Kaplan PA Law Supplement QBank Flashcards
Who is exempt from the continuing education requirements in PA?
- business entities
- licensees who have only limited lines licenses
- nonresidents who have complied with their home state’s requirement
The workers compensation statute in PA includes who in its definition of employer?
- natural persons
- partnerships
- joint stock companies
- corporations (both for profit and not for profit)
- municipal corporations
- the Commonwealth (including all government corporations created by it)
Before selling insurance policies for an insurer, a producer must first:
be appointed by the insurer before they can act as a representative of the insurer
Uninsured and Underinsured motorists coverage in PA
The purchase of uninsured motorist and underinsured motorist coverage is optional but must be included unless the named insured signs a written rejection form
- coverages must be offered in amounts equal to the bodily injury liability limits
- coverage can be less than the bodily injury liability limits if requested by the insured
- the two types of insurance must be sold separately by insurers
Under the PA motor vehicle financial responsibility law, a statute of limitations applies to recovery of first-party benefits. When benefits have not been paid, any action to recover first-party benefits must begin within
four years from the accident date
If benefits have not been paid, an action for first-party benefits must begin within four years from the date of the accident
Requirements for the Insurance Department to issue a resident or nonresident insurance producer license when the applicant
- is at least 18 years of age
- has not committed any act that is prohibited under the state’s insurance laws
- has satisfied the prelicensing education requirements
- has passed (or is exempt from) the insurance producer licensing examination
- has paid all applicable fees
- possesses the general fitness, competence, and reliability sufficient
Unfair claim practices include
- failing to investigate and pay claims promptly
- misrepresenting the amount of coverage under a policy
- failing to respond promptly to communications on claims
insurer is entitled to investigate a claim when the cause of the insured’s death is uncertain and the insurer wants to determine coverage under the policy
Once a policy covering commercial property and casualty risks has been in effect for 60 days, all of the following reasons may serve as a basis for midterm cancellation of the policy
- the insured failed to pay a premium when due
- the insured requests the cancellation
- the insured made a material misrepresentation affecting the insurability of the risk
NOT for the business owning the property suffering a financial setback
In PA, notice of nonrenewal of a commercial policy must be given to the named insured at least:
60 days in advance
How often must the Commissioner examine a domestic insurer?
At least once during a 5-year period, but may investigate an insurance company whenever it is necessary
Benefits from an auto insurer are overdue if not paid within how many days after the insurer receives proof of the amount due?
30 days
Payment of commissions
- a producer may not charge additional fees not included in his commissions for soliciting and procuring insurance or for servicing existing policyholders
- a producer may share commissions with another licensed producer
- a producer may not share commissions with unlicensed persons
- a producer may share commissions with a nonresident producer as long as she is licensed in the line of insurance involved in the transaction
A licensee whose license has lapsed has how much time to reinstate it without reapplying as a new licensee?
12 months to renew the license, pay the fee, and complete the continuing education
The insurance industry in the US primarily is regulated by the:
states, rather than the federal government as determined by the 1868 Supreme Court case of Paul v. Virginia
A producer who converts premiums for his own use
breach of fiduciary duty
A binder for temporary fire insurance is good for how many days?
30 days
A written note that temporarily obligates an insurer to provide insurance before a contract has been written or the premium paid is called a
binder
Pennsylvania workers’ compensation law
- compulsory for all private and public employments except for classes of exempt employees, such as domestic employees, part-time workers, and other defined classes
- usually compensation benefits are the exclusive remedy against the employer
- employers are generally required to provide statutory benefits for work-related injuries
- employers may formally self-insure instead of purchasing private insurance
PA FAIR plan
- stabilize property conditions in the state
- provide insurance to property owners when it is not available in the normal market
- provide a reinsurance pool involving all fire insurance companies in the state
PA Property and Casualty Insurance Guaranty Association
protects policyowners, beneficiaries, and claimants from insolvent insurers
When an insurer sends a notice of cancellation of a property or casualty policy to an insured, the notice must advise the insured of the right to request a review of the insurer’s action within
10 days after the receipt of notice
Temporary producer license
- the lines of authority under the license may be limited
- the license may be revoked immediately and without notice
- the license holder may be required to have a sponsoring insurer
- may not be transferred to another person
Minimum age a person may apply for an insurance producer’s license
18 y/o
Insurer’s cancellation of a policy covering an owner-occupied dwelling
- must include the specific reasons for cancellation
- the insured may appeal the cancellation to the Insurance Department
- must advise the insured of possible eligibility for coverage under the FAIR plan
- can be cancelled for non-payment of premium, if there are substantial increases in the hazard, or if a material misrepresentation is present
The Insurance Commissioner is responsible for
- issuing certificates of authority
- enforcing provisions of the insurance code
- conducting insurance investigations
Insurance laws are enacted by the state legislature
The workers compensation benefit for total disability
66.67% of the average weekly wage
If an insurer initiates the midterm cancellation of a policy coverage commercial property risks, any unearned premium must be returned to the insured within what period of time of the effective date of the cancellation?
10 days
If the insured cancelled the policy, the insurer must return any unearned premium no later than 30 days after the effective date of the cancellation
To motivate a buyer to sign an application for insurance, a producer promises a gift of one-half of the commission. This is an example of:
rebating
- it is illegal for insurers or producers to induce applicants to purchase insurance by making agreements that are not specifically in the insurance contract, like rebating part or all of a premium
Unfair trade practices
- making derogatory statements regarding an insurer’s financial condition
- offering advantages in dividends that were not specified in the policy
- rebating premiums
Limited tort insurance vs. full tort
limits an insured and members of their household’s ability to seek financial recovery for noneconomic losses such as pain and suffering
Insurance producer appointment
an insurance producer is a person appointed in writing by an insurance company to represent that company in selling insurance, soliciting applications, and (if authorized by the insurer) countersigning policies on the insurer’s behalf. A producer represents the company and has the power to bind it to insurance contracts
PA FAIR Plan Act
provide property owners with fire, extended coverages, vandalism, and malicious mischief coverage when insurance is unable to be purchased in the normal or standard market; for people unable to obtain coverage in the normal market and helps to improve and stabilize property conditions in the state
FAIR Plan Association
an underwriting entity called the Insurance Placement Facility of PA; a reinsurance pool involving all fire insurance companies in PA; participation in the pool is in proportion to the amount of fire insurance written by companies in PA
Federal Crop Insurance (RMA)
- indemnifies the insured for loss of yield to growing crops prior to harvest, and to harvested crops in storage
- provided by private carriers able to offer broad multiperil crop insurance that includes losses due to adverse weather, flood, drought, insect damage, etc.
- USDA sells coverage through FCIC licensed producers and reinsures some of the coverage written by private carriers
Crop insurance
- policy covers lost revenue from damaged crops
- transit of harvested crops, fire dept. service charges, catastrophic loss, and replanting
- rating considers: max num years experience, smallest geographic units, frequent revision of rates based on seasonal activity
Crop insurance exclusions
- failure of the insured to cut, dig, pick, pull, or harvest mature crops
- harvester’s inability to recover that portion of the crop
- buds, blooms, or blossoms of a crop
- leaves, vines, bushes, stalks, or squares of any crop except to the extent that the marketable crop is affected
- trees or bushes of any nut or fruit crop
- nuclear hazard
- contamination
In PA, a producer’s term of licensure is
2 years
What is the maximum period of time within which an insurance producer can reinstate a lapsed license without having to reapply for the license?
1 year
People who must be licensed to transact insurance business in PA
- producers who work for more than one insurance company
- insurance producers who hold their Chartered Life Underwriter (CLU) designation
- producers who specialize in annuities
NOT the CFO of an insurer who does not solicit or negotiate risks
What is the maximum term of a temporary license that is issued as a result of a licensee’s death?
180 days
To be qualified for an insurance producer license in PA, an individual applicant must have reached the age of
18
The Commissioner may deny, revoke, or suspend a producer license for
- committing a felony
- providing false information in a license application
- misappropriating money being held in a fiduciary capacity
NOT failing to meet the annual production quota as determined by the insurer