Licensing Flash Cards
The _______, Supervisor, or Director of Insurance is the chief insurance regulator
who protects the insuring population by regulating all insurers and insurance professionals doing
business in the State.
State Commissioner - Section 1.1
A _________ issues non-participating policies and is owned by stockholders who
received taxable corporate dividends as a return of profit.
Stock Insurance Company- Section 1.2
A _________ issues participating policies and is owned by the policyholders
who receive non-taxable dividends as a return of unused premium.
Mutual insurance company - Section 1.2
______ is the transfer of risk between insurance companies. The reinsurer assumes some or
all of the risk of the ceding, or primary, insurance company
Reinsurance Section 1.3
What is a Domicile? and what are the 3 types?
Domicile refers to the state in which an insurer is incorporated.
1 - Domestic insurer is organized under the laws of the resident state
2 - Foreign insurer is organized under the laws of another state
within the United States
3 - Alien insurer is organized under the laws of a country outside
the U.S.
Section 1.4
An_______ is authorized to do insurance business in the state and is issued a Certificate
of Authority by the state’s Department of Insurance.
Admitted Insurer - Section 1.4
The _______ department of an insurance company is responsible for the selection of risks to
insure and determines the rate to be charged.
Underwriting - Section 1.5
An _______ can be the employee of an insurance company that owns the agent’s book
of business, or an independent agent that enters into agency agreements with more than one
insurance company. Independent agent retains ownership of their books of business.
Agent/Producer Section 1.5
The _________ is a three-party relationship where a Principal authorizes an Agent to act on
its behalf to create a legal relationship with a Third Party.
Law of Agency Section 1.6
______________ is written into the producer’s agency contract; implied authority is that which
the public assumes the agent possesses; and apparent authority is created when the agent
exceeds express authority and the insurer does not respond
Express authority Section 1.6
The ____________ protects consumer privacy by ensuring that any data
collected by an insurer remains confidential, and is accurate, relevant, and used for a proper and
specific purpose.
Fair Credit Reporting Act (FCRA) Section 1.6
A is the uncertainty of a loss
Risk Section 1.8
A ____ is the cause of loss.
Peril Section 1.8
A ____ increases the probability of a loss.
Hazard chapter Section 1.8
What are the 3 types of Hazards?
Physical- A physical condition that increases the probability of loss; use, condition, or occupancy of property. Example: Flammable material stored near a furnace.
Moral Hazard - Dishonest tendencies that increase the probability of a loss; certain characteristics and behaviors of people. Example: An insured burns down his/her own house to collect the insurance payout.
Morale Hazard - Attitude that increases the probability of a loss. Example: Indifference or carelessness of leaving one’s house or vehicle unlocked.
Section 1.8
The _______ does not allow the insured to profit from a loss; instead, it restores
the insured to the same financial or economic condition that existed prior to the loss.
principle of indemnity Section 1.9
______________ in property and casualty insurance must exist at the time of the loss.
Insurable interest section 1.9
The ________ is one of adhesion; one party (the insurer) prepares the contract and
presents it to the second party (the insured), who must accept it on a “take-it-or-leave-it” basis.
insurance contract section 1.10
The _________ used to determine premium include the nature of the risk, hazards,
claims history, and other factors that vary depending upon the risk.
underwriting factors section 1.11
_______ is a rate charged to a group of policyholders who have similar exposures and
experience.
Class Rating
Section 1.11
What are the 4 types of rating factors?
- Nature of the risk.
- Hazards that are present.
- Claims history.
- Other factors that depend upon the type of risk being insured.
Section 1.11
______ is The dollar amount charged for a particular unit of insurance, such as $5 per $1,000 of
insurance.
Rate
Section 1.11
_______ is the total cost for the amount of insurance purchased.
$50,000 of coverage = $5 rate x 50 (per $1,000 of insurance) for a $250 premium.
Premium
Section 1.11
_______ is a rate based on the policyholder’s actual loss history when compared to
the loss history of similar risks.
Experience Rating
Section 1.11
________ is a rate used for a policyholder because a large enough pool of similar
risks is not available to any other type of rate. Primarily used for commercial and specialty
risks because of the number of unique variables involved.
Individual Rating
Section 1.11
_______ is an individual rate that doesn’t use loss history as a
component and that is derived largely from the underwriter’s evaluation and best judgment
the risk poses to the insurer
“A” Rating or Judgment Rating
Section 1.11
_______ A rating organization provides insurers with the portion of a rate that does
not include provisions for expenses or profit.
a. The expense and profit components to develop the final rate must be added by individual
insurers based upon their projections.
b. Loss cost rating is used on risks for which the insurer may not have enough data to
develop the rate, other than for expenses and profit.
Loss Cost Rating
Section 1.11
_________ The use of rates contained in a manual published by the insurer or those of
the rating organization of which it is a member.
Manual Rating
Section 1.11
_______ is the use of rates that rewards a policyholder that takes measures to decrease
the probability of loss by the implementation of safety programs, loss control programs, etc.
Merit Rating
Section 1.11
____________ The use of rates that adjust the policy premium to reflect the current loss experience of the policyholder. Premium adjustments are subject to minimums and maximums.
Retrospective Rating
Section 1.11
_______ is the required initial premium paid into the policy that is
subject to adjustment. A premium audit will be used to determine the actual premium based
on the risk exposures
Deposit Premium
\_\_\_\_\_\_\_ is a method of rating property and liability risks by using charges and credits to modify a class rate based on the nature of the particular risk being rated.
Schedule Rating
_____ Rates must be filed with the state insurance regulatory authority (Department
of Insurance) and may be used as soon as they are filed.
File and Use Rate Approval
_________ Insurers cannot use rates until approved by the Department of Insurance, or
until a specific time period has expired after the filing.
Prior Approval
________ Some states require that mandatory rates be used for certain lines of
insurance.
Mandatory Rates
_______ A state relies on competition between insurers to produce fair and
adequate rates.
Open Competition
Loss reserve Method
_______ – A loss reserve established for each claim, when reported.
Case Reserve Method
Loss Reserves
_______ A loss reserve established based on average settlements of
particular claim types.
Average Value Method
Loss Reserve
________ A loss reserve formula based upon the expected losses for a
particular class or line.
Loss Ratio Method
Loss Reserve-
___________ A loss reserve based upon the estimated length of an insured’s or
claimant’s life or expected disability.
Tabular Method
Financial Ratios-
_______ - Determined by dividing Paid Losses + Loss Reserves by Total Earned
Premiums.
Loss Ratio
Financial Ratio -
________ – Determined by dividing an insurer’s Total Operating Expenses by Written
Premiums.
Expense Ratio
Financial Ratios -
_________ – Sum of the loss ratio and expense ratio.
Combined Ratio
_________ – A valid contract that for reasons satisfactory to a court, may be set aside by
one of the parties. An example is an insurer may void or revoke coverage for misrepresentation
or fraud.
Voidable Contract
_________ – An agreement without legal effect because it was made illegally or it was
declared void by the courts because it doesn’t contain all the elements of a legal contract.
Void Contract
________ – One party writes the contract, without input from the other party. One
party (insurer) prepares the contract and presents it to the other party (applicant) on a “take-it-or-leave-
it” basis, without negotiation. Any doubt or ambiguity found in the document is construed
in favor of the party that did not write it (insured).
Contract of Adhesion
________ – The exchange of value is unequal. Insured’s premium payment is less than
the potential benefit to be received in the event of a loss. The insurer’s payment in the event of
a loss may be much greater, or much less (e.g., $0 in the event a loss doesn’t occur), than the
insured’s premium payment.
Aleatory Contract
______ – A contract that pays a stated amount in the event of a loss. (Most insurance
policies are NOT valued contracts unless they are endorsed.)
Valued Contract
______ – An agreement to pay on behalf of another party under specified
circumstances, such as when a loss occurs.
Indemnity Contract
_____ – The party submitting an application for insurance.
Applicant
_______ – A document submitted by an applicant to an insurer that provides information
needed for the insurer to underwrite a risk; becomes part of the insurance contract. Most
applications require statements on the application to be true to the best knowledge and belief of
the applicant.
Application
______ – A policy form that alters or adds to the provisions of a property and casualty
insurance contract.
Endorsement
________ – Owner cannot transfer or assign ownership of an insurance policy (property
and casualty) to another person.
Personal Contract
________ – Owner may transfer or assign ownership of a life or health insurance
policy to another person.
Non-Personal Contract
_______ – Policy owners may not assign or transfer their rights under an insurance contract
without the written consent of the insurer.
Assignment
_______ – Insured’s original age on the policy issue date.
Issue Age
_______ – Insured’s age at any point in time at issuance, renewal or conversion.
Attained Age
________ – Only one party is legally bound to the contractual obligations after the
premium is paid to the insurer. Only the insurer makes a promise of future performance, and
only the insurer can be charged with breach of contract.
Unilateral Contract
_________– Both parties must perform certain duties and follow rules of conduct to
make the contract enforceable. The insurer must pay claims if the insured has complied with all
the policy’s terms and conditions.
Conditional Contract
_________ – What a reasonable and prudent policy owner would expect;
the reasonable expectations of policy owners are honored by the Courts although the strict terms
of the policy may not support these expectations.
Reasonable Expectations Doctrine
________ – Statements made by the applicant on the application that are believed to be
true to the best of the knowledge and belief of the applicant; may be withdrawn prior to policy
issuance.
Representations
________ – A false statement contained in the application; usually does not void
coverage or the policy. If material to the issuance of coverage, meaning the insurer would not
have issued coverage had the misrepresentation not been made, coverage does not apply. In
some cases, a material misrepresentation may void the policy.
Misrepresentations
________ – The willful hiding or obscuring of material facts pertinent to the issuance of
insurance (or a claim). Concealment results in denial of coverage and may void the policy.
Concealment
________ – Statements in the application or stipulations in the policy that are guaranteed true
in all respects. If warranties are later discovered untrue or breached (past, present or future),
coverage (and sometimes the contract) is voided.
Warranties
________ – Intentional deception of the truth in order to induce another to part with something of
value or to surrender a legal right. Contains 5 elements:
Fraud
What are the 5 elements of Fraud?
■ False statement, made intentionally and that pertains to a material fact.
■ Disregard for the victim.
■ Victim believes the false statement.
■ Victim makes a decision and/or acts based on the belief in, or reliance upon, the false
statement.
■ The victim’s decision and/or action results in harm.
What are the 4 elements of a Legal Contract?
An _________ is an accident and includes continuous or repeated exposure to the same general
harmful conditions
Occurrence Chapter 2 section 1
If an insurer cancels an insurance policy before its expiration date, the refund is made on a _________.
pro rata basis
Chapter 2 section 1
The primary cause of a loss is referred to as the __________.
proximate cause
A _______ stays within its intended boundaries and a hostile fire burns outside its intended
boundaries.
friendly fire
An __________is a policy form that alters or adds to the provisions of a property and casualty
insurance contract
endorsement
The _________ is the specified amount of each loss that the insured must bear. A larger
________ reduces the premium and the submission of small claims.
deductible
A _________ causes damage without an intervening cause, and an indirect loss occurs as the
consequence of a direct loss.
direct loss
A _______policy specifically lists the covered causes of loss.
named perils
an ________ policy covers all causes of loss except those specifically excluded
open perils
The ________of property is the cost to replace it with property of like kind and quality,
at current pricing, without a deduction for depreciation.
replacement value
_________ is the replacement value of property minus depreciation.
Actual cash value
A _________ requires the insurance company pay the total scheduled limit of insurance for a
total loss.
valued policy
A policy insuring property for a ________ insures a single item on a single policy for a single
limit of insurance.
specific limit
. A policy insuring property for a _________ insures one or more items on a single policy and
each item is insured at a ________ limit of insurance.
scheduled limit
A policy insuring property for a _________ insures multiple items of property on a single policy
with one limit of insurance applying to all insured property
blanket limit
The _________ describes basic information about the policy; i.e., the who, what, where,
when, and how much.
declarations page
The _____ _____ is the insurer’s promise to pay the insured.
Insuring Agreement
The _______section states the obligations of the insurer and the insured, as well as any other
conditions of coverage
conditions
The ________ provision states the insured’s obligation to transfer to the insurance company its
right of recovery against any party causing a loss after it accepts payment from the insurer for a
loss.
subrogation