Level 1 chapter 3 Flashcards

(51 cards)

1
Q

stock company

A

Owned by investors. Policyholders and owners are different. Profits go to shareholders and are taxed.

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2
Q

Mutual Company

A

Owned by the policyholders. Profits may be returned to them as dividends (not taxed). Dividends are not guaranteed.

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3
Q

Participating Policy

A

May pay dividends (usually from mutual companies).

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4
Q

Fraternal Benefit Society

A

Nonprofit groups (like religious or ethnic clubs) that sell insurance only to members. Rare and mostly used for life insurance.

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5
Q

Risk Retention Group

A

A group formed by businesses in the same field to insure each other when regular insurance is too expensive.

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6
Q

Lloyd’s of London

A

not an insurance company, but a global marketplace where investors insure unique or high-risk things.

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7
Q

domestic insurer

A

an insurer doing business in the same state where it is incorporated.

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8
Q

foreign insurer

A

is an insurance company from another state.

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9
Q

alien insurer

A

an insurance company from another country.

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10
Q

Admitted carriers

A

include domestic, foreign, and alien insurers with official permission to sell in a given state.

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11
Q

non‑admitted carriers

A

Insurers not licensed in the buyer’s state, operating in the excess-and‑surplus (E&S) market to offer coverage when standard insurance is unavailable.

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12
Q

Why might someone use a non‑admitted insurer?

A

Because standard (admitted) insurers denied coverage, and they need access to unique or high-risk insurance options.

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13
Q

What are some risks or limitations of using non‑admitted carriers?

A

They may offer fewer consumer protections, and policy terms may differ significantly from standard insurance.

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14
Q

Government insurers

A

cover things private companies usually avoid, like flood damage or Medicare/Medicaid for health.

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15
Q

In what lines of insurance is the excess-and‑surplus market most commonly used?

A

Property and casualty insurance—rarely used for life or health insurance.

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16
Q

residual market

A

helps people or businesses get insurance after being denied by private companies.

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17
Q

FAIR plan

A

helps insure high-risk properties by pooling state insurers with federal support for major losses.

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18
Q

Who can be denied coverage under a FAIR plan?

A

Properties that are vacant, unsafe, poorly maintained, store hazardous materials, or show signs of fraud or negligence.

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19
Q

reinsurance

A

Insurance that insurance companies buy to protect themselves from big losses or to offer larger coverage.

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20
Q

What are the two types of reinsurance agreements?

A

Facultative (case-by-case) and Treaty (covers many policies automatically from one source).

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21
Q

Who provides reinsurance?

A

Mostly private insurers, but sometimes the government

22
Q

How does reinsurance affect consumers?

A

If insurers can’t get it, premiums may go up, rules may tighten, and people may lose or be denied coverage.

23
Q

What is Treaty Reinsurance?

A

An ongoing agreement that automatically covers multiple policies without needing individual approval.

24
Q

insurance producer

A

licensed person (like an agent or broker) who sells insurance and helps manage policies.

25
agency
A legal relationship where one person (the agent) acts on behalf of another (the principal).
26
express authority
Power clearly given to an agent, either in writing or speaking.
27
implied authority?
Unwritten power that an agent is assumed to have to do their job.
28
apparent authority
Power the public thinks the agent has, based on their actions and appearance.
29
insurance broker
works for the customer, not the insurance company.
30
Can insurance brokers bind coverage or settle claims?
No
31
What is one major difference between a broker and an agent?
works for the customer, not the insurance company. Their job is to help clients find the best coverage for their needs — often shopping around to compare different insurance carriers and plans.
32
insurance agent
works for the insurance company, not the customer. Their job is to sell insurance policies from the companies they represent. Even if they try to find good deals for clients, legally they represent the insurer’s interests.
33
field underwriting
It's when insurance agents evaluate risks using the insurance company’s guidelines before selling a policy.
34
Why is field underwriting important in property and casualty insurance?
Because companies often don’t inspect properties first, and agents may have the power to issue coverage on their behalf.
35
interim insuring agreements
Temporary coverage given while an insurance application is being reviewed, if both the application and first premium are received.
36
binder
A temporary contract giving immediate coverage, usually issued by property & casualty agents with binding authority.
37
conditional receipt
A temporary agreement that provides coverage during underwriting—but only if the applicant would have been approved without changes to the premium or policy terms.A temporary agreement that provides coverage only if the applicant would have been approved without needing a higher premium or changes.
38
suitability standard
Insurance agents (called producers) must make sure the products they recommend actually fit the customer's needs.
39
Underwriters
the people at insurance companies who decide if the company should take a risk (like insuring someone or something) and how much to charge for it.
40
insurance application
the main tool underwriters use to decide if they should offer coverage. It includes details about the person applying, what they want to insure, and how risky it is.
41
inspections or third-party reports
Property inspections Financial or credit checks Criminal background checks Health exams Reviews of past losses
42
Fair Credit Reporting Act
requires financial institutions (including insurance companies) to give notice to the public before accessing third-party inspection reports about them.
43
Actuaries
use math and statistics to help insurance companies predict how likely it is that people will file claims.
44
judgment rating
A method where the rate is based only on the underwriter’s opinion
45
loss ratio
Claims paid divided by premiums earned
46
high combined ratio
The company is less profitable or may be losing money.
47
claims adjuster
Decides if a loss is covered and how much the insurer should pay.
48
independent adjuster
work for independent adjustment bureaus rather than specific insurance companies. Insurance providers call on them when they don't have enough of their own adjusters in an area.
49
public adjuster
represent the claimants, not the insurance companies. They advocate for policyholders throughout the claims process. Public adjusters typically:
50
Company Adjusters
work directly as employees of a single insurance company. Depending on state regulations, they may or may not need to be licensed in their field.
51
direct writer
insurance company that uses its own employees to sell policies directly to the public