Section 1A Flashcards

0
Q

Texas Property and Casualty Insurance Guaranty Association

All authorized Property and Casualty insurers

A

Must participate in order to maintain their Certificate of Authority

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1
Q

Texas Property and Casualty Insurance Guaranty Association protects customers

A

In the event of insurer insolvency (bankruptcy)

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2
Q

Texas Property and Casualty Insurance Guaranty Association covers

A

Unpaid claims of insolvent insurers up to a maximum of $300,000

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3
Q

Texas Property and Casualty Insurance Guaranty Association

The Fund exercises its powers through a Board of Commissioners who will

A

Assess each member company as necessary to pay the obligations of the Fund.

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4
Q

Cancellation and Non-Renewal Requirements

Dwelling Fire and Homeowners: After a policy has been in effect for

A

60 days or upon renewal, no notice of cancellation is effective unless it is based on one or more of the following reasons:

Non-Payment of premium
Substantial Change in the Risk
Failure of the Insured to take steps to eliminate conditions that would increase the probability of a future loss

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5
Q

Cancellation and Non-Renewal Requirements

In the event of a non-renewal based upon the condition of the premises, the insured must be given

A

30 days’ notice to remedy the identified conditions.

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6
Q

Cancellation and Non-Renewal Requirements

All notices of cancellation or non-renewal must be in writing, must be mailed to the

A

Named insured at the address shown in the policy and must state the specific reason for at least 30days in advance of the end of the policy period

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7
Q

Cancellation and Non-Renewal Requirements

Proof of mailing of a notice to the named insured at the address shown in the policy is sufficient proof or required notice,

A

Whether they received it or not

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8
Q

Commercial Policies:

After a commercial policy has been in effect for at least 60 days or upon renewal, it may be

A

canceled for only the following:

Non-payment of premium or fraud
The insured’s conviction of a crime
A substantial change in the risk
A breach of contractual duties

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9
Q

Commercial Policies:

The first named must receive written notice of cancellation by certified mail at least

A

10 days in advance if the cancellation is due to non-payment of premium or 60 days in advance for any other reason.

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10
Q

For commercial renewal policies, the insurer must provide at least

A

60 days’ advance written notice to the first named insured if the renewal is subject to

A premium increase
Reduction in limits of insurance
Substantial reduction in coverage provided

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11
Q

Personal Auto Insurance CNX and Non-Renewal Requirements:

An auto insurer may not cancel or refuse to renew an auto policy

A

Solely on the grounds of the insured’s age, race, color, religion,sex or national origin or ancestry

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12
Q

For renewal policies that have been in effect for more than 60 days, the insurer

A

May only cancel or non-renew for the following reasons:

Nonpayment
The insured or HH member has had their license suspended or revoked
Has become permanently disabled
Etc…

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13
Q

However, if a driver (other than the named insured) has violated one of the above conditions, the named insured

A

May avoid cancellation or non-renewal by excluding this driver in writing from coverage (an exclusion endorsement)

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14
Q

The insured must receive at least 10 days’ written notice of cancellation and/or at least 30 days written notice of non-renewal. The notice must include the following:

A

Specific facts for the reasons for cancellation or non-renewal
Notice of insured’s right to contest the insured’s decision
A refund of any unearned premium

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15
Q

Texas Motor Vehicle Financial Responsibility Law: Every person operating a motor vehicle on any highway in this state shall possess

A

Evidence of current financial responsibility.

Ex: 
Auto liability policy
Binder
Surety bond or certificate of Deposit
Motor vehicle insurance ID card
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16
Q

Vehicles

A

Exempt from this requirement include farm tractors, farm implements temporarily on the highway , trailers not used for commercial purposes and any vehicles owned by the US Govt

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17
Q

A motor veh liability policy issued in this state shall comply with the Financial Responsibility Law if it contains the

A

Minimum required limits of split limits of $30,000 for BI, $60,000 for BI per occurrence, and $25,000 for property damage to others in any one accident, or a CSL of at least $85,000 for any one accident

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18
Q

In lieu of the above, proof of financial responsibility may be evidenced by depositing

A

Certificates of Deposit in the amount of $85,000, a surety bond of $85,000 or cash in the amount of $85,000

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19
Q

If two or more policies affording valid auto liability insurance apply to the same motor vehicle involved in an accident, it shall be presumed that the insurance afforded by the policy in which such vehicle is described (the owner’s policy) shall be

A

Primary and the insurance afforded by any other policy (the driver’s policy) shall be excess

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20
Q

TAIPA (Texas Automobile Insurance Plan)

The Commissioner will implement a reasonable plan for the distribution of applicants for motor vehicle liability policies

A

Who are in good faith entitled to but are unable to procure policies through ordinary methods.

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21
Q

All insurers authorized to issue motor vehicle liability policies

A

Must participate in the Plan as a condition of their Certificate of Authority.

22
Q

TAIPA aka the

A

Assigned Risk Pool, all auto insurers must include in their notice of cancellation or non-renewal notices language that advises insured’s that they may be eligible for coverage through the Plan

23
Q

Uninsured/Underinsured Motorists Coverage: An insured may choose to have UM/UIM coverages included in an auto liability policy.

Minimum limits are

A

$30,000 per person/$60,000 per occurrence for Bodily Injury liability and $25,000 per occurrence for Property Damage liability.

24
Q

Although coverage is optional, the insurer must offer such coverage to all applicants,

A

Who may reject it in writing

25
Q

Uninsured Motor Vehicles: For the purpose of this coverage, are defined as:

A

Hit and Run vehicles, provided a claim can be proven

26
Q

Underinsured Motorist Coverage: To the extent that the total damages exceed the total liability limits, the UIM coverage is

A

Applicable to the difference

27
Q

UM and UIM coverages are

A

Separate and distinct and apply to different accident situations.

28
Q

Insurers who make payments for damages to insured’s under UM

A

may subrogate and sue for reimbursement against the UM responsible.

29
Q

Although both coverages must be offered at policy inception, if rejected in writing by the insured,

A

The coverages need not be re-offered upon renewal.

30
Q

Texas has a

A

Compulsory Workers’ Compensation law which requires employers to comply.

31
Q

Although some states require coverage to be purchased only from the State Fund (monopolistic),

A

Texas gives employers a choice of purchasing the required coverage from the State Compensation Fund, a private insurer or self-insuring (competitive)

32
Q

Worker’s Compensation

Exclusive Remedy: The right to recover for injury or death sustained by an employee is the

A

Exclusive remedy against the employer and their insurer.

33
Q

Worker’s Compensation

Lawsuits may not be filed by injured employees

A

Unless the injury was caused by the willful misconduct of the employer indicating a willful disregard for the safety of employees

34
Q

Worker’s Compensation

Covered Employment: Employers subject to the law include the state, counties, cities and school districts and

A

Every person who regularly employs any workers, except for domestic servants

35
Q

Worker’s Compensation

Covered Injuries: Personal Injury means any of the following:

A
  • injury by accident arising out of the course of employment
  • injury caused by the willful act of a third person
  • an occupational disease which due to conditions of a particular occupation, but not ordinary diseases to which e general public is exposed
36
Q

Worker’s Compensation

No employee is entitled to receive compensation for disability from occupational disease

A

If the disability was caused by the willful misconduct

37
Q

Worker’s Compensation

Occupational disease is covered

A

If there is a direct connection to the work performed

38
Q

Worker’s Compensation

Every eligible injured employee and the dependents of an employee who is killed by an accident arising out of the course of their employment is entitled to compensation for

A

Medical expenses, nurse and hospital services and medicines and funeral expenses

39
Q

Worker’s Compensation

There is no coverage if

A

The injury was purposely self-inflicted or is due to the employee’s use of alcohol or any controlled substance which was a substantial cause of the employee’s injury or death

40
Q

Worker’s Compensation

Medical, surgical and hospital benefits are covered

A

Without limits.

41
Q

Worker’s Compensation

Disability Income Benefits: Compensation will not be paid for the first seven days after the injury

A

(Seven day waiting period)

42
Q

Worker’s Compensation

If the incapacity extends beyond seven days,

A

Compensation will begin on the eighth day

43
Q

Worker’s Compensation

A self-insurer means an individual employer or a pool that has been

A

Authorized by the Texas Workers Compensation Commission to self-insure

44
Q

Worker’s Compensation

Self-insurers must

A

Obtain a Surety Bond and specific excess insurance to protect against catastrophic losses

45
Q

Terrorism Risk Insurance Extension Act of 2005

The act is designed to

A

Safeguard commercial insurers against potential bankruptcy.

46
Q

Terrorism Risk Insurance Extension Act of 2005

The Act does not apply to

A

Personal lines, crop, livestock,mortgage,financial guaranty, medical malpractice, flood, life, and health insurance, commercial auto insurance, burglary and theft insurance, surety insurance,professional liability insurance and farm owners multiple peril insurance

47
Q

Terrorism Risk Insurance Extension Act of 2005

The terrorism act must occur

A

Within the US.

48
Q

Terrorism Risk Insurance Extension Act of 2005

TheAct does not apply to losses from acts of terrorism that, in aggregate, do not exceed

A

$25 million

49
Q

The ‘terrorism act’ must be perpetrated on behalf of a foreign person/interest. Domestic

A

Terrorism is excluded.

50
Q

Liquidated Demand: is is the Texas version of what is known as a “valued policy law”

A

Which is designed to prevent insurance companies from intentionally over insuring real property, meaning a dwelling or a home.

51
Q

Liquidated Demand: This law does not apply to

A

Contents, which are considered to be personal property.

52
Q

Liquidated Demand: the full policy limit must be paid even if

A

The limit exceeds the value of the dwelling or even its replacement cost

53
Q

Residential and Community Property: It overrides the language in a property policy that states that a spouse that is not

A

Named on the declarations page is not a named insured unless they reside with the party listed on the Declarations.