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state commissioner ( or Director of Insurance) |
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chief insurance regulator who protects the insuring population by regulating all insurers and insurance professionals doing business in the state. |
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issues non-participating policies and is owned by stockholders who received taxable dividends as a return profit |
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issue participating policies and is owned by the policyholders who receive non-taxable dividends as a return of unused premium. |
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the transfer of risk between companies. |
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refers to the state in which an insurer is incorporated. |
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is organized under the laws of the resident state. |
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is organized under the laws of another state within the United States. |
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is organized under the laws of a country outside of the United States. |
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is authorized to do insurance business in the state and is issued a certificate of authority by the state's Department of Insurance. |
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the underwriting department of an insurance company is responsible for the selection of risks to insure and determines the rate to be charged. |
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can be the employee of an insurance company that owns the agent's book of business, or independent agent that enters into the a agency agreements with more than one insurance company. Independent agent retains ownership of the books of business. |
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is a three-party relationship where an insured ( principal ) authorizes an agent to act on behalf and create a legal relationship with a third party. |
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the uncertainty of a loss |
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increases the probability of a loss |
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what are the three types of hazards? |
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physical, moral, and morale. |
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does not allow the insured to profit from a loss; instead, it it restores the insured to the same financial or economic condition that existed prior to the loss. |
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( in P&C Insurance ) Must exist at the time of the loss. |
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is one of adhesion; on party ( the insurer ) prepares the contract and presents it to the second party ( the insured) , who must accept it on a "take it or leave it" basis. |
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used to determine premium, includes the nature of the risks, hazards , claims territory, and the other factors that vary depending upon the risk. |
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accident , which includes continuous repeated exposure to the same general harmful conditions. |
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proportional / proportionally
loss payment provision requires each insurer to pay its share of a loss in proportion to the coverage of that policy as it relates to the coverage specified for a liability.(if an insurer cancels a policy before it's expiration date the refund is made on a pro-rata basis.) |
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friendly fire vs. hostile fire |
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friendly fire burns/ stays within its intended boundaries whereas a hostile fire burns outside the intended boundaries. |
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is the specified amount of each loss that the insured must bear. a larger deductible reduces the premium and the submission of smalls claims. |
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causes damage without an intervening cause, and the indirect loss occurs as a consequence of a direct loss. |
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specifically lists the covered perils ( causes of loss) and an open perils policy covers all perils except those specifically excluded. |
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the cost to replace the property with alike kind and quality , at current pricing, without a deduction for depreciation . |
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is the replacement value of property minus depreciation. |
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requires the insurance company to pay the total scheduled limit of insurance for a total loss. |
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insures a single item on a single policy for a single limit of insurance. |
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insures one or more items on a single policy and each item is insured at a scheduled limit of insurance. |
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insures multiple items of property on a single policy with one limit of insurance applying to all insured property. |
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describes basic information about the policy |
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is the insurer's promise to pay the insured |
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states that the insured's obligation to transfer to the insurance company it's right of recovery against any party causing a loss after it accepts payment from the insurer for a loss. |
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perils that are not covered by the/a policy |
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are automatically included in property policies without an additional premium and includes items such a debris removal, collapse, and fire department service charges. |
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is a common property policy provision that requires the insured to maintain a certain limit of insurance coverage in order to avoid a penalty in the event of a partial loss . |
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is assigned to one party for the conduct of another, based solely on a relationship between the two. |
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are awarded to an injured party for actual loss sustained. |
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are compensatory damages for tangible expenses such as bills, loss of earnings, and the costs to repair or replace damaged property. |
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are compensatory damages for pain, suffering, mental anguish, disfigurement, and similar types of losses that cannot be objectively calculated. |
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is the legal liability arising from physical injury , including sickness, disease and death caused by the acts of or omissions of the insured. expenses also include medical bills, lost wages, mental anguish , disfigurement, and pain and suffering. |
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property damage liability |
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pays for the legal liability arising from physical damage to tangible property, including loss of use of that property, caused by the acts of the insured. expenses include the actual cost of repair or replacement of the damaged property as wella s the inability to use damaged property ( loss of use) |
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medical payments coverage ( medpay) |
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pays for the necessary medical , surgical , x-ray, dental, ambulance, hospital , professional nursing, and funeral expenses incurred by a third party on the insured's premises regardless of fault. |
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personal injury liability |
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is the legal liability arising from wrongful conduct of the insured resulting in injuries to one's mental or emotional well being and not bodily or property damage. |
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sudden unforeseen , unintended , and unplanned event from which loss or damage results |
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specifically, the failure to use the same degree of care a reasonable and prudent person would use when given the same knowledge and set of circumstances . |
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is a defense for negligence in which the claimant was also negligent to any degree. |
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involves fault on the part of all parties and the damages are reduced in proportion to the degree of negligence. |
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a claimant does not have to prove fault in order to collect damages. |
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applies when a manufacturer is held liable whether or not its product was defective to the degree of negligence. |
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pays a covered claim after the primary policies exhaust their limits or deny coverage. |
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is the dollar amount of coverage specified for liability loss. |
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is the maximum amount of payable for loss per location or per person from all occurrences within a policy period regardless of the number of separate accidents. |
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is the amount of coverage divided between bodily injury and property damage . |
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is the policy limit applied to either bodily injury or property damage as needed or in any combination. |
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how can you be eligible for the dwelling property program ? |
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dwellings must be used principally for residential purposes, cannot contain more than 4 dwelling units, and can have no more than 5 roomers/ boarders. |
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fire or lightning and internal explosion. If an additional premium is paid for extended coverage , the following perils are also included : windstorm or hail, explosion, riot or civil commotion , aircraft, vehicles, smoke, and volcanic eruptions. the perils of vandalism or malicious mischief may also be included with additional premium. |
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true or false- losses to the dp-1 dwelling, other structures, and their contents are paid on an actual cash basis to the insured? |
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perils the DP-1 perils, the EC perils, vmm, and damage by burglars, falling objects, weight or ice snow or sleet, and accidental discharge or overflow of water or steam. |
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