principles of insurance Flashcards

1
Q

insurance is used as a protection against ______ risks

A

pure

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2
Q

pure risk

A

create either a loss or no loss

ex. house fires, auto accidents, personal illness

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3
Q

speculative risk

A

change of profit, loss or no loss

generally undertaken by entrepreneurs

generally voluntary risk and not insurable

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4
Q

subjective risk

A

differs based on an individual’s perception of risk

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5
Q

objective risk

A

does not depend on an individual’s perception, but is measurable and quantifiable

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6
Q

severity

A

the actual dollar amount of the loss

more important than the probability of a loss

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7
Q

the law of large numbers helps to reduce….

A

objective risk

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8
Q

perils

A

the actual cause of loss

ex. fire, wind, tornado, earthquake, burglary, collision

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9
Q

hazard

A

a condition that increases the likelihood of a loss occuring

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10
Q

moral hazard

A

a character flaw

character flaw would lead to filing a false claim

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11
Q

morale hazard

A

the indifference created because a person is insured

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12
Q

physical hazard

A

a tangible condition that increases the probability of a peril occurring

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13
Q

adverse selection

A

the tendency of persons with higher than average risks to purchase or renew insurance policies

managed through underwriting, denying insurance on the front end and raising premiums on the back end

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14
Q

requirements for insurable risks

A

not catastrophic, homogenous exposure units, accidental, and measurable and determinable

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15
Q

elements of a valid contract

A

competent parties
offer and acceptance
legal consideration
lawful purpose

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16
Q

principle of indemnity

A

insured is only entitled to compensation to the extent of the insured’s financial loss

insured cannot make a profit from an insurance contract

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17
Q

subrogation clause

A

insured cannot receive compensation from both an insurer and a third party for the same claim

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18
Q

principle of insurable interest

A

an insured must have an emotional or financial hardship resulting from damage, loss, or destruction

property and liability - must have insurable interest at time of inception and at time of loss

life insurance - must have insurable interest only at time of inception

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19
Q

void contract

A

was never valid and thus never came into existence

20
Q

voidable contract

A

valid contract that allows cancelation by one of the parties however the other part is bound by the agreement

21
Q

warranty

A

a promise made by the insured to the insurer

breach of warranty is grounds for avoidance

22
Q

representation

A

statements made by the insured to the insurer during the application process

23
Q

concealment

A

when the insured is silent about a fact that is material to the risk

24
Q

adhesion

A

basically “take it or leave it”
no negotiations over terms and conditions
any ambiguities in an insurance contract are found in favor of the insured

25
aleatory
money exchanged may be unequal
26
unilateral
only one promise is made by the insurer which is to pay in the event of a loss insured is not obligated to pay the premiums
27
conditional
insured must abide by the terms and conditions of the insurance contract if the terms and conditions are not followed, the insurer may not pay a claim
28
agent
a legal representative of the insurer
29
general agent
represents one insurer such as a State Farm or Allstate Insurance agent
30
independent agent
represents multiple, unrelated insurers
31
broker
represents the policy owner, not the insurance company
32
express authority
given through an agency or written agreement insurer is responsible for acts of an agent based on express authority
33
implied authority
authority that the public perceives and a valid agency agreement exists the actual delivering of an insurance contract and accepting a premium is an example insurer is still responsible even if a client is misled
34
apparent authority
when the insured believes that agent has authority to act on behalf of the insurer when in fact, no authority actually exists could be inferred based on business cards or a sign on the wall, but the agency agreement actually expired
35
regulation of the insurance industry is done at the _____ level
state
36
what are the goals of state insurance regulation?
protect the insured maintain and promote competition maintain solvency of insurers
37
replacement cost
the current cost of replacing the property with new materials of like kind
38
actual cash value
essentially replacement cost, less depreciation used for auto polices
39
agreed-upon value
a value that is determined jointly by insured and insurer typically used for arts and antiques
40
deductible
a stated amount the insured must pay before the insurer will make payments help eliminate small claims and reduce premiums used mainly for property, health and auto policies a form of retaining risk
41
copayments
insured pays a portion of the losses incurred 80/20 copayment = insured is responsible for 20% of expenses above deductible
42
coinsurance
requires the insured to cover at least a stated percentage of the property value if coverage meets or exceeds the coinsurance requirement, then the insurer pays the lesser of: face value of policy, replacement cost, or actual expenditures
43
coinsurance formula
(face value / coinsurance) x loss - deductible
44
National Association of Insurance Commissioners (NAIC)
has no regulatory power over the insurance industry it provides a watch list of insurance companies based upon financial ratio analysis
45
what are the 6 steps of risk management?
1. determine the objectives of the risk management program 2. identify the risks to which the client is exposed 3. evaluate the identified risks as to probability of occurance and potential loss 4. determine alternatives for managing risks, and select the most appropriate alternatives for each 5. implement the program 6. evaluate, monitor, and review (die die) dont insure everything
46
what are the four underwriting policy ratings for insureds?
preferred - provides the lowest policy premiums, exceeds the requirements for a standard ratings standard - an average risk for the insurance company rated - there is a scale for rated decline - insurance companies will not accept the risk of issuing a policy