Property Insurance Flashcards
It’s a social device (legal contract or policy) for the transfer of financial risk.
Insurance Policy
When a person can only stand to lose should an event occur.
Pure risk
Is a form added to an insurance policy. It is usually added for a additional premium charge to add coverage. Sometimes, however, it can be added to limit (or, restrict) coverage.
Endorsement
Is a financial interest (risk) which the insured(s) must possess at the time the policy is issued to qualify to purchase the policy as well as at the time of loss to qualify to make a claim.
Insurable interest
Indemnity=?
Reimbursement
Both the principles of indemnity (reimbursement) and insurable interest (financial interest -
Prohibit the insurance company from reimbursing (indemnifying) an insured for more than the actual amount of loss.
Is the initial amount of loss which the insured must suffer (pay) before the insurance company begins to indemnify.
Deductible
What is the purpose of a deductible.
To eliminate small claims that the insured can afford and which would not cost the insurance company to administer.
The maximum amounts which the insurance company will pay under each coverage.
Limits of Liability
What are the two other names for limits of liability?
Face Amount : Amount Carried
The maximum limit of liability that the policy will pay to all persons who are injured or who incur property damage in an occurance.
Aggregate limit
Are things specified in homeowner policies that the insurance company will pay for in addition to the homeowner policy limits of liability.
Additional Coverages
Are things specified in HOMEOWNER policies that the insurance company will pay for in addition to the homeowner policy limits of liability.
Additional Coverages
Are things specified in AUTO policies that the insurance company will pay for in addition to the AUTO policy limits of liability
Supplemental Payments
What are the “named perils”?
Basic Cause of Loss
Broad Cuases of Loss
How many perils are included in Basic Cause of Loss
12 named perils
How many perils are included in Broad cause of loss?
20 named perils
What is the amount paid on a loss?
Loss settlement or adjustment
Pays all sums for which an insured becomes legally liable (responsible) for bodily injuries (physical injuries) and/or property damage caused to someone other than the insured (referred to as 3rd parties) not to exceed the policy limits of liability.
Liability Coverage
Person making a claim.
Claimant
person against whom the claim is being madeand who is submitting the claim to an insurance company for insurance coverage
insured
Three ways a claimant can make a liability claim against insured
- Claim made by claimant with attorney and file lawsuit in the courts against the insured
- Claimant with attorney filed lawsuit in the courts, and would be resolved by an agreement between the claimant and insurance company before the hearing goes to court. It would be settled on the basis of what each side anticipates a court would order if the claim were to go to a court hearing
- Many times, the claimant with an attorney would notify the insured that the claimant intends to make a liability claim against the insured, the insured would submit claim to insurance. insurance would do due diligence and arrange a settlement with the claimant on what they anticipate the court would do or deny the claim.
It is possible for an insured to have liability coverage in effect at the time of an accident or an occurrence, for a claimant to have injuries and/or property damages, for the claimant to make a claim, for the insured to be covered by liability insurance, but the insurance company to pay no money to the claimant.
NOTE*
An insurance company will pay to an injured claimant on a liability claim only if the insurance company determines that a court would find the insured legally liable, and a court would order the insured to pay to the claimant if the claim were to go to a court hearing.
NOTE*
Insurance companies settle liability claims with 3rd party claimants on the basis of what they ______ a court would find if the claimant were to file a lawsuit and a court were to issue a court order.
Anticipate.
For a claimant to persuade a court that the insured is legally liable for an accident or an occurance and for the claimant’s injuries and/or damages, the claimant has to be able to prove to the court several _______ _________
Necessary Elements (requirements).
The most important necessary element (requirement) a claimant must satisfy to persuade a court that the insured is legally liable for an accident and the claimant’s injuries and/or damages.
Negligence
Two ways an insured can be negligent
Omission-Failing
Commission-Doin
Omission-Failing
the omission or failure to do something that he or she should have done
Commission-Doing
Commissioning or doing something that he or she should not have done
A claimant can have damages either in the form of bodily injuries or property damage or both
Damages
Bodily injuries include:
A. Reimbursement for medical bills
B. Reimbursement for lost wages
C. Compensation for pain and suffering
D. Compensation for permanent disabilities
E. Compensation for permanent scarring and disfigurement
Are the basic, regular statements on an application which the insured believes to be correct to the best of his or her knowledge
Representations
An insurance company can contest (refuse to pay) a claim due to a representation on an application if the insurance company can prove the representation was:
- False or concealed
- Material
- Intentional
Are special statements on an application which the insured guarantees to be correct.
Warranties
An insurance company can refuse to pay (contest) a claim due to a warranted, guaranteed statement on an insurance application if it was in any way ____ or ______
false or concealed (It’s easier for insurance companies to contest warranties because they only have to prove false or concealed.)
The process of deciding whether an application for insurance qualifies for coverage and what the premium charge should be.
Underwriting
The purpose for inspections are for the following
- verify the value
- verify the use of the property
- to verify the use of surrounding properties
- To verify that the property is reasonably well maintained.
The applicants right to information
Fair Credit Reporting Act
Allows various types of financial organizations such as commercial banks, investment banks, securities firms, and insurance companies to consolidate.
Gramm-Leach-Bliley Act - Privacy Act
The Gramm-Leach-Bliley Act - Privacy Act provides 4 things:
- Provides for the protection of consumer information
- Requires financial orgs to provide each consumer a privacy notice
- The privacy notice must explain the info that is to be collected about the consumer, with whom the info is to be shared, how it is to be used and how it is to be protected.
- The consumer must also be notified of his/her right to request that information not to be shared with other organizations
Some property insurance policies cover:
- only buildings
- only personal property
Many property insurance properties cover:
both buildings and personal property
Structures attached to land
buildings
Buildings are sometimes insured for _______ but are usually insured for ___________
Actual Cash Value (ACV); replacement cost
Property not attached to land or building
personal property
Personal property is often insured for it’s ___________ or, under some policies, for an extra premium charge, it can be insured for it’s ____________
actual cash value; replacement cost
If the insured person does not rebuild , repair, or replace the insured property with new materials of like kind and like quality and at the same location; then the insurance company will indemnify _________________
only the actual cash value of the loss
what will the insurance company do if a claim exceeds limit of liability?
waives the deductible
This coverage indemnifies the insured person for no more than his/her actual financial or economic loss
Actual Cash Value
Actual Cash value formula
Loss of actual cash value = replacement cost - depreciation
Depreciation = percentage of useful life used up x replacement cost
Requires the insured property to be insured for at least a specified percentage of its value at all times, continuously.
Loss Settlement Provision (Coinsurance Clause)
Some loss settlement provisions (coinsurance clauses) requires the insured property to be insured for at least 60% of its value, others 70% others up to 80%. Some times requires insured property to be insures for 100%
NOTE*
To have the full cost (100%) of repairing or rebuilding with new materials and labor less the deductible paid on a loss, the insured must keep the insured property insured for the required stated percentage of it’s value at all times including __________
the time of loss
Keeping a property insurance policy up-to-date, keeping the property continuously insured for the required amoutn or more and meeting the Loss Settlement Provision (coninsurance clause)
Insurance to value
If the insured property is not insured for the required, stated percentage of tis value at time of loss, the insurance company will pay less than 100% of the loss. The insured will be _______ at the time of loss settlement
penalized
Formula for Loss Settlement (adjustment)
Loss settlement (adjustment) = amount carried/amount required x loss
Amount required = Coinsurance percentage x replacement cost at time of loss
The principle of indemnity and insurable interest prohibit the insurance company from doing what?
Paying more than the actual amount of loss.
Continuously keeping property insured for the actual amount required or more.
Insurance to value
Parts of an insurance policy
- Dec Page
- the insured
- Insuring agreements
- Conditions
- Exclusions
The person or organization named in the dec page
Named Insured
Insuring agreements = ?
Insuring clause
What is the insuring agreement (insuring clause)?
Promise to Indemnify
Conditions = ?
requirements
What are the conditions (requirements) at the time the policy is issued (purchased)?
- application
- premium
What are the conditions (requirements) at the time of loss?
- Notice of loss
- Proof of loss
What are included in Exlusions?
a. property excluded
b. Perils excluded
c. Morale, moral, and physical hazards excluded
d. Inherent vice excluded
When a risk of loss is caused by the insured acting in an indifferent, careless or irresponsible manner
Morale Hazard
When there is a risk of loss due to legal action
Moral Hazard
When there is risk of loss due to condition or use of the property.
Physical hazard
When a special type of property has a special characteristic to deteriorate under special circumstances. (storing fur coat in damp place)
Inherent Vice
Most policies take effect, terminate, and renew at what time?
12:01 A.M.
The two reasons why people buy property insurance:
- It protects an insured against the risk of a financial loss which the insured cannot individually afford caused by a covered peril
- It is required to borrow money on a property.
Standard Fire Policy is the ______ property insurance coverage available.
Least
Standard Fire policy covers only:
Classes of property specifically described on the declarations page and only for their ACV
What perils does a Standard Fire policy cover?
A. Hostile Fire
B. Lightning
C. Removal
What perils does a Standard Fire policy cover?
A. Hostile Fire
B. Lightning
C. Removal
Standard Fire policy can be used alone but it is usually the base or cornerstone for a broader policy.
NOTE*
When must the insured give the insurance company notice of loss (notice of claim)?
Immediately
How many days does the insured have to provide the insurance company proof of loss?
60 days
The insured cannot sue the insurance company unless all of the requirements have been satisfied and then he/she must sue within ________ of the loss
12 months
The insurance company must indemnify the insured within _______ days of proof of loss
60
If the insured and the insurance company disagree as to the actual value of the loss and the damaged property cannot be repaired or replaced, they can each select an appraiser. If the appraisers disagree, they select and umpire appraiser who will make the final determination (arbitration or appraisal clause)*
NOTE*
States that the insurance company can require the insured to assign (transfer to it any legal rights which the insured has against 3rd parties to the insurance company at time of loss.
The Subrogation Clause
Clause of property insurance policy says not assignment (transfer) of the policy is valid unless signed by an officer of the insurance company.
Assignment Clause
What officers can sign an assignment clause?
President, VP, Secretary, Treasurer.
Applies when there are concurrent policies. Concurrent insurance is when two or more policies cover the same property. It is sometimes done when insuring a high value property.
Pro Rata Liability Clause
Mortgagee rights - If a mortagee (lender) is named on the declarations page, it acquires three rights in a policy:
- 10 days notice of cancellation
- To have the loss paid to the mortgagee.
- To provide proof of loss should the insured fail to.
Provides that no property can be abandoned to the insurance company without its consent
Abandonment Clause
What clause is usually found only in policies covering commercial (business) property.
Vacancy and unoccupancy clause
The Vacancy and Unoccupancy clause states that coverage is terminated after the insured property has been left vacant or unoccupied for ___ consecutive days.
60
An extra endorsement for an extra premium charge, it extends coverage beyond 60 days of vacancy or unoccupancy
The Vacancy and Unoccupancy Permit
Property excluded on the standard fire policy that are mostly indirect value
- Money
- Accounts (including bookkeeping records)
- Valuable papers
a. securities certs
b. legal docs
c. Manuscripts (such as blueprints)
Perils excluded on standard fire policy
- War
- Theft
- Neglect to save and protect from loss
- loss caused by an order of a civil authority
Two types of property and casualty insurance policies
- Personal lines property/casualty insurance.
- Commercial lines property/casualty insurance
Includes Homeowners insurance, Dwelling insurance, and personal auto
personal lines property/casualty insurance
Includes commercial property insurance, commercial package policies, commercial general liability insurance, commercial crime insurance, and business auto insurance
Commercial lines property/casualty insurance
WC Shaver
W - Windstorm
C - Civil Commotion
S - Smoke damage
H - Hail
A - aircraft
V - vehicle and volcanic action
E - Explosion
R - Riot
Extended Coverage (E.C.) endorsement covers what perils?
WC SHAVER
Extended Coverage perils exclusions
- Nuclear reaction
- Earth movement
- Flood, sewer backup and water below surface
- power interruption away from the premises
Vandalism and malicious mischief (V.M.M.) endorsement perils covered are:
Damage caused by vandalism and malicious mischief.
Vandalism and malicious mischief (V.M.M.) endorsement perils excluded:
any vandalism and malicious mischief coverage is excluded after the building has been left vacant 30 consecutive days.
Dwelling building and contents basic (DP-1) form policy requirements:
- The property must be occupied by four or less families.
- The property does not have to be owner occupied
- Dwelling policies are often used to insure rental properties that the insured owns and rents to others to live in.
DP-1 (BASIC) perils covered
- Three standard fire policy perils.
- WC Shaver (E.C.)
- V.M.M.
DP-1 perils excluded
- the 4 Standard fire policy exclusions
- The 4 E.C. perils
- V.M.M. is the premise is vacant for 30 consecutive days.
DP-1 coverages
- Coverage A - Dwelling - ACV (automatically extended)
-Coverage B - Other Structures, 10% of coverage A, (automatically extended)
Coverage C - Personal Property - (OPTIONAL, ADDITIONAL)
Coverage D - Rental Value - 10% of Coverage A (automatically extended)
Who’s personal property is covered by DP-1 Coverage C personal property?
The property owner, not the tenants.
Provides that if within the policy period the insurance company changes its policies so as to provide more coverage without additional premium charges, the policy will automatically have the broadened coverage added without any forms or endorsements added to the policy
Liberalization Clause
DP-2 = ?
Dwelling Building and Contents Broad (DP-2) form
What does DP-2 cover?
It covers dwelling buildings and, optionally, personal property owned by the insured.
What are the DP-2 BROAD form perils covered?
1-3. Standard Fire Policy perils (hostile fire, lightning, removal)
4-11. WC Shaver (E.C.)
12. V.M.M.
13. Broader explosion and broader smoke coverage
14. Glass Breakage
15. Damage caused by burglars
16. falling objects (tree limb)
17. Weight of ice, snow and sleet
18. Collapse
19. Artificially generated currents (freezer motor breaks/power surge) (electricity)
20. Freezing of or discharge from a plumbing, heating or cooling system.
DP-2 perils excluded
- the 4 perils excluded under the standard fire policy
- The perils excluded under the E.C. endorsement
- V.M.M. excluded if premises is vacant for 30 consecutive days.
- Damage caused by agricultural or industrial smudging.
DP-2 Broad Coverages
Coverage A - Dwelling - Replacement value (coinsured)
Coverage B - Other Structures - Optional, Additional
Coverage C - Personal Property - Optional, Additional
Coverage D - Rental Value - Optional, Additional
All coverages under DP-2 Broad are both ________ & _________
Optional ; Additional
The dwelling (under Coverage A, as well as B and D, if added) is protected against loss up to its _________. Personal property, if added under Coverage C, is protected against loss up to it’s _____________.
Replacement Cost ; Actual Cash Value (ACV)
Does DP-1 basic and DP-2 broad include the Liberalization Clause? (Y/N)
Yes
What does DP-3 Stand for?
Dwelling Building and Contents Special (DP-3) form
DP-3 Special form (all-risk) perils covered:
- Buildings (under Coverage A, as well as B and D, if added) are protected against damage caused by all risks.
- Personal Property (under Coverage C, if added) is protected against damage caused by the broad form named perils)
DP-3 Perils excluded
- the 4 Standard Fire policy perils
- The 4 E.C. endorsements perils
- V.M.M. is excluded if premises is vacant 30 consecutive days
- Damage caused by agricultural or industrial smudging.
- Damage caused by wear, tear, rot, deterioration, settling, cracking, mold, rust, inherent vice, discharge of pollutants.
- The cost of repairing mechanical breakdown.
- Damage caused by birds, vermin, rodents, insects or domestic animals
DP - 3 Coverages
Coverage A - Dwelling - replacement value (coinsured)
Coverage B - Other Structures ( outbuilding or appurtenant structures) - OPTIONAL & ADDITIONAL coverage
Coverage C - Personal Property - OPTIONAL & ADDITIONAL coverage
Coverage D - Rental Value - OPTIONAL AND ADDITIONAL coverage
For DP-3, the dwelling (under Coverage A, as well as B and D, if added) is protected against loss up to its ____________. Personal property, if added under Coverage C, is protected against loss up to its ______________.
Replacement Cost ; Actual Cash Value (ACV)
Does the DP-3 include a Liberalization clause? (Y/N)
Yes
This Policy is used to cover commercial (business) buildings
Building and Personal Property form
Other than covering commercial (business) buildings, what else can the building and personal property form be used for?
- It can be used for rental properties with more than 4 families
- It can be used for office buildings, store buildings, malls, warehouses, or industrial buildings
What can Building and Personal Property form be written to cover?
- Basic Cause of Loss form
- Broad Cause of Loss form
- Special (all risk) cause of loss form
What do all three forms (basic, broad, special) cover for building and personal property?
sinkholes, sprinkler leakage damage, and debris removal
Building and Personal Property excluded perils
- 4 Standard fire policy perils
- 4 E.C. coverage perils
- V.M.M. coverage is vacant for 30 consecutive days
- Damage caused by agricultural or industrial smudging
- Damage caused by wear, tear, rot, deterioration, settling, cracking, mold, rust, inherent vice, discharge of pollutants
- The cost of repairing mechanical breakdown
- Damage caused by birds, vermin, rodents, insects, or domestic animals (including watchdogs)
- Vacancy or UnOccupancy clause
Building and Personal Property form Coverages (Optional & Additional)
Coverage A - Building (including signs and objects attached to the building)
Coverage B - Personal property of the insured (either the insured premises or within 100 feet of it).
Coverage C - Personal property of others (Bailee Coverage)
Building and Personal Property form Coverage (Automatic Extensions)
- Personal Property of others and personal effects
- Off-premises
- Newly acquired property
- Valuable papers and records (but not bookkeeping records).
- Outdoor trees, shrubs, plants, fences, antennas, signs, not attached to the building, but within 100 feet of it.
The building and personal property policy covers both buildings and personal property for _____________ only.
ACV (and endorsement can be added for an extra premium charge to protect buildings and/or personal property against loss up to replacement cost)
Does the building and personal property policy include Liberalization Clause?
Y
Indirect Loss-Time Element Coverages are?
- Business Income Coverage.
- Extra Expense coverage
It covers the loss of earnings of a business while it is shutdown to remodel and restock because of a covered peril
Business income coverage
This endorsement is used when a business must continue operations while the insured premises are being remodeled and/or restocked as a result of a covered peril
Extra Expense Coverage
Dwelling does/does not need to be owner occupied?
does not
Homeowners does/does not need to be owner occupied?
Does
These policies package together property insurance and casualty insurance coverages to cover dwellings that people live in.
Homeowners Policy
Homeowners packages must be occupied by ______ families or less.
four
Homeowners Coverage A
Coverage A - Dwelling - The dwelling is protected against loss up to limits of liability stated in the policy. Except for H.O. 8, the limits of liability are determined by the replacement cost. The H.O. 8 modified form is the only homeowner policy that protects the dwelling and all types of property for ACTUAL CASH VALUE (ACV)
Except for the H.O. 8 Modified form, for an extra premium charge personal property can be covered for ______________
replacement cost
When personal property is covered for replacement cost, the Coverage C - Personal Property limit of liability is usually ____% of coverage
70
H.O. Coverage B - Other Structures (Appurtenant Structures or Outbuildings)
Coverage B - Other Structures (Appurtenant Structures or Outbuildings) - AUTOMATIC ADDITIONAL 10% of coverage A, or specified amount.
H.O. Coverage C - Personal Property
Coverage C - Personal Property - AUTOMATIC ADDITIONAL 50% of Coverage A. Without the extra premium, personal property is protected against loss up to ACV.
H.O. Coverage D - Loss of Use (Additional Living Expense and Rental Value)
Coverage D - Loss of Use (Additional Living Expense and Rental Value) - AUTOMATIC ADDITONAL 10% of Coverage A on H.O. 1 and H.O. 8. It is 30% of Coverage A on all others. “Rental Value Coverage”
H.O. Coverage E - Personal Liability Coverage
Coverage E - Personal Liability coverage -
- Pays all sums for which an insured person becomes legally liable for bodily injuries and/or property damage caused to other people other than the insured which are referred to as 3rd parties. It covers liability on or away from the insured premises not to exceed the policy limits of liability. Minimum is $25K
- Doesn’t cover personal injury liability such as libel, slander, defamation of character, wrongful entry or eviction, or false arrest or illegal detention.
- An insured is any member of the insured household who is relative or who is under 21.
H.O. Coverage F - Medical Payments
Coverage F - Medical Payments
- It covers only medical expenses incurred by somebody other than the insured or a member of his/her household.
- It pays all medical expenses incurred within 3 years of an accident on the insured premises or caused by the activities of the insured, his animal, or a resident employee away form the insured premises including ambulance and funeral expenses.
- It pays whether the insured was legally responsible for the injuries or not.
- There is usually a per person limit (such as $5,000) and an aggregate (total) limit in a higher amount (such as $25,000) per occurance.
- Having medical payments coverage will usually avoid having a liability claim made against the insured.
What are the seven policies in the Homeowner series?
HO 1, HO 2, HO 3, HO 4, HO 5, HO 6, HO 8
It protects both the dwelling and personal property against the 12 basic perils which include the 3 Standard Fire policy perils, the 8 E.C. perils and loss due to V.M.M.
H.O. 1 homeowners basic form
What is an automatic additional 10% of Coverage A under the HO 1 and HO 8?
Coverage D - Loss of Use (Additional Living Expense)
With all other homeowners policies, Coverage D - Loss of Use coverage is _____ of Coverage A
30%
HO 8 Modified form - is the same as the HO 1 basic form except:
a. The Homeowner HO 8 modified form is the only HO policy that protects both the dwelling and personal property against loss up to limits of liability that are determined by ACV
b. All of the other HO policies protect dwellings and other structures for replacement costs.
c. Like the HO 1, Coverage D - Loss of Use coverage is an AUTOMATIC ADDITIONAL 10% of coverage A
Homeowners Broad Form - Protects both the dwelling and personal property against the approximate 20 broad form named perils.
HO 2 Broad FOrm
Homeowners Special form - Protects the dwelling against all risks (except those excluded). It protects personal property (under coverage C) against the approximate 20 broad form named perils.
HO 3 Homeowners special form
Homeowners Contents Broad form (Tenants Coverage) - Protects personal property (no building or outbuilding coverage) against the approximate 20 broad form named perils.
HO 4 Homeowners Contents Broad Form (Tenants Coverage)
Protects personal property against loss up to limits of liability determined by ACV unless an extra endorsement is added for an extra premium charge to protect personal property up to its replacement cost.
HO 4 Homeowners Contents Broad form (Tenants Coverage) Coverage C
HO 4 Homeowners Contents Broad form (Tenants Coverage) - Coverage D - Loss of Use (additional living expense) is an automatic ____% of coverage C.
30%
Homeowners Comprehensive form - Protects both the dwelling and personal property against all-risks (except those excluded)
HO 5 Homeowners Comprehensive form
A separate policy must be purchased by the condominium owners’ association to cover the exterior of the buildings, outbuildings, and common properties owned by the condominium owners collectively.
HO 6 Homeowners Condominium Unit - Owner’s form
HO 6 Section 1 Coverage A
Building coverage is Replacement cost coverage to protect interior walls, ceilings, floors, and/or other structures that the condominium owner individually owns.
HO 6 Section 1 Coverage B
Other Structures are usually covered by the condominium owners’ association policy. If the condominium owner is responsible for insuring outbuildings, Coverage B - Other Structures coverage is OPTIONALLY AVAILABLE.
HO 6 Section 1 Coverage C
Protects personal property against loss up to limits of liability determined by ACV unless an extra endorsement is added for an extra premium charge to protect personal property up to its replacement cost.
HO 6 Section 1 Coverage D
Loss of use (Additional Living Expense) coverage is an additional 30% of Coverage C
HO 6 Section 2 Coverage E & F
Coverage E - Personal Liability coverage
Coverage F - Medical Payments coverage
Without additional premium, the HO 6 protects both buildings and personal property against the broad form perils. For an additional premium, buildings can be protected against the special (all risk) perils and personal property against the broad form perils
NOTE*
If an insured incurs loss of one of a pair, the insurance company has the option of paying the loss in actual cash value or restoring the pair
Loss of pairs
These coverages which the insurance company will provide in addition to the limits of liability (supplemental payments
