Unit 3: Property and Casualty Insurance Flashcards

1
Q

Property Insurance

A

Covers “My Stuff”

“My Stuff” = Personal belongings

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2
Q

Casualty Insurance

A

Casualty = Liability

Always pays the other guy, never me.

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3
Q

Describe third-party losses

A

First party - Me (insured)
Second party - my insurer
Third party - other guy

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4
Q

Policy Structure DICEE

A

Declarations - Insuring agreements - Conditions - Endorsments - Exclusions

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5
Q

Policy Structure: Declarations

A

Who, what, when, where and how much

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6
Q

Policy Structure: Insuring Agreements

A

Promise to pay and perils covered

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7
Q

Policy Structure: Conditions

A

Rules for the policy

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8
Q

Policy Structure: Endorsements

A

Changes to the original policy

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9
Q

Policy Structure: Exclusions

A

Items not covered

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10
Q

Additional Supplementary Coverage

A

Payment for additional expenses not normally covered.

may have separate limit of insurance

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11
Q

Insureds

A

Name insured - Listed on the declarations
First-named insured - First on the declarations
Insureds - by definition
Additional insured - added by endorsment

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12
Q

Policy Period

A

When the policy begins and ends

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13
Q

Policy Territory

A

Where a loss must occur

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14
Q

Cancelation

A

Occurs before the policy’s expiration date
Insurer cancellation requires advance notice
Full refund of unearned premium - pro rata
Insured cancellation - No advance notice
Partial refund of unearned premium - short rate

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15
Q

Nonrenewal

A

Occurs at the expiration date.
Insurer must give advanced notice
No advanced notice required by the insured

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16
Q

Deductible

A

Amount of the loss paid by the insured

The higher the deductible, the lower the premium

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17
Q

Other Insurance

A

Restore insured to pre-loss condition
More than one policy covers the same loss or claim
No more, no less!

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18
Q

Nonconcurrency

A

The result of two or more policies covering the same property but providing different or non-identical coverage

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19
Q

Primary and Excess

A

Primary insurance pays first; excess pays what’s left (if any)

20
Q

Pro rata

A

Each policy pays its share according to the total insurance

21
Q

Other Insurance: Pro Rata Responsibility

A

Noncurrency: Non-identical coverage

Primary Excess: Excess pays what is not covered by primary

Pro Rata: Each insurer’s liable for a portion of the loss

22
Q

Contribution by Equal Shares

A
Each policy pays the same up to the smallest policy limit
Prevents gain (indemnity)
23
Q

Named Insured Duties after Loss (PPC-MSC)

A
■ Prompt notice to insurer
■ Protect property from further damage
■ Complete proof of loss (if asked)
■ Make property available for inspection
■ Submit to examination under oath if required
■ Cooperate with insurer
24
Q

Assignment

A

CONSENT

Policy cannot be transferred without written consent from the insurer. Transfer of right

25
Abandonment
Insured cannot abandon property that can be repaired and expect to be paid as if the loss was total
26
Salvage
Insurer has the right of salvage, not the insured
27
Liberalization
■Extended coverage to insured ■ No additional premium charged ■ No action required by insured
28
Subrogation
insurer has the right to sue an at-fault party for damages the insurer had to pay the insured
29
Insurable Interest
■ Financial risk of loss | ■ Must be present at time of loss
30
Underwriting
■ Process of evaluating a risk ■ Field underwriting is performed by the agent or producer ■ Application is the primary source of information ■ Company underwriters decide if a policy is to be issued
31
Application
Primary source of underwriting information
32
Binder
■ Temporary insurance ■ Usually given by the agent—verbal or in writing ■ Can be canceled by the company ■ Does not guarantee a policy will be issued ■ Automatically ends if a policy is issued by the underwriter
33
Financial Ratios
Loss ratio Expense ratio Combined ratio
34
Loss ratio
Compares company's operations year over year
35
Expense ratio
cost of doing business
36
Combined ratio
100% is breakeven point Greater than 100% - underwriting loss Less than 100% - underwriting gain
37
Underwriting Expenses
The cost to acquire and to keep policies
38
Written premium
is the gross amount of premium income received from insureds.
39
Rate
Three ways to assign rates: Judgement - no set rates, based upon underwritters experience Manual (class) - set rates for specific risk classes Experience rating - modification factor based on loss experience (increase or decreases premium, usually a three-year preiod)
40
Loss Cost
CLAIM COSTS | Pure claims data. No operating expenses included No profits included
41
Rate Components
``` Loss costs (estimate of claim cost) Claim handling costs operating expenses profit ```
42
Fair credit reposting act
All insurers and producers (agents) must comply Notice to the applicant within three days after report was requested maximum penalty: $5,000, 1 year in prison or both
43
TRIPRA (Terrorism risk insurance)
■ Result of 9/11 Attacks on U.S. ■ Congress enacted in 2002 ■ Limits exposure of insurers in case of another catastrophic event ■ Triggering event—$100 million (increases to $200 million from 2015–2020 in $20 million increments)
44
GRAMM-LEACH-BLILEY ACT
■ A consumer is anyone about whom information is collected. ■ A customer is someone who has an ongoing relationship with a financial institution. ■The opportunity to opt out must be offered by financial institutions when an account is established and annually thereafter.
45
Fraud and False Statements
■ It is illegal to make false statements. | ■ If guilty: Fine, up to 10 years in prison, or both. Up to 15 years in prison if false statements jeopardize insurer