Main Focus Flashcards
Coverage A: dwelling
Include garage, attached patio cover, etc. can also include building materials used in the construction and/or repair of the covered structures and building it outdoor equipment used to service the premises
ISO
Insurance services office, the advisory organization that develops forms for the standard market
Coverage B: other structures
Limits insured buildings on the same proper as the dwelling but not attached to it: Detached garage, fencing, gazebo, or work shed
Coverage C: personal property
Insured contents and personal possessions kept at the primary resident. Coverage may be extended to cover personal property of guests and servants. Standard limit of coverage is 50% of coverage A
Coverage D: fair rental value
Cover the loss if fair rental value minus expenses that are not required due to the uninhabitable nature of the premises. Up to 10% of the insurance in the dwelling is available
Coverage E: additional living expense
If the insureds home is uninhabitable due to covered loss, this will cover the additional living expenses related to maintaining the insureds normal standard of living at an alternate resident until the property is repaired or the coverage limit is reached, whichever occurs first. Motel, dining, laundry, and transportation expenses.!
Eligible property for a dwelling policy
Personal residents except farm with no more than four family units and/or five timers or boarders. Manufactured mobile homes in permanent foundations, only covered by the basic form. Private out buildings used with mobile homes: household and personal property in eligible properties. Vacant buildings
DP-1: the basic dwelling policy
Automatically covers buildings and personal property for fire,lightening and internal explosion. Furnace, stove or hot water heater. Stems explosions are excluded if the equipment is owned, leases or operated by the insured party.
Extended coverage (EC)
May be added to extend the perils covered to also include: windstorm, hail, aircraft, riot and civil misconduct, vehicle, explosions, smoke.
DP-2: the broad dwelling policy
Covers building and personal property from the basic perils of perils of fire, lightning and internal explosion. Automatically provides the extended coverage perils and VMM. Falling objects, burglary, weight if Ice sleet or snow, discharge/overflow, tearing apart, freezing or plumbing, artificially generated electric current, smoke damage, vehicle damage. Minimum insurance requirement is 12,000 for the dwelling or 4,000 if the policy is written for personal property only.
VMM
Vandalism and malicious mischief
DP-3: the special dwelling policy
Written on an all-risk basis for real property and broad form for personal property. It covers the dwelling and other structures for all risk of direct physical loss. Pays replacement cost on buildings if they are insured to 80% of value and ACV on personal property. Minimum insurance requirement is 15,000 for dwelling or 4,000 if the policy is written for personal property only.
Homeowners insurance
Considered package or multi-line policies, meaning they provide both property and liability coverage. It’s divided into two sections, section 1 provides property insurance and section 2 provides liability and medical payments insurance
Coverage A: dwelling
Insures the dwelling and attached structures including garage or attached patio cover. Paint for the interior of the house is personal property that would be under coverage A
Coverage B: other structures
Insures buildings on the same property as the dwelling but not attached to it. Detached garage, fencing, gazebos or work she’s. Limit is 10% of coverage A
Coverage C: personal property
Insured contents and personal possessions kept at the primary residence for ACV. Limit is 50% of coverage A. Also insured personal property in the insureds possession anywhere in the world up to the full limit of 100% of the personal property limit/
Coverage D: loss of use
If a covered property loss leaves the insureds primary residence premises uninhabitable, the insured will have coverage for additional living expenses related to maintaining the insureds normal standard if living until resident is repaired
HO-8
BASIC
Privies basic form coverage on an ACV basis for the dwelling and personal property. HO-8 is an option for insurers when the replacement cost if the home exceeds the value. A home that is too old to qualify for replacement coverage or has historic value can be covered under HO-8
HO-2
BROAD
The standard broad form homeowner policy covering both real property and personal property for names perils. Adds some perils not covered by the DP-1 basic form and broadens the. Coverage for others. See page 16 chapter 2 for coverage
HO-4: the renters form
Used to provide coverage for tenants. Only their own personal property. Provides coverage for personal property and liability coverage at home and away.
HO-6: the condominium unit form
Provide coverage for a condominium unit owner. Designed to provide named peril or broad form coverage for personal property. Has a flat $1,000 coverage under coverage A for dwelling coverage.
HO-3: special form
Provides all risk or open peril coverage for real property and broad form or named peril basis for personal property. Exclusions are: earthquake, flood, sewer back up, building ordinance, war and nuclear hazard, wear and tear, rust, dry rot, wet rot, smoke, corrosion, deterioration, birds, rodents, animals as pets
Insurance
A contract whereby one undertakes to indemnify another person against loss, damage, or liability arising from a contingent or unknown event
Insurable events
Are past, present, and future events that may be insured. With no potential of gain or profit. There must be an insurance interest to qualify to purchase insurance policy
Parts of insurance contracts
Declaration page, insuring clause, conditions, exclusions, endorsements, and definitions. (DICEED)
Element for an insistence contract to be valid- contract law
Competent parties, consideration, agreement, legal valid purpose. (CCAL)
All insurance policies must provide the following information.
Parties to the contract. what is being insured-such as home, car, life, business. financial interest- amount of coverage. perils insured- fire, death. Premium. Policy period.
Insurance policy
Is a written instrument in which the insurance contact is set forth
Fraud
Is intentional fraudulent omission in part of an insured, and entitles the insurer to rescind contract.
Concealment
Is failure, it neglect to communicate material facts to a person who knows, that the other party does not know. Hiding, or deciding not to communicate, material facts. Entitles the injured party to rescind contract
Required disclosure
The requirement that each party shall communicate to each other, in good faith, all facts sitting their knowledge, they believe to be material to the contract.
Information not required to be communicated
Information known by the other party, information that is waived by the other party, or information which is immaterial to the contract being insured.
Determination if materiality
Based on the influence of facts provided by each party, and being aware of the disadvantages of the proposed contract
Right of rescission
Termination if a contract as if it never existed. Contract is voided, and entire premium paid to company is refunded
An insurer has right of rescission.
Anytime before the insured files a claim, or upon discovery of misrepresentation, concealment, fraud, increase risk exposure or non payment if premium
A representation
May qualify to be considered the best if belief and knowledge of the party providing information.
Is false when facts do not agree with it’s assertions or stipulations.
Can be altered it withdrawn before the policy is issues but not after issuance
Misrepresentation
No insurer, officer, or agent shall in any shape it form, misrepresent the terms, benefits, privileges, or payment of future policy dividends.
Pure risk
Loss exposure that is subject to loss only, therefore may be Insurable
Speculative risk
Loss exposure that provides possibility of gain/profit therefore is uninsurable
Peril
A cause it trigger of a loss also known as event or situation, that leads up to a loss
Hazard
Anything that increases chances if loss
Physical hazard
For example, driving on worn tires, walking in wet floor, living next to an explosive factory
Moral hazard
Intentionally creating a situation to file a claim on a loss
Morale hazard
Unintentionally creating a situation to file a claim on a loss, such as bad habits, irresponsibility, or carelessness
Law of large numbers
Is a theory used to predict losses an determine premiums
Types of exposures
Are property, liability, and human loss exposures
Types of loss exposures
Are real property and personal property loss exposure
Types of liability exposures
Are personal liability, personal automobile, professional liability, business general liability, commercial automobile liability, workers compensation, and ocean marine loss
Human loss exposure
Personal loss exposure (buying life insurance for personal needs) and personnel loss exposure (purchasing life insurance on life of valuable employee to protect business needs)
Requirements for a risk to be Insurable
Law if large numbers, measurable, uncertainty, cases economic hardship, and excludes catastrophic perils
Insurable interest
Defined as financial interest, economic interest, and emotional interest
Insurable interest in property and casualty
Required interest to exist when insurance takes effect and when loss occurs
Principle of indemnity
Means to restore insured to the same financial position, as prior to the loss (supports Insurable interest)
Private insurers
Stock insurers, mutual insurers, and reciprocals. But not fraternal a or Lloyd’s
Stock insurer
Owned by stock/shareholders/owners. Issued non participating policies
Mutual insurer
Owned by policyholders who are issued a participating policy. Any person holding a participating policy may be entitled to receive policy dividends
Policy dividends
Are not taxable or guaranteed. Any licensed person who uses policy dividends to mislead insured into purchasing insurance shall be guilty of misdemeanor
Underwriting
Is selection, classification, and rating of an application. Before accepting or rejecting a risk
Adverse selection
Risk exposure higher than the average may be rejected it have a higher premium
Self-funded
Retains risk exposure by setting an account with the runes to cover losses/claims. Allows benefits to be tailored
Deductibles
Are “first dollars” of expenses that insured agreed to pay before insurer pays for May losses. Higher deductible, loser premium. Lower deductible, higher premium.
Reinsurance
When ceding (original) insurer goes to a third party to insure themselves.
Reinsurance (section 620 of CIC)
Is used to allow ceding insurer to go over retention limit.
Retention limit
Is the maximum amount if risk an insurer can assume in any one policy
Total classes of insurance
Twenty
Insurance regulation
Is provided by federal regulation, state regulation, and self regulation
Competent parties
Must be legal age, not intoxicated, mentally capable, and the insurer is agent licensed
Legal valid purpose
Is not contrary to public policy. All parties will benefit from contract
Agreement
Includes offer and acceptance
Considerations
Includes anything if value, such as money, promise, premium, policy, giving up or exchange of an act.