Short answer Flashcards
Outline FIVE (5) considerations in evaluating a property risk. (5 marks)
Property risk considerations (any five of the following)
• Acceptable and unacceptable risks
• Claims history
• Financial factors
• Physical factors (COPE—construction, occupancy, protection, and exposure)
• COPE and a single-family dwelling
• Heritage and historic dwellings
Explain how insurers prevent some insureds from purchasing insurance far below the total value of their property to save money on premiums. (5 marks)
Insurance to value
• The practical solution to the problem has been for insurers to assume that insureds have bought insurance on the full value of their property.
• That allows the ratemaking process to assign uniform rates to similar risks within groups.
• Coinsurance penalty, applied mostly in commercial policies, helps encourages insurance to value.
• A professional insurance appraisal is the best way to determine a building’s replacement cost, but most insureds find this too expensive to have done regularly. • For personal property risks and for simple commercial risks, most insurers require completion of an estimator or calculator—a formula, devised by professional appraisers, that estimates replacement cost based on features such as the size and location of the dwelling.
Identify the critical workplace interpersonal skills brokers and adjusters must use with insureds after a loss has been reported. (5 marks)
Critical workplace interpersonal skills (any five of the following)
• Using tact and diplomacy to reassure and calm an insured
• Recognizing that everyone reacts differently to a crisis • Acknowledging feelings in a neutral way, rather than ignoring them and creating barriers
• Being patient
• Showing respect for the person even when feelings and views may not be understood
• Being observant
• Choosing words carefully, so as not to imply coverage • Listening actively
Role of Agent
• Obtains all relevant information about the property and the hazards from Mariana
• Assesses the risk and determines what coverage Mariana requires
• Helps Mariana to complete the application, eliciting all material information from her and further
confirming that the risk fits the insurer’s guidelines
• With Mariana’s help, answers additional questions from the underwriter
• When Mariana calls to report the fire, helps her begin the claims process
. Actions of underwriter
• Reviews the application to determine whether it meets the insurer’s underwriting guidelines
• Requests further information from the agent and Mariana to determine whether the coverage
applied for is appropriate
• Decides if additional coverage is needed and helps the agent with additional endorsements or
special coverage
• Accepts the application with any necessary modifications
• During the claims process, helps the agent and the claims department with any questions that
may arise
Claims questions
c. Claims questions (any five of the following)
• Does the loss fall within the policy period?
• Does the loss fall within the insuring agreement?
• Do any exclusions apply?
• Do any endorsements apply?
• Have all policy conditions been met?
• Is there a deductible to be applied?
• How much should be paid?
• Is there any other reason not to pay the claim?
Outline the benefits of the mortgage clause to a mortgagee. (5 marks)
Mortgagee benefits
• Policy covers mortgagee even if named insured is unable to recover because of breach of a
policy condition.
• Mortgagee is permitted to give notice of loss immediately and proof of loss as soon as
practicable.
• Mortgagee and its assigns are included among those who, acquiring title to the insured property,
are covered under the policy until it is cancelled or expires.
• Mortgagee to be notified of cancellation or any alteration of policy to the prejudice of the
mortgagee.
• Same notice required to mortgagees as to insureds.
In the IBC homeowners forms, 15 special limits are described in two groups; name FIVE (5) special
limits that apply only to loss caused by theft. (5 marks
Special limits for theft (any five of the following)
• Works of art
• Jewellery, gems, precious or semi-precious stones, pearls, and watches
• Fur garments, garments trimmed with fur, and all other fur items
• Numismatic property, manuscripts, stamps, and philatelic property
• Collectible cards (such as sports personality cards)
• Collections not subject to any other limitation
• Bicycles, their equipment, and accessories
Identify the purpose of a deductible. Describe FOUR (4) ways it is commonly applied. (5 marks
Application of deductibles
• A deductible is the insured’s portion of a covered loss and is intended to prevent small, frequent
claims, reducing administrative costs and premiums.
• The deductible may apply separately to the amount recoverable under each item, if the total
amount of insurance is subdivided into more than one item.
• The deductible may be subtracted from the total amount of loss or damage arising from a single
event (such as a fire or an explosion)—this is the most common application.
• The policy may also state that no loss be paid below a specified amount (the deductible) but that
a loss greater than this amount will be paid in full.
• Or, the policy may indicate a deductible and a loss amount beyond which no deductible applies
Discuss why the basic fire policy is important for understanding property insurance today. (5 marks
. Evolution of the basic fire policy
• While the basic fire policy is not really sold on its own today, this policy is the basis of today’s
property policies, so it is important to understand something of its features.
• Fire policies cover direct physical loss or damage to insured property when it occurs as a result of
an insured peril.
• At first, those perils comprised fire, lightning, and explosion of natural, coal, or manufactured gas.
• Over time, as client needs changed, additional perils were added to fire policies.
• Today, fire policies have become property policies, which insure against multiple perils—either
named perils or all perils that are not excluded
Identify five different classes or specialized forms of coverage that insurers may sell within either
personal-lines or commercial-lines property insurance. (5 marks
. Classes of property insurance and specialized coverage (any five of the following)
• Marine insurance
o Inland marine insurance
o Marine cargo insurance
• Aviation insurance
• Crop insurance
• Builders risk
• Earthquake insurance
• Equipment breakdown (boiler and machinery insurance)
• Flood insurance
• Habitational insurance
o Homeowners insurance
o Tenants/renters insurance
o Condominium unit owners insurance
Define an insurance contract. Outline the elements or principles that makes it different from other
contracts. (5 marks
The insurance contract
• The insurance contract is an agreement or promise between two or more persons, or parties, that
is intended to be legally enforceable.
• The written form of the insurance contract is issued by the insurer to the insured as a policy.
• Insurance contracts or policies include the principle of indemnity—that the insured party shall not
receive more than the actual loss suffered.
• Insurance contracts or policies include the concept of insurance interest—that the insured must
stand to benefit from the continued existence of the insured property or be prejudiced by its loss.
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• Insurance contracts or policies also include the principle of uberrimae fidei, or utmost good faith,
which requires the insured to act with a high standard of honesty and disclose those facts that a
reasonable person ought to know are material
What is covered by homeowners policy
Natalya recently bought a new house where she will live with her new husband, Jonah. She is taking
out a personal property insurance policy and would like to discuss the policy in detail. How will her
following questions be answered by the insurance agent?
What is covered by homeowners policy?
• The subject matter of the insurance in Natalya’s homeowners policy is her dwelling and its
contents belonging to the members of her household.
• Property insurance is first-party insurance, protecting the first party to the insurance contract
against the risk of financial harm resulting from loss or damage to the insured property.
• In the event of a loss, Natalya and her household members must demonstrate an insurable
interest in the property that has sustained the loss or damage.
• In contrast, liability insurance is third-party insurance, protecting the insured against the risk that a
third party will suffer loss or injury for which the insured is legally liable.
• Natalya would need to get personal liability insurance to protect herself against a situation
experienced by her father.
Natalya has heard that there are circumstances that could void her policy in the event of a fire.
Identify some of the general exclusions to basic fire insurance. (5 marks
Natalya recently bought a new house where she will live with her new husband, Jonah. She is taking
out a personal property insurance policy and would like to discuss the policy in detail. How will her
following questions be answered by the insurance agent?
Exclusions to basic fire policy (any five of the following)
• Electrical devices
• Application of heat
• War risks
• Nuclear incident
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• Excluded property • Alterations and additions • Vacancy, unoccupancy, or disuse • Volatile substances • Bylaws
Natalya recently bought a new house where she will live with her new husband, Jonah. She is taking
out a personal property insurance policy and would like to discuss the policy in detail. How will her
following questions be answered by the insurance agent?
. Who is covered by the homeowners policy?
Jonah’s son Micah is 14 and lives with Jonah and Natalya. Amelia, Natalya’s daughter, is 19 and
away at university but lives with her mother on her school breaks. Natalya’s brother Niki is
planning to move to Canada and will be living in the finished basement until he can find a job.
Finally, Jake, a classmate of Micah, has been living with the family temporarily because there are
some problems at home. Natalya is wondering how the homeowners insurance policy will protect
all the members of her household. (5 marks
Who is covered by the homeowners policy?
• Jonah is covered by the policy, as the spouse of the named insured.
• Micah is also covered, as he is a relative of Jonah’s, and a dependant under the age of 21.
• Niki will be covered when he moves in because he is a relative of the named insured
• Amelia is covered as a student who is temporarily living away from home to attend university and
still dependent on the named insured.
• Jake’s personal property is covered as he is a minor under the care of Natalya and Jonah.
Outline five questions pertaining to an applicant’s personal information that an insurer must be able to
answer. (5 marks)
Questions about personal information (any five of the following)
• What personal information is collected?
• Why is it collected?
• How is it collected?
• What is it used for?
• Where is it kept?
• How is it secured?
• Who has access to or uses it?
• To whom is it disclosed?
• When is it disposed of
Identify five provisions in the articles of the Civil Code of Québec that are similar to the statutory
conditions for property insurance. (5 marks
Civil Code provisions
• Some provisions stipulate the rights and obligations of the insured and the insurer concerning a
material change in risk and define when vacancy becomes material (Articles 2466–2468).
• Some provisions are similar to Statutory Conditions 6, 7, and 12 (Requirements After Loss,
Fraud, and When Loss Payable). (Articles 2470–2474)
• Some provisions specify that the contract may only be assigned with consent of the insurer and
then only to someone with insurable interest, similar to Statutory Condition 3. (Articles 2475–
2476)
• Some provisions address termination requirements, as well as notice to lienholders. (Articles
2477–2479)
• One provision requires the insured not to abandon the property following loss and to allow the
insurer to inspect the damage, similar to Statutory Condition 10—Entry, Control, Abandonment.
(Article 2495
Outline five pieces of privacy legislation that can affect property insurers in Canada. (5 marks
- Privacy legislation
• Personal Information Protection and Electronic Documents Act (PIPEDA)
• Freedom of Information and Protection of Privacy Act (FOIPPA)
• Personal Information Protection Act (PIPA)
• Access to Information and Protection of Privacy Act
• Act Respecting Access to Documents Held by Public Bodies and the Protection of Personal
Information
In the event his mother passes, Chen and his wife may decide to retire to Thailand. If that
happens, Chen plans to transfer the title of their home to their daughter and her husband. Explain
how a specific statutory condition would affect Chen’s decision to change the insurable interest in
the property. (5 marks)
. Chen recently moved from Montreal to Toronto to help his daughter and her husband with their new
business. Chen has purchased a large home for his family, which includes his wife, his elderly
mother, his 35-year-old daughter and her husband, and his two grandchildren. After purchasing
insurance, he has some questions about the statutory conditions in his homeowners policy because
he knows that insurance is a little different outside of Quebec.
Change in interest
• An insurance policy is a personal contract, and Chen cannot assign his rights and obligations
under the contract to another party without the insurer’s consent.
• The change of interest statutory condition identifies exceptions in which the insurer is obliged to
insure a new interest replacing the named insured’s interest, such as bankruptcy or a change of
title.
• Under this condition, the policy protects the new interests, such as Chen’s daughter and her
husband, automatically from the time of the change, regardless of whether the insurer has been
informed.
• Even in such cases, there is a reasonable obligation for the successor, such as the executor of
the estate or receiver in bankruptcy, to notify the insurer of the change in interest within a
reasonable amount of time.
• Since a title change usually comes with other changes, such as occupancy, the insurer should be
made aware so the risk can be re-evaluated
Chen wants to ensure he understands what to do in the event of a loss. Explain the statutory
condition of requirements after loss. (5 marks)
. Chen recently moved from Montreal to Toronto to help his daughter and her husband with their new
business. Chen has purchased a large home for his family, which includes his wife, his elderly
mother, his 35-year-old daughter and her husband, and his two grandchildren. After purchasing
insurance, he has some questions about the statutory conditions in his homeowners policy because
he knows that insurance is a little different outside of Quebec.
b. Requirements after loss
• In the event of a loss, Chen must provide notice of a loss to the insurer in writing.
• This notice must be given as soon as possible so that an appropriate investigation to assess
coverage can be undertaken by the insurer.
• Chen must also provide the insurer with a proof of loss.
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• The proof of loss must include how and when the loss occurred; an inventory of the damaged
property; where the property was at the time of loss; and a declaration that the loss was not
caused by a willful act of the insured.
• The proof of loss should also list any insurance covering the same property; the interest of the
insured and others; and notification of any changes in title, use, or occupation
Chen would like to know if it will be possible to cancel his policy, and whether he can be
refunded. Explain how the termination statutory condition works. (5 marks
. Chen recently moved from Montreal to Toronto to help his daughter and her husband with their new
business. Chen has purchased a large home for his family, which includes his wife, his elderly
mother, his 35-year-old daughter and her husband, and his two grandchildren. After purchasing
insurance, he has some questions about the statutory conditions in his homeowners policy because
he knows that insurance is a little different outside of Quebec.
Termination
• A policy may be terminated by either the insured or insurer, but there are requirements.
• If Chen asked to cancel his policy, premiums paid but unearned will be refunded, less a
surcharge to offset the administrative cost; this is known as a short-rate cancellation.
• Chen may be asked to sign a cancellation receipt to show the effective date of cancellation and
cancellation cannot be backdated.
• If the insurer cancels the policy, the statutory condition requires it to do so in writing; with 5 days’
notice if delivered personally, or 15 days’ notice by registered mail.
• This is a pro-rata cancellation and the insurer is required to give a proportional refund of premium
for the unexpired portion of the term with the notice of cancellation
Outline the differences between named-perils policies and all-risks policies. (5 marks
Named-perils vs all-risks
• Named-perils policies insure against direct physical loss or damage caused by only the listed
perils.
• With named-perils coverage, the onus is on the insured to prove the loss or damage was caused
by an insured peril and that no exclusion of coverage applies.
• All-risks policies insure against direct physical loss or damage caused by any peril, provided that
the peril is not excluded.
• With all-risks policies, the insured has to prove that loss or damage to insured property at an
insured location occurred during the policy term and that the loss was fortuitous.
• However, with all risks, the onus is on the insurer to prove that an exclusion applies; otherwise,
the physical damage is insured
Name FIVE (5) IBC habitational forms in which the named perils are listed in an “insured perils”
section. (5 marks)
. Named-perils section (any five of the following)
• IBC 1151 Homeowners Basic Form
• IBC 1153 Homeowners Broad Form
• IBC 1157 Mobile Homeowners Form
• IBC 1161 Tenants Basic Form
• IBC 1165 Condominium Unit Owners Basic Form
• IBC 1171 Residential Basic Form
• IBC 1173 Seasonal Residence Form
Name FIVE (5) common domestic fire hazards that should be eliminated, controlled, or reduced as
much as possible. (5 marks
Fire hazards (any five of the following)
• Cooking hazards
• Unattended portable heaters
• Clothes-dryer lint
• Overloaded electrical circuits
• Faulty or old, outdated wiring
• Unattended candles (for festive or religious ceremonies)
• Wood fireplaces and wood stoves
• Careless smoking and children playing with matches
Vivek lives near a large coastal estuary, which means he lives near a river that flows into the ocean.
He’s very concerned about the effects of climate change and severe storms and has heard that his
insurance will not cover flooding. He’s concerned about that, because he knows that water damage is
one of the most frequent causes of damage. He’s also worried about the sewer backing up or a
plumbing malfunction causing a flood, as his coworker had a terrible flood last year in his basement
caused by sewer backup. So, Vivek wants to ensure he’s protected from such problems by
purchasing a sewer back up endorsement. His broker suggests adding an extended water
endorsement to cover his concerns.
a. Clarify Vivek’s understanding of the term “flood” with examples of how people use the term
incorrectly and how such examples might be covered. (5 marks)
a. Incorrect uses of “flood”
• A pipe in the dwelling bursts, causing water to accumulate. This is not a flood and the damage is
covered.
• A toilet overflows, causing water to accumulate. This is not a flood and the damage is covered.
• A dishwasher hose breaks, causing water to accumulate. This is not a flood and the damage is
covered.
• The sewers back up, causing water to accumulate. This is not a flood and the damage is covered.
• The sump pump malfunctions, causing water to accumulate. This is not a flood, but it’s also an
excluded peril, so the damage would not be covered