehicle or as a pedestrian
YES MEDICAL PAY
aRE Other people covered under your medical med pay coverage while driving your vehicle or a vehicle you are driving.
YES MEDICAL PAY
Does medical pay cover your for injuries sustained in your own car
YES
Standard Mortgage Clause
Specifies the right and duties of the mortgage company under the policy.
The cause of loss form lists
The perils the property is insured against
Garage Cover Form
For Auto Dealerships
Form MCS-90
provides evidence of financial responsibility, on behalf of the motor carrier, to the Federal Motor Carrier Safety Administration. The endorsement must be included on all policies, and a policy must meet the financial responsibility requirements set by the Department of Transportation.
All of the following must be listed on Form MCS-90, excep
The policy premium amount
