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INS22
Personal Insurance
195
Other
Undergraduate 1
05/28/2015

Additional Other Flashcards

 


 

Cards

Term

Where are most of the differences Compare between ISO HO-3 Special Form and ISO policy:


• HO-2 Broad Form?
• HO-5 Comprehensive Form?
• HO-4 Contents Broad Form?
• HO-6 Unit-Owners Form?
• HO-8 Modified Coverage Form?

Definition

 

 

 

The primary differences between the forms occur in Section I—Property Coverages.

Term

 

 

 

What are the two differences between the HO-2 and HO-3 policy forms?

Definition

 

1. The HO-2 covers the dwelling building and other structures against fewer causes of loss. The causes of loss are limited to the named perils listed in the policy for Coverages A, B, and C. The list of named perils resembles the list of named perils in the HO-3 for Coverage C.


 

2. For the HO-2, the burden of proof shifts to the insured for losses under Coverages A and B. For coverage to apply with a named perils policy, the insured must prove that the loss was caused by a covered cause of loss.

Term

 

 

How is the HO5 (comprehensive form) different than HO3 (special form)?

Definition

1. The HO-5 is essentially an HO-3 that has been modified to provide special-form coverage to Coverage C as well as Coverages A and B.

2. The HO-5 covers personal property for loss by any peril, subject to the exclusions that also apply to Coverages A and B.

3. The HO-5 changes coverage for personal property in the following ways:
a. Covers water damage, including flood, for personal property away from the premises.
h. Coverage does apply to personal property damaged by rain through an open window, door, or roof opening even if thebuilding itself is not damaged.
c. The special limits of 1,500 for jewelry and furs, 2,500 for firearms, and 2,500 for silverware also apply not only to
theft, but also to the perils of misplacing or losing the items.

Term
One thing to know about the HO-4 Contents Broad Form (HO 00 04) is:
Definition

 

1. It is often referred to as
a “tenant homeowners policy” or a “renters policy,” ...it's designed  for those who live in a rented house or apartment.

Term
 The HO-4 contains the following (six) differences when compared to the HO-3:
Definition
1. Coverages A and B are absent from Section I.
2, Coverage C is written at a limit the insured selects as adequate to cover the insured’s personal property.
3. Coverage D is automatically provided at 30 percent of the Coverage C limit.
4. An additional coverage, “building additions and alterations,” is provided for a limit up to 10 percent of Coverage C.
5. The additional coverage for “landlord’s furnishings” is not included in the HO-4.
6. The additional coverage “ordinance or law” is provided for a limit up to 10 percent of the “building additions and alterations”
limit.
Term

 

 

One thing to know about the HO-6 Unit-Owners Form (HO 00 06)  is:

Definition

 

 

HO-6 Unit-Owners Form (HO 00 06) is a homeowners policy tailored to cover the exposures faced by people who own a condominium unit or a cooperative unit.

Term

 

The HO-6 differs from the HO-3 in the following  crucial ways:

 

(There are 9 total differences, but only a few are listed).

Definition

 1. Coverages in coverage A are for 'the unit' only and have a $5k limit.

2. Coverage B is eliminated.

3. Coverage C limit is selected by the insured.

4. Coverage D is 50% of Coverage C.

5. Section I is 'replacement cost' but repairs m/b made in reasonable time frame.

 

Term

 

 

 

One thing to know about the HO-8 Modified Coverage Form (HO 00 08) is:

Definition

 

HO-8 Modified Coverage Form (HO 00 08) is designed for use in cases in which the replacement cost of an owner-occupied dwelling significantly exceeds its market value.

Term

 

 

The HO-8 differs from the HO-3 in the following ways:

Definition

 1. Repairs use functionally equivalent materials. No antique materials.
2. If no repairs, then limit d/n exceed mkt value at time of loss.

3. Section I losses are covered for limited named perils.

4. Theft limit is $1k.

5. The HO-8 does not include the additional coverages of collapse,
landlord’s furnishings, ordinance or law, and grave markers.

Term
Endorsements that modify Section I—Property Coverages:
Two endorsements that increase limits, modify valuation, and expand covered perils:
(HO2, HO4, HO5, HO6, HO8)
Definition

1. Scheduled Personal Property Endorsement (HO 04 61) is used to provide coverage for insureds who own jewelry, furs, or other eligible property for which an unendorsed homeowners policy might not provide adequate protection.

 

2. Scheduled Personal Property Endorsement (with agreed value loss settlement) (HO 04 60) provides agreed value coverage on all scheduled property items.

Term

 

 

Endorsements that modify Section I—Property Coverages.  HO2,4,5,6 & 8

 

 Seven endorsements that increase limits:

Definition

1. Other Structures—Increased Limits Endorsement (HO 04 48)

2. Increased Limit on Personal Property in Other Residences Endorsement (HO 04 50).

3, Coverage C Increased Special Limits of Liability Endorsement
(HO 04 65 or HO 04 66).

4. Increased Limit on Business Property Endorsement (HO 04 12).

5. Credit card, fund transfer card or access device, forgery, and counterfeit money coverage (HO 04 53).

6. Ordinance or Law—Increased Amount of Coverage Endorsement (HO 04 77).

7. Inflation Guard Endorsement (HO 04 46) gradually increases.

Term

 

Endorsements that modify Section I—Property Coverages.  HO2,4,5,6 & 8.

 

Two Endorsements that change the valuation approach:

Definition

 

 

1. Additional Limits of Liability for Coverages A, B, C, and D Endorsement (HO 04 11).

 

2. Personal Property Replacement Cost Loss Settlement Endorsement (HO 04 90).

 

Term

 

 

Endorsements that modify Section I—Property Coverages:  HO2,4,5,6 & 8.

Four endorsements that add coverage for more perils:

 

Definition

 

1. Special Computer Coverage Endorsement (HO 04 14) provides special-form coverage for computers and computer equipment.

2. Special-Form Contents Coverage Endorsements (HO 05 24 or HO 17 31) can be used to modify homeowners forms other than the HO-5 to provide contents coverage similar to that of the HO-5.

3. Earthquake Endorsement (HO 04 54) provides coverage for damage caused by earthquake and land shock waves caused by volcanic eruption.

4. Water Back-Up and Sump Discharge or Overflow Endorsement (HO 04 95) provides coverage up to $5,000.

Term

Endorsements that modify Section II—Liability Coverage:


Six endorsements that modify forms (HO2, HO4, HO5, HO6, HO8).

Definition

A. Personal Injury Endorsement (HO 24 82) adds an additional liability insuring agreement expanding the homeowners policy.

B. Business Pursuits Endorsement (HO 24 71) can be added to any
homeowners form to extend Section II liability coverage to a
person and business listed on the endorsement.

C. Additional Residence Rented to Others Endorsement (HO 24 70) extends Coverages E and F to one- to four-family residences that
are owned by the insured and rented to others.

D. Incidental Low-Power Recreational Vehicles Endorsement (HO 24 13) extends Coverages E and F to cover RVs.

E. Owned Snowmobile Endorsement (HO 24 64) extends Coverages
E and F to scheduled snowmobiles while they are off an insured location.

F Watercraft Endorsement (HO 24 75) extends Coverages E and F
to an otherwise excluded watercraft.




Term

 

Endorsements that modify Sections I and II:

 

Five endorsements that modify forms HO2, HO3, HO5, HO6 and HO8.

Definition

A. Endorsements (three of 'em) dealing with who is insured.

B. Endorsements (three of 'em) providing business-related coverage.

C. Loss Assessment Coverage Endorsement (HO 04 35) provides
higher limit for this coverage under both Sections I and II.

D. Endorsements (three of 'em) for use with condominiums.

E. Premises Alarm or Fire Protection System Endorsement (HO 04 16).


Term
Key Points:
Developing a homeowners premium:
Definition
A. First step—Develop a base premium from the following factors:
1. Territory, which is the geographical division within a state.
2. Public protection class, which is a ranking of the fire protection provided in the area. Each protection class is assigned a number according to its protection ranking. The numbers range from 1 through 10, with 1 being the best.
3. Construction, which is divided into two broad classifications used to determine the homeowners base premium: frame and
masonry.
4. Coverage amount, which is the amount of coverage required for Coverage A (HO-2, 3, 5, or 8) or Coverage C (HO-4 or 6).
B. Second step—Modify the base premium for increases or decreases on coverage or loss exposures:
1. Variation in construction type—Dwellings with “superior construction” receive a premium credit.
2. Change in deductible—The standard deductible for Section I is $250. The deductible can he increased to $2,500 or decreased
to $100.
Term
Who is covered under Section II coverages?
Definition

A. Section II provides (2) types of third party coverage.

 

1. Coverage E—Personal Liability coverage.

2. Coverage F—Medical Payments to Others

Term

 

 

The following are included as insureds for Section II coverages:

Definition

1.The policyholder (the namned insured)

2.Residents of the household who are relatives

3.Residents < 21& in the care of the namned insured or resident relatives.

4.full-timne student

5.animnals or watercraft owned by 1, 2, or 3
6.Anyone employed by a person defined in 1, 2, or 3,

7.any1 using any vehicle covered by the policy on
location, with the consent of the namned insured

Term

 

 

Coverage F applies to people who are injured in the following situations:

Definition

1. A person on an “insured location” with the permission of an insured. The definition of “insured location” has 8 variations.

 2. A person off the insured location is injured:

a. b/c conditions on the insured location.
b. By insured’s activities.
c. By a “residence employee” of the insured during the course of employment.

d. By an animal owned by or in the care of an insured.

Term
Section II (nine) exclusions that apply to both Coverage E and Coverage F:
Definition

 

1. Motor vehicle, watercraft, aircraft, and hovercraft liability exclusions.
2. Expected or intended injury or damage exclusion—Section II is protection .... resulting from an accident.

3. Business exclusion—Excludes business activities of any insured, but provides coverage for occasional or part-time activities.

4. Professional services exclusion

5. Locations that are not insured

6. War exclusion

7. Communicable disease exclusion

8. Sexual molestation and physical or mental abuse exclusion

9, Controlled substances exclusion

Term
Exclusions (seven) that apply only to Coverage E—Personal Liability:
Definition

1. Loss assessment exclusion

2. Liability assumed under contract exclusion  

3. Damage to the insured’s property

4. Property in the insured’s care exclusion

5. Bodily injury to persons eligible for workers compensation benefits exclusion

6. Nuclear liability exclusion

7. Bodily injury to an insured exclusion

Term
Exclusions (four) that apply only to Coverage F—Medical Payments to
Others:
Definition

 

1. Residence employee off-premises exclusion

2. Bodily injury to persons eligible for workers compensation benefits exclusion

3. Nuclear reaction exclusion

4. Injury to residents exclusion

Term
Section II—Additional coverages—These (four) coverages are in addition to the limits for Coverage E and Coverage F
Definition

 

1. Claim expense additional coverage.

2. First-aid expenses additional coverage

3. Damage to property of others additional coverage.

4. Loss assessment additional coverage

Term
(Ten) Parts under Section II—Conditions are:
Definition

A. Limit of liability - Coverage E

B. Severability of insurance

C. Duties after loss

D. Duties of an injured person - Coverage F

E. Payment of claim - Coverage F

F Suit against the insurer

G. Bankruptcy of an insured

H. Other insurance—Coverage E—Coverage E limits are paid in excess over any other collectible insurance unless the other insurance is written specifically to provide excess coverage.
I. Policy period—Coverage

J. Concealment or fraud condition

Term
(Seven) parts under Section I and II—Conditions are:
Definition

A. Liberalization clause

B. Waiver or change of policy provisions

C. Cancellation

D. Nonrenewal

E. Assignment

F Subrogation

0. Death

 

Term

 

 

 

Definition of Severability of insurance

Definition

 

 

Policy condition that applies insurance separately to each insured;
does not increase the insurer’s limit of liability for any one occurrence.

Term
Describe Limits, triggers and defense costs of Coverage E - personal Liability under Section II—Liability Coverages:
Definition

FYI - No deductible applies to Section II coverages.

1. Limits—automatically include a basic limit generally set at $100,000 per occurrence.

2. Coverage trigger—Coverage is provided, up to the policy limit, for damages for which an insured is legally liable.

3. Defense costs coverage—the insurer pays defense costs if an insured is presented with a lawsuit that involves a claim that is covered under the policy.
a. Even if the suit is groundless, false, or fraudulent.
b. Insurer has the right to investigate and settle any
claim in a way that the insurer decides is appropriate.

Term

E (personal Liab) & F (pmts to others) Coverage does not apply to motor vehicles
that :

 

Note: It's a homeowners policy, not a car, motorcycle policy!

Definition
• Must he registered for use on public roads or property
• Are involved in an organized race
• Are rented to others
• Are used to carry persons or cargo for a charge
• Are used for any business purpose, except for motorized golf carts used on a golf course
Term
 Describe Limits and triggers for Coverage F - 'medical payments to others' under Section II—Liability Coverages:
Definition

1. Limits—automatically included in all homeowners policies for a limit generally set at 1,000 per person for a single accident.

2. Coverage trigger—Coverage is provided, up to the policy limit, for the necessary medical expenses incurred by others (not an insured) within three years of an inj ury. It does not apply to the named insured or other regular residents of the household except “residence employees.”

Term
Definition of Residence employee is...
Definition

 

 

A domestic worker whose duties include maintaining or using the household premises or performing domestic or household services.

Term

E (pers liab) & F (pmts to others) does apply to motor vehicles that are:

Definition
• In dead storage on an insured’s location
• Used solely to service an insured’s residence
• Designed for assisting people who are handicapped
• Designed for recreational use off public roads and owned by an insured and on an insured location
• Motorized golf carts, not capable of exceeding 25 mph, owned by an insured and used to play golf on a golf
course or legally used within a private residential association
• Trailers not towed by, hitched to, or carried on a motor vehicle
Term

Limits under Section II - Additional coverages are....

Definition

1. Damage to property of others additional coverage—The insurer will pay up to $1,000 per occurrence for damage to the property of others caused by an insured, Coverage is provided on a replacement cost basis.

2. Loss assessment additional coverage—Loss assessment coverage is provided up to $1,000 for an insured’s share of loss assessment charged against a policyholder during the policy period

Term
For both sections I and II, the Duties after loss are:
Definition
1. Give written notice identify the policy and the named insured, provide information about the occurrence, and state the names and addresses of the claimants and witnesses.
2. Cooperate with the insurer’s investigation, settlement, and defense activities.
3. Forward promptly to the insurer legal documents relating to an occurrence.
4. Submit evidence for damage to property of others.
5. Not make voluntary payments, assume any obligations, or incur expenses on behalf of the insurer.
Term
Duties of an injured person—Coverage F—If a person makes a claim for a loss under Coverage F, the injured person must:
Definition

 

 

1. Give the insurer written proof of the claim as soon as possible (under oath if required).


2. Authorize the insurer to obtain copies of medical reports and records.

Term

 

 

What two coverages are included under physical damage coverage on a PAP?

Definition

 

 

Collision (does not include collision with bird or animal)

 

Other than collison (previously called comprehensive)

Term

 

 

When does theft coverage begin?

Definition

 

 

48 hours after the theft and coverage extends until car is returned to use.

 

(coverage for other than theft waits only 24 hours)

 

NOTE: $20/day up to $600.

Term
Under Part D of the PAP, what is a non-owned auto?
Definition
Private passenger auto, pickup, van or trailer (including a temporary substitue vehicle) that is not owned by or made available for the regular use of the named insured.
Term

 

 

What is diminution in value?

Definition

 

 

Actual or perceived loss in resale value directly resulting from a loss.

Term

 

 

How is appraisal used and why?

 

 

Definition

 

 

In cases when the insurer and insured disagree on the amount of the loss, each hires an appraiser and the two appraisers hire a competent judge.

Term

 

 

What are the 7 general duties of the insured under Part E of the PAP?

 

PCS PEAP

Definition

1 Prompt notice

2 Cooperation with insurer.

3 Submission of legal papers to insurer.

4 Physical examination

5 Examination under oath

6 Authorization of medical records.

7 proof of loss.

Term

 

 

What is limited Mexico coverage?

Definition

 

 

PAP offers no coverage into Mexico, but an endorsement can be added for up to 25 miles.

Term
On which PAP will the INS 22 exam be based?
Definition
Most questions will be based on the 1998 PAP, but be aware of the changes in the 2005 PAP.
Term
Insured's duties under Part C - Uninsured Motorist Claim are (2):
Definition

 

 

1. Notify the police if a hit-and-run driver is involved.

 

2. Submit a copy of the legal papers to the insurance company.

Term
What are the insured's duties under PART D of the PAP (3):
Definition

 

1. Take reasonable steps after the loss to protect a covered auto or non owned auto and its equipment.

 

2. Notify the police promptly of a stolen vehicle.

 

3. Permit the insurer to inspect and appraise damage before repair or disposal.

Term
What are the (6) general provisions under the PAP?
Definition

1. Insurer's right to subrogation.

2. PAP applies during policy perior and territory.

3.Cancellation; NORMAL, >60days&<60 days.

4. Nonrenewal.

5. Automatic termination (non payment or cancell)

6. Two policies with same insurer; only highest limits apply not the combined limits).

Term

During a policy period, 4 changes by an insured that will impact premium are:

 

 

Definition

1. Change number, type or use of vehicles.

 

2. Change operators.

 

3. Change principle garage location.

 

4. Change coverage, deductibles or limits.

Term

For insured to retain right to sue the insurer:

 

In general,

 

In case of liability.

Definition

 

 

In general, must comply with policy terms.

 

In case of liability, insurer must acknowledge (in writing) that the insured is liable.

Term
Examples of how endorsements can alter the coverages in the PAP:
Definition

Misc. vehicle; e.g. ATV

Trailer/camper (plumbing)

Customized equipments (customer cabinets in van)

Snowmobile

Named non-owner (friend drives covered vehicle)

Limited Mexico.

Underinsured motorist

Towing and labor

Excess sound producing

 

Term
4 exclusions to the snowmobile endorsement are:
Definition

 

1.  Used for business.

2. Only named insured get coverage while using rental snowmobile.

3. Racing isn't covered (even ad hoc racing).

4. Liability to persons while occupying or being towed

Term

What is PAP? 

 

Does this include motorcycle?

Definition

PAP is a Personal Auto Policy.

 

Motorcycles are not covered since they have less than 4 wheels.

Term
Can a person collect under both their PAP and the uninsured motorist coverage?
Definition
NO.  No duplicate payments under PAP Parts A, B, and C.
Term

1. Does PAP, part A include coverage for intentional damager?

2. Does PAP, part B cover medical expenses resulting from a motorcycle test drive?

Definition

1. NO.

 

2. NO because less than 4 wheels.

 

 

Term
What four classes of vehicles are covered under PAP, "your covered auto"?
Definition

Any vehicle shown in the declaration.

 

A trailer owned by the insured.

 

A temporary substitute auto or trailer.

 

A newly acquired auto

Term
How are an additional auto and a replacement auto treated differently under you PAP?
Definition

An additional auto is automatically covered for 14 days when the named insured becomes the owner.

 

A replacement auto is covered for the remainer of the policy period even if the insured does not ask to have it covered.

Term

What's included under supplementary payments in Part A of the PAP?

Definition

1. Bail Bonds.

2. Premiums on appeal bonds

3. Post judgement interest

4. Lost earnings due to attending hearings and trials at the insurer's request.

5. Other reasonable expenses made at the insurer's request.

 

 

Term
Uninsured motorist coverage covers the following three groups of persons:
Definition

Named insured and family members.

 

Others occupying the vehicle.

 

Others entitled due to relationship with anyone above.

Term

What are parts A thru F of the PAP?

 

 

LI MED UN DAM DUT GEN

Definition

A = Liability

B = Medical Payments

C = Uninsured Motorist Coverage

D = Damage to your auto

E = Duties after an accident or loss

F = General provisions (cancellation, termination)

Term

Critical times for certain definitions:

 

1. Owned includes lease

2. Newly acquired car when policy HAS NO collision.

3. Newly acquired car when policy DOES HAVE collison.

 

Definition

1. At least a six month lease, but not a two-week rental.

 

2. 4 days of full coverage with $500 deductible.

 

3. 14 days

Term

 

 

In a split limit policy, what are $100/$300/$50?

Definition

 

 

Bodily injury limit of $100k/person. for up to $300k per accident and a $50k property damage liability.

Term
Difference in split limit 100/300/50and single limit of 300 PAPs?
Definition

If three injured, each receives up to 100k.  If 4 injured, $300 is the limit.  50 is the limit on liability for property damage.

 

Single limit, the insurer is limited to total of 300 per accident for liability for bodily injury and property damage.

Term
What are compensatory damages?
Definition

Includes both Special and General damages.

 

Special are out-of-pocket such as doctor and hospital bills.

 

General are include pain and suffering.

Term

 

 

5 problems with the auto insurance industry?

Definition

 

1. High frequency of accidents.

2. High cost of accidents.

3. Large underwriting losses.

4. Irresponsible drivers.

5. Availability and affordability of insurance.

Term

What are the 7 various approaches to compensate auto accident victims?

TUUF LUC

Definition

 

1. Tort liability.

2. Financial Responsibility laws

3. Compulsory Insurance laws

4. Unsatisfied judgement funds.

5. Uninsured motorists coverage.

6. Underinsured motorist coverage

7. Low-cost auto insurance

Term

 

 

Difference between contributory negligence law and comparative negligence law is.

 

Definition

 

 

Contributory law says if you are at fault by any percentage, you collect no damages.

 

Comparative - each party shares in loss based on percentage at fault.

Term

 

 

Four criticisms of financial responsibility laws are:

Definition

1. Most are only affective after an accident, so what if the negligent driver has no insurance?

2. Victims are not guaranteed payment; e.g. hit&run.

3. Long-delays in legal system, so compensation is slowly received.  e.g. court backlog.

4. Cost of injuries may exceed State's minimum required coverage.

Term
Which three criticisms are shared by both financial responsibility laws and compulsory insurance laws
Definition

1.Victims are not guaranteed payment; e.g. hit&run

2. Victim's losses may exceed State minimum coverage.

3. Delay in legal system.  compensation is slow.

Term

 

 

Which criticisms are unique to compulsory insurance laws?

Definition

 

1. The laws don't reduce the number of uninsured motorists; e.g. lapsed coverage or cancelled coverage.

2. Insurers argue that freedom to select profitable insureds is hampered.

3. Consumers argue safe drivers subsidize reckless drivers since insurers must take them.

4. The laws don't reduce the number of accidents.

Term

 

 

Four characteristics of Unsatisfied Judgements Fund are?

Definition

Injured MUST get a judgement.

Maximum amount paid usually = the State's recommended minimum.

Negligent driver is not relieved of liability when fund makes payment on their behalf.

Drivers must repay the fund.

 

 

Term

 

Four CRITICISMS of unsatisfied judgements fund are?

Definition

1. Financing is not equitable since all drivers pay a fee.

2. Fund administration is cumbersome.

3. Funds is seldom paid back.

4. Some funds are not financially stable.

Term

Tort liability system has three main characteristics, which are.......

Definition

Based on fault or negligence.

 

Traditionally used to compensate injured auto accident victims.

 

Negligent driver has legal liability for damage to property or bodily injury to injured victim.

Term

What is contributory negligence?

 

Comparative negligence?

Definition

If person contributes in any way to their resulting injuring, they can not recover damages.

 

If both the injured person and other driver are negligent, they share the financial burden according to their degree of fault.

Term
To write underinsured motorist coverage in most states, the following must occur:
Definition

Must be included in the policy.

 

Must purchase increased limits that are higher than the state's minimum limits.

 

Coverage must apply to all autos covered under the policy.

 

 

Term

Pros (1) and Cons (2) of Tort liability system.

Definition

Pros: Any operator can be held liable for their negligence.

 

Cons: 1 Accident victim must prove another driver was negligent before collecting damages.  2. Negligent party may not have insurance or resources to pay the damages.

Term
Pros (1) and cons (3) of compulsory insurance laws:
Definition

Pros: All motorists are required by law, to have insurance.

 

Cons: 1. Do not stop hit-and-run drivers, uninsured motorists or insufficient coverage.  2. Delays in compensation.  3. Do nothing to reduce the number of accidents.

Term
What (6) benefits are included under a typical no-fault law:
Definition

Medical

Rehab (medical)

Loss of earnings, time limit and $ capped.

Expenses for essential services, e.g. housework.

Funeral

Survivors' loss benefits, periodic payments to compensate survivors

Term
What are the three types of no-fault laws and what are they?
Definition

Add-on plans, benefits to victims regardless of fault but allows injured party to get damages from negligent party.

Modified, prevent injured from getting damages from negligent driver unless claim exceeds monetary or verbal (disfigurment) threshold.

Choice, Option to purchase no-fault.

Term
Five no-fault PROS
Definition

Could eliminate fault finding.

Could eliminate inequities in claim payments.

Could correct limited scope of current system.

Could decrease portion of premium dollars paying for claim investigations and legal costs.

Could prevent delays in payment

 

Term
Five no-fault cons
Definition

1Defects in tort system are exaggerated.

2Stories of lower premiums and improved efficiency are  overstated and unreliable.

3Could penalize safe drivers.

4No fault benefits do not include pain & suffering.

T5ort system only needed to be reformed, not replaced.

Term

How is the injured's right to sue under no-fault;

Pure no-fault

Add-on

Modified

Choice

Definition

Pure-insured could never sue; their insurer pays all.

Add-on, certain benefits paid regardless of fault, but injured retains their right to sue.

Modified, can sue when claim > monetary or verbal threshold.  IF < the threshold, your insuer pays.

Choice, rights to tort recovery are limited.  Rights to sue are limited, too.

 

Term
Four characteristics of auto insurance plans are:
Definition

1. Applicants must show inability to get insurance elsewhere x # of days beforehand.

2. Mimimum limits => State's minimum.

3. Certain persons are ineligible (criminals).

4. Premiums usually > standard market.

Term
 FOUR characteristics of JUA
Definition

1Sets rates.

2Approves policy forms.

3Designates insurers to service high-risk business.

4All insurers in state assessed proportionate share of JUA's losses and expenses based on their percentage of voluntary (non JUA) written premium.

Term
FOUR common characteristics of specialty insurers are:
Definition

1.Higher premiums.

 

2.Limits at least = state's miniums.

 

3.may limit medical payments.

 

4. May have high deductibles on collision.

Term

Seven Primary rating factors are:

MAS E TU Good

Definition

Marital status.

Age.

Sex

Eductation credit

Territory

Use of auto

Good student

 

Term

FIVE other rating factors for determining auto premium are:

DR Type L N

Definition

Deductibles

Record, driving

Type of vehicle

Liability limits

Number of vehicles

 

 

 

Term

 

 

The elements of property loss exposure are:

 

 

Definition

 

 

The property exposed to loss.

 

The possible cause of loss.

 

The financial consequences of loss.

Term

 

 

 

Financial consequences resulting from a property loss are: RIL

 

Definition

 

 

Reduction in property value.

 

Increased expenses.

 

Lost income (as a result of property damage)

Term

 

 

The two elements of a liability loss exposure include:

Definition

 

 

The possibility of a claim for money damages.

 

The financial consequences of the loss.

Term

 

 

Three general catagories of liability resulting in a claim for money damages are:

T C S

Definition

 

 

Tort Liability.

 

Contractual.

 

Statutory

Term

 

 

The four intentional torts are:

LATiN

Definition

 

Libel - written untrue

 

Assault - intentional threat of bodily harm.

 

Trespass -

 

Nuisance - violate others' right to enjoy their personal property

Term

 

 

The 5 catagories of personal property:

 

D H U Biz Tran

Definition

 

 

1.Dwelling Contents

2.High Value - jewelry, furs

3.Property with unusual or intrinsic value - stamp/coins collections

4.Business personal property

5.Motor vehicles, trailers, watercraft, aircraft

Term
Every loss exposure has three elements. What are they?
Definition

Asset exposed to loss

Cause of loss

Financial Consequences

Term
Losee exposure equation
Definition

The "product" of the elements "equals" a loss exposure.

 

Remove any one of the three elements, and a loss exposure is no longe present.

 

Expressed as Loss Exposure = asset exposed to loss x cause of loss x financial consequences of loss

Term
Multiplier Effect
Definition
a peril causes additional losses. For example: Vacation home suffers a vandalisim loss that isn't discovered until several days later. The broken window lets water into the property and the floors are damaged. The cause of loss is the vandalisim and the multiplier is the water damage from the broken window.
Term
Property Loss Exposure
Definition
A condition that presents the porssiblity that a person or an organization will sustain a loss resulting from damage (including destruction, taking, or loss of use) to property in which that person or organization has a financial interest.
Term
What are the three loss exposure elements for property losses?
Definition

Asset exposed to loss

Causes of loss

Financial consequence of loss

Term
Real Property includes
Definition

land

buildings

attached structures

plants growing on the land

and anything embedded in the land, such as minerals.

Term
Real Property
Definition
Tangible property consisting of land, all structures permanently attached to the land, and whatever is growing on the land.
Term
Personal Property
Definition
All other property that cannot be classified as real property is personal property.
Term
Personal Property Loss Exposure Categories
Definition

Dwelling Contents

High-value Personal Property

Rare or Unusal Property

Business Personal Property

Motor Vehicles, Tralers, Watercraft & Aircraft

Term
Dwelling Contents
Definition
A dwelling's contents may include furniture, appliances, draperies, electronics, kitcheware, groceries, clothing, sports equipment, tools, toys, and many other items common to the use of a dwelling as a home. Such itmes are generally insured as a group reather than individually.
Term
High-Value Personal Property
Definition
Items of personal property worth considerable sums of money. They usually require a more specific type of insurance, because many property insurance policies limit the maximum amount of coverage avialable under specific loss conditions.
Term
Rare or Unusual Property
Definition
Items whos value comes from their unique characteristics such as antiques, works of art, coin or stamp collections, and other collections.  Such itmes should be specifically listed for insurance purposes because most insurance policies limit the amount that an insurer will pay for this type of personal property.
Term
Business Personal Property
Definition
Personal property such as office furniture and computer equipment, used for business purposes. Most personal insurance policies limit or exclude coverage for business personal property. Additional coverage may be necessary.
Term
MOTOR VEHICLES, TRAILERS, WATERCRAFT AND AIRCRAFT
Definition
Mobile property typically excluded (or covered only up to a certain limit) in policies covering dwellings and their contents. Because these items present unique loss exposures, they should be separately insured using the appropriate coverage form.
Term
What financial consequences of loss do personal insurance polices protect agains?
Definition

Reduction in Value of Property

Increased Expenses

Lost Income

Term
Reduction in Value of Property
Definition
The difference beteween the value of the property before the loss and after the loss.
Term
Increase Expense
Definition
Expenses in addiiton to normal living expenses that are ncessary because of the loss. In the case of a fire loss, the cost of a hotel room while repairs are being made to the home would be Increased Expense.
Term
Lost Income
Definition
Loss of income that results if a property is damaged. Rental property that is damaged may result in the owner not being able to collect rent while the home is being repaired.
Term
Liability Loss Exposure
Definition
any condition or situation that presnts the possibility of a claim alleging legal responsibility of a person or business for injury or damage suffered by another party
Term
Damages
Definition
Money claimed by, or monetary award to, a party who has suffered bodily injury or property damage for which another party is legally responsible.
Term
What are the three elements of personal liability lsos exposures?
Definition

Assets exposed to loss

Causes of loss

Financial consequences of loss

Term
What assets are exposed to loss in personal liability?
Definition
The assets exposed to loss in a liability loss exposure are money or other financial assets.
Term
General Damages
Definition
A monetary award to compensate a victim for losses, such as pain and suffering, that do not involve specific measurable expenses.
Term
Special Damages
Definition
A form of compensatory damages that awards a sum of money for specific, identifiable expenses associated with the person's loss, such as medical expenses or lost wages.
Term
Punitive Damages or Exemplary Damages
Definition
A payemnt awarded by a court to punish a defendant for a reckless, malicious, or deceitful act to deter similar conduct; the award need not bear any relation to a party's actual damages.
Term
Civil Law
Definition
A classifcation of law that applies to matters not governed by criminal law and that protects rights and provides remedies for breatches of duties owed to others.
Term
Tort
Definition
A wrongful act or an omission, other than a crime or a breach of contract, that invades a legally protected right.
Term
What are the three types of damages in a personal liability claim?
Definition

General Damages

Special Damages

Punitive Damages (exemplary damages)

 

 

Term
What are the most common personal liabilty claims?
Definition

Tort liability

Contractual liability

Statutory liability

Term
Give examples of circumstances in which liability may be claimed or a suit filed.
Definition

Breach of a legal duty, if that breach causes harm to another, such as injuryies casued by an auto accident

 

Breach of contract, such as a failure to pay rent on an agreed date

 

Failure to adhere to requirements set out in statutes, regulations or local ordinances, such as failing to provide a safe sidewalk at a residence.

Term
Name sources of tort liability
Definition

Negligence

 

Intentional Torts

 

Absolute Liability

Term
Negligence
Definition
The failure to exercise the degree of care that a reasonable person in a similar situation would exercise to avoid harming others.
Term
What four legal elements must be proven before a finding of negligence can occur?
Definition

A duty to act.

A breach of that duty.

An injury or damage occurs.

The breach of duty is the direct cause of the injury or damage in an unbroken chain of events.

Term
Name examples of intentional torts
Definition

Libel

Slander

Assault

Battery

Trespass

Nuisance

Term
Libel
Definition
Written or printed untrue statement that damages a person's reputation.
Term
Slander
Definition
An oral untrue statement that damages a person's reputation.
Term
Assault
Definition
The intentional and unlawful threat of bodily harm.
Term
Battery
Definition
Unlawful physical contact with another person.
Term
Trespass
Definition
The unauthorized possession or use of land.
Term
Nuisance
Definition
The violation of a person's right to enjoy use of proeprty wihtout disruption from outside sources.
Term
Absolute Liability
Definition
Liability that does not involve proving negligence.
Term
Contractual Liability
Definition
Arises when an individual enteres into a contract or an agreement.
Term
Statutory Liability
Definition
Exists because of the passage of a statute or law.
Term
What two major financial consequences do families/individuals face concerning legal liability?
Definition

Costs of investigation and defense

Money damages awarded if the defense is not successful or if the claim is settled out of court.

Term
Personal Financial Planning Loss Exposures
Definition
Life, health, & retirement related exposures.
Term
What are the three elements of personal finance loss exposures?
Definition

The assets exposed to loss

The cuases of loss

The financial consequences of loss

Term
What are the primary examples of personal financial palnning loss exposures?
Definition

Retirement loss exposures

Premature death exposures

Poor health and disability exposures

Unemployment exposures

Term
What assets are exposed to loss when an individual retires?
Definition

Regular employment income

Related benefits (such as health insurance)

Term
What are the primary risks associated with retirement?
Definition
That the accumulated assts of an dinvidual or family has allocated for retirement will insufficently compensate for the loss of income and benefits.
Term
What is the immediate cause of the loss in retirement?
Definition
Voluntary retirement
Term
What is the actual cause of loss of retirement?
Definition
Stems from a failure to maintain resources sufficient to sustain a desired lifestyle  or from an underestimation of the length of the retrirement period.
Term
When is a death considered premature?
Definition
A premature death occurs if it occurs prior to a person reaching their full life expectancy.
Term
What assets are exposed to a loss as the result of an individual's premature death?
Definition
Expected income on which his or her family or heirs rely.
Term
What are the causes of loss associated with premature death?
Definition
Accident, illness or the intential taking of a life.
Term
What assets are exposes to a loss as a result of an individual's poor health or disability?
Definition

Income, if the person is unable to work

Individual or family savings and other financial assets which may be depleted by health-related expenditures.

Term
What are the causes of loss associated with health and disability loss exposures?
Definition

Chronic Illness

Physical or Mental disability

Term
What are the four types of disability?
Definition

Temporary partial disability

Temorary total disability

Permanent partial disability

Permanant total disability

Term
Temporary partial disability (TPD)
Definition
A disability caused by a work-related injury or disease that temporarily limits the extent tow hich a worker can perform job duties; the worker is eventually able to return to full duties and hours.
Term
Temporary Total Disability (TTD)
Definition
A disability caused by a work-related injury or disease that temporarily renders an injured worker unable to perform any job duties for a period of time.
Term
Permanent Partial Disability (PPD)
Definition
A disability cuased by a work-related injury or disease that impairs the injured employee's earning capacity for life, but the employee is able to work a reduced efficiency.
Term
Permanent Total Disability (PTD)
Definition
A disability caused by a work-related injury or disease that renders an injured employee unable to ever return to gainful employment.
Term
What are the assets exposed to loss by unemployment?
Definition
Income and employer-provided benefits.
Term
What are the cuases of loss in cases of unemployment?
Definition

Voluntary (employee quits)

Involuntary (employer terminates)

Term
What are the financial consequences of loss due to unemployment?
Definition
Loss of earnings and other employer-provided benefits.
Term
Underemployment
Definition
Reduced or limited work hours or earnings due to limited positions available
Term
Risk Management Process
Definition
The method of making, implementing, and monitoring decisions that minimizze the adverse effect of risk on an organization.
Term
What resources to individuals and families usually rely upon to identify loss exposures?
Definition

Friends

Family members

Insurance agents

Term
What are the steps of the risk manangement process?
Definition

Step 1: Identifying loss exposures

Step 2: Analyzing loss exposures

Step 3: Examining feasibility of risk managment techniques

Step 4: Selecting the appropriate risk managment techniques

Step 5: Implementing selected risk managment techniques

Step 6: Monitoring results & revising the risk managment program

Term
What are the two most common property and liability loss exposures that individuals anf families must address?
Definition
Home and automobile ownership
Term
What two steps are considered the most important compoenents of the risk management process?
Definition

Identifying the loss exposures

Analyzing the loss exposures

Term
What are the four dimentions of analyzing loss exposures?
Definition

Loss frequency

Loss severity

Total dollar losses

Timing

Term
Risk Control
Definition
A conscious acto ro decision not to act that reduces the frequency and/or severity of losses or makes losses more predictable.
Term
Risk Financing
Definition
A conscious act or decision not to act that generates thef unds to pay for losses and risk control measures or to offset variability in cash flows.
Term
What two ways can loss exposures be addressed?
Definition

Risk control techniques

Risk financing techniques

Term
How do risk control techniques work?
Definition
They minimize the frequency or severity of losses.
Term
How do risk financing techniques work?
Definition
They generate funds to finance losses that risk control techniques cannot reduce or prevent.
Term
How do risk management techniques work together?
Definition
The risk control technique alters the estimated frequency and severity of loss, and the financing technique pays for losses that occur despite the controls.
Term
What are the 6 broad categories of risk control techniques?
Definition

Avoidance

Loss Prevention

Loss Reduction

Separation

Duplication

Diversification

 

Term
ADD-ON PLAN
Definition
In a no fault system, a plan that provides certain personal insury protection (PIP)-type benefits such as medical payments and disability coverages to injured victims, without regard to fault.
Term
CHOICE NO-FAULT PLAN
Definition
In a no-fault system, aplan that gives the insured the option at the time an auto insurance policy is purchased or newed, of chooising whether to be covered on a no-fault basis.
Term

What restrictions are on the Right to Sue for each type of plan:

 

a. Modified No-Fault Plans

b. Add-On Plans

c. Choice No-Fault Plans

Definition

a. Yes

b. No

C. Only if modified no-fault is selected

Term
Explain how a monetary threshold works
Definition

A motorist can sue for noneconomic losses if the amount of their economic damages exceeds the stated threshold.

 

State's threshold: $5,000

Wage Loss & Medical: $6,000

Motorist can now sue for pain & suffering . . .

Term
Explain how a verbal threshold works
Definition

An injured motorist can sue for non-economic damages if his or her injuries are meet a verbal description of serious injuries.

 

Examples of descriptions of serious injuries include: death, permanent disfigurement or scarring, signficiant and permanent loss of bodily function. . .

Term
Personal Injury Protection Coverage (PIP) or Basic Reparations
Definition
Coverage that pays benefits, regardless of fault, for medical expense, income loss, and other benefits, resulting from bodily injury to occupants of a covered auto.
Term
What are the benefits required by No-Fault Laws?
Definition
  • Medical expenses
  • Rehabilitation expenses
  • Loss of earnings
  • Expenses for essential services (household tasks performed by others because the injured person cannot do them)
  • Funeral Expenses (usually limited)
  • Survivors' Loss Benefits (periodic income payments that partially compensate certain surviors for death of a covered victim)

 

Term
What are the reasons that no fault laws generally exclude property damage
Definition
  • amounts are relatively small
  • dagages ar usually confined to vehicles
  • the amount of damage to property can usually be determined wihtout dififculty
  • auto insurers can usually settle claims for property damage to their insured's property quickly
Term
Subrogation
Definition
The process by which an insurere can, after it has paid a loss under the policy, recover the amount paid from any part (other than the insured) who casued the loss or is otherwise legally liable for the loss.
Term
Residual Market
Definition
The term referring collectively to insurers and other oraganizations that make insurance available through a shared risk mechanism to those who cannot obtain coverage in the admitted market.
Term
Common Characteristics of a high-risk driver program
Definition
  • Limited coverage amounts to those that comply with the state's financial responsiblity or compulsory insurance requirement. In some cases, insurers offer optional higher limits.
  • Limited medical payments coverage
  • High deductible colision insurance
  • Preimums substantially higher
Term
Safe Driver Insurance Plan
Definition
Plan that allows for lower basic preimiums for accident-free driving records and a surcharge for accidents.
Term
What are the common characteristics of Automobile Insurance Plans
Definition
  • Applicants have to have been unable to obtain insurance for a period of time
  • The minium limits of insurance offered are at least equail to the state's financial responsibility or compulsory insurance requirements.
  • Ceterain applicants may be inelgible for coverage: not having a valid driver's license, habitual violators of state and local laws.
  • Premiums are generally high than premiums in the voluntary market
Term
Automobile Insurance Plan
Definition
Plan for insuring high-risk drivers in which alll auto insurers doing business in the state are assigned their proportionate share of such drivers based on the total volume of auto insurance written in the state.
Term
Joint Underwriting Associations
Definition
Organization that designates servicing insurers to handle high-risk auto insurance buisness; all auto insurers in the state are assessed a porportionate share of the losses and expenses based on their percentage of the voluntary auto insurance permiums written in the state.
Term
Reinsurance Facility
Definition
A state-wide reinsurance pool to whichi nsureres can assign premiums and losses for high-risk drivers; original insurers service the policies, but all insurers in the pool share the losses and expenses of the facility in proportion to the total auto insurance they write in that state.
Term
What are the primary rating factors?
Definition

Territory

Use of the auto

Age

Gender

Marital Status

Term
What are some typical rating factors?
Definition

Driving record

Driver education

Good student

Multi-car policy

Years of driving experience

Credit based insurance score

Type of auto

Deductibles

Liability Limits

 

Term
What are the Six Sections of a Personal Auto Policy?
Definition
  • Part A--Liability Coverage
  • Part B--Medical Payments Coverage
  • Part C--Uninsured Motorists Coverage
  • Part D--Damage to Your Auto Coverage
  • Part E--Insured Duties Following an Accident or Loss
  • Part F--General Provisions
Term
What is included on the Declarations Page in a PAP?
Definition
  • Name and Mailing address of the insured
  • Name of the insurer issuing the policy
  • name and address of the producer (if applicable)
  • Policy Period
  • Description of the covered autos
  • Limits of liability
  • premium & rating information
  • any endorsements that may apply to the policy
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