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P&C Exam-Casulty

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
Direct Physical Loss   show
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show An event that interrupts the chain of causation by providing an independent cause of the final result  
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Indirect/Consequential Loss   show
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Exposure   show
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Legal Hazard   show
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tort   show
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Elements of Insurable Risks - A risk must:   show
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Insurability of pure vs. speculative risks   show
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show Re sells reinsurance to ceding insurers; Cedent buys re from reinsurer and issues primary policies of insurance and/or business  
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show Reinsurer only pays for losses that exceed a certain dollar amount (e.g. $500,000)  
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Reinsurance - Proportional   show
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show The monetary amount an insured must pay before the insurer will begin making loss payments. A deductible is a form of risk-sharing and cost containment. Most forms of insurance contain standard deductible amounts (e.g., $500)  
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show clause requires a specified amount of insurance based on the value of the insured property. If insd insures the property for less than this amount, he/she must share in a % of a loss to the same % that the property is under insured at the time of the loss  
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show Insurers organized under the laws of the state in which they are incorporated that are owned by shareholders who elect officers and directors and share in profits through stock growth and dividends  
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Mutual Companies   show
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show Losses are shared among group members  
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Assessment Mutual Insurers: Pure Assessment Group   show
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Assessment Mutual Insurers: Advance Premium Assessment Group   show
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show Groups that exchange insurance on each other; appoint/empower attorney-in-fact which binds members together; share in profits or losses; insured members call subscribers  
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show A mutual insurer that insures people in the same profession or business  
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show not an ins co; any group of persons with similar/related liab risks who form an org; purpose is to purchase commercial liability insurance on a group basis; no specific legal structure req; members must be in sim/related business/ exposed to sim risks  
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Purchasing Groups - Trade Association   show
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RRG vs. PG   show
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show based on religious, ethnic, or national lines, and noted primarily for social and charitable functions. Fraternal Benefit Societies are societies, orders, or supreme lodges, with no capital stock that may or may not be incorporated  
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Syndicate Insurers/Lloyd's Associations   show
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show provide info on co's such as $fin. strength, mgmt caliber, & efficiency of op: publish guides to analyze almost all prop & liab business insr; review UW results, mgmt, adeq of reserves for liabs that aren't discharged, ade of PH, soundness of investments  
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show Agents appointed by an insurer to represent the company by selling and servicing policies on its behalf, representing only one company  
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Independent Agents or Brokers   show
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show An agent authorized to write business in a state other than the one in which he lives.  
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show An insurer that deals directly with the insured through a salaried representative or captive/exclusive agent rather than through independent brokers  
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show Policies are marketed from the company's home office rather than through agents. Marketing is done through direct mail, internet, newspapers or magazines, and radio or TV  
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show the insurer empowers the agent to act as a representative of the company. Legally, the acts of the agent are considered to be the acts of the principal  
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show Any act on the part of an agent of the company is the same as if the company itself did the act  
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Responsibilities to the Applicant/Insured   show
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Offer and Acceptance - for there to be an agreement   show
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show insurance policy owner must have an insurable interest in the property or person being insured - financial interest wherein the insured could lose financial position if the property were damaged or destroyed, or if the person was injured or died  
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Contract of Adhesion   show
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show Unequal amounts of money are exchanged. The premium that the insured pays is less than the potential benefit he or she will receive in the event of a loss.  
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show cover the insurable interest of the individual insured and cannot be transferred or assigned to another individual-the exception is life insurance, i.e. insurance contract  
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Unilateral Contract   show
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Legal Interpretations Affecting Contracts: Ambiguities in a Contract of Adhesion   show
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Legal Interpretations Affecting Contracts: Reasonable Expectations   show
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Legal Interpretations Affecting Contracts: Utmost Good Faith   show
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show whether intended or not, is more likely to void a policy than the insured's rep, (unless insd's misrep is material to the risk.) For example, an agent may falsely represent that certain coverage is contained in the policy, when in fact it is not.  
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Warranties   show
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Concealment   show
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show Deceit, intentional misrepresentation, or the concealment of material facts with the intention of causing injury to another party  
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show The voluntary abandonment of a known or legal right or advantage  
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Estoppel   show
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Underwriting   show
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After underwriting, an insurance application be categorized as: Acceptable with standard rates   show
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show The policy will be issued, but the insured must sign an endorsement showing that he or she accepts the changes and/or increased premium and must pay the increased premium to keep the policy in force.  
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After underwriting, an insurance application be categorized as: Unacceptable and denied coverage   show
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show one way of measuring the insurer's profitability by comparing claims expense to premiums; the lower the ratio the bettrer the insr's claims experience and more profitable the company  
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show Loss costs represent the portions of insurance rates used to cover claims and the costs of adjusting claims. Insurers determine rates by estimating their future loss costs and adding a provision for expenses, profit, and other  
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show claims costs and related expenses, insurer administrative expenses, investment income (from invested premiums and other income), producer commissions, and insurer profits  
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show a. negligence occurred b. that there was actual damage or loss c. that the negligence was the proximate cause of loss  
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Common Law defenses   show
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show The actual expenses incurred by an individual or entity as the result of lost wages or income, medical bills, or damaged property  
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show Damages due to pain, suffering, mental anguish, and similar losses  
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Punitive/Exemplary Damages   show
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show In a lawsuit when the defendant's willful acts were malicious, violent, oppresive, fraudulent, wanton, grossly reckless; could include sexual harrassment  
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Absolute/Strict Liablity   show
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show arises out of imputed negligence - one individual becomes liable for the negligent behavior of another  
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Application   show
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show It is written proof that a loss has been incurred (police report, repair estimate, medical report)  
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Additional/Supplementary Coverage   show
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Definition of an Insured   show
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show an individual or entity who, other than the named insured, qualifies as an insured under the policy. This is especially the case if there is a specific interest involved, such as a mortgage or a business arrangement  
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show Returning the policy to the insurer or to the insurer's representative; Notifying the insured in writing as to when the cancellation is to take effect  
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show 10 days before cancellation  
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show within 60 days of application  
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show cancel the policy on its anniversary date, within 31 days of written notice  
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The insurance company may cancel the policy by written notice at any time within 31 days for which reasons   show
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Non-Renewal Provisions   show
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Non-Currency   show
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show When more than one company insures a particular risk, pro rata apportionment is the division of a loss according to the percentage interest of the various companies providing the insurance on the risk  
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Limits of Liability   show
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Limits of Liability - each of these coverages have its own separate policy limit:   show
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General Liability Aggregate Limit   show
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show exists for liability that arises out of the business pursuits of the insured, including production of goods, business services and/or damage that results therefrom  
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Personal Liability Limits: Per Occurrence (Accident) Limit   show
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show amount available for any one person through the policy. Ex- Person A may only be covered for up to $20,000 after an automobile accident, but the total amount available for each claim is $40,000; often used for med cov  
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show coverage is a different amount for different things, such as $10,000 for bodily injury per person and $40,000 BI per occurrence. Split liability is shown as 20/40/15 and is usually used in general liability and auto liability.  
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Duties after loss (claims handling)   show
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show The insured must assign rights to make a claim against the other party to the insurer upon the insurer's handling of the claim settlement  
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show In the event of disagreement of the insurer's handling of a claim, the insured and the insurer may each select an appraiser, and if there is still disagreement, the two appraisers select an umpire appraiser  
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show The insurer may pay either the cost to repair or replace the damaged vehicle or property, or the Actual Cash Value; insurer has right to possess item after full value - deductible is returned to insured; can sell and keep proceeds  
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show the transfer of a policy or some of the policy's rights from the insured to another entity  
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show states that the policy cannot be assigned/transferred to another without written authorization, signed by an officer (not the agent) of the insurance company  
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show If the insurer changes the same type of policy the insured owns in any way, providing for more coverage without additional premium, the insured's original policy will be extended for those coverages without need for additional forms or premium  
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Duty to Defend   show
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show federal law that regulates the collection, dissemination, and use of consumer information, including consumer credit information  
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Use of Consumer Credit Information   show
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Insurance Companies may not use consumer credit to   show
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Underwriting Use of Credit Information   show
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show A consumer must be told if their premium has been adversely affected by a credit score; They may get a free report from the reporting agency, and challenge any adverse info  
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show a. discover what creditors issued offending information and write them asking to correct misinformation b. Write the credit company with their side of a credit dispute  
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show credit reporting co can generally report most neg info for 7 years; info about a lawsuit/judgment against you can be reported for 7 years or until statute of lim runs out, whichever is longer  
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Time limits on reporting negative information do not apply if the credit report will be used in connection with   show
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show The provision in an insurance policy that defines the method that will be used to determine if a claim will be paid and the amount of money (claim payment) the insured will receive as a result of a claim  
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show ins co can settle the claim with a 3rd party at it's own discretion, often depending on what will be most cost effective; in E&O or Malpractice (Prof Liab) case, insurer must obtain insured's consent since claim could affect the insured's reputation  
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Acts of Terrorism must first be certified by   show
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Acts of Terrorism must be certified by the proper parties and also must be:   show
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What is not considered an act of terrrorism   show
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show for purposes of WC; for the case of P&C policies where the losses resulting from the act exceed $5M in total losses  
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Insured loss from TRIA: any loss if it occurs   show
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TRIA insured loss excludes   show
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show The main difference between a certified and a non-certified act of terrorism is that a certified act always involves a foreign person or interest, while a non-certified act may not  
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show Insurers are allowed to charge extra premium for terrorism coverage, but must give the option to all commercial property and casualty insureds  
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show rates+forms for the cov dont need to be pre-filed with any state/ be subject to prior approval/ awaiting period under any state's law through 12/31/03, but may be subject to regulatory review for excessive charges/compliance with state laws once in use  
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TRIA Effect on Workers' Compensation   show
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TRIA Extention Act of 2005   show
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TRIA Exexntion Act of 2005 Marketplace Aggregate Retention Amount   show
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Reauthorization Act of 2007   show
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TRIA Deductible in Reauthorization Act of 2007   show
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Loss Assessment Coverage   show
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HO-2   show
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show Special Form Coverage, all-risks/open peril  
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HO-4   show
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show Comprehensive form with all-risk/open peril  
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HO-6   show
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show Modified coverage form, market value policy  
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show Coverage E covers personal liability; Coverage F covers medical payments to others  
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show Covers amounts for which an insured is Leg Liab because of BI/PD caused to third party, whether on or away from insured premises - includes $100,000 liability coverage  
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Onsite and Offsite examples of Coverage E   show
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show Medical payments; covers emergency medical tretment to those other than the insured for injuries on the insured premises or by an insured - considered good will; purpose is to avoid entering liability coverage by taking care of minor injuries  
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Additional Coverages for HO Section II   show
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Exclusions under HO 2000   show
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show Hovercraft and Parts; water or steam-water  
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Hovercraft and Parts   show
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Water or Steam-Water   show
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Pair and Sets Clauses   show
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show Debris removal and cost of reasonable repair to prevent add loss; loss of trees/shrubs/plants for limited perils only (5% Cov A; $500 per plant); fire dep charges up to $500; Credit card/check forg/counterfeit $ up to $500  
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show 8 general fire policy exclusions + theft & vehiclar damage to building if done by owner/tenant; V&MM if vacant for 60 days; agricultural/industrial smudging; damage by wear/tear/rot/deter/settling/cracking/mech breakdown; damage by birds etc; animals  
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show Insured must cooperate with the insurer in the event of a claim investigation  
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HO Legal Action after loss   show
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HO other insurance   show
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show Dwelling; primary limit is ACV, Market Price, or Replacement Cost  
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show Other Structures; 1 & 2 family dwellings - 50% Cov A; 3 family dwellings: 30% Cov A; 4 family dwellings: 25% Cov A  
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HO Coverage C & Limit of Liability for HO -2,-3,-5,-8   show
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HO Coverage C & Limit of Liability for HO -2,-3,-5,-8   show
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HO Coverage A & Limit of Liability for HO -4,-6   show
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HO Coverage B & Limit of Liability for HO -4,-6   show
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HO Coverage C & Limit of Liability for HO -4,-6   show
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show Any necesary increase in living expense so household can maintain normal standard of living - payment is for shortest time required to repair/replace damage or shortest time to settle elsewhere  
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show There are provisions for homeowners policies which vary from state to state. If the policy wording differs from a state law, the state law prevails.  
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HO - Limited Fungi, Wet/ Dry Rot, or Bacteria Coverage Endorsement   show
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show Remove the fungi, Tear out &replace any part of the building needed to gain access to fungi, Test air or prop to confirm the absence/presence/ level of fungi only if there is a reason to believe there is the presence of fungi, wet or dry rot or bacteria  
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show This endorsement also covers liability caused as the result of the build-up  
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HO - Limited Fungi, Wet/ Dry Rot, or Bacteria Coverage Is included in   show
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HO - Permitted Incidental Occupancies Endorsement   show
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show Covers loss caused by earthquake or volcanic eruption; quake can cover buildings only or both buildlings+Pers Prop of insured  
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HO - Earthquake Endorsement Deductible   show
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show This P&L Coverage may be both endorsed or added to the policy - typical endt is for insureds caring up to 3 children in addition to own children; special permission from UW req for more children  
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HO - Business Pursuits Endorsement   show
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HO - Business Pursuits Endorsement does not cover   show
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show Teachers, clerical employees, and salesmen  
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show provide personal liability and bodily injury for watercraft with less than 50 horsepower motor rented to you; sailing vessel with less than 26 feet owned by you; watercraft with less than 25 horsepower outboard motor owned by you  
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show to cover bodily injury and personal liability for specified watercraft not covered in other HO policies. It does not cover liability incurred in a prearranged race or competition, unless the competition is for sailing vessel or is a predicted log cruise  
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show adds coverage for non-bodily damages suffered by an individual due to such things as false arrest, slander, malicious prosecution, wrongful entry or eviction, or violation of a person's right to privacy other than by advertising or through the media  
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show Provides personal liability coverage as a separate policy (for someone who owns no property, for instance) or on a supplemental basis to the mono-line Dwelling policies.  
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show Proof of financial responsibility is required when getting a drivers license and after an accident  
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If the driver or owner of a car is involved in an accident, they must show financial responsibility unless   show
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show Show valid insurance coverage (most common), a self-insured identification card issued by the state; post money to the state's Office of Driver's Services; obtain release from injured/damaged party or file agreement to an installment plan after accident  
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Motor Vehicle Financial Responsibility Law: Failure to show or maintain proof of financial responsibility   show
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State Laws and Personal Auto Policy (PAP) - Required Limits of Liability   show
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show BI coverage per person/BI coverage per occurrence/PD coverage per occurrence  
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Personal Auto Policy - Required Proof of Insurance   show
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Automobile Insurance Plan   show
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Notice of Eligibility in Assigned Risk Plan   show
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Personal Auto Policy - After Market Parts Regulation: OEM   show
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Personal Auto Policy - After Market Parts Regulation: Non-OEM   show
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Personal Auto Policy - After-market parts   show
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show The part is equal in quality to that of the OEM and carries identification that it is an after-market-part; •The insured is notified in writing and consents in writing to the use of after-market-parts  
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show When someone has an auto policy and purchases or leases a new or additional vehicle the newly acquired auto is covered for 31 days under the current policy. You have 31days from the date of acquisition to declare the new auto  
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show Named insured & spouse; Any family members/relatives living in the insured's household; Others driving/occupying the insured auto with stated or implied permission; Omnibus clause  
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Omnibus Clause   show
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show (1977) Standard form used in US; Amendatory endorsements are required to make the policy fit individual state laws when it is used; •Does not have required language, but the PAP is used by most insurers with some modifications for competitive purposes.  
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show Pays damages for which the insured is Leg Liab b/c of BI to another person or for PD arising from the use of a described covered auto or other vehicle. Bodily Injury is also referred to as Coverage A; Property Damage is referred to as Coverage B.  
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show Max amount insurer will pay to cover legal req the insured may be liable for as result of accident is on Dec Page; many states haave min liab cov requirement; can be split amount or single limit  
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show coverage would be shown as: BI coverage per person/BI coverage per occurrence/PD coverage per occurrence. Examples of split liability limits include: 20/40/15, 50/100/25, 100/300/50, and 250/500/100  
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Personal Auto Policy - Single Liability Limit   show
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show Split: 20/40/15; Single: $55,000  
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Personal Auto Policy - Out of State Coverage   show
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Out of State Coverage Example   show
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Personal Auto Policy - Supplementary Payments   show
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show the carrying of people or prop for a fee, except for shared-expense car pools; criminal use of vehicle; the sponsoring or taking part of racing/speed contest  
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show intentional acts/at direction of the insured/failure to prevent another person's intentional act; use of non-owned vehicles without owner's permission  
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Personal Auto Policy Exclusions: Liability Incurred   show
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Personal Auto Policy Exclusions: Liability Covered by   show
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show Pays for reasonable medical or funeral expenses incurred by an insured in or caused by an auto/vehicle; covers ins whil entering/alighting from/occupying a vehicle or while a pedestrian and hit by a vehicle  
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show If an insured falls and twists her ankle on a slippery curb while getting out of the car- it's covered.  
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show generally a per person amount, which may/may not be shown on the Dec page. If limit is $10K & there are 3 injured individuals, the 3 indiv would have cov up to $10K each. There is usually also an aggregate limit, i.e. $10K/person, $50K/occurrence.  
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show Medical expenses are covered for up to one year after an accident  
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show Pays sums for only BI sustained by insd as result of accident caused by owner/op of uninsured MV or by a hit&run vehicle  
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show in most states when liability coverage is included in the policy  
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Personal Auto Policy - Uninsured Motorists Coverage (Coverage C) minimum requirement   show
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show an extension of car insurance available in some states that covers medical expenses and, in some cases, lost wages and other damages; prem shouldn't increase due to a PIP claim  
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show because the statutes enacting it are generally known as no-fault laws, and PIP is designed to be paid without regard to "fault," or more properly, legal liability  
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PIP coverage in different states   show
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PIP may cover   show
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show is for the insured's own injuries, on a first-party basis, without regard to liability. Again, it is only available in certain states  
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Underinsured Motorists Coverage (Coverage D)   show
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Underinsured Motorists/Uninsured Motorists Rejection   show
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show Pays for loss to an insured vehicle due to a collision or upset, less any applicable deductibles. Includes, for example, collision with other autos, fences, and buildings  
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Coverage for Damage to the Auto - Other than Collision (Comprehensive)   show
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show theft, riots or vandalism, flood, glass breakage & collision with an animal or a bird, fire, missiles or falling objects, and natural events such as tornado, windstorm, earthquake, etc., less applicable deductibles  
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Uninsured Motorist Property Damage (UMPD)   show
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Personal Auto Policy - Deductibles   show
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show Pays up to $15/day and up to $450 for expense to rent a substitute vehicle while the insured auto is out of service for 24 hours or more due to loss by a covered peril. Additional amounts may be purchased for additional premium  
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Personal Auto Policy Exclusions   show
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show cover non-commercial use of automobiles  
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Personal Auto Policy - Types of Covered Vehicles (1-2) - must be   show
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Personal Auto Policy - Types of Covered Vehicles (3-4) - must be   show
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Personal Auto Policy - Premium Rating Factors   show
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show Age, sex, marital status, vehicle use, annual mileage, territory of where the vehicle is garaged, and the liability limits selected.  
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Physical Damage Rating Factors   show
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Assigned Risk   show
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Personal Auto Policy Selected Endorsements: Amendment of Policy Provisions   show
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Personal Auto Policy Selected Endorsements: Towing and Personal Auto Policy Selected Endorsements: Labor Costs   show
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Personal Auto Policy Selected Endorsements: Extended Non-Owned Coverage   show
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show Extends the definition of a covered vehicle to include motorcycles, all-terrain vehicles, dune buggies, golf carts, and motor homes, but excludes coverage for any non-owned vehicles, except for temporary substitute vehicles  
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show Used on policies issued to two or more persons who live together or relatives other than husband and wife  
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Personal Auto Policy: Mexico Coverage   show
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show Insurers renewing/issuing a MV ins policy which provides Collision or Comp cov must offer in writing to the insured the opportunity to purchase rental reimbursement coverage for a temporary replacement vehicle after an accident to the insured's vehicle  
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Commercial Auto Policy   show
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show Covers vehicles used for commercial purposes; •Revised by the Insurance Services Office (ISO) along with other commercial policies to simplify and standardize them, and to make them more compatible with other commercial liability coverages  
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show Provides Auto and General Liability coverage to businesses that deal with the sales, repair, servicing, storage or parking of automobiles  
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show Provides coverage for the insured's owned autos as described in the policy declarations.  
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show Designed for businesses that transport goods or commodities for others. It is similar to the Business Auto Form  
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Commercial Auto: Motor Carriers   show
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show autos described in Dec page; replacement autos; newly acq vehicles, usually for first 30 days after acq (all other V's must be insured with same insurer; utility trailers owned by ins'd/attached to ins'd vehicle;  
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(CA) Coverage Form Setions - Covered Autos (2)   show
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show will often cover liability coverage for any auto used in the business, but will cover physical damage only to specifically listed vehicles  
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(CA) Liability Coverage   show
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(CA) Garagekeepers Coverage   show
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show Covers trailers that the insured does not own but that are in his/her possession with a trailer interchange agreement in which the insured assumes liability for the trailer  
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(CA) Physical Damage Coverage   show
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show loss caused by war etc.; loss from theft of non-permanently installed sound reproduction equipment; Radar/laser detectors; special carpeting etc; Damage due to wear & tear/mech breakdown; tire damage unless by fire/theft/vandalism  
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CA Physical Damage Exclusions - Loss caused by war &...   show
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show tape/CD players or mobile phones, and computer/FAX equipment as well as media used with these electronic devices, such as tapes, CDs, or diskettes  
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CA Physical Damage Exclusions - Special Carpeting as well as   show
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Commercial Auto Conditions   show
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(CA) Selected Endorsements - Additional Insured & Loss Payee-Lessor   show
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show Covers vehicles primarily used off of public roads when attached to the CA policy  
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show a backhoe may be insured under the BAP because it is required to have auto liability insurance. But anything attached to the backhoe, such as the bucket, is excluded from the auto policy, so the Mobile Equipment endorsement is required  
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(CA) Selected Endorsements - Auto Medical Payments Coverage   show
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(CA) Selected Endorsements - Drive Other Car Coverage   show
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show Required for all policies that have the Drive Other Car endorsement. Gives named insured status to individuals named in the endorsement, most often used to include family members of a sole proprietor in a Commercial Auto Policy  
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Commercial Carrier Regulations: The Motor Carrier Act of 1980   show
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Motor Carrier Act of 1980: MCS-90   show
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Commercial Package Policies   show
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show on a monoline basis for the builidings only; ACV basis but RC settlement can be added as endorsement; covered peril forms include those in DP and HO policies/Broad&special causes of loss forms & earthquake; sinkhole/sprinkler leak is added peril; V&MM<60  
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Commercial Building & Personal Property Covered Property   show
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show these structures are listed and described in the Declarations section; anything that is or has become a permanent part of the buildings (additions, fixtures, extensions, machinery, and equipment) is covered as well  
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Commercial Building & Personal Property Covered Property: Business Personal Property   show
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Commercial Building & Personal Property Covered Property: Personal Property of Others   show
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Policy Territory of Commercial Policy   show
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show Endorsements can modify one or more of the Commercial Package Policy coverages. An endorsement that modifies two or more coverages is called an interline endorsement  
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Commercial Policy must contain at least two of the following commercial coverages   show
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Commercial General Liability (CGL)   show
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CGL Coverage A   show
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show Provides protection for liability arising from libel or slander; false arrest; invasion of privacy; malicious prosecution; advertising injury (TM/copyright infringement; misappropriation of advertising slogans); wrongful entry/eviction  
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show is an injury to a 3rd-party brought about by the business' advertising its goods and services. Can occur by copyright or TM infringement, or as a claim of libel, slander, or invasion of privacy  
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show Intentional acts of the insured (false publication of breaking the law); breach of contract; incorrect or misleading ad; media-related business (advertising/broadcasting/publishing/telecasting); do not call laws (2007)  
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Do not call laws (2007)   show
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CGL Coverage C   show
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CGL Coverage C payment timeframe   show
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CGL Coverage C Exclusions   show
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show Supplementary Payments - for BI/PD and Personal/Advertising injury liabilities; court costs taxed against insured; bail bonds up to $250; all reasonable expenses incurred by the insured at the insurer's request including loss of income up to $100/day  
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show The 2007 CGL policy doesnt include attorney's fees and expenses taxed against an insurd. Such (attorney) costs (if awarded separately) would be paid in the form of damages to the successful plaintiff, and thus such costs are paid within the policy limit  
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CGL - Who is an Insured   show
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CGL Limits of Liability   show
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CGL Limits of Liability - separate limits apply to   show
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CGL Conditions - Property covered   show
🗑
CGL Conditions - Commercial Policies are   show
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show •Covered losses must happen during the policy period, but there is a one-year “discovery period” after the policy ends. Coverage will be extended for the loss if it is discovered during the discovery period.  
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show Losses to property other than money and securities are compensated on an ACV basis  
🗑
show Per Occurrence or Annual/General Aggregate Limit  
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CGL - Damage to Property of Others: Per Occurrence   show
🗑
CGL - Damage to Property of Others: Annual or General Aggregate Limit   show
🗑
show Separate aggregate limit for this hazard  
🗑
CGL: Contractual Liability   show
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CGL Exclusions   show
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show most common type; the damage must occur while the policy is in effect; the claim could be made either during the policy period or after the policy has terminated  
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show has a specified retroactive date and termination date, between which the occurrence must happen  
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Claims-Made Features   show
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CGL: Reporting Period/Mini-Tail   show
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show Claims must be made during the policy period or within 5 years of its termination  
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CGL: Supplemental Reporting Period/Full-Tail   show
🗑
show Policy conditions section requires that the insured give the insurer prompt notice of all occurrences and prompt written notice of all claims; full cooperation; authorization to obtain any other necessary records; authoriz to and coop in subro proceedings  
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CGL: Premises and Operations   show
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show Manufacturers/Contractors; Products Coverage covers legal liab arising from defective products; Completed Ops Cov coveres businesses doing construction/repair/servicing/installation on or away from insd place of business  
🗑
show Legal liab from defective products = covers BI/PD brought about through use of product (not damage of product); loss can be caused by neg or warranty; doesn't cover cost of product recalls  
🗑
show covers businesses doing construction, repair or servicing work, and installation away from the insured's place of business - BI/PD caused by insd neg or faulty work; doesn't cover replacing work that caused damages  
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show aka “hold harmless clause,” where the person to do the work (contractor or sub) has a policy showing that he and he alone is responsible for the work to be done and absolving the person contracting with him, as named in the policy, from any liability  
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Contingent Liability-Owners & Contractors/Independent Contractors Pertains to   show
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show owners, landlords and tenants from liability caused by contractors, or protects contractors from damage caused by subcontractors  
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Contingent Liability-Owners & Contractors/Independent Contractors Covers things such as LEASE:   show
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CGL Exclusions   show
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show A contract for a lease of premises, A sidetrack agreement with the railroad; Any easement or license agreement, excluding construction or demolition; An obligation required by ordinance to indemnify a municipality; An elevator maintenance agreement  
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show •Contract under which you assume the legal liability of another to pay a third party for bodily injury or property damage which you partially caused  
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Purpose of Insured Contract in CGL   show
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Burglary   show
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show The trigger is the notification of a claim to the insured or the insurer  
🗑
show The manifestation, or discovery, trigger activates coverage under the policy in place at the time the personal injury or property damage becomes known, or is discovered by, the property owner or victim  
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Loss Sustained Trigger   show
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Custodian   show
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show A person compensated by the insured and under the insured's service and direction  
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show Using force or illegal influence to take the property of another  
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Larceny   show
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Messenger   show
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Money   show
🗑
show An unexplained loss. Personal property is missing without any proof as to how or why it is missing  
🗑
Property Other than Money or Securities   show
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show The taking of the personal property of another by force or fear of force  
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Securities   show
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Theft   show
🗑
show Any person the insured retains who has no other duties than to protect the insured's property on the premises  
🗑
show Cov is provided for losses actually discovered during the policy period or within 60 days after the policy ends (within 1 year for employee benefit plans), regardless of whether or not the loss occurs during the pol period - ends once new pol replaces old  
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Loss Sustained Forms   show
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show Basically, the Discovery basis covers losses that are discovered by the insured during the policy period and sixty days thereafter (unless replaced) no matter when the loss occurred, and it does not matter if the insured had prior coverage.  
🗑
show the prior crime policy was in force at the time of loss; crime cov has been in effect continuously, loss would've been covered by the prior crime policy & current crime policy  
🗑
show loss from employee dishonesty; money, securities, and other property; there is always subrogation against a dishonest employee  
🗑
Employee Theft (Form A) coverage basis   show
🗑
Employee Theft (Form A) Discovery Period   show
🗑
Employee Theft (Form A) Coverage Termination   show
🗑
show Covers any loss due to forgery or alteration of a check or draft, promissory or similar written promise; also covers any legal expense if the insured is sued for refusing to pay any covered insturment that was forged/altered; doesnt cov incoming checks  
🗑
Theft, Disappearnace, or Destruction (Form C)   show
🗑
show •Covers property other than money or securities against inside or outside damage by burglary or robbery. (Can be endorsed to cover money and securities); Covers inside loss by safe burglary  
🗑
show covers prop other than $ & securities inside premises; covers damage to insured' prop; cov suspended until repairs to prem are completed; covers manuscripts, drawins, records of any kind or cost of reconstruction/reproducting info  
🗑
Premises Burglary (Form E) Limits on Special Property   show
🗑
Form E Coverages for Burglary   show
🗑
show The policy covers taking property by threat or by witnessing an unlawful act. Robbery coverage under Premises Burglary does not apply to any loss from robbery of a watchperson  
🗑
Computer Fraud (Form F)   show
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Extortion (Form G)   show
🗑
show Covers property other than money and securities outside the premises  
🗑
Lessees of Safe Deposit boxes (Form I)   show
🗑
show Covers securities from loss due to theft, disappearance, or destruction inside a custodian's premises, being transported by a custodian, or while on deposit in a depository  
🗑
show K: Guests' property while in a safe deposit on premises; L: Guests' property on premises and in the care, custody, and control of the insured  
🗑
Safe Depository (Forms M & N)   show
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Safe Depository: Legal liability for M   show
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Safe Depository: Legal liability for L   show
🗑
Money Orders and Counterfeit Money (Form R)   show
🗑
show Note that Forms O, P, and Q are government forms and are therefore taken out of order: O= Employee dishonest per loss; P= EE dishonesty-per EE; Q= robbery and safe burglary  
🗑
General crime exclusions include   show
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Farm Liability Coverage Forms   show
🗑
Custom Farming   show
🗑
show ops conducted at a premises rented to, leased to, or controlled by insured; ops for which no comensation in $ or goods is received; a neighborly exchange of services  
🗑
show Any insured's employee whose duties are principally in connection with the maintenance or use of the insured location as a farm. These duties include the maintenance or use of the insured's farm equipment; doesn't mean any EE while engaged in insds bus  
🗑
Farming   show
🗑
Unless specifically indicated in the Declarations, farming does not include:   show
🗑
Farm Bankruptcy   show
🗑
Farm: Insured's Duties In The Event Of Occurrence, Offense, Claim, Or Suit   show
🗑
show immediately record the specifics of the claims/suit and the date received; notify the inusrer in writing ASAP  
🗑
Farm: In addition to the duties after a claim, the insured must   show
🗑
show give the insured written proof of claim(under oath if req) ASAP; execute authorization to allow the insured to obtain copies of med reports/records; submit to phys examin by physican selected by insr when/as often as reasonable required  
🗑
show No payment made under the provisions of Coverage J constitutes an admission of liability by any insured or the insurer  
🗑
Farm: No Admission of Liability with Medical Payments: Other Insurance   show
🗑
show Insr will pay only the proportion of cov damaged/related def costs in cov ocur arisising from any cause except ownership/maintainence/use/op/loading/unloading of a MV; vehicle which qualifies as mobile equip whil used on prem insd owns/rents; watercraft  
🗑
show except with respect to the limits of insurance, and any rights/duties specifically assigned to the first named insd, the policy applies as if each named insured were the only NI; separate to each insd against whom claim is made/suit is brought  
🗑
Farm Liability Exclusions   show
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Farm Liability Exclusions - BI/PD arising from the use of   show
🗑
show arising out of the insured's performance of or failure to perform custom farming operations but only when receipts from custom farming operations exceed $5,000 for the 12 months immediately preceding the date of the occurrence.  
🗑
Farm Limits of Insurance   show
🗑
Farm: General Aggregate Limit is the most insurer will pay for sum of   show
🗑
show Damages under coverage H; Med expenses under Cov J due to all BI/PD arising out of any 1 occ; includes special lim of $10,000 for all cov damages insd is LL to pay b/c of stat imposed vicarious liab for actions of child/minor  
🗑
show All bodily injury and property damage resulting from any one accident or from continuous or repeated exposure to substantially the same general harmful conditions are considered to be the result of one occurrence  
🗑
show Mainly used when livestock is the only farm exposure; also used to write livestock cov separately on a named peril basis and covers death or destruction of 11 perils  
🗑
Livestock Coverage Form Covered Perils   show
🗑
show race or show animals, livestock on ranges, and livestock being transported to, from, or while at stockyards or commercial feed lots  
🗑
show Used when machinery and equipment is the only exposure. Provides all-risk coverage for mobile equipment; 80% coinsurance clause; cov written on blanket or sched form; cov is excluded for irrigation equip and dishonesty of insd; insured's EE's  
🗑
show . Crop Hail Insurance, FCIC (Federal Crop Insurance Corporation), Multi-Peril Crop Insurance  
🗑
show Issued for only 1 season at a time, covers the marketable portion of a crop against damage from hail. Some policies also insure against the perils of fire, lightning and wind. A few states require that the perils of freezing and frost be covered as well  
🗑
FCIC (Federal Crop Insurance Corporation)   show
🗑
Multi-Peril Crop Insurance   show
🗑
How to receive crop insurance   show
🗑
show Commercial package policies that provide both property and liability coverage to certain types of small businesses; includes cov for loss of eanings due to insd hazard on an actual loss sustained basis  
🗑
BOP Factors of Eligibility   show
🗑
Premiums for BOP policies are based on   show
🗑
show bus with < 100 EEs & <$1M revenue; Apartment build; that may also contain offices+certain service & mercantile occupanies; eligible office buildings; restaurants; conven stores w/ gas pumps; laundries+dry cleaners; motels; contractors; self storage  
🗑
Eligible office buildlings for the 2002 BOP policies are those that   show
🗑
Restaurants eligible for BOP   show
🗑
Convenience stores with gas pumps eligible for BOP   show
🗑
Motels eligible for BOP   show
🗑
show those not exceeding 2 stories; excludes industrial storage facilities  
🗑
BOP Cause of Loss Coverages: Standard Form   show
🗑
show open peril/all risk  
🗑
show Ordinace/law; earth movement; gov action; nuc hazard; utility failure away from insd prem; war; water i.e. flood/sewer backup; artif gen elec cur; water pipe rupt/burst; consequential loss(EE & increase of lost income);computer failure; loss to val papers  
🗑
show wear/tear; rust etc.; smog/poll; sett/cracking/expansion; damage from birds etc; dishonest/crim acts of insd or EEs; voluntary fraud; rain/snow/etc to PP not in building; colllapse; faulty planning; smoke etc; frozen plumb; weather; neg; consequential  
🗑
show $300,000 per person  
🗑
BOP Limits of Liability: Medical Expense   show
🗑
show $50,000 limit  
🗑
BOP Limits of Liability: Policy Aggregate Limit   show
🗑
show unless $ lim is specified in Dec; BI or loss of I cov provided by BOP covers actual loss sustained by interr of ops during period of restoration that toccurs within 12 consec months following date of direct physical loss/damage  
🗑
show is covered after the insured experiences a loss; this ehlps the business resume normal business activites; also means that less pure income is needed for use of EEs  
🗑
Loss Conditions for BOP: Time Element   show
🗑
show a product that addresses business interruption underwriting problems and loss experience  
🗑
BOP Time Element Automatic Feature   show
🗑
BOP Conditions   show
🗑
BOP: Inflation Guard Provision   show
🗑
show States that a negligent act of someone beyond the insured's direction or control will not affect coverage; If the insured violates contract conditions at one location, coverage to other locations will not be affected  
🗑
show Limits the insured's right to bring action against the insurer for damages to two years if the insured has complied with policy conditions and the insurer has not indemnified the insured for direct physical loss  
🗑
BOP: Policy Period, Coverage Territory Condition   show
🗑
show outdoor signs; exterior glass; interior glass; employee dishonesty; mechanical breakdown; burglary and robbery; money and securities  
🗑
BOP Additional Coverages (subject to policy limits)   show
🗑
show up to $10,000 coverage  
🗑
BOP Extended Coverages: Personal Property Off-Premises   show
🗑
show Up to $1,000 coverage with a $250 limit for any one tree, shrub or plant  
🗑
show up to $1,000 coverage  
🗑
show Business liab: $300,000 limit; fire-legal liab: $50,000 limit; Policy Aggregate: 2x the bus + med liab limits for all damages/injuries that happen during the policy period; Products & completed Ops liab separate from other liab limits  
🗑
show The business, its owner(s) and employees acting in the course of employment and under the direction of the company are considered insureds under a BOP  
🗑
show provides coverage for hired or non-owned autos when used by the business if the insured does not have Commercial Auto insurance; i.e. ER requires EE use his own vehicle to run company errands = non-owned auto  
🗑
BOP Selected Endorsements: Protective Safeguards   show
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Protective Safeguards: P-1   show
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Protective Safeguards: P-2   show
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Protective Safeguards: P-3   show
🗑
show Service Contract for a privately owned fire department  
🗑
BOP Selected Endorsements: Utility Services-Direct Damage Replacement Cost Coverage   show
🗑
Utility Services-Time Element Coverage   show
🗑
show State level; most states require; where cov is elective and not provided, ER can't use common law defense such as contrib neg if injured EE brings suit exposing ER to possible expensive legal costs/damage awards  
🗑
show state minimum requirements. If the policy does not, the law takes precedence  
🗑
show If a worker who intentionally injures him/herself  
🗑
WC: Instead of Dec Page   show
🗑
show Standard limits: $100,000/accident for injuries; $100,000/employee with a $500,000 aggregate for disease  
🗑
show The state covers all Workers' Compensation in the state and does not allow private insurers to write Workers' Compensation business in the state. The four monopolistic fund states are North Dakota, Ohio, Washington, and Wyoming  
🗑
show Offered by some states that compete with private insurers for the Workers' Compensation business in the state  
🗑
WC: Elective/Voluntary Compensation   show
🗑
WC: Compulsory Compensation   show
🗑
show for employees injured on the job. Usually this benefits the employee, for instance, they are covered even when they harm themselves  
🗑
show the employer meant to harm the employee; the employer acted with gross negligence/fraud; employee was harmed by someone other than a co-employee; employee was injured while at another place of business  
🗑
show Provides coverage to injured employees who are not covered. Also gives the employee the option of accepting the WC coverage or of suing the employer for compensation  
🗑
show All 50 states require businesses to have Workers' Compensation insurance to pay medical payments and lost wages to workers'  
🗑
show higher education; the armed forces; for disabled persons/young children; seasonal employees; students; drivers etc.  
🗑
Workers Compensation Laws: Excluded employments   show
🗑
WC: Covered Injures/Occupational Disease   show
🗑
WC Benefits Provided   show
🗑
show pain and suffering or punitive damages  
🗑
WC Benefits may be increased   show
🗑
show state fund set up encourage the hiring of the handicapped or disabled. The state pays the benefits for prior disabilities or injuries. The employer is only required to cover the most recent injury  
🗑
How to set up reimbursement for State Injury Fund the employer must demonstrate that   show
🗑
show Mandates coverage for interstate railroad workers'  
🗑
Outer Continental Shelf Lands Act   show
🗑
show Past the states jurisdiction - 3 nautical miles out - to the edge of the federal jurisdiction - up to 250 nautical miles out  
🗑
U.S. Longshore and Harbor Workers' Compensation Act   show
🗑
show Mandates coverage for crews of ocean vehicles  
🗑
WC covers claims brought by   show
🗑
show care must be taken to make sure the customers know they must purchase coverage directly from these states-including trucking companies that have routes through these states  
🗑
show unlimited dollar/time limit on covered medical expenses- necessary mental, physical, and vocational rehab including maintenance and institutional care  
🗑
WC: Income Benefits, Total Disability   show
🗑
show The percentage of wages lost is restore  
🗑
WC: Scheduled Benefits   show
🗑
show Statutory amt is provided for burial exp; also income ben for a surviving spouse and/or children; subject to weekly mins&max; spouse income ben are up to 20 years or life (whichever is 1st); children eligible until 18 or 25 if in school  
🗑
show Employers Liability Insurance; part that has a dollar limit shown for coverage; insures ERs for liab toward EE that is not covered by statutory WC provisions of state  
🗑
WC Part 3   show
🗑
If an employer has exposure in one of the four states with monopolistic funds coverage   show
🗑
WC Part 4   show
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WC Part 5   show
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WC Part 6   show
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WC Part 7   show
🗑
Voluntary Compensation   show
🗑
show gives the insurer the right to pursue any course of action in its own name or the name of a policy owner against a third party who is liable for a loss that has been paid by the insurer  
🗑
WC Premium Computation 5 Main Rating Systems   show
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Experience Modification Factor   show
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WC Premium Computation: Job Classification Payroll and Rates   show
🗑
show Credits given to larger employers because some expenses associated with the premium rate do not change with the employer's size  
🗑
show A share of surplus allocated to a policyholder in a participating insurance policy; allowed with mutual companies where PH are also shareholders; may get some of prem back if co is doing well  
🗑
show Prems adjusted at the end of the policy period due to actual losses and exposure amounts that can vary during the policy period; deposit prem charged at beg of pol per & each Q throughout pol; final prem decided after audit at end of pol per  
🗑
show the insured is either billed the additional premium not paid or is refunded the excess premium paid.  
🗑
show An individual or organization other than an insurer, or a group of two or more insurers acting together, whose purpose is to make rates, rating plans, or rating systems  
🗑
Premium Audits   show
🗑
WC: Other sources of coverage: Self-insured and employer groups   show
🗑
show covers certain types of ins that private insrs cant/wont insure  
🗑
show adds additional liability or excess coverage for $1 million or more, over and above the basic liability limits of an underlying policy  
🗑
Umbrella sits over base policies with underlying coverage such as   show
🗑
show extended by the umbrella policy to cover a broad range of activities and include activities not covered or not required to be covered by the underlying policies  
🗑
Excess Policies   show
🗑
show required by businesses and by some private individuals with higher than normal liability exposure due to the type or notoriety of the business, or because some coverages they require are not covered under other insurance  
🗑
show provides coverage for the insured and all household members against claims resulting from bodily injury or property damage to others caused by an accident on the insured's property or as a result of the insured's personal activities anywhere  
🗑
show a form used to provide personal liability insurance, and may be attached to a Dwelling Policy or written as a separate policy to provide liability coverage  
🗑
Commercial Umbrella Policy   show
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Errors and Omissions Coverage   show
🗑
show The insured's professional reputation could be affected by a claim; •Before an insurer can settle a claim out of court, the insurer must obtain the signature of the professional individual or organization  
🗑
organization. Medical Malpractice   show
🗑
Directors and Officers Liability   show
🗑
Fiduciary Liability   show
🗑
show retirement plans or investment funds for the estate of a deceased person or for a minor or other individual who cannot handle their own affairs  
🗑
Liquor Liability   show
🗑
Why is Liquor Liability needed as its own coverage   show
🗑
show covers legal costs incurred for sexual harassment claims, wrongful termination claims, and discrimination claims  
🗑
show has been changed to add the exclusion of malicious prosecution and also to state this exclusion applies even if the injury causing event occurs before, during, or after employment  
🗑
show limits the coverage for abuse or molestation only for the professional services described in the endorsement schedule, not for all of the insured's operations  
🗑
Surplus Lines   show
🗑
show The full amount/type of ins must not be available through admitted insurers; Financial consideration cannot be a deciding factor; once cov is offered by adm insurer, surplus must stop selling in the state or apply to be an admitted insr  
🗑
show provide for monetary compensation should there be a failure to perform certain specified acts within a stated time period  
🗑
show a three-party contract that guarantees a promise the insurer (surety) makes for the faithful performance or payment of an obligation by a principal or obligor to a third party, or obligee  
🗑
show the party for whom the bond is written; If the principal defaults on his or her promise to fulfill the obligation, the surety pays damages to the obligee.  
🗑
show when a city contracts to have a new town hall built & the contractor can't build the town hall, the insurance company will cover the cost. The contractor is the principal or obligor. The obligee is the city, who will be paid. The insurer is the surety  
🗑
show Guarantees the contractor will perform a job on time, according to specifications, and without liens for materials or labor  
🗑
License and Permit Bonds   show
🗑
Judicial Bonds   show
🗑
show a form of insurance protection that covers policyholders for losses that they incur as a result of fraudulent acts by specified individuals. It usually insures a business for losses caused by the dishonest acts of its employees  
🗑
show may be separate or combined into a single limit. Hull ins can be allrisk for both on ground and in flight or can be written as allrisk on ground and limit flight perils to fire/lightning/explosion - excluding crash and collision  
🗑
Bodily Injury Coverage is Aviation Liability   show
🗑
Aviation Admitted Liability Coverage/Voluntary Settlement Coverage   show
🗑
Aviation Admitted Liability Coverage/Voluntary Settlement Coverage payment requirements   show
🗑
Medical Payments for Aviation   show
🗑
Ocean Marine Insurance   show
🗑
show In the event of a total loss, the entire face amount of the policy is payable to the insured  
🗑
Major Coverages of Ocean Marine Insurance: 1   show
🗑
show The "Running Down" Clause; or RDC  
🗑
Major Coverages of Ocean Marine Insurance: 3   show
🗑
Major Coverages of Ocean Marine Insurance: 4   show
🗑
Major Coverages of Ocean Marine Insurance: 5   show
🗑
show the abandonment clause  
🗑
show Coinsurance  
🗑
Major Coverages of Ocean Marine Insurance: 8   show
🗑
show Protects a ship owner against damage to the ship itself. Written on a modified all-risk basis. Includes a “running-down“ clause (RDC) that also protects against liability caused by damage to other ships due to collision  
🗑
The RDC, or “running down” clause   show
🗑
show Protects the cargo owner from loss due to destruction  
🗑
Freight Insurance   show
🗑
Protection and Indemnity   show
🗑
Damages included in the Protection and Indemnity Clause   show
🗑
Ocean Marine Express and Implied Warranties   show
🗑
Ocean Marine Perils   show
🗑
General Average Clause   show
🗑
show the insurers of various interests to share the cost of losses incurred voluntarily to save the voyage from complete destruction; sacrifices must be made voluntarily; necessary; and successful  
🗑
show A loss which affects certain interests more than others. The opposite of general average  
🗑
show excludes from coverage partial losses to the cargo or to the hull except those resulting from stranding, sinking, burning, or collision. Under its provisions, losses below a given percentage of value, ie 10 or 15& are excluded so insr doesn't pay small $  
🗑
show Provides all-risk coverage for loss of computer programs, data or media  
🗑
Premiums for boat and yacht policies are partly determined on territory of boat/yacht use   show
🗑
Outboard Motor and Boat Insurance Policy   show
🗑
Boat Owner/Watercraft Package Policy   show
🗑
Personal Yacht Insurance   show
🗑
Other available yacht insurance coverages   show
🗑
show pays to haul the yacht out of the water if a hurricane is approach and put it back in the water after the hurricane has passed  
🗑
Yacht policy written for   show
🗑
These are included on the policy for Yacht Insurance   show
🗑
Most marine insurance policies provide a cruising territorial limit   show
🗑
show can provide worldwide coverage for any vessel on any ocean  
🗑
show Covers (to a specified limit) any cause of loss that leaves the property in a different condition than it was before, excluding fire and extended coverage perils  
🗑
DIC Insurance Provides coverage designed to do what   show
🗑
show Covers certain types of ins that private insurers cannot or will not insure; Some states require that these high-risk applicants be assigned to individual insurers on a predetermined basis while others require that losses from these individuals be shared  
🗑
Residual Markets Joint Underwriting Associations (JUAs)   show
🗑


   

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