Level 2 chapter 3 Flashcards

(60 cards)

1
Q

declarations page

A

often a first-page summary of an insurance policy

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2
Q

What typically appears on the declaration page

A

The name of the insured party who controls the coverage (often called the named insured)

Anyone who has been proactively added to the policy as an additional insured (such as a mortgage lender)

The insurance company issuing the coverage

The dollar limit of the coverage (sometimes more generally known as the insurer’s limit of liability)

The deductible, if any

The duration of the policy (often called the policy period)

Whether the property is covered up to its actual cash value or its replacement cost

The policy number

The premium

Other specifics about the insured risk, such as a property address or type of insured vehicle

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3
Q

What rights do the named insured poses

A

The responsibility to pay the premium
The right to receive premium refunds following cancellation
The ability to change coverage with the insurer’s consent
The ability to cancel the insurance (in writing)
The ability to assign rights contained in the policy (with the insurer’s consent)

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4
Q

What is the limit of liability?

A

The maximum amount an insurance company will pay for a covered loss.

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5
Q

What are per-occurrence limits?

A

A payout cap that applies to each separate loss event.

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6
Q

What are aggregate (cumulative) limits?

A

A payout cap that applies to all losses during the entire policy period.

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7
Q

What is an insurance deductible?

A

The amount you must pay out of pocket before your insurance starts paying for a covered loss.

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8
Q

Why do insurance companies use deductibles?

A

1) To make sure policyholders pay part of their losses.
2) To avoid processing small claims.

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9
Q

How do deductibles affect premiums?

A

Higher deductibles usually mean lower premiums.

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10
Q

What is a per-occurrence deductible?

A

A deductible you must pay for each separate loss event.

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11
Q

What is a per-policy period deductible?

A

A deductible you only pay once during the policy period (e.g., annually).

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12
Q

Do deductibles apply to both property and liability coverage?

A

Usually only to the property portion of a policy.

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13
Q

What is a percentage-based deductible?

A

A deductible that’s a set percentage of the home’s insured value, often used for windstorm or hail damage.

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14
Q

Policy Period

A

The set time an insurance policy is active, from its start date to its end date. Losses are only covered if they happen during this period. Usually lasts 12 months and can be renewed.

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15
Q

Definitions

A

The section of an insurance policy that explains specific meanings of key terms, which may be more restrictive than everyday usage. These definitions shape coverage and guide court interpretations in disputes. If a term isn’t defined in the policy, courts use its common dictionary meaning

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16
Q

Insuring agreement

A

in an insurance policy, the insurance company’s basic promise to the consumer

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17
Q

package policy

A

an insurance product designed to cover multiple kinds of risk and thereby containing multiple insuring agreements

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18
Q

Property Insurance common exclusions

A

intentional damage, floods, non-sudden water damage, earth movement, pollutants, nuclear events, war, wear and tear, and government-ordered destruction.

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19
Q

Casualty Insurance common exclusions

A

intentional acts, war, pollution, operating vehicles without specific coverage, liability between people under the same policy, and situations covered by workers’ compensation.

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20
Q

Supplementary Payments / Additional Coverages (Simple Definition)

A

Extra benefits in an insurance policy that help with costs beyond the main coverage, usually at no extra cost to the policyholder’s

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21
Q

In Auto Insurance supplementary payments might include…

A

The cost to defend the insured person in a lawsuit
The cost of a bail bond if a driver is arrested after an accident
The cost of taking time off from work to help an insurer in an accident-related court proceeding

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22
Q

In Property Insurance supplementary payments might include…

A

The expense of storing belongings at an off-site location after a building becomes unsecure
The cost of temporary repairs
The cost of debris removal after a covered peril
The cost to replace damaged trees or plants
Expenses charged by local fire departments after a loss

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23
Q

Conditions (Insurance Policy)

A

Rules in the policy that spell out what the policyholder must do after a loss and what the insurer must do when handling a claim.

If the rules aren’t followed, the insurer can deny or limit payment.

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24
Q

Key Policyholder Duties:

A

Report the loss quickly.

Provide proof of loss.

Cooperate with investigations.

Prevent further damage.

Report crimes to police.

Let the insurer go after the person who caused the loss.

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25
Key Insurer Limits
Deductibles, coinsurance, coverage territory. Type of valuation (ACV, replacement cost). Other insurance rules.
26
Other Conditions May Include:
How to cancel or change the policy. Record inspection rights. Payment of premiums. Arbitration/mediation options. Policy rights transfer on death.
27
STEPS FOR FILING AN INSURANCE CLAIM:
Notify insurer within required timeframe. Complete and return proof of loss. Prevent further damage. Cooperate with investigations. Document everything with receipts and photos.
28
Alternative Dispute Resolution
ways to settle disagreements without going to court.
29
Mediation
A neutral person helps both sides talk it out and try to agree. Not binding (you don’t have to accept the decision). No guarantee of a solution.
30
Arbitration
Both sides get their own appraisers. If they disagree, they pick an umpire to decide. Costs for the umpire are split 50/50. Binding (the decision is final—usually no court appeal).
31
other insurance clause
part of an insurance policy that explains how a loss will be handled if the same loss is insured under multiple policies and/or by multiple insurance companies
32
Primary Insurance
The main coverage that pays first after a loss.
33
Excess Insurance
Only pays after the primary insurance has paid.
34
Ways Policies Can Coordinate
Equal Shares and Pro Rata
35
Pro Rata Liability
Payment is proportional to each insurer's share of total coverage. Example: Policy A: $90k, Policy B: $10k → A pays 90%, B pays 10%.
36
Contribution by Equal Shares
Loss split equally until the smaller policy is exhausted, then larger policy covers remainder. Example: Policy A: $5k limit, Policy B: $15k limit Loss $4k → $2k from each. Loss $12k → $5k from A + $5k from B, then $2k extra from B.
37
What happens under the Recovered Property Clause
the insured typically has two options: Return the insurance payment and keep ownership of the recovered property. Keep the insurance payment and transfer ownership of the property to the insurance company.
38
Salvage
The damaged property that an insurer may take possession of and sell when it’s beyond repair.
39
Abandonment
When a policyholder leaves damaged property without protecting it from further harm; insurers generally do not cover additional damage caused by abandonment.
40
Insurer’s Salvage Rights
Insurers can deduct the salvage value from the settlement if the insured keeps the damaged property.
41
No Benefit to Bailee Clause
An insurance policy rule stating that a business (bailee) holding someone else’s property is not protected by the property owner’s insurance if the property is lost or damaged.
42
Liberalization Clause
A policy provision requiring insurers to give existing policyholders any free coverage enhancements offered to new customers without extra cost.
43
Limitation of Liberalization Clause
Does not apply if extra benefits require additional premiums or if new benefits are offset by removing other coverages.
44
Pro-Rata Cancellation
When the insurer cancels a policy and refunds the unused portion of the premium proportionally.
45
Short-Rate Cancellation
When the insured cancels a policy early and the insurer keeps a portion of the premium to cover administrative costs.
46
Flat Cancellation
If a consumer is entitled to a full return of premium, a flat cancellation has occurred. Although rare, this might occur if someone buys insurance far in advance and cancels it before the effective date.
47
Assignment
Giving some or all rights of an insurance policy to another person.
48
Assignment Permission
Usually, insurance companies must approve assignment in writing.
49
Why Request Assignment?
To let someone (like a contractor) bill the insurer directly after a loss.
50
Assignment and Property Transfer
New property owners need their own insurance policy; old policies can’t be assigned without insurer approval.
51
Assignment After Death
The deceased’s legal representative gets temporary coverage for the insured property automatically.
52
Subrogation
The insurer’s right to sue a third party that caused a loss after paying the policyholder.
53
How Subrogation Works
After paying a claim, the insurance company "steps into the policyholder's shoes" to recover costs from the responsible party.
54
Purpose of Subrogation
Prevents the policyholder from collecting twice and supports the principle of indemnity.
55
Subrogation with Multiple Insurers
Allows transferring rights to the correct insurer if the wrong one paid a claim.
56
Deductible and Subrogation
If the insurer recovers money, they often return some or all of the policyholder’s deductible.
57
endorsement
An amendment or change to a standard insurance policy. Add benefits, remove benefits, or modify a policy to meet specific needs or laws.
58
certificate of insurance
Proof of insurance given to a third party, showing that coverage exists
59
Who usually requests a certificate of insurance?
A third party, such as a client or business partner, to verify coverage.
60
How long does an insurer typically have to audit a business's books and records?
3 years